WorldWideScience

Sample records for service beaverhead-deerlodge national

  1. 77 FR 33390 - Beaverhead-Deerlodge National Forest; Montana; Supplemental EIS for the Beaverhead-Deerlodge...

    Science.gov (United States)

    2012-06-06

    ..., watershed, vegetation, wildlife, and recreation users. This analysis will be used to determine if snowmobile... Land and Resource Management Plan (Forest Plan) environmental analysis in response to an April 2, 2012.... District Court for the District of Montana (Case 9:10-cv-00104-DWM) alleging inadequate analysis of the...

  2. 78 FR 15681 - Beaverhead-Deerlodge National Forest, Dillon Ranger District; Montana; Birch, Willow, Lost Project

    Science.gov (United States)

    2013-03-12

    ... higher susceptibility to insect and disease such as mountain pine beetle and blister rust. Responsible... documentation. Dated: March 5, 2013. Cole Mayn, Acting Dillon District Ranger. [FR Doc. 2013-05574 Filed 3-11-13...

  3. 76 FR 31932 - Beaverhead-Deerlodge National Forest, Pintler Ranger District; Montana; Flint Foothills...

    Science.gov (United States)

    2011-06-02

    ... to (1) salvage harvest dead and dying lodgepole pine stands to create managed conditions and harvest wood products from forested stands infested or at risk for infestation with bark beetles before the value of the wood deteriorate; (2) reduce forest densities in low elevation ponderosa pine and Douglas...

  4. 77 FR 19177 - Beaverhead-Deerlodge National Forest, Jefferson Ranger District, Montana, Boulder River Salvage...

    Science.gov (United States)

    2012-03-30

    ... statement. SUMMARY: The project proposes to salvage by clearcut harvest dead and lodgepole pine infested or... Need for Action The purpose and need for this project is to harvest merchantable wood products from..., before the value of the wood deteriorates; reduce stand density in lodgepole pine and Douglas-fir stands...

  5. PLANNING NATIONAL RADIOTHERAPY SERVICES

    Directory of Open Access Journals (Sweden)

    Eduardo eRosenblatt

    2014-11-01

    Full Text Available Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education pr

  6. National Weather Service

    Science.gov (United States)

    ... GIS International Weather Cooperative Observers Storm Spotters Tsunami Facts and Figures National Water Center WEATHER SAFETY NOAA Weather Radio StormReady Heat Lightning Hurricanes Thunderstorms Tornadoes Rip Currents Floods Winter Weather ...

  7. Terminology Management at the National Language Service

    African Journals Online (AJOL)

    The National Terminology Services (NTS) and State Language Services (SLS) of .... as CD-ROM and online (i.e. the National Termbank and, in future, the Inter- ... cal Engineering, Education, Olympic Games, Mammals, Dietetics, Frail Care,.

  8. History of the National Weather Service - Public Affairs - NOAA's National

    Science.gov (United States)

    enter or select the go button to submit request City, St Go About NWS -Mission -Strategic Plan -History and local government web resources and services. Home >> History History of the National Weather Service The National Weather Service has its beginnings in the early history of the United States. Weather

  9. Psychotherapy services outside the National Health Service *

    Science.gov (United States)

    Kroll, Una

    1976-01-01

    With the help of an Upjohn Travelling Fellowship, I visited 15 units providing services for people under stress. There were nine residential units and six non-residential units, all were Christian charitable organisations and in all there was close co-operation with the medical profession. All these organisations accept referrals from general practitioners and deserve to be more widely known. PMID:1255548

  10. Psychotherapy services outside the National Health Service.

    Science.gov (United States)

    Kroll, U

    1976-02-01

    With the help of an Upjohn Travelling Fellowship, I visited 15 units providing services for people under stress. There were nine residential units and six non-residential units, all were Christian charitable organisations and in all there was close co-operation with the medical profession.All these organisations accept referrals from general practitioners and deserve to be more widely known.

  11. National directory of nuclear services

    International Nuclear Information System (INIS)

    1974-09-01

    This directory contains information on nuclear services which can be provided in South Africa. These services have to do with the application of nuclear materials and techniques in medicine, industry, agriculture, research, etc. A list of locally manufactured radioisotopes is given

  12. National Marine Fisheries Service Regions

    Data.gov (United States)

    Department of Homeland Security — The NOAA Coastal Services Center's Legislative Atlas is a regional geographic information system (GIS) that provides spatial data for state and federal coastal and...

  13. NURE and the National Park Service

    International Nuclear Information System (INIS)

    Weaver, T.A.

    1979-01-01

    Under the National Resource Evaluation (NURE), massive amounts of geological, geochemical, and geophysical data, covering the entire conterminous 48 states and Alaska, are being collected and made public. In addition to NURE goals, these data are applicable to various other researches on and in the vicinity of lands controlled by the National Park Service. Airborne geophysical and hydrogeochemical survey NURE data have been made public for the majority of the area in the combined Mt. McKinley National Park and Denali National Monument. Besides indicating potential raw material deposits, these data are also useful for geologic mapping, water quality, pollution and othe geological, biological, and environmental studies in the park

  14. Integrating ecosystem services into national Forest Service policy and operations

    Science.gov (United States)

    Robert Deal; Lisa Fong; Erin Phelps; Emily Weidner; Jonas Epstein; Tommie Herbert; Mary Snieckus; Nikola Smith; Tania Ellersick; Greg Arthaud

    2017-01-01

    The ecosystem services concept describes the many benefits people receive from nature. It highlights the importance of managing public and private lands sustainably to ensure these benefits continue into the future, and it closely aligns with the U.S. Forest Service (USFS) mission to “sustain the health, diversity, and productivity of the Nation’s forests and...

  15. Climate Prediction - NOAA's National Weather Service

    Science.gov (United States)

    Statistical Models... MOS Prod GFS-LAMP Prod Climate Past Weather Predictions Weather Safety Weather Radio National Weather Service on FaceBook NWS on Facebook NWS Director Home > Climate > Predictions Climate Prediction Long range forecasts across the U.S. Climate Prediction Web Sites Climate Prediction

  16. Who Killed the English National Health Service?

    Directory of Open Access Journals (Sweden)

    Martin Powell

    2015-05-01

    Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.

  17. NATIONAL WEATHER SERVICE MARINE PRODUCTS VIA INTERNET

    Science.gov (United States)

    the search's key words. Tide Predictions, Observations and Storm Surge Forecasts Near real-time Water , Extratropical Water Level Forecasts are available from the National Weather Service's Meteorological Development Laboratory. Status maps are provided to give the user a quick overview of a region. Forecasts of storm surge

  18. The National Library Service (SBN towards digital

    Directory of Open Access Journals (Sweden)

    Giuliana Sgambati

    2003-12-01

    Full Text Available In the sector of technologies for the Information Society, the General Direction for Library Heritage and Cultural Institutes has promoted two programs: · SBN: The National Library Service (Servizio Bibliotecario Nazionale · BDI: The Italian Digital Library (Biblioteca Digitale Italiana and another project, which was approved on March 18, 2003: · BDI&NTC: The Italian Digital Library and Cultural Tourist Network

  19. 76 FR 7807 - National Wildlife Services Advisory Committee; Reestablishment

    Science.gov (United States)

    2011-02-11

    ... Inspection Service [Docket No. APHIS-2009-0057] National Wildlife Services Advisory Committee.... SUMMARY: We are giving notice that the Secretary of Agriculture will reestablish the National Wildlife.... SUPPLEMENTARY INFORMATION: The purpose of the National Wildlife Services Advisory Committee (the Committee) is...

  20. 75 FR 36427 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Science.gov (United States)

    2010-06-25

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2... of Clinician Recruitment and Service, Health Resources and Services Administration, Parklawn Building...

  1. 76 FR 29769 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Science.gov (United States)

    2011-05-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2..., Bureau of Clinician Recruitment and Service, Health Resources and Services Administration, Parklawn...

  2. 78 FR 55264 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Science.gov (United States)

    2013-09-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2... Recruitment and Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600...

  3. National Biological Service Research Supports Watershed Planning

    Science.gov (United States)

    Snyder, Craig D.

    1996-01-01

    The National Biological Service's Leetown Science Center is investigating how human impacts on watershed, riparian, and in-stream habitats affect fish communities. The research will provide the basis for a Ridge and Valley model that will allow resource managers to accurately predict and effectively mitigate human impacts on water quality. The study takes place in the Opequon Creek drainage basin of West Virginia. A fourth-order tributary of the Potomac, the basin falls within the Ridge and Valley. The study will identify biological components sensitive to land use patterns and the condition of the riparian zone; the effect of stream size, location, and other characteristics on fish communities; the extent to which remote sensing can reliable measure the riparian zone; and the relationship between the rate of landscape change and the structure of fish communities.

  4. National Oceanic and Atmospheric Administration: National Weather Service Modernization and Weather Satellite Program

    National Research Council Canada - National Science Library

    Willemssen, Joel

    2000-01-01

    ...). At your request, we will discuss the status of the National Weather Service (NWS) systems modernization and the National Environmental Satellite, Data, and Information Service's Geostationary Operational Environmental Satellite (GOES) program...

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

    Data.gov (United States)

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

  6. National Mental Health Services Survey (N-MHSS-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...

  7. Technical Service Agreement (TSA) | Frederick National Laboratory for Cancer Research

    Science.gov (United States)

    Frederick National Laboratory for Cancer Research (FNLCR) scientists provide services and solutions to collaborators through the Technical Services Program, whose portfolio includes more than 200 collaborations with more than 80 partners. The Frederi

  8. 24-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  9. 72-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  10. 48-Hour Forecast of Air Temperatures from the National Weather Service's National Digital Forecast Database (NDFD)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...

  11. USGS NAIPPlus Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS NAIP Plus service from The National Map consists of National Agriculture Imagery Program (NAIP) and high resolution orthoimagery (HRO) that combine the...

  12. National Weather Service (NWS) Station Information System (SIS), Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — National Weather Service (NWS) Station Information System (SIS) contains observing station metadata from November 2016 to present. These are renditions are used for...

  13. Service Coordination Policies and Models: National Status.

    Science.gov (United States)

    Harbin, Gloria L.; Bruder, M.; Mazzarella, C.; Gabbard, G.; Reynolds, C.

    This report discusses the findings of a study that investigated state coordination of early intervention services for infants, toddlers, and young children with disabilities. State Part C coordinators participated in a survey that sought their perceptions of values under girding service coordination, approach to service coordination, policies,…

  14. The National Map product and services directory

    Science.gov (United States)

    Newell, Mark R.

    2008-01-01

    As one of the cornerstones of the U.S. Geological Survey's (USGS) National Geospatial Program (NGP), The National Map is a collaborative effort among the USGS and other Federal, state, and local partners to improve and deliver topographic information for the Nation. It has many uses ranging from recreation to scientific analysis to emergency response. The National Map is easily accessible for display on the Web, as products, and as downloadable data. The geographic information available from The National Map includes orthoimagery (aerial photographs), elevation, geographic names, hydrography, boundaries, transportation, structures, and land cover. Other types of geographic information can be added to create specific types of maps. Of major importance, The National Map currently is being transformed to better serve the geospatial community. The USGS National Geospatial Program Office (NGPO) was established to provide leadership for placing geographic knowledge at the fingertips of the Nation. The office supports The National Map, Geospatial One-Stop (GOS), National Atlas of the United States®, and the Federal Geographic Data Committee (FGDC). This integrated portfolio of geospatial information and data supports the essential components of delivering the National Spatial Data Infrastructure (NSDI) and capitalizing on the power of place.

  15. Developing an Employee Counselling Service within the British National Health Service.

    Science.gov (United States)

    Whelan, Linda; Robson, Maggie; Cook, Peter

    1999-01-01

    Evaluation of an employee counseling service in Britain's National Health Service by 26 staff participants found the service was valued by employees. Designed to meet the objectives of a "healthy workplace" initiative, the service appeared to be addressing staff support needs. (SK)

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

    Data.gov (United States)

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

  17. The National Terminology Services: A New Paradigm

    African Journals Online (AJOL)

    described as well as the vision and objectives for the future. ... wards the promotion of mutual scientific and technical communication in South Africa in this way. .... The NTS also has an important role to play in assisting to improve the ..... Extra funds for the expansion of language services are being made available to assist in ...

  18. USGS Hydrography (NHD) Overlay Map Service from The National Map - National Geospatial Data Asset (NGDA) National Hydrography Dataset (NHD)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS National Hydrography Dataset (NHD) service from The National Map (TNM) is a comprehensive set of digital spatial data that encodes information about...

  19. Otorhinolaryngology Services at Muhimbili National Hospital and ...

    African Journals Online (AJOL)

    Background: Epistaxis is the commonest ear, nose and throat emergency. It's mostly self-limited but it may be severe such that medical attention is sought and in such cases it may be life threatening. There is paucity of data on the prevalence and management options for epistaxis in Tanzania and at Muhimbili National ...

  20. USGS Elevation Contours Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Elevation Contours service from The National Map (TNM) consists of contours generated for the conterminous United States from 1- and 1/3 arc-second...

  1. USGS NAIP Imagery Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS NAIP Imagery service from The National Map (TNM) consists of high resolution images that combine the visual attributes of an aerial photograph with the...

  2. National All-Age Career Guidance Services: Evidence and Issues

    Science.gov (United States)

    Watts, A. G.

    2010-01-01

    The three major national all-age career guidance services--in New Zealand, Scotland and Wales--have been reviewed using an adaptation of the methodology adopted in the OECD Career Guidance Policy Review. The main features of the three services are summarised, and some key differences and distinctive strengths are outlined. The alternative approach…

  3. USGS Transportation Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Transportation service from The National Map (TNM) is based on TIGER/Line data provided through U.S. Census Bureau and road data from U.S. Forest Service....

  4. 76 FR 81515 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Science.gov (United States)

    2011-12-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National..., to hear updates from the Health Resources and Services Administration and the NHSC program, as well... comments and questions. FOR FURTHER INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and...

  5. 78 FR 39738 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Science.gov (United States)

    2013-07-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National... Affordable Care Act, NHSC retention resources, and partnerships. The public can join the meeting via audio... the call. FOR FURTHER INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and Service...

  6. The district nursing service: a national treasure.

    Science.gov (United States)

    Oldman, Crystal

    2014-08-01

    District nurses are a national treasure. They are the key professionals who will enable the agenda of patients being cared for at home to be realised. They are highly trusted and valued by communities who lead and manage teams of nurses and nursing assistants expertly to deliver high-quality care in the patient's own home. In an era where the focus is now turning to the community for more care, more actions are required to increase our district nursing workforce. This article discusses the above issues in relation to recent reports on the current status of community nursing.

  7. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e...

  8. NNDC [National Nuclear Data Center] on-line services documentation

    International Nuclear Information System (INIS)

    Dunford, C.L.; Burrows, T.W.; Tuli, J.K.

    1987-01-01

    This document summarizes and describes how to access the on-line services available from the National Nuclear Data Center (NNDC) located at Brookhaven National Laboratory. The services are available free of cost to US Department of Energy, its contractors and others who support the NNDC or supply data to the NNDC. Four of the center's data bases are now accessible to non-NNDC scientists via remote connection to the center's VAX 11/780. To use this service, you must have a terminal with access by either a telephone line or the PHYSNET network. A VT100 terminal or a terminal with VT-100 emulation is recommended but not required

  9. Planning National Radiotherapy Services: A Practical Tool (Russian Edition)

    International Nuclear Information System (INIS)

    2015-01-01

    The current and future burden of cancer incidence in developing countries requires the planning, establishment and upgrading of radiotherapy services at the national level. This publication is a practical guide outlining the main issues at stake when planning national radiotherapy services. It provides an assessment of the cancer burden, evaluates the existing resources, and determines what is needed and how to cover the gap in a resource oriented rational way. The publication will be of practical value to decision makers and programme managers in public health facing the organization or reorganization of radiotherapy services in their countries.

  10. 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.

  11. Challenges for developing national climate services – Poland and Norway

    Directory of Open Access Journals (Sweden)

    Zbigniew W. Kundzewicz

    2017-12-01

    Full Text Available This contribution discusses the challenges for developing national climate services in two countries with high fossil fuel production – Poland (coal and Norway (oil and gas. Both countries, Poland and Norway, have highly developed weather services, but largely differ on climate services. Since empirical and dynamical downscaling of climate models started in Norway over 20 years ago and meteorological and hydrological institutions in Oslo and Bergen have been collaborating on tailoring and disseminating downscaled climate projections to the Norwegian society, climate services are now well developed in Norway. The Norwegian Centre for Climate Services (NCCS was established in 2011. In contrast, climate services in Poland, in the international understanding, do not exist. Actually, Poland is not an exception, as compared to other Central and Eastern European countries, many of which neither have their national climate services, nor are really interested in European climate services disseminated via common EU initiatives. It is worth posing a question – can Poland learn from Norway as regards climate services? This contribution is based on results of the CHASE-PL (Climate change impact assessment for selected sectors in Poland project, carried out in the framework of the Polish – Norwegian Research Programme. The information generated within the Polish-Norwegian CHASE-PL project that is being broadly disseminated in Poland can be considered as a substitute for information delivered in other countries by climate services.

  12. 75 FR 31745 - Notice of Request for Approval of an Information Collection; National Veterinary Services...

    Science.gov (United States)

    2010-06-04

    ...] Notice of Request for Approval of an Information Collection; National Veterinary Services Laboratories... collection associated with the National Veterinary Services Laboratories animal health diagnostic system...: For information on request forms associated with the National Veterinary Services Laboratories animal...

  13. The National Health Services of Brazil and Northern Europe

    DEFF Research Database (Denmark)

    Gurgel Jr., Garibaldi D.; Carvalho de Sousa, Islâandia M.; de Araujo Oliveira, Sydia Rosana

    2017-01-01

    In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles......, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having...... chronic disorders and very unequal comorbidities, bring the issue of integrality in the forefront in all 3 countries, and neither the public purchaser provider markets nor the 2-tier system in Brazil delivers on that front. It will demand political leadership and strategic planning with population...

  14. A national survey of radiodiagnostic services in Ecuador

    International Nuclear Information System (INIS)

    Penaherrera S, P.; Echeverria T, F.; Buitron S, S.; Yela de Chacon, L.

    1979-11-01

    The Ecuadorian Atomic Energy Commission elaborated a Radiation Protection Regulation for Ecuador. In order to implement it, a national survey of radiodiagnostic services was implemented with the following objectives: a) Statistics of Radiodiagnostic services related to geography and population ulation density, b) To establish general patterns for X-Ray control and calibration, c) Evaluation of the professional and technical work in this field. (Author)

  15. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  16. National Plant Germplasm System: Critical Role of Customer Service

    Science.gov (United States)

    The National Plant Germplasm System (NPGS) conserves plant genetic resources, not only for use by future generations, but for immediate use by scientists and educators around the world. With a great deal of interaction between genebank curators and users of plant genetic resources, customer service...

  17. The National Terminology Services: a new paradigm | Jordaan ...

    African Journals Online (AJOL)

    The new dispensation in South Africa necessitated a paradigm shift at the National Terminology Services (NTS). Being part of the Central Government, the NTS has to implement policy as laid down by the government of the day. Former policy, processes and products are described as well as the vision and objectives for the ...

  18. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  19. USGS Map Indices Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Map Indices service from The National Map (TNM) consists of 1x1 Degree, 30x60 Minute (100K), 15 Minute (63K), 7.5 Minute (24K), and 3.75 Minute grid...

  20. Developing a Service Improvement System for the National Dutch Railways

    NARCIS (Netherlands)

    Verhoef, Peter C.; Heijnsbroek, Martin; Bosma, Joost

    2017-01-01

    Customer satisfaction is essential for public and railway services, because firms in these industries have contracts with governments requiring them to achieve specific customer satisfaction targets. In this paper, we describe a National Dutch Railways project in which we identify the major

  1. Terminology management at the national language service | Alberts ...

    African Journals Online (AJOL)

    Through the use of correct, standardised terminology, effective scientific and technical communication skills are developed. A brief overview is given of terminology development in South Africa, with special emphasis on the work of the Terminology Division of the National Language Service. Aspects of present terminology ...

  2. Computerization of the Botswana National Library Service. Restricted Technical Report.

    Science.gov (United States)

    Underwood, Peter C.

    This report discusses the scope for and feasibility of introducing automated systems into the Botswana National Library Service (BNLS). The study was undertaken at the request of BNLS and was conducted by an outside consultant who interviewed staff, read internal documents and reports, and studied patterns of work. Topics of the report include:…

  3. Tackling Work Related Stress in a National Health Service Trust

    Science.gov (United States)

    Vick, Donna; Whyatt, Hilary

    2004-01-01

    The challenge of tackling the problem of coping with work related stress in a National Health Service (NHS) Trust was undertaken. Ideas were developed within the context of two different action learning sets and led to actions resulting in a large therapy Taster Session event and the establishment of a centre offering alternative therapies and…

  4. Offer patterns of nationally placed livers by donation service area.

    Science.gov (United States)

    Lai, Jennifer C; Feng, Sandy; Vittinghoff, Eric; Roberts, John P

    2013-04-01

    We previously reported that national liver distribution is highly concentrated in 6 US centers, and this raises the possibility of expedited placement. Therefore, we evaluated all national offers of nationally placed livers (n=1625) to adult wait-list candidates from February 2005 to January 2010. We developed a model to predict national utilization pathways; pathways exceeding the best-fit linear unbiased predictions by ≥3 standard errors were defined as preferred. All 51 donation service areas (DSAs) placed 1 or more livers nationally, but the percentage per DSA ranged from 1% to 36%. Of 2830 possible national DSA-center pathways, 87% were used. Five hundred eighty livers (36%) were accepted on the first national offer. Four DSAs accounted for 47% of first-national-offer livers, and 44% of these were accepted by a single center. In comparison with first-offer livers using nonpreferred pathways, first offers along a preferred pathway were offered to fewer status 1 candidates (19% versus 61%) and had lower median model for end-stage liver disease (MELD) scores (22 versus 36, Poffer to non-status 1 candidates with MELD scores less than their local transplant MELD scores. Although this practice may facilitate liver placement, it raises the possibility of expedience trumping patient need. Here we propose changes to the national liver distribution system that will help to balance equity, efficiency, and transparency. Copyright © 2013 American Association for the Study of Liver Diseases.

  5. Impact of national cultures on automotive after sales services perception

    Directory of Open Access Journals (Sweden)

    Jose Albors-Garrigos

    2017-09-01

    Full Text Available This article clarifies the impact of national culture in the after sales service in the automotive sector. Introduction and objectives: After-sales services have become paramount in the automobile industry. However, they are not sufficiently researched, particularly in emerging markets. Here an academic gap exists because, within the automotive research literature, culture is a widely neglected issue. Thus no explicit knowledge can be applied regarding emerging markets service demand behaviour, which might be a crucial point, as some of these countries culture is different to the western culture. Methods: The research is based in a survey carried out among Chinese premium brand automotive customers. Results: It shows which individual level values are causal and positively contribute to the perception of service quality and loyalty behaviour by customers. Conclusion: The article providing a guideline how the entire process chain of after-sales services could be researched and applies successfully the individual level value theory by Schwartz. Implications and research limitation: Brand loyalty is well explained by perceived service quality significantly leads to after-sales service satisfaction, which itself is a strong predictor of workshop loyalty. Moreover, workshop loyal customers are likewise significantly brand loyal. Finally, the influence of culture is empirically verified with the one exception of after-sales service satisfaction.

  6. National Youth Service Day: A Youth Development Strategy

    Directory of Open Access Journals (Sweden)

    Silvia Blitzer Golombek

    2006-06-01

    Full Text Available A growing number of studies show connections between youth participation in service and service-learning opportunities and positive behavior outcomes. Building on this data, the article presents National Youth Service Day (NYSD as a program that can be incorporated into ongoing activities to enhance youth development goals. The paper describes the program’s components– building a network of support organizations, offering project planning grants, providing service-learning materials, and developing a media and advocacy campaign. Examples of NYSD projects show how project planners are using the program to learn and practice academic and non-academic skills. A review of evaluations to date indicates the program is annually increasing its output measures. Participants’ responses show that the program is also contributing to positive behavioral changes, in particular related to young people’s increasing awareness about specific community issues and their own competency in addressing them.

  7. 78 FR 13383 - Public Availability of the National Aeronautics and Space Administration FY 2012 Service Contract...

    Science.gov (United States)

    2013-02-27

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Public Availability of the National Aeronautics and Space Administration FY 2012 Service Contract Inventory (SCI) AGENCY: Office of Procurement, National Aeronautics and Space Administration. ACTION: Notice of Public Availability of the FY 2012 Service Contract...

  8. 76 FR 6827 - Public Availability of the National Aeronautic and Space Administration FY 2010 Service Contract...

    Science.gov (United States)

    2011-02-08

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Public Availability of the National Aeronautic and Space Administration FY 2010 Service Contract Inventory AGENCY: National Aeronautic and Space Administration. ACTION: Notice of public availability of FY 2010 Service Contract Inventories. [[Page 6828...

  9. 77 FR 7183 - Public Availability of the National Aeronautics and Space Administration FY 2011 Service Contract...

    Science.gov (United States)

    2012-02-10

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Public Availability of the National Aeronautics and Space Administration FY 2011 Service Contract Inventory AGENCY: National Aeronautics and Space Administration. ACTION: Notice of Public Availability of Analysis of the FY 2010 Service Contract Inventories and...

  10. 75 FR 57737 - Notice of Request for Approval of an Information Collection; National Veterinary Services...

    Science.gov (United States)

    2010-09-22

    ...] Notice of Request for Approval of an Information Collection; National Veterinary Services Laboratories... Service's intention to request approval of an information collection associated with National Veterinary...' Information Collection Coordinator, at (301) 851-2908. SUPPLEMENTARY INFORMATION: Title: National Veterinary...

  11. 45 CFR 2515.10 - What are the service-learning programs of the Corporation for National and Community Service?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false What are the service-learning programs of the... Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SERVICE-LEARNING PROGRAM PURPOSES § 2515.10 What are the service-learning programs of the Corporation for National and Community...

  12. Strengthening health-related rehabilitation services at national levels.

    Science.gov (United States)

    Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

    2018-04-18

    One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  13. Strengthening health-related rehabilitation services at national levels

    Directory of Open Access Journals (Sweden)

    Christoph Gutenbrunner

    2017-04-01

    Full Text Available Objective: One of the aims of the World Health Organization’s Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up rehabilitation services. This paper describes the measures required and how (advisory missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. Recommendations: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. Conclusion: This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

  14. National Coal Board Medical Service annual report 1981-82

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    Sections report on: medical examinations and consultations; protection from health hazards, such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in miners' blood, Legionnaires' disease, rehabilitation and physiotherapy, high pressure injection injuries, pump packing; National Coal Board (Coal Products) Ltd.; injuries and treatment; and nursing service. A list of staff and their publications and a supplement on occupational toxicology are included.

  15. The intelligence-security services and national security

    OpenAIRE

    Mijalković, Saša

    2011-01-01

    Since their inception, states have been trying to protect their vital interests and values more effectively, in which they are often impeded by other countries. At the same time, they seek to protect the internal order and security against the so-called internal enemy. Therefore, the states organize (national) security systems within their (state) systems, in which they form some specialized security entities. Among them, however, intelligence and security services are the ones that stand out...

  16. Refocusing and Evolving Subseasonal-to-Seasonal Services in NOAA's National Weather Service

    Science.gov (United States)

    Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Silva, V.; Mangan, M. R.; Meyers, J. C.; Zdrojewski, J.

    2017-12-01

    NOAA's National Weather Service (NWS) recently completed a reorganization to better support its goal to build a Weather-Ready Nation. As part of the reorganization, NWS streamlined its 11 national service programs, including climate services, to provide a more structured approach to supporting service delivery needs. As the American public increasingly requests information at sub-seasonal and seasonal time scales for decision making, the NWS Climate Services Program is striving to meet those needs by accelerating transition of research to operations, improving delivery of products and services, and enhancing partnerships to facilitate provision of seamless weather, water, and climate products and services at regional and local scales. Additionally, NWS forecasters are requesting more tools to be able to put severe weather and water events into a climate context to provide more effective impact-based decision support services (IDSS). This paper will describe the activities to more effectively integrate climate services into the NWS suite of environmental information, the roles of the NWS offices supporting or delivering sub-seasonal and seasonal information to the US public, and engaging NWS core and deep-core partners in provision of information on climatological risks and preparedness as a part of IDSS. We will discuss the process by which we collect user requests and/or needs and the NWS process that allows us to move these requests and needs through a formal requirements validation process and thus place the requirement on a path to identify a potential solution for implementation. The validation of a NWS climate-related requirement is also key to identify research, development, and transition mission delivery needs that are supported through the Office of Oceanic and Atmospheric Research (OAR) Climate Program Office (CPO). In addition, we will present the outcomes of key actions of the first ever NWS National Climate Services Meeting (NCSM) that was held in May

  17. Food Service Perspectives on National School Lunch Program Implementation.

    Science.gov (United States)

    Tabak, Rachel G; Moreland-Russell, Sarah

    2015-09-01

    Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

  18. 77 FR 13625 - Notice of Inventory Completion: USDA Forest Service, Daniel Boone National Forest, Winchester, KY

    Science.gov (United States)

    2012-03-07

    ... Forest Service, Daniel Boone National Forest, Winchester, KY AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture, Forest Service, Daniel Boone National Forest... culturally affiliated with the human remains may contact the Daniel Boone National Forest, Winchester, KY...

  19. The National Weather Service Ceilometer Planetary Boundary Layer Project

    Directory of Open Access Journals (Sweden)

    Hicks M.

    2016-01-01

    Full Text Available The National Weather Service (NWS is investigating the potential of utilizing the Automatic Surface Observing System’s (ASOS cloud base height indicator, the Vaisala CL31 ceilometer, to profile aerosols in the atmosphere. Field test sites of stand-alone CL31 ceilometers have been established, primarily, around the Washington DC metropolitan area, with additional systems in southwest USA and Puerto Rico. The CL31 PBL project examines the CL31 data collected for data quality, mixing height retrieval applicability, and its compliment to satellite data. This paper reviews the topics of the CL31 data quality and mixing height retrieval applicability.

  20. Design and Implementation of the Australian National Data Service

    Directory of Open Access Journals (Sweden)

    Andrew Treloar

    2009-06-01

    Full Text Available Normal 0 This paper will describe the genesis and realisation of the Australian National Data Service (ANDS. It will commence by outlining the context within which ANDS was conceived, both in the international research and Australian research support domains. It will then describe the process that brought about the ANDS vision and the principles that informed the realisation of that vision. The paper will then outline each of the four ANDS programs (Developing Frameworks, Providing Utilities, Seeding the Commons, and Building Capabilities while also discussing particular items of note about the approach ANDS is taking. The paper concludes by briefly examining related work in the UK and US.

  1. The National Health Service (NHS) at 70: some comparative reflections.

    Science.gov (United States)

    Tuohy, Carolyn H

    2018-03-16

    As the National Health Service (NHS) turns 70, it bears comparison with another universal system celebrating an anniversary this year: Canada's 50-year-old medicare model. Each system is iconically popular, and each revolves around a profession-state accommodation. Both the popularity and the central axis of each system have been tested by external shocks in the form of periodic fiscal cycles of investment and austerity, and internal stresses generating organizational cycles of centralization and decentralization. In addition, the English NHS has undergone periodic bursts of major policy change, which have arguably moved the system closer to the Canadian single-payer model.

  2. Conservation landmarks: bureau of biological survey and national biological service

    Science.gov (United States)

    Friend, M.

    1995-01-01

    A century separates the recent development of the National Biological Service (NBS) and an early predecessor, the Bureau of Biological Survey (BBS). Both organizations were established at critical crossroads for the conservation of the nation's living biological resources and are conservation landmarks of their times. The BBS of the 192()'s was described as 'a government Bureau of the first rank, handling affairs of great scientific, educational, social, and above all, economic importance throughout the United States and its outlying possessions'' (Cameron 1929:144-145). This stature was achieved at a time of great social, economic, and ecological change. BBS had the vision to pioneer new approaches that led to enhanced understanding of the relation between people, other living things, and the environment. The NBS faces similar challenges to address the issues of the 1990's and beyond.

  3. Rhetoric and Reality in the English National Health Service; Comment on “Who Killed the English National Health Service?”

    Directory of Open Access Journals (Sweden)

    Rudolf Klein

    2015-09-01

    Full Text Available Despite fiscal stress, public confidence in the National Health Service (NHS remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide.

  4. 5 CFR 831.306 - Service as a National Guard technician before January 1, 1969.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Service as a National Guard technician... National Guard technician before January 1, 1969. (a) Definitions. In this section—(1) Service as a National Guard technician is service performed under section 709 of title 32, United States Code (or under...

  5. Diagnosis of the quality of service, in customer service, at the National University of Chimborazo- Ecuador

    OpenAIRE

    Salazar Yépez, Wilfrido; Cabrera Vallejo, Mario

    2016-01-01

    The purpose of this article is to determine the quality of service of improvements in the enrollment processes at the National University of Chimborazo- Ecuador. This cross-sectional research is the result of a field work, where an analysis of the collected information was carried out, through surveys applied to the students, through the SERVQUAL model, afterwards, comparing these found aspects and determining The gap between perceptions and expectations, thus determining the quality of servi...

  6. 50 CFR 86.102 - How did the Service design the National Framework?

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false How did the Service design the National Framework? 86.102 Section 86.102 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT... INFRASTRUCTURE GRANT (BIG) PROGRAM Service Completion of the National Framework § 86.102 How did the Service...

  7. Medical Tourism and the Libyan National Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2007-01-01

    recognized location of choice for quality healthcare and an integrated centre of excellence for clinical and wellness services, medical education and research [2]. An international medical travel conference (IMTC was held in December 2006 and some web sites such as ArabMedicare.com were established to accompany the needs of this growing market.In spite of the aforementioned rewards, medical tourism is not without risks [3]. Medical tourism can do harm to national health services of the host as well as the country of origin. Besides cultural and language issues, there are risks inherent in traveling as accidents, exposure to different infectious diseases, risks from traveling soon after surgery, impossibility of treating chronic disease after a single consultation, the non familiarity of how a certain specialty applies to other communities, the on-off consultations, the limited possibility for follow up, the absence of record of the consultation [3], and most importantly fraud and abuse.The total amount of money spent by Libyans on both forms of medical tourism is difficult to estimate. It ranges between $100-200 millions per year for treatment abroad, but the accurate figures are not available. The form of medical tourism where doctors rather than patients travel, gained a momentum with the increased role of private practice in health service delivery. There is a real threat from the growing market of medical tourism in the region on the public health oriented national health system in Libya. The two neighboring countries that are mostly visited by Libyans have a lower performance of National Health Service in comparison to Libyan National Health services with an objective assessment as revealed by infant mortality rate, life expectancy at birth, maternal mortality ratio and proportion of low birth weight [7]. Giving the non-popularity of tourism among the Libyan population, traveling in itself is an important event in one’s life. We should not deny that in many cases

  8. 36 CFR 1501.1 - Cross reference to National Park Service regulations.

    Science.gov (United States)

    2010-07-01

    ... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Cross reference to National...

  9. Rather unspectacular: design choices in National Health Service glasses

    Directory of Open Access Journals (Sweden)

    Dr Joanne Gooding

    2017-04-01

    Full Text Available This article considers the design and production of spectacles in Britain following the introduction of standardised frame styles under the National Health Service. NHS spectacles were provided as a functional, durable medical appliance to be delivered cost-effectively and there was no explicit concern for fashion or the patient experience. The actions of the government and professional bodies greatly affected the trade in eyewear and thus restricted opportunities for innovative design and consumer choice. Within the range of state regulation frames there was no active concern for ‘design’ in terms of appearance and it was only through the purchase of private frames that significant choice and variety in eyewear could be attained. The scope for the public to select a more fashionable frame whilst receiving an element of state aid was through the purchase of NHS hybrid private frames.

  10. A National Medical Information System for Senegal: Architecture and Services.

    Science.gov (United States)

    Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

    2016-01-01

    In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

  11. Importance of antimicrobial stewardship to the English National Health Service

    Directory of Open Access Journals (Sweden)

    Dixon J

    2014-05-01

    Full Text Available Jill Dixon, Christopher JA Duncan Department of Infectious Diseases and Tropical Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK Abstract: Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS, a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future

  12. National audit of provision of MRI services 2006/07

    Energy Technology Data Exchange (ETDEWEB)

    Barter, S. [Royal College of Radiologists, London (United Kingdom)], E-mail: sue.barter@addenbrookes.nhs.uk; Drinkwater, K.; Remedios, D. [Royal College of Radiologists, London (United Kingdom)

    2009-03-15

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance.

  13. National audit of provision of MRI services 2006/07

    International Nuclear Information System (INIS)

    Barter, S.; Drinkwater, K.; Remedios, D.

    2009-01-01

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance

  14. 77 FR 68851 - Sunshine Act Meeting of the National Museum and Library Services Board

    Science.gov (United States)

    2012-11-16

    ... Coordinator for Special Events and Board Liaison, Institute of Museum and Library Services, 1800 M Street NW... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and...

  15. 78 FR 1824 - Notice of Request for Approval of an Information Collection; National Veterinary Services...

    Science.gov (United States)

    2013-01-09

    ...; National Veterinary Services Laboratories; Bovine Spongiform Encephalopathy Surveillance Program Documents... associated with National Veterinary Services Laboratories diagnostic support for the bovine spongiform..., Veterinary Services, APHIS, 4700 River Road Unit 43, Riverdale, MD 20737; (301) 851-3511. For copies of more...

  16. 36 CFR 6.8 - National Park Service solid waste responsibilities.

    Science.gov (United States)

    2010-07-01

    ..., DEPARTMENT OF THE INTERIOR SOLID WASTE DISPOSAL SITES IN UNITS OF THE NATIONAL PARK SYSTEM § 6.8 National Park Service solid waste responsibilities. (a) Beginning one year after January 23, 1995, a Superintendent will not permit or allow a person to dispose of solid waste at a National Park Service operated...

  17. 50 CFR 86.101 - What is the Service schedule to adopt the National Framework?

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What is the Service schedule to adopt the National Framework? 86.101 Section 86.101 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE... schedule to adopt the National Framework? The Secretary of the Interior adopted the National Framework on...

  18. Integration of Tactical EMS in the National Park Service.

    Science.gov (United States)

    Smith, William Will R

    2017-06-01

    The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers. The NPS developed a Tactical EMS (TEMS) program that closely integrated many principles from: 1) Tactical Combat Casualty Care (TCCC); 2) Tactical Emergency Casualty Care (TECC); 3) and other established federal and civilian TEMS programs. Combining these best practices into the NPS TEMS Program allowed for standardized training and implementation across not only the NPS, but also paralleled other military/federal/civilian TEMS programs. This synchronization is critical when an injury occurs in a joint tactical operation, either planned (drug interdiction) or unplanned (active shooter response), so that patient care can be uniform and efficient. The components identified for a sustainable TEMS program began with strong medical oversight, protocol development with defined phases of care, identifying specialized equipment, and organized implementation with trained TEMS instructors. Ongoing TEMS program management is continuously improving situationally appropriate training and integrating current best practices as new research, equipment, and tactics are developed. The NPS TEMS Program continues to provide ongoing training to ensure optimal patient care in tactical and other NPS settings. Copyright © 2017 Wilderness Medical Society. All rights reserved.

  19. National Survey of Substance Abuse Treatment Services (N-SSATS-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  20. National Survey of Substance Abuse Treatment Services (N-SSATS-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  1. National Survey of Substance Abuse Treatment Services (N-SSATS-2014)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  2. National Survey of Substance Abuse Treatment Services (N-SSATS-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  3. National Survey of Substance Abuse Treatment Services (N-SSATS-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  4. National Survey of Substance Abuse Treatment Services (N-SSATS-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  5. National Survey of Substance Abuse Treatment Services (N-SSATS-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  6. National Survey of Substance Abuse Treatment Services (N-SSATS-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  7. National Survey of Substance Abuse Treatment Services (N-SSATS-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  8. National Survey of Substance Abuse Treatment Services (N-SSATS-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  9. National Survey of Substance Abuse Treatment Services (N-SSATS-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  10. USGS Imagery Topo Large-scale Base Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Imagery Topo Large service from The National Map (TNM) is a dynamic topographic base map service that combines the best available data (Boundaries,...

  11. National Survey of Substance Abuse Treatment Services (N-SSATS-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  12. National Survey of Substance Abuse Treatment Services (N-SSATS-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  13. National Survey of Substance Abuse Treatment Services (N-SSATS-1997-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  14. National Survey of Substance Abuse Treatment Services (N-SSATS-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  15. The psychological contracts of National Health Service nurses.

    Science.gov (United States)

    Purvis, Lynne J; Cropley, Mark

    2003-03-01

    Following the psychological contract model of the employee-employer exchange relationship is offered as a means of understanding the expectations of a UK sample of 223 National Health Service (NHS) nurses in association with their leaving intentions. A pilot study involving 21 NHS nurses, using the repertory grid technique was conducted to elicit contract expectations. Twenty-nine categories of expectation were identified through content analysis. The study proper, employed a survey developed on the basis of results from the pilot study to identify contract profiles among 223 nurses from three London/South-east NHS hospitals, using the Q-sort method. Type of contract held (relational/transactional), satisfaction (job and organization), and leaving intentions were also examined. Q-analysis yielded four contract profiles among the nurses sampled: 'self-development and achievement'; 'belonging and development'; 'competence and collegiality' and 'autonomy and development'. Correlation analysis demonstrated that leaving intentions were associated with a need for personal autonomy and development, and the violation of expectations for being appreciated, valued, recognized and rewarded for effort, loyalty, hard-work and achievement, negative endorsement of a relational contract, positive endorsement of a transactional contract, and job and organizational dissatisfaction. Findings illustrate the diagnostic utility of the term psychological contract for understanding the expectations of NHS nurses. The potential significance of these findings for managing nurse retention is highlighted.

  16. USGS Governmental Unit Boundaries Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Governmental Unit Boundaries service from The National Map (TNM) represents major civil areas for the Nation, including States or Territories, counties (or...

  17. Current National Weather Service Watches, Warnings, or Advisories for the United States

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Weather Service (NWS) Storm Prediction Center uses RSS feeds to disseminate all watches, warnings and advisories for the United States that are...

  18. National Marine Fisheries Service Grain Size Data from the Baltimore Canyon Trough

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Grain size analyses produced by Robert Reid of the NOAA National Marine Fisheries Service for the NOAA/BLM Outer Continental Shelf Mid-Atlantic Project, Baltimore...

  19. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - U.S. POSTAL INSPECTION SERVICE FORENSIC & TECHNICAL SERVICES DIVISION - NATIONAL FORENSIC LABORATORY, DULLES, VIRGINIA

    Science.gov (United States)

    The United States Postal Service (USPS) in cooperation with EPA's National Risk Management Research Laboratory (NRMRL) is engaged in an effort to integrate waste prevention and recycling activities into the waste management programs at Postal facilities. This report describes the...

  20. 76 FR 40937 - Public Availability of National Labor Relations Board's FY 2010 Service Contract Inventory

    Science.gov (United States)

    2011-07-12

    ... NATIONAL LABOR RELATIONS BOARD Public Availability of National Labor Relations Board's FY 2010 Service Contract Inventory AGENCY: National Labor Relations Board. ACTION: Notice of public availability... Consolidated Appropriations Act of 2010 (Pub. L. 111-117), the National Labor Relations Board (NLRB) is...

  1. 77 FR 5062 - Public Availability of National Labor Relations Board's FY 2011 Service Contract Inventory

    Science.gov (United States)

    2012-02-01

    ... NATIONAL LABOR RELATIONS BOARD Public Availability of National Labor Relations Board's FY 2011 Service Contract Inventory AGENCY: National Labor Relations Board. ACTION: Notice of public availability... Consolidated Appropriations Act of 2010 (Pub. L. 111-117), the National Labor Relations Board (NLRB) is...

  2. EnviroAtlas National Layers Master Web Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This web service includes...

  3. GOODS AND SERVICE TAX ONE NATION ONE TAX IN INDIA.

    OpenAIRE

    Shuchi Sharma; Rupendra Prakash Yadav.

    2018-01-01

    Goods and Service Tax is a significant and logical step towards a comprehensive Indirect tax reform in India. This paper analyses the concept of Goods Service Tax and further discusses their impact on the various sectors in India. Brief description is given on Goods Service Tax background and Goods and Service Tax models helps to reduce tax burden. It aims at creating a single and unified market benefiting both corporate and economy because this is the only Indirect tax that directly affects ...

  4. Brookhaven National Laboratory meteorological services instrument calibration plan and procedures

    Energy Technology Data Exchange (ETDEWEB)

    Heiser, John [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2013-02-16

    This document describes the Meteorological Services (Met Services) Calibration and Maintenance Schedule and Procedures, The purpose is to establish the frequency and mechanism for the calibration and maintenance of the network of meteorological instrumentation operated by Met Services. The goal is to maintain the network in a manner that will result in accurate, precise and reliable readings from the instrumentation.

  5. Sleep medicine services in Saudi Arabia: The 2013 national survey

    Directory of Open Access Journals (Sweden)

    Ahmed S Bahammam

    2014-01-01

    Conclusion: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.

  6. National survey of pain clinics in Croatia: Organization and services

    Directory of Open Access Journals (Sweden)

    Mahir Fidahić

    2015-05-01

    Full Text Available Objective. To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Methods. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Results. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard – the systematic reviews of The Cochrane Collaboration – were used less frequently (n=12; 57% than advertising materials from pharmaceutical companies (n=16; 76%. Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. Conclusion. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.

  7. National survey of pain clinics in Croatia: Organization and services.

    Science.gov (United States)

    Fidahić, Mahir; Dogan, Katarina; Sapunar, Damir; Puljak, Livia

    2015-01-01

    To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard--the systematic reviews of The Cochrane Collaboration--were used less frequently (n=12; 57%) than advertising materials from pharmaceutical companies (n=16; 76%). Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  8. Spectrum Management Guidelines for National and Service Test and Training Ranges

    Science.gov (United States)

    2017-07-12

    Frequency Management Group RCC 700-17 SPECTRUM MANAGEMENT GUIDELINES FOR NATIONAL AND SERVICE TEST AND TRAINING RANGES DISTRIBUTION...left blank. DOCUMENT 700-01 SPECTRUM MANAGEMENT GUIDELINES FOR NATIONAL AND SERVICE TEST AND TRAINING RANGES July 2017...Prepared by RANGE COMMANDERS COUNCIL FREQUENCY MANAGEMENT GROUP Published by Secretariat Range Commanders Council U.S. Army White

  9. 75 FR 20893 - National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010

    Science.gov (United States)

    2010-04-21

    ... National Day of Service and Remembrance for Victims and Survivors of Terrorism, 2010 By the President of... innocents. On this National Day of Service and Remembrance for Victims and Survivors of Terrorism, we pause to remember victims of terrorism at home and abroad, we honor the heroes who have supported them, and...

  10. Forging University-Community Collaboration: The Agency Perspective on National Service.

    Science.gov (United States)

    Tice, Carol H.

    1994-01-01

    With passage of the National and Community Service Trust Act of 1993, national service volunteers will be joining forces with community-based organizations to work with underserved populations, creating many challenges. The community agency perspective on some anticipated challenges, possible responses, and application of principles of good…

  11. 78 FR 63518 - Uranium Enrichment Fuel Cycle Inspection Reports Regarding Louisiana Energy Services, National...

    Science.gov (United States)

    2013-10-24

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Inspection Reports Regarding Louisiana Energy Services, National Enrichment Facility, Eunice, New Mexico... Louisiana Energy Services (LES), LLC, National Enrichment Facility in Eunice, New Mexico, and has authorized...

  12. 76 FR 44323 - National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of...

    Science.gov (United States)

    2011-07-25

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-49-000] National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of Petition for Declaratory Order Take..., 18 CFR 385.207, National Grid Transmission Services Corporation and Bangor Hydro Electric Company...

  13. 78 FR 23311 - Sunshine Act Meeting of the National Museum and Library Services Board

    Science.gov (United States)

    2013-04-18

    ... policies with respect to the duties, powers, and authority of the Institute relating to museum, library and... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and...

  14. National Report on the Energy Efficiency Service Business in Sweden

    OpenAIRE

    Stenqvist, Christian; Nilsson, Lars J

    2009-01-01

    The ChangeBest project is supported by the Intelligent Energy Europe Programme of the European Commission. The purpose of the project is to promote the development of an energy efficiency service (EES) market. The project provides good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report presents the sitauation o...

  15. Nuclear information services at the National Nuclear Data Center

    International Nuclear Information System (INIS)

    Burrows, T.W.; Tuli, J.K.

    1997-01-01

    The National Nuclear Data Center (NNDC) at the Brookhaven National Laboratory has maintained and disseminated data from several numeric and bibliographic data bases for many years. These data bases now cover most of low- and medium-energy nuclear physics and are produced by the NNDC and other groups belonging to various international and national networks. The numeric and bibliographic nuclear data bases maintained by the National Nuclear Data Center and access to these data bases is described. The U.S. Nuclear Data and Reaction Data Networks is also briefly described. (author)

  16. 77 FR 19525 - National School Lunch Program: School Food Service Account Revenue Amendments Related to the...

    Science.gov (United States)

    2012-04-02

    ... National School Lunch Program: School Food Service Account Revenue Amendments Related to the Healthy... Food Service Account Revenue Amendments Related to the Healthy, Hunger-Free Kids Act of 2010'' on June... sold in a school and purchased with funds from the nonprofit school food service account, other than...

  17. 76 FR 344 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2011-01-04

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Special Education and Rehabilitative Services establishes a priority for the funding of a National SCI... Special Education and Rehabilitative Services may change the maximum amount through a notice published in...

  18. External Service Providers to the National Security Technology Incubator: Formalization of Relationships

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-04-30

    This report documents the formalization of relationships with external service providers in the development of the National Security Technology Incubator (NSTI). The technology incubator is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. This report summarizes the process in developing and formalizing relationships with those service providers and includes a sample letter of cooperation executed with each provider.

  19. The National Health Services Conunission, 1942 - 1944 - its origins ...

    African Journals Online (AJOL)

    (i) an analysis of the origins and impact ofthe National .... employee. ... century, there was growing recognition of the 'pressing ... motivated not entirely by selfless concern.30 For exam- ..... local, regional and national level satisfied the MASA, .... Rewards. Johannesburg: Caxton Press, 1977: 246-247. 62. MASA News.

  20. 77 FR 7184 - Public Availability of the National Archives and Records Administration FY 2011 Service Contract...

    Science.gov (United States)

    2012-02-10

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

  1. 77 FR 58141 - Public Buildings Service; Information Collection; Art-in-Architecture Program National Artist...

    Science.gov (United States)

    2012-09-19

    ... Buildings Service; Information Collection; Art-in- Architecture Program National Artist Registry (GSA Form... Information Collection 3090- 0274, Art-in-Architecture Program National Artist Registry (GSA Form 7437), by... corresponds with ``Information Collection 3090-0274, Art-in- Architecture Program National Artist Registry...

  2. A national survey of services for the prevention and management of falls in the UK

    Directory of Open Access Journals (Sweden)

    Potter Rachel

    2008-11-01

    Full Text Available Abstract Background The National Health Service (NHS was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines. Methods Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE. Results We identified 303 clinics across the UK. 231 (76% were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health. Conclusion The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.

  3. USGS Elevation Availability (NED) Overlay Map Service from The National Map - National Geospatial Data Asset (NGDA) National Elevation Data Set (NED)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS Elevation Availability service from The National Map (TNM) shows the best available resolution of downloadable elevation data, and is updated approximately...

  4. Provision of dysphagia services in a developing nation: Infrastructural challenges.

    Science.gov (United States)

    Mustaffa Kamal, Rahayu; Ward, Elizabeth Celeste; Cornwell, Petrea; Sharma, Shobha

    2015-04-15

    The purpose of the current study was to explore infrastructure issues that may be barriers to the establishment and improvement of dysphagia services in Malaysia compared to settings with established dysphagia management services (i.e. Queensland, Australia). A mixed method design incorporating quantitative and qualitative data was used to increase credibility, validity and comprehensiveness of the results. Thirty-eight hospitals (Malaysia = 21, Queensland = 17) participated in Phase 1 (quantitative component) of the study involving completion of an infrastructure checklist by a speech-language pathologist from each hospital regarding availability of networking and communication, staffing and financial support, facilities and documentation of guidelines for dysphagia management. Subsequently, eight sub-samples from each cohort were then involved in Phase 2 (qualitative component) of the study involving a semi-structured interview on issues related to the impact of infrastructure availability or constraints on service provision. The current study reveals that multiple challenges exist with regard to dysphagia services in Malaysian government hospitals compared to Queensland public hospitals. Overall, it was identified that service improvement in Malaysia requires change at a systems and structures level, but also, more importantly, at the individual/personal level, particularly focusing on the culture, behaviour and attitudes among the staff regarding dysphagia services.

  5. A national industrial health service on a voluntary basis.

    Science.gov (United States)

    NATVIG, H

    1955-01-01

    In Norway-a country with a population of about 3.2 million-the largest occupational group is employed in manufacturing and trade, which accounted for a total of 480 000 individuals in 1946. Most industries are small, only about 100 firms having more than 500 workers. As industry developed, there arose an increasing need for organizing a special plant health service, with the aim of protecting and promoting the health of the workers.Certain regulations were worked out, and in 1945 a general agreement was made between the Norwegian Medical Association, the Norwegian Employers' Association, and the Norwegian Federation of Labour; a tripartite body was then formed, the Board of Industrial Health Service, to give information and advice to industries. This plant health service is based on voluntary mutual agreement and not on legislation.All expenses for the plant health service are met by the industry itself. In firms with no special occupational health problems, the physician works one hour per week per 100 workers; in firms with special problems, two hours. The duties of the plant physician consist in giving the employees pre-employment and periodical health examinations, and health guidance, and carrying out other preventive measures. First aid, treatment for occupational diseases not requiring absence from work, and treatment of certain minor ailments are the only forms of therapy given at the plant. Workers in need of further medical treatment are referred to general practitioners or hospitals. Absenteeism is recorded in a uniform way in all industries that have joined this industrial health service. The plant physician has to submit an annual report on his work to the Board of Industrial Health Service.This system of industrial health service has given very good results. In 1953, 653 plants were participating with about 186 000 workers. About 260 active plant physicians are to be found in Norway at present, most of them working on a part-time basis. The cost of

  6. USGS Imagery Only Base Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — USGS Imagery Only is a tile cache base map of orthoimagery in The National Map visible to the 1:18,000 scale. Orthoimagery data are typically high resolution images...

  7. USGS Hill Shade Base Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — USGS Hill Shade (or Shaded Relief) is a tile cache base map created from the National Elevation Dataset (NED), a seamless dataset of best available raster elevation...

  8. USGS Hydro Cached Base Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The National Hydrography Dataset (NHD) is a comprehensive set of digital spatial data that encodes information about naturally occurring and constructed bodies of...

  9. Nuclear information services at the National Nuclear Data Center

    International Nuclear Information System (INIS)

    Burrows, T.W.; Tuli, J.K.

    1996-01-01

    The numeric and bibliographic nuclear data bases maintained by the National Nuclear Data Center and access to these data bases will be described. The U.S. Nuclear Data and Reaction Data Networks will also be briefly described

  10. National Coal Board Medical Service annual report 1980-1981

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    Sections report on: medical examinations and consultations; protection from health hazards such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in the blood of miners, Legionaires' disease, Perthe's disease, rehabilitation and physiotherapy, chemical hazards, public health and hygiene, noise, and the use of visual display units; diseases from coal products such as in coke and tar manufacture; first aid services, morphia, and nursing service; and back pain in the mining industry. A list of staff and their publications is also included.

  11. Policy implementation in practice: the case of national service frameworks in general practice.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2004-10-01

    National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

  12. Citizen Review Panels for Child Protective Services: A National Profile

    Science.gov (United States)

    Jones, Blake L.; Royse, David

    2008-01-01

    Citizen Review Panels (CRPs) for Child Protective Services are groups of citizen-volunteers throughout the United States who are federally mandated to evaluate local and state child protection systems. This study presents a profile of 332 CRP members in 20 states with regards to their demographic information, length of time on the panel, and …

  13. 10 Standards for Oversight and Transparency of National Intelligence Services

    NARCIS (Netherlands)

    Eskens, S.; van Daalen, O.; van Eijk, N.

    2016-01-01

    This report aims to enhance the policy debate on surveillance by intelligence services by focusing on two key components: oversight and transparency. Both oversight and transparency are essential to devising checks and balances in a way that respects human rights. By offering this concise list of

  14. LINKS to NATIONAL WEATHER SERVICE MARINE FORECAST OFFICES

    Science.gov (United States)

    ; Organization Search Search Landlubber's forecast: "City, St" or zip code (Pan/Zoom for Marine) Search SERVICE MARINE FORECAST OFFICES (Click on the NWS Forecast Center/Office of interest to link to that Marine Forecasts in text form ) Coastal NWS Forecast Offices have regionally focused marine webpages

  15. 7 CFR 2.68 - Administrator, National Agricultural Statistics Service.

    Science.gov (United States)

    2010-01-01

    ....S.C. 3318). (6) Enter cost-reimbursable agreements relating to agricultural research and statistical... promote and support the development of a viable and sustainable global agricultural system. Such work may... 7 Agriculture 1 2010-01-01 2010-01-01 false Administrator, National Agricultural Statistics...

  16. Forest Service National Visitor Use Monitoring Process: Research Method Documentation

    Science.gov (United States)

    Donald B.K. English; Susan M. Kocis; Stanley J. Zarnoch; J. Ross Arnold

    2002-01-01

    In response to the need for improved information on recreational use of National Forest System lands, the authors have developed a nationwide, systematic monitoring process. This report documents the methods they used in estimating recreational use on an annual basis. The basic unit of measure is exiting volume of visitors from a recreation site on a given day. Sites...

  17. Geo-spatial Service and Application based on National E-government Network Platform and Cloud

    Science.gov (United States)

    Meng, X.; Deng, Y.; Li, H.; Yao, L.; Shi, J.

    2014-04-01

    With the acceleration of China's informatization process, our party and government take a substantive stride in advancing development and application of digital technology, which promotes the evolution of e-government and its informatization. Meanwhile, as a service mode based on innovative resources, cloud computing may connect huge pools together to provide a variety of IT services, and has become one relatively mature technical pattern with further studies and massive practical applications. Based on cloud computing technology and national e-government network platform, "National Natural Resources and Geospatial Database (NRGD)" project integrated and transformed natural resources and geospatial information dispersed in various sectors and regions, established logically unified and physically dispersed fundamental database and developed national integrated information database system supporting main e-government applications. Cross-sector e-government applications and services are realized to provide long-term, stable and standardized natural resources and geospatial fundamental information products and services for national egovernment and public users.

  18. Performance of the ocean state forecast system at Indian National Centre for Ocean Information Services

    Digital Repository Service at National Institute of Oceanography (India)

    Nair, T.M.B.; Sirisha, P.; Sandhya, K.G.; Srinivas, K.; SanilKumar, V.; Sabique, L.; Nherakkol, A.; KrishnaPrasad, B.; RakhiKumari; Jeyakumar, C.; Kaviyazhahu, K.; RameshKumar, M.; Harikumar, R.; Shenoi, S.S.C.; Nayak, S.

    The reliability of the operational Ocean State Forecast system at the Indian National Centre for Ocean Information Services (INCOIS) during tropical cyclones that affect the coastline of India is described in this article. The performance...

  19. Measuring Changes in Service Costs to Meet the Requirements of the 2002 National Defense Authorization Act

    National Research Council Canada - National Science Library

    Shirley, Chad; Ausink, John; Baldwin, Laura H

    2004-01-01

    The National Defense Authorization Act for Fiscal Year 2002 sets forth a series of goals for the Department of Defense to reduce the cost of the services it buys over a ten-year period through changes...

  20. USGS US Topo Availability Overlay Map Service from The National Map

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The USGS US Topo Availability service from The National Map consists of footprints where US Topo products are currently available. Various green tints are used to...

  1. A Technical Report To The Secretary Of Transportation On A National Approach To Augmented Gps Services

    Science.gov (United States)

    1994-12-01

    THIS REPORT DOCUMENTS THE DEVELOPMENT OF RECOMMENDATIONS FOR A NATIONAL APPROACH TO AUGMENTED GLOBAL POSITIONING SYSTEM (GPS) SERVICES. THE INSTITUTE FOR TELECOMMUNICATION SCIENCES LED A STUDY TEAM THAT INCLUDED THE U.S. ARMY TOPOGRAPHIC ENGINEERING ...

  2. Training for Effective National Weather Service (NWS) Communication in Chat and Conference Calls

    Science.gov (United States)

    Pearce, Vanessa

    2012-01-01

    Staff of the National Weather Service Offices should be able to understand interpersonal communication and public relations in order to better serve their mission to "protect lives and property" as well as work with their internal and external partners (NWS Internet Services Team). Two technologies have been developed to assist the integration of…

  3. 75 FR 17763 - National Park Service Benefits-Sharing Final Environmental Impact Statement Record of Decision

    Science.gov (United States)

    2010-04-07

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

  4. Hardwoods for timber bridges : a national program emphasis by the USDA Forest Service

    Science.gov (United States)

    James P. Wacker; Ed Cesa

    2005-01-01

    This paper describes the joint efforts of the Forest Service and the FHWA to administer national programs including research, demonstration bridges, and technology transfer components. Summary information on a number of Forest Service-WIT demonstration bridges constructed with hardwoods is also provided.

  5. Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

    LENUS (Irish Health Repository)

    Fennelly, Orna

    2018-06-01

    Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services.

  6. 78 FR 1832 - National Wildlife Services Advisory Committee; Notice of Solicitation for Membership

    Science.gov (United States)

    2013-01-09

    ...., Washington, DC 20250, Attn: Secretary's National Wildlife Services Advisory Committee. Nomination packages... demonstrated ability to represent minorities, women, and persons with disabilities. Done in Washington, DC... Services Advisory Committee. DATES: Consideration will be given to nominations received on or before March...

  7. Laboratory services series: the utilization of scientific glassblowing in a national research and development laboratory

    International Nuclear Information System (INIS)

    Farnham, R.M.; Poole, R.W.

    1976-04-01

    Glassblowing services at a national research and development laboratory provide unique equipment tailored for specific research efforts, small-scale process items for flowsheet demonstrations, and solutions for unusual technical problems such as glass-ceramic unions. Facilities, equipment, and personnel necessary for such services are described

  8. The National Library of Medicine Programs and Services, Fiscal Year 1974.

    Science.gov (United States)

    National Library of Medicine (DHEW), Bethesda, MD.

    The activities and projects of the National Library of Medicine are described. New and continuing programs in library services and operations, on-line computer retrieval services, grants for library assistance, audiovisual programs, and health communications research are included. International activities of the Library are outlined. Summary…

  9. 31 CFR 500.575 - Certain services to Vietnamese nationals authorized.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Certain services to Vietnamese... Vietnamese nationals authorized. (a) Specific licenses may be issued on a case-by-case basis for the provision in the United States or a third country of business orientation or training services to Vietnamese...

  10. USDA Forest Service National Woodland Owner Survey, 2011-2013: design, implementation, and estimation methods

    Science.gov (United States)

    Brett J. Butler; Brenton J. Dickinson; Jaketon H. Hewes; Sarah M. Butler; Kyle Andrejczyk; Marla. Markowski-Lindsay

    2016-01-01

    The National Woodland Owner Survey (NWOS) is conducted by the U.S. Forest Service, Forest Inventory and Analysis program to increase the understanding of the attitudes, behaviors, and demographics of private forest and woodland ownerships across the United States. The information is intended to help policy makers, resource managers, educators, service providers, and...

  11. Medical Tourism and the Libyan National Health Services

    OpenAIRE

    Taguri, Adel El

    2007-01-01

    Medical tourism is a term that is used frequently by the media and travel agencies as a catchall phrase to describe a process where people travel to other countries to obtain medical, dental, and/or surgical care [1,2]. Leisure aspects of traveling are usually included on such a medical travel trip [1]. The term is also used to describe a situation where doctors travel to other places to deliver services to endogenous populations [3].Many factors have led to the recent increase in popularity ...

  12. National Park Service Vegetation Inventory Program, Cuyahoga Valley National Park, Ohio

    Science.gov (United States)

    Hop, Kevin D.; Drake, J.; Strassman, Andrew C.; Hoy, Erin E.; Menard, Shannon; Jakusz, J.W.; Dieck, J.J.

    2013-01-01

    The National Park Service (NPS) Vegetation Inventory Program (VIP) is an effort to classify, describe, and map existing vegetation of national park units for the NPS Natural Resource Inventory and Monitoring (I&M) Program. The NPS VIP is managed by the NPS Biological Resources Management Division and provides baseline vegetation information to the NPS Natural Resource I&M Program. The U.S. Geological Survey (USGS) Vegetation Characterization Program lends a cooperative role in the NPS VIP. The USGS Upper Midwest Environmental Sciences Center, NatureServe, and NPS Cuyahoga Valley National Park (CUVA) have completed vegetation classification and mapping of CUVA.Mappers, ecologists, and botanists collaborated to identify and describe vegetation types within the National Vegetation Classification Standard (NVCS) and to determine how best to map them by using aerial imagery. The team collected data from 221 vegetation plots within CUVA to develop detailed descriptions of vegetation types. Data from 50 verification sites were also collected to test both the key to vegetation types and the application of vegetation types to a sample set of map polygons. Furthermore, data from 647 accuracy assessment (AA) sites were collected (of which 643 were used to test accuracy of the vegetation map layer). These data sets led to the identification of 45 vegetation types at the association level in the NVCS at CUVA.A total of 44 map classes were developed to map the vegetation and general land cover of CUVA, including the following: 29 map classes represent natural/semi-natural vegetation types in the NVCS, 12 map classes represent cultural vegetation (agricultural and developed) in the NVCS, and 3 map classes represent non-vegetation features (open-water bodies). Features were interpreted from viewing color-infrared digital aerial imagery dated October 2010 (during peak leaf-phenology change of trees) via digital onscreen three-dimensional stereoscopic workflow systems in geographic

  13. Environmental accounting of natural capital and ecosystem services for the US National Forest System

    Science.gov (United States)

    Elliot T. Campbell; Mark T. Brown; NO-VALUE

    2012-01-01

    The National Forests of the United States encompass 192.7 million acres (78 million hectares) of land, which is nearly five percent of the total land area of the nation. These lands are managed by the US Forest Service (USFS) for multiple uses, including extraction of timber, production of fossil fuels and minerals, public recreation, and the preservation of...

  14. Health Services Use and Costs for Americans with Intellectual and Developmental Disabilities: A National Analysis

    Science.gov (United States)

    Fujiura, Glenn T.; Li, Henan; Magaña, Sandy

    2018-01-01

    Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed…

  15. 22 CFR 228.37 - Nationality of employees under contracts or subcontracts for services.

    Science.gov (United States)

    2010-04-01

    ... the Nationality of Suppliers of Services for USAID Financing § 228.37 Nationality of employees under... the United States. (b) When the contractor on a USAID-financed construction project is a United States firm, at least half of the supervisors and other specified key personnel working at the project site...

  16. 78 FR 23312 - Uranium Enrichment Fuel Cycle Inspection Reports Regarding Louisiana Energy Services, National...

    Science.gov (United States)

    2013-04-18

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 70-3103; NRC-2010-0264] Uranium Enrichment Fuel Cycle Inspection Reports Regarding Louisiana Energy Services, National Enrichment Facility, Eunice, New Mexico..., National Enrichment Facility in Eunice, New Mexico, and has authorized the introduction of uranium...

  17. 77 FR 58868 - Teleconference for the National Park Service Alaska Region's Subsistence Resource Commission Program

    Science.gov (United States)

    2012-09-24

    ... Wildlife Updates 8. NPS Staff Reports 9. New Business 10. Public and other Agency Comments 11. Select Time... Subsistence Collections Environmental Assessment Update b. SRC Letters 10. New Business a. Susitna-Watana...: National Park Service, Interior. ACTION: Notice of open public meetings. SUMMARY: The Lake Clark National...

  18. The National Workforce Assistance Collaborative: A New Institution with Plans To Improve Workforce Services.

    Science.gov (United States)

    Bergman, Terri

    The National Workforce Assistance Collaborative (NWAC) was established by the National Alliance of Business to provide assistance to community colleges and other organizations that offer programs to increase business productivity. The NWAC is charged with building the capacity of service providers that work with small and mid-sized companies in…

  19. Service-Learning. National Dropout Prevention Center/Network Newsletter. Volume 22, Number 4

    Science.gov (United States)

    Duckenfield, Marty, Ed.

    2011-01-01

    The "National Dropout Prevention Newsletter" is published quarterly by the National Dropout Prevention Center/Network. This issue contains the following articles: (1) Dropouts and Democracy (Robert Shumer); (2) 2011 NDPN Crystal Star Winners; (3) Service-Learning as Dropout Intervention and More (Michael VanKeulen); and (4) Teacher…

  20. 78 FR 43745 - Expanding National Service Through Partnerships to Advance Government Priorities

    Science.gov (United States)

    2013-07-19

    ... CNCS and the Director of the Domestic Policy Council, which shall include representatives from agencies... Affairs; (m) the Department of Homeland Security; (n) the Peace Corps; (o) the National Science Foundation...- effectiveness of national service and volunteering interventions in achieving agency priorities, and aggregate...

  1. 76 FR 7232 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Dinosaur...

    Science.gov (United States)

    2011-02-09

    .... Department of the Interior, National Park Service, Dinosaur National Monument, Dinosaur, CO AGENCY: National... Service, Dinosaur National Monument, Dinosaur, CO, has completed an inventory of human remains and... Indian tribe that believes itself to be culturally affiliated with the human remains may contact Dinosaur...

  2. The National Security Education Program and Its Service Requirement: An Exploratory Study of What Areas of Government and for What Duration National Security Education Program Recipients Have Worked

    Science.gov (United States)

    Comp, David J.

    2013-01-01

    The National Security Education Program, established under the National Security Education Act of 1991, has had a post-funding service requirement in the Federal Government for undergraduate scholarship and graduate fellowship recipients since its inception. The service requirement, along with the concern that the National Security Education…

  3. Nation Binding: How Public Service Broadcasting Mitigates Political Selective Exposure

    Science.gov (United States)

    Kruikemeier, Sanne; de Vreese, Claes

    2016-01-01

    Recent research suggests that more and more citizens select news and information that is congruent with their existing political preferences. This increase in political selective exposure (PSE) has allegedly led to an increase in polarization. The vast majority of studies stem from the US case with a particular media and political system. We contend that there are good reasons to believe PSE is less prevalent in other systems. We test this using latent profile analysis with national survey data from the Netherlands (n = 2,833). We identify four types of media use profiles and indeed only find partial evidence of PSE. In particular, we find that public broadcasting news cross-cuts all cleavages. This research note offers an important antidote in what is considered a universal phenomenon. We do find, however, a relatively large segment of citizens opting out of news consumption despite the readily available news in today’s media landscape. PMID:27218659

  4. National Assessment of Quality Programs in Emergency Medical Services.

    Science.gov (United States)

    Redlener, Michael; Olivieri, Patrick; Loo, George T; Munjal, Kevin; Hilton, Michael T; Potkin, Katya Trudeau; Levy, Michael; Rabrich, Jeffrey; Gunderson, Michael R; Braithwaite, Sabina A

    2018-01-01

    This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©. A convenience sample of respondents was enrolled between August and November, 2015. Univariate, bivariate and multiple logistic regression analyses were conducted to describe demographics and relationships between outcomes of interest and their covariates using SAS 9.3©. A total of 1,733 surveys were initiated and 1,060 surveys had complete or near-complete responses. This includes agencies from 45 states representing over 6.23 million 9-1-1 responses annually. Totals of 70.5% (747) agencies reported dedicated QI personnel, 62.5% (663) follow clinical metrics and 33.3% (353) participate in outside quality or research program. Medical director hours varied, notably, 61.5% (649) of EMS agencies had quality measures compared to fire-based agencies. Agencies in rural only environments were less likely to follow clinical quality metrics. (OR 0.47 CI 0.31 -0.72 p quality improvement resources, medical direction and specific clinical quality measures. More research is needed to understand the impact of this variation on patient care outcomes.

  5. Strengthening Climate Services Capabilities and Regional Engagement at NOAA's National Climatic Data Center

    Science.gov (United States)

    Shea, E.

    2008-12-01

    The demand for sector-based climate information is rapidly expanding. In order to support this demand, it is crucial that climate information is managed in an effective, efficient, and user-conscious manner. NOAA's National Climatic Data Center is working closely with numerous partners to develop a comprehensive interface that is authoritative, accessible, and responsive to a variety of sectors, stakeholders, and other users. This talk will explore these dynamics and activities, with additional perspectives on climate services derived from the regional and global experiences of the NOAA Integrated Data and Environmental Applications (IDEA) Center in the Pacific. The author will explore the importance of engaging partners and customers in the development, implementation and emergence of a national climate service program. The presentation will draw on the author's experience in climate science and risk management programs in the Pacific, development of regional and national climate services programs and insights emerging from climate services development efforts in NCDC. In this context, the author will briefly discuss some of guiding principles for effective climate services and applications including: - Early and continuous dialogue, partnership and collaboration with users/customers; - Establishing and sustaining trust and credibility through a program of shared learning and joint problem- solving; - Understanding the societal context for climate risk management and using a problem-focused approach to the development of products and services; - Addressing information needs along a continuum of timescales from extreme events to long-term change; and - Embedding education, outreach and communications activities as critical program elements in effective climate services. By way of examples, the author will reference lessons learned from: early Pacific Island climate forecast applications and climate assessment activities; the implementation of the Pacific Climate

  6. SWOT analysis on National Common Geospatial Information Service Platform of China

    Science.gov (United States)

    Zheng, Xinyan; He, Biao

    2010-11-01

    Currently, the trend of International Surveying and Mapping is shifting from map production to integrated service of geospatial information, such as GOS of U.S. etc. Under this circumstance, the Surveying and Mapping of China is inevitably shifting from 4D product service to NCGISPC (National Common Geospatial Information Service Platform of China)-centered service. Although State Bureau of Surveying and Mapping of China has already provided a great quantity of geospatial information service to various lines of business, such as emergency and disaster management, transportation, water resource, agriculture etc. The shortcomings of the traditional service mode are more and more obvious, due to the highly emerging requirement of e-government construction, the remarkable development of IT technology and emerging online geospatial service demands of various lines of business. NCGISPC, which aimed to provide multiple authoritative online one-stop geospatial information service and API for further development to government, business and public, is now the strategic core of SBSM (State Bureau of Surveying and Mapping of China). This paper focuses on the paradigm shift that NCGISPC brings up by using SWOT (Strength, Weakness, Opportunity and Threat) analysis, compared to the service mode that based on 4D product. Though NCGISPC is still at its early stage, it represents the future service mode of geospatial information of China, and surely will have great impact not only on the construction of digital China, but also on the way that everyone uses geospatial information service.

  7. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Science.gov (United States)

    2013-02-11

    ...), also known as the Federal Advisory Committee Act, which sets forth standards for the formation and use... retention, site administration, customer service, marketing, organizational partnerships, research, and... for the nomination (i.e., what specific attributes, perspectives, and/ or skills does the individual...

  8. 77 FR 11557 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Science.gov (United States)

    2012-02-27

    ... sets forth standards for the formation and use of advisory committees. The NAC on the NHSC is a group..., recruitment and retention, site administration, customer service, marketing, organizational partnerships... specific attributes, perspectives, and/or skills does the individual possess that would benefit the...

  9. Quality Control in the Dosimetric System of the Personnel Dosimetry Service of the Spanish National Health Service

    Energy Technology Data Exchange (ETDEWEB)

    Casal, E.; Gil, J.A.; Roig, F.; Soriano, A. [Valencia (Spain)

    1999-07-01

    The main operating and quality control procedures implemented at the Centro Nacional de Dosimetria (CND) of the Spanish National Health Service to ensure the acceptance of the dosimetry service are described. The operating procedures are routinely performed at every step, since the dosemeters are received from the manufacturer until the doses are assigned to the dosimetric history and their main aim is to ensure the traceability of the doses. They make use of control and background dosemeters and frequent cross reference (automatic and manual) of different sources of data. The control procedures are performed at the end of each monthly process to detect possible errors or systematic bias in the dosimetry service and include analysis of the measurements of quality control dosemeters irradiated at the CND's laboratory and randomly read. The results of this analysis since 1996 are presented. (author)

  10. Quality Control in the Dosimetric System of the Personnel Dosimetry Service of the Spanish National Health Service

    International Nuclear Information System (INIS)

    Casal, E.; Gil, J.A.; Roig, F.; Soriano, A.

    1999-01-01

    The main operating and quality control procedures implemented at the Centro Nacional de Dosimetria (CND) of the Spanish National Health Service to ensure the acceptance of the dosimetry service are described. The operating procedures are routinely performed at every step, since the dosemeters are received from the manufacturer until the doses are assigned to the dosimetric history and their main aim is to ensure the traceability of the doses. They make use of control and background dosemeters and frequent cross reference (automatic and manual) of different sources of data. The control procedures are performed at the end of each monthly process to detect possible errors or systematic bias in the dosimetry service and include analysis of the measurements of quality control dosemeters irradiated at the CND's laboratory and randomly read. The results of this analysis since 1996 are presented. (author)

  11. USGS Structures Overlay Map Service from The National Map - National Geospatial Data Asset (NGDA) USGS National Structures Dataset

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — USGS Structures from The National Map (TNM) consists of data to include the name, function, location, and other core information and characteristics of selected...

  12. Services of the CDRH X-ray calibration laboratory and their traceability to National Standards

    Energy Technology Data Exchange (ETDEWEB)

    Cerra, F.; Heaton, H.T. [Center for Devices and Radiological Health, Rockville, MD (United States)

    1993-12-31

    The X-ray Calibration Laboratory (XCL) of the Center for Devices and Radiological Health (CDRH) provides calibration services for the Food and Drug Administration (FDA). The instruments calibrated are used by FDA and contract state inspectors to verify compliance with federal x-ray performance standards and for national surveys of x-ray trends. In order to provide traceability of measurements, the CDRH XCL is accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for reference, diagnostic, and x-ray survey instrument calibrations. In addition to these accredited services, the CDRH XCL also calibrates non-invasive kVp meters in single- and three-phase x-ray beams, and thermoluminescent dosimeter (TLD) chips used to measure CT beam profiles. The poster illustrates these services and shows the traceability links back to the National Standards.

  13. Services of the CDRH X-ray calibration laboratory and their traceability to National Standards

    International Nuclear Information System (INIS)

    Cerra, F.; Heaton, H.T.

    1993-01-01

    The X-ray Calibration Laboratory (XCL) of the Center for Devices and Radiological Health (CDRH) provides calibration services for the Food and Drug Administration (FDA). The instruments calibrated are used by FDA and contract state inspectors to verify compliance with federal x-ray performance standards and for national surveys of x-ray trends. In order to provide traceability of measurements, the CDRH XCL is accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for reference, diagnostic, and x-ray survey instrument calibrations. In addition to these accredited services, the CDRH XCL also calibrates non-invasive kVp meters in single- and three-phase x-ray beams, and thermoluminescent dosimeter (TLD) chips used to measure CT beam profiles. The poster illustrates these services and shows the traceability links back to the National Standards

  14. 78 FR 27132 - Special Regulations of the National Park Service, Curecanti National Recreation Area, Snowmobiles...

    Science.gov (United States)

    2013-05-09

    ... designated for travel by snowmobiles from the access points to the frozen surface of Blue Mesa Reservoir... History of Curecanti National Recreation Area The Blue Mesa Dam and Reservoir, Morrow Point Dam and... as Blue Mesa Lake). The high-water mark is defined as the point at which the reservoir is at maximum...

  15. Strengthening systems for integrated early childhood development services: a cross-national analysis of governance.

    Science.gov (United States)

    Britto, Pia Rebello; Yoshikawa, Hirokazu; van Ravens, Jan; Ponguta, Liliana Angelica; Reyes, Maria; Oh, Soojin; Dimaya, Roland; Nieto, Ana María; Seder, Richard

    2014-01-01

    While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs. © 2014 New York Academy of Sciences.

  16. Customer service model for waste tracking at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Dorries, Alison M.; Montoya, Andrew J.; Ashbaugh, Andrew E.

    2010-01-01

    The deployment of any new software system in a production facility will always face multiple hurtles in reaching a successful acceptance. However, a new waste tracking system was required at the plutonium processing facility at Los Alamos National Laboratory (LANL) where waste processing must be integrated to handle Special Nuclear Materials tracking requirements. Waste tracking systems can enhance the processing of waste in production facilities when the system is developed with a focus on customer service throughout the project life cycle. In March 2010 Los Alamos National Laboratory Waste Technical Services (WTS) replaced the aging systems and infrastructure that were being used to support the plutonium processing facility. The Waste Technical Services (WTS) Waste Compliance and Tracking System (WCATS) Project Team, using the following customer service model, succeeded in its goal to meet all operational and regulatory requirements, making waste processing in the facility more efficient while partnering with the customer.

  17. Ten years of a National Service of Dosimetric calibration at radiation protection

    International Nuclear Information System (INIS)

    Morales, J.A.; Jova, L.; Hernandez, E.; Campa, R.; Walwyn, G.

    1996-01-01

    Since 1986, the CPHR has offered a national service of calibration of dosimetric instruments at levels of radiation protection. The history of such a service is the chronology of efforts to reduce the uncertainties of the calibration process, expand the ranges of useful dose rates, and enhance the radiological safety when using the sources. The crowning of those efforts is the complement and start-up of the secondary la laboratory of dosimetric calibration (SLDC), which is currently a member of the IAEA/WHO. SLDC international network. As a result of this service, 256 instruments have been calibration and 867 personal dosimeters film badges and TLD and 72 environmental TLD dosimeters have been irradiated at known doses. The service rendered has benefited 62 national institutions which are users of ionizing radiations

  18. A way to motivate Danish GPs to implement a new national service.

    Science.gov (United States)

    Kristensen, Alice; Wengler, Bente

    2012-01-01

    The Common Medicine card (CMC) is a new national service in Denmark which aim is to ensure better patient care and minimize medication errors. All health professionals as well as authorities have to use this system. CMC requires changing the organization of work for both physicians and clinical staff in General Practice (GP). Commissioning of CMC in GP requires a significant effort beyond the technical installation of the solution. Finding the right way to implement a new service in a busy GP has been the main focus of the national project organization MedCom. MedCom has in collaboration with the five regions in Denmark, established a joint plan and has created an implementation model contraining various initiatives including "after hours" meetings for each service provider of EMR (Electronic Medicine Records) in order to disseminate and support the new CMC service. This paper shows the status of the "after hours" meetings effect in dissemination of CMC from August to November 2011.

  19. Denial of service to same-sex and interracial couples: Evidence from a national survey experiment.

    Science.gov (United States)

    Powell, Brian; Schnabel, Landon; Apgar, Lauren

    2017-12-01

    Legislatures and courts are debating whether businesses can deny services to same-sex couples for religious reasons. Yet, little is known about public views on this issue. In a national survey experiment, Americans ( n = 2035) responded to an experimental vignette describing a gay or interracial couple refused service. Vignettes varied the reason for refusal (religion/nonreligious) and by business type (individual/corporation). Results confirm greater support of service refusal by the self-employed than by corporations and to gay couples than to interracial couples. However, religious reasons for refusal to gay couples elicit no more support than do nonreligious reasons. In the first national study to experimentally analyze views on service refusal to sexual minorities, we demonstrate that views vary by several factors but not by whether the refusal was for religious reasons.

  20. 75 FR 32818 - Institute of Museum and Library Services; Sunshine Act Meeting of the National Museum and Library...

    Science.gov (United States)

    2010-06-09

    ... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services; Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of Meeting. SUMMARY: This notice sets forth the agenda of...

  1. 75 FR 8139 - Institute of Museum and Library Services; Sunshine Act Meeting of the National Museum and Library...

    Science.gov (United States)

    2010-02-23

    ... policies with respect to the duties, powers, and authorities related to Museum and Library Services. If you... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services; Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and...

  2. NNDC Stand: Activities and Services of the National Nuclear Data Center

    International Nuclear Information System (INIS)

    Pritychenko, B.; Arcilla, R.; Burrows, T.W.; Dunford, C.L.; Herman, M.W.; McLane, V.; Oblozinsky, P.; Sonzogni, A.A.; Tuli, J.K.; Winchell, D.F.

    2005-01-01

    The National Nuclear Data Center (NNDC) collects, evaluates, and disseminates nuclear physics data for basic nuclear research, applied nuclear technologies including energy, shielding, medical and homeland security. In 2004, to answer the needs of nuclear data users community, NNDC completed a project to modernize data storage and management of its databases and began offering new nuclear data Web services. The principles of database and Web application development as well as related nuclear reaction and structure database services are briefly described

  3. 78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-01-04

    ...The NHTSA announces a meeting of NEMSAC to be held in the Metropolitan Washington, DC, area. This notice announces the date, time, and location of the meeting, which will be open to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA and to the Federal Interagency Committee on EMS (FICEMS).

  4. 32 CFR 1630.48 - Class 4-A-A: Registrant who has performed military service for a foreign nation.

    Science.gov (United States)

    2010-07-01

    ... military service for a foreign nation. 1630.48 Section 1630.48 National Defense Other Regulations Relating... who has performed military service for a foreign nation. In Class 4-A-A shall be placed any registrant... be written in the English language. [52 FR 24456, July 1, 1987] ...

  5. 78 FR 72703 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service...

    Science.gov (United States)

    2013-12-03

    ... of an inventory of human remains and associated funerary objects under the control of Canyonlands....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service.... Department of the Interior, National Park Service, Canyonlands National Park, has completed an inventory of...

  6. Using Satellite Remote Sensing to Assist the National Weather Service (NWS) in Storm Damage Surveys

    Science.gov (United States)

    Schultz, Lori A.; Molthan, Andrew; McGrath, Kevin; Bell, Jordan; Cole, Tony; Burks, Jason

    2016-01-01

    In the United States, the National Oceanic and Atmospheric Administration (NOAA) National Weather Service (NWS) is charged with performing damage assessments when storm or tornado damage is suspected after a severe weather event. This has led to the development of the Damage Assessment Toolkit (DAT), an application for smartphones, tablets and web browsers that allows for the collection, geolocation, and aggregation of various damage indicators collected during storm surveys.

  7. Prehistory of geophysical service establishment in the National Nuclear Center of the Republic of Kazakhstan

    International Nuclear Information System (INIS)

    Vanchugov, A.G.

    2003-01-01

    To look to the future it is necessary, seeing the present, not to forget the past. Obviously it is important to know 'how was it?', 'in the beginning was the word' - the word of the Ministry of the Republic of Kazakhstan of May 15, 1992 about establishment of the National Nuclear Center of the Republic of Kazakhstan. Originally a geophysical service formed the National Nuclear Center RK as Geophysical Party 35 and Borovoe Geophysical Observatory. (author)

  8. The Water-Quality Partnership for National Parks—U.S. Geological Survey and National Park Service, 1998–2016

    Science.gov (United States)

    Nilles, Mark A.; Penoyer, Pete E; Ludtke, Amy S.; Ellsworth, Alan C.

    2016-07-13

    The U.S. Geological Survey (USGS) and the National Park Service (NPS) work together through the USGS–NPS Water-Quality Partnership to support a broad range of policy and management needs related to high-priority water-quality issues in national parks. The program was initiated in 1998 as part of the Clean Water Action Plan, a Presidential initiative to commemorate the 25th anniversary of the Clean Water Act. Partnership projects are developed jointly by the USGS and the NPS. Studies are conducted by the USGS and findings are used by the NPS to guide policy and management actions aimed at protecting and improving water quality.The National Park Service manages many of our Nation’s most highly valued aquatic systems across the country, including portions of the Great Lakes, ocean and coastal zones, historic canals, reservoirs, large rivers, high-elevation lakes and streams, geysers, springs, and wetlands. So far, the Water-Quality Partnership has undertaken 217 projects in 119 national parks. In each project, USGS studies and assessments (http://water.usgs.gov/nps_partnership/pubs.php) have supported science-based management by the NPS to protect and improve water quality in parks. Some of the current projects are highlighted in the NPS Call to Action Centennial initiative, Crystal Clear, which celebrates national park water-resource efforts to ensure clean water for the next century of park management (http://www.nature.nps.gov/water/crystalclear/).New projects are proposed each year by USGS scientists working in collaboration with NPS staff in specific parks. Project selection is highly competitive, with an average of only eight new projects funded each year out of approximately 75 proposals that are submitted. Since the beginning of the Partnership in 1998, 189 publications detailing project findings have been completed. The 217 studies have been conducted in 119 NPS-administered lands, extending from Denali National Park and Preserve in Alaska to Everglades

  9. Inconsistencies Exist in National Estimates of Eye Care Services Utilization in the United States

    Directory of Open Access Journals (Sweden)

    Fernando A. Wilson

    2015-01-01

    Full Text Available Background. There are limited research and substantial uncertainty about the level of eye care utilization in the United States. Objectives. Our study estimated eye care utilization using, to our knowledge, every known nationally representative, publicly available database with information on office-based optometry or ophthalmology services. Research Design. We analyzed the following national databases to estimate eye care utilization: the Medical Expenditure Panel Survey (MEPS, National Health Interview Survey (NHIS, Joint Canada/US Survey of Health (JCUSH, Behavioral Risk Factor Surveillance System (BRFSS, and the National Ambulatory Medical Care Survey (NAMCS. Subjects. US adults aged 18 and older. Measures. Self-reported utilization of eye care services. Results. The weighted number of adults seeing or talking with any eye doctor ranges from 87.9 million to 99.5 million, and the number of visits annually ranges from 72.9 million to 142.6 million. There were an estimated 17.2 million optometry visits and 55.8 million ophthalmology visits. Conclusions. The definitions and estimates of eye care services vary widely across national databases, leading to substantial differences in national estimates of eye care utilization.

  10. Physiotherapists and General Practitioners attitudes towards 'Physio Direct' phone based musculoskeletal Physiotherapy services: a national survey.

    Science.gov (United States)

    Harland, Nicholas; Blacklidge, Brian

    2017-06-01

    Physiotherapy phone based, "Physio Direct" (PD) musculoskeletal triage and treat services are a relatively new phenomena. This study explored Physiotherapist and GP attitudes towards PD services. Online national survey via cascade e-mail initiated by study leads. 488 Physiotherapists and 68 GPs completed the survey. The survey asked three negatively worded and three positively worded Likert scale questions regarding PD services. It also collected demographic data and more global attitudes including a version of the friends and family test. Overall both Physiotherapists and GP's have positive attitudes towards PD services. There was global agreement that PD triage was a good idea but in both groups the majority of respondents who expressed a definite opinion thought that patients would still eventually need to be seen face to face. The vast majority of all respondents also thought patients should be given a choice about first accessing PD services. Physiotherapists with experience of PD services had more positive and less negative attitudes than those without experience. More detailed results are discussed. Relevant clinical stakeholders have generally positive attitudes towards PD services, but more so when they have experience of them. Counter to research findings significant proportions of respondents believe patients accessing PD services will still need to be seen face to face. The significant majority of respondents believe patients should be given a choice whether they access PD services in the first instance or not. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  11. Service impact of a national clinical leadership development programme: findings from a qualitative study.

    Science.gov (United States)

    Fealy, Gerard M; McNamara, Martin S; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

    2015-04-01

    The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programme's service impact. Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated. © 2013 John Wiley & Sons Ltd.

  12. 12 CFR 7.4003 - Establishment and operation of a remote service unit by a national bank.

    Science.gov (United States)

    2010-01-01

    ...(Seventh). An RSU includes an automated teller machine, automated loan machine, and automated device for... a remote service unit by a national bank. A remote service unit (RSU) is an automated facility...

  13. 75 FR 63516 - Institute of Museum and Library Services; Sunshine Act Meeting of the National Museum and Library...

    Science.gov (United States)

    2010-10-15

    ...: Elizabeth Lyons, Director of Special Events and Board Liaison, Institute of Museum and Library Services... and Library Services, related to museum and library services. If you need special accommodations due... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services...

  14. Why some countries have national health insurance, others have national health services, and the U.S. has neither.

    Science.gov (United States)

    Navarro, V

    1989-01-01

    This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the U.S. has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as 'public choice', 'power group pluralism' and 'post-industrial convergence'. The second section puts forward an alternative explanation rooted in an historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments--the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

  15. National tax regulation, voluntary international standards and the GATS : Argentina – financial services

    NARCIS (Netherlands)

    Delimatsis, Panagiotis; Hoekman, Bernard

    2018-01-01

    Can a WTO Member discriminate against foreign suppliers of services located in jurisdictions that refuse to share information with a government to permit it to determine if its nationals engage in tax evasion? Does it matter if the Member uses standards developed by an international body as the

  16. National Health Insurance, Profitability, and Service Quality: Case Study at the Private Hospital in West Java

    Directory of Open Access Journals (Sweden)

    Andriyani Rahmah Fahriati

    2018-02-01

    Full Text Available National health insurance is one of the government programs to facilitate health services for the people. The purpose of this research to determine whether there are effects of National Health Insurance program (JKN on profitability and service quality at Juanda Kuningan Hospital, of West Java. The method using the paired-t-test to analyze the difference between before and after the National Health Insurance program. The result showed that there is a difference in profitability and service quality between pre and post the implementation of national health insurance program. Gross profit margin measured the profitability, net profit margin, return on total assets, and return on equity. This result means that the value of the company's profitability is better when the program JKN yet takes place in the Juanda hospital. While on the service quality variable it is found that the mean value is higher when the JKN program has conducted at the hospital.DOI: 10.15408/etk.v17i1.7064

  17. 75 FR 27539 - Office of Special Education and Rehabilitative Services: Overview Information: National...

    Science.gov (United States)

    2010-05-17

    ... communication or language preference. Interpreter means individuals, both hearing and deaf, who provide... consumers of vocational rehabilitation (VR) services. The National Center funded under this priority must do.... Competitive Preference Priority: For FY 2010 this priority is a competitive preference priority. Under 34 CFR...

  18. 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.…

  19. Social science in the national park service: an evolving mission and program

    Science.gov (United States)

    Richard H. Briceland

    1992-01-01

    In 1988 the director of the National Park Service requested that a social science program be established. Since that time a number of new research initiatives have been developed to address this need. This paper describes seven major steps taken thus far to meet social science needs of park superintendents, program managers, and park planners. Specific examples are...

  20. 75 FR 51103 - Notice of Public Meetings for the National Park Service (NPS) Alaska Region's Subsistence...

    Science.gov (United States)

    2010-08-18

    ... SRC and Wrangell-St. Elias SRC plan to meet to develop and continue work on National Park Service (NPS... reconvene on Thursday, October 7, 2010, from 9 a.m. to 5 p.m. or until business is completed. This meeting will be held at Fast Eddy's Motel and Restaurant located at Mile 1313 on the Alaska Highway in Tok, AK...

  1. National Strategy for Promotion of Russian Universities in the World Market of Education Services

    Science.gov (United States)

    Mushketova, Natalia; Bydanova, Elizaveta; Rouet, Gilles

    2018-01-01

    Purpose: The export of Russian educational services worldwide was not considered by the Russian Government as a full-fledged economic sector until recently. However, the situation has changed since the early 2000s, when in 2002, the Russian Government approved the national strategy for higher education promotion abroad and since then has been…

  2. Sharing Your National Service Story: A Guide to Working with the Media

    Science.gov (United States)

    Corporation for National and Community Service, 2005

    2005-01-01

    Living in an information age, targeting the news media has become one of the most effective methods used by national service programs for transmitting information to the public. This report describes a strategic approach that can assist public relations departments to determine: (1) Who one's audience is and what their opinions, attitudes, and…

  3. Translating National Level Forest Service Goals to Local Level Land Management: Carbon Sequestration

    Science.gov (United States)

    McNulty, S.; Treasure, E.

    2017-12-01

    The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region and local scale. We chose to use carbon sequestration as the desired future condition because climate change has become a major area of concern during the last decade. Several studies have determined that the 193 million acres of US national forest land currently sequester 11% to 15% of the total carbon emitted as a nation. This paper provides a framework by which national scale strategies for maintaining or enhancing forest carbon sequestration is translated through regional considerations and local constraints in adaptive management practices. Although this framework used the carbon sequestration as a case study, this framework could be used with other national level priorities such as the National Environmental Protection Act (NEPA) or the Endangered Species Act (ESA).

  4. How is feedback from national clinical audits used? Views from English National Health Service trust audit leads.

    Science.gov (United States)

    Taylor, Angelina; Neuburger, Jenny; Walker, Kate; Cromwell, David; Groene, Oliver

    2016-04-01

    To explore how the output of national clinical audits in England is used by professionals and whether and how their impact could be enhanced. A mixed-methods study with the primary recipients of four national clinical audits of cancer care of 607 local audit leads, 274 (45%) completed a questionnaire and 32 participated in an interview. Our questions focused on how the audits were used and whether barriers existed to using the audits for local service improvement. We described variation in questionnaire responses between the audits using chi-squared tests. Results are reported as percentages with their 95% confidence intervals. Qualitative data were analysed using Framework analysis. More than 90% of survey respondents believed that the audit findings were relevant to their clinical work, and interviewees described how they used the audits for a range of purposes. Forty-two percent of survey respondents said they had changed their clinical practice, and 56% had implemented service improvements in response to the audits. The degree of change differed between the four audits, evident in both the questionnaire and the interview data. In the interviews, two recurring barriers emerged: (1) the importance of data quality, which, in turn, influenced the perceived relevance and validity of the audit data and therefore the ability to make changes based on it and (2) the need for clear presentation of benchmarked local performance data. The perceived authority and credibility of the professional bodies supporting the audits was a key factor underpinning the use of the audit findings. National cancer audit and feedback is used to improve services, but their impact could be enhanced by improving the data quality and relevance of feedback. © The Author(s) 2016.

  5. A Case Study - On Patient Empowerment and Integration of Telemedicine to National Healthcare Services

    DEFF Research Database (Denmark)

    Urazimbetova, Surayya

    Patient empowerment in the digitalized healthcare can be supported by means of telemedicine. As opposed to Electronic Patient Records developed by a few large business suppliers for healthcare professionals, telemedical applications include innovative solutions of small-medium size suppliers...... and are targeted at specific groups of patients (e.g., hip operated or dermatology patients) and their care network. Based on an integration experiment we argue that in order to support the national visions for patient empowerment and connectedness of healthcare at the same time, it is necessary to achieve...... the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we...

  6. Engaging and Empowering the National Park Service to apply Earth Observations to Management Decisions

    Science.gov (United States)

    Clayton, A.; Ross, K. W.; Crepps, G.; Childs-Gleason, L. M.; Ruiz, M. L.; Rogers, L.; Allsbrook, K. N.

    2017-12-01

    Since 2015, the NASA DEVELOP National Program has partnered with the National Park Service (NPS) engaging more than 120 program participants, working on over 22 projects across approximately 27 unique park units. These projects examined a variety of cultural and environmental concerns facing the NPS including landscape disturbance, invasive species mapping, archaeological site preservation, and water resources monitoring. DEVELOP, part of NASA's Applied Sciences' Capacity Building program, conducts 10-week feasibility projects which demonstrate the utility of NASA's Earth observations as an additional tool for decision-making processes. This presentation will highlight several of these projects and discuss the progress of capacity building working with individual, regional, and institutional elements within the National Park Service.

  7. Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

    Science.gov (United States)

    O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

    2017-07-01

    Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are

  8. Evaluation of streamflow forecast for the National Water Model of U.S. National Weather Service

    Science.gov (United States)

    Rafieeinasab, A.; McCreight, J. L.; Dugger, A. L.; Gochis, D.; Karsten, L. R.; Zhang, Y.; Cosgrove, B.; Liu, Y.

    2016-12-01

    The National Water Model (NWM), an implementation of the community WRF-Hydro modeling system, is an operational hydrologic forecasting model for the contiguous United States. The model forecasts distributed hydrologic states and fluxes, including soil moisture, snowpack, ET, and ponded water. In particular, the NWM provides streamflow forecasts at more than 2.7 million river reaches for three forecast ranges: short (15 hr), medium (10 days), and long (30 days). In this study, we verify short and medium range streamflow forecasts in the context of the verification of their respective quantitative precipitation forecasts/forcing (QPF), the High Resolution Rapid Refresh (HRRR) and the Global Forecast System (GFS). The streamflow evaluation is performed for summer of 2016 at more than 6,000 USGS gauges. Both individual forecasts and forecast lead times are examined. Selected case studies of extreme events aim to provide insight into the quality of the NWM streamflow forecasts. A goal of this comparison is to address how much streamflow bias originates from precipitation forcing bias. To this end, precipitation verification is performed over the contributing areas above (and between assimilated) USGS gauge locations. Precipitation verification is based on the aggregated, blended StageIV/StageII data as the "reference truth". We summarize the skill of the streamflow forecasts, their skill relative to the QPF, and make recommendations for improving NWM forecast skill.

  9. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

    Science.gov (United States)

    Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

    2009-06-01

    Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

  10. Meeting the Oral Health Needs of Immigrants: National Public Health Services Vs. Charitable Volunteer Services In Rome, Italy

    Directory of Open Access Journals (Sweden)

    Denise Corridore

    2012-03-01

    Full Text Available

    Abstract:
    Background: oral health is an important aspect of well-being. In Italy immigrants can have different access to health care services, and can opt for the national Health Service (nHS and/ or private non- profit health care organizations. The purpose of this study was to develop an instrument to evaluate oral health in the immigrant population of rome and to investigate the differences between two different types of ser- vices: the First observation unit at the department of oral and Maxillo Facial Sciences, at the "Sapienza" university of rome (a nHS affiliate, and a charitable organization, the caritas dental center (cdc.
    Methods: a multiple-choice questionnaire was administered between the last trimester of 2006 and the first trimester of 2007. a chi square analysis was performed and the level of significance was set at p<0.05. reSulTS: The sample was composed of 250 people, of which 100 were patients of the cdc and 150 were patients of the nHS. The percentage of non-Italians was 80% (n=80 in the cdc sample, and only 16% (n=25 in the nHS sample. In the cdc, definitive resolving therapies, such as tooth extractions, prevailed (60% v’s 47% nHS; p=0.033. In addition, the frequency of consumption of sugary foods and drinks was significantly higher among cdc patients (31% reported to consume these over 9 times a day compared to nHS patients (11% reporting this consumption.
    Discussion: the study shows a substantial under using of the national Health Service for oral health care needs by the immigrant population. The particular composition of the sample, with a high prevalence being of romanian nationality, might reflect specific conditions of this nationality. The results showed that immigrants were satisfied with the health care even though they encountered difficulties in terms of level of communication.

  11. Privatization of Electricity Service Delivery in Developing Nations: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Olamide Eniola Victor

    2015-09-01

    Full Text Available The provision of public utilities and infrastructures particularly electricity by the public sector (Government especially in the Developing Nations has been heavily criticized. This has been attributed to many reasons including poor electricity supply, poor distribution of service delivery of electricity due to the absence of spatial planning, insufficient government investment into the power industry, ineptitude operation on the part of the technicians, poor administration and managerial control. However, efforts to move away from government ownership, control or participation in this sector of economy towards free enterprise and increased inclusive private sector participation known as privatization, has been adopted as one of the solutions. This paper presents a critical review of privatization practices of alternative Service Delivery approach of selected Asian and African nations. The paper would elicit the common variants of privatization models adopted by these nations and the different implementation strategies which resulted in divergence in effectiveness and efficiency in the service delivery of electricity. The selected Asian countries are; Malaysia, India, and China, while the selected African nations are Nigeria, Cameroun and South Africa. The paper will draw from the literatures the various approaches, concepts adopted, practices, issues and challenges faced by these countries.

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

    Science.gov (United States)

    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.

  13. State institutions and social identity: National representation in soldiers' and civilians' interview talk concerning military service.

    Science.gov (United States)

    Gibson, Stephen; Condor, Susan

    2009-06-01

    Theory and research deriving from social identity or self-categorization perspectives often starts out with the presumption that social actors necessarily view societal objects such as nations or states as human categories. However, recent work suggests that this may be only one of a number of forms that societal representation may take. For example, nations may be understood variously as peoples, places, or institutions. This paper presents findings from a qualitative interview study conducted in England, in which soldiers and civilians talked about nationhood in relation to military service. Analysis indicated that, in this context, speakers were often inclined to use the terms 'Britain', 'nation', and 'country' as references to a political institution as opposed to a category of people. In addition, there were systematic differences between the ways in which the two samples construed their nation in institutional terms. The civilians were inclined to treat military service as a matter of obedience to the dictates of the Government of the day. In contrast, the soldiers were more inclined to frame military service as a matter of loyalty to state as symbolically instantiated in the body of the sovereign. Implications for work adopting a social identity perspective are discussed.

  14. The Third National Telemedicine & Telehealth Service Provider Showcase Conference: Advancing Telehealth Partnerships.

    Science.gov (United States)

    Alverson, Dale C; Krupinski, Elizabeth A; Erps, Kristine A; Rowe, Nancy S; Weinstein, Ronald S

    2018-05-31

    As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned. The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical. SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.

  15. Congregations and Social Services: An Update from the Third Wave of the National Congregations Study

    Directory of Open Access Journals (Sweden)

    Mark Chaves

    2016-05-01

    Full Text Available Congregations and other religious organizations are an important part of the social welfare system in the United States. This article uses data from the 2012 National Congregations Study to describe key features of congregational involvement in social service programs and projects. Most congregations (83%, containing 92% of religious service attendees, engage in some social or human service activities intended to help people outside of their congregation. These programs are primarily oriented to food, health, clothing, and housing provision, with less involvement in some of the more intense and long-term interventions such as drug abuse recovery, prison programs, or immigrant services. The median congregation involved in social services spent $1500 per year directly on these programs, and 17% had a staff member who worked on them at least a quarter of the time. Fewer than 2% of congregations received any government financial support of their social service programs and projects within the past year; only 5% had applied for such funding. The typical, and probably most important, way in which congregations pursue social service activity is by providing small groups of volunteers to engage in well-defined and bounded tasks on a periodic basis, most often in collaboration with other congregations and community organizations.

  16. Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

    Science.gov (United States)

    Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

    2017-04-01

    Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

  17. Institutional authorisation and accreditation of Transfusion Services and Blood Donation Sites: results of a national survey

    Science.gov (United States)

    Liumbruno, Giancarlo Maria; Panetta, Valentina; Bonini, Rosaria; Chianese, Rosa; Fiorin, Francesco; Lupi, Maria Antonietta; Tomasini, Ivana; Grazzini, Giuliano

    2011-01-01

    Introduction The aim of the survey described in this article was to determine decisional and strategic factors useful for redefining minimum structural, technological and organisational requisites for transfusion structures, as well as for the production of guidelines for accreditation of transfusion structures by the National Blood Centre. Materials and methods A structured questionnaire containing 65 questions was sent to all Transfusion Services in Italy. The questions covered: management of the quality system, accreditation, conformity with professional standards, structural and technological requisites, as well as potential to supply transfusion medicine-related health care services. All the questionnaires returned underwent statistical analysis. Results Replies were received from 64.7% of the Transfusion Services. Thirty-nine percent of these had an ISO 9001 certificate, with marked differences according to geographical location; location-related differences were also present for responses to other questions and were confirmed by multivariate statistical analysis. Over half of the Transfusion Services (53.6%) had blood donation sites run by donor associations. The statistical analysis revealed only one statistically significant difference between these donation sites: those connected to certified Transfusion Services were more likely themselves to have ISO 9001 certification than those connected to services who did not have such certification. Conclusions The data collected in this survey are representative of the Italian national transfusion system. A re-definition of the authorisation and accreditation requisites for transfusion activities must take into account European and national legislation when determining these requisites in order to facilitate their effective applicability, promote their efficient fulfilment and enhance the development of homogeneous and transparent quality systems. PMID:21839026

  18. Next-generation services for e-traceability to ionizing radiation national standards

    International Nuclear Information System (INIS)

    Desrosiers, M.F.; Klemick, Mark; Puhl, J.M.; Uchida, David; Mallis, Steven

    2004-01-01

    An Internet-based system for fast, remote certification of high-dose radiation sources against the US national standard is being constructed at the National Institute of Standards and Technology (NIST). The new service will establish traceability (through transfer dosimetry) in real time at a lower cost by using automated routines and the Internet. A prototype of this service was successfully demonstrated in 2000 at the American Society for Testing and Materials (ASTM) Dosimetry Workshop in San Diego. Despite this impressive accomplishment, new developments demanded that several aspects of the service be modified. The new service has been completely redesigned to address these new demands and ensure greater accessibility. A description of the hardware and software configurations of this service as well as the communication and information management aspects will be presented. The Internet-based transfer certification program will provide industry with 24-h, 7-day-per-week, on-demand certifications, immediate turnaround times, and lower cost, ultimately improving the quality of the manufacturing process

  19. Next-generation services for e-traceability to ionizing radiation national standards

    Science.gov (United States)

    Desrosiers, Marc F.; Klemick, Mark; Puhl, James M.; Uchida, David; Mallis, Steven

    2004-09-01

    An Internet-based system for fast, remote certification of high-dose radiation sources against the US national standard is being constructed at the National Institute of Standards and Technology (NIST). The new service will establish traceability (through transfer dosimetry) in real time at a lower cost by using automated routines and the Internet. A prototype of this service was successfully demonstrated in 2000 at the American Society for Testing and Materials (ASTM) Dosimetry Workshop in San Diego. Despite this impressive accomplishment, new developments demanded that several aspects of the service be modified. The new service has been completely redesigned to address these new demands and ensure greater accessibility. A description of the hardware and software configurations of this service as well as the communication and information management aspects will be presented. The Internet-based transfer certification program will provide industry with 24-h, 7-day-per-week, on-demand certifications, immediate turnaround times, and lower cost, ultimately improving the quality of the manufacturing process.

  20. The application of epidemiology in national veterinary services: Challenges and threats in Brazil.

    Science.gov (United States)

    Gonçalves, Vitor Salvador Picão; de Moraes, Geraldo Marcos

    2017-02-01

    The application of epidemiology in national veterinary services must take place at the interface between science and politics. Animal health policy development and implementation require attention to macro-epidemiology, the study of economic, social and policy inputs that affect the distribution and impact of animal or human disease at the national level. The world has changed fast over the last three decades including the delivery of veterinary services, their remit and the challenges addressed by public and animal health policies. Rethinking the role of public services and how to make public programs more efficient has been at the heart of the political discussion. The WTO through its SPS Agreement has changed the way in which national veterinary services operate and how trade decisions are made. Most low and middle income countries are still struggling to keep up with the new international scene. Some of these countries, such as Brazil, have very important livestock industries and are key to the global food systems. Over the last two decades, Brazil became a leading player in exports of livestock products, including poultry, and this created a strong pressure on the national veterinary services to respond to trade demands, leading to focus animal health policies on the export-driven sector. During the same period, Brazil has gone a long way in the direction of integrating epidemiology with veterinary services. Epidemiology groups grew at main universities and have been working with government to provide support to animal health policy. The scope and quality of the applied epidemiological work improved and focused on complex data analysis and development of technologies and tools to solve specific disease problems. Many public veterinary officers were trained in modern epidemiological methods. However, there are important institutional bottlenecks that limit the impact of epidemiology in evidence-based decision making. More complex challenges require high levels

  1. The World Report on Disability as a blueprint for international, national, and local aphasia services.

    Science.gov (United States)

    Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia

    2013-02-01

    This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.

  2. Going the distance: Service delivery for the Danish National swimming team during the Olympics

    DEFF Research Database (Denmark)

    Larsen, Carsten Hvid

    In this presentation I will outline the service delivery for the Danish National swimming team and provide an example of my work based on mindfulness and acceptance and commitment therapy (ACT) with an individual swimmer during the Olympics. Being part of the Olympics involves a range of stressors...... and distractions such as a tight packed swimming schedule (up to 12 starts across seven days), a lot of media attention, social media, others and own expectations. In my service delivery during the Olympics I tried to create an awareness of these stressors and distractions. On a normal day at the Olympics I had...

  3. Quality control and quality assurance philosophy introduced in national personnel dosimetry service

    International Nuclear Information System (INIS)

    Trousil, J.; Zelenka, Z.; Kvasnicka, O.

    2008-01-01

    There in National Personnel Dosimetry Service (NPDS) the implementation of the control system to guarantee the credibility of the measured personal dose equivalents results was given on the basis of the international recommendations published by the European Commission and the IAEA and in particular of the decree of the SUJB No. 132/2008 Coll. The quality control and the quality assurance are carried out in all three personal dosimetry services introduced in NPDS: in the film badge, thermoluminescent (TL) and neutron dosimetry. (authors)

  4. 75 FR 57978 - Notice of Intent; Request for Comments on Adoption of the National Park Service's Wetland and...

    Science.gov (United States)

    2010-09-23

    ... Code: 7B] Notice of Intent; Request for Comments on Adoption of the National Park Service's Wetland and... adopt the National Park Service's (NPS) existing final environmental impact statement/environmental... (CSCC) to assist with implementing restoration activities that have been identified and reviewed under...

  5. 76 FR 43718 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National...

    Science.gov (United States)

    2011-07-21

    ... Reservation, New Mexico (hereinafter referred to as ``The Tribes''). History and Description of the Remains... History, Chicago, IL AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture, Forest Service, Gila National Forest and the Field Museum of Natural History have...

  6. The National Health Service (NHS) at 70: Bevan's double-edged legacy.

    Science.gov (United States)

    Klein, Rudolf

    2018-01-08

    The paper analyses the achievements and problems stemming from Nye Bevan's model of a tax funded national health care system, on the assumption that only so could equity be achieved. The evidence shows that indeed the National Health Service (NHS) scores highly on equity, so vindicating Bevan's vision. The price paid is that fiscal crises are the norm for the NHS, with ever more centralisation, intensive regulation and performance management. Successive reorganisations represent attempts to square the circle - to combine the strengths of Bevan's model and those of a less hierarchic system - but have so far failed to deliver and can be expected to continue.

  7. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Golden Gate National Recreation Area

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Schey; Jim Francfort

    2014-03-01

    Battelle Energy Alliance, LLC, managing and operating contractor for the U.S. Department of Energy's Idaho National Laboratory, is the lead laboratory for U.S. Department of Energy Advanced Vehicle Testing. Battelle Energy Alliance, LLC contracted with Intertek Testing Services, North America (ITSNA) to collect data on federal fleet operations as part of the Advanced Vehicle Testing Activity's Federal Fleet Vehicle Data Logging and Characterization study. The Advanced Vehicle Testing Activity study seeks to collect data to validate the utilization of advanced electric drive vehicle transportation. This report focuses on the Golden Gate National Recreation Area (GGNRA) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of plug-in electric vehicles (PEVs) into the agencies' fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (PHEV) (collectively PEVs) can fulfill the mission requirements. GGNRA identified 182 vehicles in its fleet, which are under the management of the U.S. General Services Administration. Fleet vehicle mission categories are defined in Section 4, and while the GGNRA vehicles conduct many different missions, only two (i.e., support and law enforcement missions) were selected by agency management to be part of this fleet evaluation. The selected vehicles included sedans, trucks, and sport-utility vehicles. This report will show that battery electric vehicles and/or PHEVs are capable of performing the required missions and providing an alternative vehicle for support vehicles and PHEVs provide the same for law enforcement, because each has a sufficient range for individual trips and time is available each day for charging to accommodate multiple trips per day. These

  8. Questioning the Role of the Indian Administrative Service in National Integration

    Directory of Open Access Journals (Sweden)

    Dalal Benbabaali

    2008-09-01

    Full Text Available After Independence, the Indian Administrative Service was expected to promote national integration, from a social as well as a spatial point of view. Yet, despite the reservation policy, this elite body lacks representativeness. The partisanship of IAS officers along caste, religious and ethnic lines has further reduced their efficiency as a binding force of the nation. Being an All-India Service, the IAS encourages the spatial mobility of its members, which is not always welcome by officers posted in far-off states or in disturbed areas. In these places, the vacancy of postings in the higher administration is a sign of desertion that is contrary to the IAS mission of territorial integration.

  9. 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

  10. Logistics of national radioimmunoassay services and radioimmunoassay trouble shooting in developing countries

    International Nuclear Information System (INIS)

    Hazra, D.K.; Shukla, A.K.; Arvind, B.; Khandelwal, S.; Singh, R.; Lahiri, V.L.

    1986-01-01

    The logistics of national radioimmunoassay services are analysed in regard to: applications of immunoassays in developing countries; provision of matched reagents; collection, storage and transport of patient samples, particularly from rural areas; development of robust new immunoassay systems, especially those using non-isotopic labels; quality control; and interrelation with international agencies and commercial suppliers. The effect of using different methods and temperatures of sample storage on representative glycoprotein, steroid, thyroid and communicable disease analytes is examined. The need for stratification of assay services (district, state and national/regional levels) for various tests is discussed in relation to their clinical urgency. A trouble shooting guide suited to developing countries has been written. Starting from various symptoms of assay failure, it describes the differential diagnosis of likely causes, lists appropriate tests to confirm the diagnosis and finally suggests remedial action to prevent future similar mishaps or to salvage the assay. (author)

  11. [The strategic purchasing of health services: a big opportunity for the National Universal Health System].

    Science.gov (United States)

    González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

    2015-01-01

    proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  14. Accuracy of National Weather Service wind-direction forecasts at Macon and Augusta, Georgia

    Science.gov (United States)

    Leonidas G. Lavdas

    1997-01-01

    National Weather Service wind forecasts and observations over a nine-year period (1985 to 1993) were analyzed to determine the usefulness of these forecasts for forestry smoke management. Data from Macon, GA indicated that forecasts were accurate to within plus or minus 22.5E about 38 percent of the time. When a wider plus or minus 67.5E window was used, accuracy...

  15. The International Time Service of the National Geographic Institute (IGNA Laboratory) Argentina

    Science.gov (United States)

    Gómez, D.; Cimbaro, S.

    2014-06-01

    The "International Time Service" (Servicio Internacional de la Hora, SIH) at the Instituto Geográfico National Argentino (IGNA, formerly Instituto Geográfico Militar Argentino, IGMA), has contributed to the maintenance of the international time scale since its creation in 1931. In 2010 the IGNA started a process of upgrading its time laboratory with the objective of improving its contribution to the computation of the international reference time scales at the International Bureau of Weights and Measures (BIPM).

  16. 75 FR 2144 - Public Buildings Service; Submission for OMB Review; Art-in-Architecture Program National Artist...

    Science.gov (United States)

    2010-01-14

    ... GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0274] Public Buildings Service; Submission for OMB Review; Art-in- Architecture Program National Artist Registry AGENCY: Public Buildings Service... in 2000 when a renewed focus on commissioning works of art that are an integral part of the building...

  17. A case for increased private sector involvement in Ireland's national animal health services.

    Science.gov (United States)

    More, Simon J

    2008-02-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands).

  18. A case for increased private sector involvement in ireland's national animal health services

    Directory of Open Access Journals (Sweden)

    More Simon J

    2008-02-01

    Full Text Available Abstract Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia. The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands.

  19. The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

    Science.gov (United States)

    Leggio, William Joseph

    2014-10-01

    This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

  20. INTERVIEW: Knowledge and Terminology Management at the Danish National Board of Social Services

    DEFF Research Database (Denmark)

    Møller, Margrethe H.; Toft, Birthe

    2012-01-01

    Abstract Margrethe H. Møller interviews David Rosendahl (translator/coauthor: Birthe Toft) “We need to do more than simply create classifications” The concept secretariat of the Danish National Board of Social Services carries out terminology and classification work in connection with IT projects......, among others, in the field of social services. This work is interesting for several reasons. On the one hand, terminology work obviously contributes to enhanced efficiency and transparency from the points of view of all types of users. On the other hand, some social services professionals are skeptical...... vis-à-vis the terminology projects because they fear unification and standardization of their professionalism and working procedures in connection with the introduction of new IT systems. And finally, a number of ethical issues have to be taken into consideration when deciding on terminology...

  1. Remote access to information sources in National and university library: development of service

    Directory of Open Access Journals (Sweden)

    Gorazd Vodeb

    2006-01-01

    Full Text Available National and University Library established remote access to information sources in september 2004. The article describes implementation and development of the service. Library wanted to offer information sources to users wherever and whenever they would need them. First main evaluation criteria for software selection were integration with existing authentication system and second no need for intervention user side. The EZproxy software from Useful Utilities was chosen. Key step to implementation was establishing communication between software applications EZproxy and COBISS library automation system. Library needed to obtain licence agreements from publishers. Promotion campaign aimed to notify large number of users. Only users of National & University Library were able to use the service. Other users and libraries of Ljubljana University requested to authenticate by credentials of their library. Remote access service was developed further in order to enable authentication for other libraries. We needed to establish authentication and authorisation system and also upgrade and install the communication command procedure on different servers. The data about service usage are presented.

  2. National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

    Science.gov (United States)

    Checkland, Kath

    2004-11-01

    This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

  3. Designing and implementing E-health Applications in the UK's National Health Service.

    Science.gov (United States)

    Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

    2005-12-01

    Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

  4. Pharmacy customers' experiences with the national online service for viewing electronic prescriptions in Finland.

    Science.gov (United States)

    Lämsä, Elina; Timonen, Johanna; Mäntyselkä, Pekka; Ahonen, Riitta

    2017-01-01

    To investigate (1) Finnish pharmacy customers' familiarity with My Kanta, the national online service for viewing electronic prescriptions (ePrescriptions), (2) how commonly My Kanta is used, (3) who the typical users are, and (4) users' experiences of the usability of My Kanta. A survey was conducted among pharmacy customers (aged ≥18) purchasing medicines for themselves. Questionnaires (N=2915) were distributed from 18 community pharmacies across Finland in autumn 2015. The data obtained was stored in SPSS for Windows and subjected to descriptive analysis, chi-square tests and logistic regression analysis. In total, 1288 respondents were included (response rate 44%). Most (62%) of the customers were familiar with My Kanta. The majority of them (78%) were using it to view their ePrescriptions. My Kanta was perceived as clear, easy to use and to provide a good overall picture of the prescribed medications. Familiarity with My Kanta was associated with a higher education than basic school, regular use of prescription medicines, and sufficient information received about ePrescriptions. Men used My Kanta more often than women. Respondents aged 75 or older were less likely to be familiar with and to use the service compared to 18-34year olds. Most of the Finnish pharmacy customers were familiar with the national online service, My Kanta, for viewing ePrescriptions. Service users perceived it as easy to use and beneficial in managing their overall medication. Customers under 75, those educated beyond basic school, those using prescription medicines regularly, and those who had obtained sufficient information about ePrescriptions were most likely to be familiar with My Kanta. Men and customers under 75 were the typical users of the service. Some customers, however, were unaware of the service, or unable or reluctant to use it. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Preliminary results of a national quality audit programme in radiotherapy services in Cuba

    International Nuclear Information System (INIS)

    Dominguez Hung, L.; Larrinaga Cortina, E.F.; Campa Menendez, R.; Morales Lopez, J.L.; Garcia Yip, A.F.

    2001-01-01

    The current state of radiotherapy in Cuba has allowed to pass to a superior stage in the process of quality assurance, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices, as national regulator entity for the control and supervision of the medical devices of the National Health System, is responsible for the implementation of this program. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of 60 Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audited, such as: the installation and unit's safety, mechanical and dosimetric aspects of the treatment unit and organizational aspects of the institution quality assurance program. Also carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institutions' program of quality assurance and a feedback for the setting about to the PNAC. (author)

  6. Preliminary results of a national quality audit programme in radiotherapy services in Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez Hung, L; Larrinaga Cortina, E F [Centro de Control Estatal de Equipos Medicos, Havana (Cuba); Campa Menendez, R [Centro de Proteccion e Higiene de las Radiaciones, Havana (Cuba); Morales Lopez, J L; Garcia Yip, A F [Instituto Nacional de Oncologia y Radiobiologia, Havana (Cuba)

    2001-03-01

    The current state of radiotherapy in Cuba has allowed to pass to a superior stage in the process of quality assurance, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices, as national regulator entity for the control and supervision of the medical devices of the National Health System, is responsible for the implementation of this program. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of {sup 60}Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audited, such as: the installation and unit's safety, mechanical and dosimetric aspects of the treatment unit and organizational aspects of the institution quality assurance program. Also carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institutions' program of quality assurance and a feedback for the setting about to the PNAC. (author)

  7. The National Youth Service Corps Programme and Growing Security Threat in Nigeria

    Directory of Open Access Journals (Sweden)

    Chukwuemeka Okafor

    2014-06-01

    Full Text Available The National Youth Service Corps (NYSC was established in 1973 after the Nigerian civil war to involve Nigerian university graduates below the age of thirty in nation building. Gradually, the scheme was opened-up for polytechnic graduates.  The article presents the objectives and deployment policy of the programme. It shows that the early phase of the programme recorded the problems of corruption, ghost corps members, accommodation, language barriers as well as hostile culture. However, the contemporary Nigerian society has been overtaken by the destructive wind of insecurity. The article reveals that the various waves of political violence in the country, including Boko Haram terrorism, hostage crises, and geographical threats have turned into a collection of overwhelming menace to the programme, thereby leading to massive agitation for itabrogation. The article recommends for multiple series of reforms in order to protect the lives of many Nigerian graduates that are building the nation through this admirable development programme.

  8. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Fort Vancouver National Historic Site

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Schey; Jim Francfort

    2014-03-01

    Battelle Energy Alliance, LLC, managing and operating contractor for the U.S. Department of Energy’s Idaho National Laboratory, is the lead laboratory for the U.S. Department of Energy’s Advanced Vehicle Testing. Battelle Energy Alliance, LLC contracted with Intertek Testing Services, North America (ITSNA) to collect data on federal fleet operations as part of the Advanced Vehicle Testing Activity’s Federal Fleet Vehicle Data Logging and Characterization study. The Advanced Vehicle Testing Activity study seeks to collect data to validate the use of advanced electric drive vehicle transportation. This report focuses on the Fort Vancouver National Historic Site (FVNHS) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of electric vehicles (EVs) into the agencies’ fleet. Individual observations of the selected vehicles provided the basis for recommendations related to EV adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles) could fulfill the mission requirements. FVNHS identified three vehicles in its fleet for consideration. While the FVNHS vehicles conduct many different missions, only two (i.e., support and pool missions) were selected by agency management to be part of this fleet evaluation. The logged vehicles included a pickup truck and a minivan. This report will show that BEVs and PHEVs are capable of performing the required missions and providing an alternative vehicle for both mission categories, because each has sufficient range for individual trips and time available each day for charging to accommodate multiple trips per day. These charging events could occur at the vehicle’s home base, high-use work areas, or in intermediate areas along routes that the vehicles frequently travel. Replacement of vehicles in the current fleet would result in

  9. Projected national impact of colorectal cancer screening on clinical and economic outcomes and health services demand.

    Science.gov (United States)

    Ladabaum, Uri; Song, Kenneth

    2005-10-01

    Colorectal cancer (CRC) screening is effective and cost-effective, but the potential national impact of widespread screening is uncertain. It is controversial whether screening colonoscopy can be offered widely and how emerging tests may impact health services demand. Our aim was to produce integrated, comprehensive estimates of the impact of widespread screening on national clinical and economic outcomes and health services demand. We used a Markov model and census data to estimate the national consequences of screening 75% of the US population with conventional and emerging strategies. Screening decreased CRC incidence by 17%-54% to as few as 66,000 cases per year and CRC mortality by 28%-60% to as few as 23,000 deaths per year. With no screening, total annual national CRC-related expenditures were 8.4 US billion dollars. With screening, expenditures for CRC care decreased by 1.5-4.4 US billion dollars but total expenditures increased to 9.2-15.4 US billion dollars. Screening colonoscopy every 10 years required 8.1 million colonoscopies per year including surveillance, with other strategies requiring 17%-58% as many colonoscopies. With improved screening uptake, total colonoscopy demand increased in general, even assuming substantial use of virtual colonoscopy. Despite savings in CRC care, widespread screening is unlikely to be cost saving and may increase national expenditures by 0.8-2.8 US billion dollars per year with conventional tests. The current national endoscopic capacity, as recently estimated, may be adequate to support widespread use of screening colonoscopy in the steady state. The impact of emerging tests on colonoscopy demand will depend on the extent to which they replace screening colonoscopy or increase screening uptake in the population.

  10. Siblings' coping strategies and mental health services: a national study of siblings of persons with schizophrenia.

    Science.gov (United States)

    Friedrich, Rose Marie; Lively, Sonja; Rubenstein, Linda M

    2008-03-01

    This study examined the helpfulness of coping strategies and the relative importance of mental health services in coping with schizophrenia from the perspective of siblings. This article presents selected survey data from a national study of 746 respondents that investigated the impact of schizophrenia on siblings' lives. The authors developed the Friedrich-Lively Instrument to Assess the Impact of Schizophrenia on Siblings (FLIISS), a closed-ended questionnaire that included questions about coping strategies and mental health services. Respondents identified services for the ill sibling, including symptom control, adequate housing, and long-term planning, as more important than direct services for themselves. The top-ranked coping strategies were education about schizophrenia, a supportive family, and seeing the ill sibling suffer less because symptoms were controlled. Understanding that families were not to blame for schizophrenia was the most helpful coping strategy for nearly three-fourths of siblings. Siblings had little contact with providers in the past; yet the majority of siblings wanted providers to be available to answer questions and clarify their role in future care. At the time of the study, respondents provided social support and helped with crises, but few coordinated the total care. Siblings identified multiple ways that providers can support and assist them in coping with the impact of schizophrenia. Education and support for siblings without schizophrenia and services for their ill siblings will become increasingly important for the well-being of siblings as they are faced with the responsibility of being the primary caregivers in the future.

  11. An in-house alternative to traditional SDI services at Argonne National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Noel, R.E.; Dominiak, R.R.

    1997-02-20

    Selective Dissemination of Information (SDIs) are based on automated, well-defined programs that regularly produce precise, relevant bibliographic information. Librarians have typically turned to information vendors such as Dialog or STN international to design and implement these searches for their users in business, academia, and the science community. Because Argonne National Laboratory (ANL) purchases the Institute for Scientific Information (ISI) Current Contents tapes (all subject areas excluding Humanities). ANL scientists enjoy the benefit of in-house developments with BASISplus software programming and no longer need to turn to outside companies for reliable SDI service. The database and its customized services are known as ACCESS (Argonne Current Contents Electronic Search Service). Through collaboration with librarians on Boolean logic and selection of terms, users can now design their own personal profiles to comb the new data, thereby avoiding service fees from outside providers. Based on the feedback from scientists, it seems that this new service can help transform the ANL distributed libraries into more efficient central functioning entities that better serve the users. One goal is to eliminate the routing of paper copies of many new journal issues to different library locations for users to browse; instead users may be expected to rely more on electronic dissemination of both table of contents and customized SDIs for new scientific and technical information.

  12. Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

    Science.gov (United States)

    Fennelly, Orna; Blake, Catherine; FitzGerald, Oliver; Breen, Roisin; Ashton, Jennifer; Brennan, Aisling; Caffrey, Aoife; Desmeules, François; Cunningham, Caitriona

    2018-06-01

    Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services. Throughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs. In one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year. This national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.

  13. In Pursuit of a Multi-lateral Dialogue - the Swiss National Centre for Climate Services (NCCS)

    Science.gov (United States)

    Michiko Hama, Angela; Croci-Maspoli, Mischa; Liniger, Mark; Schwierz, Cornelia; Stöckli, Reto; Fischer, Andreas; Gubler, Stefanie; Kotlarski, Sven; Rossa, Andrea; Zubler, Elias; Appenzeller, Christof

    2017-04-01

    Kick-starting, fostering and maintaining a dialogue between primarily public and academic actors involved in the co-design, co-delivery and use of climate services is at the core of Switzerland's National Centre for Climate Services (NCCS), which was founded in late 2015 in recognition of the Global Framework for Climate Services (GFCS). This coordination and innovation mechanism is a concerted national effort comprised of seven Federal Agencies and Institutes and further partners from academia committed to implementing the Framework at national to subnational level and creating synergies the world over. The NCCS is to be regarded as vital alongside the Swiss National Adaptation Strategy, and it also contributes to putting words into action with respect to the UN's Sustainable Development Goals, the UNFCCC and the Sendai Framework for Disaster Risk Reduction. The services of the Centre provide information to support policy-makers from national to local level as well as the private sector and society at large in minimising their risks, maximising opportunities and optimising costs in the context of climate change and variability. They are indispensable for setting effective mitigation and adaptation measures and for instigating societal transformation. Hence, the goals of the NCCS are to bundle the existing climate services of the Swiss Federation, co-create new tailored solutions with users, act as a network agent and knowledge broker - to boost climate literacy and enable climate-sensitive decision-making leading to increased resilience. The services reflect the specificities and requirements of the Alpine region and its particular challenges and vulnerabilities. Pursuing a participatory approach, the NCCS has brought together essential key players, acted as a sounding board for governmental stakeholders and their needs, and accordingly defined and populated six priority themes in line with the priority areas of the GFCS. These themes are: natural hazards, health

  14. The National Oceanic and Atmospheric Administration (NOAA) Climate Services Portal: A New Centralized Resource for Distributed Climate Information

    Science.gov (United States)

    Burroughs, J.; Baldwin, R.; Herring, D.; Lott, N.; Boyd, J.; Handel, S.; Niepold, F.; Shea, E.

    2010-09-01

    With the rapid rise in the development of Web technologies and climate services across NOAA, there has been an increasing need for greater collaboration regarding NOAA's online climate services. The drivers include the need to enhance NOAA's Web presence in response to customer requirements, emerging needs for improved decision-making capabilities across all sectors of society facing impacts from climate variability and change, and the importance of leveraging climate data and services to support research and public education. To address these needs, NOAA (during fiscal year 2009) embarked upon an ambitious program to develop a NOAA Climate Services Portal (NCS Portal). Four NOAA offices are leading the effort: 1) the NOAA Climate Program Office (CPO), 2) the National Ocean Service's Coastal Services Center (CSC), 3) the National Weather Service's Climate Prediction Center (CPC), and 4) the National Environmental Satellite, Data, and Information Service's (NESDIS) National Climatic Data Center (NCDC). Other offices and programs are also contributing in many ways to the effort. A prototype NCS Portal is being placed online for public access in January 2010, http://www.climate.gov. This website only scratches the surface of the many climate services across NOAA, but this effort, via direct user engagement, will gradually expand the scope and breadth of the NCS Portal to greatly enhance the accessibility and usefulness of NOAA's climate data and services.

  15. Establishment of the Auditing National Service of quality to the instrumentation of Nuclear medicine in Cuba

    International Nuclear Information System (INIS)

    Varela C, C.; Diaz B, M.; Lopez B, G.M.; Torres A, L.A.; Coca P, M.A.

    2006-01-01

    Next to the vertiginous development of the technology in the Nuclear Medicine field, the possibility of early diagnosis of pathological processes without anatomical alterations, as well as its application with therapeutic purposes in the cancer treatment has grown. To assure a diagnosis and adapted therapy, it is vital to establish quality guarantee programs to the instrumentation. The State Medical Equipment Control Center (CCEEM), as regulator organ attributed to the Public Health Ministry of Cuba, it has licensed the Service of Quality Audits to the Nuclear medicine services, fulfilling all the technical and legal requirements to such effect. As base of these, the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine has been implemented, put out in vigour 2 national regulations, and an inter-institutional and multidisciplinary auditor equipment has been licensed. The different followed steps, as well as the realization of the first quality audits, its show not only a better execution of the tests and bigger professionalism of the involved specialists, but an increment in the taking of conscience to apply adequately the quality concepts for achieving a better service to the patient. On the other hand, the necessity of incorporating the clinical aspects to the audits, fomenting an integral harmonized advance of the quality guarantee programs is evidenced. (Author)

  16. Getting out what we put in: productivity of the English National Health Service.

    Science.gov (United States)

    Castelli, Adriana; Laudicella, Mauro; Street, Andrew; Ward, Padraic

    2011-07-01

    Many countries are incorporating direct measures of non-market outputs in the national accounts. For any particular output to be included there has to be data about it for two adjacent periods. This is problematic because the classification of non-market outputs is often subject to wholesale revision. We outline the challenges associated with classification changes and propose a solution. To illustrate we construct output and input indices and estimate productivity growth of the English National Health Service (NHS) for the period 2003-2004 to 2007-2008. Our index of output growth incorporates all care provided to NHS patients and captures improvements in survival rates, waiting times and disease management. We find that more patients are being treated and the quality of the care they receive has been improving. We implement our approach to dealing with changes as to how health services are defined and show what effect this has on estimates of output growth. Our index of input growth captures all labour, intermediate and capital inputs into health service production and we improve on how capital has been measured in the past. Inputs have increased over time but there has also been a slowdown since 2005-2006, primarily the result of a levelling off in staff recruitment and less reliance on the use of agency staff. Productivity is assessed by comparing output growth with growth in inputs, the net effect being constant productivity growth between 2003-2004 and 2007-2008.

  17. Mapping outdoor recreationists' perceived social values for ecosystem services at Hinchinbrook Island National Park, Australia

    Science.gov (United States)

    van Riper, Carena J.; Kyle, Gerard T.; Sutton, Stephen G.; Barnes, Melinda; Sherrouse, Benson C.

    2012-01-01

    Coastal ecosystems are increasingly faced with human impacts. To better understand these changing conditions, biophysical and economic values of nature have been used to prioritize spatial planning efforts and ecosystem-based management of human activities. Less is known, however, about how to characterize and represent non-material values in decision-making. We collected on-site and mailback survey data (n = 209), and analyzed these data using the Social Values for Ecosystem Services (SolVES) GIS application to incorporate measures of social value and natural resource conditions on Hinchinbrook Island National Park, Australia. Our objectives in this paper are to: 1) determine the spatial distribution and point density of social values for ecosystem services; 2) examine the relationship between social values and natural resource conditions; and 3) compare social value allocations between two subgroups of outdoor recreationists. Results suggest that high priority areas exist on Hinchinbrook's land and seascapes according to the multiple values assigned to places by outdoor recreationists engaged in consumptive (e.g., fishing) and non-consumptive (e.g., hiking) activities. We examine statistically significant spatial clustering across two subgroups of the survey population for three value types that reflect Recreation, Biological Diversity, and Aesthetic qualities. The relationship between the relative importance of social values for ecosystem services and spatially-defined ecological data is explored to guide management decision-making in the context of an island national park setting.

  18. Construction and Application of a National Data-Sharing Service Network of Material Environmental Corrosion

    Directory of Open Access Journals (Sweden)

    Xiaogang Li

    2007-12-01

    Full Text Available This article discusses the key features of a newly developed national data-sharing online network for material environmental corrosion. Written in Java language and based on Oracle database technology, the central database in the network is supported with two unique series of corrosion failure data, both of which were accumulated during a long period of time. The first category of data, provided by national environment corrosion test sites, is corrosion failure data for different materials in typical environments (atmosphere, seawater and soil. The other category is corrosion data in production environments, provided by a variety of firms. This network system enables standardized management of environmental corrosion data, an effective data sharing process, and research and development support for new products and after-sale services. Moreover this network system provides a firm base and data-service platform for the evaluation of project bids, safety, and service life. This article also discusses issues including data quality management and evaluation in the material corrosion data sharing process, access authority of different users, compensation for providers of shared historical data, and finally, the related policy and law legal processes, which are required to protect the intellectual property rights of the database.

  19. A national survey of cardiac rehabilitation services in New Zealand: 2015.

    Science.gov (United States)

    Kira, Geoff; Doolan-Noble, Fiona; Humphreys, Grace; Williams, Gina; O'Shaughnessy, Helen; Devlin, Gerry

    2016-05-27

    Guidelines for cardiac rehabilitation (CR) programmes inform best practice. In Aotearoa NewZealand, little information exists about the structure and services provided by CR programmes and there is a poor understanding of how existing CR programmes are delivered with respect to evidence-based national guidelines. All 46 CR providers in New Zealand were invited to participate in a national survey in 2015. The survey sought information on the following: unit structure; referral processes; patient assessment; audit (including quality assurance activity); Phase 2 CR content; and support for special populations. Simple descriptive analysis of the responses was conducted, involving forming counts and percentages. Thirty-six distinct units completed the survey and 94% provided Phase 2. Assessment tools, Phase 2 educational components, and the methods of providing the exercise component varied. Most units audited their services, 25% audited their programme six-monthly or more frequently. Just over half of the units (56%) reported key performance indicators. The survey identified variations in delivery and content of CR in New Zealand, with poor understanding of the impact on patient outcomes. This is likely due to the absence of standardised audit practices and routine collection of key performance indicators on a national basis.

  20. Implementation and integration of regional health care data networks in the Hellenic National Health Service.

    Science.gov (United States)

    Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-12-01

    Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

  1. A national survey of clinical pharmacy services in county hospitals in China.

    Science.gov (United States)

    Yao, Dongning; Xi, Xiaoyu; Huang, Yuankai; Hu, Hao; Hu, Yuanjia; Wang, Yitao; Yao, Wenbing

    2017-01-01

    Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China. Public county hospitals in China. A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists. The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most

  2. National forest economic clusters: a new model for assessing national-forest-based natural resources products and services.

    Science.gov (United States)

    Thomas D. Rojas

    2007-01-01

    National forest lands encompass numerous rural and urban communities. Some national-forest-based communities lie embedded within national forests, and others reside just outside the official boundaries of national forests. The urban and rural communities within or near national forest lands include a wide variety of historical traditions and cultural values that affect...

  3. A National Audit of Smoking Cessation Services in Irish Maternity Units

    LENUS (Irish Health Repository)

    2017-06-01

    There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.

  4. ReSS: Resource Selection Service for National and Campus Grid Infrastructure

    International Nuclear Information System (INIS)

    Mhashilkar, Parag; Garzoglio, Gabriele; Levshina, Tanya; Timm, Steve

    2010-01-01

    The Open Science Grid (OSG) offers access to around hundred Compute elements (CE) and storage elements (SE) via standard Grid interfaces. The Resource Selection Service (ReSS) is a push-based workload management system that is integrated with the OSG information systems and resources. ReSS integrates standard Grid tools such as Condor, as a brokering service and the gLite CEMon, for gathering and publishing resource information in GLUE Schema format. ReSS is used in OSG by Virtual Organizations (VO) such as Dark Energy Survey (DES), DZero and Engagement VO. ReSS is also used as a Resource Selection Service for Campus Grids, such as FermiGrid. VOs use ReSS to automate the resource selection in their workload management system to run jobs over the grid. In the past year, the system has been enhanced to enable publication and selection of storage resources and of any special software or software libraries (like MPI libraries) installed at computing resources. In this paper, we discuss the Resource Selection Service, its typical usage on the two scales of a National Cyber Infrastructure Grid, such as OSG, and of a campus Grid, such as FermiGrid.

  5. ReSS: Resource Selection Service for National and Campus Grid Infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Mhashilkar, Parag; Garzoglio, Gabriele; Levshina, Tanya; Timm, Steve, E-mail: parag@fnal.go, E-mail: garzogli@fnal.go, E-mail: tlevshin@fnal.go, E-mail: timm@fnal.go [Fermi National Accelerator Laboratory, P O Box 500, Batavia, IL - 60510 (United States)

    2010-04-01

    The Open Science Grid (OSG) offers access to around hundred Compute elements (CE) and storage elements (SE) via standard Grid interfaces. The Resource Selection Service (ReSS) is a push-based workload management system that is integrated with the OSG information systems and resources. ReSS integrates standard Grid tools such as Condor, as a brokering service and the gLite CEMon, for gathering and publishing resource information in GLUE Schema format. ReSS is used in OSG by Virtual Organizations (VO) such as Dark Energy Survey (DES), DZero and Engagement VO. ReSS is also used as a Resource Selection Service for Campus Grids, such as FermiGrid. VOs use ReSS to automate the resource selection in their workload management system to run jobs over the grid. In the past year, the system has been enhanced to enable publication and selection of storage resources and of any special software or software libraries (like MPI libraries) installed at computing resources. In this paper, we discuss the Resource Selection Service, its typical usage on the two scales of a National Cyber Infrastructure Grid, such as OSG, and of a campus Grid, such as FermiGrid.

  6. ReSS: Resource Selection Service for National and Campus Grid Infrastructure

    International Nuclear Information System (INIS)

    Mhashilkar, Parag; Garzoglio, Gabriele; Levshina, Tanya; Timm, Steve

    2009-01-01

    The Open Science Grid (OSG) offers access to around hundred Compute elements (CE) and storage elements (SE) via standard Grid interfaces. The Resource Selection Service (ReSS) is a push-based workload management system that is integrated with the OSG information systems and resources. ReSS integrates standard Grid tools such as Condor, as a brokering service and the gLite CEMon, for gathering and publishing resource information in GLUE Schema format. ReSS is used in OSG by Virtual Organizations (VO) such as Dark Energy Survey (DES), DZero and Engagement VO. ReSS is also used as a Resource Selection Service for Campus Grids, such as FermiGrid. VOs use ReSS to automate the resource selection in their workload management system to run jobs over the grid. In the past year, the system has been enhanced to enable publication and selection of storage resources and of any special software or software libraries (like MPI libraries) installed at computing resources. In this paper, we discuss the Resource Selection Service, its typical usage on the two scales of a National Cyber Infrastructure Grid, such as OSG, and of a campus Grid, such as FermiGrid.

  7. Assessment of the quality of service provided by a national regulatory institution

    Directory of Open Access Journals (Sweden)

    Adetunji, O.

    2013-05-01

    Full Text Available Government institutions need to assess how well they meet the needs of their customers, and what their customers think about the quality of the services they provide. This is aligned with the Batho Pele principle of the South African government. The SERVQUAL scale, augmented with a qualitative survey, was used to determine how the National Home Builders Registration Council (NHBRC is perceived by its clients, which key factors drive such perceptions, and whether the perceptions are consistent across the different client groups of this regulatory institution. The complementary role of qualitative data in illuminating issues driving quantitative results is highlighted. Service quality scores are computed for the NHBRC. The convergence of opinions of different customer groups was studied using correlation analysis. The significance of service quality perception gaps was tested using the multivariate analysis of variance, and the reliability of the SERVQUAL scale was examined using exploratory factor analysis. It was observed that by improving the feedback mechanism of the NHBRC, their clients customer service quality perceptions could be enhanced.

  8. Isotope materials availability and services for target production at the Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Ratledge, J.E.; Dahl, T.L.; Ottinger, C.L.; Aaron, W.S.; Adair, H.L.

    1987-01-01

    Materials available through the Isotope Distribution Program include separated stable isotopes, byproduct radioisotopes, and research quantities of source and special nuclear materials. Isotope products are routinely available in the forms listed in the product description section of the Isotopes Products and Services Catalog distributed by the Oak Ridge National Laboratory (ORNL). Different forms can be provided in some cases, usually at additional cost. Routinely available services include cyclotron target irradiations, fabrication of special physical forms, source encapsulation, ion implantation, and special purifications. Materials and services that are not offered as part of the routine distribution program may be made available from commercial sources in the United States. Specific forms of isotopic research materials include thin films and foils for use as accelerator targets, metal or other compounds in the form of bars or wires, and metal foils. Methods of fabrication include evaporation, sputtering, rolling, electrolytic deposition, pressing, sintering, and casting. High-purity metal forms of plutonium, americium, and curium are prepared by vacuum reduction/distillation. Both fissionable and nonfissionable neutron dosimeters are prepared for determining the neutron energy spectra, flux, and fluence at various locations within a reactor. Details on what materials are available and how the materials and related services can be obtained from ORNL are described. (orig.)

  9. Workplace harassment patterning, gender, and utilization of professional services: findings from a US national study.

    Science.gov (United States)

    Shannon, Candice A; Rospenda, Kathleen M; Richman, Judith A

    2007-03-01

    This study constitutes the first national longitudinal survey to address the relationship between workplace harassment and service utilization. We examine how patterns of sexual harassment and generalized workplace harassment are linked to utilization of mental health, health, legal, spiritual, and work-related services, and whether and how gender influences these relationships. Data derive from a random digit dial telephone survey with a continental US sample of employed adults. Eligibility criteria were being 18 years of age or over, and being employed at least 20 h per week at some time in the 12 months prior to the wave 1 survey. Out of 4116 households with eligible individuals, 2151 agreed to participate at wave 1. At wave 2, 1418 participated, thus, the overall response rate was 34.5%. We show that the patterning of workplace harassment over two time points (chronic, remission, onset, never harassed) is associated with the use of different types of services. Gender partially moderated the relationship between workplace harassment and services.

  10. Private finance of services covered by the National Health Insurance package of benefits in Israel.

    Science.gov (United States)

    Engelchin-Nissan, Esti; Shmueli, Amir

    2015-01-01

    Private health expenditure in systems of national health insurance has raised concern in many countries. The concern is mainly about the accessibility of care to the poor and the sick, and inequality in use and in health. The concern thus refers specifically to the care financed privately rather than to private health expenditure as defined in the national health accounts. To estimate the share of private finance in total use of services covered by the national package of benefits. and to relate the private finance of use to the income and health of the users. The Central Bureau of Statistics linked the 2009 Health Survey and the 2010 Incomes Survey. Twenty-four thousand five hundred ninety-five individuals in 7175 households were included in the data. Lacking data on the share of private finance in total cost of care delivered, we calculated instead the share of uses having any private finance-beyond copayments-in total uses, in primary, secondary, paramedical and total care. The probability of any private finance in each type of care is then related, using random effect logistic regression, to income and health state. Fifteen percent of all uses of care covered by the national package of benefits had any private finance. This rate ranges from 10 % in primary care, 16 % in secondary care and 31 % in paramedical care. Twelve percent of all uses of physicians' services had any private finance, ranging from 10 % in family physicians to 20 % in pulmonologists, psychiatrists, neurologists and urologists. Controlling for health state, richer individuals are more likely to have any private finance in all types of care. Controlling for income, sick individuals (1+ chronic conditions) are 30 % in total care and 60 % in primary care more likely to have any private finance compared to healthy individuals (with no chronic conditions). The national accounts' "private health spending" (39 % of total spending in 2010) is not of much use regarding equity of and

  11. Implementing SLMTA in the Kenya National Blood Transfusion Service: lessons learned

    Directory of Open Access Journals (Sweden)

    Eric N. Wakaria

    2017-04-01

    Full Text Available Background: The Kenya National Blood Transfusion Service (KNBTS is mandated to provide safe and sufficient blood and blood components for the country. In 2013, the KNBTS National Testing Laboratory and the six regional blood transfusion centres were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. The process was supported by Global Communities with funding from the United States Centers for Disease Control and Prevention. Methods: The SLMTA implementation at KNBTS followed the standard three-workshop series, on-site mentorships and audits. Baseline, midterm and exit audits were conducted at the seven facilities, using a standard checklist to measure progress. Given that SLMTA was designed for clinical and public health laboratories, key stakeholders, guided by Global Communities, tailored SLMTA materials to address blood transfusion services, and oriented trainers, auditors and mentors on the same. Results: The seven facilities moved from an average of zero stars at baseline to an average of three stars at the exit audit. The average baseline audit score was 38% (97 points, midterm 71% (183 points and exit audit 79% (205 points. The Occurrence Management and Process Improvement quality system essential had the largest improvement (at 67 percentage points, from baseline to exit, whereas Facilities and Safety had the smallest improvement (at 31 percentage points. Conclusion: SLMTA can be an effective tool for preparing a blood transfusion service for accreditation. Key success factors included customising SLMTA to blood transfusion activities; sensitising trainers, mentors and auditors on operations of blood transfusion service; creating SLMTA champions in key departments; and integrating other blood transfusion-specific accreditation standards into SLMTA.

  12. Spatial planning for a green economy: National-level hydrologic ecosystem services priority areas for Gabon.

    Science.gov (United States)

    Goldstein, Joshua Howard; Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry

    2017-01-01

    Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts

  13. Spatial planning for a green economy: National-level hydrologic ecosystem services priority areas for Gabon.

    Directory of Open Access Journals (Sweden)

    Joshua Howard Goldstein

    Full Text Available Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces, leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate

  14. Internationalization of product-service systems: Global, regional or national strategy?

    OpenAIRE

    Parry, G.; Bustinza, O. F.; Vendrell-Herrero, F.; O'Regan, N.

    2016-01-01

    This paper explores the validity of national, regional or global strategies in the provision of a music industry product service system. Quantitative analysis of cross-section data from over 70,000 respondents from 15 geographically spread countries identified a homogeneous group of so-called ‘Out of Touch’ consumers characterized by a shared attitude: they are interested in and have the money to purchase music, but no longer do so. The analysis ascertains if and how re-engaging this group in...

  15. A discussion: the future role of homeopathy in the National Health Service (NHS).

    Science.gov (United States)

    Ng, Daniel Yu-Hin

    2011-07-01

    Homeopathy has been provided by the National Health Service in the UK for over 60 years, funded largely by taxpayer's money. However, in recent years, its provision has come under much criticism questioning its true value. Taking a neutral stance, arguments both for and against the provision of homeopathy on the NHS is presented. It includes issues such as the evidence and safety profile of homeopathy, but also takes into account costs and benefits of homeopathy in a wider perspective. Overall, the provision of homeopathy is justified as long as there is a need within the population, occupying a complementary role alongside conventional medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Operational health and physics service during the maintenance of the Australian National Medical Cyclotron

    International Nuclear Information System (INIS)

    Mukherjee, B.

    1994-01-01

    Modern Medical Cyclotrons use intense beams of high energy protons or deuterons to produce large activities of short and medium lived radionuclides. After continuous operation for prolonged periods the Cyclotron components become activated through various nuclear interactions therefore, the risk of personal radiation hazard while handling such activated cyclotron components is high. This paper describes all operational aspects of the Health Physics service evolved during the first preventative maintenance program of the Australian National Medical Cyclotron, which took place in June 1993. 5 refs., 3 tabs., 2 figs

  17. National health and medical services response to incidents of chemical and biological terrorism.

    Science.gov (United States)

    Tucker, J B

    1997-08-06

    In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties. The US Congress has also established a Domestic Preparedness Program that provides for enhanced training of local first-responders and the formation of metropolitan medical strike teams in major cities around the country. While these national response capabilities are promising, their implementation to date has been problematic and their ultimate effectiveness is uncertain.

  18. Guidelines for developing effective health education service in a national health agency.

    Science.gov (United States)

    Ochor, J O

    1983-01-01

    The constraints facing health education include: the fragmentation and dispersal of health-educational services among different agencies and personnel; lack of policy guidelines; ineffectively organized and inefficiently managed health education systems; poor hierarchical status and inadequacy of resources. To resolve these constraints, national health education systems in health agencies should be developed on the basis of stipulated guidelines that could ensure their viability, efficiency and effectiveness. A study at the African Regional Health Education Centre, Ibadan, Nigeria, has yielded thirty synthesized guidelines. The "guidelines" were empirically tested as an evaluation tool by assessing the operational and organizational status of Oyo State Health Education Unit, Ibadan, Nigeria. These guidelines are adaptable to local conditions to enhance the re-organization, re-orientation and consolidation of health education in national health agencies.

  19. Photovoltaic applications in the southwest for the National Park Service. [10 to 100 kW

    Energy Technology Data Exchange (ETDEWEB)

    Peatfield, C.R.; Jarvinen, P.O.

    1977-04-28

    Nearly three megawatts of electrical power are produced annually by diesel/electric generator sets at National Park Service sites, according to a survey conducted jointly by the NPS and MIT/Lincoln Laboratory. To prove the economic viability of photovoltaic power generation systems to meet NPS electric power needs as well as to stimulate public acceptance and reliance on solar-generated electricity, NPS and MIT/LL are cooperating in a Field Tests and Applications Project sponsored by the U.S. Energy Research and Development Administration. The power level for the applications will be in the range from 10 to 100 kW. Ten of the most promising NPS sites were visited and evaluated. Based on ten criteria, Natural Bridges National Monument in Utah was selected as the optimum first pick. The FT and A Project and evaluation details for the ten sites are described.

  20. Business continuity and disaster management within the public service in relation to a national development plan.

    Science.gov (United States)

    Ferguson, Cliff

    2018-01-01

    Within South Africa, few public service departments understand the concepts of business continuity management (BCM) and what it takes to implement a well-constructed business continuity plan. Likewise, few of these entities understand the purpose of designing and maintaining resilient systems that are immune to incidents. This paper discusses the integration of the South African Disaster Management Act 2002, the Disaster Management Framework and the National Development Plan, linking these to BCM, through a resilience period model, as a means for the implementation of resilience strategies. The goals of the National Development Plan are outlined with a view to how resilience can be achieved in each. A resilience period model has been advocated for the implementation of projects within the public sector in order to provide continuity and sustainability.

  1. Obstacles to "race equality" in the English National Health Service: Insights from the healthcare commissioning arena.

    Science.gov (United States)

    Salway, Sarah; Mir, Ghazala; Turner, Daniel; Ellison, George T H; Carter, Lynne; Gerrish, Kate

    2016-03-01

    Inequitable healthcare access, experiences and outcomes across ethnic groups are of concern across many countries. Progress on this agenda appears limited in England given the apparently strong legal and policy framework. This disjuncture raises questions about how central government policy is translated into local services. Healthcare commissioning organisations are a potentially powerful influence on services, but have rarely been examined from an equity perspective. We undertook a mixed method exploration of English Primary Care Trust (PCT) commissioning in 2010-12, to identify barriers and enablers to commissioning that addresses ethnic healthcare inequities, employing:- in-depth interviews with 19 national Key Informants; documentation of 10 good practice examples; detailed case studies of three PCTs (70+ interviews; extensive observational work and documentary analysis); three national stakeholder workshops. We found limited and patchy attention to ethnic diversity and inequity within English healthcare commissioning. Marginalization of this agenda, along with ambivalence, a lack of clarity and limited confidence, perpetuated a reinforcing inter-play between individual managers, their organisational setting and the wider policy context. Despite the apparent contrary indications, ethnic equity was a peripheral concern within national healthcare policy; poorly aligned with other more dominant agendas. Locally, consideration of ethnicity was often treated as a matter of legal compliance rather than integral to understanding and meeting healthcare needs. Many managers and teams did not consider tackling ethnic healthcare inequities to be part-and-parcel of their job, lacked confidence and skills to do so, and questioned the legitimacy of such work. Our findings indicate the need to enhance the skills, confidence and competence of individual managers and commissioning teams and to improve organizational structures and processes that support attention to ethnic

  2. Aerial Radiological Survey of Abandoned Uranium Mines (AUM) Map Service, Navajo Nation, 1994-1999, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — This map service contains data from aerial radiological surveys of 41 potential uranium mining areas (1,144 square miles) within the Navajo Nation that were...

  3. Financial Management: Processing General Services Administration Rent Bills for DoD Customers in the National Capital Region

    National Research Council Canada - National Science Library

    Granetto, Paul

    2003-01-01

    .... The Washington Headquarters Services (WHS) is responsible for the oversight and management of administrative space occupied by DoD agencies and Military departments in the National Capital Region...

  4. The role of national consultant services industries to support the first nuclear power plant programme in Indonesia

    International Nuclear Information System (INIS)

    Dharu Dewi; Sahala Lumbanraja; Sriyana

    2007-01-01

    Study has been done which concerning the role of Indonesian National Consultant Services Industries to support the First Nuclear Power Plant (NPP) Programme in Indonesia. NPP programme activities will be success if the studies should be started with good planning. To obtain the optimal results, the opportunity and the role of national consultants should be considered to the localization of NPP Programme to be bigger. Utilizing of national consultants services can be expected to become second opinion which is to play important role in socialization of NPP Programme. The Government and NPP Project Owner's candidate should analysis, plan and implement the Nuclear Power Plant Programme activities, started from identification of the available national consultants, considering the national consults procurement process, definition of scope of works of national consultants activities, carry out the selection of national consultants, evaluation, monitoring and supervision so that the utilizing of national consultants will give benefit more effective, efficient, economic appropriate objectives and good quality. This study to assess the structure and type of national consultants, works package which can be done by national consultants, selection methods of national consultants, constraints of national consultants and enhancing of the role of national consultants to involve and support in the nuclear power plant programme in Indonesia. The research methods are literature study, consultation with resource person and exploring of website/internet. (author)

  5. The National 3-D Geospatial Information Web-Based Service of Korea

    Science.gov (United States)

    Lee, D. T.; Kim, C. W.; Kang, I. G.

    2013-09-01

    3D geospatial information systems should provide efficient spatial analysis tools and able to use all capabilities of the third dimension, and a visualization. Currently, many human activities make steps toward the third dimension like land use, urban and landscape planning, cadastre, environmental monitoring, transportation monitoring, real estate market, military applications, etc. To reflect this trend, the Korean government has been started to construct the 3D geospatial data and service platform. Since the geospatial information was introduced in Korea, the construction of geospatial information (3D geospatial information, digital maps, aerial photographs, ortho photographs, etc.) has been led by the central government. The purpose of this study is to introduce the Korean government-lead 3D geospatial information web-based service for the people who interested in this industry and we would like to introduce not only the present conditions of constructed 3D geospatial data but methodologies and applications of 3D geospatial information. About 15% (about 3,278.74 km2) of the total urban area's 3D geospatial data have been constructed by the national geographic information institute (NGII) of Korea from 2005 to 2012. Especially in six metropolitan cities and Dokdo (island belongs to Korea) on level of detail (LOD) 4 which is photo-realistic textured 3D models including corresponding ortho photographs were constructed in 2012. In this paper, we represented web-based 3D map service system composition and infrastructure and comparison of V-world with Google Earth service will be presented. We also represented Open API based service cases and discussed about the protection of location privacy when we construct 3D indoor building models. In order to prevent an invasion of privacy, we processed image blurring, elimination and camouflage. The importance of public-private cooperation and advanced geospatial information policy is emphasized in Korea. Thus, the progress of

  6. The Facilities of British Intelligence Service in Trabzon at the Beginning of National Struggle

    Directory of Open Access Journals (Sweden)

    Resul YAVUZ

    2017-12-01

    Full Text Available Trabzon and its surrounding has always been one of the places where the states want to expand to inner parts through North want to control in almost every period of the history. The closest attempts to realize this aim were undoubtly to be carried out by Russians in the First World War and by the British in the Turkish Independence War which began after the war. The strategic position of it was in the interest of foreign intelligence services, especially in the national struggle years, due to its sophisticated socio-economic structure compared to the region and its geographical closeness to Bolshevik Russia. During these years, the British intelligence service reported to the centers about the connection and hidden points of the city and the sketches of possible landing and pathways in order to send troops to eastern Anatolia in the event of a possible occupation. Besides, the British attempted to control all activities of the city, especially the control of arm delivery under the name of implementing the conditions of the armistice by increasing the pressure on Trabzon during the years of national struggle that started in Anatolia.

  7. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    Science.gov (United States)

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  8. Challenges of commissioning and contracting for integrated care in the National Health Service (NHS) in England.

    Science.gov (United States)

    Addicott, Rachael

    2016-01-01

    For many years there has been a separation between purchasing and provision of services in the English National Health Service (NHS). Many studies report that this commissioning function has been weak: purchasers have had little impact or power in negotiations with large acute providers, and have had limited strategic control over the delivery of care. Nevertheless, commissioning has become increasingly embedded in the NHS structure since the arrival of Clinical Commissioning Groups (CCGs) in 2012. Recently, some of these CCGs have focused on how they can contract and commission in different ways to stimulate greater collaboration across providers. This paper examines experiences of commissioning and contracting for integrated care in the English NHS, based on a series of national-level interviews and case studies of five health economies that are implementing novel contracting models. The cases illustrated here demonstrate early experiments to drive innovation through contracting in the NHS that have largely relied on the vision of individual teams or leaders, in combination with external legal, procurement and actuarial support. It is unlikely that this approach will be sustainable or replicable across the country or internationally, despite the best intentions of commissioners. Designing and operating novel contractual approaches will require considerable determination, alongside advanced skills in procurement, contract management and commissioning. The cost of developing new contractual approaches is high, and as the process is difficult and resource-intensive, it is likely that dedicated teams or programs will be required to drive significant improvement.

  9. Emergency recompression: clinical audit of service delivery at a national level.

    Science.gov (United States)

    Ross, John As; Sayer, Martin Dj

    2009-03-01

    Clinical audit is an essential element to the maintenance or improvement of delivery of any medical service. During the development phase of a National Recompression Registration Service for Scotland, clinical audit was initiated to provide a standardised tool to monitor the quality of outcome with respect to the severity of presentation. A functional audit process was an essential consideration for planned future measurement of treatment efficacy at local (single hyperbaric unit) and national (multiple hyperbaric units) scales. The audit process was designed to be undemanding, robust and informative, irrespective of the experience of treatment centre and of the clinician in charge of treatment. The clinical records from 104 cases of divers with decompression illness were used to derive and evaluate measures of severity and clinical outcome that could be used for audit and quality assurance. The various measures of disease severity were examined against clinical outcome and days spent in care after admission to a hyperbaric unit. An initial version of the clinical audit format that was developed from this process is presented.

  10. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

  11. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Science.gov (United States)

    2010-10-01

    ... Service Corps site's reimbursement obligation to the Federal Government be waived? 23.10 Section 23.10... National Health Service Corps site's reimbursement obligation to the Federal Government be waived? (a) The Secretary may waive in whole or in part the reimbursement requirements of section 334(a)(3) of the Act if he...

  12. 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…

  13. The Relationship between Sun Protection Policy and Associated Practices in a National Sample of Early Childhood Services in Australia

    Science.gov (United States)

    Ettridge, Kerry A.; Bowden, Jacqueline A.; Rayner, Joanne M.; Wilson, Carlene J.

    2011-01-01

    Limiting exposure to sunlight during childhood can significantly reduce the risk of skin cancer. This was the first national study to assess the sun protection policies and practices of early childhood services across Australia. It also examined the key predictors of services' sun protection practices. In 2007, 1017 respondents completed a…

  14. 78 FR 78380 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort...

    Science.gov (United States)

    2013-12-26

    ... completion of an inventory of human remains under the control of Fort Bowie National Historic Site, Bowie, AZ....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort... completed an inventory of human remains, in consultation with the appropriate Indian tribes or Native...

  15. Qualitative analysis of national documents on health care services and pharmaceuticals` purchasing challenges: evidence from Iran.

    Science.gov (United States)

    Bastani, Peivand; Samadbeik, Mahnaz; Dinarvand, Rassoul; Kashefian-Naeeini, Sara; Vatankhah, Soudabeh

    2018-06-05

    Iranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting. It was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president's site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10. Findings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes. It seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

  16. SU-E-P-03: The Australian Clinical Dosimetry Service, a Bespoke National Solution

    International Nuclear Information System (INIS)

    Williams, I; Lye, J; Alves, A; Lehmann, J; Kenny, J; Dunn, L; Kron, T

    2015-01-01

    Purpose: The Australian Clinical Dosimetry Service, (ACDS) was a pilot program to enable the Australian Government to determine whether a locally designed audit program was suitable for mitigating dosimetric error risk to radiotherapy patients within Australia. The outcomes from four years of operations will be presented and discussed with a focus why and how the pilot requirements were met. The consequnces of success will be considered, the lessons learnt from the pilot program and how they are impacting the future ACDS design, operation and engagement with stakeholders. Methods: The ACDS was designed over 2010/11 by experts drawn from the three professions in consultation with the national Department of Health. The list of outcomes required over a three year pilot was expressed in a Memorandum of Understanding, (MoU) between Health and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) which hosted the ACDS. Results: The ACDS has achieved all the MoU requirements. This paper describes how the staff within the ACDS engaged with the professional clinical workforce and provided a successful and functioning audit service. It identifies the strengths and weaknesses within the MoU and the ACDS structure and how the ACDS resolved a number of conflicting issues. It identifies the successes within the ACDS and how these were achieved. It provides details to assist and advise those seeking to design or modify national or regional auditing programs. Finally the paper reviews potential futures for the ACDS. Conclusion: The raw number of audits and outcomes indicate that the ACDS has met the MoU auditing requirements. The reasons for the ACDS’ success are highly dependent on: attracting quality staff who can respond with agility to changing situations, a high level of communication with the professional community, a high level of engagement by the community and an interested and engaged Federal Department. The Australian Clinical Dosimetry Service is a

  17. SU-E-P-03: The Australian Clinical Dosimetry Service, a Bespoke National Solution

    Energy Technology Data Exchange (ETDEWEB)

    Williams, I; Lye, J; Alves, A [Australian Clinical Dosimetry Service, Yallambie, Vic (Australia); Lehmann, J [University of Sydney, Sydney (Australia); Kenny, J [Epworth HealthCare, Richmond, VIC (Australia); Dunn, L [Royal Melbourne Institute of Technology, Melbourne (Australia); Kron, T [Peter MacCallum Cancer Instit., Melbourne (Australia)

    2015-06-15

    Purpose: The Australian Clinical Dosimetry Service, (ACDS) was a pilot program to enable the Australian Government to determine whether a locally designed audit program was suitable for mitigating dosimetric error risk to radiotherapy patients within Australia. The outcomes from four years of operations will be presented and discussed with a focus why and how the pilot requirements were met. The consequnces of success will be considered, the lessons learnt from the pilot program and how they are impacting the future ACDS design, operation and engagement with stakeholders. Methods: The ACDS was designed over 2010/11 by experts drawn from the three professions in consultation with the national Department of Health. The list of outcomes required over a three year pilot was expressed in a Memorandum of Understanding, (MoU) between Health and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) which hosted the ACDS. Results: The ACDS has achieved all the MoU requirements. This paper describes how the staff within the ACDS engaged with the professional clinical workforce and provided a successful and functioning audit service. It identifies the strengths and weaknesses within the MoU and the ACDS structure and how the ACDS resolved a number of conflicting issues. It identifies the successes within the ACDS and how these were achieved. It provides details to assist and advise those seeking to design or modify national or regional auditing programs. Finally the paper reviews potential futures for the ACDS. Conclusion: The raw number of audits and outcomes indicate that the ACDS has met the MoU auditing requirements. The reasons for the ACDS’ success are highly dependent on: attracting quality staff who can respond with agility to changing situations, a high level of communication with the professional community, a high level of engagement by the community and an interested and engaged Federal Department. The Australian Clinical Dosimetry Service is a

  18. [The national health service in the United Kingdom-past, present and future].

    Science.gov (United States)

    Nakanishi, N; Tatara, K

    1996-10-01

    Britain's National Health Service (NHS) came into existence in 1948. It was the first comprehensive health system in any Western society to be based on the national provision of services and to offer free medical care to the entire population. The NHS has gone through several developments since, in particular the reorganisations of 1974 and 1982 and the general management overhaul of 1984. Until 1991, however, the NHS kept to the following principles: health service for everyone; sharing of financial costs and free at the point of use; geographical equality; the same high standard of care for everyone; selection on the basis of need for health care; and encouragement of a non-exploitative ethos. Britain's achievement with respect to health care has generally received high praise. Nevertheless, Mrs. Thatcher's government was convinced that the NHS contained a number of serious weakness. This view sprang from the government's belief that, because the NHS did not have a competitive market structure, it lacked an incentive for efficient behaviour. The reforms that were introduced in 1991 were designed to overcome these perceived flaws by creating a limited or internal market in health care, in which multiple providers of services compete with each other for the custom of independent purchasers. Competitive pressures now focus greater attention on patient needs, and the separation of purchasing functions has placed resource allocation under greater scrutiny. Making hospitals financially dependent on general practitioner (GP) referrals has resulted in consultants establishing closer contact with GPs. More is being done in GP surgeries and this has the effect not only of widening the range of general practice but also of raising GP standards. However, there are also some internal problems. Administrative costs have increased steeply, and new inequalities are developing as a consequence of competition. To reduce management costs and to allocate as much of the NHS budget as

  19. The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

    Science.gov (United States)

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

    The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. [Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

    Science.gov (United States)

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Divergence of ecosystem services in U.S. National Forests and Grasslands under a changing climate.

    Science.gov (United States)

    Duan, Kai; Sun, Ge; Sun, Shanlei; Caldwell, Peter V; Cohen, Erika C; McNulty, Steven G; Aldridge, Heather D; Zhang, Yang

    2016-04-21

    The 170 National Forests and Grasslands (NFs) in the conterminous United States are public lands that provide important ecosystem services such as clean water and timber supply to the American people. This study investigates the potential impacts of climate change on two key ecosystem functions (i.e., water yield and ecosystem productivity) using the most recent climate projections derived from 20 Global Climate Models (GCMs) of the Coupled Model Intercomparison Project phase 5 (CMIP5). We find that future climate change may result in a significant reduction in water yield but an increase in ecosystem productivity in NFs. On average, gross ecosystem productivity is projected to increase by 76 ~ 229 g C m(-2) yr(-1) (8% ~ 24%) while water yield is projected to decrease by 18 ~ 31 mm yr(-1) (4% ~ 7%) by 2100 as a result of the combination of increased air temperature (+1.8 ~ +5.2 °C) and precipitation (+17 ~ +51 mm yr(-1)). The notable divergence in ecosystem services of water supply and carbon sequestration is expected to intensify under higher greenhouse gas emission and associated climate change in the future, posing greater challenges to managing NFs for both ecosystem services.

  2. Transformational leadership in the South African public service after the April 2009 national elections

    Directory of Open Access Journals (Sweden)

    Manasseh M. Mokgolo

    2012-04-01

    Full Text Available Orientation: The implementation of transformational leadership in public services after national elections has been well recorded in other parts of the world. However, this is not the case in South Africa. Research purpose: The purpose of the study is to determine whether transformational leadership has a beneficial relationship with subordinate leadership acceptance, job performance and job satisfaction. Motivation for the study: Leadership is a critical issue that the public sector needs to address in order to survive and succeed in today’s unstable environment. According to Groenewald and Ashfield (2008, transformational leadership could reduce the effects of uncertainty and change that comes with new leaders and help employees to achieve their objectives. Research design, approach and method: The sample comprised 1050 full-time employees in the public sector based in head offices. The measuring instruments included the Multifactor Leadership Questionnaire (MLQ, the Leadership Acceptance Scale (LAS, the Job Satisfaction Survey (JSS and the Job Performance Survey (JPS. Main findings: Transformational leadership had a positive correlation with subordinate leadership acceptance, performance and job satisfaction. Practical/managerial implications: Managers can train public sector leaders to be transformational leaders because of the adverse effect lack of transformation can have on employees’ attitudes in areas like satisfaction, performance and commitment. Contribution/value-add: This study makes an important contribution to our understanding of transformational leadership processes and to how the public service can improve its practices in order to render quality service to South Africans.

  3. A critique of wildlife radio-tracking and its use in National Parks: a report to the National Park Service

    Science.gov (United States)

    Mech, L. David; Barber, Shannon M.

    2002-01-01

    Because of the naturalness of National Parks and because of the public’s strong interest in the parks, the National Park Service (NPS) must gather as much information as needed to help understand and preserve the natural functioning of its ecosystems, and especially of its wildlife. The most useful technique for studying wildlife is radio-tracking, or wildlife telemetry. Radio-tracking is the technique of determining information about an animal through the use of radio signals from or to a device carried by the animal.The basic components of a traditional radio-tracking system are (1) a transmitting subsystem consisting of a radio transmitter, a power source and a propagating antenna, and (2) a receiving subsystem including a “pick-up” antenna, a signal receiver with reception indicator (speaker and/or display) and a power source. Most radio tracking systems involve transmitters tuned to different frequencies (analogous to different AM/FM radio stations) that allow individual identification.Three distinct types of radio-tracking are in use today: (1)conventional, very-high-frequency (VHF) radio tracking, (2) satellite tracking, and (3) Global Positioning System (GPS) tracking. VHF radio-tracking is the standard technique that has been in use since 1963.However, radio-tracking can be considered intrusive in that it requires live-capturing animals and attaching a collar or other device to them. A person must then monitor signals from the device, thus usually requiring people in the field in vehicles, aircraft, and on foot. Nevertheless, most national parks have recognized the benefits of radio-tracking and have hosted radio-tracking studies for many years; in some parks, hundreds of animals have been, or are being, so studied.As a result, some NPS staff are concerned about actual or potential intrusiveness of radio-tracking. Ideally, wildlife studies would still be done but with no intrusion on animals or conflict with park visitors.Thus the NPS has decided to

  4. The challenge of implementing peer-led interventions in a professionalized health service: a case study of the national health trainers service in England.

    Science.gov (United States)

    Mathers, Jonathan; Taylor, Rebecca; Parry, Jayne

    2014-12-01

    Policy Points: In 2004, England's National Health Service introduced health trainer services to help individuals adopt healthier lifestyles and to redress national health inequalities. Over time these anticipated community-focused services became more NHS-focused, delivering "downstream" lifestyle interventions. At the same time, individuals' lifestyle choices were abstracted from the wider social determinants of health and the potential to address inequalities was diminished. While different service models are needed to engage hard-to-reach populations, the long-term sustainability of any new service model depends on its aligning with the established medical system's characteristics. In 2004, the English Public Health White Paper Choosing Health introduced "health trainers" as new members of the National Health Service (NHS) workforce. Health trainers would offer one-to-one peer-support to anyone who wished to adopt and maintain a healthier lifestyle. Choosing Health implicitly envisaged health trainers working in community settings in order to engage "hard-to-reach" individuals and other groups who often have the poorest health but who engage the least with traditional health promotion and other NHS services. During longitudinal case studies of 6 local health trainer services, we conducted in-depth interviews with key stakeholders and analyzed service activity data. Rather than an unproblematic and stable implementation of community-focused services according to the vision in Choosing Health, we observed substantial shifts in the case studies' configuration and delivery as the services embedded themselves in the local NHS systems. To explain these observations, we drew on a recently proposed conceptual framework to examine and understand the adoption and diffusion of innovations in health care systems. The health trainer services have become more "medicalized" over time, and in doing so, the original theory underpinning the program has been threatened. The

  5. Economic growth and health progress in Italy: 30 years of National Health Service.

    Science.gov (United States)

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

    2012-01-01

    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.

  6. Cost of Services Provided by the National Breast and Cervical Cancer Early Detection Program

    Science.gov (United States)

    Ekwueme, Donatus U.; Subramanian, Sujha; Trogdon, Justin G.; Miller, Jacqueline W.; Royalty, Janet E.; Li, Chunyu; Guy, Gery P.; Crouse, Wesley; Thompson, Hope; Gardner, James G.

    2015-01-01

    BACKGROUND The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is the largest cancer screening program for low-income women in the United States. This study updates previous estimates of the costs of delivering preventive cancer screening services in the NBCCEDP. METHODS We developed a standardized web-based cost-assessment tool to collect annual activity-based cost data on screening for breast and cervical cancer in the NBCCEDP. Data were collected from 63 of the 66 programs that received funding from the Centers for Disease Control and Prevention during the 2006/2007 fiscal year. We used these data to calculate costs of delivering preventive public health services in the program. RESULTS We estimated the total cost of all NBCCEDP services to be $296 (standard deviation [SD], $123) per woman served (including the estimated value of in-kind donations, which constituted approximately 15% of this total estimated cost). The estimated cost of screening and diagnostic services was $145 (SD, $38) per women served, which represented 57.7% of the total cost excluding the value of in-kind donations. Including the value of in-kind donations, the weighted mean cost of screening a woman for breast cancer was $110 with an office visit and $88 without, the weighted mean cost of a diagnostic procedure was $401, and the weighted mean cost per breast cancer detected was $35,480. For cervical cancer, the corresponding cost estimates were $61, $21, $415, and $18,995, respectively. CONCLUSIONS These NBCCEDP cost estimates may help policy makers in planning and implementing future costs for various potential changes to the program. PMID:25099904

  7. Cohort profile: the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) in Korea.

    Science.gov (United States)

    Seong, Sang Cheol; Kim, Yeon-Yong; Park, Sue K; Khang, Young Ho; Kim, Hyeon Chang; Park, Jong Heon; Kang, Hee-Jin; Do, Cheol-Ho; Song, Jong-Sun; Lee, Eun-Joo; Ha, Seongjun; Shin, Soon Ae; Jeong, Seung-Lyeal

    2017-09-24

    The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker. To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003. The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women). This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS. © 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.

  8. National Trends in the Utilization of Emergency Medical Services for Acute Myocardial Infarction and Stroke

    Directory of Open Access Journals (Sweden)

    Katie Tataris

    2014-11-01

    Full Text Available Introduction: The emergency medical services (EMS system plays a crucial role in the chain of survival for acute myocardial infarction (AMI and stroke. While regional studies have shown underutilization of the 911 system for these time-sensitive conditions, national trends have not been studied. Our objective was to describe the national prevalence of EMS use for AMI and stroke, examine trends over a six-year period, and identify patient factors that may contribute to utilization. Methods: Using the National Hospital Ambulatory Medical Care Survey-ED (NHAMCS dataset from 2003-2009, we looked at patients with a discharge diagnosis of AMI or stroke who arrived to the emergency department (ED by ambulance. We used a survey-weighted χ2 test for trend and logistic regression analysis. Results: In the study, there were 442 actual AMI patients and 220 (49.8% presented via EMS. There were 1,324 actual stroke patients and 666 (50.3% presented via EMS. There was no significant change in EMS usage for AMI or stroke over the six-year period. Factors independently associated with EMS use for AMI and stroke included age (OR 1.21; 95% CI 1.12-1.31, Non-Hispanic black race (OR 1.72; 95% CI 1.16-2.29, and nursing home residence (OR 11.50; 95% CI 6.19-21.36. Conclusion: In a nationally representative sample of ED visits from 20003-2009, there were no trends of increasing EMS use for AMI and stroke. Efforts to improve access to care could focus on patient groups that underutilize the EMS system for such conditions. [West J Emerg Med. 2014;15(7:–0.

  9. Change Best.Task 2.1. National Report on the Energy Efficiency Service Business in the Netherlands

    International Nuclear Information System (INIS)

    Boonekamp, P.; Vethman, P.

    2009-11-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses Task 2.1: National Report on the Energy Efficiency Service Business in the Netherlands. More information can be found on the website of Change Best at www.changebest.eu.

  10. Change Best.Task 2.1. National Report on the Energy Efficiency Service Business in Italy

    International Nuclear Information System (INIS)

    Sabbatucci, N.; Labanca, N.

    2009-05-01

    The aim of the Change Best project is to promote the development of an energy efficiency service (EES) market and to give good practice examples of changes in energy service business, strategies, and supportive policies and measures in the course of the implementation of Directive 2006/32/EC on Energy End-Use Efficiency and Energy Services. This report addresses Task 2.1: National Report on the Energy Efficiency Service Business in Italy. More information can be found on the website of Change Best at www.changebest.eu.

  11. Parks, Place and Pedagogy - Education Partnerships with the National Park Service

    Science.gov (United States)

    Vye, E. C.; Rose, W. I.; Nash, B.; Klawiter, M.; Huntoon, J. E.; Engelmann, C. A.; Gochis, E. E.; MiTEP

    2011-12-01

    The Michigan Teaching Excellence Program (MITEP) is a multi-year program of teacher leadership development that empowers science teachers in Grand Rapids, Kalamazoo, and Jackson to lead their schools and districts through the process of improving science teaching and learning. A component of this program is facilitated through partnership between academia, K-12 educators, and the National Park Service (NPS) that aims to develop place-based education strategies that improve diversity and Earth Science literacy. This tangible education method draws upon both the sense of place that National Parks offer and the art of interpretation employed by the park service. Combined, these deepen cognitive process and provide a more diverse reflection of what place means and the processes behind shaping what we see. Our partnerships present participants the opportunity to intern in a Midwest national park for 3-8 weeks during their third year in the program. In summer 2011, eleven teachers from the Grand Rapids school district participated in this innovative way of learning and teaching Earth Science. One goal was to develop geological interpretive materials desired and needed for the parks. Secondly, and important to place-based educational methodologies, these deliverables will be used as a way of bringing the parks to urban classrooms. Participants lived in the parks and worked directly with both national park and Michigan Tech staff to create lesson plans, podcasts, media clips, video, and photographic documentation of their experiences. These lesson plans will be hosted in the Views of the National Park website in an effort to provide innovative teaching resources nationally for teachers or free-choice learners wishing to access information on Midwest national parks. To the benefit of park staff, working with teachers from urban areas offered an opportunity for park staff to access diverse learners in urban settings unable to visit the park. The foundation has been laid for

  12. Back to the market: yet more reform of the National Health Service.

    Science.gov (United States)

    Lewis, Richard; Gillam, Stephen

    2003-01-01

    Yet more reform of the National Health Service in England has been announced by the Department of Health. In opposition, the Labour Party criticized the creation of an "internal market" for health care by the Conservative government, but five years into the Blair administration, market incentives are to be reinvigorated and the private sector is to be embraced in ways not seen hitherto. New guidance signals the introduction of competitive contracting using cost-per-case currencies, more choice for patients in where they will receive hospital treatment, and the freeing of NHS care providers from the direct political control of ministers. It is intended that the monopolistic features of the NHS in England should give way to greater pluralism, in particular through contracts with privately owned health care organizations. However, there is little evidence to suggest that these policies will be effective, and a number of practical problems may obstruct implementation.

  13. A fair range of choice: justifying maximum patient choice in the British National Health Service.

    Science.gov (United States)

    Wilmot, Stephen

    2007-06-01

    In this paper I put forward an ethical argument for the provision of extensive patient choice by the British National Health Service. I base this argument on traditional liberal rights to freedom of choice, on a welfare right to health care, and on a view of health as values-based. I argue that choice, to be ethically sustainable on this basis, must be values-based and rational. I also consider whether the British taxpayer may be persuadable with regard to the moral acceptability of patient choice, making use of Rawls' theory of political liberalism in this context. I identify issues that present problems in terms of public acceptance of choice, and also identify a boundary issue with regard to public health choices as against individual choices.

  14. Does hospital competition harm equity? Evidence from the English National Health Service.

    Science.gov (United States)

    Cookson, Richard; Laudicella, Mauro; Li Donni, Paolo

    2013-03-01

    Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of competition on equity is identified by the interaction between market structure, small area income deprivation and year. We find a negative association between market competition and elective admissions in deprived areas. The effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. PATIENTS' SATISFACTION WITH HEALTH SERVICES AT THE NATIONAL INSTITUTE OF PUBLIC HEALTH OF KOSOVA.

    Science.gov (United States)

    Ramadani, Naser; Zhjeqi, Valbona; Berisha, Merita; Hoxha, Rina; Gashi, Sanije; Begolli, Ilir; Salihu, Drita; Muçaj, Sefedin

    2016-06-01

    Purpose of the research is to assess patient satisfaction with the quality of health services provided in National Institute of Public Health of Kosova. Study was observational and cross-sectional. Interviews were conducted with 625 clients of IPH. Inclusion criteria for enrollment in the study were patients above 18 years old, with verbally informed consent. In our study, access to IPH, efficacy, patient-provider interpersonal communication, and explanations regarding procedures, readiness to answer to patients need and physical settings and appearance are valued satisfactorily whereas cleanliness was rated with minimal grades. Evaluated 12 quality components, were scored with average mark 3.6. SWOT analysis, and fishbone diagram should be used on regular bases and a new position for a manager for administrative issues, is opened, complaints box and list of rights and responsibilities of patients were dislocated in a more visible place, and internal staff turnover, is introduced.

  16. The Danish National Health Service Register (NHSR) as a Source for Research on Primary Care

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan

    . The data is easy accessible from the Danish National Board of Health. Conclusion: The register's strengths include completeness, size and long follow-up period. It is useful for research purposes especially when linked with other registers. However, grave reservations must be made regarding the validity...... of the register as no studies of this point have been made. Knowledge of the working conditions in general practice is necessary in order to use the NHSR for research purposes.......Aim: To describe NHSR in relation to research. Content: The data in the register from general practice is generated through the GPs’ electronic invoices to the Regional Health Administration. Data from 1990 onwards is available covering more than 600 million patient contacts. For each service...

  17. Measurements of seasonal and daily radon daughter concentration fluctuations in National Park Service caves

    International Nuclear Information System (INIS)

    Yarborough, K.A.

    1977-01-01

    The National Park Service (NPS) is studying levels of airborne alpha radiation from radon and thoron in all NPS administered caves in which tours for visitors are regularly conducted. The NPS research has the dual but complementary objectives of safeguarding health at the NPS administered caves, and to develop data on alpha radiation levels and on natural airflows in NPS caves. The results reported here for NPS caves describe concepts hypothesized for the objectives. In addition the data can be used by various agencies to clarify health standards for exposures to low airborne alpha radiation levels in cave environments. These results show daily and seasonal trends and the influence of natural ventilation by air circulation for each cave investigated

  18. The wound dressing supply chain within England's National Health Service: unravelling the context for users.

    Science.gov (United States)

    Browne, Natasha; Grocott, Patricia; Cowley, Sarah

    2004-01-01

    To explore the representation of user needs (nurses and patients, both individuals and groups) at the industrial (wound dressing manufacture) and National Health Service interface. The wound dressing supply chain is outlined, tracking organizational changes. The methods that are used to transfer user information between industries that produce dressings and those using the products are reviewed in terms of their ability to communicate what users need from dressings. Organizational policies and systems are outlined, with the focus on their role in facilitating the communication of user needs. Methods for generating user information that can directly inform dressing design are needed together with interactive communication routes within the supply chain, specifically between users, manufacturers, purchasers and suppliers. This will facilitate dual benefits for nursing management through improvements in purchasing decisions and nurses' management of wound care.

  19. The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service.

    Science.gov (United States)

    Brooks, Ian; Brown, Reva Berman

    2002-05-01

    The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service Background. One of the ways in which it is possible to achieve successful organizational change is through the elimination of those ceremonies that reinforce or preserve the negative aspects of professional and work group autonomy, thus maintaining the barriers between subcultures. Conversely, the encouraging of ceremonies which reinforce positive aspects is likely to achieve more flexible, team-orientated changes. Aim. The paper considers those ceremonies, which perpetuate barriers in a National Health Service (NHS) Trust, and explores new ceremonies which may question, weaken or eliminate current dysfunctional practices. Design. Our research approach was mainly phenomenological, as we wished to elicit the symbolic significance of organizational routines. The primary source of data was spoken language. The findings are based on purposive sampling of informants by means of semi-structured interview and observation. Other types of information were also collected, including business plans, reports and brochures. Informants included the Chief Executive and four Board members, three consultants, the director of nursing and midwifery, 10 middle managers and eight junior, nonmedical and nonmanagerial employees. Findings. Two broad bands of ceremonies have been identified - those which preserve the existing norms and autonomy of professional and worker groups, which we have named Ceremonies of Preservation, and those which encourage change, which we have called Ceremonies of Change. Considerable data are provided to help to 'tell the story'. Conclusion. The paper argues that attention to ceremonial in the wider change process may facilitate the desired, specific change or changes in practice. It suggests that changes which confront unnecessary demarcation, but which do not undermine professional integrity, can create real benefits for NHS hospitals.

  20. An evaluation of nurse rostering practices in the National Health Service.

    Science.gov (United States)

    Silvestro, R; Silvestro, C

    2000-09-01

    An evaluation of nurse rostering practices in the National Health Service The scheduling of nursing time on hospital wards is critical to the delivery of patient care, resource utilization and employee satisfaction. Over the past decade many hospital wards in the United Kingdom (UK) have moved away from the traditional planning of rosters by a single manager, towards more participative processes known as self-rostering and team rostering. This paper tests the hypothesis, developed from the literature, that the three types of rostering approach may be positioned along a continuum. Self-rostering at one extreme, is conducive to staff empowerment, motivation and roster effectiveness, whilst departmental rostering, at the other, leads to perceived autocracy, reduced empowerment, lower levels of staff motivation and roster effectiveness. Team rostering is positioned mid-way on this continuum. This paper reports the findings of an empirical study of nurse rostering practices in the UK National Health Service (NHS), with a view to developing an understanding of the implications of implementing these three rostering approaches and testing the above hypothesis. The survey of rostering practices in 50 NHS wards, and in-depth case studies of seven wards, revealed that each of the three rostering approaches has benefits and limitations and a picture emerges quite different from that implied by the research hypothesis. Whilst the literature suggests that the choice of rostering approach determines the level of perceived autocracy, staff motivation and roster effectiveness, it is proposed in this paper that selection of rostering approach should be contingent upon operational context. The paper concludes with a framework which stipulates that the choice of rostering approach for a ward should be determined on the basis of four contingent variables, namely, ward size, demand variability, demand predictability, and complexity of skill mix. It is recommended that departmental

  1. The National Ecosystem Services Classification System: A Framework for Identifying and Reducing Relevant Uncertainties

    Science.gov (United States)

    Rhodes, C. R.; Sinha, P.; Amanda, N.

    2013-12-01

    In recent years the gap between what scientists know and what policymakers should appreciate in environmental decision making has received more attention, as the costs of the disconnect have become more apparent to both groups. Particularly for water-related policies, the EPA's Office of Water has struggled with benefit estimates held low by the inability to quantify ecological and economic effects that theory, modeling, and anecdotal or isolated case evidence suggest may prove to be larger. Better coordination with ecologists and hydrologists is being explored as a solution. The ecosystem services (ES) concept now nearly two decades old links ecosystem functions and processes to the human value system. But there remains no clear mapping of which ecosystem goods and services affect which individual or economic values. The National Ecosystem Services Classification System (NESCS, 'nexus') project brings together ecologists, hydrologists, and social scientists to do this mapping for aquatic and other ecosystem service-generating systems. The objective is to greatly reduce the uncertainty in water-related policy making by mapping and ultimately quantifying the various functions and products of aquatic systems, as well as how changes to aquatic systems impact the human economy and individual levels of non-monetary appreciation for those functions and products. Primary challenges to fostering interaction between scientists, social scientists, and policymakers are lack of a common vocabulary, and the need for a cohesive comprehensive framework that organizes concepts across disciplines and accommodates scientific data from a range of sources. NESCS builds the vocabulary and the framework so both may inform a scalable transdisciplinary policy-making application. This talk presents for discussion the process and progress in developing both this vocabulary and a classifying framework capable of bridging the gap between a newer but existing ecosystem services classification

  2. US National Geothermal Data System: Web feature services and system operations

    Science.gov (United States)

    Richard, Stephen; Clark, Ryan; Allison, M. Lee; Anderson, Arlene

    2013-04-01

    The US National Geothermal Data System is being developed with support from the US Department of Energy to reduce risk in geothermal energy development by providing online access to the body of geothermal data available in the US. The system is being implemented using Open Geospatial Consortium web services for catalog search (CSW), map browsing (WMS), and data access (WFS). The catalog now includes 2427 registered resources, mostly individual documents accessible via URL. 173 WMS and WFS services are registered, hosted by 4 NGDS system nodes, as well as 6 other state geological surveys. Simple feature schema for interchange formats have been developed by an informal community process in which draft content models are developed based on the information actually available in most data provider's internal datasets. A template pattern is used for the content models so that commonly used content items have the same name and data type across models. Models are documented in Excel workbooks and posted for community review with a deadline for comment; at the end of the comment period a technical working group reviews and discusses comments and votes on adoption. When adopted, an XML schema is implemented for the content model. Our approach has been to keep the focus of each interchange schema narrow, such that simple-feature (flat file) XML schema are sufficient to implement the content model. Keeping individual interchange formats simple, and allowing flexibility to introduce new content models as needed have both assisted in adoption of the service architecture. One problem that remains to be solved is that off-the-shelf server packages (GeoServer, ArcGIS server) do not permit configuration of a normative schema location to be bound with XML namespaces in instance documents. Such configuration is possible with GeoServer using a more complex deployment process. XML interchange format schema versions are indicated by the namespace URI; because of the schema location

  3. Contraception services for incarcerated women: a national survey of correctional health providers.

    Science.gov (United States)

    Sufrin, Carolyn B; Creinin, Mitchell D; Chang, Judy C

    2009-12-01

    Incarcerated women have had limited access to health care prior to their arrest. Although their incarceration presents an opportunity to provide them with health care, their reproductive health needs have been overlooked. We performed a cross-sectional study of a nationally representative sample of 950 correctional health providers who are members of the Academy of Correctional Health Providers. A total of 405 surveys (43%) were returned, and 286 (30%) were eligible for analysis. Most ineligible surveys were from clinicians at male-only facilities. Of eligible respondents, 70% reported some degree of contraception counseling for women at their facilities. Only 11% provided routine counseling prior to release. Seventy percent said that their institution had no formal policy on contraception. Thirty-eight percent of clinicians provided birth control methods at their facilities. Although the most frequently counseled and prescribed method was oral contraceptive pills, only 50% of providers rated their oral contraceptive counseling ability as good or very good. Contraception counseling was associated with working at a juvenile facility, and with screening for sexually transmitted infections. Contraception does not appear to be integrated into the routine delivery of clinical services to incarcerated women. Because the correctional health care system can provide important clinical and public health interventions to traditionally marginalized populations, services for incarcerated women should include access to contraception.

  4. Risk and Protective Factors for Difficulty Controlling Violent Behavior in National Guard and Reserve Service Members.

    Science.gov (United States)

    Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer

    2017-11-01

    Violent behavior is an important problem for military service members and veterans. A representative cohort of U.S. Reserve and National Guard personnel ( N = 1,293) were interviewed to assess self-reported problems controlling violent behavior, deployment traumas, posttraumatic stress disorder (PTSD), alcohol abuse, and social support. Poisson regression models were used to estimate the associations of violent behavior with risk and protective factors. Problems controlling violent behavior were uncommon among male (3.3%) and female (1.7%) service members. Adjusted prevalence ratios (aPR) showed associations between violent behavior and deployment traumas (aPR = 1.67, 95% confidence interval [CI] = [1.34, 2.08]), PTSD (aPR = 9.95, 95% CI = [5.09, 19.48]), and PTSD symptom severity (aPR for each additional PTSD symptom = 1.07, 95% CI = [1.06, 1.09]). Social support was associated with lower prevalence of violent behavior (aPR = 0.62, 95% CI = [0.52, 0.76]). The association between violent behavior and alcohol abuse was not statistically significant (aPR = 1.94, 95% CI = [0.92, 4.09]). Results were consistent when the population was restricted to personnel who had deployed to a war zone. Problems controlling violent behavior were less common in this cohort than has been documented in other studies. Associations of violent behavior with risk and protective factors are consistent with prior research.

  5. Change of government: one more big bang health care reform in England's National Health Service.

    Science.gov (United States)

    Hunter, David J

    2011-01-01

    Once again the National Health Service (NHS) in England is undergoing major reform, following the election of a new coalition government keen to reduce the role of the state and cut back on big government. The NHS has been undergoing continuous reform since the 1980s. Yet, despite the significant transaction costs incurred, there is no evidence that the claimed benefits have been achieved. Many of the same problems endure. The reforms follow the direction of change laid down by the last Conservative government in the early 1990s, which the recent Labour government did not overturn despite a commitment to do so. Indeed, under Labour, the NHS was subjected to further market-style changes that have paved the way for the latest round of reform. The article considers the appeal of big bang reform, questions its purpose and value, and critically appraises the nature and extent of the proposed changes in this latest round of reform. It warns that the NHS in its current form may not survive the changes, as they open the way to privatization and a weakening of its public service ethos.

  6. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

    Science.gov (United States)

    Wright, Adam; Sittig, Dean F

    2008-12-01

    In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

  7. An overview of the use of Facebook in National Weather Services

    Science.gov (United States)

    Palacio, Virginia; Principe, Olatz; Martija, Maialen; Gaztelumendi, Santiago

    2016-10-01

    National Meteorological Services (NMSs) use different "classical" tools in order to diffuse meteorological information, including television, radio, newspaper, phone, e-mail and websites. In recent years, new communication technologies and, in particular, the rapid expansion of Facebook allows users to efficiently exchange information and to easily share it with a large part of the population. Facebook is one of the most used social networks and it represents a perfect virtual platform to share information and to promote active and immediate interaction amongst users. This is why many NMSs develop new communication strategies and incorporate this tool for different purposes. Some NMSs not only provide forecast, real-time observed data and other routine information, but they also upload videos (for example, with the weatherperson explaining the forecast or short reports) and amazing pictures taken by followers. In addition, they also give educational and didactic information (above all about climatic issues) and organize photographic competitions. In this paper, firstly, we investigate when Facebook was introduced in different NMSs worldwide as an additional tool for the diffusion of meteorological information. Then, we propose a classification of these NMSs based on the success of their Facebook page, i.e. on the number of followers. Finally, we select some representative cases of NMSs and we analyze how Facebook is used to improve their services.

  8. Radiotherapy services in countries in transition: gross national income per capita as a significant factor

    International Nuclear Information System (INIS)

    Levin, Victor; Tatsuzaki, Hideo

    2002-01-01

    Background and purpose: The acquisition of radiotherapy by countries in transition (CITs) is an evolutionary process from having no resources whatsoever, to meeting the standards adopted by well-developed countries. The influence of the economic ability of a country to acquire and sustain this technology has intuitively been accepted as a major factor but has not before been subjected to analysis for a large group of countries. This information has been analysed to provide guidance to countries commencing and expanding radiotherapy services. Material and methods: The number of linear accelerators and 60 Co megavoltage teletherapy machines in 72 CITs, those with gross national income per capita (GNI/cap) $12000 pa were expressed as machines per million population (MEV/mil) and used as an index of the ability of the country to provide a service. This figure was related to GNI/cap. The average populations of 24 further countries without radiotherapy were compared with 21 countries with radiotherapy facilities having the same range of GNI/cap. Results: The relationship log 10 MEV/mil=-2.90+0.85 log 10 GNI/cap was identified between the machines and income. Also verified was that small low income countries were less likely to have the technology than those with large populations. Conclusions: The increase in the number of teletherapy machines is closely linked to the GNI/cap of a country. Our sample of well developed countries failed to demonstrate a levelling off of equipment acquisition with income. In the lower income group, smaller countries were less likely to have radiotherapy services than those with large populations

  9. Predicting the Storm Surge Threat of Hurricane Sandy with the National Weather Service SLOSH Model

    Directory of Open Access Journals (Sweden)

    Cristina Forbes

    2014-05-01

    Full Text Available Numerical simulations of the storm tide that flooded the US Atlantic coastline during Hurricane Sandy (2012 are carried out using the National Weather Service (NWS Sea Lakes and Overland Surges from Hurricanes (SLOSH storm surge prediction model to quantify its ability to replicate the height, timing, evolution and extent of the water that was driven ashore by this large, destructive storm. Recent upgrades to the numerical model, including the incorporation of astronomical tides, are described and simulations with and without these upgrades are contrasted to assess their contributions to the increase in forecast accuracy. It is shown, through comprehensive verifications of SLOSH simulation results against peak water surface elevations measured at the National Oceanic and Atmospheric Administration (NOAA tide gauge stations, by storm surge sensors deployed and hundreds of high water marks collected by the U.S. Geological Survey (USGS, that the SLOSH-simulated water levels at 71% (89% of the data measurement locations have less than 20% (30% relative error. The RMS error between observed and modeled peak water levels is 0.47 m. In addition, the model’s extreme computational efficiency enables it to run large, automated ensembles of predictions in real-time to account for the high variability that can occur in tropical cyclone forecasts, thus furnishing a range of values for the predicted storm surge and inundation threat.

  10. Equality, diversity and career progression: Perceptions of radiographers working in the National Health Service

    Energy Technology Data Exchange (ETDEWEB)

    Bogg, Jan [School of Community and Population Sciences, University of Liverpool, Liverpool (United Kingdom); Hussain, Zainab, E-mail: zay@liv.ac.u [School of Health Sciences, Division of Medical Imaging and Radiotherapy, University of Liverpool, L69 3GB, Liverpool, Merseyside (United Kingdom)

    2010-11-15

    This study evaluated radiographers' perceptions of equality, diversity and career progression in the National Health Service (NHS) by means of a quantitative national survey in which 120 radiographers responded. The findings were assessed in relation to the participants' own beliefs about equality and diversity. Key findings included that despite the fact that the NHS is actively attempting to address equality and diversity issues, radiographers working within the NHS still perceive that problems exist. This is apparent from the findings that 55% of participants thought that women generally experience some barriers to career progression. Sixty-seven percent perceived that people with disabilities experienced barriers to career progression and 49% felt that the profession did not reflect the community that it served. Reassuringly, policy and procedures are felt to be making a difference and worthwhile. In the light of the introduction of the Single Equality Scheme and Equality Impact Assessments, it is important that radiographer's perceptions of equality and diversity are evaluated and that incorrect beliefs are challenged.

  11. Equality, diversity and career progression: Perceptions of radiographers working in the National Health Service

    International Nuclear Information System (INIS)

    Bogg, Jan; Hussain, Zainab

    2010-01-01

    This study evaluated radiographers' perceptions of equality, diversity and career progression in the National Health Service (NHS) by means of a quantitative national survey in which 120 radiographers responded. The findings were assessed in relation to the participants' own beliefs about equality and diversity. Key findings included that despite the fact that the NHS is actively attempting to address equality and diversity issues, radiographers working within the NHS still perceive that problems exist. This is apparent from the findings that 55% of participants thought that women generally experience some barriers to career progression. Sixty-seven percent perceived that people with disabilities experienced barriers to career progression and 49% felt that the profession did not reflect the community that it served. Reassuringly, policy and procedures are felt to be making a difference and worthwhile. In the light of the introduction of the Single Equality Scheme and Equality Impact Assessments, it is important that radiographer's perceptions of equality and diversity are evaluated and that incorrect beliefs are challenged.

  12. The burden of seasonal respiratory infections on a national telehealth service in England.

    Science.gov (United States)

    Morbey, R A; Harcourt, S; Pebody, R; Zambon, M; Hutchison, J; Rutter, J; Thomas, H; Smith, G E; Elliot, A J

    2017-07-01

    Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for 'cold/flu', whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

  13. Trends in breast reconstruction: Implications for the National Health Insurance Service.

    Science.gov (United States)

    Hong, Ki Yong; Son, Yoosung; Chang, Hak; Jin, Ung Sik

    2018-05-01

    Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (PNHIS coverage (PNHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  14. Configuring the HYSPLIT Model for National Weather Service Forecast Office and Spaceflight Meteorology Group Applications

    Science.gov (United States)

    Dreher, Joseph; Blottman, Peter F.; Sharp, David W.; Hoeth, Brian; Van Speybroeck, Kurt

    2009-01-01

    The National Weather Service Forecast Office in Melbourne, FL (NWS MLB) is responsible for providing meteorological support to state and county emergency management agencies across East Central Florida in the event of incidents involving the significant release of harmful chemicals, radiation, and smoke from fires and/or toxic plumes into the atmosphere. NWS MLB uses the National Oceanic and Atmospheric Administration Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model to provide trajectory, concentration, and deposition guidance during such events. Accurate and timely guidance is critical for decision makers charged with protecting the health and well-being of populations at risk. Information that can describe the geographic extent of areas possibly affected by a hazardous release, as well as to indicate locations of primary concern, offer better opportunity for prompt and decisive action. In addition, forecasters at the NWS Spaceflight Meteorology Group (SMG) have expressed interest in using the HYSPLIT model to assist with Weather Flight Rules during Space Shuttle landing operations. In particular, SMG would provide low and mid-level HYSPLIT trajectory forecasts for cumulus clouds associated with smoke plumes, and high-level trajectory forecasts for thunderstorm anvils. Another potential benefit for both NWS MLB and SMG is using the HYSPLIT model concentration and deposition guidance in fog situations.

  15. Configuring the HYSPLIT Model for National Weather Service Forecast Office and Spaceflight Meteorology Group Applications

    Science.gov (United States)

    Dreher, Joseph G.

    2009-01-01

    For expedience in delivering dispersion guidance in the diversity of operational situations, National Weather Service Melbourne (MLB) and Spaceflight Meteorology Group (SMG) are becoming increasingly reliant on the PC-based version of the HYSPLIT model run through a graphical user interface (GUI). While the GUI offers unique advantages when compared to traditional methods, it is difficult for forecasters to run and manage in an operational environment. To alleviate the difficulty in providing scheduled real-time trajectory and concentration guidance, the Applied Meteorology Unit (AMU) configured a Linux version of the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) (HYSPLIT) model that ingests the National Centers for Environmental Prediction (NCEP) guidance, such as the North American Mesoscale (NAM) and the Rapid Update Cycle (RUC) models. The AMU configured the HYSPLIT system to automatically download the NCEP model products, convert the meteorological grids into HYSPLIT binary format, run the model from several pre-selected latitude/longitude sites, and post-process the data to create output graphics. In addition, the AMU configured several software programs to convert local Weather Research and Forecast (WRF) model output into HYSPLIT format.

  16. Can trained lay providers perform HIV testing services? A review of national HIV testing policies.

    Science.gov (United States)

    Flynn, David E; Johnson, Cheryl; Sands, Anita; Wong, Vincent; Figueroa, Carmen; Baggaley, Rachel

    2017-01-04

    Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups. 50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015. Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy. Given the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.

  17. Snakebite enquiries to the UK National Poisons Information Service: 2004-2010.

    Science.gov (United States)

    Coulson, James Michael; Cooper, Gillian; Krishna, Channarayapatna; Thompson, John Paul

    2013-11-01

    To describe trends regarding snakebite enquiries to the UK National Poisons Information Service (NPIS) from 2004 to 2010. The NPIS telephone enquiry database, the UK Poisons Information Database, was interrogated for enquiries to the four NPIS units from 2004 to 2010. Search terms used were 'snake' and 'snakebite'. Information from the national dataset was available from Cardiff and Edinburgh units from 2004 onwards, Birmingham from June 2005 and Newcastle from September 2006. Five hundred and ten cases were identified, of which 69% were male and 31% female. Average age of cases was 32 years (±1 95% CI). The snake was identified as follows: British Adder in 52% of cases, an exotic species in 26%, unknown in 18% and another UK snake in 4%. 82% of cases occurred between the months of April and September. Cases peaked during August (19%). Forty-two per cent of enquiries involved features of envenoming. Eighty-five cases were assessed as requiring antivenom. Eighty-four cases received treatment with antivenom. No adverse reactions to the antivenom were reported and resolution of clinical features was reported in all treated cases. Advice to use an antidote was followed in 98.8% of cases. Snakebites account for one to two NPIS cases per week. Adder bites account for over half of cases. A quarter of cases were due to non-UK snakes kept in captivity within the UK. Envenoming was said to have occurred in just under half of all cases. Advice given by the NPIS appears to closely reflect national practice guidelines.

  18. Radiation protection safety in Uganda -- Experience and prospects of the National Radiation Protection Service

    International Nuclear Information System (INIS)

    Kisolo, A.

    2001-01-01

    The Uganda National Radiation Protection Service (NRPS) is a technical body under the Atomic Energy Control Board, established by Law - the Atomic Energy Decree of 1972, Decree No. 12, to oversee and enforce safety of radiation sources, practices and workers; and to protect the patients, members of the public and the environment from the dangers of ionizing radiation and radioactive wastes. The Ionizing Radiation Regulations (Standards) - Statutory Instruments Supplement No. 21 of 1996 -- back up the Law. The Law requires all users, importers and operators of radiation sources and radioactive materials to notify the NRPS for registration and licensing. The NRPS is responsible for licensing and for the regulatory enforcement of compliance to the requirements for the safety of radiation sources and practices. There are about 200 diagnostic X-ray units, two radiotherapy centres, one nuclear medicine unit, several neutron probes, about three level gauges and two non-destructive testing sources and a number of small sealed sources in teaching and research institutions. About 50% of these sources have been entered in our inventory using the RAIS software provided by the IAEA. There are about 500 radiation workers and 250 underground miners. The NRPS covers about 50% of the radiation workers. It is planned that by June 2001, all occupational workers will be monitored, bringing coverage to 100%. The Government of Uganda is making the necessary legal, administrative and technical arrangements aimed at establishing the National Radiation Protection Commission as an autonomous regulatory authority. The Atomic Energy Decree of 1972 and Regulations of 1996 are being revised to provide for the National Radiation Protection Commission and to make it comply with the requirements of the International Basic Safety Standards Safety Series No. 115. (author)

  19. The medium-term sustainability of organisational innovations in the national health service

    Directory of Open Access Journals (Sweden)

    Finn Rachael

    2011-03-01

    Full Text Available Abstract Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion

  20. The medium-term sustainability of organisational innovations in the national health service

    Science.gov (United States)

    2011-01-01

    Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS) and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion Through comparison and

  1. Analysis of the use and development of the concept of national forestall service in the politics and the Colombian forestall legislation

    International Nuclear Information System (INIS)

    Bohorquez C, Nhaydu

    1998-01-01

    The concept of national forestall service is examined, the structure and basic functions of the forestall service are determined and they are analyzed and they evaluate the characteristics of the diverse types of forest administration it publishes and of national forestall service established in the politics, in the norms and law projects

  2. STAR - Research Experiences at National Laboratory Facilities for Pre-Service and Early Career Teachers

    Science.gov (United States)

    Keller, J. M.; Rebar, B.; Buxner, S.

    2012-12-01

    The STEM Teacher and Researcher (STAR) Program provides pre-service and beginning teachers the opportunity to develop identity as both teachers and researchers early in their careers. Founded and implemented by the Center for Excellence in Science and Mathematics Education (CESaME) at California Polytechnic State University on behalf of the California State University (CSU) system, STAR provides cutting edge research experiences and career development for students affiliated with the CSU system. Over the past three summers, STAR has also partnered with the NSF Robert Noyce Teacher Scholarship Program to include Noyce Scholars from across the country. Key experiences are one to three summers of paid research experience at federal research facilities associated with the Department of Energy (DOE), National Aeronautics and Space Administration (NASA), National Oceanic and Atmospheric Association (NOAA), and the National Optical Astronomy Observatory (NOAO). Anchoring beginning teachers in the research community enhances participant understanding of what it means to be both researchers and effective teachers. Since its inception in 2007, the STAR Program has partnered with 15 national lab facilities to provide 290 research experiences to 230 participants. Several of the 68 STAR Fellows participating in the program during Summer 2012 have submitted abstracts to the Fall AGU Meeting. Through continued partnership with the Noyce Scholar Program and contributions from outside funding sources, the CSU is committed to sustaining the STAR Program in its efforts to significantly impact teacher preparation. Evaluation results from the program continue to indicate program effectiveness in recruiting high quality science and math majors into the teaching profession and impacting their attitudes and beliefs towards the nature of science and teaching through inquiry. Additionally, surveys and interviews are being conducted of participants who are now teaching in the classroom as

  3. A National Approach to Quantify and Map Biodiversity Conservation Metrics within an Ecosystem Services Framework

    Science.gov (United States)

    Ecosystem services, i.e., "services provided to humans from natural systems," have become a key issue of this century in resource management, conservation planning, human well-being, and environmental decision analysis. Mapping and quantifying ecosystem services have be...

  4. 75 FR 77624 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

    Science.gov (United States)

    2010-12-13

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services Overview... months. The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-31191...

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

    Science.gov (United States)

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

    2018-05-01

    Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

  6. U.S. Public Health Service Commissioned Corps pharmacists: making a difference in advancing the nation's health.

    Science.gov (United States)

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H; Shiber, Michael; Britton, James E; Ngo, Diem-Kieu H; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2009-01-01

    To describe how U.S. Public Health Service (PHS) pharmacists serving in jobs that are normal for them, but considerably different than those found in the private sector, are making a difference in advancing the nation's health. Pharmacists who serve in the Commissioned Corps of PHS fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research, and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Health Resources and Services Administration, National Institutes of Health, Federal Bureau of Prisons, Indian Health Service, Food and Drug Administration, and U.S. Coast Guard are among the many federal agencies in which pharmacy officers are assigned. In each setting, PHS pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice.

  7. A Look into the National Drought Mitigation Center: Providing 15 Years of Drought Services (Invited)

    Science.gov (United States)

    Svoboda, M. D.; Hayes, M. J.; Knutson, C. L.; Wardlow, B. D.

    2009-12-01

    The National Drought Mitigation Center (NDMC) was formed in 1995 at the University of Nebraska-Lincoln. Over the past 15 years, the NDMC has made it a priority to work with various local, state, tribal and federal entities to provide a suite of drought/climate services, with a goal of bringing research to fruition through applications and operations. Through our research and outreach projects, the NDMC has worked to reduce risk to drought by developing several mitigation strategies, monitoring and decision making tools and other services aimed at enhancing our nation’s capacity to cope with drought. Two of the earliest NDMC activities were the creation of a website and assessing drought conditions around the United States. An electronic drought clearinghouse was built in 1995 at drought.unl.edu. The site was designed, and still concentrates, on the concepts of drought monitoring, planning, and mitigation and also serves as a repository of information from around the world. The NDMC’s electronic quarterly newsletter, DroughtScape, disseminates information about all things drought to people across the country. In addition, the NDMC has developed and is home to websites for the U.S. Drought Monitor (USDM), Drought Impact Reporter (DIR), and the Vegetation Drought Response Index (VegDRI). In an effort to inform decision makers, the NDMC continually pursues ways to raise the awareness and visibility of drought as one of the most costly hazards we face. This began in the mid-1990s with the creation of a state-based drought impact assessment map that would help lead to the formation of the USDM in 1999 and the DIR in 2005. The NDMC plays a key role in producing the weekly USDM and the monthly North American Drought Monitor (NADM). The USDM was created out of collaborations between the NDMC, United States Department of Agriculture (USDA) and National Oceanic and Atmospheric Administration (NOAA) and has quickly become one of the most widely used products in assessing

  8. Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

    Directory of Open Access Journals (Sweden)

    Collins Luke

    2011-07-01

    Full Text Available Abstract Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. Methods We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. Results The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%. Respondents considered the NHS tinnitus referral process to be generally effective (67%, but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%, nor was the opportunity to access specialist counselling provided by clinical psychology (35%. To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Conclusions Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved

  9. Crowdsourcing of weather observations at national meteorological and hydrological services in Europe

    Science.gov (United States)

    Krennert, Thomas; Pistotnik, Georg; Kaltenberger, Rainer; Csekits, Christian

    2018-05-01

    National Meteorological and Hydrological Services (NMHSs) increase their efforts to deliver impact-based weather forecasts and warnings. At the same time, a desired increase in cost-efficiency prompts these services to automatize their weather station networks and to reduce the number of human observers, which leads to a lack of ground truth information about weather phenomena and their impact. A possible alternative is to encourage the general public to submit weather observations, which may include crucial information especially in high-impact situations. We wish to provide an overview of the state and properties of existing collaborations between NMHSs and voluntary weather observers or storm spotters across Europe. For that purpose, we performed a survey among 30 European NMHSs, from which 22 NMHSs returned our questionnaire. This study summarizes the most important findings and evaluates the use of crowdsourced information. 86 % of the surveyed NMHSs utilize information provided by the general public, 50 % have established official collaborations with spotter groups, and 18 % have formalized them. The observations are most commonly used for a real-time improvement of severe weather warnings, their verification, and an establishment of a climatology of severe weather events. The importance of these volunteered weather and impact observations has strongly risen over the past decade. We expect that this trend will continue and that storm spotters will become an essential part in severe weather warning, like they have been for decades in the United States of America. A rising number of incoming reports implies that quality management will become an increasing issue, and we finally discuss an idea how to handle this challenge.

  10. Developing national on-line services to annotate and analyse underwater imagery in a research cloud

    Science.gov (United States)

    Proctor, R.; Langlois, T.; Friedman, A.; Davey, B.

    2017-12-01

    Fish image annotation data is currently collected by various research, management and academic institutions globally (+100,000's hours of deployments) with varying degrees of standardisation and limited formal collaboration or data synthesis. We present a case study of how national on-line services, developed within a domain-oriented research cloud, have been used to annotate habitat images and synthesise fish annotation data sets collected using Autonomous Underwater Vehicles (AUVs) and baited remote underwater stereo-video (stereo-BRUV). Two developing software tools have been brought together in the marine science cloud to provide marine biologists with a powerful service for image annotation. SQUIDLE+ is an online platform designed for exploration, management and annotation of georeferenced images & video data. It provides a flexible annotation framework allowing users to work with their preferred annotation schemes. We have used SQUIDLE+ to sample the habitat composition and complexity of images of the benthos collected using stereo-BRUV. GlobalArchive is designed to be a centralised repository of aquatic ecological survey data with design principles including ease of use, secure user access, flexible data import, and the collection of any sampling and image analysis information. To easily share and synthesise data we have implemented data sharing protocols, including Open Data and synthesis Collaborations, and a spatial map to explore global datasets and filter to create a synthesis. These tools in the science cloud, together with a virtual desktop analysis suite offering python and R environments offer an unprecedented capability to deliver marine biodiversity information of value to marine managers and scientists alike.

  11. A study of National Health Service management of chronic osteoarthritis and low back pain.

    Science.gov (United States)

    Hart, Oliver R; Uden, Ruth M; McMullan, James E; Ritchie, Mark S; Williams, Timothy D; Smith, Blair H

    2015-04-01

    To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.

  12. A Novel Hydro-information System for Improving National Weather Service River Forecast System

    Science.gov (United States)

    Nan, Z.; Wang, S.; Liang, X.; Adams, T. E.; Teng, W. L.; Liang, Y.

    2009-12-01

    A novel hydro-information system has been developed to improve the forecast accuracy of the NOAA National Weather Service River Forecast System (NWSRFS). An MKF-based (Multiscale Kalman Filter) spatial data assimilation framework, together with the NOAH land surface model, is employed in our system to assimilate satellite surface soil moisture data to yield improved evapotranspiration. The latter are then integrated into the distributed version of the NWSRFS to improve its forecasting skills, especially for droughts, but also for disaster management in general. Our system supports an automated flow into the NWSRFS of daily satellite surface soil moisture data, derived from the TRMM Microwave Imager (TMI) and Advanced Microwave Scanning Radiometer-Earth Observing System (AMSR-E), and the forcing information of the North American Land Data Assimilation System (NLDAS). All data are custom processed, archived, and supported by the NASA Goddard Earth Sciences Data Information and Services Center (GES DISC). An optional data fusing component is available in our system, which fuses NEXRAD Stage III precipitation data with the NLDAS precipitation data, using the MKF-based framework, to provide improved precipitation inputs. Our system employs a plug-in, structured framework and has a user-friendly, graphical interface, which can display, in real-time, the spatial distributions of assimilated state variables and other model-simulated information, as well as their behaviors in time series. The interface can also display watershed maps, as a result of the integration of the QGIS library into our system. Extendibility and flexibility of our system are achieved through the plug-in design and by an extensive use of XML-based configuration files. Furthermore, our system can be extended to support multiple land surface models and multiple data assimilation schemes, which would further increase its capabilities. Testing of the integration of the current system into the NWSRFS is

  13. Can the National Health Service Cancer Plan timeline be applied to colorectal hepatic metastases?

    LENUS (Irish Health Repository)

    Jones, Claire

    2012-02-01

    INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.

  14. Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey.

    Science.gov (United States)

    Schmied, Virginia; Fowler, Cathrine; Rossiter, Chris; Homer, Caroline; Kruske, Sue

    2014-05-01

    Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. A national survey of CFH nurses was conducted. In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for

  15. Assessing multiple goods and services derived from livestock farming on a nation-wide gradient.

    Science.gov (United States)

    Ryschawy, J; Disenhaus, C; Bertrand, S; Allaire, G; Aznar, O; Plantureux, S; Josien, E; Guinot, C; Lasseur, J; Perrot, C; Tchakerian, E; Aubert, C; Tichit, M

    2017-10-01

    Livestock farming is an essential activity in many rural areas, where it contributes to the maintenance of soil fertility and farmland biodiversity, as well as to a set of social public goods including food security, rural vitality and culture. However, livestock sustainability assessments tend to focus primarily on environmental and economic dimensions; therefore, these valuations might be limited because they do not consider the complete set of associated goods and services (GS). Hence, a need exists to recognise the multiple contributions provided by livestock to human well-being and society. The objective of this study was to analyse the provision of multiple GS derived from livestock across regions in France and empirically demonstrate sets of GS that repeatedly appeared together. We designated these multiple GS provided by livestock as contributions to productive, environmental, rural vitality and cultural benefits that human populations derive directly or indirectly from livestock agroecosystems. First, we combined expert knowledge with results of a literature review to define a bundle of GS provided by livestock. We then described indicators that quantified each good or service and screened national databases to determine the availability of supporting data. Finally, we assessed the GS and their relationships (synergies or trade-offs) on a nation-wide gradient in France at the department level (Nomenclature of Territorial Units for Statistics 3). Four main categories of GS were considered: provisioning (e.g. food quantity and quality), environmental quality (e.g. biodiversity, landscape heterogeneity, water quality), rural vitality (e.g. employment, rural dynamism) and culture (e.g. gastronomy and landscape heritage). Four major types of GS bundles were identified, which suggested strong contrasts among French rural areas in terms of the nature of the GS that occurred together and their levels of provision. GS bundles in France had a non-random spatial

  16. National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

    Science.gov (United States)

    Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2018-01-01

    Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

  17. Use of national data base for strategic management of municipal oral health services for Danish children and adolescents

    DEFF Research Database (Denmark)

    Hansen, I.; Foldspang, Anders; Poulsen, S.

    2001-01-01

    Abstract –Objective: To evaluate the use of a national register for strategic management of dental health services for 0–17-year-old Danish children and to identify determinants for their use of the system as a strategic tool in management of the services. Methods: During the period December 1997...... decreased from 1995 to 1996. Otherwise no associations between dental health and use of the system could be demonstrated. Conclusions: SCOR is widely used as a strategic planning instrument concerning the Danish dental services for children and adolescents. The predictors associated with its use are partly...

  18. National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses

    Data.gov (United States)

    Department of Veterans Affairs — The 2010 National Survey of Veterans (NSV) is the sixth in a series of comprehensive nationwide surveys designed to help the Department of Veterans Affairs (VA) plan...

  19. Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland

    Directory of Open Access Journals (Sweden)

    Muhammad Umair Khan

    2014-01-01

    Full Text Available Background: Hypertension is a silent killer, a time bomb in both the developed and developing nations of the world. It is one of the most significant risk factors for cardiovascular morbidity and mortality resulting from target-organ damage to blood vessels in the heart, brain, kidney and eyes. Adherence to long-term therapy for chronic illnesses like hypertension is an important tool to enhance the effectiveness of pharmacotherapy. Objective: The two objectives of this study were to evaluate the extent and reasons of non-adherence in patients attended National Health Service (NHS Hospital, Sunderland. Materials and Methods: The study was conducted for 4 months in the out-patient department of NHS Hospital. A total of 200 patients were selected randomly for this study. Morisky′s Medication Adherence Scale was used to assess the adherence rate and the reason of non-adherence. Data were entered and analyzed using Microsoft Excel 2010. Results: The overall adherence rate was found to be 79% (n = 158. Adherence rate in females were low was compared with their male counterparts (74.7% vs. 85.7%. The higher rate of adherence was found in age group of 30-40 years (82%, n = 64. The major intentional and non-intentional reason of non-adherence was side-effects and forgetfulness respectively. Conclusion: Overall, more than three-fourth of the hypertensive participants were found to be adherent to their treatment. On the basis of factors associated with non-adherence, it is analyzed that suitable therapy must be designed for patients individually to increase medication adherence and its effectiveness.

  20. Trends in breast reconstruction: Implications for the National Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Ki Yong Hong

    2018-05-01

    Full Text Available Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases in 2012 to 18.3% (76 cases in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05. Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05, but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05. Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

  1. Student and Nonstudent National Guard Service Members/Veterans and their Use of Services for Mental Health Symptoms

    Science.gov (United States)

    Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia

    2016-01-01

    Objective To compare mental health symptoms and service utilization among returning student and nonstudent Service Members/Veterans (SM/Vs). Participants SM/Vs (N=1439) were predominately white (83%) men (92%); half were over age 30 (48%) and 24% were students. Methods SM/Vs completed surveys six months post-deployment (October 2011–July 2013). Results Students and nonstudent SM/Vs did not differ in positive screens for depression, anxiety, hazardous drinking, or Post-traumatic Stress Disorder (PTSD). Students (n=81) and nonstudents (n=265) with mental health symptoms had low levels of mental health service use (e.g., VA, civilian, or military facilities), at 47% and 57% respectively. Fewer students used VA mental health services. Common barriers to treatment-seeking included not wanting treatment on military records and embarrassment. Conclusions Like other returning SM/Vs, student SM/Vs have unmet mental health needs. The discrepancy between potential need and treatment-seeking suggests that colleges might be helpful in further facilitating mental health service use for student SM/Vs. PMID:25337770

  2. 76 FR 10916 - Sunshine Act Meeting of the National Museum and Library Services Board

    Science.gov (United States)

    2011-02-28

    ... Lyons, Special Events and Board Liaison, Institute of Museum and Library Services, 1800 M Street, NW... Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of... Library Services Board. This notice also describes the function of the Board. Notice of the meeting is...

  3. 77 FR 24741 - Sunshine Act Meeting; National Museum and Library Services Board

    Science.gov (United States)

    2012-04-25

    ... Lyons, Special Events and Board Liaison, Institute of Museum and Library Services, 1800 M Street NW... Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of... Library Services Board. This notice also describes the function of the Board. Notice of the meeting is...

  4. Customer evaluations of after-sales service contact modes : an empirical analysis of national culture's consequences

    NARCIS (Netherlands)

    Birgelen, van M.; Ruyter, de J.C.; Jong, de A.; Wetzels, M.G.M.

    2001-01-01

    Technological advances extend the after-sales services portfolio from traditional service encounters to voice- and bit-based services. Technology enables service organizations to transcend geographical as well as cultural boundaries. It might even result in geographical convergence, often treated

  5. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

    Directory of Open Access Journals (Sweden)

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  6. Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Yong-ho Lee

    2016-02-01

    Full Text Available In 2014, the National Health Insurance Service (NHIS signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

  7. Twitter and the health reforms in the English National Health Service.

    Science.gov (United States)

    King, Dominic; Ramirez-Cano, Daniel; Greaves, Felix; Vlaev, Ivo; Beales, Steve; Darzi, Ara

    2013-05-01

    Social media (for example Facebook and YouTube) uses online and mobile technologies to allow individuals to participate in, comment on and create user-generated content. Twitter is a widely used social media platform that lets users post short publicly available text-based messages called tweets that other users can respond to. Alongside traditional media outlets, Twitter has been a focus for discussions about the controversial and radical reforms to the National Health Service (NHS) in England that were recently passed into law by the current coalition Government. Looking at over 120,000 tweets made about the health reforms, we have investigated whether any insights can be obtained about the role of Twitter in informing, debating and influencing opinion in a specific area of health policy. In particular we have looked at how the sentiment of tweets changed with the passage of the Health and Social Care Bill through Parliament, and how this compared to conventional opinion polls taken over the same time period. We examine which users appeared to have the most influence in the 'Twittersphere' and suggest how a widely used metric of academic impact - the H-index - could be applied to measure context-dependent influence on Twitter. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Productivity Growth in the English National Health Service from 1998/1999 to 2013/2014.

    Science.gov (United States)

    Bojke, Chris; Castelli, Adriana; Grašič, Katja; Street, Andrew

    2017-05-01

    Productivity growth is a key measure against which National Health Service (NHS) achievements are judged. We measure NHS productivity growth as a set of paired year-on-year comparisons from 1998/1999-1999/2000 through 2012/2013-2013/2014, which are converted into a chained index that summarises productivity growth over the entire period. Our measure is as comprehensive as data permit and accounts for the multitude of diverse outputs and inputs involved in the production process and for regular revisions to the data used to quantify outputs and inputs. Over the full-time period, NHS output increased by 88.96% and inputs by 81.58%, delivering overall total factor productivity growth of 4.07%. Productivity growth was negative during the first two terms of Blair's government, with average yearly growth rate of -1.01% per annum (pa) during the first term (to 2000/2001) and -1.49% pa during the second term (2000/2001-2004/2005). Productivity growth was positive under Blair's third term (2004/2005-2007/2008) at 1.41% pa and under the Brown government (2007/2008-2010/2011), averaging 1.13% pa. Productivity growth remained positive under the Coalition (2010/2011-2013/2014), averaging 1.56% pa. © 2016 The Authors Health Economics Published by John Wiley & Sons Ltd. © 2016 The Authors Health Economics Published by John Wiley & Sons Ltd.

  9. Enacting open disclosure in the UK National Health Service: A qualitative exploration.

    Science.gov (United States)

    Harrison, Reema; Birks, Yvonne; Bosanquet, Kate; Iedema, Rick

    2017-08-01

    Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure. Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach. Five themes were identified which appear to capture the factors that are critical in supporting open disclosure: open disclosure as a moral and professional duty, positive past experiences, perceptions of reduced litigation, role models and guidance, and clarity. Greater openness in relation to adverse events requires health professionals to recognise candour as a professional and moral duty, exemplified in the behaviour of senior clinicians and that seems more likely to occur in a nonpunitive, learning environment. Recognising incident disclosure as part of ongoing respectful and open communication with patients throughout their care is critical. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

  10. [Nutritional status in patients first hospital admissions service hematology National Cancer Institute].

    Science.gov (United States)

    Baltazar Luna, E; Omaña Guzmán, L I; Ortiz Hernández, L; Ñamendis-Silva, S A; De Nicola Delfin, L

    2013-01-01

    To determine the nutritional status of patients admitted to hospital for the first time the hematology service and who have not received treatment for cancer, to know if the nutritional status assessed by the EGS-GP and serum albumin related mortality of patients A longitudinal, prospective, analytical. EGS-Through GP assessed the nutritional status of patients, we used SPSS 19.0 for data analysis. Evaluaron 119 patients, 52.1% female and 47.9% male. The most common diagnosis was non-Hodgkin lymphoma in 43.7%. According to the EGS-GP 50.4% of patients had some degree of malnutrition or was at risk of suffering of which: 31.1% had moderate and 19.3% had severe malnutrition. The 49.6% of patients had an adequate nutritional status. 30.3% of the patients who died, 37% had severe malnutrition and 50% severe decrease in albumin concentration. The prevalence of malnutrition in hematological patients treated at the National Cancer Institute of Mexico that have not received medical treatment was high. There is an association between nutritional status and mortality in this patient group. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  11. Evaluation of the National Weather Service Extreme Cold Warning Experiment in North Dakota.

    Science.gov (United States)

    Chiu, Cindy H; Vagi, Sara J; Wolkin, Amy F; Martin, John Paul; Noe, Rebecca S

    2014-01-01

    Dangerously cold weather threatens life and property. During periods of extreme cold due to wind chill, the National Weather Service (NWS) issues wind chill warnings to prompt the public to take action to mitigate risks. Wind chill warnings are based on ambient temperatures and wind speeds. Since 2010, NWS has piloted a new extreme cold warning issued for cold temperatures in wind and nonwind conditions. The North Dakota Department of Health, NWS, and the Centers for Disease Control and Prevention collaborated in conducting household surveys in Burleigh County, North Dakota, to evaluate this new warning. The objectives of the evaluation were to assess whether residents heard the new warning and to determine if protective behaviors were prompted by the warning. This was a cross-sectional survey design using the Community Assessment for Public Health Emergency Response (CASPER) methodology to select a statistically representative sample of households from Burleigh County. From 10 to 11 April 2012, 188 door-to-door household interviews were completed. The CASPER methodology uses probability sampling with weighted analysis to estimate the number and percentage of households with a specific response within Burleigh County. The majority of households reported having heard both the extreme cold and wind chill warnings, and both warnings prompted protective behaviors. These results suggest this community heard the new warning and took protective actions after hearing the warning.

  12. The psychological contract: is the UK National Health Service a model employer?

    Science.gov (United States)

    Fielden, Sandra; Whiting, Fiona

    2007-05-01

    The UK National Health Service (NHS) is facing recruitment challenges that mean it will need to become an 'employer of choice' if it is to continue to attract high-quality employees. This paper reports the findings from a study focusing on allied health professional staff (n = 67), aimed at establishing the expectations of the NHS inherent in their current psychological contract and to consider whether the government's drive to make the NHS a model employer meets those expectations. The findings show that the most important aspects of the psychological contract were relational and based on the investment made in the employment relationship by both parties. The employment relationship was one of high involvement but also one where transactional contract items, such as pay, were still of some importance. Although the degree of employee satisfaction with the relational content of the psychological contract was relatively positive, there was, nevertheless, a mismatch between levels of importance placed on such aspects of the contract and levels of satisfaction, with employees increasingly placing greater emphasis on those items the NHS is having the greatest difficulty providing. Despite this apparent disparity between employee expectation and the fulfilment of those expectations, the overall health of the psychological contract was still high.

  13. Patient protection in radiotherapy (Radio neurosurgery National Service of the Social Security Mexican Institute)

    International Nuclear Information System (INIS)

    Espiritu R, R.

    2008-12-01

    The perspective of patient protection at the Radio neurosurgery National Service of the Social Security Mexican Institute is divided into three parts: the testing program for equipment acceptance, an assurance quality program based on periodic tests, an also other assurance quality based on tests during the application. Among the technical aspects that influence in the equipment acceptance tests, it is the collimation type, the characteristics of the lineal accelerator, the platform for planning and the network type. In the case of the collimation system and the accelerator characteristics, we consider the manufacturer's specifications and requirements of Mexican Official Standard NOM-033-NUCL-1999, T echnical Specifications for the Teletherapy Units Operation, Linear Accelerators . Planning for the platform takes into account the manufacturer's specifications. In the case of computed tomography as well as review the calibration according to manufacturer's specifications should be considered the standard NOM-229-SSA1-2002. In the case of the linear accelerator must be the radiological characterization of radiation beam as part of this, the absolute dose determination. As for the periodic tests is verified the dose constancy, as well as the flattening and symmetry of X-rays beam. There are also tests battery with daily, monthly and yearly frequencies, which make up the assurance quality program. (Author)

  14. Leadership development in the English National Health Service: A counter narrative to inform policy.

    Science.gov (United States)

    Hewison, Alistair; Morrell, Kevin

    2014-04-01

    To examine the current approach to leadership development in the English National Health Service (NHS) and consider its implications for nursing. To stimulate debate about the nature of leadership development in a range of health care settings. Good leadership is central to the provision of high quality nursing care. This has focussed attention on the leadership development of nurses and other health care staff. It has been a key policy concern in the English NHS of late and fostered the growth of leadership development programmes founded on competency based approaches. This is a policy review informed by the concept of episteme. Relevant policy documents and related literature. Using Foucault's concept of episteme, leadership development policy is examined in context and a 'counter narrative' developed to demonstrate that current approaches are rooted in competency based accounts which constitute a limited, yet dominant narrative. Leadership takes many forms and varies hugely according to task and context. Acknowledging this in the form of a counter narrative offers a contribution to more constructive policy development in the English NHS and more widely. A more nuanced debate about leadership development and greater diversity in the provision of development programmes and activities is required. Leadership development has been advocated as being crucial to the advancement of nursing. Detailed analysis of its nature and function is essential if it is to meet the needs of nurse leaders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom

    International Nuclear Information System (INIS)

    Tudor, T.L.; Noonan, C.L.; Jenkin, L.E.T.

    2005-01-01

    This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of 'waste management', to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%

  16. Seroprevalence of Trypanosoma cruzi in blood donors at the National Blood Transfusion Services--Guyana.

    Science.gov (United States)

    Bwititi, P T; Browne, J

    2012-09-01

    Blood transfusion is an important transmission route of Trypanosoma cruzi (T cruzi), a major parasitic infection in Central and South America. The limited treatment options are most effective in acute Chagas' infection. At present, there is no current data on the prevalence of T cruzi in the blood donor population of Guyana. This information is necessary to protect the supply of the blood donation programme. This study sought to determine the prevalence of T cruzi in the blood supply at the National Blood Transfusion Services of Guyana with the hope of providing knowledge to the on-going surveillance for Chagas' disease worldwide and therefore address the risk of its spread by blood transfusion. Two commercialized ELISAs utilizing crude or recombinant T cruzi antigens were used to study 2000 blood samples voluntarily donated for the purpose of altruistic or family replacement donation retrospectively. The results showed that approximately 1 in 286 donations tested positive for antibodies to T cruzi. These results indicate that T cruzi continues to be a risk in Guyana and there is a need to continue screening donated blood. Trypanosoma cruzi is a life-long infection and infected persons may be asymptomatic chronic carriers of the disease. Education, housing improvement, and controlled use of insecticides should be introduced to contain Chagas' disease.

  17. Identifying Challenging Job and Environmental Demands of Older Nurses Within the National Health Service.

    Science.gov (United States)

    Durosaiye, Isaiah Oluremi; Hadjri, Karim; Liyanage, Champika Lasanthi

    2016-04-01

    To explore the existing theoretical contexts of the job and environmental demands of the nursing profession in the National Health Service (NHS) and to investigate how these job and environmental demands impact on the personal constructs of older nurses within the NHS. Nursing is the single most widely practiced profession in the healthcare sector in the United Kingdom. However, nurses contend with challenging job and environmental demands on a daily basis, which deplete them of personal constructs (or resources) required to stay in the profession. A multilevel exploratory qualitative research design was employed. Ten managers were interviewed for the preliminary study, based on which the three characteristics of an age-friendly NHS workplace were established: health, retirement, and flexibility. Then an in-depth literature review revealed that the most adversely affected job within the NHS was the nursing profession. Finally, a focus group study was undertaken with six older nurses working in the NHS. The most compelling finding of this study is that older nurses would generally not want to stay on the job if they had to work in the ward area. The physical, cognitive, and sensory constructs of older nurses are negatively affected by the job and environmental demands of the ward areas. Understanding how these job and environmental demands of the workplace affect an older nurse's personal constructs may help support a better design of nurse work and the wards and help extend the working lives of older nurses in the NHS. © The Author(s) 2015.

  18. Analysis of forensic odontological examinations at the National Forensic Service of Korea from 2011 to 2015.

    Science.gov (United States)

    Roh, Byung-Yoon; Lee, Won-Joon; Seo, Jeong-Uk; Lee, U-Young; Lee, Sang-Seob

    2018-03-02

    The National Forensic Service (NFS) of Korea is a government agency responsible for examining and evaluating evidence obtained at crime scenes. The Section of Forensic Odontology of the Medical Examiner's Office conducts forensic odontological analyses of human remains, and mainly criminal cases are handled. In this study, 588 forensic odontological cases referred to NFS during 2011-2015 were analyzed for referral pattern, evidence material, examination criteria, and other factors and were compared with respective data from 2007 to 2010. Majority of the requests were internal (further dental examinations after autopsy) rather than external (direct requests from other agencies such as police departments). Regarding evidence materials, "Teeth" (including teeth and resected jaws) were dominant evidences. Due to the seasonal effects in Korea, the highest number of requests was in September of each year, but the number of requests in April has recently increased. Evidence materials were mostly found in suburban and rural area, especially in mountainous area due to the geographic characteristics of Korea. Regarding specific examinations, profiling, including age estimation, accounted for majority of the requests; this number had increased relative to the findings of a previous study, whereas the number of requests for dental identification and bite mark analysis had decreased. With this analysis, trends in forensic odontology can be observed, and we expect that these trends would be served as a reference for designing study and making training protocol for forensic odontology. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Sharing the British National Health Service around the world: a self-interested perspective.

    Science.gov (United States)

    Chalkidou, Kalipso; Vega, Jeanette

    2013-10-25

    As the UK reiterates its commitment to protecting and growing its development aid budget amidst an adverse economic environment for the UK and Europe, we discuss the potential to use the country's National Health Service (NHS) model as a vehicle for promoting the country's economic as well as global health diplomacy and development priorities, through a coordinated cross-government plan of action. With the country's Prime Minister serving as a co-chair of the UN post-2015 development agenda panel,a this is a unique opportunity for the UK to put forward its health system architecture as a highly applicable and well-tested model for providing access to efficient and cost-effective care, with minimal financial hardship. Arguably, such a model tailored to the needs of specific countries could consequently lead to commercial opportunities for UK plc. in areas such as consulting, training, education and healthcare products. Finally, this approach would be consistent with the current thinking on the evolving role of UK aid, especially in the case of emerging powers such as India, where the focus has shifted from aid to investment in technical assistance and cooperation as a means of boosting bilateral business and trade.

  20. XML-based clinical data standardisation in the National Health Service Scotland

    Directory of Open Access Journals (Sweden)

    Raluca Bunduchi

    2006-12-01

    Full Text Available The objective of this paper is to clarify the role that socio-economic factors played in shaping the development of XML-based clinical data standards in the National Health Service in Scotland from 2000 to 2004. The paper discusses the NHS Scotland approach to clinical data standardisation, emphasising the actors involved, their choices during the standard development process and the factors that have shaped these choices. The case suggests that the NHS Scotland approach to clinical data standardisation is shaped by strong political pressures for fast development of an integrated electronic patient care system, economic pressures for high efficiency and cost reductions, and organisational requirements for strong clinical support. Such economic, political and organisational pressures explain the informal approach to standard development, the emphasis on fast system development and strong clinical involvement. At the same time, market factors explain the low commitment of the IT vendors, which might have otherwise put significant pressure onNHSScotland to pursue a more formalised standardisation approach within an internationally recognised standard-setting body.

  1. Perceptions of radiography and the National Health Service: a qualitative study

    Energy Technology Data Exchange (ETDEWEB)

    Coombs, C.R. E-mail: c.r.coombs@lboro.ac.uk; Park, J.R.; Loan-Clarke, J.; Arnold, J.; Preston, D.; Wilkinson, A.J

    2003-05-01

    Purpose: To identify the factors that determine the attractiveness of radiography as a career choice and of the National Health Service (NHS) as an employer to potential recruits and returners. Methods: Individual and group interviews were conducted in the East Midlands region to explore participants' perceptions of the attractiveness of the NHS as an employer to potential radiography staff. Interviews were conducted with school pupils, radiography students, mature students, radiography assistants, agency radiographers and independent sector radiographers. Results: Eighty-eight individuals participated in the qualitative stage of the study. Analysis of the interview transcripts indicated that radiography as a career choice is perceived as boring and routine, involving high workloads and little recognition from the general public. Working with patients is the source of considerable job satisfaction but is offset by staff shortages, lack of flexibility over working hours and a lack of consideration of family commitments in the NHS. Financial costs are highlighted as dissuading many participants from considering a career as a radiographer in the NHS or returning to work for the NHS. Greater use of open days in conjunction with more advertising of the profession is suggested as tactics to improve recruitment. Conclusions: The provision of more flexible working hours, greater consideration of family commitments and increased financial support for training are necessary to improve the attractiveness of a radiography career. NHS Human Resource Managers should consider these findings concerning the applicant and returner pools when developing strategies to address the current shortfall of radiographers.

  2. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  3. Perceptions of radiography and the National Health Service: a qualitative study

    International Nuclear Information System (INIS)

    Coombs, C.R.; Park, J.R.; Loan-Clarke, J.; Arnold, J.; Preston, D.; Wilkinson, A.J.

    2003-01-01

    Purpose: To identify the factors that determine the attractiveness of radiography as a career choice and of the National Health Service (NHS) as an employer to potential recruits and returners. Methods: Individual and group interviews were conducted in the East Midlands region to explore participants' perceptions of the attractiveness of the NHS as an employer to potential radiography staff. Interviews were conducted with school pupils, radiography students, mature students, radiography assistants, agency radiographers and independent sector radiographers. Results: Eighty-eight individuals participated in the qualitative stage of the study. Analysis of the interview transcripts indicated that radiography as a career choice is perceived as boring and routine, involving high workloads and little recognition from the general public. Working with patients is the source of considerable job satisfaction but is offset by staff shortages, lack of flexibility over working hours and a lack of consideration of family commitments in the NHS. Financial costs are highlighted as dissuading many participants from considering a career as a radiographer in the NHS or returning to work for the NHS. Greater use of open days in conjunction with more advertising of the profession is suggested as tactics to improve recruitment. Conclusions: The provision of more flexible working hours, greater consideration of family commitments and increased financial support for training are necessary to improve the attractiveness of a radiography career. NHS Human Resource Managers should consider these findings concerning the applicant and returner pools when developing strategies to address the current shortfall of radiographers

  4. Identification and Characterization of Inter-Organizational Information Flows in the Portuguese National Health Service

    Science.gov (United States)

    Brito, António Carvalho; Cruz-Correia, Ricardo João

    2016-01-01

    Summary Objectives To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). Methods Upon identification of the institutions involved in the healthcare process, a set of interviews with experienced people from those institutions was conducted, which produced about five hours of tape. The research was focused exclusively on processes involving two different organizations and any internal processes were altogether excluded from it. Results The study allowed the identification of about 50 recurrent interaction processes, which were classified into four different varieties in accordance with the nature of the information flow: administrative, clinical, identificational and statistical. In addition, these processes were divided in accordance with the way how that integration is achieved, from completely automated to email or telephone-based. Conclusions Funds/Money related processes are technologically more rigid and standardized, whereas auditing and inspection ones are less supported by automatic systems. There emerged an interesting level of sharing and integration in clinical processes, although the integration is mostly made at the interface level. The authors identified 5 particularly relevant and dominant actors (2 classes of individuals and 3 institutions) with which there is a need for coordination and cooperation. The authors consider that, in future works, an effort should be made to provide the various institutions with guidelines/interfaces and prompt such institutions to elaborate upon these. PMID:27999840

  5. Bridging the Gap Between Research and Operations in the National Weather Service: The Huntsville Model

    Science.gov (United States)

    Darden, C.; Carroll, B.; Lapenta, W.; Jedlovec, G.; Goodman, S.; Bradshaw, T.; Gordon, J.; Arnold, James E. (Technical Monitor)

    2002-01-01

    The National Weather Service Office (WFO) in Huntsville, Alabama (HUN) is slated to begin full-time operations in early 2003. With the opening of the Huntsville WFO, a unique opportunity has arisen for close and productive collaboration with scientists at NASA Marshall Space Flight Center (MSFC) and the University of Alabama Huntsville (UAH). As a part of the collaboration effort, NASA has developed the Short-term Prediction Research and Transition (SPoRT) Center. The mission of the SPoRT center is to incorporate NASA earth science technology and research into the NWS operational environment. Emphasis will be on improving mesoscale and short-term forecasting in the first 24 hours of the forecast period. As part of the collaboration effort, the NWS and NASA will develop an implementation and evaluation plan to streamline the integration of the latest technologies and techniques into the operational forecasting environment. The desire of WFO HUN, NASA, and UAH is to provide a model for future collaborative activities between research and operational communities across the country.

  6. Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

    Science.gov (United States)

    Hughes, David; Vincent-Jones, Peter

    2008-12-01

    Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

  7. The snakes and ladders of National Health Service management in England.

    Science.gov (United States)

    Powell, Martin

    2014-01-01

    This article explores managerial careers in the National Health Service (NHS) through the lens of talent management, particularly focusing on how managers view barriers (snakes) and facilitators (ladders) to career progression. There is a significant literature on enablers and barriers to career progression, but much of this focuses on specific groups such as black and minority ethnic and female workers, and there is relatively little material on the general workforce of the NHS. The research design is a mixed method quantitative (questionnaire) and qualitative (interview and focus group) approach consisting of a quasi-probability element that focuses on a maximum variety sample and a purposive element that seeks policy views at central and strategic health authority level, and examines talent management in high-performing NHS organisations. Ladders are identified as follows: volunteering, secondment, networking, mentoring, academic qualifications, development, good role models/managers and appraisal/personal development plan. Snakes are identified as managing expectations; identity and cognitive diversity; location; sector; NHS toxic and favouritism culture; poor talent spotting; credentialism; exclusive approach to talent; and sustainability. It concludes that while previous conceptual and empirical work is fairly clear on any ladders, it is less clear on snakes. Copyright © 2013 John Wiley & Sons, Ltd.

  8. National atmospheric release advisory center (NARAC) tools and services for emergency management

    International Nuclear Information System (INIS)

    Nasstrom, J.

    2003-01-01

    Full text: This paper describes recent scientific and technological advances in the National Atmospheric Release Advisory Center (NARAC) that aid emergency management. The U.S. Department of Energy's NARAC system provides tools and services that help map the probable spread of hazardous material accidentally or intentionally released into the atmosphere. Located at Lawrence Livermore National Laboratory, NARAC is a national support and resource center for planning, real-time assessment and detailed studies of incidents involving a wide variety of hazards, including nuclear, radiological, chemical, or biological emissions. In recent years, the DOE National Nuclear Security Agency (NNSA) Office of Emergency Response and Chemical and Biological National Security Program (CBNP) have supported major upgrades and modernization of NARAC that have advanced the accuracy and utility of NARAC products for emergency planning and management. A new NARAC central modeling system, which became operational in the year 2000, has provided a higher-resolution suite of diagnostic and prognostic meteorological models, and a Lagrangian particle dispersion model, for producing predictions of air concentration, ground deposition, and dose. The 3-D meteorological data assimilation model, ADAPT, and Lagrangian particle dispersion model, LODI, allow the simulation of mean wind advection, turbulent diffusion, radioactive decay and production, bio-agent degradation, first-order chemical reactions, wet deposition, gravitational settling, dry deposition, and buoyant/momentum plume rise. The functions performed by this system have been fully automated to minimized response time for emergencies. An in-house version of the Naval Research Laboratory's COAMPS numerical weather prediction model is used to provide mesoscale forecasts. The final plume predictions are plotted with key geographical information (including estimates of the counts of affected population), and with applicable U

  9. 78 FR 78378 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant...

    Science.gov (United States)

    2013-12-26

    ... Repatriation Act (NAGPRA), 25 U.S.C. 3003, of the completion of an inventory of human remains under the control....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant... Historic Site has completed an inventory of human remains, in consultation with the appropriate Indian...

  10. 77 FR 73657 - Public Buildings Service; Submission for OMB Review; Art-in-Architecture Program National Artist...

    Science.gov (United States)

    2012-12-11

    ...-Architecture & Fine Arts Division (PCAC), 1800 F Street NW., Room 3305, Washington, DC 20405, at telephone(202... Buildings Service; Submission for OMB Review; Art-in- Architecture Program National Artist Registry (GSA... and approve an extension of a previously approved information collection requirement regarding Art-in...

  11. HRD as an Emergent and Negotiated Evolution: An Ethnographic Case Study in the British National Health Service.

    Science.gov (United States)

    Sambrook, Sally

    2001-01-01

    Using a contingency framework, three stages in the evolution of human resource development (HRD) in the National Health Service were identified: tell (training enacted within the classical management paradigm); sell (a competence approach to development for all employees); and gel (strategic HRD linked to corporate goals and future needs).…

  12. Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency

    NARCIS (Netherlands)

    Roberts, Harry W; Myerscough, James; Borsci, Simone; Ni, Melody; O'Brart, David P S

    2017-01-01

    Aim: To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies. Methods: National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one

  13. Parent Concern and Enrollment in Intervention Services for Young Children with Developmental Delays: 2007 National Survey of Children's Health

    Science.gov (United States)

    Marshall, Jennifer; Kirby, Russell S.; Gorski, Peter A.

    2016-01-01

    This study sought to address underenrollment and late entry to early intervention by identifying factors associated with parental concern and services for developmental delays. The authors analyzed responses from 27,566 parents of children from birth to age 5 from the 2007 National Survey of Children's Health to quantify and to identify factors…

  14. The U.S. Forest Service and its responsibilities under the national environmental policy act: a work design problem

    Science.gov (United States)

    Matthew Auer; Kenneth Richards; David N. Seesholtz; Burnell Fischer; Christian Freitag; Joshua. Grice

    2011-01-01

    The U.S. Forest Service’s responsibilities under the National Environmental Policy Act entail a wide range of activities including scoping, scientific analysis, social and economic analysis, managing public input and involvement, media relations, regulatory analysis, and litigation. These myriad duties raise several important organizational and management questions....

  15. 75 FR 32699 - Schools and Libraries Universal Service Support Mechanism, A National Broadband Plan for Our Future

    Science.gov (United States)

    2010-06-09

    ...-83] Schools and Libraries Universal Service Support Mechanism, A National Broadband Plan for Our... internal connections for schools and libraries serving impoverished populations. Finally, the [[Page 32700... rules. Needs and Uses: The existing information collection requires schools and libraries to report on...

  16. Methods for estimating private forest ownership statistics: revised methods for the USDA Forest Service's National Woodland Owner Survey

    Science.gov (United States)

    Brenton J. ​Dickinson; Brett J. Butler

    2013-01-01

    The USDA Forest Service's National Woodland Owner Survey (NWOS) is conducted to better understand the attitudes and behaviors of private forest ownerships, which control more than half of US forestland. Inferences about the populations of interest should be based on theoretically sound estimation procedures. A recent review of the procedures disclosed an error in...

  17. Temperature and salinity profile data from CTD casts by the National Ocean Service's Navigation Response Team No. 2, January - May 2001 (NODC Accession 0000646)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — CTD and other data were collected by the National Ocean Service's Response Team No. 2 in the Gulf of Mexico from 25 January 2001 to 05 May 2001. Data include...

  18. CAN-SDI: experience with multi-source computer based current awareness services in the National Science Library, Ottawa.

    Science.gov (United States)

    Gaffney, I M

    1973-07-01

    CAN/SDI is Canada's national Selective Dissemination of Information Service offering a choice of nine data bases to its scientific and technical community. The system is based on central processing at the National Science Library combined with the utilization of decentralized expertise and resources for profile formulation and user education. Its greatest strength lies in its wide interdisciplinary quality. The major advantage of centralized processing of many data bases is that Canadians need learn only one method of profile formulation to access many files. A breakdown of services used confirms that a single tape service does not cover all the information requirements of most users. On the average each profile accesses approximately 1.5 data bases. Constant subscriber growth and a low cancellation rate indicate that CAN/SDI is and will continue to be an important element in Canada's information system.

  19. Symbolic Power in European Diplomacy: The Struggle Between National Foreign Services and the EU's External Action Service

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca

    2014-01-01

    National diplomacy is challenged by the rise of non-state actors from transnational companies to non-governmental organisations. In trying to explain these challenges, scholars tend to either focus on a specific new actor or argue that states will remain the dominant diplomatic players. This arti...

  20. Legal and regulatory aspects of optimization comprehensive support service and combat activity of the Security service of Ukraine and the National guard of Ukraine emergency social situation

    Directory of Open Access Journals (Sweden)

    В. В. Мацюк

    2015-05-01

    Full Text Available Problem setting. The status of comprehensive support of military units in the world’s leading powers is considered to be one of the key factors which defines the success of the social emergency settling operations. The experience of service and military application of the National Guard of Ukraine in the anti-terrorist operation zone on the South-East of Ukraine shows that emergency response tasks are generally carried out in cooperation with other Ukrainian security sector authorities, mostly with the Security Service of Ukraine. However, the forces joint managing authority chiefs usually do not cover the matter of such activities’ comprehensive support, which forces the commanders of the military units to rely on themselves in this question. Recent research and publications analysis. The analysis of research of status and development prospects of the comprehensive support of the Armed Forces of Ukraine, other security authorities, armies of the world’s leading powers, peculiarities of creation and functioning of such systems, application of their means and powers, scientific thought on the problems of service and military application of the National Guard units has shown the problematic tasks of the joint unit comprehensive support system optimization. Therefore, the question of regulatory and legal support of this process is of current importance. Paper objective. The objective of this paper is to define regulatory and legal aspects of comprehensive support optimization of the Security Service of Ukraine and the National Guard of Ukraine service and combat activities during social emergencies. Paper main body. According to the current legislation, comprehensive support comprises of the following types of support: operative (also called military, moral and psychological, materiel (logistical. All other types of support are parts of these three basic ones. Their examination is necessary due to the fact, that there is confusion in the

  1. 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.

    2016-01-01

    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

  2. 75 FR 13111 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

    Science.gov (United States)

    2010-03-18

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services Overview... AGENCY: Office of Special Education and Rehabilitative Services, Department of Education. ACTION: Notice... 15, 2010. Alexa Posny, Assistant Secretary for Office of Special Education and Rehabilitative...

  3. Creating an enabling environment for investment in climate services: The case of Uruguay’s National Agricultural Information System

    Directory of Open Access Journals (Sweden)

    Catherine Vaughan

    2017-12-01

    Full Text Available Increasingly challenged by climate variability and change, many of the world’s governments have turned to climate services as a means to improve decision making and mitigate climate-related risk. While there have been some efforts to evaluate the economic impact of climate services, little is known about the contexts in which investments in climate services have taken place. An understanding of the factors that enable climate service investment is important for the development of climate services at local, national and international levels. This paper addresses this gap by investigating the context in which Uruguay’s Ministry of Livestock, Agriculture and Fisheries invested in and developed its National System of Agriculture Information (SNIA, a national-level climate service for the agriculture sector. Using qualitative research methods, the paper uses key documents and 43 interviews to identify six factors that have shaped the decision to invest in the SNIA: (1 Uruguay’s focus on sustainable agricultural intensification; (2 previous work on climate change adaptation; (3 the modernization of the meteorological service; (4 the country’s open data policy; (5 the government’s decision to focus the SNIA on near-term (e.g., seasonal rather than long-term climate risk; and (6 the participation of key individuals. While the context in which these enablers emerged is unique to Uruguay, it is likely that some factors are generalizable to other countries. Social science research needed to confirm the wider applicability of innovation systems, groundwork, data access and champion is discussed.

  4. Developing the Model for the GIS Applications in National Hydro-Meteorological Service in Poland

    Science.gov (United States)

    Kubacka, D.; Barszczynska, M.; Madej, P.

    2003-04-01

    Institute of Meteorology and Water Management (IMWM) manages the national hydrological-meteorological service, the task of which is to maintain the network of stations, process data, as well issue warnings, reports and announcements. There are 5 divisions of IMWM scattered all over Poland. Each division includes numerous stations and the scientific-research departments. The data gathered, processed and analysed in IMWM are space-related, therefore spatial information systems are indispensable for its processing and visualisation. The project of GIS application in (IMWM) will be discussed in the presentation. With the divisions being so dispersed, numerous and heterogeneous in structure, GIS implementation is very complicated. On the one hand GIS should enable advanced spatial analyses to be carried out by the research, as well as data processing departments. On the other hand, it should provide passive access to a limited scope of information (e.g. for outside customers). Need analysis was carried out first. It resulted in proposals concerning the content of shared resources of geometrical data and connections with attribute data, as well as in proposals of GIS use in routine works. A model was prepared using various types of GIS software depending on the requirements of each division. It is based on standard solutions involving professional GIS, desktop GIS and simple tools for data presentation. In some departments the specialised software had to be taken into account (e.g. satellite data processing). It is necessary to develop and implement dedicated research methods for some individual tasks. The analysis of mapping requirements showed that there is a need to prepare thematic maps at least at two levels of detail. Presently, the works are concentrated on assembling thematic layers for a general map (at 1: 500000 scale) sufficient for many applications, including data visualisation in the Internet and IMWM publications, as well as the tool for measurements and

  5. Pediatric Tape: Accuracy and Medication Delivery in the National Park Service

    Directory of Open Access Journals (Sweden)

    Danielle D. Campagne

    2015-10-01

    Full Text Available Introduction: The objective is to evaluate the accuracy of medication dosing and the time to medication administration in the prehospital setting using a novel length-based pediatric emergency resuscitation tape. Methods: This study was a two-period, two-treatment crossover trial using simulated pediatric patients in the prehospital setting. Each participant was presented with two emergent scenarios; participants were randomized to which case they encountered first, and to which case used the National Park Service (NPS emergency medical services (EMS length-based pediatric emergency resuscitation tape. In the control (without tape case, providers used standard methods to determine medication dosing (e.g. asking parents to estimate the patient’s weight; in the intervention (with tape case, they used the NPS EMS length-based pediatric emergency resuscitation tape. Each scenario required dosing two medications (Case 1 [febrile seizure] required midazolam and acetaminophen; Case 2 [anaphylactic reaction] required epinephrine and diphenhydramine. Twenty NPS EMS providers, trained at the Parkmedic/Advanced Emergency Medical Technician level, served as study participants. Results: The only medication errors that occurred were in the control (no tape group (without tape: 5 vs. with tape: 0, p=0.024. Time to determination of medication dose was significantly shorter in the intervention (with tape group than the control (without tape group, for three of the four medications used. In case 1, time to both midazolam and acetaminophen was significantly faster in the intervention (with tape group (midazolam: 8.3 vs. 28.9 seconds, p=0.005; acetaminophen: 28.6 seconds vs. 50.6 seconds, p=0.036. In case 2, time to epinephrine did not differ (23.3 seconds vs. 22.9 seconds, p=0.96, while time to diphenhydramine was significantly shorter in the intervention (with tape group (13 seconds vs. 37.5 seconds, p<0.05. Conclusion: Use of a length-based pediatric emergency

  6. 75 FR 13550 - Office of Clinical and Preventive Services: National HIV Program

    Science.gov (United States)

    2010-03-22

    ... services, reducing stigma, and making testing routine. This open competition seeks to expand fiscal... physical and mental health of the American people. Dated: March 12, 2010. Yvette Roubideaux, Director... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Office of Clinical and Preventive...

  7. 76 FR 63666 - Sunshine Act Meeting of the National Museum and Library Services Board

    Science.gov (United States)

    2011-10-13

    ... you need special accommodations due to a disability, please contact: Institute of Museum and Library... Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of... Library Services Board. This notice also describes the function of the Board. Notice of the meeting is...

  8. 75 FR 81253 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-12-27

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Special Education and Rehabilitative Services may change the maximum amount through a notice published in... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...

  9. 75 FR 5299 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-02-02

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Special Education and Rehabilitative Services may change the maximum amount through a notice published in... conference call with NIDRR staff from the Office of Special Education and Rehabilitative Services between 1...

  10. 75 FR 21270 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-04-23

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... call with NIDRR staff from the Office of Special Education and Rehabilitative Services between 1:00 p.m...

  11. 75 FR 77629 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-12-13

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Secretary for Special Education and Rehabilitative Services may change the maximum amount through a notice... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...

  12. 75 FR 75666 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

    Science.gov (United States)

    2010-12-06

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services Overview... Secretary for Special Education and Rehabilitative Services may change the maximum amount through a notice... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...

  13. [A national survey on the activities performed by nurses and aids in Italian outpatients' services].

    Science.gov (United States)

    Destrebecq, A; Lusignani, M; Terzoni, S

    2009-01-01

    In Italy, the National Health System (SSN) grants healthcare to the citizens; its realization is up to the Government, the Regions and local institutions, with the participation of citizens. The Health Ministry determines the essential levels of care, and dictates the general guidelines for the activities of the SSN. On the whole national territory, a network of Local Healthcare Units (ASL) is present; such institutions, although belonging to the SSN, have local autonomy. Their activity is based upon principles of efficacy and efficiency; each one includes one or more Districts, which usually group a minimum of 60,000 citizens. Until 1999, Italian nurses have based their activity on a law that enumerated their tasks (DPR 225/74); nowadays, they work according to the indications of a professional profile (DM 739/94), a code of deontology, a law (L. 42/99) that has eliminated the old DPR, and university programmes. Apart from nurses, both in public and private healthcare facilities it is possible to find aids called OSS; their education consists of a twelve months programme, for which the regional institutions are responsible. Specific laws define their field of activity. For all these reasons, and also because of a major nursing shortage, in Italy it is not possible to talk about tasks delegations from doctors to nurses; we can, however, think about this process from nurses to aids and employees. Italy has the highest number of doctors in the world, with more than 6 every 1000 citizens in 2005 (approximately 370,000 units); nurses suffer from the opposite problem; nurses were 348,415 in 2005 and 360,874 in 2007, that is to say 5.4 nurses each 1000 citizens. This means a shortage of 60,000 nurses. Our research is aimed at: Studying the activities deployed by nurses in outpatients' facilities, that could be assigned to aids,; Identifying the tasks currently deployed by nurses, that are beyond their competence; Estimating how much time nurses could save, if they were

  14. Severe Gastrointestinal Haemorrhage: Summary of a National Quality of Care Study with Focus on Radiological Services

    International Nuclear Information System (INIS)

    McPherson, Simon J.; Sinclair, Martin T.; Smith, Neil C. E.

    2017-01-01

    Purpose of StudyTo identify the remediable factors in the quality of care provided to patients with severe gastrointestinal (GI) bleeding.MethodAll hospital admissions in the first four months of 2013 with ICD10 coding for GI bleeding who received a transfusion of 4 units or more of blood. Up to five cases/hospital randomly selected for structured case note peer review. National availability of GI bleeding services data derived from organisational questionnaire completed by all hospitals.Results4563/29,796 (15.3%) of GI bleeds received 4 or more units of blood with a mortality rate of 20.2% compared to 7.3% without blood transfusion. 30.8% of GI bleeds received a blood transfusion. 32% (60/185) of hospitals admitting acute GI bleeds lacked 24/7 endoscopy. 26% (48/185) had on-site embolisation 24/7 with a further 34% (64/185) accessing embolisation by transfer within a validated formal network. Blood product use was inappropriate in 20% (84/426). Improved management, principally earlier senior gastroenterologist review and/or endoscopy, would have reduced blood product use in 25% (113/457). 14.5% (90/618) had a CT scan which identified the site of bleeding in 32% (29/90). 7.8% (36/459) underwent an Interventional Radiology (IR) procedure but a further 6.3% (21/33) should have had IR. 6% (36/586) underwent surgery with 21/36 for uncontrolled bleeding. In 20/35 IR was not considered despite the majority being suitable for IR. Overall 44% (210/476) received an acceptable standard of care according to peer review.Conclusions26 recommendations were made to improve the quality of care in GI bleeding, with six principle recommendations.

  15. Designing better medicines delivery in the UK National Health Services (NHS

    Directory of Open Access Journals (Sweden)

    P. John Clarkson

    2009-11-01

    Full Text Available Background: Prescribed medicines are delivered through a variety ofroutes to patients in the UK National Health Service (NHSand are regulated by a host of health and trade related policy and law. These ensure the efficient and safe supply of medicines of appropriate quality from the pharmaceutical manufacturer through to the end-user, the patient. However, persisting medication errors and therecent discovery of counter feit medicines in the bona fide supply chain have meant there are growing concerns aboutthe timely, accurate and safe supply of medicines in the NHS. Methods: This study undertakes a systems design approach to processmodelling and understanding three key supply routes fromthe manufacturer through to the patient, across bothprimary and secondary care. A systems design approachwas deployed to investigate complex interactions betweenprofessionals, products and processes to improve patient safety in collaboration with twenty five clinical and non-linical stakeholders across the supply chain and six enduser patients.Results: Several system process models were developed from the literature, field observations and alongside the interviewees. The results reveal that risk to medication safety is perceived as occurring most at the patient-end ofthe medicines supply chain: the pharmacy and the ward.There are differences observed in the responses ofinterviewees when they engage with system models.Conclusions: This paper reflects on the use of a systems design, a mainly engineering approach, to understanding a health care domain problem of medication errors. The approach provided an enhanced insight into the complex set of system factors and interactions involved in generating medication errors. This study is among the first to develop asystems-wide view of the medicines supply process ‘as-is’and identify opportunities for re-design to improve patient safety.

  16. Severe Gastrointestinal Haemorrhage: Summary of a National Quality of Care Study with Focus on Radiological Services

    Energy Technology Data Exchange (ETDEWEB)

    McPherson, Simon J., E-mail: simon.mcpherson@nhs.net, E-mail: smcpherson@ncepod.org.uk [Leeds Teaching Hospitals Trust, Department of Radiology (United Kingdom); Sinclair, Martin T.; Smith, Neil C. E. [NCEPOD (National Confidential Enquiry into Patient Outcome and Death) (United Kingdom)

    2017-02-15

    Purpose of StudyTo identify the remediable factors in the quality of care provided to patients with severe gastrointestinal (GI) bleeding.MethodAll hospital admissions in the first four months of 2013 with ICD10 coding for GI bleeding who received a transfusion of 4 units or more of blood. Up to five cases/hospital randomly selected for structured case note peer review. National availability of GI bleeding services data derived from organisational questionnaire completed by all hospitals.Results4563/29,796 (15.3%) of GI bleeds received 4 or more units of blood with a mortality rate of 20.2% compared to 7.3% without blood transfusion. 30.8% of GI bleeds received a blood transfusion. 32% (60/185) of hospitals admitting acute GI bleeds lacked 24/7 endoscopy. 26% (48/185) had on-site embolisation 24/7 with a further 34% (64/185) accessing embolisation by transfer within a validated formal network. Blood product use was inappropriate in 20% (84/426). Improved management, principally earlier senior gastroenterologist review and/or endoscopy, would have reduced blood product use in 25% (113/457). 14.5% (90/618) had a CT scan which identified the site of bleeding in 32% (29/90). 7.8% (36/459) underwent an Interventional Radiology (IR) procedure but a further 6.3% (21/33) should have had IR. 6% (36/586) underwent surgery with 21/36 for uncontrolled bleeding. In 20/35 IR was not considered despite the majority being suitable for IR. Overall 44% (210/476) received an acceptable standard of care according to peer review.Conclusions26 recommendations were made to improve the quality of care in GI bleeding, with six principle recommendations.

  17. An evaluation of staff engagement programmes in four National Health Service Acute Trusts.

    Science.gov (United States)

    Hewison, Alistair; Gale, Nicola; Yeats, Rowena; Shapiro, Jonathan

    2013-01-01

    The purpose of this paper is to report the findings from an evaluation project conducted to investigate the impact of two staff engagement programmes introduced to four National Health Service (NHS) hospital Trusts in England. It seeks to examine this development in the context of current policy initiatives aimed at increasing the level of staff involvement in decision-making, and the related literature. A mixed-methods approach incorporating document analysis, interviews, a survey and appreciative inquiry, informed by the principles of impact evaluation design, was used. The main finding to emerge was that leadership was crucial if widespread staff engagement was to be achieved. Indeed, in some of the trusts the staff engagement programmes were seen as mechanisms for developing leadership capability. The programmes had greater impact when they were "championed" by the Chief Executive. Effective communication throughout the organisations was reported to be a prerequisite for staff engagement. Problems were identified at the level of middle management where the lack of confidence in engaging with staff was a barrier to implementation. The nature of the particular organisational context is crucial to the success of efforts to increase levels of staff engagement. The measures that were found to work in the trusts would need to be adapted and applied to best meet the needs of other organisations. Many health care organisations in England will need to harness the efforts of their workforce if they are to meet the significant challenges of dealing with financial restraint and increasing patient demand. This paper provides some insights on how this can be done.

  18. Affordability as a discursive accomplishment in a changing National Health Service.

    Science.gov (United States)

    Russell, Jill; Greenhalgh, Trisha

    2012-12-01

    Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs)--requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS

  19. The changing face of the English National Health Service: new providers, markets and morality.

    Science.gov (United States)

    Frith, Lucy

    2016-09-01

    One significant change in the English National Health Service (NHS) has been the introduction of market mechanisms. This review will explore the following questions: should we have markets in healthcare? What is the underlying philosophy of introducing more market mechanisms into the NHS? What are the effects of this and does it change the NHS beyond anything Bevan might have imagined in 1948? The review will use empirical studies, philosophical literature, bioethics discussion, policy and NHS documents. The NHS is facing unprecedented challenges at the beginning of the 21st century, with funding levels not meeting the increase in demand. The extent and appropriate role for market mechanisms in the NHS is hotly debated. It will be argued that we are moving towards a more market-based NHS and the possible effects of this will be discussed. Rarely are the policy changes in the NHS evidence based in any meaningful way and they are often driven by ideological considerations rather than clear evidence. There needs to be a greater reliance on evidence of what works and a continuing commitment to healthcare as a societal good. There needs to be a discussion of what the NHS should be-a funder and provider, a funder or a partial funder? How the balance of power between regulators, different types of provider, commissioners and ultimately patients will play out in this changing environment are also areas for future study. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Understanding the working relationships between National Health Service clinicians and finance staff.

    Science.gov (United States)

    Minogue, Virginia; McCaffry, Rebecca

    2017-03-13

    Purpose The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of this paper is to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective. Design/methodology/approach Ipsos MORI were commissioned by the NHS FFF programme to undertake an online survey of NHS clinical and finance staff between June and August 2015. Findings The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face-to-face contact. Clinician's confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face-to-face contact, a professional relationship, and the availability of clear, well presented finance and activity data. Research limitations/implications Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low-response rate. Other forms of communication, including social media, were utilised to increase access to the survey. Originality/value The FFF programme is a unique programme aimed at making the NHS finance profession fit for the future. The close partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.

  1. Effectiveness of National Weather Service heat alerts in preventing mortality in 20 US cities.

    Science.gov (United States)

    Weinberger, Kate R; Zanobetti, Antonella; Schwartz, Joel; Wellenius, Gregory A

    2018-04-09

    Extreme heat is a well-documented public health threat. The US National Weather Service (NWS) issues heat advisories and warnings (collectively, "heat alerts") in advance of forecast extreme heat events. The effectiveness of these alerts in preventing deaths remains largely unknown. To quantify the change in mortality rates associated with heat alerts in 20 US cities between 2001 and 2006. Because NWS heat alerts are issued based on forecast weather and these forecasts are imperfect, in any given location there exists a set of days of similar observed heat index in which heat alerts have been issued for some days but not others. We used a case-crossover design and conditional logistic regression to compare mortality rates on days with versus without heat alerts among such eligible days, adjusting for maximum daily heat index and temporal factors. We combined city-specific estimates into a summary measure using standard random-effects meta-analytic techniques. Overall, NWS heat alerts were not associated with lower mortality rates (percent change in rate: -0.5% [95% CI: -2.8, 1.9]). In Philadelphia, heat alerts were associated with a 4.4% (95% CI: -8.3, -0.3) lower mortality rate or an estimated 45.1 (95% empirical CI: 3.1, 84.1) deaths averted per year if this association is assumed to be causal. No statistically significant beneficial association was observed in other individual cities. Our results suggest that between 2001 and 2006, NWS heat alerts were not associated with lower mortality in most cities studied, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths. These results highlight the need to better link alerts to effective communication and intervention strategies to reduce heat-related mortality. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. How to not detonate the bomb: the case of the Italian National Health Service.

    Science.gov (United States)

    La Torre, G; Federici, A

    2017-12-01

    Why is Italy one of the world's highest ranked for ability and quality of healthcare in relationship to the resources invested? The last decade has been characterized by many Italian Regions with Recovery Plans, whose main focus was on short-term issues with a high impact on healthcare costs. Italy is now leaving this phase and at the regional level there will be an increase of new hirings in the healthcare sectors, as stated by the Ministry of Health. There is a large amount of scientific literature that supports the role of factors such as lifestyles, diet and genetics as the base of population health. The success of the Italian National Health Service (INHS) function is rooted in the ability of a system to adapt to evolving situations, but it is also important to ensure a mechanism of positive feedback correction. In the future, INHS will require a new set of reforms, like the redefinition of structures and mechanisms of governance, the implementation of strategic plans that conjugate better clinical and financial issues. In this context, Health Data Entanglement could be an option to improve the effectiveness of the health governance system in order to develop better quality of care. In Public Health several criticisms could detonate the bomb, and above all the decreasing levels of primary prevention in the fight to obesity (promoting the Mediterranean Diet and physical activity), to smoking and alcohol consumption, as well as to infectious diseases (promoting high vaccination rates). Secondary prevention is also key to this function as a practical experience of re-engineering of the public expense, giving much attention to what works in terms of cost effectiveness, and in particular to cancer screening. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. National Park Service Organic Act prohibits turning the doorstep of Canyonlands National Park into a nuclear wasteland

    International Nuclear Information System (INIS)

    Bryan, J.A.

    1986-01-01

    The protection national parks enjoy under the Organic Act of 1916 is now threatened by the enlarging and advancing needs of American society, with the most destructive threat posed by excessive or incongruent development on land adjacent to the parks. The need to store high-level nuclear waste has prompted DOE to ignore the protective mandate of the Act, and the Interior Secretary has made no move to correct DOE's error. Judicial intervention is not available until park values are immediately threatened. Federal action could violate the Act's standards and irreparably scar Canyonlands National Park. Decisions of this magnitude should be made in the open, with the federal government and public cooperating in an informed manner and acknowledging what is at stake

  4. AVTA federal fleet PEV readiness data logging and characterization study for the National Park Service: Grand Canyon National Park

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Intertek Testing Services, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States); Nienhueser, Ian [Intertek Testing Services, Phoenix, AZ (United States)

    2014-08-01

    This report focuses on the Grand Canyon National Park (GCNP) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively PEVs) can fulfill the mission requirements.

  5. Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?

    Science.gov (United States)

    Dias, Sónia; Gama, Ana; Pingarilho, Marta; Simões, Daniel; Mendão, Luís

    2017-08-01

    This cross-sectional bio-behavioral survey conducted with 853 female sex workers (FSW) aimed to examine differences in use of HIV health services, testing and prevalence among migrant and national FSW. A quarter of undocumented FSW had never used National Health Service (NHS) and 15 % never tested for HIV, significantly more than nationals (p migrants (p migrants were unaware of their positive serostatus compared to nationals. Ever had HIV testing was less likely among undocumented, who never used the NHS and who didn't know where to go if suspected being HIV-infected. Promoting early diagnosis with linkage to care among migrant FSW should be supported, while developing health services better tailored to their needs. Una encuesta transversal biocomportamental fue realizada con una muestra de 853 trabajadoras sexuales (TS) con el objetivo de examinar diferencias en el uso de servicios de salud del VIH, test y prevalencia entre TS migrantes y nacionales. Un cuarto de las TS indocumentadas nunca utilizaron el Servicio Nacional de Salud (SNS) y el 15 % nunca fueron testadas respecto al VIH, porcentajes significativamente superiores a las observadas para las nacionales (p migrantes documentadas y 0.8 % de las indocumentadas (p migrantes desconocía su serostatus positivo en comparación con las nacionales. El test del VIH fue menos frecuente entre las indocumentadas, quien nunca utilizó el SNS y quien no sabía dónde recurrir si sospechaba estar infectada por el VIH. Promover un diagnóstico precoz en conexión con los cuidados en TS migrantes debe ser respaldado mientras se desarrollan servicios de salud mejor adaptados a sus necesidades.

  6. Infertility service use in the United States: data from the National Survey of Family Growth, 1982-2010.

    Science.gov (United States)

    Chandra, Anjani; Copen, Casey E; Stephen, Elizabeth Hervey

    2014-01-22

    This report presents nationally representative estimates and trends for infertility service use among women aged 15-44 and 25-44 in the United States in 1982-2010. While greater detail on types of infertility service is shown for women, basic data on types of infertility service use, as reported by men aged 25-44, are also presented. Data for this report come primarily from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The response rate for females in the 2006-2010 NSFG was 78%, and for males was 75%. Selected trends are shown based on prior NSFG cycles. Twelve percent of women aged 15-44 in 2006-2010 (7.3 million women), or their husbands or partners, had ever used infertility services. Among women aged 25-44, 17% (6.9 million) had ever used any infertility service, a significant decrease from 20% in 1995. Thirty-eight percent of nulliparous women with current fertility problems in 2006-2010 had ever used infertility services, significantly less than 56% of such women in 1982. In all survey years, ever-use of medical help to get pregnant was highest among older and nulliparous women, non-Hispanic white women, women with current fertility problems, and women with higher levels of education and household income. The most commonly used infertility services among women aged 25-44 in 2006-2010 were advice, testing, medical help to prevent miscarriage, and ovulation drugs. Ever-use of infertility services was reported by 9.4% of men aged 25-44 in 2006-2010, similar to levels seen in 2002. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  7. 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.

  8. An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

    Science.gov (United States)

    Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

    2017-01-01

    Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

  9. The critical role of nurses to the successful implementation of the National Safety and Quality Health Service Standards.

    Science.gov (United States)

    Twigg, Diane E; Duffield, Christine; Evans, Gemma

    2013-09-01

    The National Safety and Quality Health Service Standards requires health service compliance by 2013 and covers several areas including governance arrangements, partnerships with consumers and eight key clinical processes. Nurses in Australia comprise 62% of the hospital workforce, are the largest component and hence play a critical role in meeting these standards and improving the quality of patient care. Several of the standards are influenced by nursing interventions, which incorporate any direct-care treatment that the nurse performs for a patient that may be nurse or physician initiated. The ability for nurses to undertake these interventions is influenced by the hours of care available, the skill mix of the nursing workforce and the environment in which they practice. Taking into consideration the predicted nursing shortages, the challenge to successfully implement the National Safety and Quality Health Service Standards will be great. This paper examines the role of nursing in the delivery of the National Standards, analyses the evidence with regard to nursing-sensitive outcomes and discusses the implications for health service decision makers and policy.

  10. Global BUFR Data Stream: Upper Air Reports from the National Weather Service Telecommunications Gateway (NWS TG)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These are raw radiosonde and pilot balloon observations taken from various locations at various times around the globe transmitted through the National Weather...

  11. A Service evaluation of a hospital child death review process to elucidate understanding of contributory factors to child mortality and inform practice in the English National Health Service.

    Science.gov (United States)

    Magnus, Daniel S; Schindler, Margrid B; Marlow, Robin D; Fraser, James I

    2018-03-16

    To describe a novel approach to hospital mortality meetings to elucidate understanding of contributory factors to child death and inform practice in the National Health Service. All child deaths were separately reviewed at a meeting attended by professionals across the healthcare pathway, and an assessment was made of contributory factors to death across domains intrinsic to the child, family and environment, parenting capacity and service delivery. Data were analysed from a centrally held database of records. All child deaths in a tertiary children's hospital between 1 April 2010 and 1 April 2013. Descriptive data summarising contributory factors to child deaths. 95 deaths were reviewed. In 85% cases, factors intrinsic to the child provided complete explanation for death. In 11% cases, factors in the family and environment and, in 5% cases, factors in parenting capacity, contributed to patient vulnerability. In 33% cases, factors in service provision contributed to patient vulnerability and in two patients provided complete explanation for death. 26% deaths were classified as potentially preventable and in those cases factors in service provision were more commonly identified than factors across other domains (OR: 4.89; 95% CI 1.26 to 18.9). Hospital child death review meetings attended by professionals involved in patient management across the healthcare pathway inform understanding of events leading to a child's death. Using a bioecological approach to scrutinise contributory factors the multidisciplinary team concluded most deaths occurred as a consequence of underlying illness. Although factors relating to service provision were commonly identified, they rarely provided a complete explanation for death. Efforts to reduce child mortality should be driven by an understanding of modifiable risk factors. Systematic data collection arising from a standardised approach to hospital reviews should be the basis for national mortality review processes and database

  12. Managing the uncertainties of the streamflow data produced by the French national hydrological services

    Science.gov (United States)

    Puechberty, Rachel; Bechon, Pierre-Marie; Le Coz, Jérôme; Renard, Benjamin

    2015-04-01

    The French national hydrological services (NHS) manage the production of streamflow time series throughout the national territory. The hydrological data are made available to end-users through different web applications and the national hydrological archive (Banque Hydro). Providing end-users with qualitative and quantitative information on the uncertainty of the hydrological data is key to allow them drawing relevant conclusions and making appropriate decisions. Due to technical and organisational issues that are specific to the field of hydrometry, quantifying the uncertainty of hydrological measurements is still challenging and not yet standardized. The French NHS have made progress on building a consistent strategy to assess the uncertainty of their streamflow data. The strategy consists of addressing the uncertainties produced and propagated at each step of the data production with uncertainty analysis tools that are compatible with each other and compliant with international uncertainty guidance and standards. Beyond the necessary research and methodological developments, operational software tools and procedures are absolutely necessary to the data management and uncertainty analysis by field hydrologists. A first challenge is to assess, and if possible reduce, the uncertainty of streamgauging data, i.e. direct stage-discharge measurements. Interlaboratory experiments proved to be a very efficient way to empirically measure the uncertainty of a given streamgauging technique in given measurement conditions. The Q+ method (Le Coz et al., 2012) was developed to improve the uncertainty propagation method proposed in the ISO748 standard for velocity-area gaugings. Both empirical or computed (with Q+) uncertainty values can now be assigned in BAREME, which is the software used by the French NHS for managing streamgauging measurements. A second pivotal step is to quantify the uncertainty related to stage-discharge rating curves and their application to water level

  13. Ethnic differences in women's use of mental health services: do social networks play a role? Findings from a national survey.

    Science.gov (United States)

    Kapadia, Dharmi; Nazroo, James; Tranmer, Mark

    2018-04-01

    The reasons for ethnic differences in women's mental health service use in England remain unclear. The aims of this study were to ascertain: ethnic differences in women's usage of mental health services, if social networks are independently associated with service use, and if the association between women's social networks and service use varies between ethnic groups. Logistic regression modelling of nationally representative data from the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) survey conducted in England. The analytic sample (2260 women, aged 16-74 years) was drawn from the representative subsample of 2340 women in EMPIRIC for whom data on mental health services, and social networks were available. Pakistani and Bangladeshi women were less likely than White women to have used mental health services (Pakistani OR = 0.23, CI = 0.08-0.65, p = .005; Bangladeshi OR = 0.25, CI = 0.07-0.86, p = .027). Frequent contact with relatives reduced mental health service use (OR = 0.45, CI = 0.23-0.89, p = .023). An increase in perceived inadequate support in women's close networks was associated with increased odds of using mental health services (OR = 1.91, CI = 1.11-3.27, p = .019). The influence of social networks on mental health service use did not differ between ethnic groups. The differential treatment of women from Pakistani and Bangladeshi ethnic groups in primary care settings could be a possible reason for the observed differences in mental health service use.

  14. Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey.

    Science.gov (United States)

    Zhang, Jingya; Lin, Senlin; Liang, Di; Qian, Yi; Zhang, Donglan; Hou, Zhiyuan

    2017-09-01

    There have been obstacles for internal migrants in China in accessing local public health services for some time. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, and demographic characteristics and public health services utilization. Our results showed that internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The years of living in the city of residence were positively associated with the utilization of public health services. Compared to migration within the city, migration across provinces significantly reduced the probability of using health records (OR = 0.88, 95% CI: 0.86-0.90), health education (OR = 0.97, 95% CI: 0.94-1.00), and health education on non-communicable diseases (OR = 0.92, 95% CI: 0.89-0.95) or through the Internet (OR = 0.96, 95% CI: 0.94-0.99). This study concludes that public health services coverage for internal migrants has seen great improvement due to government subsidies. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

  15. Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

    Science.gov (United States)

    McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

    2016-07-28

    Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

  16. Mental health need and access to mental health services by youths involved with child welfare: a national survey.

    Science.gov (United States)

    Burns, Barbara J; Phillips, Susan D; Wagner, H Ryan; Barth, Richard P; Kolko, David J; Campbell, Yvonne; Landsverk, John

    2004-08-01

    This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were weighted to provide population estimates. Nearly half (47.9%) of the youths aged 2 to 14 years (N = 3,803) with completed child welfare investigations had clinically significant emotional or behavioral problems. Youths with mental health need (defined by a clinical range score on the Child Behavior Checklist) were much more likely to receive mental health services than lower scoring youth; still, only one fourth of such youths received any specialty mental health care during the previous 12 months. Clinical need was related to receipt of mental health care across all age groups (odds ratio = 2.7-3.5). In addition, for young children (2-5 years), sexual abuse (versus neglect) increased access to mental health services. For latency-age youths, African-American race and living at home significantly reduced the likelihood of care. Adolescents living at home were also less likely to receive services, whereas having a parent with severe mental illness increased (odds ratio = 2.4) the likelihood of service use. Routine screening for mental health need and increasing access to mental health professionals for further evaluation and treatment should be a priority for children early in their contact with the child welfare system.

  17. Health/Service Providers' Perspectives on Barriers to Healthy Weight Gain and Physical Activity in Pregnant, Urban First Nations Women.

    Science.gov (United States)

    Darroch, Francine E; Giles, Audrey R

    2016-01-01

    The purpose of this article is to examine health/service providers' perspectives of barriers to healthy weight gain and physical activity for urban, pregnant First Nations women in Ottawa, Canada. Through the use of semi-structured interviews, we explored 15 health/service providers' perspectives on the complex barriers their clients face. By using a postcolonial feminist lens and a social determinants of health framework, we identified three social determinants of health that the health/service providers believed to have the greatest influence on their clients' weight gain and physical activity during pregnancy: poverty, education, and colonialism. Our findings are then contextualized within existing Statistics Canada and the Ottawa Neighbourhood Study data. We found that health/service providers are in a position to challenge colonial relations of power. We conclude by urging health/service providers, researchers, and policymakers alike to take into consideration the ways in which these social determinants of health and their often synergistic effects affect urban First Nations women during pregnancy. © The Author(s) 2015.

  18. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Sleeping Bear Dunes National Lakeshore

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Stephen [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-11-01

    This report focuses on the Sleeping Bear Dunes National Lakeshore (SLBE) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of plug-in electric vehicles (PEVs) into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles, or PEVs) can fulfill the mission requirements.

  19. Hydrologic Modeling at the National Water Center: Operational Implementation of the WRF-Hydro Model to support National Weather Service Hydrology

    Science.gov (United States)

    Cosgrove, B.; Gochis, D.; Clark, E. P.; Cui, Z.; Dugger, A. L.; Fall, G. M.; Feng, X.; Fresch, M. A.; Gourley, J. J.; Khan, S.; Kitzmiller, D.; Lee, H. S.; Liu, Y.; McCreight, J. L.; Newman, A. J.; Oubeidillah, A.; Pan, L.; Pham, C.; Salas, F.; Sampson, K. M.; Smith, M.; Sood, G.; Wood, A.; Yates, D. N.; Yu, W.; Zhang, Y.

    2015-12-01

    The National Weather Service (NWS) National Water Center(NWC) is collaborating with the NWS National Centers for Environmental Prediction (NCEP) and the National Center for Atmospheric Research (NCAR) to implement a first-of-its-kind operational instance of the Weather Research and Forecasting (WRF)-Hydro model over the Continental United States (CONUS) and contributing drainage areas on the NWS Weather and Climate Operational Supercomputing System (WCOSS) supercomputer. The system will provide seamless, high-resolution, continuously cycling forecasts of streamflow and other hydrologic outputs of value from both deterministic- and ensemble-type runs. WRF-Hydro will form the core of the NWC national water modeling strategy, supporting NWS hydrologic forecast operations along with emergency response and water management efforts of partner agencies. Input and output from the system will be comprehensively verified via the NWC Water Resource Evaluation Service. Hydrologic events occur on a wide range of temporal scales, from fast acting flash floods, to long-term flow events impacting water supply. In order to capture this range of events, the initial operational WRF-Hydro configuration will feature 1) hourly analysis runs, 2) short-and medium-range deterministic forecasts out to two day and ten day horizons and 3) long-range ensemble forecasts out to 30 days. All three of these configurations are underpinned by a 1km execution of the NoahMP land surface model, with channel routing taking place on 2.67 million NHDPlusV2 catchments covering the CONUS and contributing areas. Additionally, the short- and medium-range forecasts runs will feature surface and sub-surface routing on a 250m grid, while the hourly analyses will feature this same 250m routing in addition to nudging-based assimilation of US Geological Survey (USGS) streamflow observations. A limited number of major reservoirs will be configured within the model to begin to represent the first-order impacts of

  20. Stigma, barriers to care, and use of mental health services among active duty and National Guard soldiers after combat.

    Science.gov (United States)

    Kim, Paul Y; Thomas, Jeffrey L; Wilk, Joshua E; Castro, Carl A; Hoge, Charles W

    2010-06-01

    This study examined rates of utilization of mental health care among active duty and National Guard soldiers with mental health problems three and 12 months after they returned from combat in Iraq. Stigma and barriers to care were also reported for each component (active duty and National Guard). Cross-sectional, anonymous surveys were administered to 10,386 soldiers across both time points and components. Mean scores from 11 items measuring stigma and barriers to care were computed. Service utilization was assessed by asking soldiers whether they had received services for a mental health problem from a mental health professional, a medical doctor, or the Department of Veterans Affairs in the past month. Risk of mental problems was measured using the Patient Health Questionnaire, the PTSD Checklist, and items asking about aggressive behaviors and "stress, emotional, alcohol, or family" problems within the past month. A higher proportion of active duty soldiers than National Guard soldiers reported at least one type of mental health problem at both three months (45% versus 33%) and 12 months (44% versus 35%) postdeployment. Among soldiers with mental health problems, National Guard soldiers reported significantly higher rates of mental health care utilization 12 months after deployment, compared with active duty soldiers (27% versus 13%). Mean stigma scores were higher among active duty soldiers than among National Guard soldiers. Active duty soldiers with a mental health problem had significantly lower rates of service utilization than National Guard soldiers and significantly higher endorsements of stigma. Current and future efforts to improve care for veterans should work toward reducing the stigma of receiving mental health care.

  1. USGS Land Cover (NLCD) Overlay Map Service from The National Map - National Geospatial Data Asset (NGDA) National Land Cover Database (NLCD)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — NLCD 1992, NLCD 2001, NLCD 2006, and NLCD 2011 are National Land Cover Database classification schemes based primarily on Landsat data along with ancillary data...

  2. New joints: Private providers and rising demand in the English National Health Service

    OpenAIRE

    Kelly, Elaine; Stoye, George

    2015-01-01

    Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands the service at all. We explore this issue by considering how demand for elective surgery responds following the entry of private providers into the market for publicly funded health care in England. For ...

  3. Implementation of the Forest Service Open Space Conservation Strategy in Washington State: Exploring the Role of the National Forest System

    Science.gov (United States)

    Richard J. Pringle; Lee K. Cerveny; Gordon A. Bradley

    2015-01-01

    The loss of open space was declared one of the “four threats to the health of our nation’s forests” by former USDA Forest Service Chief Dale Bosworth in 2004. Since then, the agencywide Open Space Conservation Strategy (OSCS) was released and the “four threats” were incorporated into the agency’s National Strategic Plan. These actions indicate that the OSCS is in the...

  4. Hazard of household cleaning products: a study undertaken by the UK National Poisons Information Service.

    Science.gov (United States)

    Williams, Hayley; Moyns, Emma; Bateman, D Nicholas; Thomas, Simon H L; Thompson, John P; Vale, J Allister

    2012-09-01

    To ascertain the reported toxicity of current United Kingdom (UK) household products following the launch of new products, such as liquid detergent capsules, and the manufacture of more concentrated formulations. Between 1 March 2008 and 30 April 2009 the UK National Poisons Information Service (NPIS) collected prospectively 5939 telephone enquiries relating to household products, approximately 10% of all telephone enquiries received over this period. The majority of enquiries (n = 3893; 65.5%) concerned children 5 years of age or less and were received predominantly from hospitals (n = 1905; 32.1%), general practitioners (n = 1768; 29.8%) and NHS Direct/NHS 24 (n = 1694; 28.5%). The majority of exposures occurred at home (n = 5795; 97.6%); most exposures were accidental (n = 5561; 93.6%). Liquid detergent capsules were most commonly involved (n = 647), followed by bleaches (n = 481), air fresheners (n = 429), multipurpose cleaners (n = 408), dishwasher products (n = 399) and descalers (n = 397). Exposure to household products occurred mainly as a result of ingestion (n = 4616; 75.8%), with eye contact (n = 513; 8.4%), inhalation (n = 420; 6.9%) and skin contact (n = 187; 3.1%) being less common; 5.1% (n = 313) of enquiries involved multiple routes of exposure. The most commonly reported features were vomiting (ingestion), pain (eye contact), dyspnoea (inhalation) and burns (skin contact). In 5840 of 5939 enquiries the Poisoning Severity Score (PSS) was known. The majority of patients (n = 4117; 70.5%) were asymptomatic (PSS 0), 28.0% (n = 1638) developed minor features (PSS 1), 1.3% (75 patients) developed moderate features (PSS 2) and 0.15% (nine patients) developed serious features (PSS 3). Four of these nine patients made a complete recovery, two died from exposure to drain cleaner and PVC solvent cleaner; the outcome in three was unknown. In the UK, advice from the NPIS is sought commonly regarding household products, but such exposures only rarely result in

  5. Scenario Planning Provides a Framework for Climate Change Adaptation in the National Park Service

    Science.gov (United States)

    Welling, L. A.

    2012-12-01

    Resource management decisions must be based on future expectations. Abundant evidence suggests climate change will have highly consequential effects on the Nation's natural and cultural resources, but specific impacts are difficult to accurately predict. This situation of too much information but not enough specificity can often lead to either paralysis or denial for decision makers. Scenario planning is an emerging tool for climate change adaptation that provides a structured framework for identifying and exploring critical drivers of change and their uncertain outcomes. Since 2007, the National Park Service (NPS) has been working with its partners to develop and apply a scenario-based approach for adaptation planning that integrates quantitative, model-driven, climate change projections with qualitative, participatory exercises to explore management and policy options under a range of future conditions. Major outcomes of this work are (1) increased understanding of key scientific results and uncertainties, (2) incorporation of alternative perspectives into park and landscape level planning, (3) identification of "no brainer" and "no gainer" actions, (4) strengthening of regional science-management partnerships, and (5) overall improved capacity for flexible decision making. The basic approach employed by NPS for scenario planning follows a typical adaptive management process: define the focal question, assess the relevant science, explore plausible futures, identify effective strategies, prioritize and implement actions, and monitor results. Many science and management partners contributed to the process, including NOAA Regional Integrated Science and Assessment teams (RISAs) and Regional Climate Centers (RCCs), USGS Research Centers, and other university and government scientists. The Global Business Network, an internationally recognized leader in scenario development, provided expert facilitation and training techniques. Climate science input is provided

  6. Adaptation to Sea Level Rise in Coastal Units of the National Park Service (Invited)

    Science.gov (United States)

    Beavers, R. L.

    2010-12-01

    83 National Park Service (NPS) units contain nearly 12,000 miles of coastal, estuarine and Great Lakes shoreline and their associated resources. Iconic natural features exist along active shorelines in NPS units, including, e.g., Cape Cod, Padre Island, Hawaii Volcanoes, and the Everglades. Iconic cultural resources managed by NPS include the Cape Hatteras Lighthouse, Fort Sumter, the Golden Gate, and heiaus and fish traps along the coast of Hawaii. Impacts anticipated from sea level rise include inundation and flooding of beaches and low lying marshes, shoreline erosion of coastal areas, and saltwater intrusion into the water table. These impacts and other coastal hazards will threaten park beaches, marshes, and other resources and values; alter the viability of coastal roads; and require the NPS to re-evaluate the financial, safety, and environmental implications of maintaining current projects and implementing future projects in ocean and coastal parks in the context of sea level rise. Coastal erosion will increase as sea levels rise. Barrier islands along the coast of Louisiana and North Carolina may have already passed the threshold for maintaining island integrity in any scenario of sea level rise (U.S. Climate Change Science Program Synthesis and Assessment Program Report 4.1). Consequently, sea level rise is expected to hasten the disappearance of historic coastal villages, coastal wetlands, forests, and beaches, and threaten coastal roads, homes, and businesses. While sea level is rising in most coastal parks, some parks are experiencing lower water levels due to isostatic rebound and lower lake levels. NPS funded a Coastal Vulnerability Project to evaluate the physical and geologic factors affecting 25 coastal parks. The USGS Open File Reports for each park are available at http://woodshole.er.usgs.gov/project-pages/. These reports were designed to inform park planning efforts. NPS conducted a Storm Vulnerability Project to provide ocean and coastal

  7. Toward a New Era of Policy: Health Care Service Delivery to First Nations

    Directory of Open Access Journals (Sweden)

    Miranda D. Kelly

    2011-05-01

    Full Text Available The disproportionate burdens of ill health experienced by First Nations have been attributed to an uncoordinated, fragmented health care system. This system is rooted in public policies that have created jurisdictional gaps and a long-standing debate between federal, provincial and First Nations governments as to who is responsible for First Nations health care. This article examines: (1 the policies that shape First Nations health care in Canada and in the province of British Columbia (BC specifically; (2 the interests of the actors involved in First Nations health policy; and (3 recent developments in BC that present an opportunity for change to First Nations health policy development and have broader implications for Indigenous health policy across Canada and worldwide.

  8. The Impact of Adventure Based Activity at Malaysian National Service Training Programme on Team Cohesion: A Demographic Analysis.

    OpenAIRE

    Jaffry Zakaria; Mazuki Mohd Yasim; Md Amin Md Taff

    2012-01-01

    The present study examines the effects of physical module elements (adventure based activity) included in the Malaysian National Service Programme and to investigate the socio-demographic variables impact on team cohesion building among the participants. In this study, the participants were selected from three different camps, namely, Tasoh camp, Guar Chenderai camp and Meranti camp, located in the state of Perlis, Malaysia. The participants were those from the second batch intake in the yea...

  9. Serving the food nation: Exploring Body Mass Index in food service workers.

    Science.gov (United States)

    Woodhall-Melnik, Julia; Cooke, Martin; Bigelow, Philip L

    2015-01-01

    Obesity is a public health concern in North America. Consumption of food prepared outside of the home is often discussed as a contributing factor. To determine whether or not Canadian food service workers are more likely to have high Body Mass Indices (BMIs) as compared with the general population, and to examine factors that contribute to BMI in this population. Analyses of secondary survey data from Cycle 5.1 of the Canadian Community Health Survey were performed. Descriptive statistics were generated to examine food service workers' risk of having above normal BMI compared to other Canadians. Logistic regression analysis was used to identify factors contributing to variation in BMI among food service workers. Analyses were stratified by age. Canadian food service workers are less likely to have BMIs in the overweight and obese ranges than the general population. Stratification by age demonstrated that this decreased risk can be attributed to the fact that food service workers tend to be younger than the general population. As age increases among food service workers, the odds of having a BMI in the overweight and obese ranges increases. Food service workers in general were not at higher risk for high BMI, but those between the ages of 41 and 64 are at higher risk of having a BMI in the overweight or obese ranges. The findings suggest that proximity to food service outlets may not be the most salient factor in explaining BMI.

  10. 78 FR 49332 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-08-13

    ... Departments of Transportation, Homeland Security, and Health & Human Services (4) Presentation and discussion... Public Good and Essential Service b. Research in Prehospital Care: Models for Success c. Emerging Digital.... Improving Internal NEMSAC Processes e. Safety (7) Other Business of the Council (8) Public Comment Period (3...

  11. How Students Rate the Quality Service Climate on Campus. National Research Report, 2012

    Science.gov (United States)

    Noel-Levitz, Inc, 2012

    2012-01-01

    How satisfied are students with the service they receive--and how important is it to them? This report documents significant strides that colleges and universities have made in recent years to improve service quality and their overall campus climate, yet also finds that campuses still have room for improvement. A few highlights: (1) While progress…

  12. How Students Rate the Quality Service Climate on Campus. National Research Report, 2011

    Science.gov (United States)

    Noel-Levitz, Inc, 2011

    2011-01-01

    How satisfied are students with the service they receive--and how important is it to them? This report documents significant strides that colleges and universities have made in recent years to improve service quality and their overall campus climate, yet also finds that campuses still have room for improvement. A few highlights: (1) While progress…

  13. Ecosystem services as a framework for forest stewardship: Deschutes National Forest overview

    Science.gov (United States)

    Nikola Smith; Robert Deal; Jeff Kline; Dale Blahna; Trista Patterson; Thomas A. Spies; Karen. Bennett

    2011-01-01

    The concept of ecosystem services has emerged as a way of framing and describing the comprehensive set of benefits that people receive from nature. These include commonly recognized goods like timber and fresh water, as well as processes like climate regulation and water purification, and aesthetic, spiritual, and cultural benefits. The USDA Forest Service has been...

  14. Assessing care-givers' satisfaction with child immunisation services in Zambia: Evidence from a national survey.

    Science.gov (United States)

    Chama-Chiliba, Chitalu Miriam; Masiye, Felix; Mphuka, Chrispin

    2017-10-09

    The main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants. This study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction. Findings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services. These findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The Impact of National Macro-Environmental Variables on Tourism Services Consumption in Romania

    Directory of Open Access Journals (Sweden)

    Untaru E.

    2009-12-01

    Full Text Available The studies of consumers’ demand represent the main objective of market research, the importance of these studies being emphasized in all marketing literature. In order to better understand the complex mechanisms of changing the needs for goods or services into demand, the marketing theory includes studying the consumer behaviour as regards tourism goods and services.

  16. 75 FR 39431 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-07-08

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  17. 75 FR 33277 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-06-11

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may change... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  18. 75 FR 27737 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-05-18

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Assistant Secretary for Special Education and Rehabilitative Services may change the maximum amount through... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  19. 75 FR 22760 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-04-30

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Special Education and Rehabilitative Services may change the maximum amount through a notice published in... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  20. 75 FR 39782 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-07-12

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... exceeding $650,000 for a single budget period of 12 months. The Assistant Secretary for Special Education... staff from the Office of Special Education and Rehabilitative Services between 1:00 p.m. and 3:00 p.m...

  1. 75 FR 36239 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-06-24

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  2. 76 FR 339 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2011-01-04

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Secretary for Special Education and Rehabilitative Services establishes a priority for the funding of a... exceeding $625,000 for a single budget period of 12 months. The Assistant Secretary for Special Education...

  3. 75 FR 33274 - Office of Special Education and Rehabilitative Services; Overview Information; National Institute...

    Science.gov (United States)

    2010-06-11

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  4. 76 FR 780 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

    Science.gov (United States)

    2011-01-06

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services Overview... of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may change... participate in this meeting by conference call with NIDRR staff from the Office of Special Education and...

  5. 76 FR 7807 - National Wildlife Services Advisory Committee; Notice of Solicitation for Membership

    Science.gov (United States)

    2011-02-11

    ... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2010-0060... Plant Health Inspection Service, USDA. ACTION: Notice of solicitation for membership. SUMMARY: We are... minorities, women, and persons with disabilities. Done in Washington, DC this 7th day of February 2011. Kevin...

  6. Research and development portfolio of the sustainability science team national sustainable operations USDA Forest Service

    Science.gov (United States)

    Trista Patterson; David Nicholls; Jonathan Long

    2015-01-01

    The Sustainability Science Team (SST) of the U.S. Department of Agriculture (USDA) Forest Service Sustainable Operations Initiative is a 18-member virtual research and development team, located across five regions and four research stations of the USDA Forest Service. The team provides research, publication, systems analysis, and decision support to the Sustainable...

  7. 78 FR 9945 - Sunshine Act Meeting of the National Museum and Library Services Board

    Science.gov (United States)

    2013-02-12

    ... Library Services. 1800 M Street, NW., 9th Floor, Washington, DC, 20036. Telephone: (202) 653-4676. STATUS..., United States Code because the Board will consider information that may disclose: Trade secrets and... Events and Board Liaison, Institute of Museum and Library Services, 1800 M Street, NW., 9th Floor...

  8. [Role of specialized care services of the national health service in the framework for the prevention of occupational risks (II)].

    Science.gov (United States)

    Gallo-Fernández, M

    Since 1986, the Government of Navarra has taken over the functions of security and health as part of the health 'area', with a broad conception of health, avoiding separating the citizen from the worker. In 1993, the Instituto Navarro de Salud Laboral created, under the direction of the departments of Health and Labor, combined diverse functions and resources, integrating preexisting structures into a technical department to be responsible for the overall health care of workers. The structure is based on two coordinated pillars, security and hygiene at work and occupational health. As more specifically to do with health, we describe the systems of epidemiological information and vigilance and programs for occupational disabilities, health activities in industry and investigation of diseases. The Unidades de Salud Laboral link the workplace with the public health service. The occupational health plan of Navarra will set out future strategies. It is necessary to involve neurologists in occupational health. Occupational risks and injury are everyone's problem. The neurologist's role in accidents is usually of health care; detection of illness is more difficult when an occupational relationship is not considered. Data from work should be included in the clinical history. The official figures for occupational neurological diseases are ridiculous and more cases should be detected. There should be a fluid relationship between neurologists, occupational doctors and experts in prevention.

  9. Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project.

    Science.gov (United States)

    Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K

    2017-10-01

    Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.

  10. The National Health Services of Brazil and Northern Europe: Universality, Equity, and Integrality-Time Has Come for the Latter.

    Science.gov (United States)

    Gurgel, Garibaldi D; de Sousa, Islândia M Carvalho; de Araujo Oliveira, Sydia Rosana; de Assis da Silva Santos, Francisco; Diderichsen, Finn

    2017-10-01

    In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles of universality, equity, and integrality. While the reform in Brazil aimed at improving equity and effectiveness, reforms in Europe aimed at improving efficiency in order to contain costs. The European reforms increased supply and utilization but never provided the large increase in efficiency that was hoped for, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having chronic disorders and very unequal comorbidities, bring the issue of integrality in the forefront in all 3 countries, and neither the public purchaser provider markets nor the 2-tier system in Brazil delivers on that front. It will demand political leadership and strategic planning with population responsibility to deal with such challenges.

  11. National Space Science Data Center data archive and distribution service (NDADS) automated retrieval mail system user's guide

    Science.gov (United States)

    Perry, Charleen M.; Vansteenberg, Michael E.

    1992-01-01

    The National Space Science Data Center (NSSDC) has developed an automated data retrieval request service utilizing our Data Archive and Distribution Service (NDADS) computer system. NDADS currently has selected project data written to optical disk platters with the disks residing in a robotic 'jukebox' near-line environment. This allows for rapid and automated access to the data with no staff intervention required. There are also automated help information and user services available that can be accessed. The request system permits an average-size data request to be completed within minutes of the request being sent to NSSDC. A mail message, in the format described in this document, retrieves the data and can send it to a remote site. Also listed in this document are the data currently available.

  12. "Trade creep" and implications of the Transatlantic Trade and Investment Partnership Agreement for the United Kingdom National Health Service.

    Science.gov (United States)

    Koivusalo, Meri; Tritter, Jonathan

    2014-01-01

    The ambitious and comprehensive Transatlantic Trade and Investment Partnership Agreement (TTIP/TAFTA) agreement between the European Union and United States is now being negotiated and may have far-reaching consequences for health services. The agreement extends to government procurement, investment, and further regulatory cooperation. In this article, we focus on the United Kingdom National Health Service and how these negotiations can limit policy space to change policies and to regulate in relation to health services, pharmaceuticals, medical devices, and health industries. The negotiation of TTIP/TAFTA has the potential to "harmonize" more corporate-friendly regulation, resulting in higher costs and loss of policy space, an example of "trade creep" that potentially compromises health equity, public health, and safety concerns across the Atlantic.

  13. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  14. Vulnerability of National Park Service beaches to inundation during a direct hurricane landfall: Fire Island National Seashore

    Science.gov (United States)

    Stockdon, Hilary F.; Thompson, David M.

    2007-01-01

    Waves and storm surge associated with strong tropical storms are part of the natural process of barrier-island evolution and can cause extensive morphologic changes in coastal parks, leading to reduced visitor accessibility and enjoyment. Even at Fire Island National Seashore, a barrier-island coastal park in New York where extratropical storms (northeasters) dominate storm activity, the beaches are vulnerable to the powerful, sand-moving forces of hurricanes. The vulnerability of park beaches to inundation, and associated extreme coastal change, during a direct hurricane landfall can be assessed by comparing the elevations of storm-induced mean-water levels (storm surge) to the elevations of the crest of the sand dune that defines the beach system. Maps detailing the inundation potential for Category 1-4 hurricanes can be used by park managers to determine the relative vulnerability of various barrier-island parks and to assess which areas of a particular park are more susceptible to inundation and extreme coastal changes.

  15. Predictive Factors of Patient Satisfaction with Pharmacy Services in South Korea: A Cross-Sectional Study of National Level Data.

    Directory of Open Access Journals (Sweden)

    Sunkyung Lee

    Full Text Available Patient satisfaction has emerged as a prerequisite to improving patients' health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom 2,188 (23.6% reported visits to pharmacy within the last 2 weeks prior to the survey. Of the patients who visited the pharmacy, 74.6% reported to be either "very satisfied" or "satisfied," and 25.4% responded as being "neutral," "dissatisfied," or "very dissatisfied." A multivariate ordinal logistic regression analysis with weighted observations revealed that patients with fair perception of health (adjusted OR 1.32; 95% CI 1.01-1.74; p<0.05 and those with middle to low family incomes (adjusted OR 1.34; 95% CI 1.02-1.76; p<0.05 were more likely to be satisfied with pharmacy services, and employment-based insurers were less likely to be satisfied with pharmacy services (adjusted OR 0.80; 95% CI 0.65-0.97; p<0.05.Our findings indicated that three out of four patients expressed satisfaction toward pharmacy services. Middle to low family incomes, fair perception of health, and employee insured individuals were significant predictors of patient satisfaction with pharmacy services.

  16. Value and Service Quality Assessment of the National Health Insurance Scheme in Ghana: Evidence from Ashiedu Keteke District.

    Science.gov (United States)

    Nsiah-Boateng, Eric; Aikins, Moses; Asenso-Boadi, Francis; Andoh-Adjei, Francis-Xavier

    2016-09-01

    Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to provide financial access to health care for all residents. This article analyzed claims reimbursement data of the NHIS to assess the value of the benefit package to the insured and responsiveness of the service to the financial needs of health services providers. Medical claims data reported between January 1, 2010, and December 31, 2014, were retrieved from the database of Ashiedu Keteke District Office of the National Health Insurance Authority. The incurred claims ratio, promptness of claims settlements, and claims adjustment rate were analyzed over the 5-year period. In all, 644,663 medical claims with a cost of Ghana cedi (GHS) 11.8 million (US $3.1 million) were reported over the study period. The ratio of claims cost to contributions paid increased from 4.3 to 7.2 over the 2011-2013 period, and dropped to 5.0 in 2014. The proportion of claims settled beyond 90 days also increased from 26% to 100% between 2011 and 2014. Generally, the amount of claims adjusted was low; however, it increased consistently from 1% to about 4% over the 2011-2014 period. The reasons for claims adjustments included provision of services to ineligible members, overbilling of services, and misapplication of diagnosis related groups. There is increased value of the NHIS benefit package to subscribers; however, the scheme's responsiveness to the financial needs of health services providers is low. This calls for a review of the NHIS policy to improve financial viability and service quality. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Pacific Islands Regional Office — National Marine Fisheries Service -

    Science.gov (United States)

    ? Report Marine Animals State-Wide Hotline 888-256-9840 Report sea turtle, monk seal, dolphin and whales (ESA) Marine Mammal Response and Rescue Protected Resources Outreach and Education Volunteer PRGC Contacts Marine National Monument Program About the Marine National Monument Program Frequently

  18. 76 FR 1458 - Public Meeting for the National Park Service Alaska Region's Subsistence Resource Commission (SRC...

    Science.gov (United States)

    2011-01-10

    ... Plan Update. c. Subsistence Uses of Horns, Antlers, Bones and Plants EA Update. 13. New Business. 14... guarantee that we will be able to do so. Wrangell-St. Elias National Park SRC Meeting Date and Location: The... if all business is completed. For Further Information on the Gates of the Arctic National Park SRC...

  19. Preliminary results of the national program of audit of quality in radiotherapy services in the Republic of Cuba

    International Nuclear Information System (INIS)

    Dominguez Hung, Lourdes; Larrinaga Cortina, Eduardo F.; Morales Lopez, Jorge L.; Garcia Yip, Fernando; Campa Menendez, Raudel

    2001-01-01

    The current state of the radiotherapy in Cuba has allowed to pass to a superior stage, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices as national regulator entity for the control and supervision of the medical devices of the National Health System is the responsible for it implementation. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of 60 Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audit, such as: the installation and unit's security, treatment unit's mechanical and dosimetric aspects and organizational aspects of the institution quality assurance program. Also were carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institution's program of quality assurance and a feedback for the setting about to the PNAC. (author)

  20. Military Emergency Medical Service System Assessment: Application of the National Park Service Needs Assessment and Program Audit to Objectively Evaluate the Military EMS System of Okinawa, Japan.

    Science.gov (United States)

    Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U

    2017-03-01

    As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.