West, R T; Howard, F H
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
Svendsen, Gunnar Lind Haase
abandoned. One outcome has been closings of schools in remote rural areas. This evidently contributes to exacerbate depopulation in these areas. To stop this tendency, we need new models for high-quality, cost effective public services in rural areas as those as we find in Denmark. This chapter introduces...... ideological roots in history pointing at 19th c. national civic movements and an early 20th c. transnational Garden City movement within urban planning as crucial. Drawing on contemporary case studies of multifunctional centers in Holland and Denmark, I then suggest that public and private donors should...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...
California Natural Resource Agency — Federal Water Contract Service Area boundaries are incorporated boundaries of districts having contracts with the U.S. Bureau of Reclamation (Reclamation), within...
Kawungezi, Peter Chris; AkiiBua, Douglas; Aleni, Carol; Chitayi, Michael; Niwaha, Anxious; Kazibwe, Andrew; Sunya, Elizabeth; Mumbere, Eliud W; Mutesi, Carol; Tukei, Cathy; Kasangaki, Arabat; Nakubulwa, Sarah
Globally every year 529,000 maternal deaths occur, 99% of this in developing countries. Uganda has high maternal and neonatal morbidity and mortality ratios, typical of many countries in sub-Saharan Africa. Recent findings reveal maternal mortality ratio of 435:100,000 live births and neonatal mortality rate of 29 deaths per 1000 live births in Uganda; these still remain a challenge. Women in rural areas of Uganda are two times less likely to attend ANC than the urban women. Most women in Uganda have registered late ANC attendance, averagely at 5.5 months of pregnancy and do not complete the required four visits. The inadequate utilization of ANC is greatly contributing to persisting high rates of maternal and neonatal mortality in Uganda. This study was set to identify the factors associated with late booking and inadequate utilization of Antenatal Care services in upcountry areas of Uganda. Cross-sectional study design with mixed methods of interviewer administered questionnaires, focus group discussions and key informant interviews. Data was entered using Epidata and analyzed using Stata into frequency tables using actual tallies and percentages. Ethical approval was sought from SOM-REC MakCHS under approval number "#REC REF 2012-117" before conducting the study. A total of four hundred one were enrolled with the majority being in the age group 20 - 24 years (mean age, 25.87 ± 6.26). Health workers played a great role (72.04%), followed by the media (15.46%) and friends (12.50%) in creating awareness about ANC. A significant number of respondents went to TBAs with reasons such as "near and accessible", "my husband decided", and "they are the only people I know". 37.63% of the respondents considered getting an antenatal Card as an importance of ANC. 71 (19.67%) respondents gave a wrong opinion (late) on booking time with reasons like demands at work, no problems during pregnancy, advised by friends, just to get a card, long distance and others didn't know
In Germany, AEG-Telefunken has been working as a supplier of irradiation equipment for more than ten years. There is a close cooperation with Radiation Dynamics Inc., Westbury, N.Y. Radiation sources are available for most industrial applications. As a special service AEG is establishing a multipurpose radiation service center in Hamburg-Wedel, Germany. This center will be used by a host of companies to investigate the effects of radiation on a broad range of materials, to develop special processing equipment, to process customer supplied products and to perform R and D work and contracts. Initially this service center will be equipped with one research type High-Power X-ray Unit (200 kV/32 mA) and one industrial type Dynamitron accelerator (1500 kV/37.5 kW). (author)
NSGIC Education | GIS Inventory — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...
Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.
Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.
U.S. Department of Health & Human Services — This file is derived from the calendar year inpatient claims data. The records contain number of discharges, length of stay, and total charges summarized by provider...
Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.
... Educators Search English Español Birthing Centers and Hospital Maternity Services KidsHealth / For Parents / Birthing Centers and Hospital Maternity Services What's in this article? Giving Birth at ...
Full Text Available Transport systems have an essential role in modern society because they facilitate access to natural resources and they stimulate trade. Current studies aimed at improving transport networks by developing new methods for optimization. Because of the increase in the global number of cars, one of the most common problems facing the transport network is congestion. By creating traffic models and simulate them, we can avoid this problem and find appropriate solutions. In this paper we propose a new method for modeling traffic. This method considers road intersections as being service centers. A service center represents a set consisting of a queue followed by one or multiple servers. This model was used to simulate real situations in an urban traffic area. Based on this simulation, we have successfully determined the optimal functioning and we have computed the performance measures.
NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...
NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Area of service. 130.310 Section 130.310 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS DEVELOPMENT CENTERS § 130.310 Area of service. The AA/SBDC shall designate in writing the Area of Service of each...
Department of Transportation — The AML LAN is designed to facilitate the services and resources needed to support the operations of the FAA Logistics Center users. The AML LAN provides support for...
The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.
Bayer, Darryl Lee
This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…
Petty, G.M.; Yokota, M.
The literature relating specifically to international nuclear fuel service centers would appear to be relatively scarce, based on the results of searches of the Energy Data Base, the libraries of the University of California at Los Angeles, and The Rand Corporation, and other sources. Works specifically relating to international service centers are annotated in this bibliography. Also listed, without annotation, are studies of various kinds of multinational public enterprises. In addition, there are references to many of the studies of the one-nation nuclear energy center concept. Most of these resulted from the survey of possible sites for these centers mandated by the US Energy Reorganization Act of 1974
This is a Portuguese translation of the Clean Energy Solutions Center Services fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.
Varner, J. D.; Cartwright, J.; McLean, S. J.; Boucher, J.; Neufeld, D.; LaRocque, J.; Fischman, D.; McQuinn, E.; Fugett, C.
Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.
Ohio Board of Regents, Columbus.
Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…
911 Call Center (PSAP) Service Areas, Master coverage of "atom" features used as a source to generate several derivative layers for the Sheriff RMS and E-911 map rolls. Cover is painstakingly maintained interactively by GIS staff. All atom boundaries are snapped to the road centerline cover, Published in 2008, 1:1200 (1in=100ft) scale, Sedgwick County Government.
NSGIC Local Govt | GIS Inventory — 911 Call Center (PSAP) Service Areas dataset current as of 2008. Master coverage of "atom" features used as a source to generate several derivative layers for the...
Cornwall, John M.
We correct an unfortunate error in an earlier work of the author, and show that in the center-vortex picture of QCD [gauge group SU(3)] the asymptotic quenched baryonic area law is the so-called Y law, described by a minimal area with three surfaces spanning the three quark world lines and meeting at a central Steiner line joining the two common meeting points of the world lines. (The earlier claim was that this area law was a so-called Δ law, involving three extremal areas spanning the three pairs of quark world lines.) By asymptotic we mean the Y law holds at asymptotically large quark separations from each other; at separations of the order of the gauge-theory scale length, there may be Δ-like contributions. We give a preliminary discussion of the extension of these results to SU(N),N>3. These results are based on the (correct) baryonic Stokes' theorem given in the earlier work claiming a Δ law. The Y-form area law for SU(3) is in agreement with the most recent lattice calculations
... company to be other than such company's study area, the Commission will consider that proposed definition... definition of a service area served by a rural telephone company. (2) The Commission shall issue a Public... to consider a definition of a service area served by a rural telephone company that is different from...
Bergeron, M.P.; Bugliosi, E.F.
Two adjacent burial areas were excavated in a clay-rich till at a radioactive waste disposal site near West Valley in Cattaraugus County, N.Y.: (1) which contains mainly low-level radioactive wastes generated onsite by a nuclear fuel reprocessing plant, has been in operation since 1966; and (2) which contains commercial low-level radioactive wastes, was operated during 1963-75. Groundwater below the upper 3 meters of till generally moves downward through a 20- to 30-meter thick sequence of tills underlain by lacustrine and kame-delta deposits of fine sand and silt. Groundwater in the weathered, upper 3 meters of till can move laterally for several meters before either moving downward into the kame-delta deposits or discharging to the land surface. A two-dimensional finite-element model that simulates two vertical sections was used to evaluate hydrologic factors that control groundwater flow in the till. Conditions observed during March 1983 were reproduced accurately in steady-state simulations that used four isotropic units of differing hydraulic conductivity to represent two fractured and weathered till units near land surfaces, an intermediate group of isolated till zones that contain significant amounts of fine sand and silt, and a sequence of till units at depths that have been consolidated by overburden pressure. Recharge rates used in the best-fit simulation ranged from 1.4 cm/yr along smooth, sloping or compacted surfaces to 3.8 cm/yr near swampy areas. Values of hydraulic conductivity and infiltration used in the calibrated best-fit model were nearly identical to values used in a previous model analysis of the nearby commercial-waste burial area. Results of the model simulations of a burial pit assumed to be filled with water indicate that water near the bottom of the burial pit would migrate laterally in the shallow, weathered till for 5 to 6 meters before moving downward into the unweathered till, and water near the top of the pit would move laterally
Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.Assessment......Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.......Assessment of development potential for individual localities using a place-based approach is in line with EU policies for rural development thereby setting a competitive framework for local development. This paper addresses place bound approaches in relation to service adjustment and discusses how local resources...... and place bound potentials are identified and how they are addressed in plans for future development. The paper draws on a study on service adjustments in rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are decided, how they are managed by rural communities...
Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.
U.S. Environmental Protection Agency — This web service contains the following layers: Mandatory Class 1 Federal Area polygons and Mandatory Class 1 Federal Area labels in the United States. The polygon...
Federal Laboratory Consortium — The mission of the Center for Surveillance, Epidemiology and Laboratory Services (CSELS) is to provide scientific service, expertise, skills, and tools in support of...
Patki, Tapasya; Bates, Natalie; Ghatikar, Girish
from a detailed, quantitative survey-based analysis and compare the perspectives of the European grid and SCs to the ones of the United States (US). We then show that contrary to the expectation, SCs in the US are more open toward cooperating and developing demand-management strategies with their ESPs......Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates...... this problem. In order to develop a symbiotic relationship between the SCs and their ESPs and to support effective power management at all levels, it is critical to understand and analyze how the existing relationships were formed and how these are expected to evolve. In this paper, we first present results...
T. Elmqvist; H. Setala; S.N. Handel; S. van der Ploeg; J. Aronson; J.N. Blignaut; E. Gomez-Baggethun; D.J. Nowak; J. Kronenberg; R. de Groot
Cities are a key nexus of the relationship between people and nature and are huge centers of demand for ecosystem services and also generate extremely large environmental impacts. Current projections of rapid expansion of urban areas present fundamental challenges and also opportunities to design more livable, healthy and resilient cities (e.g. adaptation to climate...
... NOAA to establish a National Marine Protected Area Center (``MPA Center'') within NOAA (Sec. 4(e)) to... also submit comments in writing to: National Marine Protected Areas Center, c/o Denise Ellis-Hibbett... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration National Marine Protected...
Chen, Minya; Zheng, Konglin; Xia, Yong
This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.
Goodman, Ross V.
The existing Mission Control and Computer Center at JPL will be replaced by the Space Flight Operations Center (SFOC). One part of the SFOC is the LAN-based distribution system. The purpose of the LAN is to distribute the processed data among the various elements of the SFOC. The SFOC LAN will provide a robust subsystem that will support the Magellan launch configuration and future project adaptation. Its capabilities include (1) a proven cable medium as the backbone for the entire network; (2) hardware components that are reliable, varied, and follow OSI standards; (3) accurate and detailed documentation for fault isolation and future expansion; and (4) proven monitoring and maintenance tools.
This is the Arabic translation of the Clean Energy Solutions Center Services fact sheet. The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
Silva, Islane C.S.; Silva, Iasmim M.S.; Júnior, Cláudio L.R.; Silva, Isvânia S.; Gonzalez, Kethyllém M.; Melo, Francisca A.; Lima, Fernando R.A.
The measurement of the exposure rate of the sectors of a nuclear medicine service (NMS), with the purpose of establishing safety to the service workers and the public, classifying the areas according to the monitoring is presented. Following the studies on the classifications of the areas of a Nuclear Medicine service provided by the category regulatory standard, 3.05 CNEN-NN, measures were taken in all sectors of the NMS in order to classify the areas in: Free, controlled and supervised according to with the exposure level. As a measurement instrument, a Geiger-Muller counter of the digital type was used. The results obtained show a correlation with the Brazilian norm satisfactorily, referring to the exposure rate of the studied SMN sectors
Bauer, Jeffrey T.
This viewgraph presentation reviews the areas that Dryden Flight Research Center has set up for testing small Unmanned Aerial Systems (UAS). It also reviews the requirements and process to use an area for UAS test.
Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia
Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.
This is an Arabic translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.
This is a Vietnamese translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.
This is a French translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.
Huebner, S.; Lempart, R.
Under the Radiation Protection and X-ray Ordinances, official personnel dosimetry centers are charged with measuring, documenting, and monitoring personnel doses as independent agencies. The GSF Readout Center (AWST) for Personnel Dosimeters and Area Monitors is responsible for monitoring persons occupationally exposed to radiation in the federal states of Baden-Wuerttemberg, Bavaria, Hesse, and Schleswig-Holstein. The largest German readout center uses new media in personnel dosimetry in order to simplify and speed up data transfer. In October 1998, AWST in cooperation with ADANAT ENTIRE SYSTEMS implemented an Internet interface. As a result, AWST is the first European readout center to offer not only a possibility to disseminate information through the Internet by means of the DOSIMO (DOSIMETRY On-line) Internet Service, but also enabling the interactive data exchange by electronic means with authorized customers. DOSIMO users enjoy the decisive advantage of having the results of readout of their dosimeters ready for use as soon as they have become available. (orig.) [de
Sinsabaugh, Nancy, Ed.
This collection of best practices shares how 18 higher education institutions across the country have successfully evaluated and redesigned their student financial services programs to improve services to students and their parents and find cost savings for the institution. This volume illustrates how other institutions have successfully tackled…
The creation in ENSA of the new Business Development Management is meant to leverage ENSA's activities by taking advantage of the previous experience gained by the services area to have a much more active presence than before in both the national and international market for goods and services of the nuclear industry. The Management's activities go beyond the traditional, mature activity of large nuclear components manufacturing developed in ENSA since it was founded. This article details the activities of this new Management and its future projection. (Author)
... assessment, individual counseling, group counseling, marital and family counseling for military-related... includes but is not limited to: psychosocial assessment, individual counseling, group counseling, marital... counseling currently provided in VA's Vet Centers to certain veterans of the Armed Forces and members of...
Dunford, C.L.; Burrows, T.W.; Tuli, J.K.
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
W.L. van Jaarsveld (Willem)
textabstractHigh-tech capital goods enable the production of many services and articles that have become a part of our daily lives. Examples include the refineries that produce the gasoline we put in our cars, the photolithography systems that enable the production of the chips in our cell phones
... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas. (b...
National Aeronautics and Space Administration — The NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC) is the home (archive) of Precipitation, Atmospheric Chemistry and Dynamics, and...
Crane, M.; Mackenzie, R.; Millsom, D.; Zelazny, M.
The Area Message Service (AMS) is a TCP/IP based messaging service currently in use at SLAC. A number of projects under development here at SLAC require and application level interface to the 4.3BSD UNIX socket level communications functions using TCP/IP over ethernet. AMS provides connection management, solicited message transfer, unsolicited message transfer, and asynchronous notification of pending messages. AMS is written completely in ANSI 'C' and is currently portable over three hardware/operating system/network manager platforms, VAX/VMS/Multinet, PC/MS-DOS/Pathworks, VME 68K/pSOS/pNA. The basic architecture is a client-server connection where either end of the interface may be the server. This allows for connections and data flow to be initiated from either end of the interface. Included in the paper are details concerning the connection management, the handling of the multi-platform code, and the implementation process
The Sacramento Area Office (SAO) of the Western Area Power Administration (Western) needs to increase the security of operations, to eliminate overcrowding at the current leased location of the existing facilities, to provide for future growth, to improve efficiency, and to reduce operating costs. The proposed action is to construct an approximate 40,000-square foot building and adjacent parking lot with a Solar Powered Electric Vehicle Charging Station installed to promote use of energy efficient transportation. As funding becomes available and technology develops, additional innovative energy-efficient measures will be incorporated into the building. For example the proposed construction of the Solar Powered Electric Vehicle Charging.
... mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call Center... Center personnel must determine the emergency caller's phone number and location and then transfer or otherwise redirect the call to an appropriate public safety answering point. Providers of mobile satellite...
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...
Crane, M.; Mackenzie, R.; Millsom, D.; Zelazny, M.
The Area Message Service (AMS) is a TCP/IP based messaging service currently in use at SLAC. A number of projects under development here at SLAC require an application level interface to the 4.3BSD UNIX socket level communications functions using TCP/IP over ethernet. AMS provides connection management, solicited message transfer, unsolicited message transfer, and asynchronous notification of pending messages. AMS is written completely in ANSI open-quote C close-quote and is currently portable over three hardware/operating system/network manager platforms, VAX/VMS/Multinet, PC/MS-DOS/Pathworks, VME 68K/pSOS/pNA. The basic architecture is a client-server connection where either end of the interface may be the server. This allows for connections and data flow to be initiated from either end of the interface. Included in the paper are details concerning the connection management, the handling of the multi-platform code, and the implementation process
A one-year study of the Western new York Nuclear Service Center was conducted, including consideration of the following options: (1) Federal technical and financial aid in support of decommissioning high-level waste disposal operations; (2) Federal operation for the purpose of decommissioning existing facilities and disposing of existing high-level wastes, including a demonstration program for the solidification of high-level wastes for permanent burial; (3) permanent Federal ownership of and responsibility for all or part of the Western new York Nuclear Service Center, and Federal receipt of the license from the present co-licensees; and (4) use of the Western New York Nuclear Service Center for other purposes. Environmental impacts and institutional aspects are also covered
... DEPARTMENT OF AGRICULTURE Farm Service Agency Information Collection; Customer Data Worksheet Request for Service Center Information Management System (SCIMS) Record Changes AGENCY: Farm Service... Customer Data Worksheet Request for Service Center Information Management System (SCIMS) that contains the...
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service delivery areas. 628.405 Section 628... TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.405 Service delivery... evaluate the degree to which a proposed service delivery area meets criteria established by the Governor...
CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.
Sucik, Juraj; Bukowiec, Sebastian
CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft (registered) Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.
Smith, S M; Clark, M
The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.
Legros, Benjamin; Jouini, Oualid; Koole, Ger
We consider a blended call center with calls arriving over time and an infinitely backlogged amount of outbound jobs. Inbound calls have a non-preemptive priority over outbound jobs. The inbound call service is characterized by three successive stages where the second one is a break; i.e., there is
Tereshchenko, Iu A; Zakharinskaia, O N
The authors present organizational and functional structure of occupational therapeutic service in Krasnoyarsk area, major functional divisions of the territorial occupational therapeutic center and their activities. The article covers analysis of changes in levels and structure of occupational morbidity, defines main ways to optimize occupational therapeutic service for the territorial workers.
'Mopera' information service is a mobile information service in which NTT Mobile Communications Network, Inc. offers information of various fields such as business and hobbies for the users of the portable telephone or PHS of the company. Toshiba Corp. started the contents operation center consistently performing from the preparation of contents to the management of a server for the above information service, making efforts in expanding the contents since the beginning of the service in the fall of 1998, and operating at present more than ten kinds of contents such as news, weather forecast, and stock information other than mobile 'Ekimae-Tanken Club' (adventure club in front of a station). Moreover, Toshiba takes it into consideration to build a system aiming at a stable operation like a duplex operation of a server, 24-hour automatic surveillance, etc., continuously providing highly reliable services. (translated by NEDO)
Earth Data Analysis Center, University of New Mexico — This file contains a feature class depicting National Forest System land parcels that have a Congressionally designated boundary. Examples include National...
Lai, Jennifer C; Feng, Sandy; Vittinghoff, Eric; Roberts, John P
We previously reported that national liver distribution is highly concentrated in 6 US centers, and this raises the possibility of expedited placement. Therefore, we evaluated all national offers of nationally placed livers (n=1625) to adult wait-list candidates from February 2005 to January 2010. We developed a model to predict national utilization pathways; pathways exceeding the best-fit linear unbiased predictions by ≥3 standard errors were defined as preferred. All 51 donation service areas (DSAs) placed 1 or more livers nationally, but the percentage per DSA ranged from 1% to 36%. Of 2830 possible national DSA-center pathways, 87% were used. Five hundred eighty livers (36%) were accepted on the first national offer. Four DSAs accounted for 47% of first-national-offer livers, and 44% of these were accepted by a single center. In comparison with first-offer livers using nonpreferred pathways, first offers along a preferred pathway were offered to fewer status 1 candidates (19% versus 61%) and had lower median model for end-stage liver disease (MELD) scores (22 versus 36, Poffer to non-status 1 candidates with MELD scores less than their local transplant MELD scores. Although this practice may facilitate liver placement, it raises the possibility of expedience trumping patient need. Here we propose changes to the national liver distribution system that will help to balance equity, efficiency, and transparency. Copyright © 2013 American Association for the Study of Liver Diseases.
May 21, 2018 ... additional attention and interest. Examination of the related .... activity in the main area where the logistic center to be established. Area dimensions of ... The main areas of the logistic center are divided into equal unit areas.
Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B
This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess
Chen, R. S.; MacManus, K.; Vinay, S.; Yetman, G.
The Socioeconomic Data and Applications Center (SEDAC), one of 12 Distributed Active Archive Centers (DAACs) in the NASA Earth Observing System Data and Information System (EOSDIS), has developed a variety of operational spatial data services aimed at providing online access, visualization, and analytic functions for geospatial socioeconomic and environmental data. These services include: open web services that implement Open Geospatial Consortium (OGC) specifications such as Web Map Service (WMS), Web Feature Service (WFS), and Web Coverage Service (WCS); spatial query services that support Web Processing Service (WPS) and Representation State Transfer (REST); and web map clients and a mobile app that utilize SEDAC and other open web services. These services may be accessed from a variety of external map clients and visualization tools such as NASA's WorldView, NOAA's Climate Explorer, and ArcGIS Online. More than 200 data layers related to population, settlements, infrastructure, agriculture, environmental pollution, land use, health, hazards, climate change and other aspects of sustainable development are available through WMS, WFS, and/or WCS. Version 2 of the SEDAC Population Estimation Service (PES) supports spatial queries through WPS and REST in the form of a user-defined polygon or circle. The PES returns an estimate of the population residing in the defined area for a specific year (2000, 2005, 2010, 2015, or 2020) based on SEDAC's Gridded Population of the World version 4 (GPWv4) dataset, together with measures of accuracy. The SEDAC Hazards Mapper and the recently released HazPop iOS mobile app enable users to easily submit spatial queries to the PES and see the results. SEDAC has developed an operational virtualized backend infrastructure to manage these services and support their continual improvement as standards change, new data and services become available, and user needs evolve. An ongoing challenge is to improve the reliability and performance
Bertrand, Sharon W.; Fermon, Barbara; Coleman, Julie Foley
Objectives: This research study assessed perceived changes in quality-of-life measures related to participation in complementary services consisting of a variety of nontraditional therapies and/or programs at Pathways: A Health Crisis Resource Center in Minneapolis, Minnesota. Design: Survey data were used to assess perceived changes participants ascribed to their experience with complementary services at Pathways. Quantitative data analysis was conducted using participant demographics together with participant ratings of items from the “Self-Assessment of Change” (SAC) measure developed at the University of Arizona, Tucson. Qualitative data analysis was conducted on written responses to an additional survey question: “To what extent has your participation at Pathways influenced your healing process?” Setting/Location: Pathways offers a variety of services, including one-to-one sessions using nontraditional healing therapies, support groups, educational classes, and practice groups such as yoga and meditation for those facing serious health challenges. These services are offered free of charge through community financial support using volunteer practitioners. Participants: People (126) diagnosed with serious health challenges who used Pathways services from 2007 through 2009. Interventions: Participation in self-selected Pathways services. Measures: Responses to items on the SAC measure plus written responses to the question, “To what extent has your participation at Pathways influenced your healing process?” Results: Quantitative findings: Participants reported experiencing significant changes across all components of the SAC measure. Qualitative findings: Responses to the open-ended survey question identified perspectives on the culture of Pathways and a shift in participants' perceptions of well-being based on their experience of Pathways services. Conclusions: Participation in services provided by the Pathways organization improved perceptions of
..., maintenance, debt service, and reserve requirements. Such guarantees from developers will meet the... 7 Agriculture 12 2010-01-01 2010-01-01 false Service area requirements. 1780.11 Section 1780.11... AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS General Policies and Requirements § 1780.11 Service...
.... Except for incumbent BRS licenses, BRS service areas are Basic Trading Areas (BTAs) or additional service... in places where Rand McNally has not defined BTAs: American Samoa; Guam; Gulf of Mexico Zone A; Gulf of Mexico Zone B; Gulf of Mexico Zone C; Northern Mariana Islands; Mayaguez/Aguadilla-Ponce, Puerto...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services (CMHS); Amendment of Meeting Pursuant to Public Law 92-463, notice is... Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services...
...; procuring those services using Federal Acquisition Regulation (FAR) contracts. It also plans to centralize the payment process at the Defense Finance and Accounting Service-Indianapolis Center (DFAS...
Zheng, Yihua; Kuznetsova, Masha; Pulkkinen, Antti; Taktakishvili, A.; Mays, M. L.; Chulaki, A.; Lee, H.; Hesse, M.
The NASA Space Weather Center's primary objective is to provide the latest space weather information and forecasting for NASA's robotic missions and its partners and to bring space weather knowledge to the public. At the same time, the tools and services it possesses can be invaluable for research purposes. Here we show how our archive and real-time modeling of space weather events can aid research in a variety of ways, with different classification criteria. We will list and discuss major CME events, major geomagnetic storms, and major SEP events that occurred during the years 2010 - 2012. Highlights of major tools/resources will be provided.
Fujita, Akira; Narita, Tomoyo
The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other
Wang, Lijun; Li, Bin; Qian, Jianguo; Cao, Shaoping; He, Dehua; Zheng, Yunxin
In 2011, Shanghai Medical Equipment Management Quality Control Center launched the fifth after-sale service satisfaction survey for medical devices in Shanghai area. There are 8 classes medical devices involving in the survey. This paper demonstrates the investigation results of monitoring devices which are from different manufacturers.
Arnoud, Justine; Falzon, Pierre
This study examines the way in which Shared Services Centers (SSCs) were implemented in a French multinational company. It aims to characterize the change according to the capabilities model developed by Amartya Sen: what are the effects of SSCs in terms of capabilities development and developmental quality of work, i.e. in the enabling potential of work? A 3-step methodology has been used: first, an investigation was conducted in a pay service of a local entity moving into SSC in 2013; second, two investigations were conducted in another pay service of a SSC: first, a few months after the change, and then, one year after the change (the same operators were interviewed). Results show a tendency to the decrease of the enabling potential. Additionally, it was noted that administrators are kept away from the design process and have to struggle with inappropriate rules. The efficiency and sustainability of the SSC are questioned; in this context, the human factor specialist has an important role to play.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental...
He, Yingbin; Chen, Youqi; Tang, Huajun; Yao, Yanmin; Yang, Peng; Chen, Zhongxin
Spatially explicit ecosystem services valuation and change is a newly developing area of research in the field of ecology. Using the Beijing region as a study area, the authors have developed a spatially explicit ecosystem services value index and implemented this to quantify and spatially differentiate ecosystem services value at 1-km grid resolution. A gravity model was developed to trace spatial change in the total ecosystem services value of the Beijing study area from a holistic point of view. Study results show that the total value of ecosystem services for the study area decreased by 19.75% during the period 1996-2006 (3,226.2739 US$×10(6) in 1996, 2,589.0321 US$×10(6) in 2006). However, 27.63% of the total area of the Beijing study area increased in ecosystem services value. Spatial differences in ecosystem services values for both 1996 and 2006 are very clear. The center of gravity of total ecosystem services value for the study area moved 32.28 km northwestward over the 10 years due to intensive human intervention taking place in southeast Beijing. The authors suggest that policy-makers should pay greater attention to ecological protection under conditions of rapid socio-economic development and increase the area of green belt in the southeastern part of Beijing.
Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu
Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)
... Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee; Exception to... Competition--Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program... supplement award to the University of Guam School of Nursing, an Area Health Education Center (AHEC) Program...
Full Text Available Intensification of public transport in urban areas due to increased mobility at regional and national levels, discrepancies among urban areas with same population and lack of statistical data related to performance and quality of public transport services are the main determinants of this paper. A separation line must be drawn between quality of services and performance indicators of public transport system. Service quality is a multi subjective outcome of an array of intangible variables. Service quality can be approached from four directions: consumer, vehicle performance (including the human operator, specialized company in passenger transport, and the Government (local Councils. Availability, comfort and convenience are the two main indicators that must be evaluated by citizens as being with high grades for a good quality of urban transport services. The instrument used to gather data is the preference survey.
... Cellular Geographic Service Area (CGSA) of a cellular system is the geographic area considered by the FCC... application for modification of the CGSA using FCC Form 601, a depiction of what the carrier believes the CGSA... location and the locus of points where the predicted or measured median field strength finally drops to 32...
Full Text Available As practice shows us, at the present time ecosystem services are recognized by humanity, but unfortunately are undervalued compared to their full potential. Most of planet's ecosystems are degradated by anthropic activity of humankind. It is almost impossible to say that there are no areas affected by human activity, however, the Protected Areas are a good opportunity, so the assessing of ecosystem services in Protected Areas can be a solution to the problem of economic growth. At present, there are few consistent informations on economic value of ecosystem services in Romania, on the basis of which can be adopted some sustainable financing policies of activities in Protected Areas. The premise from which we start is that a proper management of natural capital will allow biodiversity conservation and human well-being if it find appropriate economic instruments. For this reason, studies of economic research on the contribution of those ecosystem services to the communities welfare may constitute credible means for decision-makers, demonstrating the Protected Areas importance. This paper, based on the study of international and national literature, examines the state of knowledge on the economic and environmental valences of ecosystem services. The growing interest of researchers regarding the economic valuation of ecosystem services related to Protected Areas is visible through the many studies carried out at international level. Although national scientific research relating to ecosystem services is at the beginning, concerns researchers economists and ecologists have been directed toward this recess, of ecosystem services. The reason for we should assign an economic value to ecosystem services is to ensure that their value is included actively in decision-making and is not ignored because "is still available". Briefly, the paper start with an overview of the main definition of ecosystem services. From the point of economic value view, the paper
Ratliff, Eugene F.
The purpose of this study was to determine the marketing strategies South Carolina One-Stop Career Centers Area Directors felt provided the best opportunity for dislocated workers to learn about their services. Two theories emerged: the Service Marketing Theory and the Word-of-Mouth Marketing Theory. Of the 36 area directors cited for this study,…
Leptoukh, G. G.; Alcott, G. T.; Kempler, S. J.; Lynnes, C. S.; Vollmer, B. E.
The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC), in addition to serving the Earth Science community as one of the major Distributed Active Archive Centers (DAACs), provides much more than just data. Among the value-added services available to general users are subsetting data spatially and/or by parameter, online analysis (to avoid downloading unnecessary all the data), and assistance in obtaining data from other centers. Services available to data producers and high-volume users include consulting on building new products with standard formats and metadata and construction of data management systems. A particularly useful service is data processing at the DISC (i.e., close to the input data) with the users' algorithms. This can take a number of different forms: as a configuration-managed algorithm within the main processing stream; as a stand-alone program next to the on-line data storage; as build-it-yourself code within the Near-Archive Data Mining (NADM) system; or as an on-the-fly analysis with simple algorithms embedded into the web-based tools. Partnerships between the GES DISC and scientists, both producers and users, allow the scientists concentrate on science, while the GES DISC handles the of data management, e.g., formats, integration and data processing. The existing data management infrastructure at the GES DISC supports a wide spectrum of options: from simple data support to sophisticated on-line analysis tools, producing economies of scale and rapid time-to-deploy. At the same time, such partnerships allow the GES DISC to serve the user community more efficiently and to better prioritize on-line holdings. Several examples of successful partnerships are described in the presentation.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA) Advisory Committee on HIV, Viral... announcements of meetings and other committee management activities, for both the Centers for Disease Control...
This is the Vietnamese language translation of the Clean Energy Solutions Center (Solutions Center) fact sheet. The Solutions Center helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.
Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162
Pilelienė, Lina; Grigaliūnaitė, Viktorija
In tough competitive conditions of Lithuanian mobile services market, customer satisfaction becomes one of the most important factors for customer retention and attraction. Lithuanian mobile market can be described as being in a maturity stage of its life-cycle: the prices and services of different mobile operators are quite similar. However, the network coverage and signal strength differs – main differences can be observed in rural areas of the country. Therefore, the scientific...
Fang, Hongliang; Beaudoing, Hiroko K.; Mocko, David M.; Rodell, Matthew; Teng, Bill; Vollmer, Bruce
Terrestrial hydrological variables are important in global hydrology, climate, and carbon cycle studies. The North American and Global Land Data Assimilation Systems (NLDAS and GLDAS, respectively) have been generating a series of land surface states (soil moisture, snow, and temperature) and fluxes (evapotranspiration, radiation, and heat flux) variables. These data, hosted at and available from NASA s Hydrology Data and Information Services Center (HDISC), include the NLDAS hourly 1/8 degree products and the GLDAS 3-hourly 0.25 and 1.0 degree products. HDISC provides easy access and visualization and analysis capabilities for these products, thus reducing the time and resources spent by scientists on data management and facilitating hydrological research. Users can perform spatial and parameter subsetting, data format transformation, and data analysis operations without needing to first download the data. HDISC is continually being developed as a data and services portal that supports weather and climate forecasts, and water and energy cycle research.
Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen
Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.
.... Beginning in FY 1996, the Defense Finance and Accounting Service (DFAS) Indianapolis Center became responsible for preparing the financial statements for the Department 97 general fund appropriations...
.... In September 1994, the Defense Finance and Accounting Service (DFAS) transferred the responsibility for preparing the departmental accounting reports for Department 971 appropriations to the DFAS Indianapolis Center...
Anggasari, Yasi; Kartasurya, Martha Irene; Suparwati, Anneke
The decrease of IUD active family planning participants' coverage in Surabaya in the last three years, from 12.27% to 6.1%, became a special attention for Surabaya district health office. The decrease was caused by inadequate work performance of midwives in implementing IUD contraception service in the primary healthcare centers in Surabaya area. Objective of the study was to analyze factors related to the work performance of midwives in the IUD contraception service in the primary healthcare...
Mission & contact information for EPA Region 3's Laboratory and Field Services located at EPA's Environmental Science Center: the Office of Analytical Services and Quality Assurance & Field Inspection Program
Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A
Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.
... cellular market or in the Gulf of Mexico Coastal Zone (GMCZ), to allow one or more SAB extensions into the... of the cellular market boundary, but within the service area as calculated using the methods of § 22... section, SABs may be extended into adjacent cellular markets if such extensions are de minimis, are...
Background: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted ...
Full Text Available Design plays a marginal part in the discourse of diabetes care, mainly in visualizing the form and packaging of medical technologies. The authors however have a practice that advocates that design orientated solutions can add much needed dimensions to problems that havetraditionally been the exclusive preserve of expert discourses. This position has for long been a validated and largely accepted approach in design’s engagement withissues in sustainability and development studies. A similar approach in the area of medicine has been constructed bythe authors and marks out a position of advocacy where the designer takes on agency to intervene on behalf of the user community. This position contains a healthy critique of thetraditional approach of product design for manufacture while simultaneously amplifying a desire to intervene and make a substantial improvement in the quality of life ofpeople with diabetes. This article first opens out contemporary diabetes care as a contested domain and then goes on to sketch out the key aspects of a design practice focussed upon delivering positive health outcomes in diabetes care. The specific context of discussion for this article is the practice of teaching in design studios wherestudents of design listen to the voices of people with diabetes and visualize ways for design to provide products and service solutions that transform the lived experiences of people with diabetes.
Louisiana Geographic Information Center — This GIS shapefile data illustrates town center new growth areas included in the Louisiana Speaks Regional Plan Vision. Town center new growth areas include local...
Full Text Available Background & aim: Care provision is one of the most important factors in preventing and reducing mortality among pregnant mothers. Despite availability, the uptake of health services in health centers is undesirable. This study aimed to investigate the factors influencing the behavior of pregnant women towards using prenatal care services based on health belief model in healthcare centers of Tuyserkan, Hamadan Province, Iran. Methods: In this descriptive, analytical, cross-sectional study, 165 mothers visiting the health care centers of Tuyserkan, Hamadan Province, Iran, 1-15 days postpartum were chosen using the convenient sampling method during 2015. A self-structured questionnaire comprising items on demographics, knowledge, and health belief model constructs was employed for data collection. The data were analyzed using Pearson correlation coefficient, independent t-test, and logistic regression. Results: The study revealed that 72.1% of the pregnant women had regular visits, while 27.9% had irregular visits. Logistic regression reflected that knowledge (OR=0.929 and self-efficacy (OR= 0.976 were effective variables on regular prenatal visits. Conclusion: Considering pregnant women's physiological and anatomical conditions, prenatal care and regular visits are essential; thus, effective interventions in this area should be planned and implemented.
Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan
Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.
Huffer, E.; Hertz, J.; Kusterer, J.
The corpus of Earth Science data products at the Atmospheric Science Data Center at NASA's Langley Research Center comprises a widely heterogeneous set of products, even among those whose subject matter is very similar. Two distinct data products may both contain data on the same parameter, for instance, solar irradiance; but the instruments used, and the circumstances under which the data were collected and processed, may differ significantly. Understanding the differences is critical to using the data effectively. Data distribution services must be able to provide prospective users with enough information to allow them to meaningfully compare and evaluate the data products offered. Semantic technologies - ontologies, triple stores, reasoners, linked data - offer functionality for addressing this issue. Ontologies can provide robust, high-fidelity domain models that serve as common schema for discovering, evaluating, comparing and integrating data from disparate products. Reasoning engines and triple stores can leverage ontologies to support intelligent search applications that allow users to discover, query, retrieve, and easily reformat data from a broad spectrum of sources. We argue that because of the extremely complex nature of scientific data, data distribution systems should wholeheartedly embrace semantic technologies in order to make their data accessible to a broad array of prospective end users, and to ensure that the data they provide will be clearly understood and used appropriately by consumers. Toward this end, we propose a distribution system in which formal ontological models that accurately and comprehensively represent the ASDC's data domain, and fully leverage the expressivity and inferential capabilities of first order logic, are used to generate graph-based representations of the relevant relationships among data sets, observational systems, metadata files, and geospatial, temporal and scientific parameters to help prospective data consumers
... Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with authority to redelegate, the authority vested in the Secretary of the...
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Cataloging data from Defense Logistics Services Center (DLSC). 101-30.504 Section 101-30.504 Public Contracts and Property... data from Defense Logistics Services Center (DLSC). Upon receipt of cataloging data from civil agencies...
Smith, R. O.
The environmental context of the Trace Center is first briefly described as background for a more detailed description of the center's service delivery activities in the field of rehabilitation/education technology. Trace serves four major functions in rehabilitation/education technology. As a nationally funded rehabilitation engineering center,…
Support Services As part of the comprehensive care provided at the NCI Pediatric Oncology Branch, we provide a wide range of services to address the social, psychological, emotional, and practical facets of pediatric cancer and to support patients and families while they are enrolled in clinical research protocols.
Burrows, T.W.; Tuli, J.K.
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
Qin, Xiaochun; Shen, Yi; Shao, Shegang
A lot of research works have been made concerning highway service area or solar technology and acquired great achievements. However, unfortunately, few works have been made combining the two topics together of highway service areas and solar energy saving to make a systemic research on solar technology application for highway service area. In this paper, taking West Lushan highway low-carbon service area in Jiangxi Province of China as the case study, the advantages, technical principles, and...
The Nuclear Data Centers Network provides low and medium energy nuclear reaction data to users around the world. Online retrievals are available through the U.S. National Nuclear Data Center, the Nuclear Energy Agency Data Bank, and the IAEA Nuclear Data Section from these extensive bibliographic, experimental data, and evaluated data files. In addition to nuclear reaction data, the various databases also provide nuclear structure and decay data, and other information of interest to users. The WorldWideWeb sites at the National Nuclear Data Center and the NEA Data Bank provide access to some of the Centers' files. (orig.)
U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...
Full Text Available In January 2001, approximately 23 x 106 ha of land in the U.S. National Forest System were slated to remain roadless and protected from timber extraction under the Final Roadless Conservation Rule. We examined the potential contributions of these areas to the conservation of biodiversity. Using GIS, we analyzed the concordance of inventoried roadless areas (IRAs with ecoregion-scale biological importance and endangered and imperiled species distributions on a scale of 1:24,000. We found that more than 25% of IRAs are located in globally or regionally outstanding ecoregions and that 77% of inventoried roadless areas have the potential to conserve threatened, endangered, or imperiled species. IRAs would increase the conservation reserve network containing these species by 156%. We further illustrate the conservation potential of IRAs by highlighting their contribution to the conservation of the grizzly bear (Ursos arctos, a wide-ranging carnivore. The area created by the addition of IRAs to the existing system of conservation reserves shows a strong concordance with grizzly bear recovery zones and habitat range. Based on these findings, we conclude that IRAs belonging to the U.S. Forest Service are one of the most important biotic areas in the nation, and that their status as roadless areas could have lasting and far-reaching effects for biodiversity conservation.
Burrows, T.W.; Tuli, J.K.
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)
Ramona Iulia Țarțavulea (Dieaconescu
Full Text Available The process of globalization has stimulated the demand for logistics services at a level of speed and increased efficiency, which involves using of techniques, tools, technologies and modern models in supply chain management. The aim of this research paper is to present a model that can be used in order to achieve an optimized supply chain, associated with minimum transportation costs. The utilization of spatial modeling for determining the optimal locations for logistics centers in a predefined economic area is proposd in this paper. The principal methods used to design the model are mathematic optimization and linear programming. The output data of the model are the precise placement of one up to ten logistics centers, in terms of minimum operational costs for delivery from the optimum locations to consumer points. The results of the research indicate that by using the proposed model, an efficient supply chain that is consistent with optimization of transport can be designed, in order to streamline the delivery process and thus reduce operational costs
Cushing, C.E.; Mueller, R.P.
Biologists from Pacific Northwest National Laboratory (PNNL) were requested by personnel from Fort Irwin to conduct a biological reconnaissance of the Avawatz Mountains northeast of Fort Irwin, an area for proposed expansion of the Fort. Surveys of vegetation, small mammals, birds, reptiles, amphibians, and aquatic resources were conducted during 1995 to characterize the populations and habitats present with emphasis on determining the presence of any species of special concern. This report presents a description of the sites sampled, a list of the organisms found and identified, and a discussion of relative abundance. Taxonomic identifications were done to the lowest level possible commensurate with determining the status of the taxa relative to its possible listing as a threatened, endangered, or candidate species. Consultation with taxonomic experts was undertaken for the Coleoptera ahd Hemiptera. In addition to listing the macroinvertebrates found, the authors also present a discussion related to the possible presence of any threatened or endangered species or species of concern found in Sheep Creek Springs, Tin Cabin Springs, and the Amargosa River.
van Balen, Mitchell; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan
In this chapter the authors consider articles in professional literature regarding Human Resource Centers, with the goal to explore issues raised by practice: motivation, risk analysis, structure and implementation. Using Grounded Theory approach, they analysed 34 articles, and through open and
Pereira, Paulo; Depellegrin, Daniel; Misiune, Ieva; Cerda, Artemi
Maps are fundamental to understand the spatial pattern of natural and human impacts on the landscape (Brevik et al., 2016; Lavado Contador et al., 2009; Pereira et al., 2010a,b). Urban areas are subjected to an intense human pressure (Beniston et al., 2015), contributing to the degradation of the ecosystems, reducing their capacity to provide services in quality and quantity (Requier-Desjardins et al., 2011; Zhang et al., 2011). Environments that can provide a high number and quality of ecosystem services (ES) must be identified and managed correctly, since are spaces that can mitigate the impacts of human settlements and improve their quality. thus is of major importance have identify the areas that can provide better ES (Deppelegrin and Pereira, 2015). The aim of this work is to identify areas with high ES potential in Vilnius city. Here, we identified a total of 4 different land uses, agricultural areas (32.48%), water bodies (1.46%), forest and semi-natural (31.91%) areas and artificial surfaces (34.16%). CORINE land cover 2006 was used as base information to classify ES potential. The assessment of each land cover potential was carried out using expert assessment. Each land use type was ranked from 0 (no potential) to 5 (High potential). In this work the sum of total regulating, providing and cultural ES were assessed. The areas with optimal ES were the ones with the sum of all ranks equal or higher than the 3rd Quartil of each distribution. After identifying these areas, data was mapped using ArcGIS software. The results showed that on average Vilnius city has a higher potential for regulating services (20.35±15.92), followed by cultural (14.43±8.81) and providing (14.26±8.87). There was a significant correlation among the different type of services. Regulating vs cultural (0.92, p<0.001), regulating vs providing (0.72, p<0.001) and providing vs cultural (0.65, p<0.001). The results of Morans I autocorrelation index showed that regulating (Z-score: 10
Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon
Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.
Full Text Available Shopping centers in the Silesian Voivodeship have a significant impact on smaller settlement units located in outer areas of agglomerations. It consists mainly in changes related to social, economic, as well as functional and spatial spheres. Studies shows that shopping centers take over more and more functions of higher order (services, public culture, administration and restrict the economic activity in rural areas outer areas of agglomerations. At the stage of the irrepressible process of suburbanisation of rural areas surrounding large urban agglomerations and structural changes in towns, it is difficult to conclusively assess the consequences of the operation of shopping centers in outer metropolitan areas. The impact of shopping centers on small towns and rural areas is a very dynamic process and requires systematic research.
Full Text Available This paper deals with wastewater treatment systems placed in motorway service areas (MSAs. In the years 2008-2009 eight of such facilities installed on the stretch of the A2 motorway between Poznań and Nowy Tomyśl were examined and analyzed. The system consists of a septic tank, a submerged aerated biofilter and an outflow filter. The volume of traffic on the highway was analyzed, the amount of water use was measured and peak factors were calculated. On this basis it was concluded that the inflows to the wastewater treatment systems in many cases exceeded the nominal design values.
Carbone, Marco; Honda, Kohei; Yoshida, Nobuko
This article relates two different paradigms of descriptions of communication behavior, one focusing on global message flows and another on end-point behaviors, using formal calculi based on session types. The global calculus, which originates from a Web service description language (W3C WS...
Center for Data-Driven Reform in Education (NJ3), 2008
Education service providers (ESPs), or education management organizations, are for-profit or non-profit organizations that contract with new or existing public, charter, or private schools to help them implement comprehensive reforms. Which of these ESPs have evidence that they help children in elementary and secondary school of positive effects…
Shrestha, Khadka Narayan; Homer, Caroline S. E.
Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987
Resham Bahadur Khatri
Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.
Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E
Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.
João Paulo Bittencourt
Full Text Available The aim of this research was to analyze the process of implementation and management of the Shared Services Center for Human Resources, in a multinational company in the context of mergers and acquisitions. The company analyzed was called here Alpha, and is one of the largest food companies in the country that was born of a merger between Beta and Delta in 2008. The CSC may constitute a tool for strategic management of HR that allows repositioning of the role of the area in order to be more strategic at corporate level and more profitable at the operating level. The research was based on a descriptive and exploratory study of qualitative approach. Among the results, there is the fact that shared services were strategic to support, standardize and ensure the expansion of the company. The challenges found were associated with the development of a culture of service and the relationship with users and the definition of HR activities scope. The following management procedures include the adequacy of wage differences between employees, the career path limitation and the need to attract and retain talent and international expansion.
Full Text Available Background - The ICDS is world’s largest community-based child nutrition and development programme aimed at holistic development of children (0-6 years, expectant and nursing mothers through the Anganwadi centers (AWC. Improvement in nutritional and health status of their beneficiaries to prevent morbidities and mortalities due to malnutrition is one of the important objectives of ICDS. Objectives: To determine the availability and extent of utilization of AWC services by the beneficiaries, and to study factors influencing utilization and reasons for non/under utilization. Methodology: A community based cross-sectional study conducted in three well defined adopted urban field practice areas of a rural tertiary health care facility in Wardha, Maharashtra. A cluster comprising of 40 households was identified in each area to provide 140 study participants. Epi-info-3.7.1 for univariate and SYSTAT-12 used for multivariate analysis. Results: Overall 89.29% of beneficiaries utilized one or more services of AWC. Working women and those with lower socio-economic status had significantly and independently lower/non utilization of AWC services. Conclusions: Most of the study participants were aware and utilized the services of AWC. Among the women not utilizing the services; the reasons for non-utilization need to be addressed for optimal utilization of AWCs.
The audit objective was to assess the effectiveness of Defense Finance and Accounting Service Indianapolis Center management controls over payments to Defense agency personnel for temporary duty and local travel...
Diehl, Diane S
The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...
Introduction. We performed the audit in response to allegations to the Defense Hotline that the Defense Supply Center, Columbus, outsourcing study for bus and taxi service operations was based on incorrect methodology...
National Oceanic and Atmospheric Administration, Department of Commerce — This digital elevation model (DEM) is a part of a series of DEMs produced for the National Oceanic and Atmospheric Administration Coastal Services Center's Sea Level...
Full Text Available Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001. In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022. The urban comprehensive score also exceeded that of the suburbs (P<0.001. In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this
Kelsey, J. A.
An advanced Bell Laboratories and Western Electric designed electronic information retrieval system utilizing the latest Information Age technologies, and a fiber optic transmission system is featured at the Walt Disney World Resort's newest theme park - The Experimental Prototype Community of Tomorrow (EPCOT Center). The project is an interactive audio, video and text information system that is deployed at key locations within the park. The touch sensitive terminals utilizing the ARIEL (Automatic Retrieval of Information Electronically) System is interconnected by a Western Electric designed and manufactured lightwave transmission system.
... in an Indian Health Service health center, a Native Hawaiian health center, a public hospital, a migrant health center, a community health center, a nursing facility, a rural health clinic, or in a... under this section. (Approved by the Office of Management and Budget under control number 0915-0047) [50...
Bilitza, D.; King, J. H.
The activities and services of the National Space Science data Center (NSSDC) and the World Data Center A for Rockets and Satellites (WDC-A-R and S) are described with special emphasis on ionospheric physics. The present catalog/archive system is explained and future developments are indicated. In addition to the basic data acquisition, archiving, and dissemination functions, ongoing activities include the Central Online Data Directory (CODD), the Coordinated Data Analysis Workshopps (CDAW), the Space Physics Analysis Network (SPAN), advanced data management systems (CD/DIS, NCDS, PLDS), and publication of the NSSDC News, the SPACEWARN Bulletin, and several NSSD reports.
Yildiz, Kadir; Polat, Ercan; Güzel, Pinar
The purpose of this study is to investigate sport center members' perceived service quality levels with a view to Kano customer expectations and requirements model. To that end, a descriptive approach and a correlational research design featuring survey method is adopted. Research group consists of 680 (300 women, 380 men) sport center members who…
Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen
Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…
... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...
Ahmad M. Manasrah
Full Text Available Cloud computing depends on sharing distributed computing resources to handle different services such as servers, storage and applications. The applications and infrastructures are provided as pay per use services through data center to the end user. The data centers are located at different geographic locations. However, these data centers can get overloaded with the increase number of client applications being serviced at the same time and location; this will degrade the overall QoS of the distributed services. Since different user applications may require different configuration and requirements, measuring the user applications performance of various resources is challenging. The service provider cannot make decisions for the right level of resources. Therefore, we propose a Variable Service Broker Routing Policy – VSBRP, which is a heuristic-based technique that aims to achieve minimum response time through considering the communication channel bandwidth, latency and the size of the job. The proposed service broker policy will also reduce the overloading of the data centers by redirecting the user requests to the next data center that yields better response and processing time. The simulation shows promising results in terms of response and processing time compared to other known broker policies from the literature.
Full Text Available Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was descriptive using correlation by structural equations modelling. The studied population included those patients who provided their medicines from pharmacies of rural healthcare centers in Abhar and Soltanieh counties. The samples included 384 of these patients. Data was collected by outsourcing and service quality questionnaires. A structural equation modelling was used to analyze data by LISREAL software. Results indicated a positive significant effect of outsourced pharmacies of rural healthcare centers on quality of tangibles, reliability, responsiveness, assurance and empathy. findings emphasize the role of outsourcing on quality of services. Outsourced pharmacies of rural healthcare centers of Abhar and Soltanieh counties lead to improved service quality.
Gao, Jianping; Pan, Junkui; Hu, Ning; Xie, Chengzuo
Bioretention can be an effective measure for stormwater treatment. However, there is a lack of systematic analysis of the impact of bioretention design parameters on hydrologic performance. Herein, SWMM and RECARGA models were applied to generate the typical annual rainfall runoff and simulate the water balance of the bioretention system in an expressway service area. The purpose of the investigation was to identify key design parameters for the bioretention system and delineate the priorities in developing the design. Results showed that the average groundwater recharge ratios for bioretention basins with and without an underdrain were 58.29% and 92.27%, respectively, the average overflow ratios were 4.13% and 4.19%, the average evapotranspiration ratios were 4.48% and 4.47%, and the average outflow ratio for bioretention with an underdrain was 33.94%. The ratio of the bioretention area to drainage area, and the saturated infiltration rates of planting soil and native soil were the main factors influencing water balance, while the underdrain diameter and gravel layer depth exerted little effect. Based on the impact analysis, multivariate nonlinear regression models of runoff reduction rate for two types of bioretention basin were established, which both exhibited high determination coefficients and acceptable Nash-Sutcliffe coefficients.
Rhodes, Judith L. F.; Thomas, Johanna M.; Lemieux, Catherine M.; Cain, Daphne S.; Guin, Cecile C.
This article reviews literature describing truancy and its correlates, and it analyzes the current research on truancy prevention programs. Few truancy prevention programs exist in elementary school settings. This article describes Truancy Assessment and Service Centers, a theory-driven program providing case management services to children in 85…
Bullock, Charles C.; Mahon, Michael J.; Killingsworth, Charles L.
Ultimately, all successful recreation programs center around its participants wants and needs. Serving people with disabilities is no exception. "Introduction to Recreation Services for People with Disabilities" is intended to be an introductory book for anyone planning or working in the parks, recreation, and leisure service industry. Through…
to both professional fields. Yet, how human‐centered design is being practiced and applied depends on the interpretation of the concept, or the “designer’s stance” (Buchanan 2011). In this paper, I trace the shifts in design thinking and the role of people in service engineering and in service design. I...
Bains, Ranbir Mangat; Diallo, Ana F.
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients' overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an extremely cost-effective manner.
Knight, Louise; Cooper, Rhonda S; Hypki, Cinder
Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.
Ido, Haisam Kassim
His presentation will cover, the current and future, technical and organizational opportunities and challenges with virtualizing a multi-mission operations center. The full deployment of Goddard Space Flight Centers (GSFC) Virtualized Multi-Mission Operations Center (vMMOC) is nearly complete. The Space Science Mission Operations (SSMO) organizations spacecraft ACE, Fermi, LRO, MMS(4), OSIRIS-REx, SDO, SOHO, Swift, and Wind are in the process of being fully migrated to the vMMOC. The benefits of the vMMOC will be the normalization and the standardization of IT services, mission operations, maintenance, and development as well as ancillary services and policies such as collaboration tools, change management systems, and IT Security. The vMMOC will also provide operational efficiencies regarding hardware, IT domain expertise, training, maintenance and support.The presentation will also cover SSMO's secure Situational Awareness Dashboard in an integrated, fleet centric, cloud based web services fashion. Additionally the SSMO Telemetry as a Service (TaaS) will be covered, which allows authorized users and processes to access telemetry for the entire SSMO fleet, and for the entirety of each spacecrafts history. Both services leverage cloud services in a secure FISMA High and FedRamp environment, and also leverage distributed object stores in order to house and provide the telemetry. The services are also in the process of leveraging the cloud computing services elasticity and horizontal scalability. In the design phase is the Navigation as a Service (NaaS) which will provide a standardized, efficient, and normalized service for the fleet's space flight dynamics operations. Additional future services that may be considered are Ground Segment as a Service (GSaaS), Telemetry and Command as a Service (TCaaS), Flight Software Simulation as a Service, etc.
Tayyab Ikram Shah
Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood
mohammad javad tarrahi
Conclusion: Expectations of the clients in all aspects of offering services are beyond than their perceptions, and needed to improve the quality of offering services in these centers in all the dimensions especially empathy dimension. It is recommended that the quality of the offering services be assessed periodically in these centers and intervene to improve the delivering of health services.
... 10 Energy 2 2010-01-01 2010-01-01 false Determination of exclusion area, low population zone, and population center distance. 100.11 Section 100.11 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) REACTOR... and for Testing Reactors § 100.11 Determination of exclusion area, low population zone, and population...
Full Text Available With the objective of choosing a practical and valid method to delimit health service areas of regional health service centres to build a regional basic health service network, we first drew lessons from traditional geographic methods of delimiting trade areas and then applied two methods to delimit health service areas, i.e. the proximal method and the gravity method. We verified the effectiveness of these methods by an index of similarity with the aid of real in-patient data. Calculation of the similarity indices shows that health service areas delimited by the proximal method has an 87.3% similarity to the real health service area, while the gravity method gives 88.6%. Our conclusion is that both methods are suitable for delimiting health service areas at regional health service centres, but find that the proximal method is more practicable in operational terms for delimiting health service areas in region health planning.
Full Text Available Information Technology (IT is increasingly progressing. Nowadays, the success of a business of the organization/company is highly dependent on the IT infrastructure used. Therefore, organizations/companies have to manage their IT service to be optimal to their customers. Looking at this matter and the increasing dynamics of XYZ University, then Data and Information System Center (Pusdatin - an IT provider of XYZ University began implementing IT Service Management (ITSM from 2013 using the latest version of Information Technology Infrastructure Library (ITIL, namely ITIL v3 as a framework for implementing ITSM in its business processes. However, along the way, there are still some problems happen in Pusdatin in order that ITSM can actually support and align with the objectives of XYZ University. Through this paper, the authors want to explain how the implementation of ITSM at Pusdatin, identify the problems related to the implementation of ITSM, and provide the solutions for each problem. The methods used are direct observation to Pusdatin, conductan interview with the Head of Pusdatin and Staff of Pusdatin, and also perform a literature review of books and papers that discuss about ITIL. The result of this research is that ITSM process of Pusdatin generally works quite well but there are still some shortcomings because ITSM is not 100% implemented in all areas.
Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia
Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986
Kim, Min J; Winkler, Sabune J; Bierer, Barbara E; Wolf, Delia
The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator-initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor-investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator-initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter-institutional capacity. © 2014 Wiley Periodicals, Inc.
Karwowski, Waldemar; Ahram, Tareq Z
In order to leverage individual and organizational learning and to remain competitive in current turbulent markets it is important for employees, managers, planners and leaders to perform at high levels over time. Employee competence and skills are extremely important matters in view of the general shortage of talent and the mobility of employees with talent. Two factors emerged to have the greatest impact on the competitiveness of complex service systems: improving managerial and employee's knowledge attainment for skills, and improving the training and development of the workforce. This paper introduces the knowledge-based user-centered service design approach for sustainable skill and performance improvement in education, design and modeling of the next generation of complex service systems. The rest of the paper cover topics in human factors and sustainable business process modeling for the service industry, and illustrates the user-centered service system development cycle with the integration of systems engineering concepts in service systems. A roadmap for designing service systems of the future is discussed. The framework introduced in this paper is based on key user-centered design principles and systems engineering applications to support service competitiveness.
Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470
Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cellular rural service area licenses subject to... Procedures § 22.228 Cellular rural service area licenses subject to competitive bidding. Mutually exclusive initial applications for Cellular Rural Service Area licenses are subject to competitive bidding. The...
Shah, N.A.; Nisar, N.
To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)
Full Text Available Background: Healthcare Information Technology advances in the Information, Communication and Telecommunication (ICT sector have made telemedicine a common and alternate medical service delivery in remote areas. Indian Space and Research Organization (ISRO established village resource centers managed by Non-government Organizations (NGO’s all over the country in 2010. While ISRO provided satellite connectivity and required equipment for communication, tele-education, and telemedicine in Uttarakhand, Himalayan Institute Hospital Trust provided primary health care through tele-consultation to remote tribal hilly areas through village resource centers. This paper features the technical and financial challenges faced in providing tele-consultation. Methods: A cross-sectional study of 115 clients, 4 health supervisors and co-ordinating doctor from three districts was done using semi-structured questionnaires for interview. Parameters at both doctor’s and patients’ end for communication, costs involved, quality of doctor-patient interaction and patient satisfaction from Tele-consultation sessions were assessed. Results: Video quality was more satisfactory than audio. The physical presence of a doctor was felt necessary only in 33/115 (30% of the time. The average cost for telemedicine consultation works out to just Rs. 15 per patient. Around 48.7% of the queries were processed in less than 10 minutes of satellite time. Around 67% of the beneficiaries felt that their privacy was not maintained as per their expectations. The request to extend the timing of the session was made by 85% of the clients. Conclusions: Long periods of non- connectivity due to satellite failure, lack of technical staff, lack of patient’s privacy during sessions, lack of income generation for self-sustainability, were the major challenges faced. However many patients benefitted, did not have to travel long distances for medical advice and easy follow ups were
A SURVEY BY QUESTIONNAIRE WAS MADE OF THE PROBLEM OF USER SERVICES AND EXTENSION SERVICES USED IN THE DISSEMINATION OF MATERIALS AND INFORMATION TO A SELECTED NUMBER OF INDUSTRIAL LIBRARIES. THE SURVEY RESULTED IN DATA CONCERNING STAFF SIZE, PROFESSIONAL-TO-CLERICAL RATIO, SIZE OF BOOK, DOCUMENT, PERIODICAL AND MICROFORM COLLECTIONS, LIBRARY…
Full Text Available A lot of research works have been made concerning highway service area or solar technology and acquired great achievements. However, unfortunately, few works have been made combining the two topics together of highway service areas and solar energy saving to make a systemic research on solar technology application for highway service area. In this paper, taking West Lushan highway low-carbon service area in Jiangxi Province of China as the case study, the advantages, technical principles, and application methods of solar energy technology for highway service area including solar photoelectric technology and solar water heating technology were discussed based on the analysis of characteristics of highway low-carbon service area; the system types, operation mode, and installing tilt angle of the two kinds of solar systems suitable for highway service areas were confirmed. It was proved that the reduction of the cost by electricity savings of solar system was huge. Taking the investment of the solar systems into account, the payback period of solar photoelectric systems and solar water heating systems was calculated. The economic effect of the solar systems in West Lushan highway service area during the effective operation periods was also calculated and proved very considerable.
Full Text Available Under conditions of constantly growing competition, what is becoming a key problem is keeping the previously acquired clients. Their trust in the provider and regularly repeated purchases are an expression of the efficiency of marketing activities conducted by companies. What is becoming a measure of success is the satisfaction and loyalty of buyers. Companies spend a lot of money to attract clients and the competition keeps trying to take away their clients. A lost client means not just the loss of a future order – this is the loss of revenues equal to the value of all products which a particular buyer could purchase in his entire life. On top of that comes the cost of acquiring new client to replace the old one. TARP research shows that the cost of acquiring a new client is five times higher than the cost of pleasing an existing client (Kotler, 2006. In the publication the significance of the relations with the client are discussed with regard to efficient marketing strategy. Moreover, the results of client satisfaction surveys and market analysis taking into consideration the revenues from sale of services in the area of micronization are presented.
Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G
The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning
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)
This study aims to determine the effect of interaction behavior that elicits a sense of comfort for customers in the service encounter of notebook peripheral business, and investigating the mediating role of comfort on overall service quality, customer satisfaction, word of mouth and the repurchase intention. Based on 250 valid responses collected from a survey questionnaire used structural equation modeling (SEM) to examine the research model. The findings showed that all hypotheses on the r...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) Advisory Committee... and other committee management activities, for both the Centers for Disease Control and Prevention and...
Finding showed that those services which are more important in role fulfillment of Sardasht market-town include: sanitation house, health, remedial centers, drugstore, dentistry, high school, pre-university, library, transportation, trading agricultural instrument, referring to the banks, foodstuff and nonfood stuffs stores, post office and telecommunication, referring to official & disciplinary centers, medical services, veterinary. And to some extent farming instruments markets doesn’t affect role fulfillment so it should be focused by those locals in charge. Also the results showed that three settlements, Khomeinishahr, Jakdan and Goharan are going to continue the role fulfillment of Sardasht market- town.
Patz, A.; Harbo, P.; Moran, J.; van Stone, D.; Zografou, P.
The Chandra Data Archive team at the Chandra X-ray Center has developed middle tier services that are used by both our search and retrieval applications to uniformly access our data repository. Accessible through an HTTP URL interface, these services can be called by our J2EE web application (WebChaser) and our Java Swing application (Chaser), as well as any other HTTP client. Programs can call the services to retrieve observation data such as a single FITS file, a proposal abstract or a detailed report of observation parameters. Having a central interface to the archive, shared by client applications, facilitates code reusability and easier maintenance. These middle tier services have been written in Java and packaged into a single J2EE application called the Search and Retrieval (SR) Services. The package consists of a web application front-end and an Enterprise Java Beans back-end. This paper describes the design and use of the SR Services.
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.
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
Full Text Available Abstract Distribution of goods and services in cities is of utmost importance. Selecting appropriate venues for different service centers in a city not only enables the citizens to access these services much more easily, but also reduces the traffic load caused by trips made to reach them. Unfortunately, the lack of a correct urban planning has led to inappropriate formation of many cities around the world in terms of the locations assumed for different service centers. Since the private sector has been given the responsibility to construct most of these centers, changing their current locations may be restricted due to legal obligations. Therefore, it seems necessary for the government to construct new service centers with high competitive facilities to attract customers and to compete with those built by the private sector. In this paper, the selection of appropriate locations to construct new service centers has been studied. Such locations have been selected in a way to fulfill goals such as rapid and easy accessibility for the customers and reduction of traffic drawbacks caused by the related trips. In this regard, a model for service centers with restricted capacity has been designed and a parallel simulated annealing algorithm has been proposed to solve it. Finally, the proposed algorithm has been utilized to locate the health centers around the city of Isfahan and its efficiency has been investigated. The findings highlight the accuracy and speed of the proposed algorithm in location of the health centers of Isfahan.
Basir, C.; Widyaningsih, Y.; Lestari, D.
Hotspots indicate area that has a higher case intensity than others. For example, in health problems of an area, the number of sickness of a region can be used as parameter and condition of area that determined severity of an area. If this condition is known soon, it can be overcome preventively. Many factors affect the severity level of area. Some health factors to be considered in this study are the number of infant with low birth weight, malnourished children under five years old, under five years old mortality, maternal deaths, births without the help of health personnel, infants without handling the baby's health, and infant without basic immunization. The number of cases is based on every public health center area in Depok. Correspondence analysis provides graphical information about two nominal variables relationship. It create plot based on row and column scores and show categories that have strong relation in a close distance. Scan Statistic method is used to examine hotspot based on some selected variables that occurred in the study area; and Correspondence Analysis is used to picturing association between the regions and variables. Apparently, using SaTScan software, Sukatani health center is obtained as a point hotspot; and Correspondence Analysis method shows health centers and the seven variables have a very significant relationship and the majority of health centers close to all variables, except Cipayung which is distantly related to the number of pregnant mother death. These results can be used as input for the government agencies to upgrade the health level in the area.
Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho
Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.
Full Text Available Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital′s electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000, with a recurring cost of Rs 80,000 (US$ 2000 per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305 were from rural areas. Patients′ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to
Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients’ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an
PODOLYNNY S. I.
Full Text Available Problem. Nowadays providing administrative services of good quality is considered to be one of the most important conditions for establishing firm and democratic relations between local authorities and population The work for creating municipal institutions using the principle of a "single window" is being fulfilled in Dnipropetrovs’k. Two pilot projects have been done at the Department of Architectural Engineering and Design (Prydniprovs’ka State Academy of Construction and Architecture. Objective. To demonstrate peculiarities of two project proposals for CAS comparing them with the recommendations of State Administration and basic principles formed while designing similar objects in foreign practice. Main part. Basic principles for creating the Center for Administrative Services (CAS were formulated regarding foreign experience and recommendations of State Administration. These principles are organized as three conceptual blocks: city-planning relevancy, functional arrangement, form making and artistic image peculiarities. CAS on the left bank of the river is situated on the territory that is being reconstructed at the moment. It is a functional and compositional landmark of social and administrative subcentre of the left bank. The Centre is designed in a 16-storey building with a build-in and build-on 2-floor block of the front-office. The front-office is designed for 121 working places and the back-office – for 440 ones. The general area of the front-office is 605 sq. m., the area of the back-office is 2130 sq. m. Artistic characteristics are designed according to traditional office planning schemes. CAS of the right bank is planned on a vacant site on Zaporiz’ke highway. Spacious parking lots are also provided on the territory. The building is positioned sideways on to the highway with its long axis. It can serve as a peculiar sign at the entrance to the city. The front-office is situated in a two-floor stylobate of the Center
Neuhauser, D. S.; Zuzlewski, S.; Allen, R. M.
The Northern California Earthquake Data Center (NCEDC) provides data archive and distribution services for seismological and geophysical data sets that encompass northern California. The NCEDC is enhancing its ability to deliver rapid information through Web Services. NCEDC Web Services use well-established web server and client protocols and REST software architecture to allow users to easily make queries using web browsers or simple program interfaces and to receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, or MiniSEED depending on the service, and are compatible with the equivalent IRIS DMC web services. The NCEDC is currently providing the following Web Services: (1) Station inventory and channel response information delivered in StationXML format, (2) Channel response information delivered in RESP format, (3) Time series availability delivered in text and XML formats, (4) Single channel and bulk data request delivered in MiniSEED format. The NCEDC is also developing a rich Earthquake Catalog Web Service to allow users to query earthquake catalogs based on selection parameters such as time, location or geographic region, magnitude, depth, azimuthal gap, and rms. It will return (in QuakeML format) user-specified results that can include simple earthquake parameters, as well as observations such as phase arrivals, codas, amplitudes, and computed parameters such as first motion mechanisms, moment tensors, and rupture length. The NCEDC will work with both IRIS and the International Federation of Digital Seismograph Networks (FDSN) to define a uniform set of web service specifications that can be implemented by multiple data centers to provide users with a common data interface across data centers. The NCEDC now hosts earthquake catalogs and waveforms from the US Department of Energy (DOE) Enhanced Geothermal Systems (EGS) monitoring networks. These
... transportation technology transfer services, including education, training, technical assistance and related... expand tribal expertise in road and transportation areas; (2) Improve IRR Program performance; (3... transportation training and technical resource materials and present workshops; (5) Improve tribal tourism and...
In 1980, Congress passed Public Law 96-368, the West Valley Demonstration Project (WVDP) Act. As a primary objective, the Act authorized the US Department of Energy (DOE) to solidify the high-level waste (HLW) stored at the Western New York Nuclear Service Center (WNYNSC) into a form suitable for transportation and disposal in a federal repository. This report will describe how WVDP proposes to use the existing WNYNSC Facilities in an efficient and technically effective manner to comply with Public Law 96-368. In support of the above cited law, the DOE has entered into a ''Cooperative agreement between the United States Department of Energy and the New York State Energy Research and Development Authority on the Western New York Nuclear Service Center at West Valley, New York.'' The state-owned areas turned over to the DOE for use are as follows: Process Plant, Waste Storage, Low-Level Waste Treatment Facility, Service Facilities, Plant Security, and Additional Facilities. The Facilities Utilization Plan (FUP) describes how the state-owned facilities will be utilized to complete the Project; it is divided into five sections as follows: Executive Summary - an overview; Introduction - the WVDP approach to utilizing the WNYNSC Facilities; WVDP Systems - a brief functional description of the system, list of equipment and components to be used and decontamination and decommissioning (D and D) support; WVDP Support Facilities; and Caveats that could effect or change the potential usage of a particular area
Grigoriev, M.; DeMar, P.; Tierney, B.; Lake, A.; Metzger, J.; Frey, M.; Calyam, P.
The E-Center is a social collaborative web-based platform for assisting network users in understanding network conditions across network paths of interest to them. It is designed to give a user the necessary tools to isolate, identify, and resolve network performance-related problems. E-Center provides network path information on a link-by-link level, as well as from an end-to-end perspective. In addition to providing current and recent network path data, E-Center is intended to provide a social media environment for them to share issues, ideas, concerns, and problems. The product has a modular design that accommodates integration of other network services that make use of the same network path and performance data.
Grigoriev, M. [Fermilab; DeMar, P. [Fermilab; Tierney, B. [LBL, Berkeley; Lake, A. [LBL, Berkeley; Metzger, J. [LBL, Berkeley; Frey, M. [Bucknell U.; Calyam, P. [Ohio State U.
The E-Center is a social collaborative web-based platform for assisting network users in understanding network conditions across network paths of interest to them. It is designed to give a user the necessary tools to isolate, identify, and resolve network performance-related problems. E-Center provides network path information on a link-by-link level, as well as from an end-to-end perspective. In addition to providing current and recent network path data, E-Center is intended to provide a social media environment for them to share issues, ideas, concerns, and problems. The product has a modular design that accommodates integration of other network services that make use of the same network path and performance data.
Grigoriev, M; DeMar, P; Tierney, B; Lake, A; Metzger, J; Frey, M; Calyam, P
The E-Center is a social collaborative web-based platform for assisting network users in understanding network conditions across network paths of interest to them. It is designed to give a user the necessary tools to isolate, identify, and resolve network performance-related problems. E-Center provides network path information on a link-by-link level, as well as from an end-to-end perspective. In addition to providing current and recent network path data, E-Center is intended to provide a social media environment for them to share issues, ideas, concerns, and problems. The product has a modular design that accommodates integration of other network services that make use of the same network path and performance data.
... 7 Agriculture 2 2010-01-01 2010-01-01 false Area Director, Marketing Services Office... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY... Regulations Administration § 27.11 Area Director, Marketing Services Office; responsibility. Subject to this...
Ansley, Shannon Leigh
The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist.
Ansley, Shannon L.
The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist
Ansley, Shannon L.
The Idaho Nuclear Technology and Engineering Center (INTEC) Service Wastewater Discharge Facility replaces the existing percolation ponds as a disposal facility for the INTEC Service Waste Stream. A preferred alternative for helping decrease water content in the subsurface near INTEC, closure of the existing ponds is required by the INTEC Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Record of Decision (ROD) for Waste Area Group 3 Operable Unit 3-13 (DOE-ID 1999a). By August 2002, the replacement facility was constructed approximately 2 miles southwest of INTEC, near the Big Lost River channel. Because groundwater beneath the Idaho National Engineering and Environmental Laboratory (INEEL) is protected under Federal and State of Idaho regulations from degradation due to INEEL activities, preoperational data required by U.S. Department of Energy (DOE) Order 5400.1 were collected. These data include preexisting physical, chemical, and biological conditions that could be affected by the discharge; background levels of radioactive and chemical components; pertinent environmental and ecological parameters; and potential pathways for human exposure or environmental impact. This document presents specific data collected in support of DOE Order 5400.1, including: four quarters of groundwater sampling and analysis of chemical and radiological parameters; general facility description; site specific geology, stratigraphy, soils, and hydrology; perched water discussions; and general regulatory requirements. However, in order to avoid duplication of previous information, the reader is directed to other referenced publications for more detailed information. Documents that are not readily available are compiled in this publication as appendices. These documents include well and borehole completion reports, a perched water evaluation letter report, the draft INEEL Wellhead Protection Program Plan, and the Environmental Checklist
Eklund, Mona; Markström, Urban
A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned.
Alansari, Eissa M.
The purpose of this study is to review the success of implementation of cooperative learning in various courses delivered at the Center for Community Service and Continuing Education at Kuwait University. According to recent research in the field of social cognition, learning situations which make use of the social context often achieve superior…
Starling, Stacey Lee
Front and center in the endeavor to "reform" health care is the appeal to change the culture of aging within provider organizations situated in the long-term care continuum. Person-centeredness is the latest philosophical overlay to aging care and supports and services. As a dominate paradigm guiding change, the movement intends to shift…
Bryson, Stephanie A.; Corrigan, Susan K.; McDonald, Thomas P.; Holmes, Cheryl
Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of…
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delegation of Authority; Centers... Organization, Functions, and Delegations of Authority, last published at 55 FR 9363 (March 13, 1990). Part A... of Inspector General. This delegation of authority supersedes the authorities delegated under Part A...
Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; Timothy J. Callahan; Ge Sun; Masato Miwa; John E. Parsons
Managing forested wetland landscapes for water quality improvement and productivity requires a detailed understanding of functional linkages between ecohydrological processes and management practices. Studies are being conducted at Center for Forested Wetlands Research (CFWR), USDA Forest Service to understand the fundamental hydrologic and biogeochemical processes...
Sisselman, Amanda; Strolin-Goltzman, Jessica; Auerbach, Charles; Sharon, Lisa
School-based health centers (SBHCs) continue to provide essential health care services to children and families in underserved neighborhoods across the country. Preliminary studies show that students who use SBHCs have better attendance rates as well as higher rates of academic achievement and attachment to the learning environment. Few studies,…
Duckenfield, Marty, Ed.
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…
Downs, R. R.; Chen, R. S.; de Sherbinin, A. M.
Growing recognition of the importance of sharing scientific data more widely and openly has refocused attention on the state of data repositories, including both discipline- or topic-oriented data centers and institutional repositories. Data creators often have several alternatives for depositing and disseminating their natural, social, health, or engineering science data. In selecting a repository for their data, data creators and other stakeholders such as their funding agencies may wish to consider the user community or communities served, the type and quality of data products already offered, and the degree of data stewardship and associated services provided. Some data repositories serve general communities, e.g., those in their host institution or region, whereas others tailor their services to particular scientific disciplines or topical areas. Some repositories are selective when acquiring data and conduct extensive curation and reviews to ensure that data products meet quality standards. Many repositories have secured credentials and established a track record for providing trustworthy, high quality data and services. The NASA Socioeconomic Data and Applications Center (SEDAC) serves users interested in human-environment interactions, including researchers, students, and applied users from diverse sectors. SEDAC is selective when choosing data for dissemination, conducting several reviews of data products and services prior to release. SEDAC works with data producers to continually improve the quality of its open data products and services. As a Distributed Active Archive Center (DAAC) of the NASA Earth Observing System Data and Information System, SEDAC is committed to improving the accessibility, interoperability, and usability of its data in conjunction with data available from other DAACs, as well as other relevant data sources. SEDAC is certified as a Regular Member of the International Council for Science World Data System (ICSU-WDS).
Full Text Available Background: Uttar Pradesh (UP is the most populous state in India. The maternal mortality ratio, infant mortality rate, and fertility rates are all higher than the national average. Sixty percent of UP inhabitants live in rural communities. The reasons behind the poor state of health and services in many areas of UP are inadequate knowledge and availability in communities of healthy behaviors, and information on available government health services. Methods: World Vision, Inc. implemented a three-and-half year mobilizing plan for maternal and neonatal health through a birth spacing and advocacy project (MOMENT, partnering with local organizations in rural Hardoi and urban slums of Lucknow districts in UP. World Vision used print, audio, visual media, and house-to-house contacts to educate communities on timing and spacing of pregnancies; and the benefits of seeking and using maternal and child health services (MCH including immunization and family planning (FP.This paper focuses on World Vision’s social accountability strategy – Citizen Voice and Action (CVA and interface meetings – used in Hardoi that helped educate and empower Village Health Sanitation and Nutrition Committees (VHSNCs and village leaders to access government untied funds to improve community social and health services. Results: Forty VHSNCs were revived in 24 months. Nine local leaders accessed government untied funds. In addition, increased knowledge of the benefits of timing and spacing of pregnancies, maternal child health, family planning services, and access to community entitlements led the community to embrace and contribute their time to rebuild and re-open 17 non-functional Auxiliary Nurse Midwife (ANM sub-centers. Seventeen ANMs received refresher training to provide quality care. Sub-center data showed that 1,121 and 3,156 women opted for intra-uterine contraceptive device and oral pills, respectively, and 29,316 condoms were distributed. Conclusion: In Hardoi
Egoh, Benis N; Reyers, Belinda; Rouget, Mathieu; Richardson, David M
Grasslands provide many ecosystem services required to support human well-being and are home to a diverse fauna and flora. Degradation of grasslands due to agriculture and other forms of land use threaten biodiversity and ecosystem services. Various efforts are underway around the world to stem these declines. The Grassland Programme in South Africa is one such initiative and is aimed at safeguarding both biodiversity and ecosystem services. As part of this developing programme, we identified spatial priority areas for ecosystem services, tested the effect of different target levels of ecosystem services used to identify priority areas, and evaluated whether biodiversity priority areas can be aligned with those for ecosystem services. We mapped five ecosystem services (below ground carbon storage, surface water supply, water flow regulation, soil accumulation and soil retention) and identified priority areas for individual ecosystem services and for all five services at the scale of quaternary catchments. Planning for individual ecosystem services showed that, depending on the ecosystem service of interest, between 4% and 13% of the grassland biome was required to conserve at least 40% of the soil and water services. Thirty-four percent of the biome was needed to conserve 40% of the carbon service in the grassland. Priority areas identified for five ecosystem services under three target levels (20%, 40%, 60% of the total amount) showed that between 17% and 56% of the grassland biome was needed to conserve these ecosystem services. There was moderate to high overlap between priority areas selected for ecosystem services and already-identified terrestrial and freshwater biodiversity priority areas. This level of overlap coupled with low irreplaceability values obtained when planning for individual ecosystem services makes it possible to combine biodiversity and ecosystem services in one plan using systematic conservation planning. Copyright © 2011 Elsevier Ltd. All
Ahmad Nahar Quttoum
Full Text Available Today’s data center networks employ expensive networking equipments in associated structures that were not designed to meet the increasing requirements of the current large-scale data center services. Limitations that vary between reliability, resource utilization, and high costs are challenging. The era of cloud computing represents a promise to enable large-scale data centers. Computing platforms of such cloud service data centers consist of large number of commodity low-price servers that, with a theme of virtualization on top, can meet the performance of the expensive high-level servers at only a fraction of the price. Recently, the research in data center networks started to evolve rapidly. This opened the path for addressing many of its design and management challenges, these like scalability, reliability, bandwidth capacities, virtual machines’ migration, and cost. Bandwidth resource fragmentation limits the network agility, and leads to low utilization rates, not only for the bandwidth resources, but also for the servers that run the applications. With Traffic Engineering methods, managers of such networks can adapt for rapid changes in the network traffic among their servers, this can help to provide better resource utilization and lower costs. The market is going through exciting changes, and the need to run demanding-scale services drives the work toward cloud networks. These networks that are enabled by the notation of autonomic management, and the availability of commodity low-price network equipments. This work provides the readers with a survey that presents the management challenges, design and operational constraints of the cloud-service data center networks
The audit objective was to determine whether the Defense Finance and Accounting Service, Indianapolis Center, consistently and accurately compiled financial data from field entities and other sources...
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
Full Text Available Immigrant Workers Centers (IWCs are community-based organizations that have been developed in the United States to promote and protect workers’ rights through support, services, advocacy, and organizing initiatives. The purpose of this research study was to examine how IWCs in the Eastern part of the state of Massachusetts are structured along twelve dimensions of organizational development and community organizing. Qualitative research methods were used to identify shared themes within the six IWCs and three immigrant support organizations, as well as their organizational responses to the current anti-immigrant environment. IWCs constituted a convenience sample which enabled the researchers to gather data utilizing a case study methodology. In-depth semi-structured interviews were conducted between the months of July and September of 2009 to answer the following research questions: 1What are the shared themes for the development of Immigrant Workers Centers?, and 2 How do Immigrant Workers Centers respond to current anti-immigrant sentiment, intolerant immigration policies, and increased exploitation in this troubled economy? Shared themes among the IWCs include prioritizing community organizing for workers’ rights and collective empowerment. Sub-modalities such as education, training and leadership development area common feature. While some individual support is provided, and in some cases, programming, it always is offered within a context that emphasizes the need for collective action to overcome injustice. Issues addressed include health/safety, sexual harassment, discrimination, and various problems associated with wages (underpayment, missed payments, collecting back wages, and lack of overtime pay. IWCs respond to antiimmigrant policies and practices by supporting larger efforts for immigration reformat the municipal, state, and federal levels. Coalitions of IWCS and their allies attempt to make state wide and federal policy changes
... LEGAL SERVICES CORPORATION Notice and Request for Comments: LSC merger of the migrant service... Services Corporation. ACTION: Notice and Request for Comments--LSC merger of the migrant service areas in... Alabama migrant service areas. Grants for these individual service areas have been awarded to Texas Rio...
U.S. Department of Health & Human Services — The following data is being made available to applicants to the Medicare Shared Savings Program (Shared Savings Program), in order to allow them to calculate their...
Background and Objectives: In integrating HeartMath into our culture at Gundersen Health System, we have a shared focus on delivering workshops and sustaining our HeartMath practices through a variety of innovative approaches. This presentation provides examples of our success in keeping the HeartMath practices alive for our staff. Gundersen is a fully integrated delivery system of 6500 employees. More than 700 medical, dental, and associate employees are distributed throughout 41 clinic locations, a 325-bed tertiary medical center, a Level II Trauma Center, Gundersen Medical Foundation, residency and medical education programs, and a clinical research program. Our service area covers 19 counties in three states, Western Wisconsin, Southeast Minnesota and Northeast Iowa. We are a physician-led organization embracing a strong administrative/medical partnership. Three parts of the 2012–2016 strategic plan apply to this initiative: Innovate to achieve service and patient-centered experience outcomes that are best in class (Outstanding Patient Experience); create a culture that embraces a passion for caring and spirit of improvement (Great Place to Work); and engage our staff to create a safe, injury-free, and healing environment for themselves, our patients, and visitors (Great Place to Work). Rollout Method: Between February 2011 and February 2013, more than 1200 employees completed HeartMath training. This initiative started with two staff members becoming HeartMathcertified trainers in January 2011. To promote leadership support for the program, the department chair MDs received HeartMath education in May 2011. Several units were identified to be the first to receive the training. As positive reviews circulated, requests for trainings were received from other departments. These included requests to customize the HeartMath offerings for leadership summits, manager meetings, new leader on-boarding, and physician and associate staff and to offer HeartMath appetizers
Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013. Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service. Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040. Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.
Dwi Ananto Wibrata
Full Text Available Public health centers as the spearhead of health services, also provide 'emergency and observation' nursing services, due to the high number of accidents in East Java. The purpose of this study was to develop the nurse's performance model in providing 'emergency and obeservation' nursing services at Puskesgadarsi ('Emergency and Observation' Community Health Center in East Java, using cross sectional design. The subjects of 120 nurses were selected by multi stage sampling technique. Data were collected through questionnaires and FGDs, and then analyzed using structural equation modeling to produce an model of ‘emergency and observation’ nursing service for nurses at Puskesgadarsi. Components of the model were reinforcing factors, personal factors, cognition factors, affection factors, commitment, interpersonal, reinforcement and nurse performance. Nurses can use this model in providing nursing services with due regard to their knowledge and skills, facilities and infrastructure, as well as interaction and self-reinforcement, so as to be able to perform nursing services 'emergency and observation' well.
H Zare Ahmadabadi
Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.
My name is James Moon and I am a senior at Tennessee State University where my major is Aeronautical and Industrial Technology with a concentration in industrial electronics. I am currently serving my internship in the Engineering and Technical Services Directorate at the Glenn Research Center (GRC). The Engineering and Technical Service Directorate provides the services and infrastructure for the Glenn Research Center to take research concepts to reality. They provide a full range of integrated services including engineering, advanced prototyping and testing, facility management, and information technology for NASA, industry, and academia. Engineering and Technical Services contains the core knowledge in Information Technology (IT). This includes data systems and analysis, inter and intranet based systems design and data security. Including the design and development of embedded real-time s o h a r e applications for flight and supporting ground systems, Engineering and Technical Services provide a wide range of IT services and products specific to the Glenn Research Center research and engineering community. In the 7000 Directorate I work directly in the 7611 organization. This organization is known as the Aviation Environments Technical Branch. My mentor is Vincent Satterwhite who is also the Branch Chief of the Aviation Environments Technical Branch. In this branch, I serve as the Assistant program manager of the Engineering Technology Program. The Engineering Technology Program (ETP) is one of three components of the High School L.E.R.C.I.P. This is an Agency-sponsored, eight-week research-based apprenticeship program designed to attract traditionally underrepresented high school students that demonstrate an aptitude for and interest in mathematics, science, engineering, and technology.
Full Text Available Objectives: The aim of present study was determining the level of satisfaction and its relative factors among parents of mentally retarded children using the services of private rehabilitation centers. Methods: This was a descriptive-analytical study that was conducted on parents of 150 mentally retarded children, who were selected by quota sampling from eight private rehabilitation centers in Tehran. Questionnaires were used to collect data, and correlation tests, independent t-test, and one-way analysis of variance were utilized to analyze data. Results: Upon the results, overall 88% of participants expressed their satisfaction. The major related factors were the behavior of managers and employees, receiving training for follow-up rehabilitation and education programs for the child at home, and the child's progress. The factors related to dissatisfaction included nutrition services, physical condition of the center and lack of parental participation in decision- making on matters related to the child. A significant relationship was found between parental satisfaction and family size, father's job, and the number of other disabled people in the family. Discussion: According to the findings, it seems that patient satisfaction is also affected by the behavioral aspects of care, in addition to the technical aspects. Considering the humans’ need for respect and compassion and the sense of being valuable, this finding could be anticipated. The managers of private rehabilitation centers, for attracting and retain clients, need to pay attention to the factors which have impact on service users’ satisfaction.
Schnase, J. L.; Duffy, D. Q.; Tamkin, G. S.; Strong, S.; Ripley, D.; Gill, R.; Sinno, S. S.; Shen, Y.; Carriere, L. E.; Brieger, L.; Moore, R.; Rajasekar, A.; Schroeder, W.; Wan, M.
Scientific data services are becoming an important part of the NASA Center for Climate Simulation's mission. Our technological response to this expanding role is built around the concept of specialized virtual climate data servers, repetitive cloud provisioning, image-based deployment and distribution, and virtualization-as-a-service. A virtual climate data server is an OAIS-compliant, iRODS-based data server designed to support a particular type of scientific data collection. iRODS is data grid middleware that provides policy-based control over collection-building, managing, querying, accessing, and preserving large scientific data sets. We have developed prototype vCDSs to manage NetCDF, HDF, and GeoTIF data products. We use RPM scripts to build vCDS images in our local computing environment, our local Virtual Machine Environment, NASA's Nebula Cloud Services, and Amazon's Elastic Compute Cloud. Once provisioned into these virtualized resources, multiple vCDSs can use iRODS's federation and realized object capabilities to create an integrated ecosystem of data servers that can scale and adapt to changing requirements. This approach enables platform- or software-as-a-service deployment of the vCDSs and allows the NCCS to offer virtualization-as-a-service, a capacity to respond in an agile way to new customer requests for data services, and a path for migrating existing services into the cloud. We have registered MODIS Atmosphere data products in a vCDS that contains 54 million registered files, 630TB of data, and over 300 million metadata values. We are now assembling IPCC AR5 data into a production vCDS that will provide the platform upon which NCCS's Earth System Grid (ESG) node publishes to the extended science community. In this talk, we describe our approach, experiences, lessons learned, and plans for the future.
McWhirter, J.; Boler, F. M.; Bock, Y.; Jamason, P.; Squibb, M. B.; Noll, C. E.; Blewitt, G.; Kreemer, C. W.
Three geodesy Archive Centers, Scripps Orbit and Permanent Array Center (SOPAC), NASA's Crustal Dynamics Data Information System (CDDIS) and UNAVCO are engaged in a joint effort to define and develop a common Web Service Application Programming Interface (API) for accessing geodetic data holdings. This effort is funded by the NASA ROSES ACCESS Program to modernize the original GPS Seamless Archive Centers (GSAC) technology which was developed in the 1990s. A new web service interface, the GSAC-WS, is being developed to provide uniform and expanded mechanisms through which users can access our data repositories. In total, our respective archives hold tens of millions of files and contain a rich collection of site/station metadata. Though we serve similar user communities, we currently provide a range of different access methods, query services and metadata formats. This leads to a lack of consistency in the userís experience and a duplication of engineering efforts. The GSAC-WS API and its reference implementation in an underlying Java-based GSAC Service Layer (GSL) supports metadata and data queries into site/station oriented data archives. The general nature of this API makes it applicable to a broad range of data systems. The overall goals of this project include providing consistent and rich query interfaces for end users and client programs, the development of enabling technology to facilitate third party repositories in developing these web service capabilities and to enable the ability to perform data queries across a collection of federated GSAC-WS enabled repositories. A fundamental challenge faced in this project is to provide a common suite of query services across a heterogeneous collection of data yet enabling each repository to expose their specific metadata holdings. To address this challenge we are developing a "capabilities" based service where a repository can describe its specific query and metadata capabilities. Furthermore, the architecture of
Sachin S Mumbare
Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.
...-1121. If comments are sent by electronic means, please do not send duplicate comments via regular mail... Information Relay Service (FIRS) at 1-800-877-8339 between 8:00 a.m. and 8:00 p.m., Eastern Standard Time...
...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority...-wildfire threats to human safety, property and critical natural or cultural resources on National Forest... efforts to improve cost efficiencies. These cost issues affect the Forest Service BAER program since...
This report presents a series of observations of tourists' experiences with kiosks providing traveler information services at rural tourism areas. The kiosks were assessed in five areas: reliability visibility, usability, usefulness, and adaptability...
Stanhope, Victoria; Tondora, Janis; Davidson, Larry; Choy-Brown, Mimi; Marcus, Steven C
Service disengagement is a pervasive challenge the mental health care system faces. Mental health services are of little value should persons with mental illnesses continue to opt out of receiving them. Consumers attribute disengagement from care to an absence of choice in their treatment. In response, the mental health system is adopting a person-centered model, based upon recovery principles, to engage consumers more actively in their care. Person-centered care planning is a promising practice involving collaboration to develop and implement an actionable plan to assist the person in achieving personal recovery goals. This study design combines a parallel-group randomized controlled trial of community mental health organizations with qualitative methods to assess the effectiveness of person-centered care planning. Participants at 14 sites in Delaware and Connecticut will be randomized to treatment as usual or the person-centered care planning intervention. Participants will be in leadership (n = 70) or supervisory or direct care (n = 210) roles. The person-centered care planning intervention involves intensive staff training and 12 months of ongoing technical assistance. Quantitative survey data will be collected at baseline, 6 months and 12 months measuring person-centered care planning competency and organizational factors. Consumer outcomes (engagement, medication adherence, functioning and consumer satisfaction) will be assessed by Medicaid and state-level data. Qualitative data focused on process factors will include staff and consumer interviews and focus groups. In this intent-to-treat analysis, we will use mixed-effects multivariate regression models to evaluate the differential impact of the person-centered care planning intervention on each consumer and implementation outcome as well as the extent to which clinician assessments of organizational factors are associated with the implementation outcome. Mixed methods will triangulate and strengthen the
Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine
... 34 Education 3 2010-07-01 2010-07-01 false What additional services do Upward Bound Math and... Program? § 645.13 What additional services do Upward Bound Math and Science Centers provide and how are... provided under § 645.11(b), an Upward Bound Math and Science Center must provide— (1) Intensive instruction...
... Manager to select and appoint or recommend for appointment the person or legal entity to receive....55 Veterans Service Center Manager to select and appoint or recommend for appointment the person or.... The Veterans Service Center Manager is authorized to select and appoint (or in the case of a court...
Carrell, J.R.; Holton, L.K.; Siemens, D.H.
A preconceptual design for a waste conditioning and solidification system for the immobilization of the high-level liquid wastes (HLLW) stored at the Western New York Nuclear Service Center (WNYNSC), West Valley, New York was completed in 1981. The preconceptual design was conducted as part of the Department of Energy's (DOE) West Valley Demonstration Project, which requires a waste management demonstration at the WNYNSC. This paper summarizes the bases, assumptions, results and conclusions of the preconceptual design study
Larson, S; Chapman, S; Spetz, J; Brindis, CD
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...
Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.
Huang, Huan-Chun; Yun, Ying-Xia; Miao, Zhan-Tang; Hao, Cui; Li, Hong-yuan
Based on the modified Logistic-CA model, and taking the coastal area of Tianjin as a case, this paper simulated the spatial evolution patterns of ecosystem services as affected by the urban expansion in 2011-2020 under the scenarios of historical extrapolation, endogenous development, and exogenous development. Overall, the total ecosystem services of the study area under the three scenarios were generally the same, and the functional region with the lowest level ecosystem services had the identical spatial pattern. However, the spatial evolution patterns of the ecosystem services of the study area under the three scenarios had a great difference. The functional regions with lower-level ecosystem services grew in a cross-shaped pattern, with the Tanggu downtown as a center, and finally formed a full connectivity area along the Haihe River and coastal zone.
Verhagen, Willem; Kukkala, Aija S.; Moilanen, Atte; van Teeffelen, Astrid J.A.; Verburg, Peter H.
Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas
Krueger, Ute; Schimmelpfeng, Katja
A sufficient staffing level in fire and rescue dispatch centers is crucial for saving lives. Therefore, it is important to estimate the expected workload properly. For this purpose, we analyzed whether a dispatch center can be considered as a call center. Current call center publications very often model call arrivals as a non-homogeneous Poisson process. This bases on the underlying assumption of the caller's independent decision to call or not to call. In case of an emergency, however, there are often calls from more than one person reporting the same incident and thus, these calls are not independent. Therefore, this paper focuses on the dependency of calls in a fire and rescue dispatch center. We analyzed and evaluated several distributions in this setting. Results are illustrated using real-world data collected from a typical German dispatch center in Cottbus ("Leitstelle Lausitz"). We identified the Pólya distribution as being superior to the Poisson distribution in describing the call arrival rate and the Weibull distribution to be more suitable than the exponential distribution for interarrival times and service times. However, the commonly used distributions offer acceptable approximations. This is important for estimating a sufficient staffing level in practice using, e.g., the Erlang-C model.
Young, S; Erdem, S A
It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.
Fang, Hongliang; Beaudoing, Hiroko K.; Rodell, matthew; Teng, William L.; Vollmer, Bruce E.
The Global Land Data Assimilation System (GLDAS) is generating a series of land surface state (e.g., soil moisture and surface temperature) and flux (e.g., evaporation and sensible heat flux) products simulated by four land surface models (CLM, Mosaic, Noah and VIC). These products are now accessible at the Hydrology Data and Information Services Center (HDISC), a component of the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). Current data holdings include a set of 1.0 degree resolution data products from the four models, covering 1979 to the present; and a 0.25 degree data product from the Noah model, covering 2000 to the present. The products are in Gridded Binary (GRIB) format and can be accessed through a number of interfaces. Users can search the products through keywords and perform on-the-fly spatial and parameter subsetting and format conversion of selected data. More advanced visualization, access and analysis capabilities will be available in the future. The long term GLDAS data are used to develop climatology of water cycle components and to explore the teleconnections of droughts and pluvial.
A consolidated progress report for 1976 prepared for countries in the NDS service area. It is intended to encourage a closer relationship between Member States and provide for a wider circulation of unpublished progress reports from countries within the Nuclear Data Section service area
Fenwick, J.W.; Dowell, L.J.
The service areas for electric power substations can be estimated using a Cellular Automata (CA) model. The CA model is a discrete, iterative process whereby substations acquire service area by claiming neighboring cells. The service area expands from a substation until a neighboring substation service area is met or the substation`s total capacity or other constraints are reached. The CA-model output is dependent on the rule set that defines cell interactions. The rule set is based on a hierarchy of quantitative metrics that represent real-world factors such as land use and population density. Together, the metrics determine the rate of cell acquisition and the upper bound for service area size. Assessing the CA-model accuracy requires comparisons to actual service areas. These actual service areas can be extracted from distribution maps. Quantitative assessment of the CA-model accuracy can be accomplished by a number of methods. Some are as simple as finding the percentage of cells predicted correctly, while others assess a penalty based on the distance from an incorrectly predicted cell to its correct service area. This is an initial report of a work in progress.
Marcelli, Marco; Madonia, Alice; Tofani, Anna; Molino, Chiara; Manfredi Frattarelli, Francesco
Natural Capital evaluation is emerging as a fundamental tool to support the management of natural resources. Indeed, the achievement of the compatibility among their multiple uses, often in conflict in coastal areas, is a priority to avoid the increasing undesirable effects which threat both ecosystems and human health and well-being. It represents the scientific basis for actions needed to enhance the conservation and sustainable use of those systems and their contribution to human well-being. Furthermore the Millennium Ecosystem Assessment (called by Kofi Annan in 2000), assessed the consequences of ecosystem change for human well-being, and in particular, the analysis method has been centered on the linkages between "ecosystem services" and human well-being. This "Ecosystem Approach" allows to evaluate the consequences of ecosystems changes on human well-being through the assessment of the Ecosystem Services (ES), which are defined as "the benefits that people obtain from ecosystems". These include provisioning services (food, water, timber, etc.), regulating services (climate, floods, disease, etc.); cultural services (recreational, aesthetic and spiritual benefits) and supporting services (soil formation, photosynthesis, nutrient cycling, etc.) Also the reference guidelines for European Environmental Policy (Marine Strategy Framework Directive 2008/56 / EC - MSFD; Maritime Spatial Planning Directive 2014/89 / EC - MSP) are based on the principle of the Ecosystem Approach to define the monitoring criteria of marine and maritime space management ecosystems. The assessment of ES provided by Natural Capital cannot overlook the integration of ecological data with economic and socio-cultural ones, since they are considered as the direct and indirect contributions to human well-being provided by ecosystems. Cultural Ecosystem Services (CES), often omitted in the cost-benefit impact studies, has been receiving increasing interest from the scientific community in order
In fragile states context of climate change vulnerability, poverty and lack of infrastructure, the ability of ecosystem services to provide for numerous human needs is indispensable. The focus of this paper is describing the prospects for ecosystem services provision in fragile states’ urban areas. This paper presents a distinct approach by analyzing actors with capacity to provide ecosystem services in urban areas: government, international partners and citizens. Using infrastructure investm...
Teresa de Jesús Molina Gutiérrez
Full Text Available The objective of this study was to interpret the relationship between the expectations and the perceptions that the staff has about the quality of the educational service offered at the Mérida Local Center (Universidad Nacional Abierta, then the conceptual model of quality of service SERVQUAL, complemented with the qualitative approach. The informants were 15 advisors, 20 students and 5 administrative staff, the data were collected through the semi-structured interview and interpreted with the content analysis. The results indicate that there is no satisfaction with the educational service or that satisfaction is very low, because the expectations that are generated before receiving it are not surpassed by the perceived value, which is an indicator of the absence of quality of service. On the other hand, achieving quality in the service provided is the responsibility of all involved since the complexity of the roles fulfilled in the educational dialectic means that the staff act simultaneously as clients and as service providers.
Huddle, Matthew G; London, Nyall R; Stewart, C Matthew
To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.
Mender, Bedeho M. W.; Stringer, Simon M.
We present a hypothesis for how head-centered visual representations in primate parietal areas could self-organize through visually-guided learning, and test this hypothesis using a neural network model. The model consists of a competitive output layer of neurons that receives afferent synaptic connections from a population of input neurons with eye position gain modulated retinal receptive fields. The synaptic connections in the model are trained with an associative trace learning rule which has the effect of encouraging output neurons to learn to respond to subsets of input patterns that tend to occur close together in time. This network architecture and synaptic learning rule is hypothesized to promote the development of head-centered output neurons during periods of time when the head remains fixed while the eyes move. This hypothesis is demonstrated to be feasible, and each of the core model components described is tested and found to be individually necessary for successful self-organization. PMID:24349064
Sites in the Gulf States Utilities service are considered for cogeneration feasibility studies. The sources of steam considered for the Orange, Texas and Geismar, Lake Charles, and North Baton Rouge, Louisiana sites include oil, coal, HTGR steamers, consolidated nuclear steam system, atmospheric fluidized-bed coal combustion, and coal gasification. Concepts concerning cogeneration fuel systems were categorized by technical applicability as: current technology (pulverized coal-fired boilers and fuel oil-fired boilers), advanced technology under development (HTGR steamers and the CNSS), and advanced technology for future development (atmospheric fluidized-bed boilers and coal gasification). In addition to providing data on cogeneration plant generally useful in the US, the study determined the technical and economic feasibility of steam and electric power cogeneration using coal and nuclear fuels for localized industrial complexes. Details on site selection, plant descriptions, cost estimates, economic analysis, and plant schedule and implementation. (MCW)
Clark, Roger N.; Green, Robert O.; Swayze, Gregg A.; Meeker, Greg; Sutley, Steve; Hoefen, Todd M.; Livo, K. Eric; Plumlee, Geoff; Pavri, Betina; Sarture, Chuck; Wilson, Steve; Hageman, Phil; Lamothe, Paul; Vance, J. Sam; Boardman, Joe; Brownfield, Isabelle; Gent, Carol; Morath, Laurie C.; Taggart, Joseph; Theodorakos, Peter M.; Adams, Monique
This web site describes the results of an interdisciplinary environmental characterization of the World Trade Center (WTC) area after September 11, 2001.Information presented in this site was first made available to the World Trade Center emergency response teams on September 18, 2001 (Thermal hot spot information), and September 27, 2001 (maps and compositional results).The Airborne Visible / Infrared Imaging Spectrometer (AVIRIS), a hyperspectral remote sensing instrument, was flown by JPL/NASA over the World Trade Center (WTC) area on September 16, 18, 22, and 23, 2001 ( Link to the AVIRIS JPL data facility). A 2-person USGS crew collected samples of dusts and airfall debris from more than 35 localities within a 1-km radius of the World trade Center site on the evenings of September 17 and 18, 2001. Two samples were collected of indoor locations that were presumably not affected by rainfall (there was a rainstorm on September 14). Two samples of material coating a steel beam in the WTC debris were also collected. The USGS ground crew also carried out on-the-ground reflectance spectroscopy measurements during daylight hours to field calibrate AVIRIS remote sensing data. Radiance calibration and rectification of the AVIRIS data were done at JPL/NASA. Surface reflectance calibration, spectral mapping, and interpretation were done at the USGS Imaging Spectroscopy Lab in Denver. The dust/debris and beam-insulation samples were analyzed for a variety of mineralogical and chemical parameters using Reflectance Spectroscopy (RS), Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), chemical analysis, and chemical leach test techniques in U.S. Geological Survey laboratories in Denver, Colorado.
Mandak, Kelsey; Light, Janice
Although family-centered services have long been discussed as essential in providing successful services to families of children with autism spectrum disorder (ASD), ideal implementation is often lacking. This study aimed to increase understanding of how families with children with ASD and limited speech receive services from speech-language…
Frydendal, Jeppe; Hauschild, Michael Zwicky
. promote the use of Life Cycle Assessment and other product-oriented environmental tools in companies, 2. support companies and other in using environmental assessment of products and services, 3. ensure that the effort in the LCA area is based on a solid and scientific basis, and 4. maintain the well...
Neuhauser, D. S.; Zuzlewski, S.; Lombard, P. N.; Allen, R. M.
The Northern California Earthquake Data Center (NCEDC) provides data archive and distribution services for seismological and geophysical data sets that encompass northern California. The NCEDC is enhancing its ability to deliver rapid information through Web Services. NCEDC Web Services use well-established web server and client protocols and REST software architecture to allow users to easily make queries using web browsers or simple program interfaces and to receive the requested data in real-time rather than through batch or email-based requests. Data are returned to the user in the appropriate format such as XML, RESP, simple text, or MiniSEED depending on the service and selected output format. The NCEDC offers the following web services that are compliant with the International Federation of Digital Seismograph Networks (FDSN) web services specifications: (1) fdsn-dataselect: time series data delivered in MiniSEED format, (2) fdsn-station: station and channel metadata and time series availability delivered in StationXML format, (3) fdsn-event: earthquake event information delivered in QuakeML format. In addition, the NCEDC offers the the following IRIS-compatible web services: (1) sacpz: provide channel gains, poles, and zeros in SAC format, (2) resp: provide channel response information in RESP format, (3) dataless: provide station and channel metadata in Dataless SEED format. The NCEDC is also developing a web service to deliver timeseries from pre-assembled event waveform gathers. The NCEDC has waveform gathers for ~750,000 northern and central California events from 1984 to the present, many of which were created by the USGS NCSN prior to the establishment of the joint NCSS (Northern California Seismic System). We are currently adding waveforms to these older event gathers with time series from the UCB networks and other networks with waveforms archived at the NCEDC, and ensuring that the waveform for each channel in the event gathers have the highest
Background The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. Objective The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. Methods The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. Results We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. Conclusions The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost. PMID:26215155
de la Torre-Díez, Isabel; Lopez-Coronado, Miguel; Garcia-Zapirain Soto, Begonya; Mendez-Zorrilla, Amaia
The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost.
Abderrahman, Walid A.; Elamin, Abdalla S.; Al-Harazin, Ibrahim M.; Eqnaibi, Badie S.
Effective management of groundwater resources in urban centers of arid regions is vital for sustainable development and groundwater protection especially with rapid growth of water demands under water stress conditions. Greater Dammam Metropolitan Area is a good example of rapid growing urban center due to comprehensive development and population growth. The water demand has increased by many times during the last three decades. Groundwater from local aquifers namely Dammam and Umm Er Radhuma, supplies more than 85% of the total water demands. The aquifers have been subjected to extensive and increasing groundwater pumping especially during last three decades. Negative impacts such as significant decline in water levels have been experienced in the area. A new groundwater management scheme in terms of improving the long-term water pumping policies is required for protection of the aquifers groundwater productivity. A special numerical simulation model of the multi-aquifer system including Dammam and Umm Er Radhuma aquifers has been developed to assess the behavior of the aquifer system under long term water stresses in Dammam Metropolitan Area. The developed numerical simulation model has been utilized to predict the responses of the aquifer system in terms of decline in terms of water level under different pumping schemes from the two aquifers during the next 30 years. The model results have postulated the importance of Umm Er Radhuma (UER) aquifer as a major water supply source to Dammam Metropolitan Area, as well as potential recharge source of more than 30% of the total water pumped from Dammam aquifer. These findings have been utilized in improving present and future groundwater management and conservation for the study area. Similar techniques can be used to improve the groundwater management in other parts of the country as well as other arid regions. (author)
Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah
Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values quality measures in cancer hospitals. Copyright © 2015 by American Society of Clinical Oncology.
Full Text Available Public fitness centers and exercise facilities have been implicated as possible sources for transmitting community-acquired bacterial infections. However, the overall diversity of the bacterial community residing on the surfaces in these indoor environments is still unknown. In this study, we investigated the overall bacterial ecology of selected fitness centers in a metropolitan area (Memphis, TN, USA utilizing culture-independent pyrosequencing of the 16S rRNA genes. Samples were collected from the skin-contact surfaces (e.g., exercise instruments, floor mats, handrails, etc. within fitness centers. Taxonomical composition revealed the abundance of Firmicutes phyla, followed by Proteobacter and Actinobacteria, with a total of 17 bacterial families and 25 bacterial genera. Most of these bacterial genera are of human and environmental origin (including, air, dust, soil, and water. Additionally, we found the presence of some pathogenic or potential pathogenic bacterial genera including Salmonella, Staphylococcus, Klebsiella, and Micrococcus. Staphylococcus was found to be the most prevalent genus. Presence of viable forms of these pathogens elevates risk of exposure of any susceptible individuals. Several factors (including personal hygiene, surface cleaning and disinfection schedules of the facilities may be the reasons for the rich bacterial diversity found in this study. The current finding underscores the need to increase public awareness on the importance of personal hygiene and sanitation for public gym users.
Full Text Available Urbanization, and the resulting land use/cover change, is a primary cause of the degradation of coastal wetland ecosystems. Reclamation projects are seen as a way to strike a balance between socioeconomic development and maintenance of coastal ecosystems. Our aim was to understand the ecological changes to Jiangsu’s coastal wetland resulting from land use change since 1977 by using remote sensing and spatial analyses. The results indicate that: (1 The area of artificial land use expanded while natural land use was reduced, which emphasized an increase in production-orientated land uses at the expense of ecologically important wetlands; (2 It took 34 years for landscape ecological security and 39 years for ecosystem services to regain equilibrium. The coastal reclamation area would recover ecological equilibrium only after a minimum of 30 years; (3 The total ecosystem service value decreased significantly from $2.98 billion per year to $2.31 billion per year from 1977 to 2014. Food production was the only one ecosystem service function that consistently increased, mainly because of government policy; (4 The relationship between landscape ecological security and ecosystem services is complicated, mainly because of the scale effect of landscape ecology. Spatial analysis of changing gravity centers showed that landscape ecological security and ecosystem service quality became better in the north than the south over the study period.
Hummel, C.; Provenzale, A.; Van der Meer, J.; Wijnhoven, S.; Nolte, A.; Poursanidis, D.; Janss, G.; Jurek, M.; Andresen, M.; Poulin, B.; Kobler, J.; Beierkuhnlein, C.; Honrado, J.; Razinkovas, A.; Stritih, A.; Bargmann, T.; Ziemba, A.; Bonet-García, F.; Adamescu, M.C.; Janssen, G.; Hummel, H.
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers,
Hsu, J.S.; Jallouk, P.A.; Staunton, R.H.
On March 3 and 4, 1998, a visit was made to Oak Ridge National Laboratory (ORNL) by two officials from Ghana: Mr. I.K. Mintah, Acting Executive Director, Technical Wing, Ministry of Mines and Energy (MOME) and Dr. A.K. Ofosu-Ahenkorah, Coordinator, Energy Efficiency and Conservation Program, MOME. As a result of this visit, Dr. John S. Hsu of ORNL was invited by MOME to visit the Republic of Ghana in order to study the feasibility of improving electric motor service centers in Ghana.
Enwere, Emmanuel N.; Keating, Ellen A.; Weber, Robert J.
Having accurate data is essential for the pharmacy director to manage the department and develop patient-centered pharmacy services. A balanced scorecard (BSC) of essential department data, which is a broad view of a department’s function beyond its financial performance, is an important part of any department’s strategic plan. This column describes how the pharmacy director builds and promotes a department’s BSC. Specifically, this article reviews how the BSC supports the department’s mission and vision, describes the metrics of the BSC and how they are collected, and recommends how the pharmacy director can effectively use the scorecard results in promoting the pharmacy. If designed properly and updated consistently, a BSC can present a broad view of the pharmacy’s performance, serve as a guide for strategic decision making, and improve on the quality of its services. PMID:24958976
Full Text Available Green areas in cities and their ecosystem services (ES offer residents various benefits. The range of services depends on biodiversity of a green space. The aim was to determine the relationship between biodiversity in different categories of green areas in the city and the ecosystem services, which appear in it. We made 108 relevés in the autumn and spring time, within nine categories of green areas in the Municipality of Ljubljana. In each category the range of ES was assessed based on field analysis and compared with literature assessed ecosystem services. Results showed that the category of forests differ from others. Other categories were similar to each other, in particular grassland categories. Also, a positive relationship linkage was found - more plant species mean more assessed ecosystem services in a specific green infrastructure category.
Noel Torres Júnior
Full Text Available As in many developing countries, the service sector in Brazil is responsible for generating income and employment for a significant portion of the population. Due to this economic relevance, service organizations are faced with an increasingly demanding and competitive market. This demand greater innovation and business planning. Despite this, the process of service development remains a relatively unexplored subject in the literature. Several issues regarding the planning and management remain without clear ideas or propositions that guide their appropriate treatment. The result of this situation, the methods and techniques that help design the services are not properly disseminated. These are scattered through the literature of operations management services. Given this framework, the light of a review of the literature and concerning the elements that compose the service project according to the works of Machuca, Zamora-Gonzalez and Aguilar-Escobar (2007 and Edvardsson (1997, the present work points and examine the methods and techniques suggested by many authors and works on the area of Service Operations. It was found that the knowledge about the methods and techniques is diffuse. This knowledge is concentrated on the design process and determining the location of services.
Cole, M.; Bambacus, M.; Lynnes, C.; Sauer, B.; Falke, S.; Yang, W.
NASA's vast array of scientific data within its Distributed Active Archive Centers (DAACs) is especially valuable to both traditional research scientists as well as the emerging market of Earth Science Information Partners. For example, the air quality science and management communities are increasingly using satellite derived observations in their analyses and decision making. The Air Quality Cluster in the Federation of Earth Science Information Partners (ESIP) uses web infrastructures of interoperability, or Service Oriented Architecture (SOA), to extend data exploration, use, and analysis and provides a user environment for DAAC products. In an effort to continually offer these NASA data to the broadest research community audience, and reusing emerging technologies, both NASA's Goddard Earth Science (GES) and Land Process (LP) DAACs have engaged in a web services pilot project. Through these projects both GES and LP have exposed data through the Open Geospatial Consortiums (OGC) Web Services standards. Reusing several different existing applications and implementation techniques, GES and LP successfully exposed a variety data, through distributed systems to be ingested into multiple end-user systems. The results of this project will enable researchers world wide to access some of NASA's GES & LP DAAC data through OGC protocols. This functionality encourages inter-disciplinary research while increasing data use through advanced technologies. This paper will concentrate on the implementation and use of OGC Web Services, specifically Web Map and Web Coverage Services (WMS, WCS) at GES and LP DAACs, and the value of these services within scientific applications, including integration with the DataFed air quality web infrastructure and in the development of data analysis web applications.
McLane, V.; Nordborg, C.; Lemmel, H.D.; Manokhin, V.N.
The cooperating Nuclear Reaction Data Centers are involved in the compilation and exchange of nuclear reaction data for incident neutrons, charged particles and photons. Individual centers may also have services in other areas, e.g., evaluated data, nuclear structure and decay data, reactor physics, nuclear safety; some of this information may also be exchanged between interested centers. 20 refs., 1 tab
Audit Report on tile Compilation of the FY 1997 Navy General Fund Financial Statements at the Defense Finance and Accounting Service Cleveland Center Our objective was to determine whether the DFAS...
This report provides additional detail on the Centers for Medicare & Medicaid Services (CMS)2 progress in implementing the debt-referral requirements of DCIA to collect delinquent Medicare debts and includes several recommendations...
Apr 20, 1991 ... ledge of health and other services by black elderly persons in two townships in the Cape ... people live) and open areas were not included in the sampling plan. .... Khayelitsha are generally less well iriformed on these matters.
This document presents documentation regarding tourist intercept surveys for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive description of tra...
This document presents information regarding data collection and dissemination functions for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive de...
This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...
Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency
Mandak, Kelsey; Light, Janice
This study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists (SLPs) who served children with complex communication needs regarding their provision of family-centered services. Participants revealed that despite their desire for family involvement and reported beliefs in the importance of family-centered services, there were barriers in place that often limited family-centered service provision. Across the SLPs, many were dissatisfied with their current provision of family-centered services. The SLPs varied in their reported practices, with some reporting family-centered services and others, professional-centered services. Future research is recommended in order to investigate which factors contribute to the variation among SLPs and how the variation impacts children who require augmentative and alternative communication (AAC) and their families. Potential clinical implications for in-service and pre-service SLPs are discussed to improve future family-centered AAC services.
The rational planning and financing of occupational health services at the national level have to be based on an appropriate system of information about individual units and their financial status that could illustrate their financial administration. This is required not only in view of the internal needs of public money management, but also in view of the national health accounts. The major task in this regard is to assess the level and structure of financing to individual units and to check the soundness of criteria used in the process of supplying financial means. The results of such an analysis can be a valuable source of information for planning carried out also by the institutions which provide funds to cover the cost of tasks performed by individual units. The aim of the project implemented by the Nofer Institute of Occupational Medicine was to collect, process and analyze data on the level and structure of financing of provincial occupational medicine centers. In this paper, the objectives, methodology and analytical tools are discussed. The results and structural data on the level and structure of financing of regional occupational health services centers covering a two-year period are presented. At the same time, the criteria for allocating funds were identified, which made it possible to evaluate the situation and to propose new solutions.
Electric Service Areas, Electric Servic Area - given to us from GA power and Planters Electric - distributed by the EMA Director, Val Ashcraft, Published in 2008, 1:2400 (1in=200ft) scale, Effingham County Government.
NSGIC Local Govt | GIS Inventory — Electric Service Areas dataset current as of 2008. Electric Servic Area - given to us from GA power and Planters Electric - distributed by the EMA Director, Val...
Becker, Janine M.
This research investigates Student Services/One Stop Centers at three post-secondary institutions, looking at the origination of the centers and success through the lens of behavioral theories. Comparing the 3-stage Group Dynamics Theory of Lewin (1947), Social Learning Theory of Bandura (1977), and the 8-stage Change Management Model of Kotter…
Full Text Available Background: Family planning has been defined in the framework of mothers and children plan as one of Primary Healthcare (PHC details. Besides quantity, the quality of services, particularly in terms of ethics, such as observing individuals’ privacy, is of great importance in offering family planning services.Objective: A preliminary study to gather information about the degree of medical ethics offered during family planning services at Tehran urban healthcare centers.Materials and Methods: A questionnaire was designed for study. In the first question regarding informed consent, 47 clients who were advised about various contraception methods were asked whether advantages and disadvantages of the contraceptive methods have been discussed by the service provider. Then a certain rank was measured for either client or method in 2007. Finally, average value of advantage and disadvantage for each method was measured. In questions about autonomy, justice and beneficence, yes/no answers have been expected and measured accordingly.Results: Health care providers have stressed more on the advantages of pills and disadvantages of tubectomy and have paid less attention to advantages of injection ampoules and disadvantages of pills in first time clients. While they have stressed more on the advantages and disadvantages of tubectomy and less attention to advantages of condom and disadvantages of vasectomy in second time clients. Clients divulged their 100% satisfaction in terms of observing turns and free charges services.Observance degree of autonomy was 64.7% and 77.3% for first time and second- time clients respectively.Conclusion: Applying the consultant’s personal viewpoint for selecting a method will breach an informed consent for first and second time clients. System has good consideration to justice and no malfeasance
Gabriela Teixeira Duarte
Full Text Available Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention
Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira
Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution.
Durán, América P.; Casalegno, Stefano; Marquet, Pablo A.; Gaston, Kevin J.
Protected areas are increasingly considered to play a key role in the global maintenance of ecosystem processes and the ecosystem services they provide. It is thus vital to assess the extent to which existing protected area systems represent those services. Here, for the first time, we document the effectiveness of the current Chilean protected area system and its planned extensions in representing both ecosystem services (plant productivity, carbon storage and agricultural production) and biodiversity. Additionally, we evaluate the effectiveness of protected areas based on their respective management objectives. Our results show that existing protected areas in Chile do not contain an unusually high proportion of carbon storage (14.9%), agricultural production (0.2%) or biodiversity (11.8%), and also represent a low level of plant productivity (Normalized Difference Vegetation Index of 0.38). Proposed additional priority sites enhance the representation of ecosystem services and biodiversity, but not sufficiently to attain levels of representation higher than would be expected for their area of coverage. Moreover, when the species groups were assessed separately, amphibians was the only one well represented. Suggested priority sites for biodiversity conservation, without formal protection yet, was the only protected area category that over-represents carbon storage, agricultural production and biodiversity. The low representation of ecosystem services and species’ distribution ranges by the current protected area system is because these protected areas are heavily biased toward southern Chile, and contain large extents of ice and bare rock. The designation and management of proposed priority sites needs to be addressed in order to increase the representation of ecosystem services within the Chilean protected area system. PMID:24376559
Hu, Teh-Wei; Wise, Karl
The purpose of this study is to provide day care center management and government funding agencies with empirical estimates of the costs of day care centers in Pennsylvania. Based on cost data obtained from the Department of Public Welfare and survey information from the Pennsylvania Day Care Study Project, average and marginal costs of day care…
Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
Nana SHI; Jinyan ZHAN; Feng WU; Jifu DU
According to the ecosystem assessment framework developed by the Millennium Ecosystem Assessment (MA), this paper designs an evaluation system of ecosystem services in Poyang Lake area. On the basis of relevant variables disaggregated to 1 km grid using the gridded 1 km, this paper employs factor analysis to extract a number of factors which characterize the ecosystem services of Poyang Lake area. The extracted principal component are then represented onto 1 km ×1 km grids by spatial clustering analysis to recognize and identify the minimal but consistent mapping units for ecosystem services which can be used to delimit the boundaries of ecological service zones. The research identifies ten ecosystem service zones in Poyang Lake area according to the consistent principle of core ecosystem service unit.Four kinds of core ecosystem services including supporting function, provisioning function, regulating function and cultural function are identified and represented. The research results could provide both spatially and temporally valuable decision-making information for sustainable ecosystem management in the targeted area.
Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra
In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.
Voth, M.H.; Jester, W.A.
The power reactor industry emerged from extensive research and development performed at nonpower reactors (NPRs). As the industry matures, NPRs continue to support and enhance power reactor technology. With the closure of many government and private industry NPRS, there is an increasing call for the 33 universities with operating research reactors to provide the needed services. The Penn State Radiation Science and Engineering Center (RSEC) includes a 1-MW pool-type pulsing TRIGA reactor, a neutron beam laboratory with real-time neutron radiography equipment, hot cells with master-slave manipulators for remote handling of radioactive materials, a gamma-ray irradiation pool, a low-level radiation monitoring laboratory, and extensive equipment for radiation monitoring, dosimetry, and material properties determination. While equipment is heavily utilized in the instructional and academic research programs, significant time remains available for service work. Cost recovery for service work generates income for personnel, equipment maintenance, and facility improvements. With decreasing federal and state funding for educational programs, it is increasingly important that facilities be fully utilized to generate supplementary revenue. The following are examples of such work performed at the RSEC
Full Text Available A pilot Postharvest Training and Services Center (PTSC was launched in October 2012 in Arusha, Tanzania as part of a United States Agency for International Development (USAID funded project. The five key components of the PTSC are (1 training of postharvest trainers, (2 postharvest training and demonstrations for local small-scale clientele, (3 adaptive research, (4 postharvest services, and (5 retail sales of postharvest tools and supplies. During the years of 2011–2012, a one year e-learning program was provided to 36 young horticultural professionals from seven Sub-Saharan African countries. These postharvest specialists went on to train more than 13,000 local farmers, extension workers, food processors, and marketers in their home countries in the year following completion of their course. Evaluators found that these specialists had trained an additional 9300 people by November 2014. When asked about adoption by their local trainees, 79% reported examples of their trainees using improved postharvest practices. From 2012–2013, the project supported 30 multi-day training programs, and the evaluation found that many of the improved practices being promoted were adopted by the trainees and led to increased earnings. Three PTSC components still require attention. Research activities initiated during the project are incomplete, and successful sales of postharvest goods and services will require commitment and improved partnering.
Percy, Andrew; Carr-Hill, Roy; Dixon, Paul; Jamison, James Q.
Describes study of administrative data from Northern Ireland on the costs of family and child care services, using small area utilization modeling, to derive a new set of needs indicators that could be used within the family and child care capitation funding formula. Argues that small area utilization modeling produces a fairer and more equitable…
BARNES, JOHN O., JR.
THE NEED FOR AN ADULT EDUCATION PROGRAM IN THE MARSHALL COUNTY (TENNESSEE) HIGH SCHOOL SERVICE AREA WAS STUDIED THROUGH QUESTIONNAIRES COMPLETED BY 207 ADULTS, EXAMINATION OF SCHOOL AND GOVERNMENT RECORDS, AND PERSONAL INTERVIEWS. IT WAS FOUND THAT OVER HALF OF THE AREA RESIDENTS WERE NOT HIGH SCHOOL GRADUATES, AND THAT MANY ADULTS DESIRED MORE…
... Traffic Service Routes; Windsor Locks Area; CT AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... coordinate for one point in the description of area navigation (RNAV) route T-300. DATES: Effective date 0901... action under 1 CFR part 51, subject to the annual revision of FAA Order 7400.9 and publication of...
Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George
Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573
... DEPARTMENT OF ENERGY Western Area Power Administration Desert Southwest Customer Service Region... CONTACT: Mr. Jack Murray, Rates Manager, Desert Southwest Customer Service Region, Western Area Power... Customer Service Region Network Integration Transmission Service Rate Schedules PD-NTS3 and INT-NTS3 for P...
... Migrant Service Area Beginning January 1, 2012 AGENCY: Legal Services Corporation. ACTION: Notice and Request for Comments. SUMMARY: The Legal Services Corporation will eliminate the West Virginia migrant service area, i.e., MWV effective January 1, 2012, because any eligible migrant population in West...
Full Text Available Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.
Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas. PMID:29140983
Hummel, Christiaan; Provenzale, Antonello; van der Meer, Jaap; Wijnhoven, Sander; Nolte, Arno; Poursanidis, Dimitris; Janss, Guyonne; Jurek, Matthias; Andresen, Magnus; Poulin, Brigitte; Kobler, Johannes; Beierkuhnlein, Carl; Honrado, João; Razinkovas, Arturas; Stritih, Ana; Bargmann, Tessa; Ziemba, Alex; Bonet-García, Francisco; Adamescu, Mihai Cristian; Janssen, Gerard; Hummel, Herman
Protected Areas are a key component of nature conservation. They can play an important role in counterbalancing the impacts of ecosystem degradation. For an optimal protection of a Protected Area it is essential to account for the variables underlying the major Ecosystem Services an area delivers, and the threats upon them. Here we show that the perception of these important variables differs markedly between scientists and managers of Protected Areas in mountains and transitional waters. Scientists emphasise variables of abiotic and biotic nature, whereas managers highlight socio-economic, cultural and anthropogenic variables. This indicates fundamental differences in perception. To be able to better protect an area it would be advisable to bring the perception of scientists and managers closer together. Intensified and harmonised communication across disciplinary and professional boundaries will be needed to implement and improve Ecosystem Service oriented management strategies in current and future Protected Areas.
Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young
Data center interconnection with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented cross stratum optimization of optical network and application stratums resources that allows to accommodate data center services. In view of this, this study extends the data center resources to user side to enhance the end-to-end quality of service. We propose a novel data center service localization (DCSL) architecture based on virtual resource migration in software defined elastic data center optical network. A migration evaluation scheme (MES) is introduced for DCSL based on the proposed architecture. The DCSL can enhance the responsiveness to the dynamic end-to-end data center demands, and effectively reduce the blocking probability to globally optimize optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of our OpenFlow-based enhanced SDN testbed. The performance of MES scheme under heavy traffic load scenario is also quantitatively evaluated based on DCSL architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning scheme.
Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J
As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success
Fazila Said; Mohammad Nasir Saluddin
The comparative study between four service center was constructed from the development of House of Quality (HoQ). HoQ is a simple and attractive service innovation tool which can be used to directly show a comprehensive information which contained the voice of customer (VOC), technical response, technical correlation and matrix relationship. The indirect information is a report on technical and planning part which shows the comparison between four service center. This study revealed that the information from HoQ with further discussion on planning part which can be used to assist management in knowing the overall detail information of service center achievement and recognizes the solution for unsatisfied customer through priority improvement activity to enhance the customer satisfaction in future. (author)
Vermont Center for Geographic Information — (Link to Metadata) A ZIP Code Tabulation Area (ZCTA) is a statistical geographic entity that approximates the delivery area for a U.S. Postal Service five-digit...
Dekorvin, Andre; Shipley, Margaret F.; Lea, Robert N.
In the present work, we consider the general problem of knowledge acquisition under uncertainty. Simply stated, the problem reduces to the following: how can we capture the knowledge of an expert when the expert is unable to clearly formulate how he or she arrives at a decision? A commonly used method is to learn by examples. We observe how the expert solves specific cases and from this infer some rules by which the decision may have been made. Unique to our work is the fuzzy set representation of the conditions or attributes upon which the expert may possibly base his fuzzy decision. From our examples, we infer certain and possible fuzzy rules for closing a customer service center and illustrate the importance of having the decision closely relate to the conditions under consideration.
Full Text Available In this paper, an uncertain integrated model for simultaneously locating temporary health centers in the affected areas, allocating affected areas to these centers, and routing to transport their required good is considered. Health centers can be settled in one of the affected areas or in a place out of them; therefore, the proposed model offers the best relief operation policy when it is possible to supply the goods of affected areas (which are customers of goods directly or under coverage. Due to that the problem is NP-Hard, to solve the problem in large-scale, a meta-heuristic algorithm based on harmony search algorithm is presented and its performance has been compared with basic harmony search algorithm and neighborhood search algorithm in small and large scale test problems. The results show that the proposed harmony search algorithm has a suitable efficiency.
Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C
To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.
Adel A. Alhamdan
Full Text Available Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs in Riyadh, Kingdom of Saudi Arabia (KSA, and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.
Antczak, Paul; Jacinto,Gilda; Simek, Jimmy
The National Aeronautics and Space Administration's (NASA) agency-wide movement to cultivate a quality workplace is the basis for Lewis Research Center to implement Total Quality Fundamentals (TQF) initiatives. The Lewis Technical Services Directorate (TSD) introduced the Total Quality Fundamentals (TQF) workshops to its work force as an opportunity to introduce the concepts and principles of TQF. These workshops also provided the participants with the opportunity to dialogue with fellow TSD employees and managers. This report describes, through the perspective of the Lewis TSD TQF Coaches, how the TQF work- shop process was accomplished in TSD. It describes the structure for addressing the need, implementation process, input the TSD Coaches provided, common themes and concerns raised, conclusions, and recommendations. The Coaches concluded that these types of workshops could be the key to open the communication channels that are necessary to help everyone at Lewis understand where they fit in the organization. TQF workshops can strengthen the participant's connection with the Mission, Vision of the Center, and Vision of the Agency. Reconunendations are given based on these conclusions that can help the TSD Quality Board develop attainable measures towards a quality workplace.
Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen
We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.
El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E
Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and
Gurunluoglu, Raffi; Glasgow, Mark; Arton, Jamie; Bronsert, Michael
Facial dog bite injuries pose a significant public health problem. Seventy-five consecutive patients (45 males, 30 females) treated solely by plastic surgery service for facial dog bite injuries at a Level I trauma center in the Denver Metro area between 2006 and 2012 were retrospectively reviewed. The following information were recorded: breed, relationship of patient to dog, location and number of wounds, the duration between injury and surgical repair and dog bite incident, type of repair, and antibiotic prophylaxis. Primary end points measured were wound infection, the need for revision surgery, and patient satisfaction. Ninety-eight wounds in the head and neck region were repaired (46 children; mean age, 6.8 years) and (29 adults; mean age, 47.3 years). Twelve different breeds were identified. There was no significant association between the type of dog breed and the number of bite injuries. The duration between injury and repair ranged from 4 hours to 72 hours (mean [SD], 13.7 [10.9] hours). The majority of bite wounds (76 of 98) involved the cheek, lip, nose, and chin region. Direct repair was the most common surgical approach (60 of 98 wounds) (p reconstruction versus direct repair according to dog breed (p = 0.25). Ten wounds required grafting. Twenty-five wounds were managed by one-stage or two-stage flaps. Only three patients (3.06 %) underwent replantation/revascularization of amputated partial lip (n = 2) and of cheek (n = 1). There was one postoperative infection. Data from five-point Likert scale were available for fifty-two patients. Forty patients were satisfied (5) with the outcome, while five patients were somewhat satisfied (4), and seven were neutral. Availability of the plastic surgery service at a Level I trauma center is vital for the optimal treatment of facial dog bite injuries. Direct repair and reconstruction of facial dog bite injuries at the earliest opportunity resulted in good outcomes as evidenced by the satisfaction survey data and
Seyed Ali Ziaee Azimi
Full Text Available The present research is classified as an applied one employing a descriptive survey design to describe the status quo of the factors affecting customers’ satisfaction with the E-service centers of Iran’s police, known as 10 + police centers. The research population involves all the costumers of the 10+ police centers, among which 420 individuals were chosen through simple random sampling technique. Furthermore, 45 10 + police service centers were selected with probability proportional to size. After Determining the validity and reliability of the researcher-made questionnaire, it has been used to collect the required data. Then, a conceptual model was developed using the theoretical framework and background literature. After that, SPSS software was used to examine and make an analysis of the research hypothesises. The findings indicate that all the identified indices to the customers’ satisfaction with the 10 + police e- service centers (including trust and confidence, staff performance, system facility, environmental facility, basic amenity, providing sufficient notification, time and cost, easy access to the office have an effect on the customers’ satisfaction. In the end, some practical suggestions were made for an improvement in the satisfaction level of the customers to the 10 + police e- service centers.
Goldstein, Joshua Howard; Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry
Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts
Joshua Howard Goldstein
Full Text Available Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of "green" economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces, leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country's extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate
Mieke van der Bijl-Brouwer
Full Text Available Service design is one of the keys to improving how we target today’s complex societal problems. The predominant view of service systems is mechanistic and linear. A service infrastructure—which includes solutions like service blueprints, scripts, and protocols—is, in some ways, designed to control the behavior of service professionals at the service interface. This view undermines the intrinsic motivation, expertise, and creativity of service professionals. This article presents a different perspective on service design. Using theories of social systems and complex responsive processes, I define service organizations as ongoing iterated patterns of relationships between people, and identify them as complex social service systems. I go on to show how the human-centeredness of design practices contributes to designing for such service systems. In particular, I show how a deep understanding of the needs and aspirations of service professionals through phenomenological themes contributes to designing for social infrastructures that support continuous improvement and adaptation of the practices executed by service professionals at the service interface.
Levis, C. A.; Wang, C.-W.; Yamamura, Y.; Reilly, C. H.; Gonsalvez, D. J.
An implicit relationship is derived which relates the topocentric separation of two satellites required for a given level of single-entry protection to the separation and orientation of their service areas. The results are presented explicitly for circular beams and topocentric angles. A computational approach is given for elliptical beams and for use with longitude and latitude variables. It is found that the geocentric separation depends primarily on the service area separation, secondarily on a parameter which characterizes the electrical design, and only slightly on the mean orbital position of the satellites. Both linear programming and mixed integer programming algorithms are implemented. Possible objective function choices are discussed, and explicit formulations are presented for the choice of the sum of the absolute deviations of the orbital locations from some prescribed 'ideal' location set. A test problem involving six service areas is examined with results that are encouraging with respect to applying the linear programming procedure to larger scenarios.
Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at
Full Text Available Abstract Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i Telecollaboration and teleconsultation services between remotely located healthcare providers, ii telemedicine services in emergencies, iii home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G, and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances
Sautkin, I. S.; Rogova, T. V.
The article is devoted to the identification and analysis of cultural ecosystem services of recreational areas from the different forest plant functional groups in the suburbs of Kazan. The study explored two cultural ecosystem services supplied by forest plants by linking these services to different plant functional traits. Information on the functional traits of 76 plants occurring in the forest ecosystems of the investigated area was collected from reference books on the biological characteristics of plant species. Analysis of these species and traits with the Ward clustering method yielded four functional groups with different potentials for delivering ecosystem services. The results show that the contribution of species diversity to services can be characterized through the functional traits of plants. This proves that there is a stable relationship between biodiversity and the quality and quantity of ecosystem services. The proposed method can be extended to other types of services (regulating and supporting). The analysis can be used in the socio-economic assessment of natural ecosystems for recreation and other uses.
Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan
There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.
Scolozzi, Rocco; Schirpke, Uta; Morri, Elisa; D'Amato, Dalia; Santolini, Riccardo
An ecosystem services-based SWOT analysis is proposed in order to identify and quantify internal and external factors supporting or threatening the conservation effectiveness of protected areas. The proposed approach concerns both the ecological and the social perspective. Strengths and weaknesses, opportunities and threats were evaluated based on 12 selected environmental and socio-economic indicators for all terrestrial Italian protected areas, belonging to the Natura 2000 network, and for their 5-km buffer area. The indicators, used as criteria within a multi-criteria assessment, include: core area, cost-distance between protected areas, changes in ecosystem services values, intensification of land use, and urbanization. The results were aggregated for three biogeographical regions, Alpine, Continental, and Mediterranean, indicating that Alpine sites have more opportunities and strengths than Continental and Mediterranean sites. The results call attention to where connectivity and land-use changes may have stronger influence on protected areas, in particular, whereas urbanization or intensification of agriculture may hamper conservation goals of protected areas. The proposed SWOT analysis provides helpful information for a multiple scale perspective and for identifying conservation priorities and for defining management strategies to assure biodiversity conservation and ecosystem services provision. Copyright © 2014 Elsevier Ltd. All rights reserved.
Louis, Christopher J; Clark, Jonathan R; Gray, Barbara; Brannon, Diane; Parker, Victoria
Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. In this article, we explore service line structure, with an aim of advancing our understanding of the role service line structure plays in producing coordinated, patient-centered care. We do so by giving special attention to the cognitive roots of patient-centeredness. Our exploratory study relied on comparative case studies of the breast cancer service lines in three health systems. Nonprobability discriminative snowball sampling was used to identify the final sample of key informants. We employed a grounded approach to analyzing and interpreting the data. We found substantial variation across the three service lines in terms of their structure. We also found corresponding variation across the three case sites in terms of where informant attention was primarily focused in the process of coordinating care. Drawing on the attention-based view of the firm, our results draw a clear connection between structural characteristics and the dominant focus of attention (operational tactics, provider roles and relationships, or patient needs and engagement) in health care service lines. Our exploratory results suggest that service line structures influence attention in two ways: (a) by regulating the type and intensity of the problems facing service line participants and (b) by encouraging (or discouraging) a shared purpose around patient needs. Patient-centered attention-a precursor to coordinated, patient-centered care-depends on the internal choices organizations make around service line structure. Moreover, a key task for organizational and service line leaders is to structure service lines to create a context that minimizes distractions and enables care providers to focus their attention on
.... Specifically, we reviewed accounting records for payroll and related expenditures to determine the validity of payroll expenses that the DFAS Columbus Center submitted to the DFAS Indianapolis Center...
Perrin, James M; Romm, Diane; Bloom, Sheila R; Homer, Charles J; Kuhlthau, Karen A; Cooley, Carl; Duncan, Paula; Roberts, Richard; Sloyer, Phyllis; Wells, Nora; Newacheck, Paul
To present a conceptual definition of a family-centered system of services for children and youth with special health care needs (CYSHCN). Previous work by the Maternal and Child Health Bureau to define CYSHCN has had widespread program effects. This article similarly seeks to provide a definition of a system of services. Comprehensive literature review of systems of services and consensus panel organized to review and refine the definition. Policy research group and advisors at multiple sites. Policy researchers, content experts on CYSHCN, family representatives, and state program directors. Definition of a system of services for CYSHCN. This article defines a system of services for CYSHCN as a family-centered network of community-based services designed to promote the healthy development and well-being of these children and their families. The definition can guide discussion among policy makers, practitioners, state programs, researchers, and families for implementing the "community-based systems of services" contained in Title V of the Social Security Act. Critical characteristics of a system include coordination of child and family services, effective communication among providers and the family, family partnership in care provision, and flexibility. This definition provides a conceptual model that can help measurement development and assessment of how well systems work and achieve their goals. Currently available performance objectives for the provision of care for CYSHCN and national surveys of child health could be modified to assess systems of services in general.
José Carlos MACÍA ARCE
Full Text Available One of the pillars of the technological revolution that began in the seventies was the development of the Internet. This network has evolved in such a way that it now forms a complex structure that radically changed the social and economic dynamics at the end of century XX. Nowadays, new technologies allow anything from communication and information exchange to the realization of complex financial transactions, all from anywhere in the world and almost instantaneously. In spite of the widespread use of the Internet, there are still territories and inhabitants, mostly emplaced in remote rural areas, who live outside of this technological revolution. By contrast, urban areas enjoy a privileged position in the dissemination of the information society by concentrating most of the telecommunications infrastructure and monopolize the most qualified people. But there are many disparities in terms of diffusion of new technologies and these will transfer, in turn, to the enterprise sector which is the subject of this research. The differences in the use of new technologies and more specifically the use of advanced services on the Internet are related to the sector where the population is employed and its level of training. One of the advanced services offered by the Network is teleworking. Nowadays there are companies that offer their employees the opportunity to develop their professional activities outside their headquarters, using their homes as an alternative or call centers enabled with computers and Internet access. The purpose of this research is the study of the consumption of Internet advanced services by companies in the metropolitan area of Madrid, analyzing the spread of telework in more detail,a potential offered by new technologies and which may modify the current pattern of mobility in the main urban areas because it is from here where big companies are guiding the global economy.
Li, Cui-ling; Zhao, Kai; Li, Hui; Farah, Omar Ibrahim; Wang, Jiao-jiao; Sun, Rong-ze; Zhang, Hui-ping
This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be
Full Text Available OBJECTIVE: This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. METHODS: Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. RESULTS: A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM and Toxoplasma gondii (IgM, respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. CONCLUSION: Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of
This includes the treatment of common skin conditions such as acne, dermatitis, psoriasis, vitiligo or alopecia to the more complex laser surgeries and...Phototherapy, Laser Surgery, Pediatric Dermatology, HIV Dermatology, Patch Testing, MOHS Micrographic Surgery, and Dermatologic Surgery. The entire...Dermatology Service is located on the first floor of the hospital. Minor surgical and MOHS Micrographic Surgery, ultraviolet treatment, and laser surgery
Goerler, W; Benz, A [Technische Werke der Stadt Stuttgart A.G. (F.R. Germany)
In congested areas the line construction engineer has to cope with a great variety of difficulties - amenity problems, line crossings, and road crossings. The authors describe the prerequisites for and the construction of a HV shared-service line of approx. 25 km in the congested area of Stuttgart, where several three-phase and single- phase a.c. systems are run on one set of pylons.
Swords, Douglas S; Hadley, Edmund D; Swett, Katrina R; Pranikoff, Thomas
Total body surface area (TBSA) burned is a powerful descriptor of burn severity and influences the volume of resuscitation required in burn patients. The incidence and severity of TBSA overestimation by referring institutions (RIs) in children transferred to a burn center (BC) are unclear. The association between TBSA overestimation and overresuscitation is unknown as is that between TBSA overestimation and outcome. The trauma registry at a BC was queried over 7.25 years for children presenting with burns. TBSA estimate at RIs and BC, total fluid volume given before arrival at a BC, demographic variables, and clinical variables were reviewed. Nearly 20 per cent of children arrived from RIs without TBSA estimation. Nearly 50 per cent were overestimated by 5 per cent or greater TBSA and burn sizes were overestimated by up to 44 per cent TBSA. Average TBSA measured at BC was 9.5 ± 8.3 per cent compared with 15.5 ± 11.8 per cent as measured at RIs (P < 0.0001). Burns between 10 and 19.9 per cent TBSA were overestimated most often and by the greatest amounts. There was a statistically significant relationship between overestimation of TBSA by 5 per cent or greater and overresuscitation by 10 mL/kg or greater (P = 0.02). No patient demographic or clinical factors were associated with TBSA overestimation. Education efforts aimed at emergency department physicians regarding the importance of always calculating TBSA as well as the mechanics of TBSA estimation and calculating resuscitation volume are needed. Further studies should evaluate the association of TBSA overestimation by RIs with adverse outcomes and complications in the burned child.
How useful are disability services in the current higher education for college students with psychiatric disabilities? The purpose of this research paper is to answer this question by exploring an agenda of accommodation and support at a disabilities service center for college students with psychiatric disabilities. Two studies were conducted using questionnaires to collect data from students （study 1） and staffs （teaching and clerical staff） （study 2） in higher education. The ...
families on USAF and Army installations. The mission of AAFES is to provide quality goods and services at competitively low prices and generate...quality goods and services at competitively low prices and generate earnings to support morale, welfare, and recreation (MWR) programs (AAFES 2008...Court Building 12 3,773 Remain in current location with expansion planned. Car Care Center Building 501 1,250 Remain in current location Starbucks
Full Text Available Background Given that the protection of children's health is of special importance due to their special age and physical conditions, the present study aimed to investigate the condition of children's Geographic access to health services (Health Centers and Clinical Laboratories in Kermanshah city, Iran. Materials and Methods: In this applied study, the research approach was descriptive-analytic using quantitative models in Geographic information system (GIS environment. The statistical population was the whole population of young girls aged 0-14 years old in Kermanshah, Iran. Moreover, to evaluate the spatial deployment pattern of health services and the correct and true access of this groupto such services, all data and information were collected through the Iranian Statistics Center and evaluated using the Arc-GIS Software. The latest published population statistics on the Population and Housing Census in 2011 were considered the basis for the analyses. Results: The results of the present study demonstrated that more than 40% and 60% of the young girls aged 0-14 years old in Kermanshah were deprived of proper access to health centers and clinical laboratories, respectively. In terms of the status of children’s access in the Second Scenario (access to health services by vehicles and during 5, 10, and 15 minutes, about 5.53%, 93.1% and 15.1% lacked access to health centers, respectively. In addition, in terms of the status of children’s access to clinical laboratories during 5, 10, and 15 minutes, 17.26%, 65.4% and 51% lacked access to clinical laboratories, respectively. Conclusion: The access of young girls aged 0-14 years old to health services in Kermanshah was undesirable in the access to health services through walking. Additionally, the access of this groupto health services in the access to health services by vehicles was far better than the first one.
Wan, Fangjun; Xin, Zheng; Zhou, Lin; Bai, Li; Wang, Yongming; Gu, Shaohua; Liu, Shouqin; Li, Mengmeng; Sang, Shaowei; Zhang, Ji; Liu, Qiyong
To find out the differences in regional characteristics of heat vulnerability between people living in urban centers and urban-fringe areas of Jinan city so as to provide basis for the development of adaptation measures to heat. A cross-sectional survey on heat vulnerability was conducted in urban center and urban-fringe areas of Jinan city, using a self-designed questionnaire among 801 residents at the age of 16 years or older in August 2013. Data of 23 indicators related to heat vulnerability were collected and aggregated to 7 dimensions:health and medical insurance, social networks, heat perception and adaptive behavior, economic status, resources, living environment and working environment. An index score was calculated using a balanced weighted average approach for each dimension, ranging from 0 to 1, with the closer to 1 as greater vulnerability. The scores on heat perception and adaptive behavior, economic status, resources and working environment dimensions for urban-fringe areas were 0.42,0.63,0.55 and 0.62, statistically significantly higher than the urban center area of 0.41,0.51,0.26 and 0.41. Scores of living environment, social networks and health/medical insurance dimensions for urban center area were 0.57,0.49 and 0.31, which were all higher than the urban-fringe areas of 0.50,0.46 and 0.25, with differences statistically significant. Residents living in the urban center might be more vulnerable to heat in terms of living environment, health/medical insurance and social networks while residents living in the urban-fringe areas might more be vulnerable in terms of heat perception and adaptive behavior, economic status, life resources and working environment. These facts indicated that heat vulnerability among residents could be quite different, even at a fine geographic sale. We would thus suggest that intervention strategies on protecting people from heat, should be more targeted.
Daněk, Jan; Vačkář, David; Lorencová, Eliška
Roč. 10, 1-2 (2017), s. 99-112 ISSN 1803-2451 R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:67179843 Keywords : ecosystem services * economic valuation * Protected Landscape Areas * forest ecosystems Subject RIV: EH - Ecology, Behaviour OBOR OECD: Environmental sciences (social aspects to be 5.7)
Jun 2, 2014 ... related problem, being consumer-oriented with diverse dimensions ... The order of importance of the factors is need, enabling, predisposing and health services. 11 variables .... influence utilization behavior, they have the advantage of reminding .... area and also from the researcher's personal knowledge.
Estuaries provide multiple ecosystem services from which humans benefit. Currently, thirty-six Great Lakes estuaries in the United States and Canada are designated as Areas of Concern (AOCs) due to a legacy of chemical contamination, degraded habitat, and non-point-source polluti...
Foko, Thato E
Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...
Cattapan, Paolo; Passarelli, Mariacarmela; Petrone, Michele
This paper contributes to the literature on innovation brokerage by analysing the effects of brokerage activities on the innovation and growth of small and medium-sized enterprises (SMEs). The authors provide a detailed description of the Technology Transfer Service (TTS), credited as a European best-practice innovation broker, at Area Science…
This article presents the findings of a study that was undertaken in Kampala City, Uganda, in nine libraries belonging to the private sector, government, academic and diplomatic- related institutions. The aim of the study was to establish trends in marketing library services in urban areas with a view to identify marketing ...
Full Text Available Background: Regular IEC programs during antenatal and intranatal period, through individual or group approach, brings desirable changes in health practices of people, resulting in a healthy mother and a healthy baby. Materials and Methods: This study was conducted to assess the level of IEC services regarding pregnancy and child care, received by the women at an MCH clinic of an urban health center, where the study subjects comprised 400 antenatal (AN and postnatal (PN women and mothers of children under five years. Results: Warning signs of danger was explained to only 10% of the AN and PN women. Advice regarding family planning appeared to be the most frequently covered, though that too was explained to less than half of the subjects. About one third of the women were advised on breast feeding. Only 8% of the mothers had been told about all issues regarding pregnancy and child care. Breast feeding and weaning was properly explained to 85.7 and 81.1% of the total mothers of U5 children. Advice regarding subsequent nutrition was given to 60.9% of mothers. About only a quarter of the total mothers were advised on home management of diarrhea and acute respiratory infections. Very few mothers were counseled about the growth pattern of the children and none were shown the growth chart. Only 12.9% of the mothers were informed about all issues. Conclusion: IEC regarding maternal and child care other than feeding practices is a neglected service in the health facility where the study was conducted.
Gleason, J. L.; Little, M. M.
NASA science and engineering efforts rely heavily on compute and data handling systems. The nature of NASA science data is such that it is not restricted to NASA users, instead it is widely shared across a globally distributed user community including scientists, educators, policy decision makers, and the public. Therefore NASA science computing is a candidate use case for cloud computing where compute resources are outsourced to an external vendor. Amazon Web Services (AWS) is a commercial cloud computing service developed to use excess computing capacity at Amazon, and potentially provides an alternative to costly and potentially underutilized dedicated acquisitions whenever NASA scientists or engineers require additional data processing. AWS desires to provide a simplified avenue for NASA scientists and researchers to share large, complex data sets with external partners and the public. AWS has been extensively used by JPL for a wide range of computing needs and was previously tested on a NASA Agency basis during the Nebula testing program. Its ability to support the Langley Science Directorate needs to be evaluated by integrating it with real world operational needs across NASA and the associated maturity that would come with that. The strengths and weaknesses of this architecture and its ability to support general science and engineering applications has been demonstrated during the previous testing. The Langley Office of the Chief Information Officer in partnership with the Atmospheric Sciences Data Center (ASDC) has established a pilot business interface to utilize AWS cloud computing resources on a organization and project level pay per use model. This poster discusses an effort to evaluate the feasibility of the pilot business interface from a project level perspective by specifically using a processing scenario involving the Clouds and Earth's Radiant Energy System (CERES) project.
Qin, Zhang-jian; Chen, Chuan; Luo, Jun-song; Xie, Xing-hong; Ge, Liang-quan [School of Information Science & Technology, Chengdu University of Technology, Chengdu (China); Wu, Qi-fan [Department of Engineering Physics, Tsinghua University, Beijing (China)
Wavelet analysis is commonly used to detect and localize peaks within a signal, such as in Gamma-ray energy spectra. This paper presents a peak area estimation method based on a new wavelet analysis. Another Mexican Hat Wavelet Signal (MHWS) named after the new MHWS is obtained with the convolution of a Gaussian signal and a MHWS. During the transform, the overlapping background on the Gaussian signal caused by Compton scattering can be subtracted because the impulse response function MHWS is a second-order smooth function, and the amplitude of the maximum within the new MHWS is the net height corresponding to the Gaussian signal height, which can be used to estimate the Gaussian peak area. Moreover, the zero-crossing points within the new MHWS contain the information of the Gaussian variance whose valve should be obtained when the Gaussian peak area is estimated. Further, the new MHWS center is also the Gaussian peak center. With that distinguishing feature, the channel address of a characteristic peak center can be accurately obtained which is very useful in the stabilization of airborne Gamma energy spectra. In particular, a method for determining the correction coefficient k is given, where the peak area is calculated inaccurately because the value of the scale factor in wavelet transform is too small. The simulation and practical applications show the feasibility of the proposed peak center and area estimation method.
Kawulok, M.; Sulimowski, Z.
Due to ground deformations caused by underground mining, building structures in mining areas are frequently subjected to considerable deformations and damage to the finishing and structural elements. As a consequence, serviceable values of such structures are distinctly diminished, and in extreme cases, seriously damaged structures may be exempted from further service. These problems are not duly represented in the existing building standard codes. It is also important to determine relationship between damage stage and value of the building, and hence the strategy for reconstruction or renovation works. The paper presents proposals concerning serviceability criteria of building structures in mining areas, in terms of basic standard requirements valid in building in Poland, as well as proposals of Eurocodes. Building structures under consideration have been divided into structures designed to resist mining influences and existing structures, not adapted to conform to these influences at the design and erection stages
Liu, Ya Ru; Wang, Cong; Yan, Li Jiao
Under the rapid urbanization, quantitatively assessing the impacts of land use and cover change (LUCC) on ecosystem service is of great significance for regional ecological environment construction. Based on the land use maps of Shangqiu City (as the typical agricultural area of North China Plain) in the year of 1990, 2005 and 2015, the spatio-temporal dynamics of land use and ecosystem service were analyzed, and the impacts of LUCC on ecosystem services was quantified with the impact assessment model. The results showed that, from 1990 to 2015, farmland and construction land area, which covered more than 95% of the total area of the research area, changed the most in quantity as -104.38 and 201.59 km 2 respectively, while forestland, grassland and water area changed the most by 79.3%, -73.7% and -24.2%, respectively. The total value of ecosystem service continuously decreased by 1.005 billion yuan, among which the value of hydrolo-gical regulation service suffered the most. The value of ecosystem service (ESV) presented an increasing trend in the west and a decreasing trend in the east. Extending from the center of the city to the outside, the value of ecosystem services was "high-low-high" in the east to west direction. The rate of farmland and water area contributed more than 95% to the total ecosystem service value, which had the greatest impact. The main drivers for the changes of land use and ESV in Shangqiu were population pressure, economic growth, regional policy, and urban planning. In the urban and rural development planning of Shangqiu City, more attention should be paid to the protection of na-tural resources and rational adjustment of the land use structure to realize sustainable development based on the harmony of economy, society and environment.
Resendiz G, G.; Perez P, M.; Figueroa M, E. [Clinica Medica Sur, Servicio de Radioterapia, Puente de Piedra No. 150, Col. Toriello Guerra, Mexico 14050 D. F. (Mexico)
The General Regulation of Radiation Safety, it clearly provides the classification, requirements and obligations of the various figures relating to a radiation protection system, i.e., the occupationally exposed personnel, the radiation safety responsible, the legal representative, the type of installation, etc. For new installations, the shieldings calculation should be contained in the analytical report with due consideration of factors, such as those surrounding the areas classification based on the occupation type, the work load of the equipment and others. The operation license involves requirements such as the Report and the Radiation Safety Handbook, the Emergencies Plan, the establishment of register levels, investigation and intervention, the way it is carried out medical surveillance of the occupationally exposed personnel, and the description of the protection mechanisms and detection instrumentation and radiation measurement. Deserves mention the case when high readings are recorded in the personal dosimeters, which must submit to an interrogation to the employee, you must determine if it is an incorrect reading to the service provider, you must perform a medical exam blood cell count with relevant to the dose determination, may eventually can lead to a cytogenetic study and the determination to do if confirmed an unexpectedly high dose. Moreover, the technology evolution also implies the development of adaptation measures. For example, the Intensity Modulated Radiation Therapy, which is an advanced high-precision radiotherapy that uses X-ray accelerators for computer-controlled radiation doses precisely to a malignant tumor or specific areas within the tumor, taking into account requires regard to equipment, and space and shielding, time and staff hours for treatment, personnel training, materials for making images (such as two-dimensional arrangements of integrated circuits or diodes, films or portal images), the attention given by the engineers of
Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J
The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.
Marco Túlio Ospina Patino
Full Text Available The challenges faced for Multinational Companies (MTNs at elaboration and consolidation of their strategic planning, in a even more competitive global market, compel them to search for new alternatives to deal with this competitive environment, as well as, look for specific actions in structure and organizational development in order to increase investments and maximize profits. In this context, the MTNs adopt the model of the Shared Service Centers (SSCs where, after identifying the essential activities, they centralize their activities of support. This work analyzes three SSCs installed in Brazil. The enterprise A acts in the food market, beverages; the enterprise B works at the sweet drops market; and the enterprise C acts in the pharmaceutical industry. Even tough, at the beginning the localization factor do not represents too much impact in terms of cost reduction, the SSCs constant evolution and the benefits from process scaling or re-engineering, increase the importance of the geographical localization to maximize cost reduction with the qualified hand labor factor being a competitive differential.
The Defense Finance and Accounting Service Financial Systems Organization, under the control of the Deputy Director for Information Management, Defense Finance and Accounting Service, is responsible...
Hearty, Thomas; Savtchenko, Andrey; Vollmer, Bruce; Albayrak, Arif; Theobald, Mike; Esfandiari, Ed; Wei, Jennifer
This talk will describe the support and distribution of CO2 data products from OCO-2, AIRS, and ACOS, that are archived and distributed from the Goddard Earth Sciences Data and Information Services Center. We will provide a brief summary of the current online archive and distribution metrics for the OCO-2 Level 1 products and plans for the Level 2 products. We will also describe collaborative data sets and services (e.g., matchups with other sensors) and solicit feedback for potential future services.
AlBalkhi, Khalid M; AlShahrani, Ibrahim; AlMadi, Abdulaziz
The purpose of this study was to demonstrate how to establish the area center (centroid) of both the soft and hard tissues of the outline of the lateral cephalometric skull image, and to introduce the concept of a new non-anatomical centroid line. Lateral cephalometric radiographs, size 12 x 14 inch, of fifty seven adult subjects were selected based on their pleasant, balanced profile, Class I skeletal and dental relationship and no major dental malocclusion or malrelationship. The area centers (centroids) of both soft and hard tissue skull were practically established using a customized software computer program called the m -file . Connecting the two centers introduced the concept of a new non-anatomical soft and hard centroids line. (author)
Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.
In 1988, a review was conducted of the business component of associate in arts and associate in science (AS) degree programs, and of the certificate programs in business in Florida community colleges and area vocational-technical centers. Focusing primarily on business programs in marketing, general business management, and small business…
Schultz, Caroline; Seith, David
The Work Advancement and Support Center (WASC) program in Fort Worth was part of a demonstration that is testing innovative strategies to help increase the income of low-wage workers, who make up a large segment of the U.S. workforce. The program offered services to help workers stabilize their employment, improve their skills, and increase their…
Full Text Available AIM: To observe the application of Suresight handheld auto-refractometer in measuring diopter of infants in Community Health Service Center. METHODS:Totally 836 cases(1 672 eyesfrom June 2013 to December 2013 were examined diopter of infants by Suresight handheld auto-refractometer in Community Health Service Center. RESULTS: Within 1 672 eyes of 836 infants were examined, 202 eyes were diagnosed ametropia, 38 eyes were suspicious, 240 eyes were transferred to the department of ophthalmology, the referral rate was 14.35%; 172 eyes were diagnosed ametropia, and the diagnosis rate of the referral patients was 71.67%. Among 172 eyes, 46 eyes were provided with corrected glasses, accounting for 2.75% of the number of screening, and 126 eyes were given intensive monitoring, accounting for 7.54% of the number of screening.CONCLUSION: Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center is convenient and effective. With two-way referral between community health service center and department of ophthalmology can monitor and intervene vision development of infants much earlier.
Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F
The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.
Dyson, Kate; Kruger, Estie; Tennant, Marc
This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Full Text Available Objectives: The present study was attempted to assess the perception of patients on ART about the services availed at Link ART Centers (LAC in selected states of India. Methods: A total of 354 PLHAs were selected from 20 systematic randomly selected LACs from Gujarat, Maharashtra, Rajasthan and Uttar Pradesh. Results: Study reveals that majority (97% of the patients seeking services from LACs made regular visits to the center. It was found that 57 percent of the patients had spent less than 100 rupees during the last visit. More than 95 percent of the clients reported waiting time less than 30 minutes for availing counseling and collection of drugs at LACs. The mean±SD score of patient’s level of satisfaction with the services availed at LACs is 4.7±0.5. Conclusions: Study concludes that while majority of the patients were satisfied with the services at LACs, there is need of strengthening the existing ‘package’ of services in these centers and expand the network across the country.
Full Text Available Objectives: The present study was attempted to assess the perception of patients on ART about the services availed at Link ART Centers (LAC in selected states of India. Methods: A total of 354 PLHAs were selected from 20 systematic randomly selected LACs from Gujarat, Maharashtra, Rajasthan and Uttar Pradesh. Results: Study reveals that majority (97% of the patients seeking services from LACs made regular visits to the center. It was found that 57 percent of the patients had spent less than 100 rupees during the last visit. More than 95 percent of the clients reported waiting time less than 30 minutes for availing counseling and collection of drugs at LACs. The mean±SD score of patient’s level of satisfaction with the services availed at LACs is 4.7±0.5. Conclusions: Study concludes that while majority of the patients were satisfied with the services at LACs, there is need of strengthening the existing ‘package’ of services in these centers and expand the network across the country.
Full Text Available Protected areas around the world are increasingly being recognized for their potential to protect various ecosystem services in addition to biodiversity. We carried out an ecosystem services (ES assessment at the Rizoelia National Forest Park, a biodiversity hotspot in Cyprus. For ES assessment we used TESSA v.1.1 and an ES matrix-approach to map the capacity of habitat types in the area. According to TESSA the most important ES provided by the study area are aesthetic benefits, recreation/ tourism, biodiversity, global climate regulation, and environmental education. Total Carbon stock was estimated to 14247.327 tonnes and the total number of annual visits was 14471. There were no statistically significant differences in the number of visits among visitation periods but there were statistically significant differences among National Holidays, Weekends and Weekdays. We identified that plantations had the highest capacity for most groups of services particularly where their understory comprises semi-natural habitat types rich in biodiversity. This is the first study in Cyprus which provides a preliminary quantification of ES in a protected area context using widely employed tools. The paper discusses how these findings can help decision-makers to plan direct future restoration and management actions to the benefit of a wide range of stakeholders.
DeCarlo, S.; Potemra, J. T.; Wang, K.
The International Pacific Research Center (IPRC) at the University of Hawaii maintains a data center for climate studies called the Asia-Pacific Data-Research Center (APDRC). This data center was designed within a center of excellence in climate research with the intention of serving the needs of the research scientist. The APDRC provides easy access to a wide collection of climate data and data products for a wide variety of users. The data center maintains an archive of approximately 100 data sets including in-situ and remote data, as well as a range of model-based output. All data are available via on-line browsing tools such as a Live Access Server (LAS) and DChart, and direct binary access is available through OPeNDAP services. On-line tutorials on how to use these services are now available. Users can keep up-to-date with new data and product announcements via the APDRC facebook page. The main focus of the APDRC has been climate scientists, and the services are therefore streamlined to such users, both in the number and types of data served, but also in the way data are served. In addition, due to the integration of the APDRC within the IPRC, several value-added data products (see figure for an example using Argo floats) have been developed via a variety of research activities. The APDRC, therefore, has three main foci: 1. acquisition of climate-related data, 2. maintenance of integrated data servers, and 3. development and distribution of data products The APDRC can be found at http://apdrc.soest.hawaii.edu. The presentation will provide an overview along with specific examples of the data, data products and data services available at the APDRC.; APDRC product example: gridded field from Argo profiling floats
Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping
Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P neglect (P abuse, and to increase the rate of registry. Cases of physical abuse had a higher Injury Severity Score, longer duration of hospitalization, and more injuries of head, face, and neck compared with other types of abuse. The reported rate of neglect was highly elevated after the CPMSDC established during the study period. Recognition of neglect is not easy, but the consequent injury, especially
Ramos Cordero, Primitivo; López Trigo, José Antonio; Maíllo Pedraz, Herminio; Paz Rubio, José María
Physical and pharmacological restraints are a controversial issue in the context of geriatric care due to their moral, ethical, social and legal repercussions and, despite this fact, no specific legislation exists at a national level. The use of restraints is being questioned with growing frequency, as there are studies that demonstrate that restraints do not reduce the number of falls or their consequences, but rather can increase them, cause complications, injuries and potentially fatal accidents. Restraints are not always used rationally, despite compromising a fundamental human right, that is, freedom, protected in the Constitution, as well as values and principles, such as dignity and personal self-esteem. There are centers where restraints are applied to more than 50% of patients, and in some cases without the consent of their legal representatives. On some occasions, restraints are used for attaining organizational or environmental objectives, such as complying with tight schedules, and for reducing or avoiding the supervision of patients who walk erratically and, at times, are used indefinitely. Even greater confusion exists with respect to the emerging concept of chemical or pharmacological restraints, since no conceptual framework exists based on scientific evidence, and with sufficient consensus for guiding healthcare workers. In this context, the Sociedad Española de Geriatría y Gerontología (SEGG--Spanish Geriatrics and Gerontology Society), aware of the significance and transcendence of the issue, and in an attempt to preserve and guarantee maximum freedom, dignity and self-esteem, on the one hand, and to ensure the maximum integrity and legal certainty of the persons cared for in geriatric and gerontology services and centers, on the other, decided to create an "Interdisciplinary Committee on Restraints" made up by members from different disciplines and members of SEGG Working Groups or Committees, external health care workers, groups
Johnson, Jill W. (Compiler)
This Corrective Measures Implementation (CMI) Progress Report documents: (i) activities conducted as part of supplemental assessment activities completed from June 2009 through November 2014; (ii) Engineering Evaluation (EE) Advanced Data Packages (ADPs); and (iii) recommendations for future activities related to corrective measures at the Site. Applicable meeting minutes are provided as Appendix A. The following EE ADPs for CRHE are included with this CMI Progress Report: center dot Supplemental Site Characterization ADP (Step 1 EE) (Appendix B) center dot Site Characterization ADP (Step 1 EE) for Hot Spot 1 (HS1) (Appendix C) center dot Remedial Alternatives Evaluation (Step 2 EE) ADP for HS1 (Appendix D) center dot Interim Measures Work Plan (Step 3 EE) ADP for HS1 (Appendix E) center dot Site Characterization ADP (Step 1 EE) ADP for Hot Spot 2 (HS2), High Concentration Plume (HCP), and Low Concentration Plume (LCP) (Appendix F) A summary of direct-push technology (DPT) and groundwater monitoring well sampling results are provided in Appendices G and H, respectively. The Interim Land Use Control Implementation Plan (LUCIP) is provided as Appendix I. Monitoring well completion reports, other applicable field forms, survey data, and analytical laboratory reports are provided as Appendices J through M, respectively, in the electronic copy of this document. Selected Site photographs are provided in Appendix N. The interim groundwater monitoring plan and document revision log are included as Appendices O and P, respectively. KSC Electronic Data Deliverable (KEDD) files are provided on the attached compact disk.
Ascoli, Peter A.; Haddock, Michael H.
An Orion Crew Module Service Module Structural Weight and Center of Gravity Simulator and a Vehicle Motion Simulator Hoist Structure for Orion Service Module Umbilical Testing were designed during a summer 2014 internship in Kennedy Space Centers Structures and Mechanisms Design Branch. The simulator is a structure that supports ballast, which will be integrated into an existing Orion mock-up to simulate the mass properties of the Exploration Mission-1 flight vehicle in both fueled and unfueled states. The simulator mimics these configurations through the use of approximately 40,000 lbf of steel and water ballast, and a steel support structure. Draining four water tanks, which house the water ballast, transitions the simulator from the fueled to unfueled mass properties. The Ground Systems Development and Operations organization will utilize the simulator to verify and validate equipment used to maneuver and transport the Orion spacecraft in its fueled and unfueled configurations. The second design comprises a cantilevered tripod hoist structure that provides the capability to position a large Orion Service Module Umbilical in proximity to the Vehicle Motion Simulator. The Ground Systems Development and Operations organization will utilize the Vehicle Motion Simulator, with the hoist structure attached, to test the Orion Service Module Umbilical for proper operation prior to installation on the Mobile Launcher. Overall, these two designs provide NASA engineers viable concepts worthy of fabricating and placing into service to prepare for the launch of Orion in 2017.
Huntington, Ciara R; Blair, Laurel J; Cox, Tiffany C; Prasad, Tanushree; Kercher, Kent W; Augenstein, Vedra A; Heniford, B Todd
To reduce costs, the Centers for Medicare and Medicaid Services (CMS) implemented new policies governing which patients are automatically admitted as inpatients (staying greater than "two midnights") and which require additional justification with physician documentation to be admitted. This study examines procedures missing from the Medicare Inpatient Only (MIO) list and uses national data to evaluate its appropriateness. Non-MIO procedures were identified from the current MIO list. Utilizing relevant billing codes, procedures were queried in the National Surgery Quality Improvement Program database for length of stay (LOS), percentage requiring >2 day stay, and inpatient status from 2005 to 2012. In addition, a separate analysis was performed for patients 65 years old or older who would qualify for Medicare. A majority of patients stayed more than 2 days for several procedures not included on the MIO list (% staying >2 days, mean LOS), including component separation (79.1%, 5.9 ± 12.3 days), diagnostic laparoscopy (64.2%, 5.5 ± 11.9 days), laparoscopic splenectomy (60.0%, 9.0 ± 13.6 days), open recurrent ventral hernia repair (58.2%, 6.3 ± 9.0 days), laparoscopic esophageal surgery (46.4%, 5.3 ± 13.3 days), and laparoscopic ventral hernia repair (24.7%, 2.5 ± 8.8 days). In patients ≥65 years, the average LOS was longer than the general population; for example, 40.2% of laparoscopic appendectomies and 38.7% of laparoscopic cholecystectomies in this older group required more than two nights in the hospital. In 92.3% of procedures examined, patients ≥65 years required greater than two nights in the hospital with an average LOS of 2.5-10.7 days. Commonly encountered non-MIO surgical procedures have national precedents for inpatient status. Before enacting policy, CMS and other regulatory bodies should consider current data to ensure rules are evidence-based and applicable.
Khair, H.; Putri, C. N.; Dalimunthe, R. A.; Matsumoto, T.
Municipal solid waste (MSW) management is still an issue in many cities in Indonesia including Medan. Understanding the waste generation, its characteristic and communities involvement could provide effective solid waste management. This research compares waste generation from people who live in the city center and suburban area. The research also examines the willingness and participation of community about environmental aspect, especially solid waste management. The method of waste generation used Indonesian Nasional Standard 19-3964-1994. The city center generates 0.295 kg/person/day of solid waste and 0.180 kg/person/day for suburbs. The result showed that there are the common amount of waste compositions between the city center and suburban area. The majority waste composition was an organic fraction. Questionnaires were distributed to examine the community awareness. The descriptive statistic used to analyze the data. The result showed that people living in the city center are slightly higher in community awareness than in the suburb. This paper highlights that area of living could give some effect to solid waste generation, waste composition and rate of awareness.
Maslow, Carey B; Friedman, Stephen M; Pillai, Parul S; Reibman, Joan; Berger, Kenneth I; Goldring, Roberta; Stellman, Steven D; Farfel, Mark
We assessed associations between new-onset (post-September 11, 2001 [9/11]) lower respiratory symptoms reported on 2 surveys, administered 3 years apart, and acute and chronic 9/11-related exposures among New York City World Trade Center-area residents and workers enrolled in the World Trade Center Health Registry. World Trade Center-area residents and workers were categorized as case participants or control participants on the basis of lower respiratory symptoms reported in surveys administered 2 to 3 and 5 to 6 years after 9/11. We created composite exposure scales after principal components analyses of detailed exposure histories obtained during face-to-face interviews. We used multivariate logistic regression models to determine associations between lower respiratory symptoms and composite exposure scales. Both acute and chronic exposures to the events of 9/11 were independently associated, often in a dose-dependent manner, with lower respiratory symptoms among individuals who lived and worked in the area of the World Trade Center. Study findings argue for detailed assessments of exposure during and after events in the future from which potentially toxic materials may be released and for rapid interventions to minimize exposures and screen for potential adverse health effects.
Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and
Bärnighausen, Till; Bloom, David E
In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes
Beg Prasad Garbuja
Full Text Available This study focuses on exploring the status and contribution of inter- linkage relationship between service center and rural hinterland. The study was conducted in Bima and Darbang Village Development Committees (VDCs of Myagdi district. This paper has used rural development perspective. The respondents were from 63 sample households including producers, consumers and service providers selected by using probability and non probability sampling methods. The primary data were collected through survey questionnaire, key informant interview, participant observation and focus group discussion whereas secondary data were generated from published and unpublished books, articles, journals, profile of VDCs and DDC. The study has revealed with various types of linkage between service center and rural hinterland i.e. service delivery, spatial or physical, administrative, economic, technological, financial and socio-cultural, educational and health service linkage. The study also highlighted productive role of remittance, international experience and adaptation of modern agriculture technology that has been positively affecting socio-economic life of the rural people. Further, joint efforts of public and private sectors’ and local stakeholders’ can be applied for developing and promoting service delivery opportunities and marketing facilities to the local people. The finding of the study has very strong implications to the local stakeholders for formulation of short run and long run local development plan in a similar situation.
According to the current IEEE 802.11 wireless LAN standards, IEEE 802.11 ad hoc networks have the limitation that all STAs (Stations) are in the one-hop transmission range of each other. In this paper, to alleviate the limitation of IEEE 802.11 ad hoc networks we propose the efficient method for selecting the most appropriate pseudo AP (Access Point) from among the set of ad hoc STAs and extending the service area of IEEE 802.11 ad hoc networks by the pseudo AP's relaying the internal traffic of IEEE 802.11 ad hoc networks. Numerical examples show that the proposed method significantly extends the service area of IEEE 802.11 ad hoc networks.
A wide-area service water system is required to be more resistant to emergency situations, e.g., drought and hazards, and meet consumers' diversifying needs in each area, while stably supplying water at ordinary times by utilizing purification plants located in places within its system and piping networks in the water area. Fuji Electric is providing information management systems for wide-area service water systems, developed based on the company's abundant system know-hows accumulated for a long time and latest techniques. They are characterized by (1) Web monitoring, aided by an intranet system, (2) high-speed data transmission by a digital transmission system, (3) open network environments, and (4) emergency calling of the staff, and management of stock materials. The system allows to monitor operating conditions within the area on real time, needless to say, and business administration with civil minimum taken into consideration, e.g., stabilizing water quality by coordinating the purification plants within the system. (translated by NEDO)
Full Text Available The article herein deals with a topic of current interest, not only because the latest economic and social phenomena within the context of globalized crisis in the world, but also from the perspective of the evolution and specific processes in the medical area in Romania. The writer accomplishes a journey into the various medical systems in national economies, by analyzing the features of each type of system and the opportunity for a ‘capitalist’ vision related to the healthcare services in general. The dental medical services share a series of characteristics that help them be better defined from the point of view of provider-customer relation. Thus, it becomes evident that, for Romania, the process initiated in 2006 meaning liberalization of practicing the dental doctor profession represents a natural way of developing the market specific to such services. From this perspective, this issue targets the mentalities level only – to impose quality standards on the market and to witness the offer-demand balance, both deriving from the specific nature itself of the dental services. The involvement of the authorities at Health Department into developing a health insurance policy in the dental field and the support of the private initiative in the underserved areas are the main targets of the ‘reform’.
Matsumura, Kouji; Antoku, Yasuaki; Inoue, Reika; Kobayashi, Mariko; Hanada, Eisuke; Iwasaki, Yasutaka; Kumagai, Yasushi; Iwamoto, Haruya; Tsuchihashi, Saburo; Iwaki, Miho; Kira, Jun-ichi; Nose, Yoshiaki
A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered
Szczerbinska, Barbara [Texas A& M University Corpus Christi, Madison, SD (United States)
For last six years Center for Theoretical Underground Physics and Related Areas (CETUP*) successfully provided a stimulating environment for creative thinking and open communication between researches of varying ages and nationalities in dynamic atmosphere of intense scientific interactions. Ongoing and proposed Neutrino and Dark Matter experiments are expected to unveil the answers to fundamental questions about the Universe. CETUP*2016 was focused exactly on these subjects bringing together experts in dark matter, neutrino physics, particle and nuclear physics, astrophysics and cosmology from around the world. Scientists invited to participate in the program not only provided theoretical support to the underground science, but they also examined core questions including: What is the nature of dark matter?, What is the origin of the neutrino masses?, How well do we know the neutrino parameters?, How have neutrinos shaped the evolution of the universe?, , What are the fundamental underlying symmetries of the Universe? Is there a Grand Unified Theory of the Universe? and many others. The 2016 CETUP* summer program consisted of three sessions (June 6 – July 16, 2016) covering various aspects of theoretical and experimental neutrino physics, unification and dark matter. The two week long session on Physics and Instrumentation of the Near Detector for the Long-Baseline Neutrino Experiments (June 6 – June 16) was followed by the two week long Neutrino Physics/Unification session: “From Grand Unification to String Theory and Back” (June 20 – July 2). The program ended with two week long session on Dark Matter Physics (July 4 – July 16). This six-week long program allowed for thorough discussions and an effective and comprehensive analysis of topics related to Dark Matter, Dark Energy, Neutrino Physics including astrophysical neutrinos, near and far detector physics, neutrino interactions, Higgs Boson, Inflation, Leptogenesis and many others that will advance
Szczerbinska, Barbara [Dakota State Univ., Madison, SD (United States)
In response to an increasing interest in experiments conducted at deep underground facilities around the world, in 2010 the theory community has proposed a new initiative - a Center for Theoretical Underground Physics and Related Areas (CETUP*). The main goal of CETUP* is to bring together people with different talents and skills to address the most exciting questions in particle and nuclear physics, astrophysics, geosciences, and geomicrobiology. Scientists invited to participate in the program do not only provide theoretical support to the underground science, they also examine underlying universal questions of the 21st century including: What is dark matter?, What are the masses of neutrinos?, How have neutrinos shaped the evolution of the universe?, How were the elements from iron to uranium made?, What is the origin and thermal history of the Earth? The mission of the CETUP* is to promote an organized research in physics, astrophysics, geoscience, geomicrobiology and other fields related to the underground science via individual and collaborative research in dynamic atmosphere of intense scientific interactions. Our main goal is to bring together scientists scattered around the world, promote the deep underground science and provide a stimulating environment for creative thinking and open communication between researches of varying ages and nationalities. CETUP*2014 included 5 week long program (June 24 – July 26, 2013) covering various theoretical and experimental aspects of Dark Matter, Neutrino Physics and Astrophysics. Two week long session focused on Dark Matter (June 24-July 6) was followed by two week long program on Neutrino Physics and Astrophysics (July 15-26). The VIIth International Conference on Interconnections between Particle Physics and Cosmology (PPC) was sandwiched between these sessions (July 8-13) covering the subjects of dark matter, neutrino physics, gravitational waves, collider physics and other from both
Braekers, K.; Caris, A.; Janssens, G.K.
This paper deals with the operational planning of drayage operations in the service area of intermodal container terminals. Drayage operations refer to the full truckload container transpot activities that take place on a regional scale around these terminals. They involve the transport of loaded and empty containers between container terminals, container depots, consignees and shippers. Drayage operations are mostly performed by truck and constitute a large part of total costs of an intermo...
Svoboda, M. D.; Hayes, M. J.; Knutson, C. L.; Wardlow, B. D.
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
Dubois, Gregoire; Hartley, Andrew; Peedell, Stephen; de Jesus, Jorge; Ó Tuama, Éamonn; Cottam, Andrew; May, Ian; Fisher, Ian; Nativi, Stefano; Bertrand, Francis
The Digital Observatory for Protected Areas (DOPA) is a biodiversity information system currently developed as an interoperable web service at the Joint Research Centre of the European Commission in collaboration with other international organizations, including GBIF, UNEP-WCMC, Birdlife International and RSPB. DOPA is designed to assess the state and pressure of Protected Areas (PAs) and to prioritize them accordingly, in order to support decision making and fund allocation processes. To become an operational web service allowing the automatic monitoring of protected areas, DOPA needs to be able to capture the dynamics of spatio-temporal changes in habitats and anthropogenic pressure on PAs as well as the changes in the species distributions. Because some of the most valuable natural ecosystems and species on the planet cover large areas making field monitoring methods very difficult for a large scale assessment, the automatic collection and processing of remote sensing data are processes at the heart of the problem. To further be able to forecast changes due to climate change, DOPA has to rely on an architecture that enables it to communicate with the appropriate modeling web services. The purpose of this presentation is to present the architecture of the DOPA with special attention to e-Habitat, its web processing service designed for assessing the irreplaceability of habitats as well as for the modeling of habitats under different climate change scenarios. The use of open standards for spatial data and of open source programming languages for the development of the core functionalities of the system are expected to encourage the participation of the scientific community beyond the current partnerships and to favour the sharing of such an observatory which could be installed at any other location. Acknowledgement: Part of this work is funded under the 7th Framework Programme by the EuroGEOSS (www.eurogeoss.eu) project of the European Commission. The views
Full Text Available The objectives of this research were 1 to study the current and the expected Conditions of school management effectiveness, Buriram Office of Primary Educational Service Area 4 and 2 to construct administrative strategies of such schools. Eighty of directors, board chairpersons, teachers and parents were sampled. The instruments for data collection were 5-level rating scale questionnaires with the IOC value between 0.60–1.00 and the reliability value of 0.88 and in-depth interview forms. Quantitative data were analyzed by computer and qualitative data were inductively analyzed. The findings were as follows: 1. The current conditions school management effectiveness, Buriram Office of Primary Educational Service Area 4 was moderate while the expected conditions was high. By means of expected condition can be listed from high to low were atmosphere and environment management, administration, learning management and participation. 2. Strategies for effective management of schools under the Office of Educational Service Area 4 consists of four elementary Bachelor’s strategy is the first strategic development, management efficiency. 2 learners develop strategies to meet educational standards. Strategy 3: create an atmosphere and environment conducive to development. Strategy 4 and the joint cooperation of network.
Full Text Available High mountain areas are experiencing some of the earliest and greatest impacts of climate change. However, knowledge on how climate change impacts multiple ecosystem services that benefit different stakeholder groups remains scattered in the literature. This article presents a review of the literature on climate change impacts on ecosystem services benefiting local communities and tourists in high mountain areas. Results show a lack of studies focused on the global South, especially where there are tropical glaciers, which are likely to be the first to disappear. Climate change impacts can be classified as impacts on food and feed, water availability, natural hazards regulation, spirituality and cultural identity, aesthetics, and recreation. In turn, climate change impacts on infrastructure and accessibility also affect ecosystem services. Several of these impacts are a direct threat to the lives of mountain peoples, their livelihoods and their culture. Mountain tourism is experiencing abrupt changes too. The magnitude of impacts make it necessary to strengthen measures to adapt to climate change in high mountain areas.
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services (OSERS); Overview... from the Office of Special Education and Rehabilitative Services. The pre-application meeting will be.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-11007...
Ethelwynn L. Stellenberg
Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa. Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test. Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
Stellenberg, Ethelwynn L
Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
Verhagen, Willem; Kukkala, Aija S; Moilanen, Atte; van Teeffelen, Astrid J A; Verburg, Peter H
Policies and research increasingly focus on the protection of ecosystem services (ESs) through priority-area conservation. Priority areas for ESs should be identified based on ES capacity and ES demand and account for the connections between areas of ES capacity and demand (flow) resulting in areas of unique demand-supply connections (flow zones). We tested ways to account for ES demand and flow zones to identify priority areas in the European Union. We mapped the capacity and demand of a global (carbon sequestration), a regional (flood regulation), and 3 local ESs (air quality, pollination, and urban leisure). We used Zonation software to identify priority areas for ESs based on 6 tests: with and without accounting for ES demand and 4 tests that accounted for the effect of ES flow zone. There was only 37.1% overlap between the 25% of priority areas that encompassed the most ESs with and without accounting for ES demand. The level of ESs maintained in the priority areas increased from 23.2% to 57.9% after accounting for ES demand, especially for ESs with a small flow zone. Accounting for flow zone had a small effect on the location of priority areas and level of ESs maintained but resulted in fewer flow zones without ES maintained relative to ignoring flow zones. Accounting for demand and flow zones enhanced representation and distribution of ESs with local to regional flow zones without large trade-offs relative to the global ES. We found that ignoring ES demand led to the identification of priority areas in remote regions where benefits from ES capacity to society were small. Incorporating ESs in conservation planning should therefore always account for ES demand to identify an effective priority network for ESs. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.
Lakhani, Ali; McDonald, Donna; Zeeman, Heidi
Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research
This thesis aims to find out about the influence of brand image, service quality and customer satisfaction to customer loyalty from Nokia phone users across Jakarta area. The method used in this study is a descriptive analysis of the census data collection system through the use of questionnaires to the respondents. Respondents in this study amounted to 200 people. Data processing technique and analysis of themodel using SPSS version 20 and the Structural Equation Model (SEM) with Lisrel 8.7 ...
for the clinical managemen t of all ages and populations affected by disasters and public health emergencies , in accordance with...Essential VII, Objective 9 8.0 Demonstrate knowledge of public health principles and practices for the managemen t of all ages and...Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204
Binda, Luigia; Cardani, Giuliana; Modena, Claudio; Valluzzi, Maria Rosa; Saisi, Antonella
After the earthquake that hit central Italy in 1979, many small historic centers were restored. A subsequent seismic event occurred in 1997 in Umbria-Marche regions revealed that some techniques used in the previous interventions were not successful due to low durability of new materials and/or incompatibility between the new and the existing materials and structures. An extensive investigation on four small typical historic centers in Umbria was carried out. The objectives of the research were: (i) to define a methodology for the vulnerability analysis of historic buildings at the level of the historic centre, (ii) to collect information on the effectiveness of the repair techniques both traditional and new, (iii) to set up Databases storing the information useful to prepare rescue plans, (iv) to use the collected knowledge for the implementation of reliable models for the vulnerability analysis, (v) to prepare guidelines for investigation and vulnerability analysis
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
Wicks, Angela M; Chin, Wynne W
The purpose of this research is to develop an alternative method of measuring out-patient satisfaction where satisfaction is the central construct. The Gap Model operationalized by SERVQUAL is widely used to measure service quality. However, the SERVQUAL instrument only measures expectations (resulting from the pre-process segment of the service experience) and perceptions (resulting from the post-process segment). All three segments should be measured. The lack of proper segmentation and methodological criticisms in the literature motivated this study. A partial least squares (PLS) approach, a form of structural equation modeling, is used to develop a framework to evaluate patient satisfaction in three service process segments: pre-process, process, and post-process service experiences. Results indicate that each process stage mediates subsequent stages, that the process segment is the most important to the patient and that the antecedents have differing impacts on patient satisfaction depending where in the process the antecedent is evaluated. Only one out-patient surgery center was evaluated. Patient satisfaction criteria specific to hospital selection are not included in this study. Results indicate what is important to patients in each service process segment that focus where ambulatory surgery centers should allocate resources. This study is the first to evaluate patient satisfaction with all three process segments.
Ronchi, Silvia; Salata, Stefano
Recently, in Italy, a legislative proposal has been set to reform the role and the functions of natural protected areas promoting their aggregation (or the abolition) pursuing a better efficiency for their administration and economic saving. The system of natural protected areas is composed of different conservation levels: there are the Natural parks, established in the ‘80 by national or regional institution for the safeguard of natural elements, the Natura 2000 -Habitat 92/43/CEE promoted by European Union, with conservation measures for maintaining or restoring habitats and species of Communitarian interest, and the local parks of supra-municipal interest (namely PLIS) created by single municipalities or their aggregation aimed at limiting the soil sealing process. The hierarchical level of protection has determined differences in the management of the areas which leads to various approaches and strategies for biodiversity conservation and integrity. In order to assess strengths and weaknesses of the legislative initiative, the new management framework should be designed, considering the ecosystem characteristics of each natural protected area to define the future opportunities and critics, rather than, in the extreme case, remove the level of protection due to the absence of valuable ecosystem conditions. The paper provides an operative support to better apply the legislative proposal investigating the dynamics that affect all protected areas using the land take process as a major threat to biodiversity conservation in natural zones. The land take process is explored using the Land Use Change analysis (LUCa) as a possible way to determine the impact and the environmental effects of land transitions. LUCa is also useful to determine the loss of protected zones capacity to support Ecosystem Services. Finally, the assessment of the Ecosystem Services Capacity (ESC) index expresses the ability of each LULC to provide ES and, in particular, the Ecological
Matuszek, J.M.; Strnisa, F.V.; Baxter, C.F.
A commercial radioactive waste burial site has operated since 1963 at the Western New York Nuclear Service Center. Solid low-level radioactive wastes are buried in trenches excavated from a very fine-grained heterogeneous mixture of silt and clay (silty till) and are then covered with the excavated material. Despite many operational precautions, water levels in three burial trenches rose to within a few centimeters of the covering material by late 1973. Activity levels of HTO, 90 Sr, and 137 Cs in trench water and core samples were measured to obtain preliminary information on the degree of subsurface radionuclide migration from the burial trenches into the surrounding soil. Tritium concentrations measured in void-space water from vertical cores appeared to peak in the cover material 1.5 to 2m below the ground surface. Concentrations of 90 Sr and 137 Cs in the silty till were greatest near the surface of the cover material. Concentrations of HTO and 90 Sr, measured in a series of slant-hole core samples collected until the trench was intercepted, showed tritium migration to have progressed less than 0.3m, while 90 Sr migration appeared to be somewhat less. The preliminary data suggest that: (a) radionuclide migration from the burial trenches into the undisturbed silty till is slight; (b) radioactivity in the surface soil is not necessarily caused by migration of trench water; (c) groundwater movement is not massive; (d) rainwater infiltration, with settlement and compaction of buried wastes, is the most likely cause of rising trench water levels; and (e) surface contamination may occur from spills during burial operations, from trench digging, and from deposition of stack effluents from a nearby nuclear fuel reprocessing plant. By January 1975 the steadily rising water levels in three trenches were approximately 1m above the undisturbed soil from which the trenches were excavated, resulting in increased radioactivity levels in local streams draining the site. To
Tsai, S.Y.; Smith, W.H.
Radiological surveys were conducted to determine the potential migration of radionuclides from the waste area to the area commonly referred to as the Back Forty, located in the southern portion of the ARC site. The survey results indicated that parts of the Back Forty contain soils contaminated with uranium, thorium, and their associated decay products. A hydrogeologic characterization study was conducted at the Back Forty as part of an effort to more thoroughly assess radionuclide migration in the area. The objectives of the study were: (1) to define the soil characteristics and stratigraphy at the site, (2) to describe the general conditions of each geologic unit, and (3) to determine the direction and hydraulic gradient of areal groundwater flow. The site investigation activities included literature review of existing hydrogeological data for the Albany area, onsite borehold drilling, and measurement of groundwater levels. 7 references, 9 figures, 2 tables
Gabriel L. Vides-Hernández
Full Text Available Increasing urbanization has led to natural ecosystems being constantly replaced by an urban landscape, a process that is very noticeable in El Salvador, due to its small territorial extension (21.041 km. and high population density (291 hab/km.. We performed an inventory in 12 urban green areas, with different sizes, shape and distances from the largest forest area in the metropolitan zone, based on the McArthur and Wilson’s (1967 island biogeography theory. We evaluated if the richness, diversity and equitability of birds were related to the size and distance of the green areas and if their shape had any effect on the richness of birds. We observed a total of 20 bird species and we classified them according to their diet (generalist and specialist. We observed that the distance did not influence the bird richness and that there was no interaction between size and distance variables, but the size of the green area did influence. The richness of birds with specialist diet increased in the more circular green areas than in the irregular ones. We conclude that in the urban center of San Salvador, the presence of large and circular green areas contributes more to the specialist diet birds’ richness, than areas of similar size but of irregular shape. However, small areas contribute more to the specialist diet birds’ richness, if its shape is more circular.
Bravo Santisteban, Ramiro D; Youm, Sekyoung; Park, Seung-Hun
Studies have demonstrated that technological innovation is vital for prosperous economies, and greater technological innovation leads to improved public health indicators. The South Korean government has implemented policies to provide city services using information communication technologies, and ubiquitous healthcare (u-healthcare) wellness is one of these. This article presents the effects of using a u-healthcare center model that proves self-healthcare monitoring can work for the general population. The u-healthcare center has provided service to the public since April 2013. It is equipped with medical devices that evaluate physiological parameters such as weight, body mass index (BMI), blood pressure (BP), pulse rate (PR), and body fat (BF). This article focuses on the analysis of BMI, BP, PR, and BF parameters. Health test results from 12,766 voluntary patients of the u-healthcare center were analyzed during a 1-year period. The four health parameters from each of the four seasons were analyzed and compared, showing statistically significant seasonal differences. A Duncan's post hoc analysis showed that BMI did not differ between spring and summer, whereas BP differed throughout all seasons. Participation of females was higher compared with males, and men's average BMI was statistically higher than that of the women. Some additional significant findings for all participants were as follows: 48.8% scored normal in BMI, 31.7% scored normal-controlled in BP, 90.7% scored normal in PR, and 24.8% scored normal in BF. A survey showed that 96.4% found the u-healthcare center to be generally helpful, and 95.7% responded that they would recommend it. Implementation of u-healthcare projects provides a new public service toward evaluating health parameters, providing historical health information access, promoting self-monitoring, and motivating users to be more aware of their own health status.
Doz Mora, J F; Mengual, L; Torné, M; Bonilla, P
To find the individual and socio-family characteristics of that sector of the population which uses Primary Care Social Services (PCSS) at the Primary Care Centre (PCC) and the social problems which occasion demand. A retrospective descriptive study, based on checking over social work case files. A PCC situated in Barcelona's second industrial belt, serving a population with a low socio-economic level. The population group under study were the users with social work files open from January 1st 1985 to July 31st 1991 (a total of 690 case histories). A representative sample of 296 was selected. In comparison with the population of the basic Health Area, the user population of the PCSS at the PCC was predominantly women, and had an older average age, a higher proportion of divorce/separation and widowhood, and, in the labour context, higher unemployment and retirement. A high proportion of one-parent families (12.8%) was found. Analysis of the work situation showed that 50% of the workers were temporary and 75% of the unemployed received no benefit. 51% of the retired people received the minimum pension and 11% received no pension. Monthly family income, recorded for 46.5% of the cases, was 75,362 pesetas (SD 37,643). The most common problems were those related to the "HEALTH" section (61%). The user population of the PCSS at the PCC is, in socio-economic terms, deteriorated, a condition closely related to the development of chronic illnesses. Tackling health inequalities from Primary Care is under discussion.
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Chevallereau, Christine; Pisla, Doina; Bleuler, Hannes; Rodić, Aleksandar
Medical and service robotics integrates several disciplines and technologies such as mechanisms, mechatronics, biomechanics, humanoid robotics, exoskeletons, and anthropomorphic hands. This book presents the most recent advances in medical and service robotics, with a stress on human aspects. It collects the selected peer-reviewed papers of the Fourth International Workshop on Medical and Service Robots, held in Nantes, France in 2015, covering topics on: exoskeletons, anthropomorphic hands, therapeutic robots and rehabilitation, cognitive robots, humanoid and service robots, assistive robots and elderly assistance, surgical robots, human-robot interfaces, BMI and BCI, haptic devices and design for medical and assistive robotics. This book offers a valuable addition to existing literature.
Kline, Ronald M; Muldoon, L Daniel; Schumacher, Heidi K; Strawbridge, Larisa M; York, Andrew W; Mortimer, Laura K; Falb, Alison F; Cox, Katherine J; Bazell, Carol; Lukens, Ellen W; Kapp, Mary C; Rajkumar, Rahul; Bassano, Amy; Conway, Patrick H
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations. Policy and technical decisions include the definition of the episode, including its initiation, duration, and included services; the identification of beneficiaries included in the model; and beneficiary attribution to practitioners with overall responsibility for managing their care. In addition, the calculation and risk adjustment of benchmark episode prices for the bundle of services must reflect geographic cost variations and diverse patient populations, including varying disease subtypes, medical comorbidities, changes in standards of care over time, the adoption of expensive new drugs (especially in oncology), as well as diverse practice patterns. Other steps include timely monitoring and intervention as needed to avoid shifting the attribution of beneficiaries on the basis of their expected episode expenditures as well as to ensure the provision of necessary medical services and the development of a meaningful link to quality measurement and improvement through the episode-based payment methodology. The complex and diverse nature of oncology business relationships and the specific rules and requirements of Medicare payment systems for different types of providers intensify these issues. The Centers for Medicare & Medicaid Services believes that by sharing its approach to addressing these decisions and challenges, it may facilitate greater understanding of the model within the oncology
Fahey, T M; Gallitano, D G
Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services.
The purpose of this study was twofold. First, it identified the priority needs common to all science teachers in secondary schools in Kumasi, Ghana. Second, it investigated the relationship existing between the identified priority needs and the teacher demographic variables (type of school, teacher qualification, teaching experience, subject discipline, and sex of teacher) to be used as a basis for implementing in-service education training programs at the Science Resource Centers in Kumasi Ghana. An adapted version of the Moore Assessment Profile (MAP) survey instrument and a set of open-ended questions were used to collect data from the science teachers. The researcher handed out one hundred and fifty questionnaire packets, and all one hundred and fifty (100%) were collected within a period of six weeks. The data were analyzed using descriptive statistics, content analysis, and inferential statistics. The descriptive statistics reported the frequency of responses, and it was used to calculate the Need Index (N) of the identified needs of teachers. Sixteen top-priority needs were identified, and the needs were arranged in a hierarchical order according to the magnitude of the Need Index (0.000 ≤ N ≤ 1.000). Content analysis was used to analyze the responses to the open-ended questions. One-way analysis of variance (ANOVA) was used to test the null hypotheses of the study on each of the sixteen identified top-priority needs and the teacher demographic variables. The findings of this study were as follows: (1) The science teachers identified needs related to "more effective use of instructional materials" as a crucial area for in-service training. (2) Host and Satellite schools exhibited significant difference on procuring supplementary science books for students. Subject discipline of teachers exhibited significant differences on utilizing the library and its facilities by students, obtaining information on where to get help on effective science teaching
Murphy, Sarah Anne; Cerqua, Judith
A customer contact center offers academic libraries the ability to consistently improve their telephone, e-mail, and IM services. This paper discusses the establishment of a contact center and the benefits of implementing the contact center model at this institution. It then introduces a practical methodology for developing a valid measurement…
Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar
Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P addiction treatment clinics.
Talpalariu, C.; Talpalariu, J.; Vaja, N.; Matei, C.
This system is intended for the protection of personnel working in those areas of the Reactor Building and Service Building where high gamma radiation fields are expected. A detector, sensitive to gamma radiation, is installed in each of the areas to be monitored. The detector will send a signal, proportional to the radiation level in the area, to a corresponding electronic module (Alarm Unit), where the signal will be amplified and checked against alarm set points for possible alarming conditions. In case the field exceeds the alarm set values, the Alarm Unit will produce a signal that will trigger the field alarms (Horn and Beacon) located in the area where the condition occurred. Each Alarm Unit will send a numerical input to central computer command. he system is required to accomplish the following tasks: - Monitors the level of gamma radiation in those areas of the Station where high radiation fields are expected; - Provides a continuous and centralized display of the radiation level in each of the monitored areas. The display shall be in exposure rate units (R/h); - Provides a visual and audible alarm in each monitored areas; Allows the control room operator to check at any time the radiation levels and alarm conditions in each of the monitored areas; - Control room operator shall be alerted of any alarm conditions that occurs in the Station. A typical monitoring loop is composed of the following components: Detector Assembly type: CI-MA - 522 two channels, two ranges; Horn and Beacon Assembly; Remote Indicating Meter with Warning Lights; Central computer; common equipment for all 40 loops. (authors)
Pawit Muhammad Yusup
Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.
An aerial radiological survey was performed over the area surrounding the Feed Materials Production Center, located near Fernald, Ohio, during the period April 24 to 27, 1985. The survey covered a 70-square-kilometer (27-square-mile) area centered on the plant. The highest exposure rates, in excess of 0.35 milliroentgens per hour (mR/h), were inferred from the data measured directly over the plant. This radiation was due to the presence of nuclides which were consistent with normal plant operations. For the remainder of the survey area, the inferred radiation exposure rates, varying from 6 to 12 microroentgens per hour (μR/h), were due to naturally-occurring potassium, uranium, thorium, and daughter products. The reported exposure rate values include an estimated cosmic ray contribution of 3.7μR/h. Ground-based measurements, conducted during the time of the aerial survey, were compared to the aerial results. Pressurized ionization chamber readings and a group of soil samples were acquired at several locations within the survey area. The exposure rate values obtained from these measurements were in agreement with the inferred aerial results. Soil sample results showed several areas just outside the site boundary with slightly elevated amounts of U-238. The levels, however, were well below the detection limit of the aerial system. The only off-site area that showed apparent above background activity in the aerial data was directly west of the storage silos. The symmetric shape of the contours, however, suggests that these elevated levels are due to ''shine'' from material stored on-site in the silos and not to actual off-site contamination. Detailed comparison of the 1985 aerial survey data with a previous survey conducted in 1976 showed no significant change in any area outside the plant boundary. 6 refs., 9 figs., 3 tabs
Smith, Robin M.
When students with disabilities are isolated socially and physically, their self-confidence and engagement may be low. Encouraging leadership and service in students who are often overlooked for these roles enhances peer relations, engagement, and self-confidence. Principles and strategies for fostering leadership and service are described.…
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-14405 Filed 6-15-10; 8:45 am... Reinvestment Act of 2009, Pub. L. 111-5 (ARRA). Applicable Regulations: (a) The Education Department General...
Gagin, Roni; Cohen, Miri; Greenblatt, Lee; Solomon, Hanah; Itskovitz-Eldor, Joseph
A law permitting couples to conceive biological children through surrogacy was legislated in Israel in March 1996. The Rambam Medical Center has established the only nonprofit Surrogate Parenting Center at a public hospital in Israel. The multidisciplinary teamwork at the Center is case managed by a social worker. An important role of the social work intervention is consultation and support for the couple and the surrogate at all stages of the process. The case study presented in the article illustrates the need for sensitive and professional intervention due to the complexity of the surrogacy process and the crisis it involves for both the surrogate and the couple. In light of the growing parenting surrogacy cases in the United States, Europe, and Israel, a structured social work intervention model is described, which may be implemented at public or private surrogate parenting centers.
Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes
Biedron, William S.
Since 1990 there has been a rapid increase in the demand for communication services, especially local and wide area network (LAN/WAN) oriented services. With the introduction of the DFB laser transmitter, hybrid-fiber-coax (HFC) cable plant designs, ATM transport technologies and rf modems, new LAN/WAN services can now be defined and marketed to residential and business customers over existing cable TV systems. The term metropolitan area network (MAN) can be used to describe this overall network. This paper discusses the technical components needed to provision these services as well as provides some perspectives on integration issues. Architecture at the headend and in the backbone is discussed, as well as specific service definitions and the technology issues associated with each. The TCP/IP protocol is suggested as a primary protocol to be used throughout the MAN.
National Oceanic and Atmospheric Administration, Department of Commerce — This is one of the CPC?s Monthly Atmospheric and SST Indices. It is the 850-hPa trade wind anomalies averaged over the area 5oN ? 5oS, 135oE-180o (western equatorial...
National Oceanic and Atmospheric Administration, Department of Commerce — This is one of the CPC?s Monthly Atmospheric and SST Indices. It is the 850-hPa trade wind anomalies averaged over the area 5oN ? 5oS, 135oW-120oW (eastern...
National Oceanic and Atmospheric Administration, Department of Commerce — This is one of the CPC?s Monthly Atmospheric and SST Indices. It is the 850-hPa trade wind anomalies averaged over the area 5oN ? 5oS, 175oW-140oW (central...
Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas
There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.
Palmier, Andréa Clemente; Andrade, Danielle Alves; Campos, Ana Cristina Viana; Abreu, Mauro Henrique Nogueira Guimarães; Ferreira, Efigênia Ferreira
To evaluate the association between the proportion of tooth extractions, socioeconomic indicators, and the availability of oral health services in an underprivileged area of Brazil. An ecological study was carried out in 52 municipalities in the state of Minas Gerais, Brazil. The socioeconomic indicators employed were criteria for health care resources allocation, municipal human development index, Theil index, Gini coefficient, and sanitation conditions. Concerning the availability of oral health services, the following were considered: number of inhabitants, number of dental surgeons living in the city, number of dentists working in the public services, and number of municipal oral health care teams. The utilization of oral health services was evaluated using the indicators recommended by the Health Ministry's Basic Care Package (Pacto da Atencão Básica in Portuguese) and the number of procedures carried out in the primary care setting. The 17 variables assessed were grouped into factorial components, which were then analyzed in terms of their relationship with the dependent variable, tooth extractions. The following six components explained 73.5% of the overall variance: socioeconomic conditions, social inequality, Basic Care Package indicators, number of procedures carried out, ratio of dentists to inhabitants, and coverage of the Family Health Strategy. Inequalities in income distribution (P = 0.031) and coverage by the Family Health Strategy (P = 0.015) contributed significantly to explain the difference in the proportion of tooth extractions in the different municipalities under study. The dental loss observed in the region is largely explained by socioeconomic factors and aspects related to the organization of oral health services.
Smith, S M; Campbell, N C
There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen.
Perry, Charleen M.; Vansteenberg, Michael E.
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.
S. V. Myamlin
Full Text Available Purpose. The scientific work supposed: 1 the search of accounting ways of the local corrosion damages influence to the car design, that were expired the appointed time, for the purpose of renewal; 2 experimental verification of conformity of material construction requirements of the normative documentation and justification for extending the services of passenger cars with pockets of corrosion after 30 years of operation; 3 the conformity assessment of residual life of the structure of car bodies operating pressures in the next 5 years of use. Methodology. The developed algorithm of technical diagnostics of cars with pockets of corrosion of the center sill contains several stages. First, a survey of technical condition of structures is conducted by a visual-optical method and nondestructive control methods, and the degree of damage is determined. In the next phase the experimental verification of conformity of the structure and mechanical properties of the center sill of the car with the pockets of corrosion to regulatory requirements are executed. Next, the study of strength of the supporting structures of car bodies on the basis of experimental static and impact tests of strength is executed. Finally, the endurance tests are conducted on the effect of the longitudinal forces and the evaluation and prediction of compliance resource car bodies for the next period are executed. Findings. The actual work is completed by obtaining the experimental data on the feasibility of extending the service life of passenger cars as from the point of view of an operating time of load-bearing elements of the car body to the resource, and from the point of view of chemical composition, structure and mechanical properties of the center sill with pockets of corrosion. The presence of local corrosion damages of the center sill of the presented size is not a threat to the structural strength and safety. Originality. The authors conducted a comprehensive study to
Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou
The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be
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.
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
A survey is presented of tasks and functions of the nuclear research centers, which belong to the 13 big research establishments in the Federal Republic of Germany. The central R+D-activities in the nuclear field (high temperature reactor, fast breeder, uranium enrichment, reprocessing, waste handling, nuclear safety, nuclear fusion, fusion technology, plasma physics and technology) and the manpower assigned to these activities are described. Future developments in R+D and in manpower are discussed. An outline is given of cooperation established with industry, universities and other institutions. The number of staff and its composition in terms of education and qualification are indicated. Staff mobility, especially transfer to industry, manpower development of junior staff and training efforts are discussed. (orig.) [de
Liu, Z.; Ostrenga, D.; Vollmer, B.; Kempler, S.; Deshong, B.; Greene, M.
The NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC) hosts and distributes GPM data within the NASA Earth Observation System Data Information System (EOSDIS). The GES DISC is also home to the data archive for the GPM predecessor, the Tropical Rainfall Measuring Mission (TRMM). Over the past 17 years, the GES DISC has served the scientific as well as other communities with TRMM data and user-friendly services. During the GPM era, the GES DISC will continue to provide user-friendly data services and customer support to users around the world. GPM products currently and to-be available: -Level-1 GPM Microwave Imager (GMI) and partner radiometer products, DPR products -Level-2 Goddard Profiling Algorithm (GPROF) GMI and partner products, DPR products -Level-3 daily and monthly products, DPR products -Integrated Multi-satellitE Retrievals for GPM (IMERG) products (early, late, and final) A dedicated Web portal (including user guides, etc.) has been developed for GPM data (http://disc.sci.gsfc.nasa.gov/gpm). Data services that are currently and to-be available include Google-like Mirador (http://mirador.gsfc.nasa.gov/) for data search and access; data access through various Web services (e.g., OPeNDAP, GDS, WMS, WCS); conversion into various formats (e.g., netCDF, HDF, KML (for Google Earth), ASCII); exploration, visualization, and statistical online analysis through Giovanni (http://giovanni.gsfc.nasa.gov); generation of value-added products; parameter and spatial subsetting; time aggregation; regridding; data version control and provenance; documentation; science support for proper data usage, FAQ, help desk; monitoring services (e.g. Current Conditions) for applications. The United User Interface (UUI) is the next step in the evolution of the GES DISC web site. It attempts to provide seamless access to data, information and services through a single interface without sending the user to different applications or URLs (e.g., search, access
Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra
To identify the problems faced by parents of children with developmental disabilities in availing rehabilitative services and to find their satisfaction level. This study was carried out at a Child Development Clinic (CDC) located in Northern India. Children with developmental disabilities, who were availing services at CDC for at least last 3 mo and had at least 3 follow-up visits, were enrolled. A questionnaire pertaining to the socio-demographic profile, problems faced in availing services and satisfaction level was filled by the parents of the enrolled children. During the study period, 161 parents filled the questionnaire. 77.6% had some problems in getting the services, the major being difficulty in commuting (50%) and financial constraint (21.7%). More than 80% parents use public transport to reach CDC with 19% travelling more than 50 Km. 29.8% had difficulty in bringing their child to the clinic, either due to severe behavioral problems or physical disability. However, majority of the families were well satisfied with the services as 95% of them graded their satisfaction level at 3 or more on the scale of 0-5. Parents of children with developmental disabilities face many problems in getting rehabilitative services. They travel long distances, face hardships in carrying their child, and lose their day's earnings, apart from spending time and money for their child's therapy. However, most of the parents are well satisfied with the services.
Full Text Available This paper deals with the application of High Altitude Platforms for the provision of third generation mobile services in sparsely-populated areas or in developing countries. It focuses on the behavior of large cells provided via a multiple HAP deployment and shows the possibilities of using small cells located inside these large cells to serve hot-spot areas. The impact of the different types of HAP antenna masks and their adjustment on cell capacity and the quality of coverage is presented. The main parameter of the antenna radiation pattern under investigation is the power roll-off at the cell edge. Optimal values of this parameter are presented for different scenarios. Simulations of system level parameters were based on an iteration loops approach.
Valentini, Francesco; Ninin, Pierre
CERN hosts a number of other experimental areas with a rich research program ranging from fundamental physics to medical applications. The risk assessments have shown a large palette of potential hazards (radiological, electrical, chemical, laser, etc.) that need to be properly mitigated in order to ensure the safety of personnel working inside these areas. A Personnel Protection System, typically, accomplishes this goal by implementing a certain number of heterogeneous functionalities as interlocks of critical elements, management of a local HMI, data monitoring and interfacing with RFID badge readers. Given those requirements, reducing system complexity and costs are key parameters to be optimized in the solution. This paper is aimed at summarizing the findings, in terms of costs, complexity and maintenance reduction, offered by a technology from National Instruments® based on cRIO controllers and a new series of SIL-3 certified safety I/O modules. A use case based on a service for the protection of Class ...
The general directions of the European Community concerning lead resulted to be useful for analysing the biologic impact on the population living in an industrial immission area and for differentiating within this locality affected and non-affected residential districts. Consequently the social-hygienic and regional-hygienic measures are limited and justified territorially. The environmental parameters, their relation to the distance at which an industrial plant is situated and the blood lead values are indicated. Recommendations are given, which concern the protection of health and even the reconstruction of the residential area by immission-reducing measures. It was found that the lead impact on children is higher than that on grown-ups. Tables illustrate the symptomatology of lead impacts, its relation to blood lead concentration, the degree of impact measured in children and grown-ups and the corresponding necessary measures as auxiliary methods for the Public Health Service and the physicians.
Treasury for collection when the debts are delinquent more than 120 days.9 Further, UBOs can transfer debt to the Defense Finance and Accounting ...Comptroller); • Defense Finance and Accounting Service; • MEDCOM; • RHCE; and • LRMC. During the site visits to LRMC and MEDCOM, we observed daily...Uniform Business Office Manual,” November 2006; and • MEDCOM Finance and Accounting Division Standard Operating Procedures Medical Services Account
Pescaroli, G.; Magni, M.
Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and behavioural patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence on Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in-depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via short message service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated as well as flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for implementation. Finally, the statistical output is used to suggest new questions and new directions for research.
Pescaroli, G.; Magni, M.
Many studies discuss the economic and technical aspects of flood warnings. Less attention has been given to the social and psychological patterns that affect alert services. In particular, the literature focuses on warnings activated in river basins or marine environments without providing clear evidence of relevance to Mediterranean coastal areas, even though these are subjected to growing flood risk related to climate change. This paper is a first attempt to bridge this gap. Our research develops an in- depth analysis of the village of Cesenatico on the Adriatic Sea coast. Here the municipality adopted two complementary warning systems: a siren and an alert via Short Message Service (SMS). The analysis focuses on a survey conducted in 2011 and 2012 with 228 participants. The relationships between social and behavioural variables and warning services are investigated, and so are flood preparedness and information dissemination. Qualitative evidence from informal interviews is used to support the understanding of key responses. The conclusions show how different social and behavioural patterns can influence the effectiveness and use of warning systems, regardless of the technology adopted and the structural mitigation measures implemented. Education, training and accountability are seen to be critical elements for improvement. Finally, the statistical output is used to suggest new questions and new directions for research.
Full Text Available This article discusses about the importance of the industrial revolution and the remains left behind from its beginnings, which reminds us of an extremely important period very different from our own. The architecture of the industrial sites from the second half of the 19th century and the beginning of the 20th century shows us both a unique architectural style, created by the economic needs of that time, but also a way of life and socio-economic development for cities. To not lose important remains such as this, in this study, we proposed the transformation of the important industrial complexes and buildings in Bucharest decided by their history and former functions, adding innovative elements to grow their attractiveness. These buildings currently in a state of degradation, once transformed into different cultural attractions, will have the purpose of increasing the quality of the spaces around the city’s center, will help with the gentrifying process of the city’s abandoned zones, with growing the attractiveness and the revenues of the city and at the same time they will keep alive the history of the city through elements of identity which lead to its development.
Oprea, C.D.; Mihul, Al.
The results on monitoring of oil pollution around the town of Ploiesti (South Romania), known for its petrochemical and chemical industry complexes and crude oil activity, are reported. The distribution of heavy metals, rare earth and other microelements along the wind rose profile (the oil complex ∼ 20 km distance) was examined through the analysis of soil samples. Mosses were chosen as biomonitors of local atmospheric pollution with heavy metals and other toxic elements. The trace element content of vegetation growing near the territory of the plant was compared with that of the background one. The contamination of the river flowing in the vicinity of the plant was examined. Comparison of the spatial trends of different pollutants shows the influence of the same atmospheric transport phases on the uptake of trace elements by vegetation. A comparative evaluation of the results was carried out to find to what extent the amount of pollutants in the atmosphere or the amount deposited in the soil or transported by sediments contributes to pollution of the local ecosystem in the vicinity of a petrochemical center. (authors)
Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A
The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Full Text Available Being familiar with all the benefits of e-Health and the strategic plan for the Slovenian health sector’s informatization, Telekom Slovenia and the Faculty of Medicine from the University of Maribor, along with other partners, have initiated an e-Health project. The project group is developing various e-Health services that are based on modern ICT (information and communications technology solutions and will be available on several screens. In order to meet the users’ needs and expectations and, consequently, achieve the high acceptance of e-Health services, the user-centered design (UCD approach was employed in the e-Health project. However, during the research it was found that conventional UCD methods are not completely appropriate for older adults: the target population of the e-Health services. That is why the selected UCD methods were modified and adapted for older adults. The modified UCD methods used in the research study are presented in this paper. Using the results of the adapted UCD methods, a prototype for a service named MedReminder was developed. The prototype was evaluated by a group of 12 study participants. The study participants evaluated the MedReminder service as acceptable with a good potential for a high adoption rate among its target population, i.e., older adults.
Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann
The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available The performance of community health service centers (CHSCs has not been well monitored and analysed since China's latest community health reforms in 2009. The aim of the current investigation was to evaluate the performing trends of the CHSCs and to analyze the main factors that could affect the performance in Pudong new district of Shanghai, China.A regional performance assessment indicator system was applied to the evaluation of Pudong CHSCs' performance from 2011 to 2013. All of the data were sorted out by a panel, and analyzed using descriptive statistics and a generalized estimating equation model.We found that the overall performance increased annually, with a growing number of CHSCs achieving high scores. Significant differences were observed in institutional management, public health services, basic medical services and comprehensive satisfaction during the period of three years. However, we found no differences in the service scores of Chinese traditional medicine (CTM. The investigation also demonstrated that the key factors affecting performance were the location, information system level, family GP program and medical association program rather than the size of the center. However, the medical association participation appeared to have a significant negative effect on performance.It can be concluded from the three-year investigation that the overall performance was improved, but that it could have been further enhanced, especially in institutional management and basic medical service; therefore, it is imperative that CHSCs undertake approaches such as optimizing the resource allocation and utilization, reinforcing the establishment of the information system level, extending the family GP program to more local communities, and promoting the medical association initiative.
Sun, Xiaoming; Li, Yanting; Liu, Shanshan; Lou, Jiquan; Ding, Ye; Liang, Hong; Gu, Jianjun; Jing, Yuan; Fu, Hua; Zhang, Yimin
The performance of community health service centers (CHSCs) has not been well monitored and analysed since China's latest community health reforms in 2009. The aim of the current investigation was to evaluate the performing trends of the CHSCs and to analyze the main factors that could affect the performance in Pudong new district of Shanghai, China. A regional performance assessment indicator system was applied to the evaluation of Pudong CHSCs' performance from 2011 to 2013. All of the data were sorted out by a panel, and analyzed using descriptive statistics and a generalized estimating equation model. We found that the overall performance increased annually, with a growing number of CHSCs achieving high scores. Significant differences were observed in institutional management, public health services, basic medical services and comprehensive satisfaction during the period of three years. However, we found no differences in the service scores of Chinese traditional medicine (CTM). The investigation also demonstrated that the key factors affecting performance were the location, information system level, family GP program and medical association program rather than the size of the center. However, the medical association participation appeared to have a significant negative effect on performance. It can be concluded from the three-year investigation that the overall performance was improved, but that it could have been further enhanced, especially in institutional management and basic medical service; therefore, it is imperative that CHSCs undertake approaches such as optimizing the resource allocation and utilization, reinforcing the establishment of the information system level, extending the family GP program to more local communities, and promoting the medical association initiative.
Hermida, Jorge D.
Technologies developed and used at the Constituyentes Atomic Center (CAC) are applied in Argentina in different fields, such as seamless pipes industry, non-destructive testing and quality assurance, food industry, microalloyed steels, medicine, space activities, air pollution studies, etc. The CAC has also a wide program of technical assistance to the industry
Hildebrandt, Susan A.
This article reports on a project designed to provide mutually beneficial solutions to challenges faced by world language teacher candidates, their preparation program, and a local community center. The project provided opportunities for teacher candidates enrolled in a world language (WL) teacher education course to complete clinical experiences…
Hanson, Jessica; Maxwell, Jeffrey; Mulder, Monika
Intensive English language programs (IEPs) at American universities have the task of recruiting, retaining, and preparing international students for mainstream classes. In order to achieve these tasks, many programs have explored using supplemental instruction (SI) in the form of learning centers (LCs) to support their students. In this study, we…
Pedro Felipe da Costa Coelho
Full Text Available The advent of the Brazilian Law on the Inclusion of People with Disabilities, in 2015, has brought a series of implications for marketing researchers, since it concerns the rights to include people with disabilities in public and private consumption spaces, such as shopping malls. Despite the growth of these consumer spaces in Brazil, several failures in service encounters are frequent, especially when consumers are visually impaired. Therefore, this study aims to understand the consequences of service encounters failures in shopping malls for the consumer with visual disabilities. To reach this goal, we used a qualitative approach of phenomenological nature. Data were collected through direct and naturalistic observations and conduct of nine face-to-face interviews with visually impaired consumers. Through content analysis of the results, we concluded that there is a diversity of failures occurred in service encounters, such as excessive piety of sellers to consumers, contempt and the sudden change in the service script. For this reason, the consequences of service encounter failure were from the verbal confrontation and the withdrawal of the transaction to the word-of-mouth and negative expressions of frustration in virtual social networks. This article also presents managerial and academic contributions for marketing researchers.
Linggi, A; Pelham, L D
A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.
Full Text Available The main objective of this study was to investigate the effect of the use health smart card on the aspects quality of healthcare services in doctor martyr beheshti medical research center in qom . With regard to the measures taken in the context of the establishment of this card in Qom and the lack of previous experience in this province, one of the concerns of the authorities to investigate the performance and capabilities of the card and its effects on the quality of health services is affecting the present study is to respond to this concerns. This research method is descriptive and applied to the target population of physicians, nurses and medical record experts employed at the Medical Center have formed a martyr Beheshti Qom due to more awareness cognitive advantages associated with its use of smart cards have given. The population is equal to the number of 444 and 124 questionnaire for data analysis is used. The sampling method used in this research was stratified random sampling conducted in the respective classes. Spss software for data analysis & exploratory factor analysis & confirmed, Kolmogorov-Smirnov Test, Wilcoxon Test & matrix of factors were used. The analysis results showed that Health Smart Cards for quality of health care services positive and significant effects on Dimension quality of the reliability & Tangibles . Analysis of demographic variables that influence opinions about the quality of health care Health Smart Cards significantly related to gender and education level, and also no experience discussed the variables significantly associated with age.
Mirsepassi, Zahra; Tabatabaee, Maryam; Sharifi, Vandad; Mottaghipour, Yasaman
Family and patient psychoeducation have demonstrated significant improvement in clinical and social outcomes for patients suffering from severe mental disorders and their families. However, these evidence-based practices are not widely implemented at service delivery level and into routine clinical practice, especially in less developed countries. The aim of this article is to report the processes of development and implementation of a psychoeducational service for patients with severe mental illnesses and their families in Iran. The program was developed at Roozbeh Hospital in Tehran, Iran. A group of clinicians worked on the development phase of the program and drafting the manuals. Then, a series of workshops and supervision sessions were held to train group leaders for implementation of the group psychoeducation for patients and families. In the pilot phase, the services were delivered to two groups of patients and families, and then the manual was revised based on the feedback from group leaders and participants. The program consisted of eight 90-minute weekly patient group sessions and 6 weekly multiple family group sessions. Two manuals for patient education (schizophrenia and bipolar disorder) were developed. Several information sheets were developed and distributed during different sessions of family and patient psychoeducation related to the content of each session. Despite providing the hospital clinicians with the information regarding these new services, less than 10% of the admitted patients were referred by their clinicians. Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.
Inês Rego; Giuliano Russo; Luzia Gonçalves; Julian Perelman; Pedro Pita Barros
Introduction: In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. Material and Methods: A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the...
Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.
This paper presents graphical integrated model based academic research on telephone call centres. This paper introduces an important feature of impatient customers and abandonments in the queue system. However the modern call centre is a complex socio-technical system. Queuing theory has now become a suitable application in the telecom industry to provide better online services. Through this Matlab-simulink multi queuing structured models provide better solutions in complex situations at call centres. Service performance measures analyzed at optimal level through Simulink queuing model.
Regulatory considerations are discussed. Alternatives for the continued operation or decommissioning of the state-licensed burial area, the low-level waste treatment facilities, and the NRC licensed burial area are evaluated. Radiological impact analyses were also performed for alternatives on other facilities
Full Text Available The article looks at the underexplored area of light goods vehicle (LGV operation. Specifically, it is investigated to what extent various location based services (LBS can be applied in the context of LGV operation in order to improve their environmental friendliness in urban areas. In doing so, LBS applied in real time navigation, dynamic fleet management, freight tracking and monitoring, hazardous materials transport, location-specific tolls and taxes and geo-eco-driving are described in relation to their usefulness in LGV operation as well as the potential in reducing LGV-originating pollution. Where available, real world examples of such applications are given. The discussion reveals particular significance in that context of real time navigation and dynamic fleet management, which are widely applicable solutions in LGVs operation. Freight monitoring and tracking, including hazardous materials transport, have been also found to be of an importance due, yet with a more limited applicability. As regards location-specific tolls and taxes, and geo-eco-driving, significant potential of these LBS has been identified, yet due to their very limited applicability in general, no robust conclusions could be drawn. Last but not least, a significant gap in the detailed knowledge regarding the area has been revealed and directions for further research have been suggested.
Service report (Mleling, 1982) interviewed many military clinical psychologi-sts, optometrists, pharmacists , podiatrists, and physician assistants. There...Psychology x 7, Referrals back to Psychiatry x 8, Timely Psychology QA Minutes X 9. Assessment Response timeliness X Uti lization 10. Supply costs X 11
Kotamraju, Nalini; van der Geest, Thea
The absence of user involvement in the design and development of e-government is often cited as a reason for the lag in e-government uptake. Drawing on our involvement with PortNL, an integrated e-government service for expatriates in the Netherlands, we explain this absence as a result of an
Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara
Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…
Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.
Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…
..., vending machines, disciplinary fines, and donations, and is run by an elected student government, with the... the Secretary: (a) A quality living and learning environment that supports the overall training... week, 24 hours a day; (b) An ongoing, structured counseling program for students; (c) Food service...
...) The following are examples of CEAS projects and services: (1) CEAS prepares data-based studies and... experiment design, data analysis, and data management support to project managers and produces merged... global oceanographic data base from observations taken during the First GARP Global Experiment (FGGE). (b...
Oprea, C.D.; Mihul, Al.
The Southern part of Romania is a highly industrialized region, including oil refining, ferrous and non-ferrous, chemical and power point source categories. The results from monitoring oil pollution around the town Ploiesti (South Romania), known for its petrochemical and chemical industrial compounds and crude oil activity, are reported. The distribution of heavy metals, rare earth and other microelements along the wind rose profile (at 20 Km distance from the oil complex ) was examined through the analysis of soil samples. Mosses were chosen as biomonitors of local atmospheric pollution with heavy metals and other toxic elements. The trace elements content of vegetation growing near the plant's area was compared with that of the background one. The contamination of the river flowing in the vicinity of the plant was examined. Comparison of the spatial trends of different pollutants shows the influence of the some atmospheric transport phases on the uptake of trace elements by vegetation. A comparative evaluation of the results was carried out to indicate at which extend the amount of pollutant in the atmosphere or the amount deposited in the soil or transported by sediment contributes to pollution of the local ecosystem in the vicinity of a petrochemical compound. (authors)
Pilloy, W.J.; Hellwig, D.; Schaeffer, A.; Hoffmann, P.; Lens, V.
Aim: Demonstration of bi-directional PET data transmission, interactive display and co-registration, for the purpose of correlative imaging, treatment planning and teaching. Material and Method: In the year 2000, the initial problem to attend was to provide an effective PET service to a hospital (in Luxemburg) which lies 150 km away from a PET center (in another country). Once this solved, the procedure was expanded (in 2001) to co-registration with CT/MRI scans performed locally, and with radiotherapy simulation CT performed in another center 25 km away (in 2002). Equipment from various vendors was used (Siemens, Adac, GE, Hermes). With preliminary agreement of the national medical aid, patients are sent from the Nuclear Medicine Dept of the Centre Hospitalier in Luxemburg (CHL) to the Dept NM of the Saarland University Medical Center for PET examination. The digital data are then sent from the Siemens PET camera to a PC connected to the LAN, and then to a FTP server (Healthnet). The data are similarly collected by a PC of the hospital network in Luxemburg, and transferred to a Hermes NM station. The Dicom PET data are converted on the fly to Interfile, displayed interactively as any other tomographic data, printed and available on the NM image server. Since 2001, the PET data are co-registered with whole-body CT data recorded at CHL according to a specific protocol (see other paper of this group). Now in 2002, we are busy implementing the co-registration of PET data and simulation CT data obtained from the Centre Baclesse (CFB, 25 km from CHL) for the treatment planning of brain tumours (input into an ADAC system). Furthermore, we plan to send the data (after deletion of their digital ID) to a (South African) university which does not yet dispose of a PET camera, to allow the training of their registrars. Results: For the end-user clinician at CHL and CFB , the PET data have the quality of 'live data', which can be examined interactively, along with other imaging
Rodgers, Nancy J; Cutshall, Susanne M; Dion, Liza J; Dreyer, Nikol E; Hauschulz, Jennifer L; Ristau, Crystal R; Thomley, Barb S; Bauer, Brent A
The use of complementary and integrative medicine therapies is steadily becoming an integral part of health care. Massage therapy is increasingly offered to hospitalized patients for various conditions to assist with the management of common symptoms such as pain, anxiety, and tension. This article summarizes a decade of building the massage therapy service at a large tertiary care medical center, from the early pilot studies and research to the current program offerings, and the hopes and dreams for the future. Copyright © 2014 Elsevier Ltd. All rights reserved.
Snider, H. L.; Reeder, F. L.; Dirkin, W. J.
Fourteen C-130 airplane center wings, each containing service-imposed fatigue damage resulting from 4000 to 13,000 accumulated flight hours, were tested to determine their fatigue crack propagation and static residual strength characteristics. Eight wings were subjected to a two-step constant amplitude fatigue test prior to static testing. Cracks up to 30 inches long were generated in these tests. Residual static strengths of these wings ranged from 56 to 87 percent of limit load. The remaining six wings containing cracks up to 4 inches long were statically tested as received from field service. Residual static strengths of these wings ranged from 98 to 117 percent of limit load. Damage-tolerant structural design features such as fastener holes, stringers, doublers around door cutouts, and spanwise panel splices proved to be effective in retarding crack propagation.
Hegde, Mahabaleshwara; Strub, Richard F.; Lynnes, Christopher S.; Fang, Hongliang; Teng, William
Mirador is a web interface for searching Earth Science data archived at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). Mirador provides keyword-based search and guided navigation for providing efficient search and access to Earth Science data. Mirador employs the power of Google's universal search technology for fast metadata keyword searches, augmented by additional capabilities such as event searches (e.g., hurricanes), searches based on location gazetteer, and data services like format converters and data sub-setters. The objective of guided data navigation is to present users with multiple guided navigation in Mirador is an ontology based on the Global Change Master directory (GCMD) Directory Interchange Format (DIF). Current implementation includes the project ontology covering various instruments and model data. Additional capabilities in the pipeline include Earth Science parameter and applications ontologies.
Full Text Available The design of learner-centered guided in-service program for technical teacher education has been launched at Estonian Centre for Engineering Pedagogy at Tallinn University of Technology. The aim of the program has been facilitating the initial in-service teaching experience, involving mentoring, peer support and cognitive apprenticeship. The emphasis has been on teaching for knowledge application, including the choice of content and processes, motivation, reflection, problem-solving, choice of educational technology, effective teaching methods, teaching models and strategies ཿ concepts, tools and procedures of the field of engineering, organized in ways enabling teachers to formulate real world problems, apply and solve them. The program has been implemented since 2012 and covers IGIP curriculum requirements. In the present article the designed program is described and analyzed.
Shariatmadar, Mehran; Narasimhan, Vasantha
This paper reviews the studies which were undertaken jointly by Telesat and Industry Canada to provide an estimate of the market opportunities for residential multi-media services in the rural and small urban areas of Canada. This study is part of the Advanced Satcom program, a Ka-band satellite system proposal which is currently in the implementation proposal phase by the government and the Canadian space industry of which Telesat is an active member. Advanced Satcom extends the reach of terrestrial information highways to the remote and sparsely populated parts of the country in a cost-effective manner and thus provides a ubiquitous coverage of the information highways to all Canadians. Therefore, the rural and small urban markets are believed to be good opportunities for the Advanced Satcom. Although the results are primarily intended for fixed residential applications, they can also be used as input to market opportunity studies for wideband mobile applications.
Leukert, K.; Telser, H.; Vaterlaus, S.; Mahler, P.
This report for the Swiss Federal Office of Energy (SFOE) takes a look at the results of a study made on the willingness to pay for public services and quality of supply in the electricity area. First, the starting point of the study and definitions of quality of supply and security of supply are noted. The methods used in the study are presented and macro-economic aspects are reviewed. The costs of black-outs are examined and the carrying out of surveys in the electricity market is discussed. The results of surveys made in households and commercial enterprises concerning the willingness to pay for security of supply and the costs incurred when supplies fail are presented and discussed. The report is completed with a comprehensive list of references and an appendix containing the results of the various tests and surveys made.
Mariela Verónica Rocca
Full Text Available This article deals with the State regulation of drinking water and sanitation services in the Metropolitan Area of Buenos Aires. Its main objective is to identify the continuities and ruptures in State regulation during the transition from private management (1993-2006 to renationalisation and State management (2006 onwards. The concept of “State capacities” (both administrative and relational is used to assess regulatory performance. For the administrative capacities, the correspondence between the design and resources of the agencies, as well as the differences between their formal functions and actual practices, is examined. For the relational capacities, the policies of the National Government and its interaction with both the water and sanitation companies and the regulatory and control agencies are considered. The analysis is based on official documents, legislation and statistics, company balance sheets and reports, newspaper articles and semi-structured interviews.
Full Text Available The use of QR codes accelerates the sharing of information and provides more practical access to information. In today's information age, in the limited area unlimited information, data and contents can be transferred with using QR code. This study examines how consumers use QR code technology using by the service sector and aim of inform consumers about their perception and usage levels. In the application part of the study, 180 consumers responded the survey questions. The t-test, ANOVA, variance analysis and regression analysis method were used to test hypotheses established in the research. Thus, factors affecting the perceptions of consumers on QR code technology have been identified. The finance and banking sectors have been identified as the sectors in which consumers use the QR code most frequently, and the speed and availability factors for this sector have been analyzed separately.
Full Text Available Abstract Background The importance of Small Area Variation Analysis for policy-making contrasts with the scarcity of work on the validity of the statistics used in these studies. Our study aims at 1 determining whether variation in utilization rates between health areas is higher than would be expected by chance, 2 estimating the statistical power of the variation statistics; and 3 evaluating the ability of different statistics to compare the variability among different procedures regardless of their rates. Methods Parametric bootstrap techniques were used to derive the empirical distribution for each statistic under the hypothesis of homogeneity across areas. Non-parametric procedures were used to analyze the empirical distribution for the observed statistics and compare the results in six situations (low/medium/high utilization rates and low/high variability. A small scale simulation study was conducted to assess the capacity of each statistic to discriminate between different scenarios with different degrees of variation. Results Bootstrap techniques proved to be good at quantifying the difference between the null hypothesis and the variation observed in each situation, and to construct reliable tests and confidence intervals for each of the variation statistics analyzed. Although the good performance of Systematic Component of Variation (SCV, Empirical Bayes (EB statistic shows better behaviour under the null hypothesis, it is able to detect variability if present, it is not influenced by the procedure rate and it is best able to discriminate between different degrees of heterogeneity. Conclusion The EB statistics seems to be a good alternative to more conventional statistics used in small-area variation analysis in health service research because of its robustness.
National Oceanic and Atmospheric Administration, Department of Commerce — This data set consists of 0.5-meter pixel resolution, four band orthoimages covering the Humboldt Bay area. An orthoimage is remotely sensed image data in which...
Full Text Available It is of theoretical and practical significance to understand what factors influence the sustainable development of home healthcare services in China. Based on a face-to-face survey, we find that the location planning, which is decisive for the improvement of patient satisfaction, can effectively reduce the risks, as well as the costs of redundant construction and re-construction of service centers for home healthcare and, thus, helps ensure the sustainability of health and the environment. The purposes of this paper are to investigate the existing problem of home healthcare in Shanghai and to find the optimum location planning scheme under several realistic constraints. By considering differentiated services provided by the medical staff at different levels and the degrees of patient satisfaction, a mixed integer programming model is built to minimize the total medical cost. The IBM ILOGCPLEX is used to solve the above model. Finally, a case study of Putuo district in Shanghai is conducted to validate the proposed model and methodology. Results indicate that the model used in this paper can effectively reduce the total medical cost and enhance the medical sustainability, and therefore, the results of the model can be used as a reference for decision makers on the location planning problem of home healthcare services in China.
Geeta S. Pardeshi
Full Text Available Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC, Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27% had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms.
Wong, Edwin S; Liu, Chuan-Fen
In the U.S., economic conditions are intertwined with labor market decisions, access to health care, health care utilization and health outcomes. The Veterans Affairs (VA) health care system has served as a safety net provider by supplying free or reduced cost care to qualifying veterans. This study examines whether local area labor market conditions, measured using county-level unemployment rates, influence whether veterans obtain health care from the VA. We used survey data from the Behavioral Risk Factor Surveillance System in years 2000, 2003 and 2004 to construct a random sample of 73,964 respondents self-identified as veterans. VA health service utilization was defined as whether veterans received all, some or no care from the VA. Hierarchical ordered logistic regression was used to address unobserved state and county random effects while adjusting for individual characteristics. Local area labor market conditions were defined as the average 12-month unemployment rate in veterans' county of residence. The mean unemployment rate for veterans receiving all, some and no care was 5.56%, 5.37% and 5.24%, respectively. After covariate adjustment, a one percentage point increase in the unemployment rate in a veteran's county of residence was associated with an increase in the probability of receiving all care (0.34%, p-value = 0.056) or some care (0.29%, p-value = 0.023) from the VA. Our findings suggest that the important role of the VA in providing health care services to veterans is magnified in locations with high unemployment.
NOAA Coastal Services Center Coastal Inundation Digital Elevation Model: Philadelphia, Pennsylvania Weather Forecast Office (PHI WFO) and Wakefield, Virginia Weather Forecast Office (AKQ WFO) - Eastern Shore of Maryland
National Oceanic and Atmospheric Administration, Department of Commerce — These data were created as part of the National Oceanic and Atmospheric Administration Coastal Services Center's efforts to create an online mapping viewer called...
Markot, Peter B
...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...
Plazzotta, Fernando; Mayan, John C; Storani, Fernando D; Ortiz, Juan M; Lopez, Gastón E; Gimenez, Gastón M; Luna, Daniel R
Multimedia elements add value to text documents by transmitting information difficult to express in words. In healthcare, many professional and services keep this elements in their own repositories. This brings the problem of information fragmentation in different silos which hinder its access to other healthcare professionals. On the other hand patients have clinical data of their own in different formats generated in different healthcare organizations which is not accessible to professionals within our healthcare network. This paper describes the design, development and implementation processes of a service which allows media elements to be loaded in a patient clinical data repository (CDR) either through an electronic health record by professionals (EHR) or through a personal health record (PHR) by patients, in order to avoid fragmentation of the information.
Emotional Support Services The diagnosis of a brain tumor elicits many different and sometimes difficult emotions, not only for the patient, but also for their family members. Patients may encounter changes in cognitive functioning and language, a diminished ability to focus or make decisions, or short-term memory loss, all of which can greatly affect their personal and professional lives. We are dedicated to helping patients and their families deal with the physical and emotional facets of this disease.
Binaural .Ap’ii2cation for HearLng Impaired 367 Listeners. (T:7-73 SP C) xiv DEPARTMENT OF SURGERY conined Otolaryngology Service conaUmed PAGE 2523 The...GYNECOLOGY 4116 The Evaluation of Fetal Systolic Time Intervals and Beat to Beat 434 Interval Variations in Fetal Heart Rate as Early Indicators of Fetal...Disorders. Schwartz DM, et al. Binaural Hearing Aids: A Paradox. In Bess FH, Amplification in Education On press). Schwartz DM, et al. The Relationship
Full Text Available This paper illustrates how our development team has used some information technologies to let physicians obtain an instant abnormal laboratory result report for critical patient care services. We have implementeda healthcare message alerting system (HMAS on a healthcare short message service (HSMS engine and the distributed healthcare-oriented service environment (DiHOSE in the National Taiwan University Hospital (NTUH. The HSMS engine has a general interface for all applications which could easily send any kind of alerting messages. Fundamentally, the DiHOSE uses HL7 standard formats to process the information exchange behaviors and can be flexibly extended for reasonable user requirements. The disease surveillance subsystem is an integral part of NTUH new hospital information system which is based on DiHOSE and the disease surveillance subsystem would send alerting messages through the HSMS engine. The latest cell phone message alerting subsystem, a case study, in NTUH proved that the DiHOSE could integrate the user required functions without much work. We concluded that both HSMS and DiHOSE can generalize and extend application demands efficiently.
Liu, Zhong; Ostrenga, D.; Vollmer, B.; Deshong, B.; Greene, M.; Teng, W.; Kempler, S. J.
On February 27, 2014, the NASA Global Precipitation Measurement (GPM) mission was launched to provide the next-generation global observations of rain and snow (http:pmm.nasa.govGPM). The GPM mission consists of an international network of satellites in which a GPM Core Observatory satellite carries both active and passive microwave instruments to measure precipitation and serve as a reference standard, to unify precipitation measurements from a constellation of other research and operational satellites. The NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC) hosts and distributes GPM data within the NASA Earth Observation System Data Information System (EOSDIS). The GES DISC is home to the data archive for the GPM predecessor, the Tropical Rainfall Measuring Mission (TRMM). Over the past 16 years, the GES DISC has served the scientific as well as other communities with TRMM data and user-friendly services. During the GPM era, the GES DISC will continue to provide user-friendly data services and customer support to users around the world. GPM products currently and to-be available include the following: 1. Level-1 GPM Microwave Imager (GMI) and partner radiometer products. 2. Goddard Profiling Algorithm (GPROF) GMI and partner products. 3. Integrated Multi-satellitE Retrievals for GPM (IMERG) products. (early, late, and final)A dedicated Web portal (including user guides, etc.) has been developed for GPM data (http:disc.sci.gsfc.nasa.govgpm). Data services that are currently and to-be available include Google-like Mirador (http:mirador.gsfc.nasa.gov) for data search and access; data access through various Web services (e.g., OPeNDAP, GDS, WMS, WCS); conversion into various formats (e.g., netCDF, HDF, KML (for Google Earth), ASCII); exploration, visualization, and statistical online analysis through Giovanni (http:giovanni.gsfc.nasa.gov); generation of value-added products; parameter and spatial subsetting; time aggregation; regridding; data
Ostrenga, D.; Liu, Z.; Vollmer, B.; Teng, W. L.; Kempler, S. J.
On February 27, 2014, the NASA Global Precipitation Measurement (GPM) mission was launched to provide the next-generation global observations of rain and snow (http://pmm.nasa.gov/GPM). The GPM mission consists of an international network of satellites in which a GPM "Core Observatory" satellite carries both active and passive microwave instruments to measure precipitation and serve as a reference standard, to unify precipitation measurements from a constellation of other research and operational satellites. The NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC) hosts and distributes GPM data within the NASA Earth Observation System Data Information System (EOSDIS). The GES DISC is home to the data archive for the GPM predecessor, the Tropical Rainfall Measuring Mission (TRMM). Over the past 16 years, the GES DISC has served the scientific as well as other communities with TRMM data and user-friendly services. During the GPM era, the GES DISC will continue to provide user-friendly data services and customer support to users around the world. GPM products currently and to-be available include the following: Level-1 GPM Microwave Imager (GMI) and partner radiometer products Goddard Profiling Algorithm (GPROF) GMI and partner products Integrated Multi-satellitE Retrievals for GPM (IMERG) products (early, late, and final) A dedicated Web portal (including user guides, etc.) has been developed for GPM data (http://disc.sci.gsfc.nasa.gov/gpm). Data services that are currently and to-be available include Google-like Mirador (http://mirador.gsfc.nasa.gov/) for data search and access; data access through various Web services (e.g., OPeNDAP, GDS, WMS, WCS); conversion into various formats (e.g., netCDF, HDF, KML (for Google Earth), ASCII); exploration, visualization, and statistical online analysis through Giovanni (http://giovanni.gsfc.nasa.gov); generation of value-added products; parameter and spatial subsetting; time aggregation; regridding
Balgah Roland Azibo; Emmanuel Yenshu Vubo; Innocent Ndoh Mbue; Jude Ndzifon Kimengsi
The role of development nongovernmental organizations (DNGOs) in driving change, servicing the very poor and reducing poverty especially in rural areas in developing countries has been generally affirmed in the rural economics literature. This romantic image accounts to a large extent for the exponential numeric growth observed in the sector, and for burgeoning research on the subject by rural development economists. However, not enough empirical evidence exists on the extent to which such or...
The objective of this thesis was to analyse the data of pollutant parameters for waste water from the service stations situated in the operative area of the Viikinmäki and Suomenoja WWTPs in the Helsinki Region Environmental Services Authority (HSY). The main reason for this analysis was that HSY wanted to know about the quality of waste water discharged from the service stations into the influent of its WWTPs. The number of cars used in Finland is increasing day by day; hence, au...
Housne Ara Begum
Full Text Available Bangladesh has one of the highest maternal mortality rates (MMR in the world. The estimated lifetime risk of dying from pregnancy and childbirth related causes in Bangladesh is about 100 times higher compare to developed countries. However, utilization of maternal health care services (MHCS is notably low. This study examines the socio-economic determinants of utilization of MHCS in some slum areas of Dhaka city. The overall utilization was 86.3% of women; however, utilization of different sorts of MHCS was very low, i.e., the mean utilization was found to be 2.25 out of 5 MHCS. Indicator wise, ANC, TT, institutional delivery, delivery assistance by health professional and PNC were received by 61.3%, 80.4%, 12.6%, 33.2% and 55.4% of women respectively. Variation was observed with different socio-economic variables. Multiple regression model could explain 38% of variance (P<0.001. Among the significant determinants, order of last birth negatively explained the most variance (15.2%. Similarly, distance between home and clinic was found to affect the utilization negatively. Besides, some respondents’ socio economic variables had a significant positive effect on MHCS utilization. To reduce maternal mortality in disadvantaged women in slum areas, this study might suggest a few pointers while considering formulation of policies and planning. Ibrahim Med. Coll. J. 2010; 4(2: 44-48
Thacker, Stephen B; Stroup, Donna F; Sencer, David J
Since 1946, the Centers for Disease Control and Prevention has responded to urgent requests from US states, federal agencies, and international organizations through epidemic-assistance investigations (Epi-Aids). The authors describe the first 60 years of Epi-Aids, breadth of problems addressed, evolution of methodologies, scope of activities, and impact of investigations on population health. They reviewed Epi-Aid reports and EIS Bulletins, contacted current and former Epidemic Intelligence Service staff, and systematically searched the PubMed and Web of Science databases. They abstracted information on dates, location, staff involved, health problems, methods, and impacts of investigations according to a preplanned protocol. They assessed the methods presented as well as the quality of reports. During 1946-2005, a total of 4,484 investigations of health events were initiated by 2,815 Epidemic Intelligence Service officers. In the early years, the majority were in response to infectious agents, although environmental problems emerged. Investigations in subsequent years focused on occupational conditions, birth defects, reproductive health, tobacco use, cancer, violence, legal debate, and terrorism. These Epi-Aids heralded expansion of the agency's mission and presented new methods in statistics and epidemiology. Recommendations from Epi-Aids led to policy implementation, evaluation, or modification. Epi-Aids provide the Centers for Disease Control and Prevention with the agility to respond rapidly to public health crises.
Ferrandiz, Ana; Scallan, Gavin
The available bit rate (ABR) service allows connections to exceed their negotiated data rates during the life of the connections when excess capacity is available in the network. These connections are subject to flow control from the network in the event of network congestion. The ability to dynamically adjust the data rate of the connection can provide improved utilization of the network and be a valuable service to end users. ABR type service is therefore appropriate for the transmission of bursty LAN traffic over a wide area network in a manner that is more efficient and cost effective than allocating bandwdith at the peak cell rate. This paper describes the ABR service and discusses if it is realistic to operate a LAN like service over a wide area using ABR.
Rego, Inês; Russo, Giuliano; Gonçalves, Luzia; Perelman, Julian; Pita Barros, Pedro
In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the changes brought to their workload. This paper provides a descriptive statistical analysis of physicians' responses. In connection to the crisis, our surveyed physicians perceived an increase in demand but a decrease of supply of public health services, as well as an increase in the supply of health services by the private sector. Damaging government policies for the public sector, and the rise of private services and insurance providers were identified as game changers for the sector. Physicians reported a decrease in public remuneration (- 30.5%) and a small increase of public sector hours. A general reduction in living standard was identified as the main adaptation strategy to the crisis. Passion for the profession, its independence and flexibility, were the most frequently mentioned compensating factors. A percentage of 15% of physicians declared considering migration as a possibility for the near future. The crisis has brought non-negligible changes to physicians' working conditions and to the wider market for medical services in Portugal. The physicians' intrinsic motivation for the professions helped counterbalance salary cuts and deteriorating working conditions.
Niv, Yaron; Dickman, Ram; Levi, Zohar; Neumann, Gadi; Ehrlich, Dorit; Bitterman, Haim; Dreiher, Jacob; Cohen, Arnon; Comaneshter, Doron; Halpern, Eyran
To combine community and hospital services in order to enable improvements in patient management, an integrated gastroenterology service (IGS) was established. Referral patterns to specialist clinics were optimized; open access route for endoscopic procedures (including esophago-gastro-duodenoscopy, sigmoidoscopy and colonoscopy) was established; family physicians' knowledge and confidence were enhanced; direct communication lines between experts and primary care physicians were opened. Continuing education, guidelines and agreed instructions for referral were promoted by the IGS. Six quality indicators were developed by the Delphi method, rigorously designed and regularly monitored. Improvement was assessed by comparing 2010, 2011 and 2012 indicators. An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of coordination. In this paper we describe a new integrated gastroenterology service established in April 2010. Waiting time for procedures decreased: 3 mo in April 30th 2010 to 3 wk in April 30th 2011 and stayed between 1-3 wk till December 30th 2012. Average cost for patient's visit decreased from 691 to 638 NIS (a decrease of 7.6%). Six health indicators were improved significantly comparing 2010 to 2012, 2.5% to 67.5%: Bone densitometry for patients with inflammatory bowel disease, preventive medications for high risk patients on aspirin/NSAIDs, colonoscopy following positive fecal occult blood test, gastroscopy in Barrett's esophagus, documentation of family history of colorectal cancer, and colonoscopy in patients with a family history of colorectal cancer. Establishment of an IGS was found to effectively improve quality of care, while being cost-effective.
The article reveals the relevance of evaluation method for personnel assessment center technologies. The efficiency of the method in terms of accuracy and validity of the assessment of employees. Identified positive factors and problematic use of assessment center technology service company/
Full Text Available Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM, which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS. Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy.
Machado, Jessica S.; Souza, Daiane C.; Rodrigues Junior, Orlando; Gerulis, Eduardo; Todo, Alberto S.
This research was developed at the Radiopharmacy Center of the Nuclear and Energy Research Institute - IPEN/CNEN/SP, Brazil, that performs the production of radiopharmaceuticals with isotopes of the 131 I, 123 I, 201 Tl, 67 Ga, 18 F and 99 Mo for use in nuclear medicine. The radioisotopes are produced on an industrial scale and the installation was designed to meet radiation safety standards and quality control requirements. To ensure the production, there are skilled professionals who perform the tasks of maintenance of the equipment and instruments, installed in the cells of processing of radiopharmaceuticals, without which it is not possible to conduct the work with safety and quality. This study was done a survey called Survey of Variables, based on the maintenance operations and interventions in restricted areas of the Centre of Radiopharmacy and in the survey of the distribution of doses in these tasks, carried out during the period from 2005 to 2011. This research aims to identify and determine the main variables that have an impact on the worker's dose. The results are presented for the Occupationally Exposed Individual variable, variable operation, variable area/Cell, task and Feature variable and variable duration of operation, depending on the Dose variable. It is intended in this way to contribute to improvements in operations in restricted areas that may result in lower individual doses without causing significant changes in the routine of work
Swartzendruber, Andrea; Newton-Levinson, Anna; Feuchs, Ashley E; Phillips, Ashley L; Hickey, Jennifer; Steiner, Riley J
Pregnancy resource centers (PRCs) are nonprofit organizations with a primary mission of promoting childbirth among pregnant women. Given a new state grant program to publicly fund PRCs, we analyzed Georgia PRC websites to describe advertised services and related health information. We systematically identified all accessible Georgia PRC websites available from April to June 2016. Entire websites were obtained and coded using defined protocols. Of 64 reviewed websites, pregnancy tests and testing (98%) and options counseling (84%) were most frequently advertised. However, 58% of sites did not provide notice that PRCs do not provide or refer for abortion, and 53% included false or misleading statements regarding the need to make a decision about abortion or links between abortion and mental health problems or breast cancer. Advertised contraceptive services were limited to counseling about natural family planning (3%) and emergency contraception (14%). Most sites (89%) did not provide notice that PRCs do not provide or refer for contraceptives. Two sites (3%) advertised unproven "abortion reversal" services. Approximately 63% advertised ultrasound examinations, 22% sexually transmitted infection testing, and 5% sexually transmitted infection treatment. None promoted consistent and correct condom use; 78% with content about condoms included statements that seemed to be designed to undermine confidence in condom effectiveness. Approximately 84% advertised educational programs, and 61% material resources. Georgia PRC websites contain high levels of false and misleading health information; the advertised services do not seem to align with prevailing medical guidelines. Public funding for PRCs, an increasing national trend, should be rigorously examined. Increased regulation may be warranted to ensure quality health information and services. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of
Full Text Available Intensive spatial processes taking place around metropolitan areas leads to many economic, structural and social changes in their surroundings. The small towns and rural areas located in the outer zone of metropolitan areas are most affected by this functional changes. In the outer zone of a big urban canters appears a lot of new competing possibilities on the labor market and a comprehensive commercial, service and cultural offer to smaller centres. One of the most competitive advantage of the metropolitan zones becomes modern shopping centres being established in the most accessible places, providing a comprehensive shopping-services and even cultural-recreational offer.
Ashrafi-Rizi, Hasan; Kazempour, Zahra
Marketing is one of the essential parts of any business corporation in the modern management. One can see the difference between corporations in gaining their goals, considering their marketing methods. Gaining more advantage or acquiring more funds can be of reasons for marketing, but these are not all the reasons. Perhaps the most important reason for marketing is increasing the customer satisfaction. This, in turn, leads to more willingness in payment and using services. Nowadays, due to rapid growth in ICT, changes in budgets, rapid growth in development and use of knowledge, variety of users and their needs, marketing has become an important factor in any library activities. Libraries are now more responsible in this regard, because marketing is now an important tool in improving users' satisfaction in using library services. Hence, marketing is now very important for libraries to survive in the increasing pressures of competitive conditions of the information market. This article is tapping on issues such as information marketing, principles of marketing, marketing techniques, developing markets, and marketing skills. Some recommendations are also presented for marketing in libraries.
Ashrafi-rizi, Hasan; Kazempour, Zahra
Marketing is one of the essential parts of any business corporation in the modern management. One can see the difference between corporations in gaining their goals, considering their marketing methods. Gaining more advantage or acquiring more funds can be of reasons for marketing, but these are not all the reasons. Perhaps the most important reason for marketing is increasing the customer satisfaction. This, in turn, leads to more willingness in payment and using services. Nowadays, due to rapid growth in ICT, changes in budgets, rapid growth in development and use of knowledge, variety of users and their needs, marketing has become an important factor in any library activities. Libraries are now more responsible in this regard, because marketing is now an important tool in improving users’ satisfaction in using library services. Hence, marketing is now very important for libraries to survive in the increasing pressures of competitive conditions of the information market. This article is tapping on issues such as information marketing, principles of marketing, marketing techniques, developing markets, and marketing skills. Some recommendations are also presented for marketing in libraries. PMID:23555112
Lopez-Hoffman, Laura; Semmens, Darius J.; Diffendorfer, Jay
Species that migrate through protected and wilderness areas and utilize their resources, deliver ecosystem services to people in faraway locations. The mismatch between the areas that most support a species and those areas where the species provides most benefits to society can lead to underestimation of the true value of protected areas such as wilderness. We present a method to communicate the “off-site” value of wilderness and protected areas in providing habitat to migratory species that, in turn, provide benefits to people in distant locations. Using northern pintail ducks (Anas acuta) as an example, the article provides a method to estimate the amount of subsidy – the value of the ecosystem services provided by a migratory species in one area versus the cost to support the species and its habitat elsewhere.
Smagala, G.; Tanczyk, R.
Full text: Poland's experience in combating illicit trafficking in nuclear and radioactive materials dates from the end of 1990 when the government decided to expand detection capabilities at the border check-points and initiated a gradual deployment of the portal radiation devices to detect all attempts of imported commodities with raised radiation level. Although the country had already had well-developed regulations in place as well as accountability and control systems over nuclear material, radiation sources and devices, the need to enforce the control activities and to strengthen cooperation among the nuclear safety and radiological protection bodies and the law enforcement authorities appeared. Then, besides the importation of the post Chernobyl contamination transports, Poland experienced: the lost and vagabonding nuclear materials or radioactive sources from the former Soviet/Russian military bases deployed in Poland; the tourism trafficking in radioactive materials The task of combating illegal radioactive traffic has been entrusted to: the Border Guard and Customs services - at the borders; the Police and State Security services - mainly within the state Some contribution to that action have had also the recycling of metallurgical scrap plants, which decided to install fixed radiation control devices to protect their products from the presence of radioactive isotopes. The duty of the coordinator as well as providing an immediate assistance in case of a seizure or a suspicion about the seizure of unknown radioactive material, fulfils the Emergency Service Centre (ODSA) at the Central Laboratory for Radiological Protection (CLOR). ODSA has been established in the mid-60s and its fundamental responsibility is to collect notifications on radiological emergency events and to organize help to liquidate consequences of a radiation incident with involved sources. All users of radiation sources and the law enforcement officers are obliged to inform ODSA about
Alonso, Lou, Comp.
Listed in the directory are over 200 educational programs and services for deaf blind children in the United States and U. S. territories. It is noted that the 10 coordinators of regional centers for services to deaf blind children have aided in compilation of the directory. Listings are arranged by state within the New England, Mid-Atlantic…
van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W
To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.
Rea, Luca; Pompei, Sergio; Valenti, Alessandro; Matera, Francesco; Zema, Cristiano; Settembre, Marina
We report an experimental investigation about the Virtual Private LAN Service technique to guarantee the quality of service in the metro/core network and also in the presence of access bandwidth bottleneck. We also show how the virtual private network can be set up for answering to a user request in a very fast way. The tests were performed in a GMPLS test bed with GbE core routers linked with long (tens of kilometers) GbE G.652 fiber links.
Mine E. Ocaktan; Emine Baran; Recep Akdur
To evaluate that habitual behaviors related to genital hygiene in women living in a Health Care Center Area. In this cross-sectional study, 400 women were sampled to represent women in reproductive ages (15-49 ages) living in the Park Health Care Center Area, Ankara, Turkey between June and September 2008. Three hundred and eighty-six (96.5%) women were interviewed for evaluation of habitual behaviors related to genital hygiene. The chi-square test was used for statistical analysis. The mean age of the study group was 32.19+/-9.54 (15-49) years. Of the study group, 21.5% had daily baths, 77.2% used cotton underwear, and 71.8% wiped front to back after using the toilet. Of those who menstruated, 83.4% used hygienic pads during menstrual periods, and 42.1% of the 321 married women confirmed practicing vaginal douching. The education level p=0.001, p=0.000, income level p=0.034, p=0.005, employment p=0.022, p=0.000, and house type p=0.005, p=0.006 were found as factors affecting general frequency of bathing and type of pad used during the menstrual period. Frequency of vaginal douching was higher in housewives than employed women p=0.000. The rate of women who had appropriate behaviors related to genital hygiene among the study group was found to be low, particularly within groups with a low socioeconomic level. Thus, it will be useful for health care employers to emphasize this issue at every opportunity (Author).
Braid, R.B. Jr.
The paper investigates a variety of community impacts including: public services, fiscal issues, economic matters, land and water use, political and social cohesion, and legal considerations. Comparisons of socioeconomic impacts of colocated versus dispersed sites are made on the basis of the size of the impacted communities, the size and type of nuclear facility, and the facility's construction time frame. The paper concludes that, under similar circumstances, most of the socioeconomic impacts of colocated nuclear facilities would be somewhat less than the sum of the impacts associated with equivalent dispersed sites. While empirical data is non-existent, the paper contends, however, that because the socioeconomic impacts of colocated facilities are so great and readily identifiable to a public unskilled in making comparisons with the dispersed alternative, the facilities will likely generate so much public opposition that IFSCs will probably prove infeasible
Caroline Lopes Ciofi-Silva
Full Text Available ABSTRACT Objective: to analyze the scientific evidence on aerosols generated during cleaning activities of health products in the Central Service Department (CSD and the impact of the negative pressure of the ambient air in the cleaning area to control the dispersion of aerosols to adjacent areas. Method: for this literature systematic review the following searches were done: search guidelines, manuals or national and international technical standards given by experts; search in the portal and databases PubMed, Scopus, CINAHL and Web of Science; and a manual search of scientific articles. Results: the five technical documents reviewed recommend that the CSD cleaning area should have a negative differential ambient air pressure, but scientific articles on the impact of this intervention were not found. The four articles included talked about aerosols formed after the use of a ultrasonic cleaner (an increased in the contamination especially during use and pressurized water jet (formation of smaller aerosols 5μm. In a study, the aerosols formed from contaminated the hot tap water with Legionella pneumophila were evaluated. Conclusions: there is evidence of aerosol formation during cleanup activities in CSD. Studies on occupational diseases of respiratory origin of workers who work in CSD should be performed.
Lumpe, J. D.; Foroosh, H.; Eastes, R.; Krywonos, A.; Evans, J. S.; Burns, A. G.; Strickland, D. J.; Daniell, R. E.; England, S.; Solomon, S. C.; McClintock, W. E.; Anderson, D. N.
The Global-scale Observations of the Limb and Disk (GOLD) instrument is an imaging spectrograph to be launched onboard a commercial communications satellite in 2017. From its vantage point in geosynchronous orbit GOLD will image the Earth in the far-ultraviolet from 132 to 162 nm. The instrument consists of two independent optical channels, allowing for simultaneous implementation of multiple measurement sequences with different temporal sampling and spectral resolution. In addition to continuously scanning the disk of the Earth, GOLD will also perform routine limb scan and stellar occultation measurements. These measurements will be used to retrieve a variety of data products characterizing the temperature and composition of the thermosphere-ionosphere, and their response to geomagnetic storms and solar forcing. Primary data products include: daytime neutral temperatures near 160 km altitude; daytime O/N2 column density ratios; nighttime peak electron density; thermospheric O2 density profiles (day and night); daytime exospheric neutral temperature on the limb; atmospheric tides from temperature perturbations; and the location and evolution of ionospheric bubbles. GOLD data will be processed at the Science Data Center (SDC) located at the University of Central Florida. The SDC will also serve as the primary gateway for distribution of GOLD data products to end-users. In this talk we summarize the heritage and theoretical basis of the GOLD retrieval algorithms and describe the full range of GOLD data products that will be available at the SDC, including estimates of data latency and quality.
Sima, Mihaela; Micu, Dana; Dragota, Carmen-Sofia; Mihalache, Sorin
undertaken with key institutions focusing on environmental, health and urban development issues. The survey was conducted in order to identify the local authorities' perception and needs on climate change information and the importance of climate services for the city and institution's activity. Generally, the results suggest that the selected institutions are poorly aware of the potential impacts of climate change and associated extremes in the area, but they showed a real interest for future climate estimations necessary to undertake reliable adaptation measures. At institutional level, do not exist specialized departments (job positions) to tackle or manage climate information and climate-related aspects, this not being a pressing or priority issue for the city. The climate services aspects are seen with interest mainly in supplying climate scenarios and models for a relatively short term (next 10 or 15 years), the climate information being in this way included in the local planning strategies.
Hernán García, M; Gutiérrez Cuadra, J L; Lineros González, C; Ruiz Barbosa, C; Rabadán Asensio, A
To report the opinions of practitioners at health centers on dimensions of quality that affect user satisfaction. Cross-sectional study of focus groups (FG). Bahía de Cádiz and La Janda health centers in southwestern Spain. We studied 4 FG whose participants were staff members of the two health centers: FG1, physicians; FG2, user satisfaction service staff; FG3, social workers; FG4, nurses. The groups were based on the different functions of staff at the two centers. The analysis was based on variables in the SERCAL model (an adaptation of the SERVQUAL model for the Spanish health care system) of opinions regarding service quality: access, comfort (tangibles), personalized service (courtesy), competence, and loyalty. The data were analyzed with version N-Vivo of the NUDIST program. All dimensions of the theoretical model were identified by practitioners as constructs of users' perceptions of service quality. Users' and practitioners' views contrasted with and complemented each other to generate a model that could be validated. Access, personalized service and problem-solving (responsiveness) were key variables. Practitioners' opinions provided information of use in improving the quality model. Differences in opinion between users and practitioners merit further study based on an understanding of these groups' values and interests, and on the care provision context. Practitioners identified access, personalized service and problem-solving as features that influenced users' opinions of the quality of the health center.
... Health Inspection Service's Wildlife Services (APHIS-WS) program is making a policy decision on how to... this definition. Otherwise, APHIS will refer all requests for operational assistance with urban rodent...
Romeiro Lopes, Tiara Cristina; Franca Gravena, Angela Andreia; Demitto, Marcela de Oliveira; Brischiliari, Sheila Cristina Rocha; Borghesan, Deise Helena Pelloso; Dell Agnolo, Catia Millene; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa
To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.
Ayad Sleibi Mustafa
Full Text Available The simulation of groundwater movement has been carried out by using MODFLOW model in order to show the impact of change of water surface elevation of the Tigris river on layers of the aquifer system for Nuclear Research Center at Al-Tuwaitha area, in addition to evaluate the ability of the proposed pumping well to collect groundwater and change the direction of flow at steady-state. The results of the study indicated that there is a good match between the values of groundwater levels that calculated in the model and measured in the field, where mean error is 0.09 m.The study also showed that the increasing of water surface elevation of the Tigris river led to increase in the hydraulic head of observed wells, while the use proposed pumping well reduced the hydraulic head and intercepted the movement of groundwater flow. The flow direction is toward the Tigris river, and the velocity of flow is clear in the third layer identified medium sand which is 0.0015 m/day. The using of the proposed pumping well has changed the direction of groundwater, especially in the area around the well.
Patel, Ashruta; Knox, Regina J; Logan, Alicia; Summerville, Katie
This paper evaluated the implementation West Central Alabama Area Health Education Center programs for high school students in grades 9-12 through participant-reported evaluations and feedback during the September 1st, 2013 to August 31st, 2014 fiscal year. The programs targeted racial/ethnic minorities and/or rural individuals interested in pursuing a career as a healthcare provider in medically underserved counties of Alabama. Students participated in enrichment activities related to prospective health careers that included: successful college preparedness, knowledge about health careers, and the types of primary care health professions that are needed in underserved Alabama communities. The curriculum studied 593 (ACT preparation: n = 172, AHEC 101: n = 56, FAFSA: n = 109, Health Career Exploration: n = 159, College Career Readiness: n = 67, Dixie Scholars NERD: n = 30) baseline measures for the programs to evaluate effectiveness when rated by participants both quantitatively and qualitatively. Interactive activities with video incorporation, hands-on experiences, and group discussions paired with student motivation and interest in specific health career-related activities provided the highest program ratings. It is important to use a variety of successful program strategies when forming healthcare workforce development interventions. Student evaluations can help adapt methods for future program implementation to ultimately achieve strategies for health professional recruitment, training, and retention in areas that lack access to quality healthcare.
Karina Yuri Harada
Full Text Available CONTEXT: The drawing up of adequate Public Health action planning to address the true needs of the population would increase the chances of effectiveness and decrease unnecessary expenses. OBJECTIVE: To identify homogeneous regions in the UNIFESP/EPM healthcare center (HCC coverage area based on sociodemographic indicators and to relate them to causes of deaths in 1995. DESIGN: Secondary data analysis. SETTING: HCC coverage area; primary care. SAMPLE: Sociodemographic indicators were obtained from special tabulations of the Demographic Census of 1991. MAIN MEASURES: Proportion of children and elderly in the population; family providers’ education level (maximum: >15 years, minimum: 20 minimum wages, minimum: <1 minimum wage; proportional mortality distribution. RESULTS: The maximum income permitted the construction of four homogeneous regions, according to income ranking. Although the proportion of children and of elderly did not vary significantly among the regions, minimum income and education showed a statistically significant (p<0.05 difference between the first region (least affluent and the others. A clear trend of increasing maximum education was observed across the regions. Mortality also differed in the first region, with deaths generated by possibly preventable infections. CONCLUSION: The inequalities observed may contribute to primary health prevention.
Harada, K Y; Silva, J G; Schenkman, S; Hayama, E T; Santos, F R; Prado, M C; Pontes, R H
The drawing up of adequate Public Health action planning to address the true needs of the population would increase the chances of effectiveness and decrease unnecessary expenses. To identify homogeneous regions in the UNIFESP/EPM healthcare center (HCC) coverage area based on sociodemographic indicators and to relate them to causes of deaths in 1995. Secondary data analysis. HCC coverage area; primary care. Sociodemographic indicators were obtained from special tabulations of the Demographic Census of 1991. Proportion of children and elderly in the population; family providers' education level (maximum: > 15 years, minimum: 20 minimum wages, minimum: < 1 minimum wage); proportional mortality distribution The maximum income permitted the construction of four homogeneous regions, according to income ranking. Although the proportion of children and of elderly did not vary significantly among the regions, minimum income and education showed a statistically significant (p < 0.05) difference between the first region (least affluent) and the others. A clear trend of increasing maximum education was observed across the regions. Mortality also differed in the first region, with deaths generated by possibly preventable infections. The inequalities observed may contribute to primary health prevention.
Liao, Yangzhe; Leeson, Mark S; Higgins, Matthew D
Wireless body area sensor networks (WBASNs) are becoming an increasingly significant breakthrough technology for smart healthcare systems, enabling improved clinical decision-making in daily medical care. Recently, radio frequency ultra-wideband technology has developed substantially for physiological signal monitoring due to its advantages such as low-power consumption, high transmission data rate, and miniature antenna size. Applications of future ubiquitous healthcare systems offer the prospect of collecting human vital signs, early detection of abnormal medical conditions, real-time healthcare data transmission and remote telemedicine support. However, due to the technical constraints of sensor batteries, the supply of power is a major bottleneck for healthcare system design. Moreover, medium access control (MAC) needs to support reliable transmission links that allow sensors to transmit data safely and stably. In this Letter, the authors provide a flexible quality of service model for ad hoc networks that can support fast data transmission, adaptive schedule MAC control, and energy efficient ubiquitous WBASN networks. Results show that the proposed multi-hop communication ad hoc network model can balance information packet collisions and power consumption. Additionally, wireless communications link in WBASNs can effectively overcome multi-user interference and offer high transmission data rates for healthcare systems.
Khan, Samee Ullah
This handbook offers a comprehensive review of the state-of-the-art research achievements in the field of data centers. Contributions from international, leading researchers and scholars offer topics in cloud computing, virtualization in data centers, energy efficient data centers, and next generation data center architecture. It also comprises current research trends in emerging areas, such as data security, data protection management, and network resource management in data centers. Specific attention is devoted to industry needs associated with the challenges faced by data centers, such as various power, cooling, floor space, and associated environmental health and safety issues, while still working to support growth without disrupting quality of service. The contributions cut across various IT data technology domains as a single source to discuss the interdependencies that need to be supported to enable a virtualized, next-generation, energy efficient, economical, and environmentally friendly data cente...