WorldWideScience

Sample records for service center asc

  1. Ambulatory Surgical Center (ASC) Payment System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains a summary of service utilization by ASC supplier and is derived from 2011 ASC line item level data, updated through June 2012, that is, line items...

  2. Factors Affecting Innovation Within Aeronautical Systems Center (ASC) Organizations - An inductive Study

    National Research Council Canada - National Science Library

    Feil, Eric

    2003-01-01

    .... This thesis analyzed data collected during the 2002 Chief of Staff of the Air Force Organizational Climate Survey to identify factors that affect innovation within Aeronautical Systems Center (ASC) organizations...

  3. ASC Distribution Management Center (DMC) Provides Materiel Management Capability

    National Research Council Canada - National Science Library

    Stewart, Tyler J

    2008-01-01

    ... logistics to sustain a transforming Army at war. The ASM Distribution Management Center (DMC) is the single interface for the synchronization and integration of logistical functions among active Army units in CONUS, Army Commands...

  4. ASC-1

    DEFF Research Database (Denmark)

    Jakimoski, Goce; Khajuria, Samant

    2011-01-01

    uses leak extraction from diÆerent AES rounds to compute the key material that is XOR-ed with the message to compute the ciphertext. Unlike LEX, the ASC-1 operates in a CFB fashion to compute an authentication tag over the encrypted message. We argue that ASC-1 is secure by reducingits (IND-CCA , INT......The goal of the modes of operation for authenticated encryption is to achieve faster encryption and message authentication by performing both the encryption and the message authentication in a single pass as opposed to the traditional encrypt-then-mac approach, which requires two passes....... Unfortunately, the use of a block cipher as a building block limits the performance of the authenticated encryption schemes to at most one message block per block cipher evaluation. In this paper, we propose the authenticated encryption scheme ASC-1 (Authenticating Stream Cipher One). Similarly to LEX, ASC-1...

  5. Advanced Stirling Convertor (ASC) Technology Maturation

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Scott; Collins, Josh; Wilson, Kyle

    2016-01-01

    The Advanced Stirling Convertor (ASC) development effort was initiated by NASA Glenn Research Center with contractor Sunpower, Inc., to develop high-efficiency thermal-to-electric power conversion technology for NASA Radioisotope Power Systems (RPSs). Early successful performance demonstrations led to the expansion of the project as well as adoption of the technology by the Department of Energy (DOE) and system integration contractor Lockheed Martin Space Systems Company as part of the Advanced Stirling Radioisotope Generator (ASRG) flight project. The ASRG integrates a pair of ASCs to convert the heat from a pair of General Purpose Heat Source (GPHS) modules into electrical power. The expanded NASA ASC effort included development of several generations of ASC prototypes or engineering units to help prepare the ASC technology and Sunpower for flight implementation. Sunpower later had two parallel contracts allowing the last of the NASA engineering units called ASC-E3 to serve as pathfinders for the ASC-F flight convertors being built for DOE. The ASC-E3 convertors utilized the ASC-F flight specifications and were built using the ASC-F design and process documentation. Shortly after the first ASC-F pair achieved initial operation, due to budget constraints, the DOE ASRG flight development contract was terminated. NASA continues to invest in the development of Stirling RPS technology including continued production of the ASC-E3 convertors, seven of which have been delivered with one additional unit in production. Starting in fiscal year 2015, Stirling Convertor Technology Maturation has been reorganized as an element of the RPS Stirling Cycle Technology Development (SCTD) Project and long-term plans for continued Stirling technology advancement are in reformulation. This paper provides a status on the ASC project, an overview of advancements made in the design and production of the ASC at Sunpower, and a summary of acceptance tests, reliability tests, and tactical

  6. 75 FR 80813 - Appraisal Subcommittee (ASC); ASC Rules of Operation; Amended

    Science.gov (United States)

    2010-12-23

    ... name and must rely on the General Services Administration (GSA) for the procurement of office space by... administration, procurement, and other services, consistent with directives of the ASC. In executing this... Conduct Section 11.01. Ethics Provision. The ASC members of the ASC and its officers and employees shall...

  7. Pangasius in the EU market; Prospects for the position of (ASC-certified) pangasius in the EU retail and food service sector

    NARCIS (Netherlands)

    Beukers, R.; Pijl, van der W.; Duijn, van A.P.

    2014-01-01

    The objective of this market study is to investigate the potential short- and long-term benefits for investors to invest in the production of pangasius with a trademark based on ASC certification, for the retail and food service market segments in the EU market.

  8. Performance Measurement of Advanced Stirling Convertors (ASC-E3)

    Science.gov (United States)

    Oriti, Salvatore M.

    2013-01-01

    NASA Glenn Research Center (GRC) has been supporting development of the Advanced Stirling Radioisotope Generator (ASRG) since 2006. A key element of the ASRG project is providing life, reliability, and performance testing data of the Advanced Stirling Convertor (ASC). The latest version of the ASC (ASC-E3, to represent the third cycle of engineering model test hardware) is of a design identical to the forthcoming flight convertors. For this generation of hardware, a joint Sunpower and GRC effort was initiated to improve and standardize the test support hardware. After this effort was completed, the first pair of ASC-E3 units was produced by Sunpower and then delivered to GRC in December 2012. GRC has begun operation of these units. This process included performance verification, which examined the data from various tests to validate the convertor performance to the product specification. Other tests included detailed performance mapping that encompassed the wide range of operating conditions that will exist during a mission. These convertors were then transferred to Lockheed Martin for controller checkout testing. The results of this latest convertor performance verification activity are summarized here.

  9. Pathfinding the Flight Advanced Stirling Convertor Design with the ASC-E3

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Kyle; Smith, Eddie; Collins, Josh

    2012-01-01

    The Advanced Stirling Convertor (ASC) was initially developed by Sunpower, Inc. under contract to NASA Glenn Research Center (GRC) as a technology development project. The ASC technology fulfills NASA's need for high efficiency power convertors for future Radioisotope Power Systems (RPS). Early successful technology demonstrations between 2003 to 2005 eventually led to the expansion of the project including the decision in 2006 to use the ASC technology on the Advanced Stirling Radioisotope Generator (ASRG). Sunpower has delivered 22 ASC convertors of progressively mature designs to date to GRC. Currently, Sunpower with support from GRC, Lockheed Martin Space System Company (LMSSC), and the Department of Energy (DOE) is developing the flight ASC-F in parallel with the ASC-E3 pathfinders. Sunpower will deliver four pairs of ASC-E3 convertors to GRC which will be used for extended operation reliability assessment, independent validation and verification testing, system interaction tests, and to support LMSSC controller verification. The ASC-E3 and -F convertors are being built to the same design and processing documentation and the same product specification. The initial two pairs of ASC-E3 are built before the flight units and will validate design and processing changes prior to implementation on the ASC-F flight convertors. This paper provides a summary on development of the ASC technology and the status of the ASC-E3 build and how they serve the vital pathfinder role ahead of the flight build for ASRG. The ASRG is part of two of the three candidate missions being considered for selection for the Discovery 12 mission.

  10. Advanced Stirling Convertor (ASC-E2) Characterization Testing

    Science.gov (United States)

    Williams, Zachary D.; Oriti, Salvatore M.

    2012-01-01

    Testing has been conducted on Advanced Stirling Convertors (ASCs)-E2 at NASA Glenn Research Center in support of the Advanced Stirling Radioisotope Generator (ASRG) project. This testing has been conducted to understand sensitivities of convertor parameters due to environmental and operational changes during operation of the ASRG in missions to space. This paper summarizes test results and explains the operation of the ASRG during space missions

  11. A multipurpose radiation service center

    International Nuclear Information System (INIS)

    Hofmann, E.-G.

    1977-01-01

    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)

  12. Advanced Stirling Convertor (ASC) Development for NASA RPS

    Science.gov (United States)

    Wong, Wayne A.; Wilson, Scott; Collins, Josh

    2014-01-01

    Sunpower's Advanced Stirling Convertor (ASC) initiated development under contract to the NASA Glenn Research Center (GRC) and after a series of successful demonstrations, the ASC began transitioning from a technology development project to flight development project. The ASC has very high power conversion efficiency making it attractive for future Radioisotope Power Systems (RPS) in order to make best use of the low plutonium-238 fuel inventory in the U.S. In recent years, the ASC became part of the NASA-Department of Energy Advanced Stirling Radioisotope Generator (ASRG) Integrated Project. Sunpower held two parallel contracts to produce ASC convertors, one with the Department of Energy/Lockheed Martin to produce the ASC-F flight convertors, and one with NASA GRC for the production of ASC-E3 engineering units, the initial units of which served as production pathfinders. The integrated ASC technical team successfully overcame various technical challenges that led to the completion and delivery of the first two pairs of flight-like ASC-E3 by 2013. However, in late Fall 2013, the DOE initiated termination of the Lockheed Martin ASRG flight development contract driven primarily by budget constraints. NASA continues to recognize the importance of high efficiency ASC power conversion for RPS and continues investment in the technology including the continuation of ASC-E3 production at Sunpower and the assembly of the ASRG Engineering Unit #2. This paper provides a summary of ASC technical accomplishments, overview of tests at GRC, plans for continued ASC production at Sunpower, and status of Stirling technology development.

  13. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... 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 ...

  14. Advanced Stirling Convertor (ASC) Technology Maturation in Preparation for Flight

    Science.gov (United States)

    Wong, Wayne A.; Cornell, Peggy A.

    2012-01-01

    The Advanced Stirling Convertor (ASC) is being developed by an integrated team of Sunpower and National Aeronautics and Space Administration s (NASA s) Glenn Research Center (GRC). The ASC development, funded by NASA s Science Mission Directorate, started as a technology development effort in 2003 and has since evolved through progressive convertor builds and successful testing to demonstrate high conversion efficiency, low mass, and capability to meet long-life Radioisotope Power System (RPS) requirements. The technology has been adopted by the Department of Energy and Lockheed Martin Space Systems Company s Advanced Stirling Radioisotope Generator (ASRG), which has been selected for potential flight demonstration on Discovery 12. This paper provides an overview of the status of ASC development including the most recent ASC-E2 convertors that have been delivered to GRC and an introduction to the ASC-E3 and ASC flight convertors that Sunpower will build next. The paper also describes the technology maturation and support tasks being conducted at GRC to support ASC and ASRG development in the areas of convertor and generator extended operation, high-temperature materials, heater head life assessment, organics, nondestructive inspection, spring fatigue testing, and other reliability verification tasks.

  15. Revision of ASCE 4

    International Nuclear Information System (INIS)

    Nelson, T.A.; Murray, R.C.; Short, S.A.

    1995-01-01

    The original version of ASCE Standard 4, ''Seismic Analysis of Safety-Related Nuclear Structures'' was published in September 1986. It is ASCE policy to update its standards on a five year interval and the Working Group on Seismic Analysis of Safety Related Nuclear Structures was reconvened to formulate the revisions. The goal in updating the standard is to make sure that it is still relevant and that it incorporates the state of the practice in seismic engineering or, in some cases, where it has been demonstrated that state-of-the-art improvements need to be made to standard practice; new improvements are included. The contents of the new standard cover the same areas as the original version, with some additions. The contents are as follows: Input - response spectra and time histories; modeling of structures; analysis of structures; soil-structure interaction; input for subsystem analysis; special structures - buried pipes and conduits, earth-retaining walls, above-ground vertical tanks, raceways, and base-isolated structures; and an appendix providing seismic probabilistic risk assessment and margin assessment

  16. Structure of AscE and Induced Burial Regions in AscE and AscG upon Formation of the Chaperone Needle-subunit Complex of Type III Secretion System in Aeromonas Hydrophila

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Y.; Yu, H; Leung, K; Sivaraman, J; Mok, Y

    2008-01-01

    In the type III secretion system (T3SS) of Aeromonas hydrophila, the putative needle complex subunit AscF requires both putative chaperones AscE and AscG for formation of a ternary complex to avoid premature assembly. Here we report the crystal structure of AscE at 2.7 A resolution and the mapping of buried regions of AscE, AscG, and AscF in the AscEG and AscEFG complexes using limited protease digestion. The dimeric AscE is comprised of two helix-turn-helix monomers packed in an antiparallel fashion. The N-terminal 13 residues of AscE are buried only upon binding with AscG, but this region is found to be nonessential for the interaction. AscE functions as a monomer and can be coexpressed with AscG or with both AscG and AscF to form soluble complexes. The AscE binding region of AscG in the AscEG complex is identified to be within the N-terminal 61 residues of AscG. The exposed C-terminal substrate-binding region of AscG in the AscEG complex is induced to be buried only upon binding to AscF. However, the N-terminal 52 residues of AscF remain exposed even in the ternary AscEFG complex. On the other hand, the 35-residue C-terminal region of AscF in the complex is resistant to protease digestion in the AscEFG complex. Site-directed mutagenesis showed that two C-terminal hydrophobic residues, Ile83 and Leu84, of AscF are essential for chaperone binding.

  17. Clean Energy Solutions Center Services

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    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.

  18. Client-Centered Employee Assistance Services.

    Science.gov (United States)

    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…

  19. International nuclear service centers: a bibliography

    International Nuclear Information System (INIS)

    Petty, G.M.; Yokota, M.

    1978-03-01

    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

  20. Clean Energy Solutions Center Services (Portuguese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    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.

  1. Authenticated Secure Container System (ASCS)

    International Nuclear Information System (INIS)

    1991-01-01

    Sandia National Laboratories developed an Authenticated Secure Container System (ASCS) for the International Atomic Energy Agency (IAEA). Agency standard weights and safeguards samples can be stored in the ASCS to provide continuity of knowledge. The ASCS consists of an optically clear cover, a base containing the Authenticated Item Monitoring System (AIMS) transmitter, and the AIMS receiver unit for data collection. The ASCS will provide the Inspector with information concerning the status of the system, during a surveillance period, such as state of health, tampering attempts, and movement of the container system. The secure container is located inside a Glove Box with the receiver located remotely from the Glove Box. AIMS technology uses rf transmission from the secure container to the receiver to provide a record of state of health and tampering. The data is stored in the receiver for analysis by the Inspector during a future inspection visit. 2 refs

  2. Health services at the Kennedy Space Center

    Science.gov (United States)

    Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.

    1992-01-01

    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.

  3. Modern Data Center Services Supporting Science

    Science.gov (United States)

    Varner, J. D.; Cartwright, J.; McLean, S. J.; Boucher, J.; Neufeld, D.; LaRocque, J.; Fischman, D.; McQuinn, E.; Fugett, C.

    2011-12-01

    The National Oceanic and Atmospheric Administration's National Geophysical Data Center (NGDC) World Data Center for Geophysics and Marine Geology provides scientific stewardship, products and services for geophysical data, including bathymetry, gravity, magnetics, seismic reflection, data derived from sediment and rock samples, as well as historical natural hazards data (tsunamis, earthquakes, and volcanoes). Although NGDC has long made many of its datasets available through map and other web services, it has now developed a second generation of services to improve the discovery and access to data. These new services use off-the-shelf commercial and open source software, and take advantage of modern JavaScript and web application frameworks. Services are accessible using both RESTful and SOAP queries as well as Open Geospatial Consortium (OGC) standard protocols such as WMS, WFS, WCS, and KML. These new map services (implemented using ESRI ArcGIS Server) are finer-grained than their predecessors, feature improved cartography, and offer dramatic speed improvements through the use of map caches. Using standards-based interfaces allows customers to incorporate the services without having to coordinate with the provider. Providing fine-grained services increases flexibility for customers building custom applications. The Integrated Ocean and Coastal Mapping program and Coastal and Marine Spatial Planning program are two examples of national initiatives that require common data inventories from multiple sources and benefit from these modern data services. NGDC is also consuming its own services, providing a set of new browser-based mapping applications which allow the user to quickly visualize and search for data. One example is a new interactive mapping application to search and display information about historical natural hazards. NGDC continues to increase the amount of its data holdings that are accessible and is augmenting the capabilities with modern web

  4. Modeling Road Traffic Using Service Center

    Directory of Open Access Journals (Sweden)

    HARAGOS, I.-M.

    2012-05-01

    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.

  5. 77 FR 25168 - Appraisal Subcommittee (ASC); ASC Rules of Operation; Amended

    Science.gov (United States)

    2012-04-27

    ... heads of the Bureau of Consumer Financial Protection and the Federal Housing Finance Agency. The ASC Rules of Operation serve as corporate bylaws outlining the ASC's purpose, functions, authority... Title XI. The ASC Rules of Operation serve as corporate bylaws outlining the ASC's purpose, functions...

  6. Test Hardware Design for Flightlike Operation of Advanced Stirling Convertors (ASC-E3)

    Science.gov (United States)

    Oriti, Salvatore M.

    2012-01-01

    NASA Glenn Research Center (GRC) has been supporting development of the Advanced Stirling Radioisotope Generator (ASRG) since 2006. A key element of the ASRG project is providing life, reliability, and performance testing of the Advanced Stirling Convertor (ASC). For this purpose, the Thermal Energy Conversion branch at GRC has been conducting extended operation of a multitude of free-piston Stirling convertors. The goal of this effort is to generate long-term performance data (tens of thousands of hours) simultaneously on multiple units to build a life and reliability database. The test hardware for operation of these convertors was designed to permit in-air investigative testing, such as performance mapping over a range of environmental conditions. With this, there was no requirement to accurately emulate the flight hardware. For the upcoming ASC-E3 units, the decision has been made to assemble the convertors into a flight-like configuration. This means the convertors will be arranged in the dual-opposed configuration in a housing that represents the fit, form, and thermal function of the ASRG. The goal of this effort is to enable system level tests that could not be performed with the traditional test hardware at GRC. This offers the opportunity to perform these system-level tests much earlier in the ASRG flight development, as they would normally not be performed until fabrication of the qualification unit. This paper discusses the requirements, process, and results of this flight-like hardware design activity.

  7. Medical service plans in academic medical centers.

    Science.gov (United States)

    Siegel, B

    1978-10-01

    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.

  8. Center for Surveillance, Epidemiology and Laboratory Services (CSELS)

    Data.gov (United States)

    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...

  9. Supercomputing Centers and Electricity Service Providers

    DEFF Research Database (Denmark)

    Patki, Tapasya; Bates, Natalie; Ghatikar, Girish

    2016-01-01

    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...

  10. [Development and application of hospital customer service center platform].

    Science.gov (United States)

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

    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.

  11. Clean Energy Solutions Center Services (Arabic Translation) (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-06-01

    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.

  12. Clean Energy Solutions Center Services (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-04-01

    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.

  13. Tri-Service Center for Oral Health Studies (TSCOHS)

    Data.gov (United States)

    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...

  14. Clean Energy Solutions Center Services (Arabic Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    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.

  15. Clean Energy Solutions Center Services (Vietnamese Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    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.

  16. Clean Energy Solutions Center Services (French Translation)

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    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.

  17. Student Centered Financial Services: Innovations That Succeed

    Science.gov (United States)

    Sinsabaugh, Nancy, Ed.

    2007-01-01

    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…

  18. Identifying Natural Alignments Between Ambulatory Surgery Centers and Local Health Systems: Building Broader Communities of Surgical Care.

    Science.gov (United States)

    Funk, Russell J; Owen-Smith, Jason; Landon, Bruce E; Birkmeyer, John D; Hollingsworth, John M

    2017-02-01

    To develop and compare methods for identifying natural alignments between ambulatory surgery centers (ASCs) and hospitals that anchor local health systems. Using all-payer data from Florida's State Ambulatory Surgery and Inpatient Databases (2005-2009), we developed 3 methods for identifying alignments between ASCS and hospitals. The first, a geographic proximity approach, used spatial data to assign an ASC to its nearest hospital neighbor. The second, a predominant affiliation approach, assigned an ASC to the hospital with which it shared a plurality of surgeons. The third, a network community approach, linked an ASC with a larger group of hospitals held together by naturally occurring physician networks. We compared each method in terms of its ability to capture meaningful and stable affiliations and its administrative simplicity. Although the proximity approach was simplest to implement and produced the most durable alignments, ASC surgeon's loyalty to the assigned hospital was low with this method. The predominant affiliation and network community approaches performed better and nearly equivalently on these metrics, capturing more meaningful affiliations between ASCs and hospitals. However, the latter's alignments were least durable, and it was complex to administer. We describe 3 methods for identifying natural alignments between ASCs and hospitals, each with strengths and weaknesses. These methods will help health system managers identify ASCs with which to partner. Moreover, health services researchers and policy analysts can use them to study broader communities of surgical care.

  19. 77 FR 14707 - Vet Center Services

    Science.gov (United States)

    2012-03-13

    ... 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...

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  1. Maintenance Centered Service Parts Inventory Control

    NARCIS (Netherlands)

    W.L. van Jaarsveld (Willem)

    2013-01-01

    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

  2. Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Data.gov (United States)

    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...

  3. 47 CFR 25.284 - Emergency Call Center Service.

    Science.gov (United States)

    2010-10-01

    ... 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...

  4. Health Services Cost Analyzing in Tabriz Health Centers 2008

    Directory of Open Access Journals (Sweden)

    Massumeh gholizadeh

    2015-08-01

    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. ​

  5. Utilization of maternal health services in rural primary health centers ...

    African Journals Online (AJOL)

    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 ...

  6. ASC-PROBA Interface Control Document

    DEFF Research Database (Denmark)

    Betto, Maurizio; Jørgensen, John Leif; Jørgensen, Finn E

    1999-01-01

    of Automation of the Technical University of Denmark. The document is structured as follows. First we present the ASC - heritage, system description, performance - then we address more specifically the environmental properties, like the EMC compatibility and thermal characteristics, and the design...... and reliability issues. Section 6 deals with the testing and the calibration procedures and in section 7 the mechanical and electrical interfaces are given. In section 8 and 9 we address issues like manufacturing, transportation and storage and to conclude we review the ASC specifications against the PROBA...

  7. The AscSimulationMode command

    DEFF Research Database (Denmark)

    Jørgensen, John Leif

    1998-01-01

    Complex instruments like the ASC may be quite difficult to test in closed loops. This problem is augmented by the fact, that no direct stimulation of the CHU is possible that will render the full performance, noise-spectrum and real-timeliness with high fidelity. In order to circumvent this impasse...

  8. Western New York Nuclear Service Center study. Companion report

    International Nuclear Information System (INIS)

    1978-01-01

    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

  9. 75 FR 45600 - Information Collection; Customer Data Worksheet Request for Service Center Information Management...

    Science.gov (United States)

    2010-08-03

    ... 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...

  10. Bureau of Indian Education (BIE), Albuquerque Service Center (ASC) Dispute Resolution in Special Education through Mediation. Parent/School and Mediator's Manual. Revised

    Science.gov (United States)

    Copenhaver, John

    2007-01-01

    Parents and school staff usually agree upon issues regarding evaluation, eligibility, program, and placement of students with disabilities. However, there are times when disagreement occurs. Disagreements and conflict are often inevitable, but they need not produce negative results. Mediation in special education is a process to assist parents and…

  11. Experience with Server Self Service Center (S3C)

    CERN Multimedia

    Sucik, J

    2009-01-01

    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.

  12. Experience with Server Self Service Center (S3C)

    International Nuclear Information System (INIS)

    Sucik, Juraj; Bukowiec, Sebastian

    2010-01-01

    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.

  13. Hospital image and the positioning of service centers: an application in market analysis and strategy development.

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

    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.

  14. Blended call center with idling times during the call service

    NARCIS (Netherlands)

    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

  15. Ambulatory surgery center market share and rates of outpatient surgery in the elderly.

    Science.gov (United States)

    Hollenbeck, Brent K; Hollingsworth, John M; Dunn, Rodney L; Zaojun Ye; Birkmeyer, John D

    2010-12-01

    Relative to outpatient surgery in hospital settings, ambulatory surgery centers (ASCs) are more efficient and associated with a lower cost per case. However, these facilities may also spur higher overall procedure utilization and thus lead to greater overall health care costs. The authors used the State Ambulatory Surgery Database from the State of Florida to identify Medicare-aged patients undergoing 4 common ambulatory procedures in 2006, including knee arthroscopy, cystoscopy, cataract removal, and colonoscopy. Hospital service areas (HSAs) were characterized according to ASC market share, that is, the proportion of residents undergoing outpatient surgery in these facilities. The authors then examined relationships between ASC market share and rates of each procedure. Age-adjusted rates of ambulatory surgery ranged from 190.5 cases per 1000 to 320.8 cases per 1000 in HSAs with low and high ASC market shares, respectively (P market share. The greatest difference, both in relative and absolute terms, was observed for patients undergoing cystoscopy. In areas of high ASC market share, the age-adjusted rate of cystoscopy was nearly 3-fold higher than in areas with low ASC market share (34.5 vs 11.9 per 1000 population; P elderly. Whether ASCs are meeting unmet clinical demand or spurring overutilization is not clear.

  16. Contents operation center for 'mopera' information service; Mopera joho service muke contents un'ei center

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    '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)

  17. ASC deficiency suppresses proliferation and prevents medulloblastoma incidence.

    Science.gov (United States)

    Knight, E R W; Patel, E Y; Flowers, C A; Crowther, A J; Ting, J P; Miller, C R; Gershon, T R; Deshmukh, M

    2015-01-15

    Apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) is silenced by promoter methylation in many types of tumors, yet ASC's role in most cancers remains unknown. Here, we show that ASC is highly expressed in a model of medulloblastoma, the most common malignant pediatric brain cancer; ASC is also expressed in human medulloblastomas. Importantly, while ASC deficiency did not affect normal cerebellar development, ASC knockout mice on the Smoothened (ND2:SmoA1) transgenic model of medulloblastoma exhibited a profound reduction in medulloblastoma incidence and a delayed tumor onset. A similar decrease in tumorigenesis with ASC deficiency was also seen in the hGFAP-Cre:SmoM2 mouse model of medulloblastoma. Interestingly, hyperproliferation of the external granule layer (EGL) was comparable at P20 in both wild-type and ASC-deficient SmoA1 mice. However, while the apoptosis and differentiation markers remained unchanged at this age, proliferation makers were decreased, and the EGL was reduced in thickness and area by P60. This reduction in proliferation with ASC deficiency was also seen in isolated SmoA1 cerebellar granule precursor cells in vitro, indicating that the effect of ASC deletion on proliferation was cell autonomous. Interestingly, ASC-deficient SmoA1 cerebella exhibited disrupted expression of genes in the transforming growth factor-β pathway and increased level of nuclear Smad3. Taken together, these results demonstrate an unexpected role for ASC in Sonic hedgehog-driven medulloblastoma tumorigenesis, thus identifying ASC as a promising novel target for antitumor therapy.

  18. Pathways to Healing: Person-centered Responses to Complementary Services

    Science.gov (United States)

    Bertrand, Sharon W.; Fermon, Barbara; Coleman, Julie Foley

    2014-01-01

    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

  19. Medicare program; update of ratesetting methodology, payment rates, payment policies, and the list of covered procedures for ambulatory surgical centers effective October 1, 1998; reopening of comment period and delay in adoption of the proposed rule as final--HCFA. Notice of reopening of comment period for proposed rule and delay in adoption of provisions of the proposed rule as final.

    Science.gov (United States)

    1998-10-01

    This notice reopens the comment period for a proposed rule affecting Medicare payments to ambulatory surgical centers (ASCs) that was originally published in the Federal Register on June 12, 1998 (63 FR 32290). This document gives notice of a delay in the adoption of the provisions of the June 12, 1998 ASC proposed rule as a final rule to be concurrent with the adoption as final of the hospital outpatient prospective payment system (PPS) that is the subject of a proposed rule published in the Federal Register on September 8, 1998 (63 FR 47551). In addition this document confirms that the current ASC payment rates that are effective for services furnished on or after October 1, 1998, will remain in effect until rebased ASC rates and the provisions of the June 12, 1998 ASC proposed rule are adopted as final to be concurrent with the adoption as final of the Medicare hospital PPS.

  20. ASC Trilab L2 Codesign Milestone 2015

    Energy Technology Data Exchange (ETDEWEB)

    Trott, Christian Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hammond, Simon David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dinge, Dennis [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lin, Paul T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vaughan, Courtenay T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cook, Jeanine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Edwards, Harold C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rajan, Mahesh [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hoekstra, Robert J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    For the FY15 ASC L2 Trilab Codesign milestone Sandia National Laboratories performed two main studies. The first study investigated three topics (performance, cross-platform portability and programmer productivity) when using OpenMP directives and the RAJA and Kokkos programming models available from LLNL and SNL respectively. The focus of this first study was the LULESH mini-application developed and maintained by LLNL. In the coming sections of the report the reader will find performance comparisons (and a demonstration of portability) for a variety of mini-application implementations produced during this study with varying levels of optimization. Of note is that the implementations utilized including optimizations across a number of programming models to help ensure claims that Kokkos can provide native-class application performance are valid. The second study performed during FY15 is a performance assessment of the MiniAero mini-application developed by Sandia. This mini-application was developed by the SIERRA Thermal-Fluid team at Sandia for the purposes of learning the Kokkos programming model and so is available in only a single implementation. For this report we studied its performance and scaling on a number of machines with the intent of providing insight into potential performance issues that may be experienced when similar algorithms are deployed on the forthcoming Trinity ASC ATS platform.

  1. DOSIMO - an interactive web service of the GSF Readout Center

    International Nuclear Information System (INIS)

    Huebner, S.; Lempart, R.

    2002-01-01

    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

  2. 77 FR 50519 - Center for Mental Health Services (CMHS); Amendment of Meeting

    Science.gov (United States)

    2012-08-21

    ... 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...

  3. Paying Personal Property Transportation Contracts at the Defense Finance and Accounting Service-Indianapolis Center

    National Research Council Canada - National Science Library

    Bridges, W

    1997-01-01

    ...; 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...

  4. NASA Space Weather Center Services: Potential for Space Weather Research

    Science.gov (United States)

    Zheng, Yihua; Kuznetsova, Masha; Pulkkinen, Antti; Taktakishvili, A.; Mays, M. L.; Chulaki, A.; Lee, H.; Hesse, M.

    2012-01-01

    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.

  5. [Patient-centered medicine for tuberculosis medical services].

    Science.gov (United States)

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    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

  6. ASC FY17 Implementation Plan, Rev. 1

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, P. G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-06-14

    The Stockpile Stewardship Program (SSP) is an integrated technical program for maintaining the safety, surety, and reliability of the U.S. nuclear stockpile. The SSP uses nuclear test data, computational modeling and simulation, and experimental facilities to advance understanding of nuclear weapons. It includes stockpile surveillance, experimental research, development and engineering programs, and an appropriately scaled production capability to support stockpile requirements. This integrated national program requires the continued use of experimental facilities and programs, and the computational capabilities to support these programs. The Advanced Simulation and Computing Program (ASC) is a cornerstone of the SSP, providing simulation capabilities and computational resources that support annual stockpile assessment and certification, study advanced nuclear weapons design and manufacturing processes, analyze accident scenarios and weapons aging, and provide the tools to enable stockpile Life Extension Programs (LEPs) and the resolution of Significant Finding Investigations (SFIs). This requires a balance of resources, including technical staff, hardware, simulation software, and computer science solutions.

  7. Shared services centers and work sustainability: which contributions from ergonomics?

    Science.gov (United States)

    Arnoud, Justine; Falzon, Pierre

    2012-01-01

    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.

  8. 78 FR 45543 - Center for Mental Health Services; Notice of Meeting

    Science.gov (United States)

    2013-07-29

    ... 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...

  9. Current neurotrauma treatment practice in secondary medical service centers

    International Nuclear Information System (INIS)

    Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

    2011-01-01

    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)

  10. Area health education centers and health science library services.

    Science.gov (United States)

    West, R T; Howard, F H

    1977-07-01

    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.

  11. Value-added Data Services at the Goddard Earth Sciences Data and Information Services Center

    Science.gov (United States)

    Leptoukh, G. G.; Alcott, G. T.; Kempler, S. J.; Lynnes, C. S.; Vollmer, B. E.

    2004-05-01

    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.

  12. 77 FR 72868 - The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA...

    Science.gov (United States)

    2012-12-06

    ... 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...

  13. NLRP3 and ASC suppress lupus-like autoimmunity by driving the immunosuppressive effects of TGF-β receptor signalling.

    Science.gov (United States)

    Lech, Maciej; Lorenz, Georg; Kulkarni, Onkar P; Grosser, Marian O O; Stigrot, Nora; Darisipudi, Murthy N; Günthner, Roman; Wintergerst, Maximilian W M; Anz, David; Susanti, Heni Eka; Anders, Hans-Joachim

    2015-12-01

    The NLRP3/ASC inflammasome drives host defence and autoinflammatory disorders by activating caspase-1 to trigger the secretion of mature interleukin (IL)-1β/IL-18, but its potential role in autoimmunity is speculative. We generated and phenotyped Nlrp3-deficient, Asc-deficient, Il-1r-deficient and Il-18-deficient C57BL/6-lpr/lpr mice, the latter being a mild model of spontaneous lupus-like autoimmunity. While lack of IL-1R or IL-18 did not affect the C57BL/6-lpr/lpr phenotype, lack of NLRP3 or ASC triggered massive lymphoproliferation, lung T cell infiltrates and severe proliferative lupus nephritis within 6 months, which were all absent in age-matched C57BL/6-lpr/lpr controls. Lack of NLRP3 or ASC increased dendritic cell and macrophage activation, the expression of numerous proinflammatory mediators, lymphocyte necrosis and the expansion of most T cell and B cell subsets. In contrast, plasma cells and autoantibody production were hardly affected. This unexpected immunosuppressive effect of NLRP3 and ASC may relate to their known role in SMAD2/3 phosphorylation during tumour growth factor (TGF)-β receptor signalling, for example, Nlrp3-deficiency and Asc-deficiency significantly suppressed the expression of numerous TGF-β target genes in C57BL/6-lpr/lpr mice and partially recapitulated the known autoimmune phenotype of Tgf-β1-deficient mice. These data identify a novel non-canonical immunoregulatory function of NLRP3 and ASC in autoimmunity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Clean Energy Solutions Center Services (Vietnamese Translation) (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-11-01

    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.

  15. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    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

  16. The Astrobiology in Secondary Classrooms (ASC) curriculum: focusing upon diverse students and teachers.

    Science.gov (United States)

    Arino de la Rubia, Leigh S

    2012-09-01

    The Minority Institution Astrobiology Collaborative (MIAC) began working with the NASA Goddard Center for Astrobiology in 2003 to develop curriculum materials for high school chemistry and Earth science classes based on astrobiology concepts. The Astrobiology in Secondary Classrooms (ASC) modules emphasize interdisciplinary connections in astronomy, biology, chemistry, geoscience, physics, mathematics, and ethics through hands-on activities that address national educational standards. Field-testing of the Astrobiology in Secondary Classrooms materials occurred over three years in eight U.S. locations, each with populations that are underrepresented in the career fields of science, technology, engineering, and mathematics. Analysis of the educational research upon the high school students participating in the ASC project showed statistically significant increases in students' perceived knowledge and science reasoning. The curriculum is in its final stages, preparing for review to become a NASA educational product.

  17. The development of the brake system of the BMW 850i including ABS and ASC. Entwicklung des Bremssystems des BMW 850i einschliesslich ABS und ASC

    Energy Technology Data Exchange (ETDEWEB)

    Kraft, H.J.; Leffler, H.

    1990-02-01

    The brake system of the new BMW 850i is described in the following. The brake actuation takes place via an hydraulic brake booster. The disc brakes at front and rear axle are arranged in diagnonal brake split. The 4-channel ABS is fitted as standard equipment. The ABS control unit also incorporates the algorithm for the Automatic Stability Control System ASC or ASC+T. The ASC+T shows improved traction compared with the pure stability system ASC and is standard in the BMW 850i with manual gear box. The automatic gear box equipped BMW 850i are supplied with ASC, the ASC+T is available as an option. Both systems, the ASC and the ASC+T are described with special view on the electronical and hydraulical network in the car. A performance comparison of the ASC-systems completes the description. (orig.).

  18. ASC Addresses Unit Commanders' Concerns through LBE and Reset Programs

    National Research Council Canada - National Science Library

    Young, Mark E

    2008-01-01

    .... Army Sustainment Command (ASC), part of the U.S. Army Materiel Command (AMC) team, is available to assist, identify, and resolve equipment and maintenance problems as well as materiel readiness issues for combatant commanders...

  19. USDA-ASCS 1936-1939 Air Photos

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data set is a digital version of aerial photographs taken during the 1936-1939 time frame for the USDA-ASCS. These photos were originally recorded at a scale of...

  20. The American Satellite Company (ASC) satellite deployed from payload bay

    Science.gov (United States)

    1985-01-01

    The American Satellite Company (ASC) communications satellite is deployed from the payload bay of the Shuttle Discovery. A portion of the cloudy surface of the earth can be seen to the left of the frame.

  1. Terrestrial Hydrological Data from NASA's Hydrology Data and Information Services Center (HDISC): Products, Services, and Applications

    Science.gov (United States)

    Fang, Hongliang; Beaudoing, Hiroko K.; Mocko, David M.; Rodell, Matthew; Teng, Bill; Vollmer, Bruce

    2010-01-01

    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.

  2. Statement of Accountability Reconciliation Procedures for Defense Finance and Accounting Service Columbus Center, Disbursing Station 6551

    National Research Council Canada - National Science Library

    1998-01-01

    .... 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...

  3. Documentation of the Federal Financial System Process at the Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1997-01-01

    .... 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...

  4. About Region 3's Laboratory and Field Services at EPA's Environmental Science Center

    Science.gov (United States)

    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

  5. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

    Energy Technology Data Exchange (ETDEWEB)

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia; Pilch, Martin M.

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.

  6. Quality of Family Planning Services in Primary Health Centers of ...

    African Journals Online (AJOL)

    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 ...

  7. Semantic Data Access Services at NASA's Atmospheric Science Data Center

    Science.gov (United States)

    Huffer, E.; Hertz, J.; Kusterer, J.

    2012-12-01

    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

  8. 78 FR 14303 - Statement of Delegation of Authority; Health Resources and Services Administration and Centers...

    Science.gov (United States)

    2013-03-05

    ... 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...

  9. 41 CFR 101-30.504 - Cataloging data from Defense Logistics Services Center (DLSC).

    Science.gov (United States)

    2010-07-01

    ... 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...

  10. Ambulatory surgery centers and interventional techniques: a look at long-term survival.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Parr, Allan T; Singh, Vijay; Fellows, Bert

    2011-01-01

    With health care expenditures skyrocketing, coupled with pervasive quality deficits, pressures to provide better and more proficient care continue to shape the landscape of the U.S. health care system. Payers, both federal and private, have laid out several initiatives designed to curtail costs, including value-based reimbursement programs, cost-shifting expenses to the consumer, reducing reimbursements for physicians, steering health care to more efficient settings, and finally affordable health care reform. Consequently, one of the major aspects in the expansion of health care for improving quality and reducing the costs is surgical services. Nearly 57 million outpatient procedures are performed annually in the United States, 14 million of which occur in elderly patients. Increasing use of these minor, yet common, procedures contributes to rising health care expenditures. Once exclusive within hospitals, more and more outpatient procedures are being performed in freestanding ambulatory surgery centers (ASCs), physician offices, visits to which have increased over 300% during the past decade. Concurrent with this growing demand, the number of ASCs has more than doubled since the 1990s, with more than 5,000 facilities currently in operation nationwide. Further, total surgical center ASC payments have increased from $1.2 billion in 1999 to $3.2 billion in 2009, a 167% increase. On the same lines, growth and expenditures for hospital outpatient department (HOPD) services and office procedures also have been evident at similar levels. Recent surveys have illustrated on overall annual growth per capita in Medicare allowed ASC services of pain management of 23%, with 27% growth seen in ASCs and 16% of the growth seen in HOPD. Further, the proportion of interventional pain management which was 4% of Medicare ASC spending in 2000 has increase to 10% in 2007. Thus, interventional pain management as an evolving specialty is one of the most commonly performed procedures in

  11. Service Delivery and Related Issues at the Trace Research and Development Center.

    Science.gov (United States)

    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,…

  12. Pediatric Oncology Branch - Support Services | Center for Cancer Research

    Science.gov (United States)

    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.

  13. Nuclear information services at the National Nuclear Data Center

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  14. Nuclear data services of the Nuclear Data Centers Network available at the National Nuclear Data Center

    International Nuclear Information System (INIS)

    McLane, V.

    1997-01-01

    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.)

  15. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    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,...

  16. Nuclear information services at the National Nuclear Data Center

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  17. HR Shared Service Centers: From Brand Management Towards Success

    NARCIS (Netherlands)

    van Balen, Mitchell; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    2009-01-01

    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

  18. Structured Communication-Centered Programming for Web Services

    DEFF Research Database (Denmark)

    Carbone, Marco; Honda, Kohei; Yoshida, Nobuko

    2012-01-01

    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...

  19. CSRQ Center Report on Education Service Providers: Educator's Summary

    Science.gov (United States)

    Center for Data-Driven Reform in Education (NJ3), 2008

    2008-01-01

    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…

  20. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    Science.gov (United States)

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    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

  1. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Directory of Open Access Journals (Sweden)

    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.

  2. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Science.gov (United States)

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    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.

  3. Defense Agency Travel Payments at Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    1997-01-01

    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...

  4. Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

    National Research Council Canada - National Science Library

    Diehl, Diane S

    2004-01-01

    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...

  5. Outsourcing of Defense Supply Center, Columbus, Bus and Taxi Service Operations

    National Research Council Canada - National Science Library

    Granetto, Paul

    1999-01-01

    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...

  6. NOAA Coastal Services Center Coastal Inundation Digital Elevation Model: Philadelphia WFO - Pennsylvania

    Data.gov (United States)

    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...

  7. World Key Information Service System Designed For EPCOT Center

    Science.gov (United States)

    Kelsey, J. A.

    1984-03-01

    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.

  8. National Space Science Data Center and World Data Center A for Rockets and Satellites - Ionospheric data holdings and services

    Science.gov (United States)

    Bilitza, D.; King, J. H.

    1988-01-01

    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.

  9. A Study Investigating the Perceived Service Quality Levels of Sport Center Members: A Kano Model Perspective

    Science.gov (United States)

    Yildiz, Kadir; Polat, Ercan; Güzel, Pinar

    2018-01-01

    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…

  10. Utilization of Mental Health Services in School-Based Health Centers

    Science.gov (United States)

    Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-01-01

    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…

  11. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Science.gov (United States)

    2010-10-01

    ... 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...

  12. A Variable Service Broker Routing Policy for data center selection in cloud analyst

    Directory of Open Access Journals (Sweden)

    Ahmad M. Manasrah

    2017-07-01

    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.

  13. Effect of Outsourced Pharmacies of Rural Healthcare Centers on Service Quality in Abharand Soltanieh Counties

    Directory of Open Access Journals (Sweden)

    Ali Maher

    2016-05-01

    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.

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

    Science.gov (United States)

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

    2010-01-01

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

  15. Introduction to Recreation Services for People with Disabilities: A Person-Centered Approach. 3rd Edition

    Science.gov (United States)

    Bullock, Charles C.; Mahon, Michael J.; Killingsworth, Charles L.

    2010-01-01

    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…

  16. Human‐Centered Design: Integrating Services & Systems Around People By Providing A Common Ground for Action

    DEFF Research Database (Denmark)

    Junginger, Sabine

    2014-01-01

    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...

  17. Mental Health Services in School-Based Health Centers: Systematic Review

    Science.gov (United States)

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    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…

  18. Service of Remembrance: a comprehensive cancer center's response to bereaved family members.

    Science.gov (United States)

    Knight, Louise; Cooper, Rhonda S; Hypki, Cinder

    2012-01-01

    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.

  19. Virtualized Multi-Mission Operations Center (vMMOC) and its Cloud Services

    Science.gov (United States)

    Ido, Haisam Kassim

    2017-01-01

    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.

  20. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010

    Directory of Open Access Journals (Sweden)

    mohammad javad tarrahi

    2012-06-01

    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.

  1. Product and service design for patient centered diabetes care

    Directory of Open Access Journals (Sweden)

    Soumitri Varadarajan

    2009-11-01

    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.

  2. Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: Providing an IND/IDE Consult Service in a Decentralized Network of Academic Healthcare Centers

    Science.gov (United States)

    Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia

    2014-01-01

    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

  3. Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: providing an IND/IDE consult service in a decentralized network of academic healthcare centers.

    Science.gov (United States)

    Kim, Min J; Winkler, Sabune J; Bierer, Barbara E; Wolf, Delia

    2014-04-01

    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.

  4. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  5. Innovation in user-centered skills and performance improvement for sustainable complex service systems.

    Science.gov (United States)

    Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    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.

  6. USER SERVICES AND EXTENSION SERVICES IN SELECTED SPECIAL LIBRARIES AND INFORMATION CENTERS IN THE UNITED STATES.

    Science.gov (United States)

    NONINI, CERISE

    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…

  7. Spatial Data Services for Interdisciplinary Applications from the NASA Socioeconomic Data and Applications Center

    Science.gov (United States)

    Chen, R. S.; MacManus, K.; Vinay, S.; Yetman, G.

    2016-12-01

    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

  8. Extended Operation of Stirling Convertors at NASA Glenn Research Center

    Science.gov (United States)

    Oriti, Salvatore, M.

    2012-01-01

    NASA Glenn Research Center (GRC) has been supporting development of free-piston Stirling conversion technology for spaceflight electrical power generation since 1999. GRC has also been supporting the development of the Advanced Stirling Radioisotope Generator (ASRG) since 2006. A key element of the ASRG project is providing life, reliability, and performance data for the Advanced Stirling Convertor (ASC). The Thermal Energy Conversion branch at GRC is conducting extended operation of several free-piston Stirling convertors. The goal of this effort is to generate long-term performance data (tens of thousands of hours) on multiple units to build a life and reliability database. Currently, GRC is operating 18 convertors. This hardware set includes Technology Demonstration Convertors (TDCs) from Infinia Corporation, of which one pair (TDCs #13 and #14) has accumulated over 60,000 hr (6.8 years) of operation. Also under test are various Sunpower, Inc. convertors that were fabricated during the ASC development activity, including ASC-0, ASC-E (including those in the ASRG engineering unit), and ASC-E2. The ASC-E2s also completed, or are in progress of completing workmanship vibration testing, performance mapping, and extended operation. Two ASC-E2 units will also be used for durability testing, during which components will be stressed to levels above nominal mission usage. Extended operation data analyses from these tests are covered in this paper.

  9. Evaluation and Validation of Organic Materials for Advanced Stirling Convertors (ASCs): Overview

    Science.gov (United States)

    Shin, Euy-Sik Eugene

    2015-01-01

    Various organic materials are used as essential parts in Stirling Convertors for their unique properties and functionalities such as bonding, potting, sealing, thread locking, insulation, and lubrication. More efficient Advanced Stirling Convertors (ASC) are being developed for future space applications especially with a long mission cycle, sometimes up to 17 years, such as deep space exploration or lunar surface power or Mars rovers, and others. Thus, performance, durability, and reliability of those organics should be critically evaluated in every possible material-process-fabrication-service environment relations based on their mission specifications. In general, thermal stability, radiation hardness, outgassing, and material compatibility of the selected organics have been systematically evaluated while their process and fabrication conditions and procedures were being optimized. Service environment-simulated long term aging tests up to 4 years were performed as a function of temperature for durability assessment of the most critical organic material systems.

  10. Evaluation of poison information services provided by a new poison information center.

    Science.gov (United States)

    Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G

    2013-01-01

    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

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

    International Nuclear Information System (INIS)

    Vanchugov, A.G.

    2003-01-01

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

  12. INTERACTION BEHAVIOUR LEADING TO COMFORTIN SERVICE ENCOUNTER OF NOTEBOOK PERIPHERAL SERVICE CENTER BUSINESS

    OpenAIRE

    Dr. Wachyudi.N.*

    2018-01-01

    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...

  13. 75 FR 78997 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

    Science.gov (United States)

    2010-12-17

    ... 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...

  14. Managing service potentiality of small urban centers case study: City of Sardasht, south east of Iran

    Directory of Open Access Journals (Sweden)

    Farjam Rasoul

    2017-06-01

    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.

  15. Middle Tier Services Accessing the Chandra X-Ray Center Data Archive

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  17. Competitive service centers location in the cities with aim to reduce traffic (Case study: Health centers location in the city if Isfahan

    Directory of Open Access Journals (Sweden)

    Hamid Moradi

    2011-03-01

    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.

  18. Using the "customer service framework" to successfully implement patient- and family-centered care.

    Science.gov (United States)

    Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

    2011-01-01

    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.

  19. Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

    Science.gov (United States)

    Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

    2016-10-01

    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

  20. Web Services and Other Enhancements at the Northern California Earthquake Data Center

    Science.gov (United States)

    Neuhauser, D. S.; Zuzlewski, S.; Allen, R. M.

    2012-12-01

    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

  1. Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

    Science.gov (United States)

    Eklund, Mona; Markström, Urban

    2015-11-01

    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.

  2. Implementation of Cooperative Learning in the Center for Community Service and Continuing Education at Kuwait University

    Science.gov (United States)

    Alansari, Eissa M.

    2006-01-01

    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…

  3. Competing Goodness: Perceptions of Person-Centered Culture Change within Human Service Agencies

    Science.gov (United States)

    Starling, Stacey Lee

    2012-01-01

    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…

  4. Characteristics of Children with Autism Spectrum Disorders Who Received Services through Community Mental Health Centers

    Science.gov (United States)

    Bryson, Stephanie A.; Corrigan, Susan K.; McDonald, Thomas P.; Holmes, Cheryl

    2008-01-01

    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…

  5. 76 FR 13618 - Delegation of Authority; Centers for Medicare & Medicaid Services

    Science.gov (United States)

    2011-03-14

    ... 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...

  6. An Overview of Hydrologic Studies at Center for Forested Wetlands Research, USDA Forest Service

    Science.gov (United States)

    Devendra M. Amatya; Carl C. Trettin; R. Wayne Skaggs; Timothy J. Callahan; Ge Sun; Masato Miwa; John E. Parsons

    2004-01-01

    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...

  7. Innovative Services Offered by School-Based Health Centers in New York City

    Science.gov (United States)

    Sisselman, Amanda; Strolin-Goltzman, Jessica; Auerbach, Charles; Sharon, Lisa

    2012-01-01

    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,…

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

    Science.gov (United States)

    Duckenfield, Marty, Ed.

    2011-01-01

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

  9. Interconnection Structures, Management and Routing Challenges in Cloud-Service Data Center Networks: A Survey

    Directory of Open Access Journals (Sweden)

    Ahmad Nahar Quttoum

    2018-01-01

    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

  10. Compilation of FY 1995 and FY 1996 DOD Financial Statements at the Defense Finance and Accounting Service, Indianapolis Center

    National Research Council Canada - National Science Library

    1996-01-01

    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...

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

    Science.gov (United States)

    Shea, E.

    2008-12-01

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

  12. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

    Directory of Open Access Journals (Sweden)

    Arezoo Chouhdari

    2015-03-01

    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.

  13. Model of Emergency and Observation Nursing Services at the Community Health Center in East Java

    Directory of Open Access Journals (Sweden)

    Dwi Ananto Wibrata

    2017-07-01

    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.

  14. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    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.

  15. [The Engineering and Technical Services Directorate at the Glenn Research Center

    Science.gov (United States)

    Moon, James

    2004-01-01

    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.

  16. Satisfaction and Related Factors among the Service Users of Private Rehabilitation Centers

    Directory of Open Access Journals (Sweden)

    Shahrzad Pakjouei

    2014-12-01

    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.

  17. iRODS-Based Climate Data Services and Virtualization-as-a-Service in the NASA Center for Climate Simulation

    Science.gov (United States)

    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.

    2011-12-01

    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.

  18. The Geodetic Seamless Archive Centers Service Layer: A System Architecture for Federating Geodesy Data Repositories

    Science.gov (United States)

    McWhirter, J.; Boler, F. M.; Bock, Y.; Jamason, P.; Squibb, M. B.; Noll, C. E.; Blewitt, G.; Kreemer, C. W.

    2010-12-01

    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

  19. Pros and cons of practice-owned and office-based ambulatory surgery centers.

    Science.gov (United States)

    Bert, J M

    2000-01-01

    A detailed feasibility analysis is imperative to ensure the success of a practice-owned ASC. Analysis of the payer mix and the market relating to surgical volume that can be performed at the ASC is imperative. If overbuilding, overequipping, and overstaffing are avoided and the group has adequate volume that can be managed at the ASC, the facility should be a success. Building a practice-owned ASC without an accurate and detailed financial feasibility and payer study can place the endeavor at risk. A well-planned, economically constructed and properly managed ASC will result in an efficient and successful ancillary service for the orthopedic group practice.

  20. Person-centered care planning and service engagement: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Stanhope, Victoria; Tondora, Janis; Davidson, Larry; Choy-Brown, Mimi; Marcus, Steven C

    2015-04-22

    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

  1. Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

    Science.gov (United States)

    Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine

    2010-01-01

    Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

  2. 34 CFR 645.13 - What additional services do Upward Bound Math and Science Centers provide and how are they...

    Science.gov (United States)

    2010-07-01

    ... 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...

  3. 38 CFR 13.55 - Veterans Service Center Manager to select and appoint or recommend for appointment the person or...

    Science.gov (United States)

    2010-07-01

    ... 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...

  4. High-level waste solidification system for the Western New York Nuclear Service Center

    International Nuclear Information System (INIS)

    Carrell, J.R.; Holton, L.K.; Siemens, D.H.

    1982-01-01

    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

  5. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    OpenAIRE

    Larson, S; Chapman, S; Spetz, J; Brindis, CD

    2017-01-01

    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...

  6. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr. (,; .); Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  7. Service utilization in community health centers in China: a comparison analysis with local hospitals

    Directory of Open Access Journals (Sweden)

    Wang Xiaohang

    2006-08-01

    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.

  8. Characteristics of service requests and service processes of fire and rescue service dispatch centers: analysis of real world data and the underlying probability distributions.

    Science.gov (United States)

    Krueger, Ute; Schimmelpfeng, Katja

    2013-03-01

    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.

  9. Global Land Data Assimilation System (GLDAS) Products, Services and Application from NASA Hydrology Data and Information Services Center (HDISC)

    Science.gov (United States)

    Fang, Hongliang; Beaudoing, Hiroko K.; Rodell, matthew; Teng, William L.; Vollmer, Bruce E.

    2009-01-01

    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.

  10. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  11. Expectations and Perceptions of the Educational Service at the Universidad Nacional Abierta (Local Center Merida, Venezuela

    Directory of Open Access Journals (Sweden)

    Teresa de Jesús Molina Gutiérrez

    2017-08-01

    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.

  12. Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

    Science.gov (United States)

    Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

    2018-02-01

    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.

  13. FY17 ASC CSSE L2 Milestone 6018: Power Usage Characteristics of Workloads Running on Trinity.

    Energy Technology Data Exchange (ETDEWEB)

    Pedretti, Kevin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-09-01

    The overall goal of this work was to utilize the Advanced Power Management (APM) capabilities of the ATS-1 Trinity platform to understand the power usage behavior of ASC workloads running on Trinity and gain insight into the potential for utilizing power management techniques on future ASC platforms.

  14. Family-Centered Services for Children with ASD and Limited Speech: The Experiences of Parents and Speech-Language Pathologists

    Science.gov (United States)

    Mandak, Kelsey; Light, Janice

    2018-01-01

    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…

  15. Web Services and Data Enhancements at the Northern California Earthquake Data Center

    Science.gov (United States)

    Neuhauser, D. S.; Zuzlewski, S.; Lombard, P. N.; Allen, R. M.

    2013-12-01

    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

  16. Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers

    Science.gov (United States)

    2015-01-01

    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

  17. Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers.

    Science.gov (United States)

    de la Torre-Díez, Isabel; Lopez-Coronado, Miguel; Garcia-Zapirain Soto, Begonya; Mendez-Zorrilla, Amaia

    2015-07-27

    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.

  18. Referral Practices Among U.S. Publicly Funded Health Centers That Offer Family Planning Services.

    Science.gov (United States)

    Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan

    2018-01-29

    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.

  19. Factors influencing the behavior of pregnant women towards using prenatal care services in Iranian healthcare centers

    Directory of Open Access Journals (Sweden)

    Parisa Parsa

    2018-01-01

    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.

  20. Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

    Science.gov (United States)

    Manzano, Joanna-Grace M; Gadiraju, Sahitya; Hiremath, Adarsh; Lin, Heather Yan; Farroni, Jeff; Halm, Josiah

    2015-09-01

    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.

  1. Differential splicing of the apoptosis-associated speck like protein containing a caspase recruitment domain (ASC regulates inflammasomes

    Directory of Open Access Journals (Sweden)

    Rojanasakul Yon

    2010-05-01

    Full Text Available Abstract Background The apoptotic speck-like protein containing a caspase recruitment domain (ASC is the essential adaptor protein for caspase 1 mediated interleukin (IL-1β and IL-18 processing in inflammasomes. It bridges activated Nod like receptors (NLRs, which are a family of cytosolic pattern recognition receptors of the innate immune system, with caspase 1, resulting in caspase 1 activation and subsequent processing of caspase 1 substrates. Hence, macrophages from ASC deficient mice are impaired in their ability to produce bioactive IL-1β. Furthermore, we recently showed that ASC translocates from the nucleus to the cytosol in response to inflammatory stimulation in order to promote an inflammasome response, which triggers IL-1β processing and secretion. However, the precise regulation of inflammasomes at the level of ASC is still not completely understood. In this study we identified and characterized three novel ASC isoforms for their ability to function as an inflammasome adaptor. Methods To establish the ability of ASC and ASC isoforms as functional inflammasome adaptors, IL-1β processing and secretion was investigated by ELISA in inflammasome reconstitution assays, stable expression in THP-1 and J774A1 cells, and by restoring the lack of endogenous ASC in mouse RAW264.7 macrophages. In addition, the localization of ASC and ASC isoforms was determined by immunofluorescence staining. Results The three novel ASC isoforms, ASC-b, ASC-c and ASC-d display unique and distinct capabilities to each other and to full length ASC in respect to their function as an inflammasome adaptor, with one of the isoforms even showing an inhibitory effect. Consistently, only the activating isoforms of ASC, ASC and ASC-b, co-localized with NLRP3 and caspase 1, while the inhibitory isoform ASC-c, co-localized only with caspase 1, but not with NLRP3. ASC-d did not co-localize with NLRP3 or with caspase 1 and consistently lacked the ability to function as an

  2. Report on the feasibility study for improving electric motor service centers in Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, J.S.; Jallouk, P.A.; Staunton, R.H.

    1999-12-10

    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.

  3. Balanced Scorecards As a Tool for Developing Patient-Centered Pharmacy Services

    Science.gov (United States)

    Enwere, Emmanuel N.; Keating, Ellen A.; Weber, Robert J.

    2014-01-01

    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

  4. Web Services Implementations at Land Process and Goddard Earth Sciences Distributed Active Archive Centers

    Science.gov (United States)

    Cole, M.; Bambacus, M.; Lynnes, C.; Sauer, B.; Falke, S.; Yang, W.

    2007-12-01

    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.

  5. Compilation of the FY 1997 Navy General Fund Financial Statements at the Defense Finance and Accounting Service Cleveland Center

    National Research Council Canada - National Science Library

    1998-01-01

    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...

  6. DEBT COLLECTION IMPROVEMENT ACT OF 1996: HHS's Centers for Medicare & Medicaid Services Faces Challenges to Fully Implement Certain Key Provisions

    National Research Council Canada - National Science Library

    2002-01-01

    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...

  7. Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

    Science.gov (United States)

    2008-06-06

    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

  8. Family-centered services for children with complex communication needs: the practices and beliefs of school-based speech-language pathologists.

    Science.gov (United States)

    Mandak, Kelsey; Light, Janice

    2018-06-01

    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.

  9. Dimorfismo de ascósporos em Glomerella cingulata f.sp. phaseoli

    OpenAIRE

    Castro, Renata A.; Mendes-Costa, Maria C.; Souza, Elaine A.

    2006-01-01

    O objetivo deste trabalho foi caracterizar linhagens de Glomerella cingulata f. sp. phaseoli quanto ao crescimento micelial, formação de peritécio e dimorfismo de ascósporos. Foram avaliadas quatro linhagens nos meios de cultura de folhas de feijoeiro e meio M3 e em condições com e sem fotoperíodo. O comprimento dos ascósporos da linhagem normal e da mutante foi determinado. Houve diferença significativa quanto ao crescimento micelial e tamanho dos ascósporos. Constatou-se, pela primeira vez,...

  10. [Financing of regional occupational health service centers: structure and financial criteria in years 2000-2001].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2003-01-01

    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.

  11. Student Services/One Stop Centers: A Qualitative Examination of Implementation at Three Post-Secondary Institutions

    Science.gov (United States)

    Becker, Janine M.

    2012-01-01

    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…

  12. Observing principles of medical ethics during family planning services at Tehran urban healthcare centers in 2007

    Directory of Open Access Journals (Sweden)

    Saeed Motevallizadeh

    2011-01-01

    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

  13. A Cost Analysis of Day Care Centers in Pennsylvania. Center for Human Service Development Report No. 21.

    Science.gov (United States)

    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…

  14. Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

    Science.gov (United States)

    Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

    2015-10-01

    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.

  15. Implementation an human resources shared services center: Multinational company strategy in fusion context

    Directory of Open Access Journals (Sweden)

    João Paulo Bittencourt

    2016-09-01

    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.

  16. Power reactor services provided by the Penn State Radiation Science and Engineering Center

    International Nuclear Information System (INIS)

    Voth, M.H.; Jester, W.A.

    1993-01-01

    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

  17. Extension of Small-Scale Postharvest Horticulture Technologies—A Model Training and Services Center

    Directory of Open Access Journals (Sweden)

    Lisa Kitinoja

    2015-07-01

    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.

  18. Aeroacoustics research in Europe : the CEAS-ASC report on 2007 highlights

    NARCIS (Netherlands)

    Brouwer, H.H.; Rienstra, S.W.

    2008-01-01

    The Council of European Aerospace Societies (CEAS) Aeroacoustics Specialists Committee (ASC) supports and promotes the interests of the scientific and industrial aeroacoustics community on a European scale and European aeronautics activities internationally. In this context, "aeroacoustics"

  19. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    Science.gov (United States)

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2006-01-01

    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

  20. Performance evaluation of data center service localization based on virtual resource migration in software defined elastic optical network.

    Science.gov (United States)

    Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young

    2015-09-07

    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.

  1. Absence of the inflammasome adaptor ASC reduces hypoxia-induced pulmonary hypertension in mice.

    Science.gov (United States)

    Cero, Fadila Telarevic; Hillestad, Vigdis; Sjaastad, Ivar; Yndestad, Arne; Aukrust, Pål; Ranheim, Trine; Lunde, Ida Gjervold; Olsen, Maria Belland; Lien, Egil; Zhang, Lili; Haugstad, Solveig Bjærum; Løberg, Else Marit; Christensen, Geir; Larsen, Karl-Otto; Skjønsberg, Ole Henning

    2015-08-15

    Pulmonary hypertension is a serious condition that can lead to premature death. The mechanisms involved are incompletely understood although a role for the immune system has been suggested. Inflammasomes are part of the innate immune system and consist of the effector caspase-1 and a receptor, where nucleotide-binding oligomerization domain-like receptor pyrin domain-containing 3 (NLRP3) is the best characterized and interacts with the adaptor protein apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC). To investigate whether ASC and NLRP3 inflammasome components are involved in hypoxia-induced pulmonary hypertension, we utilized mice deficient in ASC and NLRP3. Active caspase-1, IL-18, and IL-1β, which are regulated by inflammasomes, were measured in lung homogenates in wild-type (WT), ASC(-/-), and NLRP3(-/-) mice, and phenotypical changes related to pulmonary hypertension and right ventricular remodeling were characterized after hypoxic exposure. Right ventricular systolic pressure (RVSP) of ASC(-/-) mice was significantly lower than in WT exposed to hypoxia (40.8 ± 1.5 mmHg vs. 55.8 ± 2.4 mmHg, P right ventricular remodeling. RVSP of NLRP3(-/-) mice exposed to hypoxia was not significantly altered compared with WT hypoxia. Whereas hypoxia increased protein levels of caspase-1, IL-18, and IL-1β in WT and NLRP3(-/-) mice, this response was absent in ASC(-/-) mice. Moreover, ASC(-/-) mice displayed reduced muscularization and collagen deposition around arteries. In conclusion, hypoxia-induced elevated right ventricular pressure and remodeling were attenuated in mice lacking the inflammasome adaptor protein ASC, suggesting that inflammasomes play an important role in the pathogenesis of pulmonary hypertension. Copyright © 2015 the American Physiological Society.

  2. The Union Health Center: a working model of clinical care linked to preventive occupational health services.

    Science.gov (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

    1997-03-01

    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

  3. Comparative Study of Customer Satisfaction for Four Service Center by Using House of Quality (HoQ)

    International Nuclear Information System (INIS)

    Fazila Said; Mohammad Nasir Saluddin

    2012-01-01

    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)

  4. Test Rack Development for Extended Operation of Advanced Stirling Convertors at NASA Glenn Research Center

    Science.gov (United States)

    Dugala, Gina M.

    2010-01-01

    The U.S. Department of Energy, Lockheed Martin Space Systems Company, Sunpower Inc., and NASA Glenn Research Center (GRC) have been developing an Advanced Stirling Radioisotope Generator (ASRG) for use as a power system on space science missions. This generator will make use of free-piston Stirling convertors to achieve higher conversion efficiency than with currently available alternatives. One part of NASA GRC's support of ASRG development includes extended operation testing of Advanced Stirling Convertors (ASCs) developed by Sunpower Inc. and GRC. The ASC consists of a free-piston Stirling engine integrated with a linear alternator. NASA GRC has been building test facilities to support extended operation of the ASCs for several years. Operation of the convertors in the test facility provides convertor performance data over an extended period of time. One part of the test facility is the test rack, which provides a means for data collection, convertor control, and safe operation. Over the years, the test rack requirements have changed. The initial ASC test rack utilized an alternating-current (AC) bus for convertor control; the ASRG Engineering Unit (EU) test rack can operate with AC bus control or with an ASC Control Unit (ACU). A new test rack is being developed to support extended operation of the ASC-E2s with higher standards of documentation, component selection, and assembly practices. This paper discusses the differences among the ASC, ASRG EU, and ASC-E2 test racks.

  5. Determining rules for closing customer service centers: A public utility company's fuzzy decision

    Science.gov (United States)

    Dekorvin, Andre; Shipley, Margaret F.; Lea, Robert N.

    1992-01-01

    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.

  6. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers.

    Science.gov (United States)

    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

    2015-09-01

    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.

  7. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

    Directory of Open Access Journals (Sweden)

    Adel A. Alhamdan

    2015-09-01

    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.

  8. Providing Total Quality Fundamentals: 1995 Workshops for the NASA Lewis Research Center's Technical Services Directorate

    Science.gov (United States)

    Antczak, Paul; Jacinto,Gilda; Simek, Jimmy

    1997-01-01

    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.

  9. Utilization of Mental Health Services in School-Based Health Centers.

    Science.gov (United States)

    Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-08-01

    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.

  10. Immunocytoexpression profile of ProExC in smears interpreted as ASC-US, ASC-H, and cervical intraepithelial lesion

    Directory of Open Access Journals (Sweden)

    Zeynep Tosuner

    2017-01-01

    Full Text Available Aims: We aimed to investigate the immunocytoexpression profiles of a novel assay ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 in abnormal interpreted smears. Settings and Design: Screening programs with Papanicolaou smear and high risk group human papilloma virus testing have yielded a dramatic reduction of cervical cancer incidence. However, both of these tests have limited specificity for the detection of clinically significant cervical high grade lesions. ProEx C for topoisomerase II alpha (TOP2A and minichromosome maintenance protein 2 (MCM2 has been considered to have tight association with high grade intraepithelial lesions. Materials and Methods: A total number of 54 SurePath cervical cytology specimens of patients previously interpreted as atypical squamous cells-undetermined significance (ASC-US, atypical squamous cells-cannot exclude high grade squamous intraepithelial lesion (ASC-H, low grade squamous intraepithelial lesion (LSIL, and high grade squamous intraepithelial lesion (HSIL were included in our study. Results and Conclusions: ProEx C was positive in 14 of HSILs (100%, 3 of 19 LSILs (16%, 2 of 4 ASC-Hs, and none of ASC-USs (0%. The ProEx C test showed very intense nuclear staining in all cytologically abnormal cells. Further studies are indicated to evaluate the diagnostic role of ProEx C.

  11. The Identifying, Evaluating and Prioritizing the Factors Affecting Customers’ Satisfaction with E-service Centers of Iran's Police

    Directory of Open Access Journals (Sweden)

    Seyed Ali Ziaee Azimi

    2016-11-01

    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.

  12. Impelementation of Information Technology Service Management at Data And Information System Center of XYZ University

    Directory of Open Access Journals (Sweden)

    Kornelius Irfandhi

    2016-03-01

    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.

  13. Designing for Social Infrastructures in Complex Service Systems: A Human-Centered and Social Systems Perspective on Service Design

    Directory of Open Access Journals (Sweden)

    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.

  14. Service line structure and decision-maker attention in three health systems: Implications for patient-centered care.

    Science.gov (United States)

    Louis, Christopher J; Clark, Jonathan R; Gray, Barbara; Brannon, Diane; Parker, Victoria

    2017-06-15

    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

  15. Acute stress among adolescents and female rape victims measured by ASC-Kids: a pilot study.

    Science.gov (United States)

    Nilsson, Doris; Nordenstam, Carin; Green, Sara; Wetterhall, Annika; Lundin, Tom; Svedin, Carl Göran

    2015-01-01

    Rape is considered a stressful trauma and often with durable consequences. How the aftermath of rape is for young adolescents' girls considering acute stress is an overlooked field and remains to be studied. In this study, we wanted to investigate acute stress among adolescent victims of rape and the psychometric properties of the Acute Stress Checklist for Children (ASC-Kids). A clinical sample (n = 79) of raped girls, 13-17 years old who had turned to a special rape victim unit for treatment, answered the ASC-Kids. ASC-Kids was also given to a group of minor stressed, non-raped adolescents in the same age range (n = 154) together with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI), and the Sense of Coherence Scale 13 (SOC-13). The scores from the groups were compared and showed significant differences in mean values on all the diagnostic criteria of acute stress disorder. In the clinical group, 36.7% obtained full ASD criteria. ASC-Kids could discriminate well between groups. Cronbach's alpha was found to be excellent, and the correlation between the UCLA PTSD RI and ASC-Kids found to be good; both ASC-Kids and UCLA PTSD RI had a good and moderate negative correlation with SOC-13. Adolescent female rape victims were shown to have a very high level of acute stress, and the ASC-Kids was found to have sound psychometrics and can be a valuable screening instrument to support clinicians in their assessments of an indication of adolescents after potentially stressful events such as rape.

  16. Payroll Expenses Reported by the Defense Finance and Accounting Service Columbus Center

    National Research Council Canada - National Science Library

    1998-01-01

    .... 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...

  17. A family-centered, community-based system of services for children and youth with special health care needs.

    Science.gov (United States)

    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

    2007-10-01

    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.

  18. A Proposal for the Consolidation of Dermatology Services of Walter Reed Army Medical Center and the National Naval Medical Center

    Science.gov (United States)

    1999-08-01

    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

  19. Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

    Science.gov (United States)

    Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

    2007-01-01

    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.

  20. Innovative Practices to Sustain and Renew Service and Patient-centered Outcomes

    Science.gov (United States)

    Noelke, Nancy

    2014-01-01

    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

  1. Exploring an Agenda of Accommodation and Support at a Disabilities Service Center for College Students with Psychiatric Disabilities

    OpenAIRE

    松田, 康子

    2016-01-01

    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 ...

  2. Final Environmental Assessment: Addressing An Army and Air Force Exchange Service (AAFES) Lifestyle Center at Eglin Air Force Base, Florida

    Science.gov (United States)

    2008-11-01

    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

  3. A Study of Children's Geographic Access to Health Services (Health Care Centers and Clinical Laboratories in Kermanshah City, Iran

    Directory of Open Access Journals (Sweden)

    Sohyla Reshadat

    2018-02-01

    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.

  4. Factors Related to the Work Performance of Midwives in the IUD Contraception Service in Primary Healthcare Centers of Surabaya City

    OpenAIRE

    Anggasari, Yasi; Kartasurya, Martha Irene; Suparwati, Anneke

    2013-01-01

    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...

  5. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Waste Disposal Facility

    Energy Technology Data Exchange (ETDEWEB)

    Ansley, Shannon Leigh

    2002-02-01

    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.

  6. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility; TOPICAL

    International Nuclear Information System (INIS)

    Ansley, Shannon L.

    2002-01-01

    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

  7. Information, education, and communication services in MCH care provided at an urban health center

    Directory of Open Access Journals (Sweden)

    Banerjee Bratati

    2009-01-01

    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.

  8. An Analysis of Cloud Computing with Amazon Web Services for the Atmospheric Science Data Center

    Science.gov (United States)

    Gleason, J. L.; Little, M. M.

    2013-12-01

    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.

  9. Preoperational Subsurface Conditions at the Idaho Nuclear Technology and Engineering Center Service Wastewater Discharge Facility

    International Nuclear Information System (INIS)

    Ansley, Shannon L.

    2002-01-01

    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

  10. Immigrant Workers Centers in Eastern Massachusetts, USA: Fostering Services, Support, Advocacy, and Community Organizing

    Directory of Open Access Journals (Sweden)

    Humberto Reynoso-Vallejo

    2013-01-01

    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

  11. Single-Molecule Fluorescence Reveals the Oligomerization and Folding Steps Driving the Prion-like Behavior of ASC.

    Science.gov (United States)

    Gambin, Yann; Giles, Nichole; O'Carroll, Ailís; Polinkovsky, Mark; Hunter, Dominic; Sierecki, Emma

    2018-02-16

    Single-molecule fluorescence has the unique ability to quantify small oligomers and track conformational changes at a single-protein level. Here we tackled one of the most extreme protein behaviors, found recently in an inflammation pathway. Upon danger recognition in the cytosol, NLRP3 recruits its signaling adaptor, ASC. ASC start polymerizing in a prion-like manner and the system goes in "overdrive" by producing a single micron-sized "speck." By precisely controlling protein expression levels in an in vitro translation system, we could trigger the polymerization of ASC and mimic formation of specks in the absence of inflammasome nucleators. We utilized single-molecule spectroscopy to fully characterize prion-like behaviors and self-propagation of ASC fibrils. We next used our controlled system to monitor the conformational changes of ASC upon fibrillation. Indeed, ASC consists of a PYD and CARD domains, separated by a flexible linker. Individually, both domains have been found to form fibrils, but the structure of the polymers formed by the full-length ASC proteins remains elusive. For the first time, using single-molecule Förster resonance energy transfer, we studied the relative positions of the CARD and PYD domains of full-length ASC. An unexpectedly large conformational change occurred upon ASC fibrillation, suggesting that the CARD domain folds back onto the PYD domain. However, contradicting current models, the "prion-like" conformer was not initiated by binding of ASC to the NLRP3 platform. Rather, using a new method, hybrid between Photon Counting Histogram and Number and Brightness analysis, we showed that NLRP3 forms hexamers with self-binding affinities around 300nM. Overall our data suggest a new mechanism, where NLRP3 can initiate ASC polymerization simply by increasing the local concentration of ASC above a supercritical level. Copyright © 2017. Published by Elsevier Ltd.

  12. Activities of an ethics consultation service in a Tertiary Military Medical Center.

    Science.gov (United States)

    Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

    2000-07-01

    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.

  13. THE SHARED SERVICES CENTERS OF THE MULTINATIONAL COMPANIES: LOCALIZATION AND CULTURAL CHALLENGES.

    Directory of Open Access Journals (Sweden)

    Marco Túlio Ospina Patino

    2014-10-01

    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.

  14. Control of Database Applications at the Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    1997-01-01

    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...

  15. PRINCIPLES OF DESIGNING THE CENTER FOR ADMINISTRATIVE SERVICES IN DNIPROPETROVS’K

    Directory of Open Access Journals (Sweden)

    PODOLYNNY S. I.

    2016-01-01

    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

  16. Ambulatory surgery center and general hospital competition: entry decisions and strategic choices.

    Science.gov (United States)

    Al-Amin, Mona; Housman, Michael

    2012-01-01

    General hospitals are consistently under pressure to control cost and improve quality. In addition to mounting payers' demands, hospitals operate under evolving market conditions that might threaten their survival. While hospitals traditionally were concerned mainly with competition from other hospitals, today's reimbursement schemes and entrepreneurial activities encouraged the proliferation of outpatient facilities such as ambulatory surgery centers (ASCs) that can jeopardize hospitals' survival. The purpose of this article was to examine the relationship between ASCs and general hospitals. More specifically, we apply the niche overlap theory to study the impact that competition between ASCs and general hospitals has on the survival chances of both of these organizational populations. Our analysis examined interpopulation competition in models of organizational mortality and market demand. We utilized Cox proportional hazard models to evaluate the impact of competition from each on ASC and hospital exit while controlling for market factors. We relied on two data sets collected and developed by Florida's Agency for Health Care Administration: outpatient facility licensure data and inpatient and outpatient surgical procedure data. Although ASCs do tend to exit markets in which there are high levels of ASC competition, we found no evidence to suggest that ASC exit rates are affected by hospital density. On the other hand, hospitals not only tend to exit markets with high levels of hospital competition but also experience high exit rates in markets with high ASC density. The implications from our study differ for ASCs and hospitals. When making decisions about market entry, ASCs should choose their markets according to the following: demand for outpatient surgery, number of physicians who would practice in the surgery center, and the number of surgery centers that already exist in the market. Hospitals, on the other hand, should account for competition from ASCs

  17. CO2 Data Distribution and Support from the Goddard Earth Science Data and Information Services Center (GES-DISC)

    Science.gov (United States)

    Hearty, Thomas; Savtchenko, Andrey; Vollmer, Bruce; Albayrak, Arif; Theobald, Mike; Esfandiari, Ed; Wei, Jennifer

    2015-01-01

    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.

  18. Career Advancement and Work Support Services on the Job: Implementing the Fort Worth Work Advancement and Support Center Program

    Science.gov (United States)

    Schultz, Caroline; Seith, David

    2011-01-01

    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…

  19. Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center

    Directory of Open Access Journals (Sweden)

    Li-Hua Guo

    2014-08-01

    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.

  20. Comparison of Simulated Microgravity and Hydrostatic Pressure for Chondrogenesis of hASC.

    Science.gov (United States)

    Mellor, Liliana F; Steward, Andrew J; Nordberg, Rachel C; Taylor, Michael A; Loboa, Elizabeth G

    2017-04-01

    Cartilage tissue engineering is a growing field due to the lack of regenerative capacity of native tissue. The use of bioreactors for cartilage tissue engineering is common, but the results are controversial. Some studies suggest that microgravity bioreactors are ideal for chondrogenesis, while others show that mimicking hydrostatic pressure is crucial for cartilage formation. A parallel study comparing the effects of loading and unloading on chondrogenesis has not been performed. The goal of this study was to evaluate chondrogenesis of human adipose-derived stem cells (hASC) under two different mechanical stimuli relative to static culture: microgravity and cyclic hydrostatic pressure (CHP). Pellets of hASC were cultured for 14 d under simulated microgravity using a rotating wall vessel bioreactor or under CHP (7.5 MPa, 1 Hz, 4 h · d-1) using a hydrostatic pressure vessel. We found that CHP increased mRNA expression of Aggrecan, Sox9, and Collagen II, caused a threefold increase in sulfated glycosaminoglycan production, and resulted in stronger vimentin staining intensity and organization relative to microgravity. In addition, Wnt-signaling patterns were altered in a manner that suggests that simulated microgravity decreases chondrogenic differentiation when compared to CHP. Our goal was to compare chondrogenic differentiation of hASC using a microgravity bioreactor and a hydrostatic pressure vessel, two commonly used bioreactors in cartilage tissue engineering. Our results indicate that CHP promotes hASC chondrogenesis and that microgravity may inhibit hASC chondrogenesis. Our findings further suggest that cartilage formation and regeneration might be compromised in space due to the lack of mechanical loading.Mellor LF, Steward AJ, Nordberg RC, Taylor MA, Loboa EG. Comparison of simulated microgravity and hydrostatic pressure for chondrogenesis of hASC. Aerosp Med Hum Perform. 2017; 88(4):377-384.

  1. Exploring spatial change and gravity center movement for ecosystem services value using a spatially explicit ecosystem services value index and gravity model.

    Science.gov (United States)

    He, Yingbin; Chen, Youqi; Tang, Huajun; Yao, Yanmin; Yang, Peng; Chen, Zhongxin

    2011-04-01

    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.

  2. PERCEPTION OF PATIENTS ON ART ABOUT THE SERVICES AVAILED AT LINK ART CENTERS IN SELECTED STATES OF INDIA

    Directory of Open Access Journals (Sweden)

    Ruchi Sogarwal

    2012-07-01

    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.

  3. PERCEPTION OF PATIENTS ON ART ABOUT THE SERVICES AVAILED AT LINK ART CENTERS IN SELECTED STATES OF INDIA

    Directory of Open Access Journals (Sweden)

    Ruchi Sogarwal

    2012-06-01

    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.

  4. MicroASC instrument onboard Juno spacecraft utilizing inertially controlled imaging

    DEFF Research Database (Denmark)

    Pedersen, David Arge Klevang; Jørgensen, Andreas Härstedt; Benn, Mathias

    2016-01-01

    This contribution describes the post-processing of the raw image data acquired by the microASC instrument during the Earth-fly-by of the Juno spacecraft. The images show a unique view of the Earth and Moon system as seen from afar. The procedure utilizes attitude measurements and inter......-calibration of the Camera Head Units of the microASC system to trigger the image capturing. The triggering is synchronized with the inertial attitude and rotational phase of the sensor acquiring the images. This is essentially works as inertially controlled imaging facilitating image acquisition from unexplored...

  5. Fundamentals of civil engineering an introduction to the ASCE body of knowledge

    CERN Document Server

    McCuen, Richard H; Wong, Melanie K

    2011-01-01

    While the ASCE Body of Knowledge (BOK2) is the codified source for all technical and non-technical information necessary for those seeking to attain licensure in civil engineering, recent graduates have notoriously been lacking in the non-technical aspects even as they excel in the technical. Fundamentals of Civil Engineering: An Introduction to the ASCE Body of Knowledge addresses this shortfall and helps budding engineers develop the knowledge, skills, and attitudes suggested and implied by the BOK2. Written as a resource for all of the non-technical outcomes not specifically covered in the

  6. Required number of records for ASCE/SEI 7 ground-motion scaling procedure

    Science.gov (United States)

    Reyes, Juan C.; Kalkan, Erol

    2011-01-01

    The procedures and criteria in 2006 IBC (International Council of Building Officials, 2006) and 2007 CBC (International Council of Building Officials, 2007) for the selection and scaling ground-motions for use in nonlinear response history analysis (RHA) of structures are based on ASCE/SEI 7 provisions (ASCE, 2005, 2010). According to ASCE/SEI 7, earthquake records should be selected from events of magnitudes, fault distance, and source mechanisms that comply with the maximum considered earthquake, and then scaled so that the average value of the 5-percent-damped response spectra for the set of scaled records is not less than the design response spectrum over the period range from 0.2Tn to 1.5Tn sec (where Tn is the fundamental vibration period of the structure). If at least seven ground-motions are analyzed, the design values of engineering demand parameters (EDPs) are taken as the average of the EDPs determined from the analyses. If fewer than seven ground-motions are analyzed, the design values of EDPs are taken as the maximum values of the EDPs. ASCE/SEI 7 requires a minimum of three ground-motions. These limits on the number of records in the ASCE/SEI 7 procedure are based on engineering experience, rather than on a comprehensive evaluation. This study statistically examines the required number of records for the ASCE/SEI 7 procedure, such that the scaled records provide accurate, efficient, and consistent estimates of" true" structural responses. Based on elastic-perfectly-plastic and bilinear single-degree-of-freedom systems, the ASCE/SEI 7 scaling procedure is applied to 480 sets of ground-motions. The number of records in these sets varies from three to ten. The records in each set were selected either (i) randomly, (ii) considering their spectral shapes, or (iii) considering their spectral shapes and design spectral-acceleration value, A(Tn). As compared to benchmark (that is, "true") responses from unscaled records using a larger catalog of ground

  7. Data and Data Products for Climate Research: Web Services at the Asia-Pacific Data-Research Center (APDRC)

    Science.gov (United States)

    DeCarlo, S.; Potemra, J. T.; Wang, K.

    2012-12-01

    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

  8. Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan.

    Science.gov (United States)

    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

    2016-11-01

    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

  9. [Physical and pharmacological restraints in geriatric and gerontology services and centers].

    Science.gov (United States)

    Ramos Cordero, Primitivo; López Trigo, José Antonio; Maíllo Pedraz, Herminio; Paz Rubio, José María

    2015-01-01

    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

  10. Orion Crew Module / Service Module Structural Weight and Center of Gravity Simulator and Vehicle Motion Simulator Hoist Structure for Orion Service Module Umbilical Testing

    Science.gov (United States)

    Ascoli, Peter A.; Haddock, Michael H.

    2014-01-01

    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.

  11. The Centers for Medicare and Medicaid Services (CMS) two midnight rule: policy at odds with reality.

    Science.gov (United States)

    Huntington, Ciara R; Blair, Laurel J; Cox, Tiffany C; Prasad, Tanushree; Kercher, Kent W; Augenstein, Vedra A; Heniford, B Todd

    2016-02-01

    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.

  12. Inter-linkage between Hinterlands and Service Centers of Bima and Darbang VDCs in Myagdi District: A Rural Development Perspective

    Directory of Open Access Journals (Sweden)

    Beg Prasad Garbuja

    2015-12-01

    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.

  13. Report of experiments and evidence for ASC L2 milestone 4467 : demonstration of a legacy application's path to exascale.

    Energy Technology Data Exchange (ETDEWEB)

    Curry, Matthew L.; Ferreira, Kurt Brian; Pedretti, Kevin Thomas Tauke; Leung, Vitus Joseph; Moreland, Kenneth D.; Lofstead, Gerald Fredrick, II; Gentile, Ann C. (Sandia National Laboratories, Livermore, CA); Klundt, Ruth Ann; Ward, H. Lee; Laros, James H., III; Hemmert, Karl Scott; Fabian, Nathan D.; Levenhagen, Michael J.; Barrett, Brian W.; Brightwell, Ronald Brian; Barrett, Richard; Wheeler, Kyle Bruce; Kelly, Suzanne Marie; Rodrigues, Arun F.; Brandt, James M. (Sandia National Laboratories, Livermore, CA); Thompson, David (Sandia National Laboratories, Livermore, CA); VanDyke, John P.; Oldfield, Ron A.; Tucker, Thomas (Open Grid Computing, Inc., Austin, TX); Vaughan, Courtenay Thomas

    2012-03-01

    This report documents thirteen of Sandia's contributions to the Computational Systems and Software Environment (CSSE) within the Advanced Simulation and Computing (ASC) program between fiscal years 2009 and 2012. It describes their impact on ASC applications. Most contributions are implemented in lower software levels allowing for application improvement without source code changes. Improvements are identified in such areas as reduced run time, characterizing power usage, and Input/Output (I/O). Other experiments are more forward looking, demonstrating potential bottlenecks using mini-application versions of the legacy codes and simulating their network activity on Exascale-class hardware. The purpose of this report is to prove that the team has completed milestone 4467-Demonstration of a Legacy Application's Path to Exascale. Cielo is expected to be the last capability system on which existing ASC codes can run without significant modifications. This assertion will be tested to determine where the breaking point is for an existing highly scalable application. The goal is to stretch the performance boundaries of the application by applying recent CSSE RD in areas such as resilience, power, I/O, visualization services, SMARTMAP, lightweight LWKs, virtualization, simulation, and feedback loops. Dedicated system time reservations and/or CCC allocations will be used to quantify the impact of system-level changes to extend the life and performance of the ASC code base. Finally, a simulation of anticipated exascale-class hardware will be performed using SST to supplement the calculations. Determine where the breaking point is for an existing highly scalable application: Chapter 15 presented the CSSE work that sought to identify the breaking point in two ASC legacy applications-Charon and CTH. Their mini-app versions were also employed to complete the task. There is no single breaking point as more than one issue was found with the two codes. The results were

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

    Science.gov (United States)

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

    2009-12-01

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

  15. 75 FR 25845 - Office of Special Education and Rehabilitative Services (OSERS); Overview Information; Centers...

    Science.gov (United States)

    2010-05-10

    ... 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...

  16. Profiling Autism Symptomatology: An Exploration of the Q-ASC Parental Report Scale in Capturing Sex Differences in Autism

    Science.gov (United States)

    Ormond, Sarah; Brownlow, Charlotte; Garnett, Michelle Sarah; Rynkiewicz, Agnieszka; Attwood, Tony

    2018-01-01

    The Questionnaire for Autism Spectrum Conditions (Q-ASC) was developed by Attwood et al. (2011) to identify gender-sensitive profiles of autism symptomatology; prioritise and adjust the direction of clinical interventions; and support positive psychosocial outcomes and prognosis into adulthood. The current research piloted the Q-ASC with parents…

  17. Structure and assembly of the mouse ASC inflammasome by combined NMR spectroscopy and cryo-electron microscopy

    Science.gov (United States)

    Sborgi, Lorenzo; Ravotti, Francesco; Dandey, Venkata P.; Dick, Mathias S.; Mazur, Adam; Reckel, Sina; Chami, Mohamed; Scherer, Sebastian; Huber, Matthias; Böckmann, Anja; Egelman, Edward H.; Stahlberg, Henning; Broz, Petr; Meier, Beat H.; Hiller, Sebastian

    2015-01-01

    Inflammasomes are multiprotein complexes that control the innate immune response by activating caspase-1, thus promoting the secretion of cytokines in response to invading pathogens and endogenous triggers. Assembly of inflammasomes is induced by activation of a receptor protein. Many inflammasome receptors require the adapter protein ASC [apoptosis-associated speck-like protein containing a caspase-recruitment domain (CARD)], which consists of two domains, the N-terminal pyrin domain (PYD) and the C-terminal CARD. Upon activation, ASC forms large oligomeric filaments, which facilitate procaspase-1 recruitment. Here, we characterize the structure and filament formation of mouse ASC in vitro at atomic resolution. Information from cryo-electron microscopy and solid-state NMR spectroscopy is combined in a single structure calculation to obtain the atomic-resolution structure of the ASC filament. Perturbations of NMR resonances upon filament formation monitor the specific binding interfaces of ASC-PYD association. Importantly, NMR experiments show the rigidity of the PYD forming the core of the filament as well as the high mobility of the CARD relative to this core. The findings are validated by structure-based mutagenesis experiments in cultured macrophages. The 3D structure of the mouse ASC-PYD filament is highly similar to the recently determined human ASC-PYD filament, suggesting evolutionary conservation of ASC-dependent inflammasome mechanisms. PMID:26464513

  18. 18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

  19. How many records should be used in ASCE/SEI-7 ground motion scaling procedure?

    Science.gov (United States)

    Reyes, Juan C.; Kalkan, Erol

    2012-01-01

    U.S. national building codes refer to the ASCE/SEI-7 provisions for selecting and scaling ground motions for use in nonlinear response history analysis of structures. Because the limiting values for the number of records in the ASCE/SEI-7 are based on engineering experience, this study examines the required number of records statistically, such that the scaled records provide accurate, efficient, and consistent estimates of “true” structural responses. Based on elastic–perfectly plastic and bilinear single-degree-of-freedom systems, the ASCE/SEI-7 scaling procedure is applied to 480 sets of ground motions; the number of records in these sets varies from three to ten. As compared to benchmark responses, it is demonstrated that the ASCE/SEI-7 scaling procedure is conservative if fewer than seven ground motions are employed. Utilizing seven or more randomly selected records provides more accurate estimate of the responses. Selecting records based on their spectral shape and design spectral acceleration increases the accuracy and efficiency of the procedure.

  20. Aeroacoustics research in Europe : the CEAS-ASC report on 1997 highlights

    NARCIS (Netherlands)

    Rienstra, S.W.

    1998-01-01

    This paper is a report on the highlights of aeroacoustics research and development in Europe in 1997, compiled from information provided in the CEAS Aeroacoustics Specialists Committee (ASC). The Confederation of European Aerospace Societies (CEAS) comprises the national Aerospace Societies of

  1. Probability-Based Design Criteria of the ASCE 7 Tsunami Loads and Effects Provisions (Invited)

    Science.gov (United States)

    Chock, G.

    2013-12-01

    Mitigation of tsunami risk requires a combination of emergency preparedness for evacuation in addition to providing structural resilience of critical facilities, infrastructure, and key resources necessary for immediate response and economic and social recovery. Critical facilities would include emergency response, medical, tsunami refuges and shelters, ports and harbors, lifelines, transportation, telecommunications, power, financial institutions, and major industrial/commercial facilities. The Tsunami Loads and Effects Subcommittee of the ASCE/SEI 7 Standards Committee is developing a proposed new Chapter 6 - Tsunami Loads and Effects for the 2016 edition of the ASCE 7 Standard. ASCE 7 provides the minimum design loads and requirements for structures subject to building codes such as the International Building Code utilized in the USA. In this paper we will provide a review emphasizing the intent of these new code provisions and explain the design methodology. The ASCE 7 provisions for Tsunami Loads and Effects enables a set of analysis and design methodologies that are consistent with performance-based engineering based on probabilistic criteria. . The ASCE 7 Tsunami Loads and Effects chapter will be initially applicable only to the states of Alaska, Washington, Oregon, California, and Hawaii. Ground shaking effects and subsidence from a preceding local offshore Maximum Considered Earthquake will also be considered prior to tsunami arrival for Alaska and states in the Pacific Northwest regions governed by nearby offshore subduction earthquakes. For national tsunami design provisions to achieve a consistent reliability standard of structural performance for community resilience, a new generation of tsunami inundation hazard maps for design is required. The lesson of recent tsunami is that historical records alone do not provide a sufficient measure of the potential heights of future tsunamis. Engineering design must consider the occurrence of events greater than

  2. National atmospheric release advisory center (NARAC) tools and services for emergency management

    International Nuclear Information System (INIS)

    Nasstrom, J.

    2003-01-01

    Full text: This paper describes recent scientific and technological advances in the National Atmospheric Release Advisory Center (NARAC) that aid emergency management. The U.S. Department of Energy's NARAC system provides tools and services that help map the probable spread of hazardous material accidentally or intentionally released into the atmosphere. Located at Lawrence Livermore National Laboratory, NARAC is a national support and resource center for planning, real-time assessment and detailed studies of incidents involving a wide variety of hazards, including nuclear, radiological, chemical, or biological emissions. In recent years, the DOE National Nuclear Security Agency (NNSA) Office of Emergency Response and Chemical and Biological National Security Program (CBNP) have supported major upgrades and modernization of NARAC that have advanced the accuracy and utility of NARAC products for emergency planning and management. A new NARAC central modeling system, which became operational in the year 2000, has provided a higher-resolution suite of diagnostic and prognostic meteorological models, and a Lagrangian particle dispersion model, for producing predictions of air concentration, ground deposition, and dose. The 3-D meteorological data assimilation model, ADAPT, and Lagrangian particle dispersion model, LODI, allow the simulation of mean wind advection, turbulent diffusion, radioactive decay and production, bio-agent degradation, first-order chemical reactions, wet deposition, gravitational settling, dry deposition, and buoyant/momentum plume rise. The functions performed by this system have been fully automated to minimized response time for emergencies. An in-house version of the Naval Research Laboratory's COAMPS numerical weather prediction model is used to provide mesoscale forecasts. The final plume predictions are plotted with key geographical information (including estimates of the counts of affected population), and with applicable U

  3. Measuring the three process segments of a customer's service experience for an out-patient surgery center.

    Science.gov (United States)

    Wicks, Angela M; Chin, Wynne W

    2008-01-01

    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.

  4. Radionuclide dynamics and health implications for the New York nuclear service center's radioactive waste burial site

    International Nuclear Information System (INIS)

    Matuszek, J.M.; Strnisa, F.V.; Baxter, C.F.

    1976-01-01

    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

  5. Development of Telecommunications of Prao ASC Lpi RAS

    Science.gov (United States)

    Isaev, E. A.; Dumskiy, D. V.; Likhachev, S. F.; Shatskaya, M. V.; Pugachev, V. D.; Samodurov, V. A.

    The new modern and reliable data storage system was acquired in 2010 in order to develop internal telecommunication resources of the Observatory. The system is designed for store large amounts of observation data obtained from the three radio-astronomy complexes (PT-22, DKR-1000 and BSA). The digital switching system - "Elcom" is installed in the Pushchino Radio Astronomy Observatory to ensure the observatory by phone communications. The phone communication between buildings of the observatory carried out over fiber-optic data links by using the ip-telephony. The direct optical channel from tracking station RT-22 in Pushchino to Moscow processing center has been created and put into operation to transfer large amounts of data at the final stage of the establishment of ground infrastructure for the international space project "Radioastron". A separate backup system for processing and storing data is organized in Pushchino Radio Astronomy Observatory to eliminate data loss during communication sessions with the Space Telescope.

  6. U-Healthcare Center Service in Busan City, South Korea: An Empirical Analysis and the Results of 1 Year of Service.

    Science.gov (United States)

    Bravo Santisteban, Ramiro D; Youm, Sekyoung; Park, Seung-Hun

    2015-10-01

    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.

  7. Awareness and pattern of utilizing family planning services among women attending urban health care center Azizabad Sukkur

    International Nuclear Information System (INIS)

    Shah, N.A.; Nisar, N.

    2008-01-01

    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)

  8. New trends in medical and service robots human centered analysis, control and design

    CERN Document Server

    Chevallereau, Christine; Pisla, Doina; Bleuler, Hannes; Rodić, Aleksandar

    2016-01-01

    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.

  9. Social accountability and education revives health sub-centers in India and increases access to family planning services

    Directory of Open Access Journals (Sweden)

    Susan Otchere

    2017-01-01

    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

  10. Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.

    Science.gov (United States)

    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

    2017-07-01

    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

  11. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    Science.gov (United States)

    Fahey, T M; Gallitano, D G

    1993-03-01

    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.

  12. Implementing the Customer Contact Center: An Opportunity to Create a Valid Measurement System for Assessing and Improving a Library's Telephone Services

    Science.gov (United States)

    Murphy, Sarah Anne; Cerqua, Judith

    2012-01-01

    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…

  13. Analysis of Gap in Service Quality in Drug Addiction Treatment Centers of Kerman, Iran, Using SERVQUAL Model.

    Science.gov (United States)

    Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar

    2014-01-01

    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.

  14. Optimizing Data Center Services to Foster Stewardship and Use of Geospatial Data by Heterogeneous Populations of Users

    Science.gov (United States)

    Downs, R. R.; Chen, R. S.; de Sherbinin, A. M.

    2017-12-01

    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).

  15. Front and Center: Contradicting Isolation by Supporting Leadership and Service by Students with Disabilities

    Science.gov (United States)

    Smith, Robin M.

    2009-01-01

    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.…

  16. 75 FR 34251 - Office of Special Education and Rehabilitative Services; Overview Information; Centers for...

    Science.gov (United States)

    2010-06-16

    ... 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...

  17. Developing the role of the social worker as coordinator of services at the surrogate parenting center.

    Science.gov (United States)

    Gagin, Roni; Cohen, Miri; Greenblatt, Lee; Solomon, Hanah; Itskovitz-Eldor, Joseph

    2004-01-01

    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.

  18. A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

    Science.gov (United States)

    Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

    2013-01-01

    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.

  19. National Space Science Data Center data archive and distribution service (NDADS) automated retrieval mail system user's guide

    Science.gov (United States)

    Perry, Charleen M.; Vansteenberg, Michael E.

    1992-01-01

    The National Space Science Data Center (NSSDC) has developed an automated data retrieval request service utilizing our Data Archive and Distribution Service (NDADS) computer system. NDADS currently has selected project data written to optical disk platters with the disks residing in a robotic 'jukebox' near-line environment. This allows for rapid and automated access to the data with no staff intervention required. There are also automated help information and user services available that can be accessed. The request system permits an average-size data request to be completed within minutes of the request being sent to NSSDC. A mail message, in the format described in this document, retrieves the data and can send it to a remote site. Also listed in this document are the data currently available.

  20. THE RATIONALE FOR EXTENDING THE SERVICES OF PASSENGER CARS WITH POCKETS OF CORROSION IN THE CENTER SILL

    Directory of Open Access Journals (Sweden)

    S. V. Myamlin

    2015-09-01

    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

  1. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

    Science.gov (United States)

    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    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

  2. Global Precipitation Measurement (GPM) Mission Products and Services at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Science.gov (United States)

    Liu, Z.; Ostrenga, D.; Vollmer, B.; Kempler, S.; Deshong, B.; Greene, M.

    2015-01-01

    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

  3. Small Radioisotope Power System Testing at NASA Glenn Research Center

    Science.gov (United States)

    Dugala, Gina; Bell, Mark; Oriti, Salvatore; Fraeman, Martin; Frankford, David; Duven, Dennis

    2013-01-01

    In April 2009, NASA Glenn Research Center (GRC) formed an integrated product team (IPT) to develop a Small Radioisotope Power System (SRPS) utilizing a single Advanced Stirling Convertor (ASC) with passive balancer. A single ASC produces approximately 80 We making this system advantageous for small distributed lunar science stations. The IPT consists of Sunpower, Inc., to provide the single ASC with a passive balancer, The Johns Hopkins University Applied Physics Laboratory (JHUAPL) to design an engineering model Single Convertor Controller (SCC) for an ASC with a passive balancer, and NASA GRC to provide technical support to these tasks and to develop a simulated lunar lander test stand. The single ASC with a passive balancer, simulated lunar lander test stand, and SCC were delivered to GRC and were tested as a system. The testing sequence at GRC included SCC fault tolerance, integration, electromagnetic interference (EMI), vibration, and extended operation testing. The SCC fault tolerance test characterized the SCCs ability to handle various fault conditions, including high or low bus power consumption, total open load or short circuit, and replacing a failed SCC card while the backup maintains control of the ASC. The integrated test characterized the behavior of the system across a range of operating conditions, including variations in cold-end temperature and piston amplitude, including the emitted vibration to both the sensors on the lunar lander and the lunar surface. The EMI test characterized the AC and DC magnetic and electric fields emitted by the SCC and single ASC. The vibration test confirms the SCCs ability to control the single ASC during launch. The extended operation test allows data to be collected over a period of thousands of hours to obtain long term performance data of the ASC with a passive balancer and the SCC. This paper will discuss the results of each of these tests.

  4. Availing services for developmental disabilities: parental experiences from a referral center in developing country.

    Science.gov (United States)

    Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra

    2012-09-01

    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.

  5. MRI-tracking of transplanted human ASC in a SCID mouse model

    Energy Technology Data Exchange (ETDEWEB)

    Siegmund, Birte J.; Kasten, Annika [Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center (Germany); Kühn, Jens-Peter [Institute of Diagnostic Radiology and Neuroradiology, Greifswald University Medical Center (Germany); Winter, Karsten [Institute of Anatomy, Faculty of Medicine, University of Leipzig (Germany); Grüttner, Cordula [Micromod Partikeltechnologie GmbH, Rostock (Germany); Frerich, Bernhard, E-mail: bernhard.frerich@med.uni-rostock.de [Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center (Germany)

    2017-04-01

    Background: Regarding strategies improving the efficacy of stem cell transplantation in adipose tissue engineering, cell tracking might be useful. Here we report the in vivo tracking of adipose tissue derived stem cells (ASC) by means of nanoparticle labeling and magnetic resonance imaging (MRI). Here we report the in vivo tracking of adipose tissue derived stromal cells (ASC) by means of nanoparticle labeling and magnetic resonance imaging (MRI). Materials and methods: Human ASC were amplified and labeled with two types of magnetic nanoparticles (MNP), BNF starch and nanomag®-D-spio. Adipose tissue constructs were fabricated by seeding collagen scaffolds with labeled and unlabeled ASCs. Constructs were implanted subcutaneously in the back of severe combined immunodeficient (SCID) mice (n =69, group 1: control with cells w/o label, group 2: BNF starch labeled cells, group 3: nanomag®-D-spio labeled cells). MRI scans were performed at 24 hours, four, twelve and 28 days and four months in a 7.1 T animal device. Explanted constructs were analyzed histomorphometrically. Results: MRI scans showed high contrast of the labeled cells in t2-tse-sequence compared to unlabeled controls. Loss of volume of the implants was observed over time due to partial loss for transplanted cells without significant difference (level of significance p<0.017). Compared to histomorphometry, there was found a positiv correlations in measurement of implant size with a significant at day four (correlation coefficient =0.643; p=0.024) and day twelve (correlation coefficient =0.687; p=0.010). Additional Prussian blue stain showed iron in all implants. Significant differences between the three groups (significance level p<0.017) were found after twelve days between control group and group 3 (p=0.008) and after 28 days between control group and group 2 and 3 (p=0.011). Conclusion: Both MNPs might be suitable for tracking of ASC in vivo and show long term stability over 4 months. - Highlights:

  6. Antidepressant-Like Effects of Central BDNF Administration in Mice of Antidepressant Sensitive Catalepsy (ASC) Strain.

    Science.gov (United States)

    Tikhonova, Maria; Kulikov, Alexander V

    2012-08-31

    Although numerous data evidence the implication of brain-derived neurotrophic factor (BDNF) in the pathophysiology of depression, the potential for BDNF to correct genetically defined depressive-like states is poorly studied. This study was aimed to reveal antidepressant-like effects of BDNF (300 ng, 2×, i.c.v.) on behavior and mRNA expression of genes associated with depression-like state in the brain in mice of antidepressant sensitive catalepsy (ASC) strain characterized by high hereditary predisposition to catalepsy and depressive-like features. Behavioral tests were held on the 7th-16th days after the first (4th-13th after the second) BDNF injection. Results showed that BDNF normalized impaired sexual motivation in the ASC males, and this BDNF effect differed, with advantageous effects, from that of widely used antidepressants. The anticataleptic effect of two BDNF injections was enhanced compared with a single administration. A tendency to decrease the immobility duration in tail-suspension test was observed in BDNF-treated ASC mice. The effects on catalepsy and sexual motivation were specific since BDNF did not alter locomotor and exploratory activity or social interest in the ASC mice. Along with behavioral antidepressant-like effects on the ASC mice, BDNF increased hippocampal mRNA levels of Bdnf and Creb1 (cAMP response element-binding protein gene). BDNF also augmented mRNA levels of Arc gene encoding Arc (Activity-regulated cytoskeleton-associated) protein involved in BDNF-induced processes of neuronal and synaptic plasticity in hippocampus and prefrontal cortex. The data suggest that: [1] BDNF is effective in the treatment of some genetically defined behavioral disturbances; [2] BDNF influences sexually-motivated behavior; [3] Arc mRNA levels may serve as a molecular marker of BDNF physiological activity associated with its long-lasting behavioral effects; [4] ASC mouse strain can be used as a suitable model to study mechanisms of BDNF effects on

  7. [Effects of chronic fluoxetine treatment on manifestation of sexual motivation and social behavior in mice of ASC line].

    Science.gov (United States)

    Tikhonova, M A; Otroshchenko, E A; Kulikov, A V

    2010-02-01

    Sexual dysfunctions are the typical symptoms accompanying depressive disorders. However antidepressants which improve general state of the patients have no effect on sexual disorders. Mice of ASC (Antidepressant Sensitive Catalepsy) line with high hereditary predisposition to catalepsy were proposed as a model of genetically associated depressive-like condition. The work was aimed at comparison of behavioral indices of sexual motivation and social interest of ASC mice with those of mice of parental inbred AKR and CBA strains, and at the study of the effects of chronic fluoxetine treatment in doses of 10 and 20 mg/kg on these parameters in ASC mice. ASC males demonstrated reduced sexual motivation which was not corrected by fluoxetine. ASC mice did not differ in the expression of social interest and aggression towards juvenile intruder from mice of parental strains. Fluoxetine failed to alter social behavior of ASC mice in social interaction test but its higher dose decreased percentage of aggressors. ASC mouse line seems to be a perspective model to study genetic mechanisms of sexual dysfunctions associated with depressive conditions.

  8. 25 CFR 170.166 - What services do Indian LTAP centers provide?

    Science.gov (United States)

    2010-04-01

    ... 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...

  9. Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

    Science.gov (United States)

    2016-04-28

    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

  10. Ambulatory Surgery Centers and Prices in Hospital Outpatient Departments.

    Science.gov (United States)

    Carey, Kathleen

    2017-04-01

    Specialty providers claim to offer a new competitive benchmark for efficient delivery of health care. This article explores this view by examining evidence for price competition between ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). I studied the impact of ASC market presence on actual prices paid to HOPDs during 2007-2010 for four common surgical procedures that were performed in both provider types. For the procedures examined, HOPDs received payments from commercial insurers in the range of 3.25% to 5.15% lower for each additional ASC per 100,000 persons in a market. HOPDs may have less negotiating leverage with commercial insurers on price in markets with high ASC market penetration, resulting in relatively lower prices.

  11. Over-expression, purification and characterization of an Asc-1 homologue from Gloeobacter violaceus

    DEFF Research Database (Denmark)

    Wang, Xiaole; Hald, Helle; Ernst, Heidi Asschenfeldt

    2010-01-01

    The human alanine-serine-cysteine transporter 1 (Asc-1) belongs to the slc7a family of solute carrier transporters. Asc-1 mediates the uptake of D-serine in an exchanger-type fashion, coupling the process to the release of alanine and cysteine. Among the bacterial Asc-1 homologues, one transporter...... of auto-induction was crucial for obtaining high yields and purity of the transporter. The transporter was purified with yields in the range of 0.2-0.4 mg per L culture and eluted in a single peak from a size-exclusion column. The circular dichroism spectrum revealed a folded and apparently all...

  12. NASA Glenn Research Center Support of the Advanced Stirling Radioisotope Generator Project

    Science.gov (United States)

    Wilson, Scott D.; Wong, Wayne A.

    2015-01-01

    A high-efficiency radioisotope power system was being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center. DOE initiated termination of that contract in late 2013, primarily due to budget constraints. Sunpower, Inc., held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with Lockheed Martin to produce ASC-F flight units, and one with Glenn for the production of ASC-E3 engineering unit "pathfinders" that are built to the flight design. In support of those contracts, Glenn provided testing, materials expertise, Government-furnished equipment, inspection capabilities, and related data products to Lockheed Martin and Sunpower. The technical support included material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests were performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests were conducted to characterize performance under operating conditions that are representative of various mission conditions. Despite termination of the ASRG flight development contract, NASA continues to recognize the importance of high-efficiency ASC power conversion for Radioisotope Power Systems (RPS) and continues investment in the technology, including the continuation of the ASC-E3 contract. This paper describes key Government support for the ASRG project and future tests to be used to provide data for ongoing reliability assessments.

  13. Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

    Science.gov (United States)

    Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

    2018-05-15

    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.

  14. Adapted User-Centered Design: A Strategy for the Higher User Acceptance of Innovative e-Health Services

    Directory of Open Access Journals (Sweden)

    Dejan Dinevski

    2012-08-01

    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.

  15. Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

    Science.gov (United States)

    Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

    2015-06-01

    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.

  16. ASC Tri-lab Co-design Level 2 Milestone Report 2015

    Energy Technology Data Exchange (ETDEWEB)

    Hornung, Rich [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Jones, Holger [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Keasler, Jeff [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Neely, Rob [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pearce, Olga [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hammond, Si [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Trott, Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lin, Paul [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vaughan, Courtenay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cook, Jeanine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hoekstra, Rob [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bergen, Ben [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Payne, Josh [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Womeldorff, Geoff [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-09-23

    In 2015, the three Department of Energy (DOE) National Laboratories that make up the Advanced Sci- enti c Computing (ASC) Program (Sandia, Lawrence Livermore, and Los Alamos) collaboratively explored performance portability programming environments in the context of several ASC co-design proxy applica- tions as part of a tri-lab L2 milestone executed by the co-design teams at each laboratory. The programming environments that were studied included Kokkos (developed at Sandia), RAJA (LLNL), and Legion (Stan- ford University). The proxy apps studied included: miniAero, LULESH, CoMD, Kripke, and SNAP. These programming models and proxy-apps are described herein. Each lab focused on a particular combination of abstractions and proxy apps, with the goal of assessing performance portability using those. Performance portability was determined by: a) the ability to run a single application source code on multiple advanced architectures, b) comparing runtime performance between \

  17. Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey.

    Directory of Open Access Journals (Sweden)

    Xiaoming Sun

    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.

  18. Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey.

    Science.gov (United States)

    Sun, Xiaoming; Li, Yanting; Liu, Shanshan; Lou, Jiquan; Ding, Ye; Liang, Hong; Gu, Jianjun; Jing, Yuan; Fu, Hua; Zhang, Yimin

    2015-01-01

    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.

  19. Goods and services from the activities of the Constituyentes Atomic Center

    International Nuclear Information System (INIS)

    Hermida, Jorge D.

    2001-01-01

    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

  20. Mutually Beneficial Service Learning: Language Teacher Candidates in a Local Community Center

    Science.gov (United States)

    Hildebrandt, Susan A.

    2014-01-01

    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…

  1. State of the Art Student Support Services in an IEP Learning Center

    Science.gov (United States)

    Hanson, Jessica; Maxwell, Jeffrey; Mulder, Monika

    2015-01-01

    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…

  2. The Consequences of Service Encounter Failure in Shopping Centers: A Study with Visually Impaired Consumers

    Directory of Open Access Journals (Sweden)

    Pedro Felipe da Costa Coelho

    2017-06-01

    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.

  3. Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

    Science.gov (United States)

    Linggi, A; Pelham, L D

    1986-09-01

    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.

  4. West Valley Demonstration Project facilities utilization plan for the existing facilities at the Western New York Nuclear Service Center

    International Nuclear Information System (INIS)

    Skillern, C.G.

    1986-05-01

    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

  5. The effect of Health smart cards for Quality Health care services ( doctor martyr Beheshti medical research center in Qom

    Directory of Open Access Journals (Sweden)

    Saeed zarandi

    2016-03-01

    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.

  6. Effects of Metal Micro and Nano-Particles on hASCs: An In Vitro Model

    OpenAIRE

    Palombella, Silvia; Pirrone, Cristina; Rossi, Federica; Armenia, Ilaria; Cherubino, Mario; Valdatta, Luigi; Raspanti, Mario; Bernardini, Giovanni; Gornati, Rosalba

    2017-01-01

    As the knowledge about the interferences of nanomaterials on human staminal cells are scarce and contradictory, we undertook a comparative multidisciplinary study based on the size effect of zero-valent iron, cobalt, and nickel microparticles (MPs) and nanoparticles (NPs) using human adipose stem cells (hASCs) as a model, and evaluating cytotoxicity, morphology, cellular uptake, and gene expression. Our results suggested that the medium did not influence the cell sensitivity but, surprisingly...

  7. 42 CFR 416.171 - Determination of payment rates for ASC services.

    Science.gov (United States)

    2010-10-01

    ... relative value units under § 414.22(b)(5)(i)(B) of this subchapter multiplied by the conversion factor... applicable conversion factor and the relative payment weight established under § 416.167(b), unless otherwise indicated in this section. (1) Conversion factor for CY 2008. CMS calculates a conversion factor so that...

  8. Patient and family psychoeducation: Service development and implementation in a center in Iran.

    Science.gov (United States)

    Mirsepassi, Zahra; Tabatabaee, Maryam; Sharifi, Vandad; Mottaghipour, Yasaman

    2018-02-01

    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.

  9. Intracellular invasion of Orientia tsutsugamushi activates inflammasome in asc-dependent manner.

    Directory of Open Access Journals (Sweden)

    Jung-Eun Koo

    Full Text Available Orientia tsutsugamushi, a causative agent of scrub typhus, is an obligate intracellular bacterium, which escapes from the endo/phagosome and replicates in the host cytoplasm. O. tsutsugamushi infection induces production of pro-inflammatory mediators including interleukin-1β (IL-1β, which is secreted mainly from macrophages upon cytosolic stimuli by activating cysteine protease caspase-1 within a complex called the inflammasome, and is a key player in initiating and maintaining the inflammatory response. However, the mechanism for IL-1β maturation upon O. tsutsugamushi infection has not been identified. In this study, we show that IL-1 receptor signaling is required for efficient host protection from O. tsutsugamushi infection. Live Orientia, but not heat- or UV-inactivated Orientia, activates the inflammasome through active bacterial uptake and endo/phagosomal maturation. Furthermore, Orientia-stimulated secretion of IL-1β and activation of caspase-1 are ASC- and caspase-1- dependent since IL-1β production was impaired in Asc- and caspase-1-deficient macrophages but not in Nlrp3-, Nlrc4- and Aim2-deficient macrophages. Therefore, live O. tsutsugamushi triggers ASC inflammasome activation leading to IL-1β production, which is a critical innate immune response for effective host defense.

  10. A Comparison of ASCE and FAO56 Reference Evapotranspiration at Different Subdaily Timescales: a Numerical Study

    Directory of Open Access Journals (Sweden)

    Farzin Parchami-Araghi

    2017-01-01

    Full Text Available Introduction: Subdaily estimates of reference evapotranspiration (ETo are needed in many applications such as dynamic agro-hydrological modeling. The ASCE and FAO56 Penman–Monteith models (ASCE-PM and FAO56-PM, respectively has received favorable acceptance and application over much of the world, including the United States, for establishing a reference evapotranspiration (ETo index as a function of weather parameters. In the past several years various studies have evaluated ASCE-PM and FAO56-PM models for calculating the commonest hourly or 15-min ETo either by comparing them with lysimetric measurements or by comparison with one another (2, 3, 5, 9, 10, 11, 16, 17, 19. In this study, sub-daily ET o estimates made by the ASCE-PM and FAO56-PM models at different timescales (1-360 min were compared through conduction of a computational experiment, using a daily to sub-daily disaggregation framework developed by Parchami-Araghi et al. (14. Materials and Methods: Daily and sub-daily weather data at different timescales (1-360 min were generated via a daily-to-sub-daily weather data disaggregation framework developed by Parchami-Araghi et al. (14, using long-term (59 years daily weather data obtained from Abadan synoptic weather station. Daily/sub-daily net long wave radiation (Rnl was estimated through 6 different approaches, including using two different criteria for identifying the daytime/nighttime periods : 1 the standard criteria implemented in both ASCE-PM and FAO56-PM models and 2 criterion of actual time of sunset and sunrise in combination with 1 estimation of clear-sky radiation (Rso based on the standard approach implemented in both ASCE-PM and FAO56-PM models (1st and 2nd Rnl estimation approaches, respectively, 2 integral of the Rso estimates derived via a physically based solar radiation model developed by Yang et al. (25, YNG model, for one-second time-steps (3rd and 4th Rnl estimation approaches, respectively, and 3 integral of

  11. Optimal service using Matlab - simulink controlled Queuing system at call centers

    Science.gov (United States)

    Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.

    2018-04-01

    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.

  12. Establishment of a Separate Psychology Service at Walter Reed Army Medical Center

    Science.gov (United States)

    1989-07-01

    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

  13. The tension between user-centered design and e-government services

    NARCIS (Netherlands)

    Kotamraju, Nalini; van der Geest, Thea

    2012-01-01

    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

  14. Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning

    Science.gov (United States)

    Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara

    2017-01-01

    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.…

  15. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    Science.gov (United States)

    Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

    2017-01-01

    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…

  16. 20 CFR 670.525 - What residential support services must Job Corps center operators provide?

    Science.gov (United States)

    2010-04-01

    ..., 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...

  17. 15 CFR 950.7 - Center for Environmental Assessment Services (CEAS).

    Science.gov (United States)

    2010-01-01

    ...) 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...

  18. The Progress of LCA Center Denmark After Almost Two Years of Service

    DEFF Research Database (Denmark)

    Frydendal, Jeppe; Hauschild, Michael Zwicky

    2004-01-01

    . 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...

  19. A decade of building massage therapy services at an academic medical center as part of a healing enhancement program.

    Science.gov (United States)

    Rodgers, Nancy J; Cutshall, Susanne M; Dion, Liza J; Dreyer, Nikol E; Hauschulz, Jennifer L; Ristau, Crystal R; Thomley, Barb S; Bauer, Brent A

    2015-02-01

    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.

  20. Residual strength and crack propagation tests on C-130 airplane center wings with service-imposed fatigue damage

    Science.gov (United States)

    Snider, H. L.; Reeder, F. L.; Dirkin, W. J.

    1972-01-01

    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.

  1. Semantic Web Data Discovery of Earth Science Data at NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Science.gov (United States)

    Hegde, Mahabaleshwara; Strub, Richard F.; Lynnes, Christopher S.; Fang, Hongliang; Teng, William

    2008-01-01

    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.

  2. Design, Implementation and Analysis of Learner-Centered Guided In-Service Programme for Technical Teacher Education

    Directory of Open Access Journals (Sweden)

    Tiia Rüütmann

    2014-03-01

    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.

  3. Repair of Achilles tendon defect with autologous ASCs engineered tendon in a rabbit model.

    Science.gov (United States)

    Deng, Dan; Wang, Wenbo; Wang, Bin; Zhang, Peihua; Zhou, Guangdong; Zhang, Wen Jie; Cao, Yilin; Liu, Wei

    2014-10-01

    Adipose derived stem cells (ASCs) are an important cell source for tissue regeneration and have been demonstrated the potential of tenogenic differentiation in vitro. This study explored the feasibility of using ASCs for engineered tendon repair in vivo in a rabbit Achilles tendon model. Total 30 rabbits were involved in this study. A composite tendon scaffold composed of an inner part of polyglycolic acid (PGA) unwoven fibers and an outer part of a net knitted with PGA/PLA (polylactic acid) fibers was used to provide mechanical strength. Autologous ASCs were harvested from nuchal subcutaneous adipose tissues and in vitro expanded. The expanded ASCs were harvested and resuspended in culture medium and evenly seeded onto the scaffold in the experimental group, whereas cell-free scaffolds served as the control group. The constructs of both groups were cultured inside a bioreactor under dynamic stretch for 5 weeks. In each of 30 rabbits, a 2 cm defect was created on right side of Achilles tendon followed by the transplantation of a 3 cm cell-seeded scaffold in the experimental group of 15 rabbits, or by the transplantation of a 3 cm cell-free scaffold in the control group of 15 rabbits. Animals were sacrificed at 12, 21 and 45 weeks post-surgery for gross view, histology, and mechanical analysis. The results showed that short term in vitro culture enabled ASCs to produce matrix on the PGA fibers and the constructs showed tensile strength around 50 MPa in both groups (p > 0.05). With the increase of implantation time, cell-seeded constructs gradually form neo-tendon and became more mature at 45 weeks with histological structure similar to that of native tendon and with the presence of bipolar pattern and D-periodic structure of formed collagen fibrils. Additionally, both collagen fibril diameters and tensile strength increased continuously with significant difference among different time points (p tendon tissue with fibril structure observable only at 45 weeks

  4. Location Planning Problem of Service Centers for Sustainable Home Healthcare: Evidence from the Empirical Analysis of Shanghai

    Directory of Open Access Journals (Sweden)

    Gang Du

    2015-11-01

    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.

  5. 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

    Data.gov (United States)

    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...

  6. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B

    2007-01-01

    ...) 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Neuro-Oncology Branch patient emotional support services | Center for Cancer Research

    Science.gov (United States)

    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.

  9. Annual Progress Report (FY-79) Clinical Investigation Service. Walter Reed Army Medical Center

    Science.gov (United States)

    1979-09-30

    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

  10. A Service-Oriented Healthcare Message Alerting Architecture in an Asia Medical Center: A Case Study

    Directory of Open Access Journals (Sweden)

    Jin-Shin Lai

    2009-06-01

    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.

  11. Global Precipitation Measurement (GPM) Mission Products and Services at the NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC)

    Science.gov (United States)

    Liu, Zhong; Ostrenga, D.; Vollmer, B.; Deshong, B.; Greene, M.; Teng, W.; Kempler, S. J.

    2015-01-01

    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

  12. Global Precipitation Measurement (GPM) Mission Products and Services at the NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC)

    Science.gov (United States)

    Ostrenga, D.; Liu, Z.; Vollmer, B.; Teng, W. L.; Kempler, S. J.

    2014-12-01

    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

  13. ASCE application guide for recommended practice for fiber-reinforced polymer products for overhead utility line structures

    Energy Technology Data Exchange (ETDEWEB)

    Gnandt, E. [T and D High Voltage Consulting, Vancouver, BC (Canada)

    2002-07-01

    The participants to the American Society of Civil Engineers (ASCE) prepared an application guide to provide guidelines to utilities and manufacturers on topics ranging from design to manufacture, testing and installation of fiber-reinforced polymer (FRP) products. The intent was also to help utilities with a possible replacement material for wood, steel and pre-stressed concrete. FRP products are constructed from fiber and resin and offer several advantages such as light weight and high strength-to-weight ratio, low maintenance, dimensional stability, resistance to rot, corrosion, chemicals and pest damage. FRP products can be used for lighting poles, ladders and grating, transformer pads, pole line hardware and crossarms, and other applications. There are five structural configurations: (1) cantilevered structures (single pole), (2) guyed structures, framed structures (H-Frame), (4) a combination of (1), (2), and (3), and (5) lattice structures (transmission class). The author listed some of the initial considerations: physical characteristics, guying and grounding, deflection and load testing, attached items, and durability to name only a few. The materials and manufacturing processes were briefly explained, namely the pultrusion method, the filament winding method, and the centrifugal casting method. Design loads considerations are discussed, as are performance-based criteria such as mechanical, coating durability and electrical. Quality control, assembly erection and storage, and in-service considerations are also discussed. The author concluded the presentation with a section dealing with field inspections. figs.

  14. Epidemic assistance by the Centers for Disease Control and Prevention: role of the Epidemic Intelligence Service, 1946-2005.

    Science.gov (United States)

    Thacker, Stephen B; Stroup, Donna F; Sencer, David J

    2011-12-01

    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.

  15. Establishing an integrated gastroenterology service between a medical center and the community.

    Science.gov (United States)

    Niv, Yaron; Dickman, Ram; Levi, Zohar; Neumann, Gadi; Ehrlich, Dorit; Bitterman, Haim; Dreiher, Jacob; Cohen, Arnon; Comaneshter, Doron; Halpern, Eyran

    2015-02-21

    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.

  16. Simulation assessment center in the service of the company as a factor in the accuracy and validity of the information about the employee

    OpenAIRE

    Borodai V.A.

    2017-01-01

    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/

  17. Sexual and Reproductive Health Services and Related Health Information on Pregnancy Resource Center Websites: A Statewide Content Analysis.

    Science.gov (United States)

    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.

  18. Marketing information goods and services in medical libraries and information centers.

    Science.gov (United States)

    Ashrafi-Rizi, Hasan; Kazempour, Zahra

    2012-01-01

    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.

  19. Marketing information goods and services in medical libraries and information centers

    Science.gov (United States)

    Ashrafi-rizi, Hasan; Kazempour, Zahra

    2012-01-01

    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

  20. Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

    Science.gov (United States)

    Plotzke, Michael Robert; Courtemanche, Charles

    2011-07-01

    Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC. Copyright © 2010 John Wiley & Sons, Ltd.

  1. Domestic cooperation in combating illegal nuclear traffic - Experience of the Emergency Service Center

    International Nuclear Information System (INIS)

    Smagala, G.; Tanczyk, R.

    2001-01-01

    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

  2. Directory of Regional Centers and Educational Programs Providing Services to Deaf/Blind Children and Youth in the United States (Including Puerto Rico and the Virgin Islands).

    Science.gov (United States)

    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…

  3. Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

    Science.gov (United States)

    van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

    2015-02-01

    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.

  4. Comparison of the socioeconomic impacts of international fuel service centers versus dispersed nuclear facilities

    International Nuclear Information System (INIS)

    Braid, R.B. Jr.

    1979-01-01

    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

  5. Radiation protection in medical centers : teletherapy service; Proteccion radiologica en centros hospitalarios : servicio de teleterapia

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2008-12-15

    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

  6. The GOLD Science Data Center - Algorithm Heritage, Data Product Descriptions and User Services

    Science.gov (United States)

    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.

    2013-12-01

    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.

  7. [Patients and quality of primary health care services. Survey of practitioners at the Bahía de Cádiz and La Janda health centers].

    Science.gov (United States)

    Hernán García, M; Gutiérrez Cuadra, J L; Lineros González, C; Ruiz Barbosa, C; Rabadán Asensio, A

    2002-10-31

    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.

  8. Antiproliferative effect of ASC-J9 delivered by PLGA nanoparticles against estrogen-dependent breast cancer cells.

    Science.gov (United States)

    Verderio, Paolo; Pandolfi, Laura; Mazzucchelli, Serena; Marinozzi, Maria Rosaria; Vanna, Renzo; Gramatica, Furio; Corsi, Fabio; Colombo, Miriam; Morasso, Carlo; Prosperi, Davide

    2014-08-04

    Among polymeric nanoparticles designed for cancer therapy, PLGA nanoparticles have become one of the most popular polymeric devices for chemotherapeutic-based nanoformulations against several kinds of malignant diseases. Promising properties, including long-circulation time, enhanced tumor localization, interference with "multidrug" resistance effects, and environmental biodegradability, often result in an improvement of the drug bioavailability and effectiveness. In the present work, we have synthesized 1,7-bis(3,4-dimethoxyphenyl)-5-hydroxyhepta-1,4,6-trien-3-one (ASC-J9) and developed uniform ASC-J9-loaded PLGA nanoparticles of about 120 nm, which have been prepared by a single-emulsion process. Structural and morphological features of the nanoformulation were analyzed, followed by an accurate evaluation of the in vitro drug release kinetics, which exhibited Fickian law diffusion over 10 days. The intracellular degradation of ASC-J9-bearing nanoparticles within estrogen-dependent MCF-7 breast cancer cells was correlated to a time- and dose-dependent activity of the released drug. A cellular growth inhibition associated with a specific cell cycle G2/M blocking effect caused by ASC-J9 release inside the cytosol allowed us to put forward a hypothesis on the action mechanism of this nanosystem, which led to the final cell apoptosis. Our study was accomplished using Annexin V-based cell death analysis, MTT assessment of proliferation, radical scavenging activity, and intracellular ROS evaluation. Moreover, the intracellular localization of nanoformulated ASC-J9 was confirmed by a Raman optical imaging experiment designed ad hoc. PLGA nanoparticles and ASC-J9 proved also to be safe for a healthy embryo fibroblast cell line (3T3-L1), suggesting a possible clinical translation of this potential nanochemotherapeutic to expand the inherently poor bioavailability of hydrophobic ASC-J9 that could be proposed for the treatment of malignant breast cancer.

  9. Function of microRNAs in the Osteogenic Differentiation and Therapeutic Application of Adipose-Derived Stem Cells (ASCs

    Directory of Open Access Journals (Sweden)

    Walter M. Hodges

    2017-12-01

    Full Text Available Traumatic wounds with segmental bone defects represent substantial reconstructive challenges. Autologous bone grafting is considered the gold standard for surgical treatment in many cases, but donor site morbidity and associated post-operative complications remain a concern. Advances in regenerative techniques utilizing mesenchymal stem cell populations from bone and adipose tissue have opened the door to improving bone repair in the limbs, spine, and craniofacial skeleton. The widespread availability, ease of extraction, and lack of immunogenicity have made adipose-derived stem cells (ASCs particularly attractive as a stem cell source for regenerative strategies. Recently it has been shown that small, non-coding miRNAs are involved in the osteogenic differentiation of ASCs. Specifically, microRNAs such as miR-17, miR-23a, and miR-31 are expressed during the osteogenic differentiation of ASCs, and appear to play a role in inhibiting various steps in bone morphogenetic protein-2 (BMP2 mediated osteogenesis. Importantly, a number of microRNAs including miR-17 and miR-31 that act to attenuate the osteogenic differentiation of ASCs are themselves stimulated by transforming growth factor β-1 (TGFβ-1. In addition, transforming growth factor β-1 is also known to suppress the expression of microRNAs involved in myogenic differentiation. These data suggest that preconditioning strategies to reduce TGFβ-1 activity in ASCs may improve the therapeutic potential of ASCs for musculoskeletal application. Moreover, these findings support the isolation of ASCs from subcutaneous fat depots that tend to have low endogenous levels of TGFβ-1 expression.

  10. Cervical spine surgery performed in ambulatory surgical centers: Are patients being put at increased risk?

    Science.gov (United States)

    Epstein, Nancy E

    2016-01-01

    Spine surgeons are being increasingly encouraged to perform cervical operations in outpatient ambulatory surgical centers (ASC). However, some studies/data coming out of these centers are provided by spine surgeons who are part or full owners/shareholders. In Florida, for example, there was a 50% increase in ASC (5349) established between 2000-2007; physicians had a stake (invested) in 83%, and outright owned 43% of ASC. Data regarding "excessive" surgery by ASC surgeon-owners from Idaho followed shortly thereafter. The risks/complications attributed to 3279 cervical spine operations performed in 6 ASC studies were reviewed. Several studies claimed 99% discharge rates the day of the surgery. They also claimed major complications were "picked up" within the average postoperative observation window (e.g., varying from 4-23 hours), allowing for appropriate treatment without further sequelae. Morbidity rates for outpatient cervical spine ASC studies (e.g. some with conflicts of interest) varied up to 0.8-6%, whereas morbidity rates for 3 inpatient cervical studies ranged up to 19.3%. For both groups, morbidity included postoperative dysphagia, epidural hematomas, neck swelling, vocal cord paralysis, and neurological deterioration. Although we have no clear documentation as to their safety, "excessive" and progressively complex cervical surgical procedures are increasingly being performed in ASC. Furthermore, we cannot rely upon ASC-based data. At least some demonstrate an inherent conflict of interest and do not veridically report major morbidity/mortality rates for outpatient procedures. For now, cervical spine surgery performed in ASC would appear to be putting patients at increased risk for the benefit of their surgeon-owners.

  11. Mammographic Screening of Women Attending a Reference Service Center in Southern Brazil.

    Science.gov (United States)

    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

    2016-01-01

    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.

  12. [Poverty and disease: users of the primary care social services of a primary care center].

    Science.gov (United States)

    Doz Mora, J F; Mengual, L; Torné, M; Bonilla, P

    1994-06-15

    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.

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

    Science.gov (United States)

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

    2015-08-01

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

  14. Comparison of Helicopter Emergency Medical Services Transport Types and Delays on Patient Outcomes at Two Level I Trauma Centers.

    Science.gov (United States)

    Nolan, Brodie; Tien, Homer; Sawadsky, Bruce; Rizoli, Sandro; McFarlan, Amanda; Phillips, Andrea; Ackery, Alun

    2017-01-01

    Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems. In Ontario, transportation for trauma patients is through one of three ways: scene call, modified scene call, or interfacility transfer. We hypothesize that differences exist between these types of transports in both patient demographics and patient outcomes. This study compares the characteristics of patients transported by each of these methods to two level 1 trauma centers and assesses for any impact on morbidity or mortality. As a secondary outcome reasons for delay were identified. A local trauma registry was used to identify and abstract data for all patients transported to two trauma centers by HEMS over a 36-month period. Further chart abstraction using the HEMS patient care reports was done to identify causes of delay during HEMS transport. During the study period HEMS transferred a total of 911 patients of which 139 were scene calls, 333 were modified scene calls and 439 were interfacility transfers. Scene calls had more patients with an ISS of less than 15 and had more patients discharged home from the ED. Modified scene calls had more patients with an ISS greater than 25. The most common delays that were considered modifiable included the sending physician doing a procedure, waiting to meet a land EMS crew, delays for diagnostic imaging and confirming disposition or destination. Differences exist between the types of transports done by HEMS for trauma patients. Many identified reasons for delay to HEMS transport are modifiable and have practical solutions. Future research should focus on solutions to identified delays to HEMS transport. Key words: helicopter emergency medical services; trauma; prehospital care; delays.

  15. Centers for medicare and medicaid services: using an episode-based payment model to improve oncology care.

    Science.gov (United States)

    Kline, Ronald M; Bazell, Carol; Smith, Erin; Schumacher, Heidi; Rajkumar, Rahul; Conway, Patrick H

    2015-03-01

    Cancer is a medically complex and expensive disease with costs projected to rise further as new treatment options increase and the United States population ages. Studies showing significant regional variation in oncology quality and costs and model tests demonstrating cost savings without adverse outcomes suggest there are opportunities to create a system of oncology care in the US that delivers higher quality care at lower cost. The Centers for Medicare and Medicaid Services (CMS) have designed an episode-based payment model centered around 6 month periods of chemotherapy treatment. Monthly per-patient care management payments will be made to practices to support practice transformation, including additional patient services and specific infrastructure enhancements. Quarterly reporting of quality metrics will drive continuous quality improvement and the adoption of best practices among participants. Practices achieving cost savings will also be eligible for performance-based payments. Savings are expected through improved care coordination and appropriately aligned payment incentives, resulting in decreased avoidable emergency department visits and hospitalizations and more efficient and evidence-based use of imaging, laboratory tests, and therapeutic agents, as well as improved end of life care. New therapies and better supportive care have significantly improved cancer survival in recent decades. This has come at a high cost, with cancer therapy consuming $124 billion in 2010. CMS has designed an episode-based model of oncology care that incorporates elements from several successful model tests. By providing care management and performance based payments in conjunction with quality metrics and a rapid learning environment, it is hoped that this model will demonstrate how oncology care in the US can transform into a high value, high quality system. Copyright © 2015 by American Society of Clinical Oncology.

  16. Evolution of Information Management at the GSFC Earth Sciences (GES) Data and Information Services Center (DISC): 2006-2007

    Science.gov (United States)

    Kempler, Steven; Lynnes, Christopher; Vollmer, Bruce; Alcott, Gary; Berrick, Stephen

    2009-01-01

    Increasingly sophisticated National Aeronautics and Space Administration (NASA) Earth science missions have driven their associated data and data management systems from providing simple point-to-point archiving and retrieval to performing user-responsive distributed multisensor information extraction. To fully maximize the use of remote-sensor-generated Earth science data, NASA recognized the need for data systems that provide data access and manipulation capabilities responsive to research brought forth by advancing scientific analysis and the need to maximize the use and usability of the data. The decision by NASA to purposely evolve the Earth Observing System Data and Information System (EOSDIS) at the Goddard Space Flight Center (GSFC) Earth Sciences (GES) Data and Information Services Center (DISC) and other information management facilities was timely and appropriate. The GES DISC evolution was focused on replacing the EOSDIS Core System (ECS) by reusing the In-house developed disk-based Simple, Scalable, Script-based Science Product Archive (S4PA) data management system and migrating data to the disk archives. Transition was completed in December 2007

  17. Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; electronic reporting pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; revision to Quality Improvement Organization regulations. Final rule with comment period.

    Science.gov (United States)

    2012-11-15

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).

  18. The Needs Assessment in order to develop the Service of Psychological Lab and Counseling Center, Department of Educational Psychology and Guidance, the Faculty of Education, Mahasarakham University

    Directory of Open Access Journals (Sweden)

    Chaiporn Pongpisanrat

    2017-03-01

    Full Text Available The purpose of this study was to explore the needs assessment in order to develop the service of Psychological Lab and Counseling Center, Department of Educational Psychology and Guidance, the Faculty of Education, Mahasarakham University. This study aimed to compare the realistic service and the desirable service, as well as, to explore the directions to improve the service of Psychological Lab and Counseling Center among the service recipients based on their gender, age range, and field of studies. A total sample of 150 participants were service recipients; college students, lecturers, staff during the first semester academic year 2014 until the first semester academic year 2015. The instruments used included: the Questionnaire on needs assessment of the development of Psychological Lab and Counseling Center, and a focus group discussion. Frequency distribution, percentage, means, standard deviation, and variance were used to analyze the data. The needs assessment results showed as follows: 1 Overall the realistic basis of Psychological Lab and Counseling Center service was in an “above level of needs” while “the highest level of needs” was found in the desirable qualification. After having divided into categories, the result yielded an “above level” on the realistic basis of the counselor characteristics, task planning, and facility arrangement. For the desired qualification, the results showed that the needs on the counselors’ characteristics, task planning, and facility arrangement were identified as at a highest level of needs. 2 No differences were found on the realistic basis needs of the clients, the services provided, gender, and age range of the clients although they responded differently to the questionnaire. The clients who responded to the questionnaire from different field of studies showed the different needs of services provided in the realistic basis significantly at the level of .05 in which the General Sciences

  19. Optimizing the ASC WAN: evaluating network performance tools for comparing transport protocols.

    Energy Technology Data Exchange (ETDEWEB)

    Lydick, Christopher L.

    2007-07-01

    The Advanced Simulation & Computing Wide Area Network (ASC WAN), which is a high delay-bandwidth network connection between US Department of Energy National Laboratories, is constantly being examined and evaluated for efficiency. One of the current transport-layer protocols which is used, TCP, was developed for traffic demands which are different from that on the ASC WAN. The Stream Control Transport Protocol (SCTP), on the other hand, has shown characteristics which make it more appealing to networks such as these. Most important, before considering a replacement for TCP on any network, a testing tool that performs well against certain criteria needs to be found. In order to try to find such a tool, two popular networking tools (Netperf v.2.4.3 & v.2.4.6 (OpenSS7 STREAMS), and Iperf v.2.0.6) were tested. These tools implement both TCP and SCTP and were evaluated using four metrics: (1) How effectively can the tool reach a throughput near the bandwidth? (2) How much of the CPU does the tool utilize during operation? (3) Is the tool freely and widely available? And, (4) Is the tool actively developed? Following the analysis of those tools, this paper goes further into explaining some recommendations and ideas for future work.

  20. Clinical significance of HPV DNA cotesting in Korean women with ASCUS or ASC-H.

    Science.gov (United States)

    Lee, Sanghoon; Kim, Jae Won; Hong, Jin Hwa; Song, Jae Yun; Lee, Jae Kwan; Kim, In Sun; Lee, Nak Woo

    2014-12-01

    The purpose of this study was to evaluate the clinical significance of Human papillomavirus (HPV) DNA cotesting in Korean women with abnormal Papanicolaou (Pap) smear results based on colposcopic pathology. A total of 1012 women underwent liquid-based Pap smears and hybrid capture II HPV DNA tests followed by colposcopy at the Korea University Hospital from January 2007 to May 2012. Of these women, 832 women were included in this retrospective study. The mean patient age was 45.4 ± 13.7 years (range:15-80). The distribution of Pap smear results was normal (4.7%), atypical squamous cells of uncertain significance (ASCUS) (42.1%), low-grade squamous intraepithelial lesion (26.8%), ASC-H (7.0%), and high-grade squamous intraepithelial lesion (HSIL) (19.5%). In women with ASCUS, none of the 87 HPV-negative had ≥cervical intraepithelial neoplasia (CIN2) (P age groups: ASCUS and ASC-H furnish healthcare providers with informative data. There is a lower proportion of ≥CIN2 in HPV-negative women and a higher proportion of ≥CIN2 in HPV-positive. When HPV data were further evaluated by age group, the risk of ≥CIN2 was lower in HPV-negative women, especially in women ≥30. © 2014 Wiley Periodicals, Inc.

  1. Comparison of lysimeter based and calculated ASCE reference evapotranspiration in a subhumid climate

    Science.gov (United States)

    Nolz, Reinhard; Cepuder, Peter; Eitzinger, Josef

    2016-04-01

    The standardized form of the well-known FAO Penman-Monteith equation, published by the Environmental and Water Resources Institute of the American Society of Civil Engineers (ASCE-EWRI), is recommended as a standard procedure for calculating reference evapotranspiration (ET ref) and subsequently plant water requirements. Applied and validated under different climatic conditions it generally achieved good results compared to other methods. However, several studies documented deviations between measured and calculated reference evapotranspiration depending on environmental and weather conditions. Therefore, it seems generally advisable to evaluate the model under local environmental conditions. In this study, reference evapotranspiration was determined at a subhumid site in northeastern Austria from 2005 to 2010 using a large weighing lysimeter (ET lys). The measured data were compared with ET ref calculations. Daily values differed slightly during a year, at which ET ref was generally overestimated at small values, whereas it was rather underestimated when ET was large, which is supported also by other studies. In our case, advection of sensible heat proved to have an impact, but it could not explain the differences exclusively. Obviously, there were also other influences, such as seasonal varying surface resistance or albedo. Generally, the ASCE-EWRI equation for daily time steps performed best at average weather conditions. The outcomes should help to correctly interpret ET ref data in the region and in similar environments and improve knowledge on the dynamics of influencing factors causing deviations.

  2. Effects of Metal Micro and Nano-Particles on hASCs: An In Vitro Model.

    Science.gov (United States)

    Palombella, Silvia; Pirrone, Cristina; Rossi, Federica; Armenia, Ilaria; Cherubino, Mario; Valdatta, Luigi; Raspanti, Mario; Bernardini, Giovanni; Gornati, Rosalba

    2017-08-03

    As the knowledge about the interferences of nanomaterials on human staminal cells are scarce and contradictory, we undertook a comparative multidisciplinary study based on the size effect of zero-valent iron, cobalt, and nickel microparticles (MPs) and nanoparticles (NPs) using human adipose stem cells (hASCs) as a model, and evaluating cytotoxicity, morphology, cellular uptake, and gene expression. Our results suggested that the medium did not influence the cell sensitivity but, surprisingly, the iron microparticles (FeMPs) resulted in being toxic. These data were supported by modifications in mRNA expression of some genes implicated in the inflammatory response. Microscopic analysis confirmed that NPs, mainly internalized by endocytosis, persist in the vesicles without any apparent cell damage. Conversely, MPs are not internalized, and the effects on hASCs have to be ascribed to the release of ions in the culture medium, or to the reduced oxygen and nutrient exchange efficiency due to the presence of MP agglomerating around the cells. Notwithstanding the results depicting a heterogeneous scene that does not allow drawing a general conclusion, this work reiterates the importance of comparative investigations on MPs, NPs, and corresponding ions, and the need to continue the thorough verification of NP and MP innocuousness to ensure unaffected stem cell physiology and differentiation.

  3. 12 CFR 1102.310 - Service of process.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Service of process. 1102.310 Section 1102.310... Office, Procedures, Public Information § 1102.310 Service of process. (a) Service. Any subpoena or other... 20006. Where the ASC is named as a party, service of process shall be made pursuant to the Federal Rules...

  4. The role of colposcopy and typization of human papillomavirus in further diagnostic proceedings in patients with ASC-US cytological finding of the uterine cervix

    Directory of Open Access Journals (Sweden)

    Živadinović Radomir

    2009-01-01

    Full Text Available Background/Aim. Bethesda system of classification of cytological findings was introduced in 2001 two subcategories in the category of atypical squamous cells (ASC findings: ASC of undetermined significance (ASC-US and ASC which cannot exclude high-grade intraepithelial lesions (ASC-H. The aim of our study was to assess a possible association of these two subcategories with pathologic biopsy finding and to find out the best further diagnostic proceedings. Methods. At the Clinic of Gynecology and Obstetrics, Niš 130 patients with ASC findings were analyzed. Colposcopy was performed in all study participants. Patients with pathological colposcopic findings underwent cervical biopsy. In 10 patients with pathologic histologic and 15 with benign findings human papilloma virus (HPV typization was done using the Hybrid Capture method. Results. Patients with ASC-H finding had significantly more pathologic biopsies compared with patients with ASC-US finding (57.84: 20.72. Conclusion. Colposcopy was exhibited somewhat higher sensitivity compared to HPV typization (94.7 : 90, but lower sensitivity (79.27 : 86.6. The usage of HPV typization in the triage of patients with ASC cytologic smear induces statistically significant reduction of unnecessary percentage of cervical biopsies.

  5. ASC ATDM Level 2 Milestone #5325: Asynchronous Many-Task Runtime System Analysis and Assessment for Next Generation Platforms.

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Gavin Matthew; Bettencourt, Matthew Tyler; Bova, Steven W.; Franko, Ken; Gamell, Marc; Grant, Ryan; Hammond, Simon David; Hollman, David S; Knight, Samuel; Kolla, Hemanth; Lin, Paul; Olivier, Stephen Lecler; Sjaardema, Gregory D.; Slattengren, Nicole Lemaster; Teranishi, Keita; Wilke, Jeremiah J; Bennett, Janine Camille; Clay, Robert L.; Kale, Laxkimant; Jain, Nikhil; Mikida, Eric; Aiken, Alex; Bauer, Michael; Lee, Wonchan; Slaughter, Elliott; Treichler, Sean; Berzins, Martin; Harman, Todd; Humphreys, Alan; Schmidt, John; Sunderland, Dan; Mccormick, Pat; Gutierrez, Samuel; Shulz, Martin; Gamblin, Todd; Bremer, Peer-Timo

    2015-09-01

    This report provides in-depth information and analysis to help create a technical road map for developing next- generation Orogramming mocleN and runtime systemsl that support Advanced Simulation and Computing (ASC) work- load requirements. The focus herein is on 4synchronous many-task (AMT) model and runtime systems, which are of great interest in the context of "Oriascale7 computing, as they hold the promise to address key issues associated with future extreme-scale computer architectures. This report includes a thorough qualitative and quantitative examination of three best-of-class AIM] runtime systemsHCharm-HE, Legion, and Uintah, all of which are in use as part of the Centers. The studies focus on each of the runtimes' programmability, performance, and mutability. Through the experiments and analysis presented, several overarching Predictive Science Academic Alliance Program II (PSAAP-II) Ascl findings emerge. From a performance perspective, AIVT11runtimes show tremendous potential for addressing extreme- scale challenges. Empirical studies show an AM11 runtime can mitigate performance heterogeneity inherent to the machine itself and that Message Passing Interface (MP1) and AM11runtimes perform comparably under balanced con- ditions. From a programmability and mutability perspective however, none of the runtimes in this study are currently ready for use in developing production-ready Sandia ASCIapplications. The report concludes by recommending a co- design path forward, wherein application, programming model, and runtime system developers work together to define requirements and solutions. Such a requirements-driven co-design approach benefits the community as a whole, with widespread community engagement mitigating risk for both application developers developers. and high-performance computing inntime systein

  6. Atypical squamous cells, cannot exclude high grade squamous intraepithelial (ASC-H in HIV-positive women

    Directory of Open Access Journals (Sweden)

    Michelow Pam

    2010-01-01

    Full Text Available Objective: South Africa has very high rates of both HIV infection and cervical pathology. The management of ASC-H is colposcopy and directed biopsy, but with so many women diagnosed with HSIL and a dearth of colposcopy centres in South Africa, women with cytologic diagnosis of ASC-H may not be prioritized for colposcopy. The aim of this study was to determine if HIV-positive women with a cytologic diagnosis of ASC-H should undergo immediate colposcopy or whether colposcopy can be delayed, within the context of an underfunded health care setting with so many competing health needs. Materials and Methods: A computer database search was performed from the archives of an NGO-administered clinic that offers comprehensive HIV care. All women with a cytologic diagnosis of ASC-H on cervical smears from September 2005 until August 2009 were identified. Histologic follow up was sought in all patients. Results: A total of 2111 cervical smears were performed and 41 diagnosed as ASC-H (1.94%. No histologic follow up data was available in 15 cases. Follow up histologic results were as follows: three negative (11.5%, five koilocytosis and/ or CIN1 (19.2%, ten CIN2 (38.5% and eight CIN3 (30.8%. There were no cases of invasive carcinoma on follow up. Conclusion: The current appropriate management of HIV-positive women in low-resource settings with a diagnosis of ASC-H on cervical smear is colposcopy, despite the costs involved. In the future and if cost-effective in developing nations, use of novel markers may help select which HIV-positive women can be managed conservatively and which ones referred for more active treatment. More research in this regard is warranted.

  7. Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study.

    Science.gov (United States)

    Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P

    2014-05-19

    User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often

  8. Visualization on supercomputing platform level II ASC milestone (3537-1B) results from Sandia.

    Energy Technology Data Exchange (ETDEWEB)

    Geveci, Berk (Kitware, Inc., Clifton Park, NY); Fabian, Nathan; Marion, Patrick (Kitware, Inc., Clifton Park, NY); Moreland, Kenneth D.

    2010-09-01

    This report provides documentation for the completion of the Sandia portion of the ASC Level II Visualization on the platform milestone. This ASC Level II milestone is a joint milestone between Sandia National Laboratories and Los Alamos National Laboratories. This milestone contains functionality required for performing visualization directly on a supercomputing platform, which is necessary for peta-scale visualization. Sandia's contribution concerns in-situ visualization, running a visualization in tandem with a solver. Visualization and analysis of petascale data is limited by several factors which must be addressed as ACES delivers the Cielo platform. Two primary difficulties are: (1) Performance of interactive rendering, which is most computationally intensive portion of the visualization process. For terascale platforms, commodity clusters with graphics processors(GPUs) have been used for interactive rendering. For petascale platforms, visualization and rendering may be able to run efficiently on the supercomputer platform itself. (2) I/O bandwidth, which limits how much information can be written to disk. If we simply analyze the sparse information that is saved to disk we miss the opportunity to analyze the rich information produced every timestep by the simulation. For the first issue, we are pursuing in-situ analysis, in which simulations are coupled directly with analysis libraries at runtime. This milestone will evaluate the visualization and rendering performance of current and next generation supercomputers in contrast to GPU-based visualization clusters, and evaluate the performance of common analysis libraries coupled with the simulation that analyze and write data to disk during a running simulation. This milestone will explore, evaluate and advance the maturity level of these technologies and their applicability to problems of interest to the ASC program. Scientific simulation on parallel supercomputers is traditionally performed in four

  9. Drivers of Medicare Reimbursement for Thoracolumbar Fusion: An Analysis of Data From The Centers For Medicare and Medicaid Services.

    Science.gov (United States)

    Khanna, Krishn; Padegimas, Eric M; Zmistowski, Benjamin; Howley, Michael; Verma, Kushagra

    2017-11-01

    A retrospective observational study. The purpose of this study is to examine the variation in thoracolumbar fusion (TLF) payment and determine the drivers of this variation. As health care spending continues to increase, variation in surgical procedures reimbursements has come under more scrutiny. TLF is an example of a high-cost, proven-benefit procedure that is often the focus of Centers for Medicare and Medicaid Services (CMS) administrators. There is a wide variation in TLF charges, but the drivers for this variation are not clear. Claims for TLF were identified in the CMS data by analyzing Diagnosis Related Group (DRG) number 460 ("Spinal Fusion Except Cervical without Major Complications or Comorbidities"). Data on factors that may impact cost of care were collected from four sources: the United States Census Bureau, CMS, the Dartmouth Atlas, and WWAMI Rural Health Research Center. These were then grouped into seven categories: quality, supply, demand, substitute treatment availability, patient characteristics, competitive factors, and provider characteristics. Predictive reimbursement models were created from the data using multivariate linear regression to understand the factors that influence TLF reimbursement. There was significant geographic variability in reimbursement. The largest contribution to reimbursement variation came from variables in the demand (ΔR = 13.4%, P reimbursement were provider charges (β = 0.37, P reimbursement in the region (β = 0.19, P reimbursement. There was wide variation in reimbursement for TLF across the U.S. The variables that drive TLF reimbursement variation include supply, demand, and competition. Interestingly, quality of care was not associated with increased TLF reimbursement. N/A.

  10. Examination of Industry Payments to Radiation Oncologists in 2014 Using the Centers for Medicare and Medicaid Services Open Payments Database

    Energy Technology Data Exchange (ETDEWEB)

    Jairam, Vikram [Yale School of Medicine, New Haven, Connecticut (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

    2016-01-01

    Purpose: To use the Centers for Medicare and Medicaid Services Open Payments database to characterize payments made to radiation oncologists and compare their payment profile with that of medical and surgical oncologists. Methods and Materials: The June 2015 release of the Open Payments database was accessed, containing all payments made to physicians in 2014. The general payments dataset was used for analysis. Data on payments made to medical, surgical, and radiation oncologists was obtained and compared. Within radiation oncology, data regarding payment category, sponsorship, and geographic distribution were identified. Basic statistics including mean, median, range, and sum were calculated by provider and by transaction. Results: Among the 3 oncologic specialties, radiation oncology had the smallest proportion (58%) of compensated physicians and the lowest mean ($1620) and median ($112) payment per provider. Surgical oncology had the highest proportion (84%) of compensated physicians, whereas medical oncology had the highest mean ($6371) and median ($448) payment per physician. Within radiation oncology, nonconsulting services accounted for the most money to physicians ($1,042,556), whereas the majority of the sponsors were medical device companies (52%). Radiation oncologists in the West accepted the most money ($2,041,603) of any US Census region. Conclusions: Radiation oncologists in 2014 received a large number of payments from industry, although less than their medical or surgical counterparts. As the Open Payments database continues to be improved, it remains to be seen whether this information will be used by patients to inform choice of providers or by lawmakers to enact policy regulating physician–industry relationships.

  11. Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use.

    Science.gov (United States)

    Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen; Wells, Kenneth B; Kominski, Gerald; Mays, Vickie M

    2015-12-01

    The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. A total of 2,358 adults, aged 18-64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. We defined "usual provider" as a primary care provider/practice, and "PCMH provider" as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2-13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4-21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7-14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5-15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI

  12. Program for establishing long-time flight service performance of composite materials in the center wing structure of C-130 aircraft. Phase 5: flight service and inspection. Final report

    International Nuclear Information System (INIS)

    Kizer, J.A.

    1981-10-01

    Inspections of the C-130 composite-reinforced center wings were conducted over the flight service monitoring period of more than six years. Twelve inspections were conducted on each of the two C-130H airplanes having composite reinforced center wing boxes. Each inspection consisted of visual and ultrasonic inspection of the selective boron-epoxy reinforced center wings which included the inspection of the boron-epoxy laminates and the boron-epoxy reinforcement/aluminum structure adhesive bondlines. During the flight service monitoring period, the two C-130H aircraft accumulated more than 10,000 flight hours and no defects were detected in the inspections over this period. The successful performance of the C-130H aircraft with composite-reinforced center wings allowed the transfer of the responsibilities of inspecting and maintaining these two aircraft to the U. S. Air Force

  13. LINKING CLASSROOM AND COMMUNITY: A THEORETICAL ALIGNMENT OF SERVICE LEARNING AND A HUMAN-CENTERED DESIGN METHODOLOGY IN CONTEMPORARY COMMUNICATION DESIGN EDUCATION

    Directory of Open Access Journals (Sweden)

    Anneli Bowie

    2016-04-01

    Full Text Available The current emphasis on social responsibility and community collaboration within higher education has led to an increased drive to include service learning in the curriculum. With its emphasis on mutually beneficial collaborations, service learning can be meaningful for both students and the community, but is challenging to manage successfully. From a design education perspective, it is interesting to note that contemporary design practice emphasises a similar approach known as a human-centered design, where users are considered and included throughout the design process. In considering both service learning and human-centred design as foundations for design pedagogy, various philosophical and methodological similarities are evident. The paper explores the relationship between a service learning community engagement approach and a human-centered design approach in contemporary communication design education. To this end, each approach is considered individually after which a joint frame of reference is presented. Butin’s service learning typology, namely the four Rs – respect, reciprocity, relevance and reflection – serves as a point of departure for the joint frame of reference. Lastly, the potential value and relevance of a combined understanding of service learning and human-centered design is considered.

  14. Sliding and Rocking of Unanchored Components and Structures: Chapter 7.6 ASCE 4 Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    S. R. Jensen

    2011-04-01

    Chapter 7.6 of ASCE 4-Rev 2, Seismic Analysis of Safety-Related Nuclear Structures: Standard and Commentary, provides updated guidance for analysis of rocking and sliding of unanchored structures and components subjected to seismic load. This guidance includes provisions both for simplified approximate energy-based approaches, and for detailed probabilistic time history analysis using nonlinear methods. Factors to be applied to the analytical results are also provided with the intent of ensuring achievement of the 80% non-exceedence probability target of the standard. The present paper surveys the published literature supporting these provisions. The results of available testing and analysis are compared to results produced by both simplified and probabilistic approaches. In addition, adequacy of the standard's provisions for analysis methods and factors is assessed. A comparison is made between the achieved level of conservatism and the standard's non-exceedence probability target.

  15. An interprofessional service-learning course: uniting students across educational levels and promoting patient-centered care.

    Science.gov (United States)

    Dacey, Marie; Murphy, Judy I; Anderson, Delia Castro; McCloskey, William W

    2010-12-01

    Recognizing the importance of interprofessional education, we developed a pilot interprofessional education course at our institution that included a total of 10 nursing, BS health psychology, premedical, and pharmacy students. Course goals were for students to: 1) learn about, practice, and enhance their skills as members of an interprofessional team, and 2) create and deliver a community-based service-learning program to help prevent or slow the progression of cardiovascular disease in older adults. Teaching methods included lecture, role-play, case studies, peer editing, oral and poster presentation, and discussion. Interprofessional student teams created and delivered two different health promotion programs at an older adult care facility. Despite barriers such as scheduling conflicts and various educational experiences, this course enabled students to gain greater respect for the contributions of other professions and made them more patient centered. In addition, inter-professional student teams positively influenced the health attitudes and behaviors of the older adults whom they encountered. Copyright 2010, SLACK Incorporated.

  16. Heat-pump-centered integrated community energy systems. System development, Consolidated Natural Gas Service Company, interim report

    Energy Technology Data Exchange (ETDEWEB)

    Tison, R.R.; Baker, N.R.; Yudow, B.D.; Sala, D.L.; Donakowski, T.D.; Swenson, P.F.

    1979-08-01

    Heat-pump-centered integrated community energy systems are energy systems for communities that provide heating, cooling, and/or other thermal energy services through the use of heat pumps. Since heat pumps primarily transfer energy from existing and otherwise probably unused sources, rather than convert it from electrical or chemical to thermal form, HP-ICES offer a significant potential for energy savings. Results of the System Development Phase of the HP-ICES Project are given. The heat-actuated (gas) heat-pump incorporated into this HP-ICES concept is under current development and demonstration. The concurrent program was redirected in September 1977 toward large-tonnage applications; it is currently focusing on 60- to 400-ton built-up systems for multi-zone applications. This study evaluates the performance of a HAHP-ICES as applied to a community of residential and commercial buildings. To permit a general assessment of the concept in non-site-specific terms, the sensitivity of the system's performance and economics to climate, community size, utility rate structures, and economic assumptions is explored. (MCW)

  17. Integrating Traditional Chinese Medicine Services in Community Health Centers: Insights into Utilization Patterns in the Pearl River Region of China

    Directory of Open Access Journals (Sweden)

    Vincent C. H. Chung

    2013-01-01

    Full Text Available In China's healthcare reform, community health centers (CHCs are designed to take a pivotal role in providing primary care. Whilst about 20% of all outpatient care in China is delivered by the traditional Chinese medicine (TCM sector, hospitals, instead of CHCs, are major providers. Using current patterns of patient utilization this study aims to inform CHCs on how they may strengthen access to TCM services. Three thousand three hundred and sixty CHC patients from six cities within the urban Pearl Delta Region were enumerated using multistage cluster sampling. Fifty-two percent had visited herbalists within three months with a mean visit frequency of 1.50 times. Herbal treatments, which are cheaper than western medicines, were more popular amongst those who needed to pay out of pocket including the uninsured. Herbal medicines appeared to be an alternative for those who are underinsured. Acupuncturists and massage therapists were visited by smaller proportions, 6.58% and 5.98%, respectively, with a mean three-month visit of 0.27 and 0.26 times. Access was restricted by lack of social insurance coverage. Whilst increasing provision of TCM in CHCs might respond to patient demand, increasing insurance coverage for TCM needs to be evaluated using current evidence on safety and effectiveness.

  18. Geotechnical analysis of soil samples from test trench at Western New York Nuclear Service Center, West Valley, New York

    International Nuclear Information System (INIS)

    Fickies, R.H.; Fakundiny, R.H.; Mosley, E.T.

    1979-04-01

    In July 1977, a deep research trench was excavated and soil samples collected at the Western New York Nuclear Services Center, West Valley, NY. The glacial till horizons sampled are considered to be representative of the till serving as a burial medium at the nearby low-level radioactive waste burial ground. A series of laboratory tests were conducted consisting of unit weight, moisture content, Atterberg limits, unconfined compression, dispersion, swell, permeability, and consolidation. These laboratory analyses and field observations indicate that the till exposed in the research trench is a generally dense mixture of silt and clay of low to medium plasticity, with minor amounts of fine to coarse sand and fine gravel. The till has a generally low coefficient of permeability in the range of 10 -7 cm/s horizontal and 10 -8 cm/s vertical. A network of vertical fractures exists in the upper 15 feet of weathered till which may allow some downward percolation of surface runoff. The test data indicates that the maximum depth to which these fractures could possibly penetrate is 50 feet

  19. Latest Community Coordinated Modeling Center (CCMC) services and innovative tools supporting the space weather research and operational communities.

    Science.gov (United States)

    Mendoza, A. M. M.; Rastaetter, L.; Kuznetsova, M. M.; Mays, M. L.; Chulaki, A.; Shim, J. S.; MacNeice, P. J.; Taktakishvili, A.; Collado-Vega, Y. M.; Weigand, C.; Zheng, Y.; Mullinix, R.; Patel, K.; Pembroke, A. D.; Pulkkinen, A. A.; Boblitt, J. M.; Bakshi, S. S.; Tsui, T.

    2017-12-01

    The Community Coordinated Modeling Center (CCMC), with the fundamental goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research, has been serving as an integral hub for over 15 years, providing invaluable resources to both space weather scientific and operational communities. CCMC has developed and provided innovative web-based point of access tools varying from: Runs-On-Request System - providing unprecedented global access to the largest collection of state-of-the-art solar and space physics models, Integrated Space Weather Analysis (iSWA) - a powerful dissemination system for space weather information, Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and Mobile apps to view space weather data anywhere to the scientific community. In addition to supporting research and performing model evaluations, CCMC also supports space science education by hosting summer students through local universities. In this poster, we will showcase CCMC's latest innovative tools and services, and CCMC's tools that revolutionized the way we do research and improve our operational space weather capabilities. CCMC's free tools and resources are all publicly available online (http://ccmc.gsfc.nasa.gov).

  20. The Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality Demonstration: a descriptive overview.

    Science.gov (United States)

    Reilly, Karen E; Mueller, Christine; Zimmerman, David R

    2007-01-01

    This paper presents the first comprehensive account of a major national demonstration designed to integrate skilled nursing facilities (SNF) prospective case-mix payment and quality of care. It describes the Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality (NHCMQ) Demonstration-the template for Medicare's SNF Prospective Payment System (PPS) implemented July 1998. The NHCMQ Demonstration provided the basis for one of the most significant changes in SNF reimbursement and quality monitoring policies to date. Prospective reimbursement policies created positive incentive for providers to admit Medicare residents under more equitable payment rates. However, controversy regarding unanticipated perverse provider incentives remains. The quality management system designed under the NHCMQDemonstration is currently used in over 17,000 nursing homes. Furthermore, under the NHCMQ Demonstration, one standardized assessment tool-the MDS-was used to assess a resident's clinical condition, to monitor quality, and to calculate provider reimbursement. Experiences from the NHCMQ Demonstration and continued evaluation of the current national PPS, along with state systems, provide a rich information source regarding prospective, case-mix reimbursement, and provider incentives.

  1. Career Advancement and Work Support Services on the Job: Implementing the Fort Worth Work Advancement and Support Center Program. Executive Summary

    Science.gov (United States)

    Schultz, Caroline; Seith, David

    2011-01-01

    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…

  2. Genetic and physical analysis of a YAC contig spanning the fungal disease resistance locus Asc of tomato (Lycopersicon esculentum)

    NARCIS (Netherlands)

    Mesbah, L.A.; Kneppers, T.J.A.; Takken, F.L.W.; Laurent, P.; Hille, J.; Nijkamp, H.J.J.

    1998-01-01

    The Alternaria stem canker disease of tomato is caused by the necrotrophic fungal pathogen Alternaria alternata f. sp. lycopersici (AAL). The fungus produces AAL toxins that kill the plant tissue. Resistance to the fungus segregates as a single locus, called Asc, and has been genetically mapped on

  3. Genetic and physical analysis of a YAC contig spannig the fungal disease resistance locus Asc of tomato (Lycopersicon esculentum)

    NARCIS (Netherlands)

    Mesbah, L.A.; Kneppers, T.J.A.; Takken, F.L.W.; Laurent, P.J.F.; Hille, J.; Nijkamp, H.J.J.

    1999-01-01

    The Alternaria in stem canker disease of tomato is caused by the necrotrophic fungal pathogen Alternaria alternata f. sp. lycopersici (AAL). The fungus produces AAL toxins that kill the plant tissue. Resistance to the fungus segregates as a single locus, called Asc, and has been genetically mapped

  4. Improving the provision of language services at an academic medical center: ensuring high-quality health communication for limited-English-proficient patients.

    Science.gov (United States)

    Standiford, Connie J; Nolan, Elizabeth; Harris, Michelle; Bernstein, Steven J

    2009-12-01

    To evaluate and improve the provision of language services at an academic medicine center caring for a diverse population including many limited-English-proficient (LEP) patients. The authors performed a prospective observational study between November 2006 and December 2008 evaluating the provision of language services at the University of Michigan Health System. The primary performance measures were (1) screening patients for their preferred language for health care, (2) assessing the proportion of LEP patients receiving language services from a qualified language services provider, and (3) assessing whether there were any disparities in diabetes care for LEP patients compared with English-speaking patients. The proportion of patients screened for preferred language increased from 59% to 96% with targeted inventions, such as training staff to capture preferred language for health care and correcting prior inaccurate primary language data entry. The proportion of LEP outpatients with a qualified language services provider increased from 19% to 83% through the use of staff and contract interpreters, over-the-phone interpreting and bilingual providers. There were no systematic differences in diabetes quality performance measures between LEP and English-proficient patients. Academic medical centers should measure their provision of language services and compare quality and safety data (e.g., performance measures and adverse events) between LEP and English-speaking patients to identify disparities in care. Leadership support and ongoing training are needed to ensure language-specific services are embedded into clinical care to meet the needs of our diverse patient populations.

  5. Characterization of a novel variant of amino acid transport system asc in erythrocytes from Przewalski's horse (Equus przewalskii).

    Science.gov (United States)

    Fincham, D A; Ellory, J C; Young, J D

    1992-08-01

    In thoroughbred horses, red blood cell amino acid transport activity is Na(+)-independent and controlled by three codominant genetic alleles (h, l, s), coding for high-affinity system asc1 (L-alanine apparent Km for influx at 37 degrees C congruent to 0.35 mM), low-affinity system asc2 (L-alanine Km congruent to 14 mM), and transport deficiency, respectively. The present study investigated amino acid transport mechanisms in red cells from four wild species: Przewalski's horse (Equus przewalskii), Hartmann's zebra (Zebra hartmannae), Grevy's zebra (Zebra grevyi), and onager (Equus hemonius). Red blood cell samples from different Przewalski's horses exhibited uniformly high rates of L-alanine uptake, mediated by a high-affinity asc1-type transport system. Mean apparent Km and Vmax values (+/- SE) for L-alanine influx at 37 degrees C in red cells from 10 individual animals were 0.373 +/- 0.068 mM and 2.27 +/- 0.11 mmol (L cells.h), respectively. As in thoroughbreds, the Przewalski's horse transporter interacted with dibasic as well as neutral amino acids. However, the Przewalski asc1 isoform transported L-lysine with a substantially (6.4-fold) higher apparent affinity than its thoroughbred counterpart (Km for influx 1.4 mM at 37 degrees C) and was also less prone to trans-stimulation effects. The novel high apparent affinity of the Przewalski's horse transporter for L-lysine provides additional key evidence of functional and possible structural similarities between asc and the classical Na(+)-dependent system ASC and between these systems and the Na(+)-independent dibasic amino acid transport system y+. Unlike Przewalski's horse, zebra red cells were polymorphic with respect to L-alanine transport activity, showing high-affinity or low-affinity saturable mechanisms of L-alanine uptake. Onager red cells transported this amino acid with intermediate affinity (apparent Km for influx 3.0 mM at 37 degrees C). Radiation inactivation analysis was used to estimate the target

  6. Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

    Science.gov (United States)

    2015-11-13

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

  7. Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1): A Systematic Review.

    Science.gov (United States)

    Pepper, Dominique J; Jaswal, Dharmvir; Sun, Junfeng; Welsh, Judith; Natanson, Charles; Eichacker, Peter Q

    2018-04-17

    This article has been corrected. To see what has changed, please read the Letter to the Editor and the authors' response. The original version (PDF) is appended to this article as a Supplement. The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced in 2015 by the Centers for Medicare & Medicaid Services (CMS), requires the reporting of up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. To evaluate whether moderate- or high-level evidence shows that use of the 2015 SEP-1 or its hemodynamic interventions improves survival in adults with sepsis. PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to 28 November 2017 with no language restrictions. Randomized and observational studies of death among adults with sepsis who received versus those who did not receive either the entire SEP-1 bundle or 1 or more SEP-1 hemodynamic interventions, including serial lactate measurements; a fluid infusion of 30 mL/kg of body weight; and assessment of volume status and tissue perfusion with a focused examination, bedside cardiovascular ultrasonography, or fluid responsiveness testing. Two investigators independently extracted study data and assessed each study's risk of bias; 4 authors rated level of evidence by consensus using CMS criteria published in 2013. High- or moderate-level evidence required studies to have no confounders and low risk of bias. Of 56 563 references, 20 studies (18 reports) met inclusion criteria. One single-center observational study reported lower in-hospital mortality after implementation of the SEP-1 bundle. Sixteen studies (2 randomized and 14 observational) reported increased survival with serial lactate measurements or 30-mL/kg fluid infusions. None of the 17 studies were free of confounders or at low risk of bias. In 3 randomized trials, fluid responsiveness testing did not alter survival. Few trials, poor-quality and

  8. Perceptions of inpatient rehabilitation changes after the Centers for Medicare and Medicaid Service 2010 regulatory updates contrasted with actual performance.

    Science.gov (United States)

    Riggs, Richard V; Roberts, Pamela S; DiVita, Margaret A; Niewczyk, Paulette; Granger, Carl V

    2014-01-01

    To compare and contrast subjective perceptions with objective compliance of the impact of the 2010 Centers for Medicare and Medicaid Service updates of the Medicare Benefit Policy Manual. Cross-sectional survey. An electronic survey was sent by the Uniform Data System for Medical Rehabilitation to all enrolled inpatient rehabilitation facility subscribers (n = 817). The survey was sent April 15, 2011, and responses were tabulated if they were received by May 15, 2011. Comparing and contrasting of the subjective perception to objective evaluation and/or compliance with the Medicare Benefit Policy Manual on case mix index, length of stay, admissions by diagnostic category as well as perception of preadmission screening, postadmission evaluation, plan of care, and interdisciplinary conferencing. Twenty-five percent of the 817 facilities responded, for a total of 209 responses. Complete data were present in 148 of the respondents. For most diagnostic categories, perception of change did not mirror reality of change; neither did the perception between change in case mix index and length of stay. Perception did match reality in stroke and multiple trauma cases; respondents perceived an increase in admissions for the 2 impairments, and there was an overall increase in reality. Comparison with actual data identified that gaps exist between diagnostic category perceptions and actual diagnostic category admission performance. Regulations such as the 75%-60% rule and audit focus on non-neurologic conditions as well as actual inpatient rehabilitation facility program payment reports may have influenced respondents perceptions to change associated with the Medicare Benefit Policy Manual modifications. This disparity between perception and actual data may have implications for programmatic planning, forecasting, and resource allocation. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  9. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

    Directory of Open Access Journals (Sweden)

    Chang Ching

    2008-04-01

    Full Text Available Abstract Background Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. Methods This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54 to analyze and evaluate the data. Results The findings are as follows: (1 Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2 After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3 Network security contributes a positive moderating effect on service quality and patient satisfaction. Conclusion It revealed that the impact of electronic workflow (online appointment system service on service quality was greater than electronic facilities (electronic medical record systems in technology-based service encounters. Convenience and

  10. An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan.

    Science.gov (United States)

    Chang, Hsin Hsin; Chang, Ching Sheng

    2008-04-17

    Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality

  11. Find a Health Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — HRSA Health Centers care for you, even if you have no health insurance – you pay what you can afford based on your income. Health centers provide services that...

  12. Putting "Service" into Library Staff Training: A Library Manager's Training Guide. LAMA Occasional Papers Series. A Patron-Centered Guide.

    Science.gov (United States)

    Bessler, Joanne M.

    This guide is built on librarianship training literature and customer service research from a variety of professions. It tells library managers how to identify and describe service ideals, to translate these ideals into realistic goals, and to lead new and experienced staff in fulfilling these service ideals. They are encouraged to focus the…

  13. Analisis Pengaruh Citra Merek Dan Kualitas Layanan Service Center Terhadap Loyalitas Pelanggan Melalui Kepuasan Pelanggan (Studi Kasus: Nokia Care Center Wilayah Jakarta)

    OpenAIRE

    Sasongko, Gerry

    2014-01-01

    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 ...

  14. Evaluation of input and process components of quality of child health services provided at 24 × 7 primary health centers of a district in Central Gujarat

    Directory of Open Access Journals (Sweden)

    Paragkumar Chavda

    2015-01-01

    Full Text Available Context: With the critical Indian challenge on child survival and health, time is ripe to initiate focus on quality of services apart from measuring coverage, to bring about improvements. Aims: To assess the quality of child health services provided at 24 × 7 Primary Health Centers of Vadodara District in Gujarat in terms of Input and Process Indicators. Settings and Design: The study was carried out in 12 randomly chosen 24 × 7 Primary Health Centers (PHCs of Vadodara district using a modified quality assessment checklist of the Program on District Quality Assurance for Reproductive and Child Health (RCH services with use of scores from May 2010 to June 2011. Subjects and Methods: Inputs assessment was done by facility survey. Process assessment for the four child health service components used actual observation of service, review of records and interview of service providers and clients. Results: The mean obtained score for facilities in Input section was 65%. Highest score was obtained for Drugs and Consumables (86% followed by Equipments and Supplies (74%. The score obtained for Infrastructure facility was 65%, Personnel and training was 56% and Essential protocols and guidelines scored 43%. The mean obtained score in the process section was 55%. Highest scores were obtained for immunization at 76%. This was followed by newborn care (52%, growth monitoring (52%. management of sick child (41%. Conclusion: Quality improvement efforts should focus not only on resource-intensive structural improvements, but also on cost-effective measures at improving service delivery process, especially adherence to service guidelines by providers.

  15. The Role of Wellbeing and Wellness: A Positive Psychological Model in Supporting Young People With ASCs

    Directory of Open Access Journals (Sweden)

    Irina Roncaglia

    2017-04-01

    Full Text Available In the last 10 years sport psychology expanded its applicability in a variety of fields which have helped to address some of the challenges related to high level performance and sport competition. When we talk about performance in its wider sense, sport psychology is able to help develop a better understanding on how strategies can be adopted in improving general human performance levels. This includes increasing the knowledge of key concepts such as motivation, self-confidence and resilience. Furthermore performance in its wider sense helps in the understanding of the impact of stress and arousal and how these can affect both positively and negatively performance levels including appreciating individual differences as well as dynamics between groups of individuals. In this paper performance rather than solely be related to the field of competitive or professional sport has been discussed in people with ASCs and aims to explore how by adopting a positive psychological model in the formulation of individual assessments and subsequent interventions have led to improvement in individual skills, participation, engagement and ultimately quality of life. Positive psychological principles, such as the role of wellbeing and wellness, the PERMA Model has increased our understanding of human potentials, performance and wellbeing. The aim of this paper is to present and reflect on the applicability and benefits of adopting sport psychology models, the PERMA model and positive psychological principles in special education and care settings with the presentation and discussion of their theoretical and some practical implementation in two case studies.

  16. BioPortal: enhanced functionality via new Web services from the National Center for Biomedical Ontology to access and use ontologies in software applications.

    Science.gov (United States)

    Whetzel, Patricia L; Noy, Natalya F; Shah, Nigam H; Alexander, Paul R; Nyulas, Csongor; Tudorache, Tania; Musen, Mark A

    2011-07-01

    The National Center for Biomedical Ontology (NCBO) is one of the National Centers for Biomedical Computing funded under the NIH Roadmap Initiative. Contributing to the national computing infrastructure, NCBO has developed BioPortal, a web portal that provides access to a library of biomedical ontologies and terminologies (http://bioportal.bioontology.org) via the NCBO Web services. BioPortal enables community participation in the evaluation and evolution of ontology content by providing features to add mappings between terms, to add comments linked to specific ontology terms and to provide ontology reviews. The NCBO Web services (http://www.bioontology.org/wiki/index.php/NCBO_REST_services) enable this functionality and provide a uniform mechanism to access ontologies from a variety of knowledge representation formats, such as Web Ontology Language (OWL) and Open Biological and Biomedical Ontologies (OBO) format. The Web services provide multi-layered access to the ontology content, from getting all terms in an ontology to retrieving metadata about a term. Users can easily incorporate the NCBO Web services into software applications to generate semantically aware applications and to facilitate structured data collection.

  17. Building and evaluating an informatics tool to facilitate analysis of a biomedical literature search service in an academic medical center library.

    Science.gov (United States)

    Hinton, Elizabeth G; Oelschlegel, Sandra; Vaughn, Cynthia J; Lindsay, J Michael; Hurst, Sachiko M; Earl, Martha

    2013-01-01

    This study utilizes an informatics tool to analyze a robust literature search service in an academic medical center library. Structured interviews with librarians were conducted focusing on the benefits of such a tool, expectations for performance, and visual layout preferences. The resulting application utilizes Microsoft SQL Server and .Net Framework 3.5 technologies, allowing for the use of a web interface. Customer tables and MeSH terms are included. The National Library of Medicine MeSH database and entry terms for each heading are incorporated, resulting in functionality similar to searching the MeSH database through PubMed. Data reports will facilitate analysis of the search service.

  18. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  19. Tipo de respuesta según el genotipado del virus del papiloma humano según cobas 4800 en las lesiones asc-us HPV positivas

    OpenAIRE

    Kanjou Augé, Nadwa

    2016-01-01

    Objetivos: Evaluar el riesgo de patología subyacente en las pacientes ASC-US HPV positivas de nuestra área de influencia analizadas por el método COBAS 4800. Se estudió el riesgo de CIN2+ en el momento del diagnóstico de las mujeres ASC-US HPV positivas según el genotipo del virus del papiloma: HPV16, HPV18 ( ambos incluyendo coinfecciones) u otros HPV de alto riesgo (HR-HPV). El objetivo es detectar aquellas mujeres con citologías ASC-US HPV positivo con un mayor riesgo de progresión y por l...

  20. Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

    Energy Technology Data Exchange (ETDEWEB)

    East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

    2008-09-22

    This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.

  1. Estabilidade de ácido ascórbico em sucos de frutas frescos sob diferentes formas de armazenamento

    OpenAIRE

    Cunha, Kelly Damasceno; Silva, Priscila Ribeiro da; Costa, Ana Lígia Faria e Silva da Fonseca; Teodoro, Anderson Junger; Koblitz, Maria Gabriela Bello

    2014-01-01

    O ácido ascórbico é uma vitamina hidrossolúvel de importância nutricional há muito estabelecida, por sua atuação como cofator em diversos processos fisiológicos e como antioxidante. O ser humano depende da ingestão diária desse micronutriente, cujas principais fontes são as frutas e hortaliças. Por ser um nutriente menos estável, o ácido ascórbico sofre perdas no processamento e no armazenamento, influenciadas por diversos fatores, como pH, temperatura, presença de íons, etc. A literatura apr...

  2. Evaluation of service quality by using fuzzy MCDM: A case study in Iranian health-care centers

    Directory of Open Access Journals (Sweden)

    Leili Afkham

    2012-01-01

    Full Text Available Service quality plays an important role in health care systems since hospitals are responsible for people's lives. This study presents an effective approach for evaluating and comparing service qualities of four hospitals. Service quality consists of different attributes and many of them are intangible and difficult to measure. Therefore, we propose a fuzzy method to resolve the ambiguity of the concepts, which are associated with human judgments. SERVQUAL model is used to evaluate the respondents' judgments of service quality and multi attribute decision making approach is implemented for the comparison among hospitals. The paper use analytical hierarchy process (AHP for obtaining criteria weight and TOPSIS for ranking the cases.

  3. Clinical Informatics Fellowship Programs: In Search of a Viable Financial Model: An open letter to the Centers for Medicare and Medicaid Services.

    Science.gov (United States)

    Lehmann, C U; Longhurst, C A; Hersh, W; Mohan, V; Levy, B P; Embi, P J; Finnell, J T; Turner, A M; Martin, R; Williamson, J; Munger, B

    2015-01-01

    In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.

  4. Differential regulation of caspase-1 activation, pyroptosis, and autophagy via Ipaf and ASC in Shigella-infected macrophages.

    Directory of Open Access Journals (Sweden)

    Toshihiko Suzuki

    2007-08-01

    Full Text Available Shigella infection, the cause of bacillary dysentery, induces caspase-1 activation and cell death in macrophages, but the precise mechanisms of this activation remain poorly understood. We demonstrate here that caspase-1 activation and IL-1beta processing induced by Shigella are mediated through Ipaf, a cytosolic pattern-recognition receptor of the nucleotide-binding oligomerization domain (NOD-like receptor (NLR family, and the adaptor protein apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain (ASC. We also show that Ipaf was critical for pyroptosis, a specialized form of caspase-1-dependent cell death induced in macrophages by bacterial infection, whereas ASC was dispensable. Unlike that observed in Salmonella and Legionella, caspase-1 activation induced by Shigella infection was independent of flagellin. Notably, infection of macrophages with Shigella induced autophagy, which was dramatically increased by the absence of caspase-1 or Ipaf, but not ASC. Autophagy induced by Shigella required an intact bacterial type III secretion system but not VirG protein, a bacterial factor required for autophagy in epithelial-infected cells. Treatment of macrophages with 3-methyladenine, an inhibitor of autophagy, enhanced pyroptosis induced by Shigella infection, suggesting that autophagy protects infected macrophages from pyroptosis. Thus, Ipaf plays a critical role in caspase-1 activation induced by Shigella independently of flagellin. Furthermore, the absence of Ipaf or caspase-1, but not ASC, regulates pyroptosis and the induction of autophagy in Shigella-infected macrophages, providing a novel function for NLR proteins in bacterial-host interactions.

  5. 77 FR 58584 - Stream Global Services, Inc., AdCenter, Beaverton, OR; Notice of a Revised Determination on...

    Science.gov (United States)

    2012-09-21

    ... supply of services like or directly competitive with the customer relationship management and business... subject worker group includes workers involved in employment related to the supply of customer relationship management and business process outsourcing services. The subject worker group does not include on...

  6. Compilation of the FY 1998 Army General Fund Financial Statements at the Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    1999-01-01

    Our objective was to determine whether the DFAS Indianapolis Center consistently and accurately compiled financial data from field activities and other sources for the FY 1998 Army General Fund financial statements...

  7. Compilation of the FY 1996 Army Financial Statements at the Defense Finance and Accounting Service Indianapolis Center

    National Research Council Canada - National Science Library

    Lane, F

    1998-01-01

    ... Consolidated Financial Statements of the Army General Fund. We evaluated the processes, including internal controls and methods that the DFAS Indianapolis Center used to compile the Army FY 1996 General Fund financial statements...

  8. "Let's stick together"--a grounded theory exploration of interprofessional working used to provide person centered chronic back pain services.

    Science.gov (United States)

    Howarth, Michelle; Warne, Tony; Haigh, Carol

    2012-11-01

    Chronic back pain is a global phenomenon and a common reason why patients seek help from health professionals. Person-centered interprofessional working is acknowledged as the main strategy for chronic back pain management; however, the complexity of chronic pain can present significant challenges for teams. Although methods used by interprofessional teams to collaborate have been previously explored, how they work together to deliver person-centered chronic back pain care has received limited attention. The aim of this study was to explore person-centered care from the perspectives of people with chronic back pain and the interprofessional teams who cared for them. A grounded theory methodology was used to capture the interprofessional team's perspectives of person-centered working. A purposive sample of four chronic back pain management teams participated in semi-structured face-to-face interviews and focus groups. Data were thematically analyzed using a constant comparative method. Three categories emerged, collective efficacy, negotiated space and team maturity, which illustrated the attributes of interprofessional teams that influenced person-centered working. The findings suggest that collective efficacy matures over time within a negotiated coalesced space and re-enforces the need for teams to stick together to ensure effective person-centered care.

  9. Results from an experimental trial at a Head Start center to evaluate two meal service approaches to increase fruit and vegetable intake of preschool aged children

    Directory of Open Access Journals (Sweden)

    Harnack Lisa J

    2012-04-01

    Full Text Available Abstract Background Strategies to increase fruit and vegetable consumption of preschool aged children are needed. Objectives Evaluate the independent effects of the following meal service strategies on intake of fruits and vegetables of preschool children: 1. Serving fruits and vegetables in advance of other menu items as part of traditional family style meal service; and 2. Serving meals portioned and plated by providers. Methods Fifty-three preschool aged children completed a randomized crossover experiment conducted at a Head Start center in Minneapolis, MN. Over a six week trial period each of the experimental meal service strategies (serving fruits and vegetable first and serving meals portioned by providers was implemented during lunch service for two one-week periods. Two one-week control periods (traditional family style meal service with all menu items served at once were also included over the six week trial period. Childrens lunch intake was observed as a measure of food and nutrient intake during each experimental condition. Results Fruit intake was significantly higher (p Conclusions Serving fruits in advance of other meal items may be a low cost easy to implement strategy for increasing fruit intake in young children. However, serving vegetables first does not appear to increase vegetable intake. Results provide support for current recommendations for traditional family style meal service in preschool settings.

  10. Budget-impact model for colonoscopy cost calculation and comparison between 2 litre PEG+ASC and sodium picosulphate with magnesium citrate or sodium phosphate oral bowel cleansing agents.

    Science.gov (United States)

    Gruss, H-J; Cockett, A; Leicester, R J

    2012-01-01

    With the availability of several bowel cleansing agents, physicians and hospitals performing colonoscopies will often base their choice of cleansing agent purely on acquisition cost. Therefore, an easy to use budget impact model has been developed and established as a tool to compare total colon preparation costs between different established bowel cleansing agents. The model was programmed in Excel and designed as a questionnaire evaluating information on treatment costs for a range of established bowel cleansing products. The sum of costs is based on National Health Service reference costs for bowel cleansing products. Estimations are made for savings achievable when using a 2-litre polyethylene glycol with ascorbate components solution (PEG+ASC) in place of other bowel cleansing solutions. Test data were entered into the model to confirm validity and sensitivity. The model was then applied to a set of audit cost data from a major hospital colonoscopy unit in the UK. Descriptive analysis of the test data showed that the main cost drivers in the colonoscopy process are the procedure costs and costs for bed days rather than drug acquisition costs, irrespective of the cleansing agent. Audit data from a colonoscopy unit in the UK confirmed the finding with a saving of £107,000 per year in favour of PEG+ASC when compared to sodium picosulphate with magnesium citrate solution (NaPic+MgCit). For every patient group the model calculated overall cost savings. This was irrespective of the higher drug expenditure associated with the use of PEG+ASC for bowel preparation. Savings were mainly realized through reduced costs for repeat colonoscopy procedures and associated costs, such as inpatient length of stay. The budget impact model demonstrated that the primary cost driver was the procedure cost for colonoscopy. Savings can be realized through the use of PEG+ASC despite higher drug acquisition costs relative to the comparator products. From a global hospital funding

  11. ["AGAINST ALL ODDS" - PROMOTING RESEARCH, CLINICAL DEVELOPMENT AND MEDICAL SERVICES OF THE CONFLICT IN THE GALILEE MEDICAL CENTER].

    Science.gov (United States)

    Bornstein, Jacob

    2017-05-01

    The Galilee Medical Center (GMC) is unique in several aspects. Firstly, in the clinical aspect: In recent years, led by the Director of Medical Center, Dr. Masad Barhoum, a considerable momentum of development has taken place to reduce health discrepancies between the center and the periphery. Despite the under- financing of the health system in the Galilee, the GMC opened new clinical departments, introduced advanced medical technology and key staff members were added. This approach is depicted in publications presented in the current issue. Secondly, the aspect of medicine standoff: The GMC is the nearest hospital to the border with neighboring countries. It is also a tertiary center for trauma, due to the establishment of the Department of Neurosurgery, Department of Oral and Maxillofacial Surgery and the Departments of Orthopedic Surgery, general invasive radiology and invasive radiology of the brain. In recent years, the medical center treated hundreds of victims of the civil war in Syria, a third of them - women and children. The injured patients presented unique medical problems that are described in the papers in this issue. Thirdly, the research aspect: The medical center is the main teaching facility of medical students of the Faculty of Medicine in the Galilee of Bar-Ilan University. The Faculty of Medicine, led by the Dean, Prof. Ran Tur-Kaspa, promotes research and teaching in the medical center. Even before the establishment of the Faculty of Medicine, former hospital director, Prof. Shaul Shasha, not only extolled the importance of research, but established a research laboratory years ago. The laboratory continues to pursue translational research by the physicians of the medical center, led by Dr. Shifra Sela and Prof. Batya Kristal, and supported by the current medical center director, Dr. Masad Barhoum. Several studies conducted in this research laboratory are published herewith. With these unique aspects and despite the discrimination in funding

  12. ASCS online fault detection and isolation based on an improved MPCA

    Science.gov (United States)

    Peng, Jianxin; Liu, Haiou; Hu, Yuhui; Xi, Junqiang; Chen, Huiyan

    2014-09-01

    Multi-way principal component analysis (MPCA) has received considerable attention and been widely used in process monitoring. A traditional MPCA algorithm unfolds multiple batches of historical data into a two-dimensional matrix and cut the matrix along the time axis to form subspaces. However, low efficiency of subspaces and difficult fault isolation are the common disadvantages for the principal component model. This paper presents a new subspace construction method based on kernel density estimation function that can effectively reduce the storage amount of the subspace information. The MPCA model and the knowledge base are built based on the new subspace. Then, fault detection and isolation with the squared prediction error (SPE) statistic and the Hotelling ( T 2) statistic are also realized in process monitoring. When a fault occurs, fault isolation based on the SPE statistic is achieved by residual contribution analysis of different variables. For fault isolation of subspace based on the T 2 statistic, the relationship between the statistic indicator and state variables is constructed, and the constraint conditions are presented to check the validity of fault isolation. Then, to improve the robustness of fault isolation to unexpected disturbances, the statistic method is adopted to set the relation between single subspace and multiple subspaces to increase the corrective rate of fault isolation. Finally fault detection and isolation based on the improved MPCA is used to monitor the automatic shift control system (ASCS) to prove the correctness and effectiveness of the algorithm. The research proposes a new subspace construction method to reduce the required storage capacity and to prove the robustness of the principal component model, and sets the relationship between the state variables and fault detection indicators for fault isolation.

  13. Products and Services Available from the Southern California Earthquake Data Center (SCEDC) and the Southern California Seismic Network (SCSN)

    Science.gov (United States)

    Yu, E.; Bhaskaran, A.; Chen, S.; Chowdhury, F. R.; Meisenhelter, S.; Hutton, K.; Given, D.; Hauksson, E.; Clayton, R. W.

    2010-12-01

    cooperation with QCN and CSN is exploring ways to archive and distribute data from high density low cost networks. As a starting point the SCEDC will store a dataset from QCN and CSN and distribute it through a separate STP client. New archival methods: ● The SCEDC is exploring the feasibility of archiving and distributing waveform data using cloud computing such as Google Apps. A month of continuous data from the SCEDC archive will be stored in Google Apps and a client developed to access it in a manner similar to STP. XML formats: ● The SCEDC is now distributing earthquake parameter data through web services in QuakeML format. ● The SCEDC in collaboration with the Northern California Earthquake Data Center (NCEDC) and USGS Golden has reviewed and revised the StationXML format to produce version 2.0. The new version includes a rules on extending the schema, use of named complex types, and greater consistency in naming conventions. Based on this work we plan to develop readers and writers of the StationXML format.

  14. Leading Causes of Anesthesia-Related Liability Claims in Ambulatory Surgery Centers.

    Science.gov (United States)

    Ranum, Darrell; Beverly, Anair; Shapiro, Fred E; Urman, Richard D

    2017-11-16

    We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value. Ambulatory surgery center claims were more likely to be classified as medium severity than HOR claims, more likely to involve dental damage or pain than HOR claims, but less likely to involve death or respiratory or cardiac arrest. Technical performance was the most common contributing factor: 47% of ASCs and 48% of HORs. Only 7% of allegations relating to technical performance were judged to be a direct result of poor technical performance. The most common anesthesia procedures resulting in ASC claims were injection of anesthesia into a peripheral nerve (34%) and intubation (29%). Obesity was the most common contributing comorbidity in both settings. Mean closed claim value was significantly lower for ASC than HOR claims, averaging US $87,888 versus $107,325. Analysis of ASC and HOR claims demonstrates significant differences and several common sources of liability. These include improving strategies for thorough screening, preoperative assessment and risk stratifying of patients, incorporating routine dental and airway assessment and documentation, diagnosing and treating perioperative pain adequately, and improving the efficacy of communication between patients and care providers.

  15. An Alternative Optimization Model and Robust Experimental Design for the Assignment Scheduling Capability for Unmanned Aerial Vehicles (ASC-U) Simulation

    National Research Council Canada - National Science Library

    Oliver, Derek M

    2007-01-01

    .... TRAC selected ASC-U to provide insight into the programmatic decisions addressed in the U.S. Army UAV-Mix Analysis that directly affects future development and fielding of UAVs to include the Future Combat System...

  16. A study of HPV typing for the management of HPV-positive ASC-US cervical cytologic results.

    Science.gov (United States)

    Schiffman, Mark; Vaughan, Laurence M; Raine-Bennett, Tina R; Castle, Philip E; Katki, Hormuzd A; Gage, Julia C; Fetterman, Barbara; Befano, Brian; Wentzensen, Nicolas

    2015-09-01

    In US cervical screening, immediate colposcopy is recommended for women with HPV-positive ASC-US (equivocal) cytology. We evaluated whether partial typing by Onclarity™ (BD) might identify HPV-positive women with low enough CIN3+ risk to permit 1-year follow-up instead. The NCI-Kaiser Permanente Northern California Persistence and Progression cohort includes a subset of 13,890 women aged 21+ with HC2 (Qiagen)-positive ASC-US at enrollment; current median follow-up is 3.0years. Using stratified random sampling, we typed 2079 archived enrollment specimens including 329 women subsequently diagnosed with CIN3+, 563 with CIN2, and 1187 with ASC-US was 5.2%; this establishes the "benchmark" risk for colposcopic referral. Hierarchically, 3-year cumulative risks for each typing channel were 16.0% for HPV16, 7.4% for HPV18, 7.0% for HPV31, 7.1% for grouped HPV33/58, 4.3% for HPV52, 3.9% for HPV45, 2.7% for HPV51, 1.6% for HPV39/68/35, and 1.3% for HPV59/56/66. ASC-US linked to HPV16, HPV18, HPV31, or HPV33/58 warrants immediate colposcopy. Optimal management of women with HPV52 or HPV45 is uncertain. Risk of women with only HPV51, HPV39/68/35, or HPV59/56/66 might be low enough to recommend 1-year retesting permitting viral clearance. This strategy would defer colposcopy for 40% of women with HPV-positive ASC-US, half of whom would be cotest-negative at 1-year return. Approximately 10% of those with CIN3 diagnosable at enrollment would be delayed 1year instead. Cost-effectiveness analyses are needed. Published by Elsevier Inc.

  17. The Application of Strategic Planning Tools for Enhanced Palliative Care Services at the Minneapolis Veterans Affairs Medical Center

    National Research Council Canada - National Science Library

    Mylan, Marci M

    2005-01-01

    .... Using selected strategic planning tools, the study examined the gaps in services by gathering staff opinions, examining local statistics regarding end-of-life care, and looking at community and national trends...

  18. ESRD QIP - In- Center Hemodialysis Consumer Assessment Of Healthcare Providers And Services Systems ( ICH CAHPS) Survey - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset include facility details, performance rate, measure score, and the state and national average scores for each of the ICH CAHPS survey metrics that are...

  19. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    International Nuclear Information System (INIS)

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-01-01

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  20. The Virtual Climate Data Server (vCDS): An iRODS-Based Data Management Software Appliance Supporting Climate Data Services and Virtualization-as-a-Service in the NASA Center for Climate Simulation

    Science.gov (United States)

    Schnase, John L.; Tamkin, Glenn S.; Ripley, W. David III; Stong, Savannah; Gill, Roger; Duffy, Daniel Q.

    2012-01-01

    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 a Virtual Climate Data Server (vCDS), repetitive provisioning, image-based deployment and distribution, and virtualization-as-a-service. The vCDS is an iRODS-based data server specialized to the needs of a particular data-centric application. 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 one or more of these virtualized resource classes, vCDSs can use iRODS s federation capabilities to create an integrated ecosystem of managed collections that is scalable and adaptable to changing resource requirements. This approach enables platform- or software-asa- service deployment of vCDS 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.

  1. Needs assessment of science teachers in secondary schools in Kumasi, Ghana: A basis for in-service education training programs at the Science Resource Centers

    Science.gov (United States)

    Gyamfi, Alexander

    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

  2. The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

    Science.gov (United States)

    Berglas, Nancy F; Battistelli, Molly F; Nicholson, Wanda K; Sobota, Mindy; Urman, Richard D; Roberts, Sarah C M

    2018-01-01

    Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. More and higher quality research is needed to determine if there is a public health problem to be addressed through facility

  3. Partners in Community Service: Making a Community Connection Is Part of "The Stafford Way" at Vermont's Stafford Technical Center

    Science.gov (United States)

    Lucci, William, Jr.

    2005-01-01

    The Stafford Technical Center (STC) in Rutland, Vermont, operates with a mission statement that proudly touts its desire to "create a learning environment that promotes pride in work, a sense of self-worth and the ability to respect others by developing effective communication and life skills." Stafford acknowledges that these learning…

  4. Perceived job stress and health complaints at a bank call center: comparison between inbound and outbound services.

    Science.gov (United States)

    Lin, Yen-Hui; Chen, Chih-Yong; Hong, Wei-Hsien; Lin, Yu-Chao

    2010-01-01

    This study investigated how perceived job stress and health status differ, as well as the relationships to inbound (incoming calls) versus outbound (outgoing calls) calling activities, for call center workers in a bank in Taiwan. The sample bank employed 289 call center workers at the time of the survey, ranging in age from 19 to 54 yr old. Data were obtained on individual factors, health complaints, perceived level job stress, and major job stressors. Overall, 33.5% of outbound operators and 27.1% of inbound operators reported frequently or always experiencing high stress at work, however, the differences between inbound and outbound operators were insignificant. "Having to deal with difficult customers" was the most frequent job stressor for all workers. Musculoskeletal discomfort, eye strain, and hoarse or sore throat were the most prevalent complaints among call center workers. The relationship between perceived job stress and health complaints indicated that workers who perceived higher job stress had significantly increased risk of multiple health problems, including eye strain, tinnitus, hoarse or sore throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, and musculoskeletal discomfort (with odds ratios ranging from 2.13 to 8.24). These analytical results suggest that perceived job stress in the call center profoundly affected worker health. This study identified main types of job stressors requiring further investigation.

  5. Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

    Science.gov (United States)

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-01

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of 1,009,095.35 euros. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  6. Gender in relation to work motivation, satisfaction and use of day center services among people with psychiatric disabilities.

    Science.gov (United States)

    Eklund, Mona; Eklund, Lisa

    2017-05-01

    Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.

  7. Use of Banking Services in Emerging Markets -Household-Level Evidence (Replaces CentER DP 2010-092)

    OpenAIRE

    Beck, T.H.L.; Brown, M.

    2011-01-01

    This paper uses survey data for 60,000 households from 29 transition economies in 2006 and 2010 to explore how the use of banking services is related to household characteristics, as well as to bank ownership, deposit insurance and creditor protection. At the household level we find that the holding of a bank account, a bank card, or a mortgage increases with income and education in most countries and find evidence for an urban-rural gap. The use of banking services is also related to the rel...

  8. 42 CFR 416.48 - Condition for coverage-Pharmaceutical services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Pharmaceutical services. 416... Coverage § 416.48 Condition for coverage—Pharmaceutical services. The ASC must provide drugs and... direction of an individual designated responsible for pharmaceutical services. (a) Standard: Administration...

  9. Use of Banking Services in Emerging Markets -Household-Level Evidence (Replaces CentER DP 2010-092)

    NARCIS (Netherlands)

    Beck, T.H.L.; Brown, M.

    2011-01-01

    This paper uses survey data for 60,000 households from 29 transition economies in 2006 and 2010 to explore how the use of banking services is related to household characteristics, as well as to bank ownership, deposit insurance and creditor protection. At the household level we find that the holding

  10. 78 FR 30916 - CenterPoint Energy Bakken Crude Services, LLC; Notice of Petition for Declaratory Order

    Science.gov (United States)

    2013-05-23

    ... it to an interconnection with Great Northern Gathering and Marketing, L.L.C.'s Watford Terminal... notification when a document is added to a subscribed docket(s). For assistance with any FERC Online service...-8659. Comment Date: 5:00 p.m. Eastern time on June 10, 2013. Dated: May 16, 2013. Kimberly D. Bose...

  11. 76 FR 22708 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

    Science.gov (United States)

    2011-04-22

    ... Surveillance, Expanded HIV Testing, and Fiscal Year 2012 Activities; (4) Panel Presentation on CDC Strategic Priorities and Coordination of Media and Social Marketing related to HIV, STD and Viral Hepatitis prevention..., Management Analysis and Services Office, has been delegated [[Page 22709

  12. Application of Pole Walking to Day Service Centers for Use by Community-dwelling Frail Elderly People

    Directory of Open Access Journals (Sweden)

    Susumu Ota

    2014-03-01

    Conclusion: The effects of 3 months of pole walking on community-dwelling elderly day service users showed improved Physical Component Summary scores of higher QoL. However, there was no significant effect of physical functions due to the intervention.

  13. Pricing the Services of the Computer Center at the Catholic University of Louvain. Program on Institutional Management in Higher Education.

    Science.gov (United States)

    Hecquet, Ignace; And Others

    Principles are outlined that are used as a basis for the system of pricing the services of the Computer Centre. The system illustrates the use of a management method to secure better utilization of university resources. Departments decide how to use the appropriations granted to them and establish a system of internal prices that reflect the cost…

  14. Inpatient satisfaction and usage patterns of personalized smart bedside station system for patient-centered service at a tertiary university hospital.

    Science.gov (United States)

    Ryu, Borim; Kim, Seok; Lee, Kee-Hyuck; Hwang, Hee; Yoo, Sooyoung

    2016-11-01

    for patient-centered services. Further research should be directed at developing sophisticated patient-centered services as a communication tool between the hospital and the patient. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Evaluation of How Integrative Oncology Services Are Valued between Hematology/Oncology Patients and Hematologists/Oncologists at a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    D. M. Hansra

    2018-01-01

    Full Text Available Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods. A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians (P≤0.05. Conclusion. With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints.

  16. Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H cannot be ruled out

    Directory of Open Access Journals (Sweden)

    Andréa Cytryn

    Full Text Available CONTEXT AND OBJECTIVE: The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS into ASC-US (undetermined significance and ASC-H (high-grade intraepithelial lesion cannot be ruled out. The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF with ASC-H cytology, and compare them with ASC-US cases. DESIGN AND SETTING: Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. METHODS: ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis was taken as the gold standard. RESULTS: The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55% and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764. Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83; P = 0.2786998. There were no uterine cervical cancer cases. CONCLUSION: The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

  17. Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H) cannot be ruled out.

    Science.gov (United States)

    Cytryn, Andréa; Russomano, Fábio Bastos; Camargo, Maria José de; Zardo, Lucília Maria Gama; Horta, Nilza Maria Sobral Rebelo; Fonseca, Rachel de Carvalho Silveira de Paula; Tristão, Maria Aparecida; Monteiro, Aparecida Cristina Sampaio

    2009-09-01

    The latest update of the Bethesda System divided the category of atypical squamous cells of undetermined significance (ASCUS) into ASC-US (undetermined significance) and ASC-H (high-grade intraepithelial lesion cannot be ruled out). The aims here were to measure the prevalence of pre-invasive lesions (cervical intraepithelial neoplasia, CIN II/III) and cervical cancer among patients referred to Instituto Fernandes Figueira (IFF) with ASC-H cytology, and compare them with ASC-US cases. Cross-sectional study with retrospective data collection, at the IFF Cervical Pathology outpatient clinic. ASCUS cases referred to IFF from November 1997 to September 2007 were reviewed according to the 2001 Bethesda System to reach cytological consensus. The resulting ASC-H and ASC-US cases, along with new cases, were analyzed relative to the outcome of interest. The histological diagnosis (or cytocolposcopic follow-up in cases without such diagnosis) was taken as the gold standard. The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55%) and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764). Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83); P = 0.2786998). There were no uterine cervical cancer cases. The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions.

  18. Impact of the marketing activities related to service offer an the Nuclear Information Center of the brazilian National Nuclear Energy Commission

    International Nuclear Information System (INIS)

    Amaral, Sueli Angelica do

    1998-01-01

    Exploratory field research confirms the marketing administration philosophy in Nuclear Information Center (CIN) of National Commission of Nuclear Energy (CNEN), analyzing marketing activities referring to SONAR-INIS (current awareness) and SERVIR-INIS (provision of copies) promotion, in order to evaluate the impact of these activities relating to the use of the services by real users. The data collecting took place using a technique of documental analysis, semi-structured interviews with five managers of the Center, simple no-participant observation accomplished by the researcher in CIN, questionnaires about the administration philosophy applied to the managers, and questionnaires sent by mail to 176 users of the international sample. The 122 users'answers (69,31% of answers rate) were analyzed according to the statistical procedures of Statistical Package of Social Sciences (SPSS), with 0,05% of error margin, and 95% of confidence level. Nine assumptions of research were tested. It was concluded that: the first knowledge of the services was by circulars or letters; SONAR-INIS was not considered as the principal service by its information contents in order to develop professional activities by 60,5% of the users; SERVIR-INIS was considered the main service to access the documents related to the interest of 47,8% of the user; to the majority the most important reason to use both services was the convenience and facilities to access the services; suitability of interest was the most important criterion in order to accomplish the appropriate service; the CIN inquiry frequency to know about users' satisfaction level, their information interests, needs and expectation in order to adapt information offer to demand was irregular and seldom; CIN's concerns about knowing users' critics, complaints and suggestions was recognized by users; the majority of the users was interested in receiving information about the benefits of the services; the price of the copies obtained in

  19. Engineer Research and Development Center's Materials Testing Center (MTC)

    Data.gov (United States)

    Federal Laboratory Consortium — The Engineer Research and Development Center's Materials Testing Center (MTC) is committed to quality testing and inspection services that are delivered on time and...

  20. Androgen receptor (AR) degradation enhancer ASC-J9® in an FDA-approved formulated solution suppresses castration resistant prostate cancer cell growth.

    Science.gov (United States)

    Cheng, Max A; Chou, Fu-Ju; Wang, Keliang; Yang, Rachel; Ding, Jie; Zhang, Qiaoxia; Li, Gonghui; Yeh, Shuyuan; Xu, Defeng; Chang, Chawnshang

    2018-03-28

    ASC-J9 ® is a recently-developed androgen receptor (AR)-degradation enhancer that effectively suppresses castration resistant prostate cancer (PCa) cell proliferation and invasion. The optimal half maximum inhibitory concentrations (IC 50 ) of ASC-J9 ® at various PCa cell confluences (20%, 50%, and 100%) were assessed via both short-term MTT growth assays and long-term clonogenic proliferation assays. Our results indicate that the IC 50 values for ASC-J9 ® increased with increasing cell confluency. The IC 50 values were significantly decreased in PCa AR-positive cells compared to PCa AR-negative cells or in normal prostate cells. This suggests that ASC-J9 ® may function mainly via targeting the AR-positive PCa cells with limited unwanted side-effects to suppress the surrounding normal prostate cells. Mechanism dissection indicated that ASC-J9 ® might function via altering the apoptosis signals to suppress the PCa AR-negative PC-3 cells. Preclinical studies using multiple in vitro PCa cell lines and an in vivo mouse model with xenografted castration-resistant PCa CWR22Rv1 cells demonstrated that ASC-J9 ® has similar AR degradation effects when dissolved in FDA-approved solvents, including DMSO, PEG-400:Tween-80 (95:5), DMA:Labrasol:Tween-80 (10:45:45), and DMA:Labrasol:Tween-20 (10:45:45). Together, results from preclinical studies suggest a potential new therapy with AR-degradation enhancer ASC-J9 ® may potentially be ready to be used in human clinical trials in order to better suppress PCa at later castration resistant stages. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Human adipose stem cell and ASC-derived cardiac progenitor cellular therapy improves outcomes in a murine model of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Davy PMC

    2015-10-01

    Full Text Available Philip MC Davy,1 Kevin D Lye,2,3 Juanita Mathews,1 Jesse B Owens,1 Alice Y Chow,1 Livingston Wong,2 Stefan Moisyadi,1 Richard C Allsopp1 1Institute for Biogenesis Research, 2John A. Burns School of Medicine, University of Hawaii at Mānoa, 3Tissue Genesis, Inc., Honolulu, HI, USA Background: Adipose tissue is an abundant and potent source of adult stem cells for transplant therapy. In this study, we present our findings on the potential application of adipose-derived stem cells (ASCs as well as induced cardiac-like progenitors (iCPs derived from ASCs for the treatment of myocardial infarction. Methods and results: Human bone marrow (BM-derived stem cells, ASCs, and iCPs generated from ASCs using three defined cardiac lineage transcription factors were assessed in an immune-compromised mouse myocardial infarction model. Analysis of iCP prior to transplant confirmed changes in gene and protein expression consistent with a cardiac phenotype. Endpoint analysis was performed 1 month posttransplant. Significantly increased endpoint fractional shortening, as well as reduction in the infarct area at risk, was observed in recipients of iCPs as compared to the other recipient cohorts. Both recipients of iCPs and ASCs presented higher myocardial capillary densities than either recipients of BM-derived stem cells or the control cohort. Furthermore, mice receiving iCPs had a significantly higher cardiac retention of transplanted cells than all other groups. Conclusion: Overall, iCPs generated from ASCs outperform BM-derived stem cells and ASCs in facilitating recovery from induced myocardial infarction in mice. Keywords: adipose stem cells, myocardial infarction, cellular reprogramming, cellular therapy, piggyBac, induced cardiac-like progenitors

  2. Rural development NGOS and service delivery to the very poor: An empirical analysis of a training center in rural Cameroon

    OpenAIRE

    Balgah Roland Azibo; Emmanuel Yenshu Vubo; Innocent Ndoh Mbue; Jude Ndzifon Kimengsi

    2015-01-01

    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...

  3. Creating Processes Associated with Providing Government Goods and Services Under the Commercial Space Launch Act at Kennedy Space Center

    Science.gov (United States)

    Letchworth, Janet F.

    2011-01-01

    Kennedy Space Center (KSC) has decided to write its agreements under the Commercial Space Launch Act (CSLA) authority to cover a broad range of categories of support that KSC could provide to our commercial partner. Our strategy was to go through the onerous process of getting the agreement in place once and allow added specificity and final cost estimates to be documented on a separate Task Order Request (TOR). This paper is written from the implementing engineering team's perspective. It describes how we developed the processes associated with getting Government support to our emerging commercial partners, such as SpaceX and reports on our success to date.

  4. No association between Centers for Medicare and Medicaid services payments and volume of Medicare beneficiaries or per-capita health care costs for each state.

    Science.gov (United States)

    Harewood, Gavin C; Alsaffar, Omar

    2015-03-01

    The Centers for Medicare and Medicaid Services recently published data on Medicare payments to physicians for 2012. We investigated regional variations in payments to gastroenterologists and evaluated whether payments correlated with the number of Medicare patients in each state. We found that the mean payment per gastroenterologist in each state ranged from $35,293 in Minnesota to $175,028 in Mississippi. Adjusted per-physician payments ranged from $11 per patient in Hawaii to $62 per patient in Washington, DC. There was no correlation between the mean per-physician payment and the mean number of Medicare patients per physician (r = 0.09), there also was no correlation between the mean per-physician payment and the overall mean per-capita health care costs for each state (r = -0.22). There was a 5.6-fold difference between the states with the lowest and highest adjusted Medicare payments to gastroenterologists. Therefore, the Centers for Medicare and Medicaid Services payments do not appear to be associated with the volume of Medicare beneficiaries or overall per-capita health care costs for each state. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  5. Billing and reimbursement for a bedside toxicology service at a tertiary care academic center during its first fiscal year.

    Science.gov (United States)

    Wiegand, Timothy J; Crane, Peter W; Kamali, Michael; Reif, Marilynn; Wratni, Rose; Montante, Ronald; Loveland, Tracey

    2015-03-01

    A bedside toxicology consult service may improve clinical care, facilitate patient clearance and disposition, and result in potential cost savings for poisoning exposures. Despite this, there is scant data regarding economic feasibility for such a service. Previously published information suggests low hourly reimbursement at approximately $26.00/h at the bedside for toxicology consultations. A bedside toxicology consultant service was initiated in 2011. Coverage was available 24 h a day for 50 out of 52 weeks. Bedside rounding on toxicology consult patients was available 6/7 days per week. The practice is associated with >800 bed teaching institution in a large upstate NY region with elements of urban and suburban practice. Demographic and billing data was collected for all patients consulted upon from July 1, 2011 to June 31, 2012. In charges of $514,941 were generated during the period of data collection. Monthly average was $42,912. Net reimbursement of charges was 29 % of overall charges at $147,792. In terms of total encounters, net collection rate in which something was reimbursed or "paid" against charges for that encounter was 82.6 % of all encounters at 999/1,210. Average encounter time for inpatients, including critical care, was 1.05 h, and the average time spent for outpatients was 1.18 h. Reimbursement rates appear higher than previously reported. Revenue generated from reimbursement from toxicology consultation can result in recouping a substantial portion of a toxicologist's salary or potentially fund fellowship positions and salaries or toxicology division infrastructure.

  6. Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center

    Directory of Open Access Journals (Sweden)

    Pappas Gregory

    2007-11-01

    Full Text Available Abstract Background Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC, it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005. Methods An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes. Results The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative. Conclusion The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC

  7. Customer care policy for utilities - demonstrated with the example of a call center; Customer Care fuer EVU - Wirkungszusammenhaenge am Beispiel des Telefon-Service

    Energy Technology Data Exchange (ETDEWEB)

    Weisse, D. [Consulting und Services, pdv Unternehmensberatung GmbH, Roesrath (Germany)

    2000-01-10

    Customer care policy, for preventing change to another provider and consolidating customer loyalty, is becoming a strategic (powerful) instrument for a utility in the competitive market. But what does this really imply for the day-to-day process of dealing with client-specific operations and workflows? The article describes the interactions between strategic marketing for ensuring client satisfaction and the resulting requirements to be met by a utility's call center, and also describes the key 'parameters' and requirements for successful day-to-day management of call centers. (orig./CB) [German] Customer Care zur Reduzierung der Wechselbereitschaft bzw. zur Erhoehung der Kundenbindung wird fuer EVU zu einem strategischen Instrument im Kampf um die Kunden. Aber was bedeutet dies fuer die operative Abwicklung der kundenbezogenen Geschaeftsprozesse? Der Verfasser erlaeutert die Zusammenhaenge zwischen dem strategischen Ziel der Kundenzufriedenheit und der operativen Umsetzung des Telefon-Service und beschreibt die 'Stellschrauben', die fuer diesen Zweck bei der Planung aber auch im taeglichen Management eines Call Centers zur Verfuegung stehen. (orig.)

  8. Hydrologic Modeling at the National Water Center: Operational Implementation of the WRF-Hydro Model to support National Weather Service Hydrology

    Science.gov (United States)

    Cosgrove, B.; Gochis, D.; Clark, E. P.; Cui, Z.; Dugger, A. L.; Fall, G. M.; Feng, X.; Fresch, M. A.; Gourley, J. J.; Khan, S.; Kitzmiller, D.; Lee, H. S.; Liu, Y.; McCreight, J. L.; Newman, A. J.; Oubeidillah, A.; Pan, L.; Pham, C.; Salas, F.; Sampson, K. M.; Smith, M.; Sood, G.; Wood, A.; Yates, D. N.; Yu, W.; Zhang, Y.

    2015-12-01

    The National Weather Service (NWS) National Water Center(NWC) is collaborating with the NWS National Centers for Environmental Prediction (NCEP) and the National Center for Atmospheric Research (NCAR) to implement a first-of-its-kind operational instance of the Weather Research and Forecasting (WRF)-Hydro model over the Continental United States (CONUS) and contributing drainage areas on the NWS Weather and Climate Operational Supercomputing System (WCOSS) supercomputer. The system will provide seamless, high-resolution, continuously cycling forecasts of streamflow and other hydrologic outputs of value from both deterministic- and ensemble-type runs. WRF-Hydro will form the core of the NWC national water modeling strategy, supporting NWS hydrologic forecast operations along with emergency response and water management efforts of partner agencies. Input and output from the system will be comprehensively verified via the NWC Water Resource Evaluation Service. Hydrologic events occur on a wide range of temporal scales, from fast acting flash floods, to long-term flow events impacting water supply. In order to capture this range of events, the initial operational WRF-Hydro configuration will feature 1) hourly analysis runs, 2) short-and medium-range deterministic forecasts out to two day and ten day horizons and 3) long-range ensemble forecasts out to 30 days. All three of these configurations are underpinned by a 1km execution of the NoahMP land surface model, with channel routing taking place on 2.67 million NHDPlusV2 catchments covering the CONUS and contributing areas. Additionally, the short- and medium-range forecasts runs will feature surface and sub-surface routing on a 250m grid, while the hourly analyses will feature this same 250m routing in addition to nudging-based assimilation of US Geological Survey (USGS) streamflow observations. A limited number of major reservoirs will be configured within the model to begin to represent the first-order impacts of

  9. Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.

    Science.gov (United States)

    Basu, Sanjay; Phillips, Russell S; Song, Zirui; Landon, Bruce E; Bitton, Asaf

    2016-09-01

    We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. We estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. © 2016 Annals of Family Medicine, Inc.

  10. Low-frequency, low-magnitude vibrations (LFLM enhances chondrogenic differentiation potential of human adipose derived mesenchymal stromal stem cells (hASCs

    Directory of Open Access Journals (Sweden)

    Krzysztof Marycz

    2016-02-01

    Full Text Available The aim of this study was to evaluate if low-frequency, low-magnitude vibrations (LFLM could enhance chondrogenic differentiation potential of human adipose derived mesenchymal stem cells (hASCs with simultaneous inhibition of their adipogenic properties for biomedical purposes. We developed a prototype device that induces low-magnitude (0.3 g low-frequency vibrations with the following frequencies: 25, 35 and 45 Hz. Afterwards, we used human adipose derived mesenchymal stem cell (hASCS, to investigate their cellular response to the mechanical signals. We have also evaluated hASCs morphological and proliferative activity changes in response to each frequency. Induction of chondrogenesis in hASCs, under the influence of a 35 Hz signal leads to most effective and stable cartilaginous tissue formation through highest secretion of Bone Morphogenetic Protein 2 (BMP-2, and Collagen type II, with low concentration of Collagen type I. These results correlated well with appropriate gene expression level. Simultaneously, we observed significant up-regulation of α3, α4, β1 and β3 integrins in chondroblast progenitor cells treated with 35 Hz vibrations, as well as Sox-9. Interestingly, we noticed that application of 35 Hz frequencies significantly inhibited adipogenesis of hASCs. The obtained results suggest that application of LFLM vibrations together with stem cell therapy might be a promising tool in cartilage regeneration.

  11. Increasing the Role of the Internet Service Center in Distric to Stimuli the Society towards Tourism Village

    Directory of Open Access Journals (Sweden)

    Sumarsono Soemardjo

    2014-07-01

    Full Text Available The use of internet was expanding, reaching various lines of human life, including ecotourism development sector. However, internet as a tool as well as an enabler, occasionally are less contributing to better accomplish human activity since various determinants which underestimated. Related to that, the government has made programs to expand internet access to rural areas in order to introduce innovation and creating opportunities through the construction of the District Internet Service Centre (PLIK. The research question is how the role of the District Internet Service Centre (PLIK as stimuli for the rural community to develop a tourism village. The purpose of this research is to analyze the role of PLIK to stimuli the rural community to develop the tourism village. This research reveals how the internet could represent as a stimuli for the rural community to develop a tourism village. In addition, the approach of the research is qualitative. Data gathering through in-depth interview with purposive chosen key informants. The result indicates that the role of the internet can be increased to develop a tourism village through various activities of information dissemination and giving encouragement and transformation value of “sapta pesona” to the local rural community.

  12. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

    Science.gov (United States)

    Mudumbai, Seshadri C

    2016-01-01

    Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report ... Management Services Veterans Service Organizations Office of Accountability & Whistleblower ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery Act ... Management Services Veterans Service Organizations Office of Accountability & Whistleblower ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget ... Management Services Veterans Service Organizations Office of Accountability & Whistleblower ...

  16. Arranging for personal assistance services and assistive technology at work. A report of the rehabilitation research and training center on personal assistance services.

    Science.gov (United States)

    Stoddard, Susan; Kraus, Lewis

    2006-01-01

    For an employee with a disability, reasonable accommodation can make the difference in finding work, maintaining employment, and succeeding on the job. Today, employers and employees alike are more aware that appropriate accommodation, including workplace personal assistance services (PAS) as well as assistive technology, improves an employee's ability to succeed. While assistive technology is in widespread use as an accommodation, workplace personal assistance is less understood. The goal of the study was to learn more about how workplace PAS and AT are arranged for in the workplace, and the issues that arise. Structured phone interviews were conducted with 20 workplace PAS users, 21 employers familiar with workplace PAS, and 19 employment organizations. Interview transcripts are the basis for the qualitative analysis of findings. Requirements for personal assistance accommodations focus on task-related needs. Personal care needs at work are not included in the Americans with Disabilities act but may be needed by the employee. Employers and PAS users have developed many creative ways to address PAS need. Organizations can construct an approach that fits the needs, abilities, and constraints of each organization. The interview respondents have identified a number of practices that are succeeding, including establishment of policies for arranging for PAS; centralization of accommodation budgets to remove work unit disincentives; and providing a shared personal assistant for interpreting or for task-related and personal care tasks. A number of important research questions remain. What is the extent of the need for PAS in the workplace? Will an expanded PAS supply increase the employment opportunities for people with disabilities? Will better models of workplace PAS be adopted by employers?

  17. Audio Visual Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Audiovisual Services Center provides still photographic documentation with laboratory support, video documentation, video editing, video duplication, photo/video...

  18. Climate Prediction Center - Outlooks

    Science.gov (United States)

    Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center Home Site Map News Web resources and services. HOME > Outreach > Publications > Climate Diagnostics Bulletin Climate Diagnostics Bulletin - Tropics Climate Diagnostics Bulletin - Forecast Climate Diagnostics

  19. Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study

    Directory of Open Access Journals (Sweden)

    Cantrell Jennifer

    2009-12-01

    Full Text Available Abstract Background Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. Methods The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26 and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. Results Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. Conclusions Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Locator Hospitals and Clinics Vet Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Get help from ... Resource Directory Grants Management Services Veterans Service Organizations Office of Accountability & Whistleblower Protection Transparency Media Room Inside ...

  1. Locating distribution/service centers based on multi objective decision making using set covering and proximity to stock market

    Directory of Open Access Journals (Sweden)

    Mazyar Dabibi

    2016-09-01

    Full Text Available In the present competitive world, facility location is an important aspect of the supply chain (sc optimization. It involves selecting specific locations for facility construction and allocation of the distribution channel among different SC levels. In fact, it is a strategic issue which directly affects many operational/tactical decisions. Besides the accessibility, which results in customer satisfaction, the present paper optimizes the establishment costs of a number of distribution channels by considering their proximity to the stock market of the goods they distribute, and proposes mathematical models for two objective functions using the set covering problem. Then, two objective functions are proposed into one through the ε-constraint method and solved by the metaheuristic Genetic Algorithm (GA. To test the resulted model, a smaller scale problem is solved. Results from running the algorithm with different ε-values show that, on average, a 10% increase in ε, which increases the value of the second objective function - distance covered by customers will cause a 2% decrease in the value of the first objective function including the costs of establishing distribution centers. The repeatability and solution convergence of the two-objective model presented by the GA are other results obtained in this study.

  2. Interferência do ácido ascórbico na dosagem glicêmica - doi: 10.5102/ucs.v6i2.722

    OpenAIRE

    Aline Cardoso Barbosa; Tania Cristina Andrade

    2009-01-01

    Sabe-se que exames laboratoriais estão sujeitos a fatores interferentes. A literatura científica cita interferência do ácido ascórbico em dosagens que envolvam oxirredução, como a glicêmica. Devido a isto, buscou-se avaliar o efeito do ácido ascórbico sobre a dosagem glicêmica em dois tipos de soro controle submetidos a diferentes concentrações de ácido ascórbico, variando de 2,5 a 100 mg/dL. Utilizou-se um soro controle com valores normais de glicemia e outro com valores patológicos. Observo...

  3. The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services.

    Science.gov (United States)

    Spira, Thomas; Lindegren, Mary Lou; Ferris, Robert; Habiyambere, Vincent; Ellerbrock, Tedd

    2009-06-01

    The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms.

  4. Attendance and Utilization of Antenatal Care (ANC) Services: Multi-Center Study in Upcountry Areas of Uganda.

    Science.gov (United States)

    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

    2015-03-01

    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

  5. Observed activation status of lane departure warning and forward collision warning of Honda vehicles at dealership service centers.

    Science.gov (United States)

    Reagan, Ian J; McCartt, Anne T

    2016-11-16

    There are little objective data on whether drivers with lane departure warning and forward collision warning systems actually use them, but self-report data indicate that lane departure warning may be used less and viewed less favorably than forward collision warning. The current study assessed whether the systems were turned on when drivers brought their vehicles to dealership service stations and whether the observational protocol is a feasible method for collecting similar data on various manufacturers' systems. Observations of 2013-2015 Honda Accords, 2014-2015 Odysseys, and 2015 CR-Vs occurred at 2 U.S. Honda dealerships for approximately 4 weeks during Summer 2015. Of the 265 vehicles observed to have the 2 systems, 87 (32.8%) had lane departure warning turned on. Accords were associated with a 66% increase in the likelihood that lane departure warning was turned on compared with Odysseys, but the rate was still only about 40% in Accords. In contrast, forward collision warning was turned on in all but one of the observed vehicles. Observations found that the activation rate was much higher for forward collision warning than lane departure warning. The observation method worked well and appears feasible for extending to other manufacturers.

  6. Nurse Practitioner Independent Practice Authority and Mental Health Service Delivery in U.S. Community Health Centers.

    Science.gov (United States)

    Yang, Bo Kyum; Trinkoff, Alison M; Zito, Julie Magno; Burcu, Mehmet; Safer, Daniel J; Storr, Carla L; Johantgen, Mary E; Idzik, Shannon

    2017-10-01

    Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs). State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP- and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA. The adjusted odds of mental health-related visits in CHCs provided by NPs in states with and without NP-IPA were compared by using multiple logistic regression models while accounting for the complex survey design. Between 2006 and 2011, the odds of NP- versus physician-provided mental health-related visits in CHCs were more than two times greater in states with NP-IPA than in states with no NP-IPA (adjusted odds ratio [OR]= 2.43, 95% confidence interval [CI]=1.12-4.60). In contrast, no significant difference between states with and without NP-IPA was noted in non-mental health-related CHC visits provided by NPs. Among all mental health-related visits, the odds of visits in which psychotropic medications were prescribed by an NP were more than three times higher in states with NP-IPA than in those without NP-IPA (adjusted OR=3.14, CI=1.50-6.54). Compared with physicians, NPs provided proportionally more CHC mental health-related visits in states with NP-IPA than in states without NP-IPA.

  7. Observaciones histopatologicas de juveniles penaeus vannamei sometidos a dietas artificiales con diferentes concentraciones de una sal de ácido ascórbico (vitamina c)

    OpenAIRE

    Vera Muñoz, L.

    1995-01-01

    Observaciones histopatologicas de juveniles Penaeus Vannamei sometidos a dietas artificiales con diferentes concentraciones de una sal de ácido ascórbico (vitamina C) Se realizaron análisis histológicos y comprobación mediante métodos histoquímicos de la presencia de melanina, a juveniles Penaeus vannamei sometidos a cinco dietas experimentales con diferentes concentraciones de una sal de L-Ascorbato-2-Fosfato de Mg (APM) usada como fuente de ácido ascórbico (AA).

  8. Culture-centered engagement with delivery of health services: co-constructing meanings of health in the Tzu Chi Foundation through Buddhist philosophy.

    Science.gov (United States)

    Dillard, Sydney J; Dutta, Mohan; Sun, Wei-San

    2014-01-01

    The shift in health communication scholarship from the narrow focus on curing to the complexly intertwined spaces of health, illness, healing, and curing attends to the dynamic cultural contexts within which meanings and practices are negotiated, directing scholarship toward alternative spaces of health care delivery. This study utilized the culture-centered approach as a theoretical lens for providing a discursive space for understanding meanings of health constituted in the practices of the Tzu Chi Foundation, an organization that offers biomedical services within the larger philosophical understandings of Buddhism with 10 million members in over 50 different countries. The emerging perspective promotes non-biomedical meanings of health through selfless giving and assistance founded in Buddhist principles, simultaneously seeking purity of the mind, body, and soul holistically. Through the negotiation of the principles driving Buddhist philosophy and the principles that shape biomedical health care delivery, this study seeks to understand the interpretive frames that circulate among foundation staff and care recipients.

  9. Alternatives for conversion to solid interim waste forms of the radioactive liquid high-level wastes stored at the Western New York Nuclear Service Center

    International Nuclear Information System (INIS)

    Vogler, S.; Trevorrow, L.E.; Ziegler, A.A.; Steindler, M.J.

    1981-08-01

    Techniques for isolating and solidifying the nuclear wastes in the storage tanks at the Western New York Nuclear Service Center plant have been examined. One technique involves evaporating the water and forming a molten salt containing the precipitated sludge. The salt is allowed to solidify and is stored in canisters until processing into a final waste form is to be done. Other techniques involve calcining the waste material, then agglomerating the calcine with sodium silicate to reduce its dispersibility. This option can also involve a prior separation and decontamination of the supernatant salt. The sludge and all resins containing fission-product activity are then calcined together. The technique of removing the water and solidifying the salt may be the simplest method for removing the waste from the West Valley Plant

  10. Geologic and hydrologic research at the Western New York Nuclear Service Center, West Valley, New York. Final report, August 1982-December 1983

    International Nuclear Information System (INIS)

    Albanese, J.R.; Anderson, S.L.; Fakundiny, R.H.; Potter, S.M.; Rogers, W.B.; Whitbeck, L.F.; LaFleur, R.G.; Boothroyd, J.C.; Timson, B.S.

    1984-06-01

    This report is the last in a series by the New York State Geological Survey on studies funded by the US Nuclear Regulatory Commission. The report covers five important aspects of the geology and hydrology of the Western New York Nuclear Service Center, near West Valley, New York: geomorphology, stratigraphy, sedimentology, surface water, and radionuclide analyses. We reviewed past research on these subjects and present new data obtained in the final phase of NYSGS research at the site. Also presented are up-to-date summaries of the present knowledge of geomorphology and stratigraphy. The report contains a significant bibliography of previous West Valley studies. Appendices include a report on the Fall 1983 Drilling Project and the procedures used, history and prognosis of Cattaraugus Creek and tributaries down cutting, and bar modification and landslide processes of Buttermilk Valley. 100 references, 7 figures, 7 tables

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan Centers ... Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research Research ...

  12. Predictors of outpatients' request for palliative care service at a medical oncology clinic of a German comprehensive cancer center.

    Science.gov (United States)

    Tewes, Mitra; Rettler, Teresa; Wolf, Nathalie; Hense, Jörg; Schuler, Martin; Teufel, Martin; Beckmann, Mingo

    2018-05-05

    Early integration of palliative care (PC) is recommended. The determination of predictors for patients' request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC. Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients' request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC. A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors "depression," "anxiety," and "weakness" with an explained variance of 22%. Combining a standardized screening questionnaire and the assessment of patients' request for PC allows systematic monitoring for patients' need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.

  13. Investigation of Barriers of Access to Children’s Oral and Dental Health Services from the Point of View of Mothers Referring to Health Centers of Qom City, 2016 (Iran

    Directory of Open Access Journals (Sweden)

    Yasamin Berakyan

    2017-07-01

    Full Text Available Background and Objectives: Adequate access to oral and dental health services in childhood can reduce long-term complications in the following years of life. The objective of this study was to determine the barriers of access to children’s oral and dental health services from the point of view of mothers referring to health centers in Qom city. Methods: In this cross-sectional study, the statistical population included 325 mothers referred to health centers. Data were collected using a questionnaire consisted of items, including age, educational level, job, and barriers of access to oral health services. Data were analyzed using descriptive statistical indicators and logistic regression test. Results: In this study, lack of insurance coverage for dentistry costs (59.7% had the highest frequency in barriers of access to dental health services, followed by child's fear of dentistry (53.2% and high costs of dental services (49.8%. There was no significant relationship between mother's job and barriers of access to dental health services, but the chance of barriers of access to dental health services increased 1.60 times with father’s employment in government jobs. Also, the results showed that the chance of barriers of access to dental health services increased 3.60 times with residence in Pardisan region, on the other hand, the chance of access to the services, was improved up to 52% with residence in Tohid region. Conclusion: Expansion of insurance coverage of oral and dental health services and increase of public centers providing dental services can be eliminate the major part of barriers of access to these services. In addition, the proportional distribution of these services in different regions of the city can be effective in easy and low-cost access.

  14. Inflammasome components ASC and AIM2 modulate the acute phase of biomaterial implant-induced foreign body responses

    Science.gov (United States)

    Christo, Susan N.; Diener, Kerrilyn R.; Manavis, Jim; Grimbaldeston, Michele A.; Bachhuka, Akash; Vasilev, Krasimir; Hayball, John D.

    2016-01-01

    Detailing the inflammatory mechanisms of biomaterial-implant induced foreign body responses (FBR) has implications for revealing targetable pathways that may reduce leukocyte activation and fibrotic encapsulation of the implant. We have adapted a model of poly(methylmethacrylate) (PMMA) bead injection to perform an assessment of the mechanistic role of the ASC-dependent inflammasome in this process. We first demonstrate that ASC−/− mice subjected to PMMA bead injections had reduced cell infiltration and altered collagen deposition, suggesting a role for the inflammasome in the FBR. We next investigated the NLRP3 and AIM2 sensors because of their known contributions in recognising damaged and apoptotic cells. We found that NLRP3 was dispensable for the fibrotic encapsulation; however AIM2 expression influenced leukocyte infiltration and controlled collagen deposition, suggesting a previously unexplored link between AIM2 and biomaterial-induced FBR. PMID:26860464

  15. The TiM system: developing a novel telehealth service to improve access to specialist care in motor neurone disease using user-centered design.

    Science.gov (United States)

    Hobson, Esther V; Baird, Wendy O; Partridge, Rebecca; Cooper, Cindy L; Mawson, Susan; Quinn, Ann; Shaw, Pamela J; Walsh, Theresa; Wolstenholme, Daniel; Mcdermott, Christopher J

    2018-08-01

    Attendance at a specialist multidisciplinary motor neurone disease (MND) clinic is associated with improved survival and may also improve quality of life and reduce hospital admissions. However, patients struggle to travel to clinic and may experience difficulties between clinic visits that may not be addressed in a timely manner. We wanted to explore how we could improve access to specialist MND care. We adopted an iterative, user-centered co-design approach, collaborating with those with experience of providing and receiving MND care including patients, carers, clinicians, and technology developers. We explored the unmet needs of those living with MND, how they might be met through service redesign and through the use of digital technologies. We developed a new digital solution and performed initial testing with potential users including clinicians, patients, and carers. We used these findings to develop a telehealth system (TiM) using an Android app into which patients and carers answer a series of questions about their condition on a weekly basis. The questions aim to capture all the physical, emotional, and social difficulties associated with MND. This information is immediately uploaded to the internet for review by the MND team. The data undergoes analysis in order to alert clinicians to any changes in a patient or carer's condition. We describe the benefits of developing a novel digitally enabled service underpinned by participatory design. Future trials must evaluate the feasibility and acceptability of the TiM system within a clinical environment.

  16. Application of Digital Object Identifiers to data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Science.gov (United States)

    Vollmer, B.; Ostrenga, D.; Johnson, J. E.; Savtchenko, A. K.; Shen, S.; Teng, W. L.; Wei, J. C.

    2013-12-01

    Digital Object Identifiers (DOIs) are applied to selected data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). The DOI system provides an Internet resolution service for unique and persistent identifiers of digital objects. Products assigned DOIs include data from the NASA MEaSUREs Program, the Earth Observing System (EOS) Aqua Atmospheric Infrared Sounder (AIRS) and EOS Aura High Resolution Dynamics Limb Sounder (HIRDLS). DOIs are acquired and registered through EZID, California Digital Library and DataCite. GES DISC hosts a data set landing page associated with each DOI containing information on and access to the data including a recommended data citation when using the product in research or applications. This work includes participation with the earth science community (e.g., Earth Science Information Partners (ESIP) Federation) and the NASA Earth Science Data and Information System (ESDIS) Project to identify, establish and implement best practices for assigning DOIs and managing supporting information, including metadata, for earth science data sets. Future work includes (1) coordination with NASA mission Science Teams and other data providers on the assignment of DOIs for other GES DISC data holdings, particularly for future missions such as Orbiting Carbon Observatory -2 and -3 (OCO-2, OCO-3) and projects (MEaSUREs 2012), (2) construction of landing pages that are both human and machine readable, and (3) pursuing the linking of data and publications with tools such as the Thomson Reuters Data Citation Index.

  17. DOC/WSNSO [Department of Commerce/Weather Service Nuclear Support Office] operational support to Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Mueller, P.

    1989-01-01

    The National Weather Service (NWS) is an agency of the Department of Commerce. The NWS has hundreds of weather offices throughout the United States. The Weather Service Nuclear Support Office (WSNSO) is a highly specialized unit of NWS that provides direct support to the U.S. Department of Energy's (DOE's) underground nuclear testing program. The WSNSO has been associated with the DOE for >33 yr. As a result of the unique relationship with the DOE, all WSNSO emergency response meteorologists and meteorological technicians are allowed access to classified material. Meteorological phenomena play a significant role during a Federal Radiological Monitoring and Assessment Center (FRMAC) event, and WSNSO meteorologists provide direct support to ARAC. The marriage of state-of-the-art computer systems together with proven technology provides the on-scene WSNSO meteorologist with essentially a portable fully equipped, fully functional, advanced NWS weather station. The WSNSO's emergency response personnel and hardware are at the ready and can be mobilized within 2 h. WSNSO can provide on-scene weather forecasts and critical weather data collection whenever and wherever necessary

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

    Directory of Open Access Journals (Sweden)

    Mérida R. Rodríguez

    2012-10-01

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

  19. search GenBank: interactive orchestration and ad-hoc choreography of Web services in the exploration of the biomedical resources of the National Center For Biotechnology Information.

    Science.gov (United States)

    Mrozek, Dariusz; Małysiak-Mrozek, Bożena; Siążnik, Artur

    2013-03-01

    Due to the growing number of biomedical entries in data repositories of the National Center for Biotechnology Information (NCBI), it is difficult to collect, manage and process all of these entries in one place by third-party software developers without significant investment in hardware and software infrastructure, its maintenance and administration. Web services allow development of software applications that integrate in one place the functionality and processing logic of distributed software components, without integrating the components themselves and without integrating the resources to which they have access. This is achieved by appropriate orchestration or choreography of available Web services and their shared functions. After the successful application of Web services in the business sector, this technology can now be used to build composite software tools that are oriented towards biomedical data processing. We have developed a new tool for efficient and dynamic data exploration in GenBank and other NCBI databases. A dedicated search GenBank system makes use of NCBI Web services and a package of Entrez Programming Utilities (eUtils) in order to provide extended searching capabilities in NCBI data repositories. In search GenBank users can use one of the three exploration paths: simple data searching based on the specified user's query, advanced data searching based on the specified user's query, and advanced data exploration with the use of macros. search GenBank orchestrates calls of particular tools available through the NCBI Web service providing requested functionality, while users interactively browse selected records in search GenBank and traverse between NCBI databases using available links. On the other hand, by building macros in the advanced data exploration mode, users create choreographies of eUtils calls, which can lead to the automatic discovery of related data in the specified databases. search GenBank extends standard capabilities of the

  20. [Fact-finding survey on regional healthcare services for patients with epilepsy based on a questionnaire administered to public health centers in Japan].

    Science.gov (United States)

    Fujii, Masami; Ishimaru, Yasutaka; Takahashi, Hiroyuki; Egami, Hirofumi; Nishida, Hideki; Oka, Shinji; Shirabe, Komei

    2015-01-01

    Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. The prevalence of epilepsy is about 1%, and its incidence is increasing with the aging population. In addition to their medical problems, epilepsy patients face many social problems, including schooling, working, and maintaining their driver's licenses. However, these problems are not fully recognized by the regional healthcare centers (HCCs), and the inadequacy of collaboration between medical services, healthcare, and welfare is sometimes pointed out. Under these circumstances, this fact-finding survey was administered in the form of a questionnaire to HCCs across the nation for the purpose of improving the support system and educational activities for epilepsy in Japan. A mail-back survey on regional healthcare services for epilepsy patients was sent out to 490 HCCs across the nation. Public health nurses (PHNs) responded to the self-completed questionnaire on behalf of each HCC. The questionnaire was comprised of the presence or absence of consultations on epilepsy, content of the consultations, and holding of workshops, lectures, or conferences in the community covered by the HCC. We obtained responses from 347 HCCs (response rate 71%). Seventy-three percent of the PHNs had experience with consultations regarding the medical and healthcare issues associated with epilepsy. However, only 10% of the PHNs responded that they could provide appropriate consultation for these issues. The content of the consultations mainly included medical services, clinical symptoms of epilepsy, and anxieties about their social life and their future. Workshops, lectures, or conferences on epilepsy were held for residents or health and welfare professionals in only 8% of the communities. This percentage is lower than those (21-70%) for other intractable or mental disorders that are mainly managed by HCCs (Prestrictions. To improve these situations, regional education programs for

  1. Sociodemographic profile and psychiatric diagnosis of patients referred to consultation-liaison psychiatric services of general hospital psychiatric unit at a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Shri Gopal Goyal

    2017-01-01

    Full Text Available Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psychiatric diagnosis of patients referred to C-L psychiatric services at a tertiary care center. Settings and Design: This was a descriptive cross-sectional study conducted in a tertiary care multispecialty teaching institution. Patients and Methods: The study population comprised all the patients who were referred for psychiatric consultation from other departments to C-L services of psychiatry department for 2 months. Information was collected using semi-structured pro forma, and diagnosis was made based on the International Classification of Diseases-10 criteria. Results: A total of 160 patients were referred for C-L psychiatric services. Majority of the patients were in the age group of 31–45 years, married, educated matriculation or beyond, belonged to Hindu religion, nuclear family, and residing in urban area. The maximum referrals were from internal medicine department (17.5 followed by nephrology (15.0% and neurology (10.6%. The most common psychiatric diagnosis was depression (12% followed by delirium (8%. The most common reason for seeking psychiatric consultation was psychiatric clearance of prospective kidney donor and bone marrow transplant/stem cell transplant recipient. Conclusions: Psychiatric comorbidity may present with chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric comorbidity.

  2. Offshoring de serviços de call center: um estudo comparativo entre Brasil, Índia e África do Sul Offshoring de servicios de call center: un estudio comparativo entre Brasil, India y África del Sur Offshoring of call center services: a comparison of brazilian, indian and south african options

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Gião

    2009-06-01

    centers en tres países emergentes: India, África del Sur y Brasil. El segundo es entender los motivos que llevaron India a ocupar un rol de destaque mundial en offshoring de servicios de call center. El tercer objetivo es entender lo que distingue los call centers brasileños de los indianos, cuanto a las variables relevantes para el offshoring. Para eso fueron analizados datos primarios de 235 empresas de call center colectados a partir de la aplicación de un survey en los tres países analizados. Esos datos son oriundos de una investigación internacional intitulada The Global Call Center Industry Project (GCCIP, que está siendo realizada de manera simultánea en veinte países de todos los continentes.The call center sector has made great progress worldwide, driven by advances in telecommunications and information technology as well as the need to provide customer service, often as required by regulating agencies. A strong international trend has been observed to offshore these services from developed to emergent countries. This trend was discussed with three objectives. The call center industry was first compared in developing countries, Brazil, India and South Africa based on critical variables. Then the prominent world role of India for offshoring of these services was investigated. Finally a search was made for reasons that distinguish Brazilian and Indian call centers based on relevant variables for offshoring. Primary data were collected by a survey and analyzed regarding 235 call center organizations in the three countries in question. These data are from the international survey, The Global Call Center Industry Project, conducted simultaneously in twenty countries on all continents.

  3. Consumer participation in quality improvements for chronic disease care: development and evaluation of an interactive patient-centered survey to identify preferred service initiatives.

    Science.gov (United States)

    Fradgley, Elizabeth A; Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J

    2014-12-19

    With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen's kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of

  4. Consumer Participation in Quality Improvements for Chronic Disease Care: Development and Evaluation of an Interactive Patient-Centered Survey to Identify Preferred Service Initiatives

    Science.gov (United States)

    Paul, Christine L; Bryant, Jamie; Roos, Ian A; Henskens, Frans A; Paul, David J

    2014-01-01

    Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement

  5. WASCAL - West African Science Service Center on Climate Change and Adapted Land Use Regional Climate Simulations and Land-Atmosphere Simulations for West Africa at DKRZ and elsewhere

    Science.gov (United States)

    Hamann, Ilse; Arnault, Joel; Bliefernicht, Jan; Klein, Cornelia; Heinzeller, Dominikus; Kunstmann, Harald

    2014-05-01

    Changing climate and hydro-meteorological boundary conditions are among the most severe challenges to Africa in the 21st century. In particular West Africa faces an urgent need to develop effective adaptation and mitigation strategies to cope with negative impacts on humans and environment due to climate change, increased hydro-meteorological variability and land use changes. To help meet these challenges, the German Federal Ministry of Education and Research (BMBF) started an initiative with institutions in Germany and West African countries to establish together a West African Science Service Center on Climate Change and Adapted Land Use (WASCAL). This activity is accompanied by an establishment of trans-boundary observation networks, an interdisciplinary core research program and graduate research programs on climate change and related issues for strengthening the analytical capabilities of the Science Service Center. A key research activity of the WASCAL Competence Center is the provision of regional climate simulations in a fine spatio-temporal resolution for the core research sites of WASCAL for the present and the near future. The climate information is needed for subsequent local climate impact studies in agriculture, water resources and further socio-economic sectors. The simulation experiments are performed using regional climate models such as COSMO-CLM, RegCM and WRF and statistical techniques for a further refinement of the projections. The core research sites of WASCAL are located in the Sudanian Savannah belt in Northern Ghana, Southern Burkina Faso and Northern Benin. The climate in this region is semi-arid with six rainy months. Due to the strong population growth in West Africa, many areas of the Sudanian Savannah have been already converted to farmland since the majority of the people are living directly or indirectly from the income produced in agriculture. The simulation experiments of the Competence Center and the Core Research Program are

  6. Nuclear Reaction Data Centers

    International Nuclear Information System (INIS)

    McLane, V.; Nordborg, C.; Lemmel, H.D.; Manokhin, V.N.

    1988-01-01

    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

  7. 76 FR 17139 - Health Center Program

    Science.gov (United States)

    2011-03-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... Improvement Project (CIP) from Saint Vincent's Catholic Medical Centers (SVCMC) of New York, current grantee...

  8. The effect of magnetic stimulation on the osteogenic and chondrogenic differentiation of human stem cells derived from the adipose tissue (hASCs)

    Energy Technology Data Exchange (ETDEWEB)

    Lima, João; Gonçalves, Ana I.; Rodrigues, Márcia T.; Reis, Rui L. [3Bs Research Group–Biomaterials, Biodegradables and Biomimetics, University of Minho, Guimarães (Portugal); ICVS/3Bs–PT Government Associate Laboratory, Braga/Guimarães (Portugal); Gomes, Manuela E., E-mail: megomes@dep.uminho.pt [3Bs Research Group–Biomaterials, Biodegradables and Biomimetics, University of Minho, Guimarães (Portugal); ICVS/3Bs–PT Government Associate Laboratory, Braga/Guimarães (Portugal)

    2015-11-01

    The use of magnetic nanoparticles (MNPs) towards the musculoskeletal tissues has been the focus of many studies, regarding MNPs ability to promote and direct cellular stimulation and orient tissue responses. This is thought to be mainly achieved by mechano-responsive pathways, which can induce changes in cell behavior, including the processes of proliferation and differentiation, in response to external mechanical stimuli. Thus, the application of MNP-based strategies in tissue engineering may hold potential to propose novel solutions for cell therapy on bone and cartilage strategies to accomplish tissue regeneration. The present work aims at studying the influence of MNPs on the osteogenic and chondrogenic differentiation of human adipose derived stem cells (hASCs). MNPs were incorporated in hASCs and cultured in medium supplemented for osteogenic and chondrogenic differentiation. Cultures were maintained up to 28 days with/without an external magnetic stimulus provided by a magnetic bioreactor, to determine if the MNPs alone could affect the osteogenic or chondrogenic phenotype of the hASCs. Results indicate that the incorporation of MNPs does not negatively affect the viability nor the proliferation of hASCs. Furthermore, Alizarin Red staining evidences an enhancement in extracellular (ECM) mineralization under the influence of an external magnetic field. Although not as evident as for osteogenic differentiation, Toluidine blue and Safranin-O stainings also suggest the presence of a cartilage-like ECM with glycosaminoglycans and proteoglycans under the magnetic stimulus provided. Thus, MNPs incorporated in hASCs under the influence of an external magnetic field have the potential to induce differentiation towards the osteogenic and chondrogenic lineages. - Highlights: • Cellular viability was not negatively influenced by the nanoparticles. • Chondrogenic medium influences more the synthesis of cartilage-like ECM than MNPs. • Synergetic effect among

  9. Genomic presence of gadD1 glutamate decarboxylase correlates with the organization of ascB-dapE internalin cluster in Listeria monocytogenes.

    Science.gov (United States)

    Chen, Jianshun; Fang, Chun; Zheng, Tianlun; Zhu, Ningyu; Bei, Yijiang; Fang, Weihuan

    2012-02-01

    The ability to survive and proliferate in acidic environments is a prerequisite for the infection of Listeria monocytogenes. The glutamate decarboxylase (GAD) system is responsible for acid resistance, and three GAD homologs have been identified in L. monocytogenes: gadD1, gadD2, and gadD3. To examine whether GAD genes are specific to lineage, serovar, or certain subpopulation, we performed a systematic investigation on the prevalence of GAD genes in 164 L. monocytogenes. In contrast to gadD2 and gadD3 conserved in all L. monocytogenes strains, gadD1 was identified in 36.6% (60/164) of L. monocytogenes strains, including all serovar 1/2c and 68.5% (37/54) of serovar 1/2a strains, as well as a small fraction of serovar 1/2b (3.4%, 1/29) and lineage III (13.8%, 4/29) strains. All serovar 4b and lineage IV strains lacked this gene. According to the ascB-dapE structure, L. monocytogenes strains were classified into four subpopulations, carrying inlC2DE, inlGC2DE, inlGHE, or no internalin cluster, respectively. All L. monocytogenes strains with inlGC2DE or inlGHE pattern harbored gadD1, whereas those bearing inlC2DE or no internalin cluster between ascB and dapE lacked gadD1. In addition, other five non-monocytogenes Listeria species lacking ascB-dapE internalin cluster were gadD1-negative. Overall, the presence of gadD1 is not fully dependent on lineages or serovars but correlates with ascB-dapE internalin profiles, suggesting gadD1 might have co-evolved with the ascB-dapE internalin cluster in the primitive L. monocytogenes before divergence of serovars.

  10. The effect of magnetic stimulation on the osteogenic and chondrogenic differentiation of human stem cells derived from the adipose tissue (hASCs)

    International Nuclear Information System (INIS)

    Lima, João; Gonçalves, Ana I.; Rodrigues, Márcia T.; Reis, Rui L.; Gomes, Manuela E.

    2015-01-01

    The use of magnetic nanoparticles (MNPs) towards the musculoskeletal tissues has been the focus of many studies, regarding MNPs ability to promote and direct cellular stimulation and orient tissue responses. This is thought to be mainly achieved by mechano-responsive pathways, which can induce changes in cell behavior, including the processes of proliferation and differentiation, in response to external mechanical stimuli. Thus, the application of MNP-based strategies in tissue engineering may hold potential to propose novel solutions for cell therapy on bone and cartilage strategies to accomplish tissue regeneration. The present work aims at studying the influence of MNPs on the osteogenic and chondrogenic differentiation of human adipose derived stem cells (hASCs). MNPs were incorporated in hASCs and cultured in medium supplemented for osteogenic and chondrogenic differentiation. Cultures were maintained up to 28 days with/without an external magnetic stimulus provided by a magnetic bioreactor, to determine if the MNPs alone could affect the osteogenic or chondrogenic phenotype of the hASCs. Results indicate that the incorporation of MNPs does not negatively affect the viability nor the proliferation of hASCs. Furthermore, Alizarin Red staining evidences an enhancement in extracellular (ECM) mineralization under the influence of an external magnetic field. Although not as evident as for osteogenic differentiation, Toluidine blue and Safranin-O stainings also suggest the presence of a cartilage-like ECM with glycosaminoglycans and proteoglycans under the magnetic stimulus provided. Thus, MNPs incorporated in hASCs under the influence of an external magnetic field have the potential to induce differentiation towards the osteogenic and chondrogenic lineages. - Highlights: • Cellular viability was not negatively influenced by the nanoparticles. • Chondrogenic medium influences more the synthesis of cartilage-like ECM than MNPs. • Synergetic effect among

  11. The effect of magnetic stimulation on the osteogenic and chondrogenic differentiation of human stem cells derived from the adipose tissue (hASCs)

    Science.gov (United States)

    Lima, João; Gonçalves, Ana I.; Rodrigues, Márcia T.; Reis, Rui L.; Gomes, Manuela E.

    2015-11-01

    The use of magnetic nanoparticles (MNPs) towards the musculoskeletal tissues has been the focus of many studies, regarding MNPs ability to promote and direct cellular stimulation and orient tissue responses. This is thought to be mainly achieved by mechano-responsive pathways, which can induce changes in cell behavior, including the processes of proliferation and differentiation, in response to external mechanical stimuli. Thus, the application of MNP-based strategies in tissue engineering may hold potential to propose novel solutions for cell therapy on bone and cartilage strategies to accomplish tissue regeneration. The present work aims at studying the influence of MNPs on the osteogenic and chondrogenic differentiation of human adipose derived stem cells (hASCs). MNPs were incorporated in hASCs and cultured in medium supplemented for osteogenic and chondrogenic differentiation. Cultures were maintained up to 28 days with/without an external magnetic stimulus provided by a magnetic bioreactor, to determine if the MNPs alone could affect the osteogenic or chondrogenic phenotype of the hASCs. Results indicate that the incorporation of MNPs does not negatively affect the viability nor the proliferation of hASCs. Furthermore, Alizarin Red staining evidences an enhancement in extracellular (ECM) mineralization under the influence of an external magnetic field. Although not as evident as for osteogenic differentiation, Toluidine blue and Safranin-O stainings also suggest the presence of a cartilage-like ECM with glycosaminoglycans and proteoglycans under the magnetic stimulus provided. Thus, MNPs incorporated in hASCs under the influence of an external magnetic field have the potential to induce differentiation towards the osteogenic and chondrogenic lineages.

  12. Evaluation of Routine HIV Opt-Out Screening and Continuum of Care Services Following Entry into Eight Prison Reception Centers--California, 2012.

    Science.gov (United States)

    Lucas, Kimberley D; Eckert, Valorie; Behrends, Czarina N; Wheeler, Charlotte; MacGowan, Robin J; Mohle-Boetani, Janet C

    2016-02-26

    Early diagnosis of human immunodeficiency virus (HIV) infection and initiation of antiretroviral treatment (ART) improves health outcomes and prevents HIV transmission. Before 2010, HIV testing was available to inmates in the California state prison system upon request. In 2010, the California Correctional Health Care Services (CCHCS) integrated HIV opt-out screening into the health assessment for inmates entering California state prisons. Under this system, a medical care provider informs the inmate that an HIV test is routinely done, along with screening for sexually transmitted, communicable, and vaccine-preventable diseases, unless the inmate specifically declines the test. During 2012-2013, CCHCS, the California Department of Public Health, and CDC evaluated HIV screening, rates of new diagnoses, linkage to and retention in care, ART response, and post-release linkage to care among California prison inmates. All prison inmates are processed through one of eight specialized reception center facilities, where they undergo a comprehensive evaluation of their medical needs, mental health, and custody requirements for placement in one of 35 state prisons. Among 17,436 inmates who entered a reception center during April-September 2012, 77% were screened for HIV infection; 135 (1%) tested positive, including 10 (0.1%) with newly diagnosed infections. Among the 135 HIV-positive patient-inmates, 134 (99%) were linked to care within 90 days of diagnosis, including 122 (91%) who initiated ART. Among 83 who initiated ART and remained incarcerated through July 2013, 81 (98%) continued ART; 71 (88%) achieved viral suppression (care within 30 days of release were virally suppressed at that time. Only one of nine persons with a viral load test conducted between 91 days and 1 year post-release had viral suppression. Although high rates of viral suppression were achieved in prison, continuity of care in the community remains a challenge. An infrastructure for post

  13. Central Laboratories Services

    Data.gov (United States)

    Federal Laboratory Consortium — The TVA Central Laboratories Services is a comprehensive technical support center, offering you a complete range of scientific, engineering, and technical services....

  14. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  15. Primary Care DirectConnect: How the Marriage of Call Center Technology and the EMR Brought Dramatic Results—A Service Quality Improvement Study

    Science.gov (United States)

    Bowman, Brent; Smith, Scott

    2010-01-01

    Of the key Health Plan patient satisfaction measures used in Kaiser Permanente Colorado, ease of contacting the physician's office with a medical question was consistently rated as the lowest quarterly patient satisfaction measure. Furthermore, medical office staff had become dissatisfied with their inability to contact patients who had previously left messages. In addition to the shear volume of messages, the return calls were often unanswered, leading to subsequent attempts to reach patients, creating additional work for medical office staff. DirectConnect—the project name for a system and set of processes focused on improving patient satisfaction with the ability to contact Primary Care delivery teams by telephone—focuses on isolating medical advice calls from the other types of calls handled by the centralized Call Center. The system identifies the patient using his/her unique electronic medical record number, then automatically routes medical advice calls directly to the appropriate Primary Care Physician (PCP) or staff. The clinician may then evaluate and respond to the patient's need quickly, thus managing more of their panel's requests in real time. How is DirectConnect different from simply having the patient contact their PCP's office directly? The primary difference is “one-number” convenience that allows all patients to dial one number to access their PCP's team. In addition, calls are routed to various staff as available to reduce long telephone queues and wait times. The DirectConnect system has resulted in statistically significant improvement in key service quality measures. Patient satisfaction improved from a pre-implementation nine quarter mean of 55.9% to a post-implementation 12 quarter mean of 70.2%. Fourteen percent to 17% of all Primary Care calls are now handled by the patient's home medical office team, creating a 54% improvement in the centralized Call Center's speed of answering calls in the first quarter post implementation

  16. Dampak Pemulihan Jasa terhadap Kepuasan Pelanggan: sebuah Perbandingan antara Pelanggan yang Komplain dan Pelanggan yang Tidak Komplain (Studikasus: Service Center Esia Dimargonda Depok)

    OpenAIRE

    Fauzan, Rusli; Halim, Rizal Edy

    2008-01-01

    Nowadays, the industry of telecommunication service provider in Indonesia is thriving. Telecommunication operators, both GSM-based and CDMA-based, compete for bigger share of the market. We can see that there are a lot of packages and added features offered. However, service failures still occur that requires providers to do service recoveries. Good service recovery after service failure occurrences is identified in the service industry as one of the key for customer loyalty.This research aim...

  17. Quality control in environmental radioactivity measurements: experience of the Central Service for Protection against Ionizing Radiation, acting as International Reference Center Of the World Health Organization

    Energy Technology Data Exchange (ETDEWEB)

    Remy, M L; Gahinet, M E; Moroni, J P; De Zertucha, J; Pellerin, P [Service Central de Protection contre les Rayonnements Ionisants, 78 - Le Vesinet (France)

    1978-01-01

    The purpose of this paper is to make known the experiences in the Central Service for Protection against Ionizing Radiation (SCPRI) in two fields: (i)in relation to the survey of, and research on, environmental radiation in France for 15 years, and (ii) as the International Reference Center (IRC), a responsibility which has been assigned to it by the World Health Organisation (WHO) for more than 7 years. The SCPRI has no permanent activity in pure metrology but the control which it exerts on a national scale (more than 30,000 environmental samples analyzed each year) and the periodic intercomparisons which it organizes with a large number of foreign Public Health Laboratories have led to the development of a strict quality control program for the techniques of preparation and verification of standard sources and reference samples which are essential in the use of counters, the application and development of spectrometric and radiochemical analytical methods and in the distribution of samples for intercomparison purposes. A description is given of practical experience of quality control in the preparation of standards and in international inter-comparisons organized under the sponsorship of the World Health Organization.

  18. Long-term management of liquid high-level radioactive wastes stored at the Western New York Nuclear Service Center, West Valley. Final environmental impact statement

    International Nuclear Information System (INIS)

    1982-06-01

    The statement assesses and compares environmental implications of possible alternatives for long-term management of the liquid high-level radioactive wastes stored in underground tanks at the Western New York Nuclear Service Center in West Valley, New York. Four basic alternatives, as well as options within these alternatives, have been considered in the EIS: (1) onsite processing to a terminal waste form for shipment and disposal in a federal repository (the preferred alternative); (2) onsite conversion to a solid interim form for shipment to a federal waste facility for later processing to a terminal form and shipment and subsequent disposal in a federal repository; (3) mixing the liquid wastes with cement and other additives, pouring it back into the existing tanks, and leaving onsite; and (4) no action (continued storage of the wastes in liquid form in the underground tanks at West Valley). Mitigative measures for environmental impacts have been considered for all alternatives. No significant stresses on supplies or irreversible and irretrievable resources are anticipated, and no scarce resource would be required

  19. Case Study for the ARRA-funded Ground Source Heat Pump (GSHP) Demonstration at Wilders Grove Solid Waste Service Center in Raleigh, NC

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xiaobing [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Malhotra, Mini [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Xiong, Zeyu [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-11-01

    High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This paper highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects, a distributed GSHP system for providing all the space conditioning, outdoor air ventilation, and 100% domestic hot water to the Wilders Grove Solid Waste Service Center of City of Raleigh, North Carolina. This case study is based on the analysis of measured performance data, construction costs, and simulations of the energy consumption of conventional central heating, ventilation, and air-conditioning (HVAC) systems providing the same level of space conditioning and outdoor air ventilation as the demonstrated GSHP system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GSHP system, pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the GSHP system compared with conventional HVAC systems. This case study also identified opportunities for reducing uncertainties in the performance evaluation and improving the operational efficiency of the demonstrated GSHP system.

  20. Having faith in each other: not-for-profit giant Ascension Health hooks up with United Surgical Partners for ASC joint venture.

    Science.gov (United States)

    Romano, Michael

    2004-09-13

    In the biggest deal of its kind, not-for-profit giant Ascension is going to build ambulatory surgery centers with for-profit United Surgical Partners, which already has a deal with Baylor, left. "Hospitals are realizing that outpatient services are the future. This strategy is sound," one healthcare consultant said.