WorldWideScience

Sample records for service center lesson

  1. Lessons for the new CMS innovation center from the Medicare health support program.

    Science.gov (United States)

    Barr, Michael S; Foote, Sandra M; Krakauer, Randall; Mattingly, Patrick H

    2010-07-01

    The Patient Protection and Affordable Care Act establishes a new Center for Medicare and Medicaid Innovation in the Centers for Medicare and Medicaid Services (CMS). The center is intended to enhance the CMS's role in promoting much-needed improvements in payment and service delivery. Lessons from the Medicare Health Support Program, a chronic care pilot program that ran between 2005 and 2008, illustrate the value of drawing on experience in planning for the center and future pilot programs. The lessons include the importance of strong leadership; collaboration and flexibility to foster innovation; receptivity of beneficiaries to care management; and the need for timely data on patients' status. The lessons also highlight pitfalls to be avoided in planning future pilot programs, such as flawed strategies for selecting populations to target when testing payment and service delivery reforms.

  2. Lessons learnt from WLCG service deployment

    International Nuclear Information System (INIS)

    Shiers, J D

    2008-01-01

    This paper summarises the main lessons learnt from deploying WLCG production services, with a focus on Reliability, Scalability, Accountability, which lead to both manageability and usability. Each topic is analysed in turn. Techniques for zero-user-visible downtime for the main service interventions are described, together with pathological cases that need special treatment. The requirements in terms of scalability are analysed, calling for as much robustness and automation in the service as possible. The different aspects of accountability - which covers measuring/tracking/logging/monitoring what is going on - and has gone on - is examined, with the goal of attaining a manageable service. Finally, a simple analogy is drawn with the Web in terms of usability - what do we need to achieve to cross the chasm from small-scale adoption to ubiquity?

  3. 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)

  4. Climate services: Lessons learned and future prospects

    Science.gov (United States)

    Brasseur, Guy P.; Gallardo, Laura

    2016-03-01

    This perspective paper reviews progress made in the last decades to enhance the communication and use of climate information relevant to the political and economic decision process. It focuses, specifically, on the creation and development of climate services, and highlights a number of difficulties that have limited the success of these services. Among them are the insufficient awareness by societal actors of their vulnerability to climate change, the lack of relevant products and services offered by the scientific community, the inappropriate format in which the information is provided, and the inadequate business model adopted by climate services. The authors suggest that, to be effective, centers should host within the same center a diversity of staff including experts in climate science, specialists in impact, adaptation, and vulnerability, representatives of the corporate world, agents of the public service as well as social managers and communication specialists. The role and importance of environmental engineering is emphasized.

  5. The use of high impact practices (HIPs) on chemistry lesson design and implementation by pre-service teachers

    Science.gov (United States)

    Chamrat, Suthida; Apichatyotin, Nattaya; Puakanokhirun, Kittaporn

    2018-01-01

    The quality of lesson design is essential to learning effectiveness. Research shows some characteristics of lessons have strong effect on learning which were grouped into "High Impact Practices or HIPs. This research aims to examine the use of HIPs on chemistry lesson design as a part of Teaching Science Strand in Chemistry Concepts course. At the first round of lesson design and implementing in classroom, 14 chemistry pre-services teachers freely selected topics, designed and implemented on their own ideas. The lessons have been reflected by instructors and their peers. High Impact Practices were overtly used as the conceptual framework along with the After-Action Review and Reflection (AARR). The selected High Impact practice in this study consisted of 6 elements: well-designed lesson, vary cognitive demand/academic challenge, students center approach, opportunity of students to reflect by discussion or writing, the assignment of project based learning or task, and the lesson reflects pre-service teachers' Technological Pedagogical Content Knowledge (TPACK). The second round, pre-service teachers were encouraged to explicitly used 6 High Impact Practices in cooperated with literature review specified on focused concepts for bettering designed and implemented lessons. The data were collected from 28 lesson plans and 28 classroom observations to compare and discuss between the first and second lesson and implementation. The results indicated that High Impact Practices effect on the quality of delivered lesson. However, there are some elements that vary on changes which were detailed and discussed in this research article.

  6. 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 ...

  7. Reliability centered maintenance streamlining through lessons learned

    International Nuclear Information System (INIS)

    Strong, D.K.

    1991-01-01

    In late 1986, PSE and G concluded that the Nuclear Department would develop a consistent approach to maintenance at Artificial Island (Salem and Hope Creak nuclear units). Preventive maintenance (PM) would be the heart of this approach. In the last six months of 1987 departments affected by the maintenance program participated on working groups that developed the Artificial Island maintenance philosophy. The central theme of the maintenance philosophy is the RCM (reliability centered maintenance) process. A pilot project tested the process in 1988. In 1989 the Central PM Group formed and in 1990 was given responsibility and authority to analyze, approve, implement, and control PM program changes. RCM is the central theme of the PM improvement effort but not the whole effort. Other important pieces included in this paper are: development of a common PM program, improvement of work instructions, development of predictive maintenance techniques into programs, development of a PM basis database, development of PM feedback from failure trends, root cause analysis, maintenance performance indicators, technicians, and engineers

  8. Art and community health: lessons from an urban health center.

    Science.gov (United States)

    Siegel, Wilma Bulkin; Bartley, Mary Anne

    2004-01-01

    Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

  9. 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.

  10. 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…

  11. 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

  12. Community Service: Lessons from the Corporate World.

    Science.gov (United States)

    Porterfield, Kitty

    2003-01-01

    Describes several corporation-derived client-satisfaction and customer-service standards that principals can use to strengthen relationships with their parents and community. For example, only our clients can judge the quality of our service; our first job is to understand and manage our client's expectations; no matter what we do, some people…

  13. Utility Energy Services Contracts Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    None

    2001-08-01

    This document describes best practices in the use of Utility Energy Services Contracts. The recommendations were generated by a group of innovative energy managers in many successful projects. The topics include project financing, competition between utility franchises, and water conservation.

  14. 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.

  15. Measuring Quality in Special Libraries: Lessons from Service Marketing.

    Science.gov (United States)

    White, Marilyn Domas; Abels, Eileen G.

    1995-01-01

    Surveys the service marketing literature for models and data-gathering instruments measuring service quality, particularly the instruments SERVQUAL and SERVPERF, and assesses their applicability to special libraries and information centers. Topics include service characteristics and definitions of service; performance-minus-expectations and…

  16. 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.

  17. Early Lessons on Bundled Payment at an Academic Medical Center.

    Science.gov (United States)

    Jubelt, Lindsay E; Goldfeld, Keith S; Blecker, Saul B; Chung, Wei-Yi; Bendo, John A; Bosco, Joseph A; Errico, Thomas J; Frempong-Boadu, Anthony K; Iorio, Richard; Slover, James D; Horwitz, Leora I

    2017-09-01

    Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group). We examined total episode costs and costs by service category. We included 2,940 intervention episodes and 1,474 control episodes. Relative to the trend in the control group, lower extremity joint arthroplasty episodes achieved the greatest savings: adjusted average episode cost during the intervention period decreased by $3,017 (95% confidence interval [CI], -$6,066 to $31). For cardiac procedures, the adjusted average episode cost decreased by $2,999 (95% CI, -$8,103 to $2,105), and for spinal fusion, it increased by $8,291 (95% CI, $2,879 to $13,703). Savings were driven predominantly by shifting postdischarge care from inpatient rehabilitation facilities to home. Spinal fusion index admission costs increased because of changes in surgical technique. Under bundled payment, New York University Langone Medical Center decreased total episode costs in patients undergoing lower extremity joint arthroplasty. For patients undergoing cardiac valve procedures, evidence of savings was not as strong, and for patients undergoing spinal fusion, total episode costs increased. For all three conditions, the proportion of patients referred to inpatient rehabilitation facilities upon discharge decreased. These changes were not associated with an increase in index hospital length of stay or readmission rate

  18. Outsourced design services lessons learned from LHC civil engineering

    CERN Document Server

    Watson, T

    2003-01-01

    In April 1996 CERN awarded three contracts for the provision of civil engineering design and site supervision services associated with the LHC Project. These three contracts with an average value at signature of 12MCHF were placed using the “two envelope” award system. Eight firms from six member states were integrated into three Joint Ventures. For Projects prior to the LHC, CERN would have carried out the design and supervision using in-house staff. The change to out-sourced services represented a major step for CERN. After seven years, the contracts are now coming to their conclusion. This paper aims to discuss the reasons why these contracts were originally implemented, the lessons than have been learnt over the last seven years and conclusions on how CERN could approach the need for civil engineering design services in the future.

  19. 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

  20. Lessons Learned from Engineering a Multi-Mission Satellite Operations Center

    Science.gov (United States)

    Madden, Maureen; Cary, Everett, Jr.; Esposito, Timothy; Parker, Jeffrey; Bradley, David

    2006-01-01

    NASA's Small Explorers (SMEX) satellites have surpassed their designed science-lifetimes and their flight operations teams are now facing the challenge of continuing operations with reduced funding. At present, these missions are being re-engineered into a fleet-oriented ground system at Goddard Space Flight Center (GSFC). When completed, this ground system will provide command and control of four SMEX missions and will demonstrate fleet automation and control concepts. As a path-finder for future mission consolidation efforts, this ground system will also demonstrate new ground-based technologies that show promise of supporting longer mission lifecycles and simplifying component integration. One of the core technologies being demonstrated in the SMEX Mission Operations Center is the GSFC Mission Services Evolution Center (GMSEC) architecture. The GMSEC architecture uses commercial Message Oriented Middleware with a common messaging standard to realize a higher level of component interoperability, allowing for interchangeable components in ground systems. Moreover, automation technologies utilizing the GMSEC architecture are being evaluated and implemented to provide extended lights-out operations. This mode of operation will provide routine monitoring and control of the heterogeneous spacecraft fleet. The operational concepts being developed will reduce the need for staffed contacts and is seen as a necessity for fleet management. This paper will describe the experiences of the integration team throughout the re-enginering effort of the SMEX ground system. Additionally, lessons learned will be presented based on the team's experiences with integrating multiple missions into a fleet-automated ground system.

  1. 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.

  2. Lesson Study-Building Communities of Learning Among Pre-Service Science Teachers

    Science.gov (United States)

    Hamzeh, Fouada

    Lesson Study is a widely used pedagogical approach that has been used for decades in its country of origin, Japan. It is a teacher-led form of professional development that involves the collaborative efforts of teachers in co-planning and observing the teaching of a lesson within a unit for evidence that the teaching practices used help the learning process (Lewis, 2002a). The purpose of this research was to investigate if Lesson Study enables pre-service teachers to improve their own teaching in the area of science inquiry-based approaches. Also explored are the self-efficacy beliefs of one group of science pre-service teachers related to their experiences in Lesson Study. The research investigated four questions: 1) Does Lesson Study influence teacher preparation for inquiry-based instruction? 2) Does Lesson Study improve teacher efficacy? 3) Does Lesson Study impact teachers' aspiration to collaborate with colleagues? 4) What are the attitudes and perceptions of pre-service teachers to the Lesson Study idea in Science? The 12 participants completed two pre- and post-study surveys: STEBI- B, Science Teaching Efficacy Belief Instrument (Enochs & Riggs, 1990) and ASTQ, Attitude towards Science Teaching. Data sources included student teaching lesson observations, lesson debriefing notes and focus group interviews. Results from the STEBI-B show that all participants measured an increase in efficacy throughout the study. This study added to the body of research on teaching learning communities, professional development programs and teacher empowerment.

  3. Lessons Learned from Implementing the Patient-Centered Medical Home

    Directory of Open Access Journals (Sweden)

    Ellen P. Green

    2012-01-01

    Full Text Available The Patient-Centered Medical Home (PCMH is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA. Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients’ needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH.

  4. Streamlining Workflow for Endovascular Mechanical Thrombectomy: Lessons Learned from a Comprehensive Stroke Center.

    Science.gov (United States)

    Wang, Hongjin; Thevathasan, Arthur; Dowling, Richard; Bush, Steven; Mitchell, Peter; Yan, Bernard

    2017-08-01

    Recently, 5 randomized controlled trials confirmed the superiority of endovascular mechanical thrombectomy (EMT) to intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. The implication is that our health systems would witness an increasing number of patients treated with EMT. However, in-hospital delays, leading to increased time to reperfusion, are associated with poor clinical outcomes. This review outlines the in-hospital workflow of the treatment of acute ischemic stroke at a comprehensive stroke center and the lessons learned in reduction of in-hospital delays. The in-hospital workflow for acute ischemic stroke was described from prehospital notification to femoral arterial puncture in preparation for EMT. Systematic review of literature was also performed with PubMed. The implementation of workflow streamlining could result in reduction of in-hospital time delays for patients who were eligible for EMT. In particular, time-critical measures, including prehospital notification, the transfer of patients from door to computed tomography (CT) room, initiation of intravenous thrombolysis in the CT room, and the mobilization of neurointervention team in parallel with thrombolysis, all contributed to reduction in time delays. We have identified issues resulting in in-hospital time delays and have reported possible solutions to improve workflow efficiencies. We believe that these measures may help stroke centers initiate an EMT service for eligible patients. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  5. [Managing digital medical imaging projects in healthcare services: lessons learned].

    Science.gov (United States)

    Rojas de la Escalera, D

    2013-01-01

    Medical imaging is one of the most important diagnostic instruments in clinical practice. The technological development of digital medical imaging has enabled healthcare services to undertake large scale projects that require the participation and collaboration of many professionals of varied backgrounds and interests as well as substantial investments in infrastructures. Rather than focusing on systems for dealing with digital medical images, this article deals with the management of projects for implementing these systems, reviewing various organizational, technological, and human factors that are critical to ensure the success of these projects and to guarantee the compatibility and integration of digital medical imaging systems with other health information systems. To this end, the author relates several lessons learned from a review of the literature and the author's own experience in the technical coordination of digital medical imaging projects. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  6. Service Oriented Robotic Architecture for Space Robotics: Design, Testing, and Lessons Learned

    Science.gov (United States)

    Fluckiger, Lorenzo Jean Marc E; Utz, Hans Heinrich

    2013-01-01

    This paper presents the lessons learned from six years of experiments with planetary rover prototypes running the Service Oriented Robotic Architecture (SORA) developed by the Intelligent Robotics Group (IRG) at the NASA Ames Research Center. SORA relies on proven software engineering methods and technologies applied to space robotics. Based on a Service Oriented Architecture and robust middleware, SORA encompasses on-board robot control and a full suite of software tools necessary for remotely operated exploration missions. SORA has been eld tested in numerous scenarios of robotic lunar and planetary exploration. The experiments conducted by IRG with SORA exercise a large set of the constraints encountered in space applications: remote robotic assets, ight relevant science instruments, distributed operations, high network latencies and unreliable or intermittent communication links. In this paper, we present the results of these eld tests in regard to the developed architecture, and discuss its bene ts and limitations.

  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. Warfighter information services: lessons learned in the intelligence domain

    Science.gov (United States)

    Bray, S. E.

    2014-05-01

    A vision was presented in a previous paper of how a common set of services within a framework could be used to provide all the information processing needs of Warfighters. Central to that vision was the concept of a "Virtual Knowledge Base". The paper presents an implementation of these ideas in the intelligence domain. Several innovative technologies were employed in the solution, which are presented and their benefits explained. The project was successful, validating many of the design principles for such a system which had been proposed in earlier work. Many of these principles are discussed in detail, explaining lessons learned. The results showed that it is possible to make vast improvements in the ability to exploit available data, making it discoverable and queryable wherever it is from anywhere within a participating network; and to exploit machine reasoning to make faster and better inferences from available data, enabling human analysts to spend more of their time doing more difficult analytical tasks rather than searching for relevant data. It was also demonstrated that a small number of generic Information Processing services can be combined and configured in a variety of ways (without changing any software code) to create "fact-processing" workflows, in this case to create different intelligence analysis capabilities. It is yet to be demonstrated that the same generic services can be reused to create analytical/situational awareness capabilities for logistics, operations, planning or other military functions but this is considered likely.

  10. Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned.

    Science.gov (United States)

    Murphy, Sean M; Leff, Jared A; Linas, Benjamin P; Morgan, Jake R; McCollister, Kathryn; Schackman, Bruce R

    2018-03-20

    Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. We designed a consultation service that is free to researchers whose work aligns with CHERISH's mission. The service includes up to six hours of consulting time. After prospective consultees submit their request online, they receive a screening call from the consultation service director, who connects them with a consultant with relevant expertise. Consultees and consultants complete web-based evaluations following the consultation; consultees also complete a six-month follow-up. We report on the status of the service from its inception in July 2015 through June 2017. We have received 28 consultation requests (54% Early Stage Investigators, 57% MD or equivalent, 28% PhD, 61% women) on projects typically related to planning a study or grant application (93%); 71% were HIV/AIDS-related. Leading topics included cost-effectiveness (43%), statistical-analysis/econometrics (36%), cost (32%), cost-benefit (21%), and quality-of-life (18%). All consultees were satisfied with their overall experience, and felt that consultation expectations and objectives were clearly defined and the consultant's expertise was matched appropriately with their needs. Results were similar for consultants, who spent a median of 3 hours on consultations. There is a need for health-economic methodological guidance among substance use, HCV, and HIV researchers. Lessons learned

  11. Transformation of an academic medical center: lessons learned from restructuring and downsizing.

    Science.gov (United States)

    Woodard, B; Fottler, M D; Kilpatrick, A O

    1999-01-01

    This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

  12. Beyond the Art Lesson: Free-Choice Learning Centers

    Science.gov (United States)

    Werth, Laurie

    2010-01-01

    In this article, the author emphasizes that by providing learning centers in the art studio environment and by providing "free-choice time," art educators can encourage and reinforce the natural learning styles of students. Learning centers give elementary students the freedom to pursue individual artistic expression. They give students an…

  13. 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...

  14. Lessons learned: mobile device encryption in the academic medical center.

    Science.gov (United States)

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

  15. Interprofessional education through service-learning: lessons from a student-led free clinic.

    Science.gov (United States)

    Farlow, Janice L; Goodwin, Charles; Sevilla, Javier

    2015-05-01

    The academic community must replicate and strengthen existing models for interprofessional education (IPE) to meet widespread calls for team-based patient-centered care. One effective but under-explored possibility for IPE is through student-led clinics, which now exist in the majority of medical schools. This short report presents the Indiana University Student Outreach Clinic (IU-SOC), which involves seven different professional programs across three institutions, as a model for how IPE can be delivered formally through service learning. Lessons learned, such as nurturing an intentional interprofessional program, structured orientation and reflection, and resource and knowledge sharing between the clinic and academic institutions, can be applied to all student-led clinics, but also can inform other IPE initiatives in health professional curricula.

  16. [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.

  17. Lessons Learned from an LGBTQ Senior Center: A Bronx Tale.

    Science.gov (United States)

    McGovern, Justine; Brown, Dwayne; Gasparro, Vita

    This article describes an interdisciplinary pilot study exploring the impact of LGBTQ senior centers on the lives of center members. Many LGBTQ adults face the future having experienced stigma and bias, restricted rights, and rejection from family of origin, and are now growing older without the support of a partner and adult children. As a result, older LGBTQ adults experience higher rates of depression, loneliness and isolation, and shortened life expectancy as compared to non-LGBTQ peers. Findings from focus group and key informant interviews highlight features of LGBTQ senior center experiences that can significantly improve members' quality of life. These include providing family, acceptance and a home, which can have an impact on outlook and outcomes. Moreover, findings suggest the need for re-thinking hetero-normative definitions of "community" in the context of LGBTQ aging. Beyond sharing findings from the study, suggesting a conceptual framework for deepening understanding about LGBTQ aging, and identifying lines of future inquiry, the article articulates implications for social work research, practice and education. Ultimately, the article argues that social work is well positioned to improve quality of life for this under-served population when it adopts a cultural humility stance in research, practice and education.

  18. 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.

  19. Advantages and Disadvantages of the Patient-Centered Medical Home: A Critical Analysis and Lessons Learned.

    Science.gov (United States)

    Budgen, Jacqueline; Cantiello, John

    This article provides a detailed examination of the pros and cons associated with patient-centered medical homes (PCMHs). Opinions and findings from those who have studied PCMHs and those who have been directly involved with this type of health care model are outlined. Key lessons from providers are detailed, and critical success factors are highlighted. This synthesized analysis serves to lend evidence to health care managers and providers who are considering implementation of the PCMH model.

  20. 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.

  1. 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...

  2. Transforming doctor-patient relationships to promote patient-centered care: lessons from palliative care.

    Science.gov (United States)

    Yedidia, Michael J

    2007-01-01

    Palliative care was studied for its potential to yield lessons for transforming doctor-patient relationships to promote patient-centered care. Examination of patient and provider experiences of the transition from curative to palliative care promises valuable insights about establishing and maintaining trust as the goals of care shift and about addressing a broad spectrum of patient needs. The study was guided by a conceptual framework grounded in existing models to address five dimensions of doctor-patient relationships: range of needs addressed, source of authority, maintenance of trust, emotional involvement, and expression of authenticity. Data collection included observation of the care of 40 patients in the inpatient hospice unit and at home, interviews with patients and family members, and in-depth interviews with 22 physicians and two nurses providing end-of-life care. Standard qualitative procedures were used to analyze the data, incorporating techniques for maximizing the validity of the results and broadening their relevance to other contexts. Findings provide evidence for challenging prominent assumptions about possibilities for doctor-patient relationships: questioning the merits of the prohibition on emotional involvement, dependence on protocols for handling difficult communication issues, unqualified reliance on consumer empowerment to assure that care is responsive to patients' needs, and adoption of narrowly defined boundaries between medical and social service systems in caring for patients. Medical education can play a role in preparing doctors to assume new roles by openly addressing management of emotions in routine clinical work, incorporating personal awareness training, facilitating reflection on interactions with patients through use of standardized patients and videotapes, and expanding capacity to effectively address a broad range of needs through teamwork training.

  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)

    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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

    Science.gov (United States)

    Kinlaw, Dennis C.; Eads, Jeannette

    1992-01-01

    It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

  9. 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…

  10. 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...

  11. 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

  12. 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

  13. 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...

  14. Theory and Practice in In-Service Teacher Learning: Teachers' Reconceptualisation of Curriculum in History Lessons

    Science.gov (United States)

    Moyo, Nathan; Modiba, Maropeng

    2014-01-01

    This paper reports on the findings of a qualitative interpretive study that was undertaken to determine how in-service teachers at Great Zimbabwe University were able (or not) to translate a theory that they were exposed to into practice during history lessons. Drawing on a range of data, the study explored how the teachers, who were purposively…

  15. Reflections on Designing a MPA Service-Learning Component: Lessons Learned

    Science.gov (United States)

    Roman, Alexandru V.

    2015-01-01

    This article provides the "lessons learned" from the experience of redesigning two sections (face-to-face and online) of a core master of public administration class as a service-learning course. The suggestions made here can be traced to the entire process of the project, from the "seed idea" through its conceptualization and…

  16. 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...

  17. 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. ​

  18. 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

  19. 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 ...

  20. Lessons learned from the NRU vessel leak repair and return to service projects

    International Nuclear Information System (INIS)

    Heeney, P.; Turcotte, J.

    2011-01-01

    In May 2009 the National Research Universal (NRU) reactor was shut down due to a small leak detected from the reactor vessel into the annulus surrounding the reactor. What ensued was a challenging, yet successful, 15 month long Repair and Return to Service Outage. This Repair and Return to Service Outage presented many first-of-a-kind challenges that provide learning opportunities which have been incorporated into subsequent planned outages. These lessons learned are invaluable tools to be used in the planning and execution of future outages. Following the repair of the NRU vessel, AECL was required to conduct annual inspections of the vessel wall. These inspections require an annual Extended Outage (up to 4 weeks in length). A planned Extended Outage was conducted in May/June 2011 and provided an opportunity to implement some of the lessons learned during the Repair and Return to Service Outage. Lessons learned from that Extended Outage have been incorporated in the subsequent monthly maintenance outages, with lessons learned sessions being held after each outage to ensure that the execution of outages is constantly improving. (author)

  1. Lessons from empirical studies in product and service variety management.

    OpenAIRE

    Lyons, Andrew C.L.

    2013-01-01

    [EN] For many years, a trend for businesses has been to increase market segmentation and extend product and service-variety offerings in order to provid more choice for customers and gain a competitive advantags. However, there have been relatively few variety-related, empirical studies that have been undertaken. In this research, two empirical studies are presented that address the impact of product and service variety on business and business function performance. In the first (service-vari...

  2. Creating a Community of Practice: Lessons Learned from the Center for Astronomy Education (Invited)

    Science.gov (United States)

    Brissenden, G.

    2009-12-01

    The Center for Astronomy Education (CAE) is devoted to improving teaching and learning in Astro 101. To accomplish this, a vital part of CAE is our broader community of practice which includes over 1000 instructors, graduate and undergraduate students, and postdocs. It is this greater community of practice that supports each other, helps, and learns from each other beyond what would be possible without it. As our community of practice has grown, we at CAE have learned many lessons about how different facets of CAE can best be used to promote and support our community both as a whole and for individual members. We will discuss the various facets of CAE, such as our online discussion group Astrolrner@CAE (http://astronomy101.jpl.nasa.gov/discussion) and its Guest Moderator program, our CAE Regional Teaching Exchange Coordinator program, our CAE Workshop Presenter Apprenticeship Training program, our online This Month’s Teaching Strategy, monthly newsletters, and various types of socializing and networking sessions we hold at national meetings. But more importantly, we will discuss the lessons we’ve learned about what does and does not work in building community within each of these facets.

  3. Marine Corps Center for Lessons Learned. Volume 8, Issue 11, November 2012

    Science.gov (United States)

    2012-11-01

    MARINE CORPS CENTER FOR LESSONS LEARNED M C C L L R E P O R T: F E AT U R E D A R T I C L E S A N D L E S S O N S : R E G U L A R F E AT U R E S...L O A D S F R O M T H E M C C L L W E B S I T E , OCTOBER 2012 R E G U L A R F E AT U R E S : Photo credit: Sgt Rachael Moore A Joint Terminal...Follower by Ira Chaleff, and ▪ Fahim Speaks by Fahim Fazli and Michael Moffett . 19 MCCLL Products "in the Pipeline" Several recent, ongoing and

  4. 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

  5. 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...

  6. Lessons from empirical studies in product and service variety management.

    Directory of Open Access Journals (Sweden)

    Andrew C.L. Lyons

    2013-07-01

    Full Text Available For many years, a trend for businesses has been to increase market segmentation and extend product and service-variety offerings in order to provid more choice for customers and gain a competitive advantags. However, there have been relatively few variety-related, empirical studies that have been undertaken. In this research, two empirical studies are presented that address the impact of product and service variety on business and business function performance. In the first (service-variety study, the focus concerns the relationship between service provision offered by UK-based, third-party logistics (3PL providers and the operational and financial performance of those providers. Here, the results of a large survey identify the  most important services offered by 3PLs and the most important aspects of 3PL operational performance. Also, the research suggests that the range of service variety offered by 3PLs does not directly influence the 3PLs’ financial performance. The second (product-variety study presents the findings from an analysis of data from 163 manufacturing plants where the impact of product variety on the performance of five business functions is examined. An increase in product variety was found to influence business functions differently depending on the combination of customisation and variety offered to customers

  7. DCDM1: Lessons Learned from the World's Most Energy Efficient Data Center

    Energy Technology Data Exchange (ETDEWEB)

    Sickinger, David E [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Van Geet, Otto D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Carter, Thomas [Johnson Controls

    2018-05-03

    This presentation discusses the holistic approach to design the world's most energy-efficient data center, which is located at the U.S. Department of Energy National Renewable Energy Laboratory (NREL). This high-performance computing (HPC) data center has achieved a trailing twelve-month average power usage effectiveness (PUE) of 1.04 and features a chiller-less design, component-level warm-water liquid cooling, and waste heat capture and reuse. We provide details of the demonstrated PUE and energy reuse effectiveness (ERE) and lessons learned during four years of production operation. Recent efforts to dramatically reduce the water footprint will also be discussed. Johnson Controls partnered with NREL and Sandia National Laboratories to deploy a thermosyphon cooler (TSC) as a test bed at NREL's HPC data center that resulted in a 50% reduction in water usage during the first year of operation. The Thermosyphon Cooler Hybrid System (TCHS) integrates the control of a dry heat rejection device with an open cooling tower.

  8. 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.

  9. Customer service as an act of(f) balance: lessons for the tourism and hospitality industry

    OpenAIRE

    S Henning

    2014-01-01

    This article reports on corporate customers' perceptions of a telecommunications organisation in South Africa and the lessons learned for the tourism industry. The purpose of the research was to explore reasons for the decline in customers' perceptions of overall quality of service at Telematics SA from a systems theory perspective. The Three State Triangle model (Henning, 2009) was presented as the three dynamic states of all living systems, including businesses and i...

  10. Cybernetic Service-Learning Course Development: Lessons Learned

    Science.gov (United States)

    Marx, Jonathan I.; Miller, Lee Q.

    2009-01-01

    Although the title of the course, Combating Loneliness among Older People in Contemporary Society, states a clear goal, our service-learning class was shaped by five guiding parameters. By avoiding certain things, we allowed the course to self-organize and evolve into a learning experience beyond the one originally envisioned. This paper…

  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. Lessons Learned from Creating the Public Earthquake Resource Center at CERI

    Science.gov (United States)

    Patterson, G. L.; Michelle, D.; Johnston, A.

    2004-12-01

    The Center for Earthquake Research and Information (CERI) at the University of Memphis opened the Public Earthquake Resource Center (PERC) in May 2004. The PERC is an interactive display area that was designed to increase awareness of seismology, Earth Science, earthquake hazards, and earthquake engineering among the general public and K-12 teachers and students. Funding for the PERC is provided by the US Geological Survey, The NSF-funded Mid America Earthquake Center, and the University of Memphis, with input from the Incorporated Research Institutions for Seismology. Additional space at the facility houses local offices of the US Geological Survey. PERC exhibits are housed in a remodeled residential structure at CERI that was donated by the University of Memphis and the State of Tennessee. Exhibits were designed and built by CERI and US Geological Survey staff and faculty with the help of experienced museum display subcontractors. The 600 square foot display area interactively introduces the basic concepts of seismology, real-time seismic information, seismic network operations, paleoseismology, building response, and historical earthquakes. Display components include three 22" flat screen monitors, a touch sensitive monitor, 3 helicorder elements, oscilloscope, AS-1 seismometer, life-sized liquefaction trench, liquefaction shake table, and building response shake table. All displays include custom graphics, text, and handouts. The PERC website at www.ceri.memphis.edu/perc also provides useful information such as tour scheduling, ask a geologist, links to other institutions, and will soon include a virtual tour of the facility. Special consideration was given to address State science standards for teaching and learning in the design of the displays and handouts. We feel this consideration is pivotal to the success of any grass roots Earth Science education and outreach program and represents a valuable lesson that has been learned at CERI over the last several

  16. Privatization of solid waste collection services: Lessons from Gaborone.

    Science.gov (United States)

    Bolaane, Benjamin; Isaac, Emmanuel

    2015-06-01

    Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Mental health services commissioning and provision: Lessons from the UK?

    Science.gov (United States)

    Ikkos, G; Sugarman, Ph; Bouras, N

    2015-01-01

    The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers

  18. Epidemiologic methods lessons learned from environmental public health disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina.

    Science.gov (United States)

    Svendsen, Erik R; Runkle, Jennifer R; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A; Bennett, Charles

    2012-08-01

    Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

  19. Renal services disaster planning: lessons learnt from the 2011 Queensland floods and North Queensland cyclone experiences.

    Science.gov (United States)

    Johnson, David W; Hayes, Bronwyn; Gray, Nicholas A; Hawley, Carmel; Hole, Janet; Mantha, Murty

    2013-01-01

    In 2011, Queensland dialysis services experienced two unprecedented natural disasters within weeks of each other. Floods in south-east Queensland and Tropical Cyclone Yasi in North Queensland caused widespread flooding, property damage and affected the provision of dialysis services, leading to Australia's largest evacuation of dialysis patients. This paper details the responses to the disasters and examines what worked and what lessons were learnt. Recommendations are made for dialysis units in relation to disaster preparedness, response and recovery. © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.

  20. Privatization of solid waste collection services: Lessons from Gaborone

    International Nuclear Information System (INIS)

    Bolaane, Benjamin; Isaac, Emmanuel

    2015-01-01

    Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process

  1. Privatization of solid waste collection services: Lessons from Gaborone

    Energy Technology Data Exchange (ETDEWEB)

    Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

    2015-06-15

    Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.

  2. Predictive Analytics for City Agencies: Lessons from Children's Services.

    Science.gov (United States)

    Shroff, Ravi

    2017-09-01

    Many municipal agencies maintain detailed and comprehensive electronic records of their interactions with citizens. These data, in combination with machine learning and statistical techniques, offer the promise of better decision making, and more efficient and equitable service delivery. However, a data scientist employed by an agency to implement these techniques faces numerous and varied choices that cumulatively can have significant real-world consequences. The data scientist, who may be the only person at an agency equipped to understand the technical complexity of a predictive algorithm, therefore, bears a good deal of responsibility in making judgments. In this perspective, I use a concrete example from my experience of working with New York City's Administration for Children's Services to illustrate the social and technical tradeoffs that can result from choices made in each step of data analysis. Three themes underlie these tradeoffs: the importance of frequent communication between the data scientist, agency leadership, and domain experts; the agency's resources and organizational constraints; and the necessity of an ethical framework to evaluate salient costs and benefits. These themes inform specific recommendations that I provide to guide agencies that employ data scientists and rely on their work in designing, testing, and implementing predictive algorithms.

  3. 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)

  4. Planning diabetic retinopathy serviceslessons from Latin America

    Directory of Open Access Journals (Sweden)

    Pedro Gomez-Bastar

    2011-09-01

    Full Text Available The World Health Organization encourages the promotion and development of programmes for the prevention, detection, and management of diabetic retinopathy (DR. Such programmes must identify effective strategies and technology so that they can be adapted to the situation in each part of the world. Programmes must also be monitored and continuously improved.The guidelines discussed in this article were developed by experts brought together during workshops hosted by the VISION 2020 Latin America technical subcommittee on DR and technical support was provided by the Pan-American Asociation of Ophthalmology (PAAO. Although these guidelines have been developed for Latin America, we hope that the principles they contain will provide a good starting point for the planning of DR services in other low- and middle-income countries.

  5. MARKETIZATION IN PUBLIC EMPLOYMENT SERVICES: LESSONS FROM UK EXPERIENCE FOR TURKEY

    Directory of Open Access Journals (Sweden)

    Varol DUR

    2017-07-01

    Full Text Available With its liberal welfare regime and different understanding on social issues, United Kingdom separates from continental European countries. These differences create opportunities for UK’s governments to materialize “most advanced” neo-liberal reforms in the fi eld of public employment services. Not only the current situation of marketized employment services in UK, but also its historical developments provide numbers of positive and negative examples for the countries planning to implement similar reforms.. This study does not reach a conclusion indicating that UK has best or worst practices in this fi eld. However, it suggests that the UK’s example contains very valuable inputs about pros and cons of marketization in public employment services and how this process should manage. In this scope, the study aims to derive lessons from UK case for Turkish public employment services from objective point of view.

  6. Impact of the Implementation of Information Technology on the Center for Army Lessons Learned

    National Research Council Canada - National Science Library

    Wizner, Anthony

    2001-01-01

    .... This research evaluates the impact that the implementation of an Information Technology infrastructure has had on the efficiency of Army's Lessons Learned Process and the overall effectiveness...

  7. Lessons Learned Recruiting Minority Participants for Research in Urban Community Health Centers.

    Science.gov (United States)

    Fam, Elizabeth; Ferrante, Jeanne M

    2018-02-01

    To help understand and mitigate health disparities, it is important to conduct research with underserved and underrepresented minority populations under real world settings. There is a gap in the literature detailing real-time research staff experience, particularly in their own words, while conducting in-person patient recruitment in urban community health centers. This paper describes challenges faced at the clinic, staff, and patient levels, our lessons learned, and strategies implemented by research staff while recruiting predominantly low-income African-American women for an interviewer-administered survey study in four urban Federally Qualified Health Centers in New Jersey. Using a series of immersion-crystallization cycles, fieldnotes and research reflections written by recruiters, along with notes from team meetings during the study, were qualitatively analyzed. Clinic level barriers included: physical layout of clinic, very low or high patient census, limited private space, and long wait times for patients. Staff level barriers included: unengaged staff, overburdened staff, and provider and staff turnover. Patient level barriers included: disinterested patients, patient mistrust and concerns over confidentiality, no-shows or lack of patient time, and language barrier. We describe strategies used to overcome these barriers and provide recommendations for in-person recruitment of underserved populations into research studies. To help mitigate health disparities, disseminating recruiters' experiences, challenges, and effective strategies used will allow other researchers to build upon these experience in order to increase recruitment success of underserved and underrepresented minority populations into research studies. Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.

  8. Engaging the Deaf American Sign Language Community: Lessons From a Community-Based Participatory Research Center

    Science.gov (United States)

    McKee, Michael; Thew, Denise; Starr, Matthew; Kushalnagar, Poorna; Reid, John T.; Graybill, Patrick; Velasquez, Julia; Pearson, Thomas

    2013-01-01

    Background Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. Objectives The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. Methods We review the process of CBPR in a Deaf ASL community and identify the lessons learned. Results Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. Conclusions This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations. PMID:22982845

  9. Bringing authentic service learning to the classroom: benefits and lessons learned

    Science.gov (United States)

    Chamberlain, Leslie C.

    2016-06-01

    Project-based learning, which has gained significant attention within K-12 education, provides rich hands-on experiences for students. Bringing an element of service to the projects allow students to engage in a local or global community, providing an abundance of benefits to the students’ learning. For example, service projects build confidence, increase motivation, and exercise problem-solving and communication skills in addition to developing a deep understanding of content. I will present lessons I have learned through four years of providing service learning opportunities in my classroom. I share ideas for astronomy projects, tips for connecting and listening to a community, and helpful guidelines to hold students accountable in order to ensure a productive and educational project.

  10. Implementation of Technology in an Elementary Mathematics Lesson: The Experiences of Pre-Service Teachers at One University

    Science.gov (United States)

    Herron, Julie

    2010-01-01

    This study examined pre-service teachers' responses to implementing technology into elementary mathematics lessons. Instructional Architect (IA) was the web-base technology used by the pre-service teachers. Four themes emerged from the data: (a) insights into technology, (b) struggles with technology, (c) access to the mathematics and (d) learning…

  11. Learning to love the rain in Bergen (Norway) and other lessons from a Climate Services neophyte

    Science.gov (United States)

    Sobolowski, Stefan; Wakker, Joyce

    2014-05-01

    A question that is often asked of regional climate modelers generally, and Climate Service providers specifically, is: "What is the added-value of regional climate simulations and how can I use this information?" The answer is, unsurprisingly, not straightforward and depends greatly on what one needs to know. In particular it is important for scientist to communicate directly with the users of this information to determine what kind of information is important for them to do their jobs. This study is part of the ECLISE project (Enabling Climate Information Services for Europe) and involves a user at the municipality of Bergen's (Norway) water and drainage administration and a provider from Uni Research and the Bjerknes Center for Climate Research. The water and drain administration is responsible for communicating potential future changes in extreme precipitation, particularly short-term high-intensity rainfall, which is common in Bergen and making recommendations to the engineering department for changes in design criteria. Thus, information that enables better decision-making is crucial. This study then actually has two relevant components for climate services: 1) is a scientific exercise to evaluate the performance of high resolution regional climate simulations and their ability to reproduce high intensity short duration precipitation and 2) an exercise in communication between a provider community and user community with different concerns, mandates, methodological approaches and even vocabularies. A set of Weather Research and Forecasting (WRF) simulations was run at high resolution (8km) over a large domain covering much of Scandinavia and Northern Europe. One simulation was driven by so-called "perfect" boundary conditions taken from reanalysis data (ERA-interim, 1989-2010) the second and third simulations used Norway's global climate model as boundary forcing (NorESM) and were run for a historical period (1950-2005) and a 30yr. end of the century time

  12. The Midwifery Services Framework: Lessons learned from the initial stages of implementation in six countries.

    Science.gov (United States)

    Garg, Shantanu; Moyo, Nester T; Nove, Andrea; Bokosi, Martha

    2018-07-01

    In 2015, the International Confederation of Midwives (ICM) launched the Midwifery Services Framework (MSF): an evidence-based tool to guide countries through the process of improving their sexual, reproductive, maternal and newborn health services through strengthening and developing the midwifery workforce. The MSF is aligned with key global architecture for sexual, reproductive, maternal and newborn health and human resources for health. This third in a series of three papers describes the experience of starting to implement the MSF in the first six countries that requested ICM support to adopt the tool, and the lessons learned during these early stages of implementation. The early adopting countries selected a variety of priority work areas, but nearly all highlighted the importance of improving the attractiveness of midwifery as a career so as to improve attraction and retention, and several saw the need for improvements to midwifery regulation, pre-service education, availability and/or accessibility of midwives. Key lessons from the early stages of implementation include the need to ensure a broad range of stakeholder involvement from the outset and the need for an in-country lead organisation to maintain the momentum of implementation even when there are changes in political leadership, security concerns or other barriers to progress. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. 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

  14. 10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center.

    Science.gov (United States)

    Chen, Jenny T; Nayar, Harry S; Rao, Venkat K

    2017-09-01

    In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

  15. Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan).

    Science.gov (United States)

    Bricknell, Martin C M; Nadin, M

    2017-08-01

    This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ' the golden thread ' and eight ' silver bullets ' as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. 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/.

  16. 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

  17. Supporting Elementary Education in-Service Teachers' Proficiency in Planning STEM-Centric Lessons

    Science.gov (United States)

    Bowers, Sharon W.

    The purpose of this study was to explore the McDaniel College Elementary STEM Instructional Leader (ESIL) pilot cohort's ability to proficiently plan lessons that incorporated the Maryland State STEM Standards of Practice (SOP), targeting integration of STEM content, inquiry learning, students' abilities to collaborate as a STEM team and students' strategic application of technology. Data collection, in the form of reviewing and analyzing study participants' lesson plans and self-reflections, was completed by three independent assessors. The researcher examined the interrater reliability among the three assessors using the Fleiss' kappa statistic. A 0.91 proportion of agreement consensus was documented among the three assessors. A test of hypothetical value was conducted using the nonparametric Wilcoxonsigned- rank Test. Interpretation of the Wilcoxon-signed-rank Test results suggest that the sample population demonstrated proficient planning abilities for the four targeted Maryland State STEM SOP. Findings from this research add to the field's knowledge of elements in the promotion of graduate coursework that leads to elementary in-service teachers' proficiency in planning STEM-centric lessons, however the findings also have broader implications for teacher education at large. The McDaniel College ESIL model could frame K-12 teacher education for both preservice and in-service teachers. The pragmatic, hybrid experience maximizes flexibility, promotes analytical thinking and self-reflection and builds communication skills. The introduction and development of inquiry and design-based learning through the 7E Learning Cycle develops the teachers' understanding of practices promoted not only within the Maryland State STEM SOP, but also within the Next Generation Science Standards. The McDaniel College ESIL model also builds upon the collective efforts of academia, a non-profit STEM research facility, and local school divisions to align efforts that may lead to

  18. Lessons Learned (3 Years of H2O2 Propulsion System Testing Efforts at NASA's John C. Stennis Space Center)

    Science.gov (United States)

    Taylor, Gary O.

    2001-01-01

    John C. Stennis Space Center continues to support the Propulsion community in an effort to validate High-Test Peroxide as an alternative to existing/future oxidizers. This continued volume of peroxide test/handling activity at Stennis Space Center (SSC) provides numerous opportunities for the SSC team to build upon previously documented 'lessons learned'. SSC shall continue to strive to document their experience and findings as H2O2 issues surface. This paper is intended to capture all significant peroxide issues that we have learned over the last three years. This data (lessons learned) has been formulated from practical handling, usage, storage, operations, and initial development/design of our systems/facility viewpoint. The paper is intended to be an information type tool and limited in technical rational; therefore, presenting the peroxide community with some issues to think about as the continued interest in peroxide evolves and more facilities/hardware are built. These lessons learned are intended to assist industry in mitigating problems and identifying potential pitfalls when dealing with the requirements for handling high-test peroxide.

  19. 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...

  20. 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...

  1. 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.

  2. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.

    Science.gov (United States)

    Edlynn, Emily S; Derrington, Sabrina; Morgan, Helene; Murray, Jennifer; Ornelas, Beatriz; Cucchiaro, Giovanni

    2013-04-01

    We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.

  3. Customer service as an act of(f balance: lessons for the tourism and hospitality industry

    Directory of Open Access Journals (Sweden)

    S Henning

    2014-01-01

    Full Text Available This article reports on corporate customers' perceptions of a telecommunications organisation in South Africa and the lessons learned for the tourism industry. The purpose of the research was to explore reasons for the decline in customers' perceptions of overall quality of service at Telematics SA from a systems theory perspective. The Three State Triangle model (Henning, 2009 was presented as the three dynamic states of all living systems, including businesses and industries. The states were identified as Stable equilibrium (Se, Explosive instability (Ei and Bounded instability (Bi. The model was applied to interpret the findings and offered a way to interpret customer experiences at Telematics SA. Qualitative research was the chosen method of inquiry. A card game was the conversational instrument used to conduct 10 in-depth interviews with Virtual Private Network customers. Purposeful sampling fitted the rationale of the study. Content analysis was done to identify coding categories, while touch-point validity confirmed that the findings were aligned with the systems theoretical concepts. The research methodology can be applied as a qualitative diagnostic tool in different business contexts, while the Three State Triangle model reveals the underlying dynamic processes in organisations. The research results are applied as lessons to be learned for the continuous improvement of products and services of businesses in the hospitality and tourism industry. Businesses should not get stuck in old strategies and policies but adopt a state of Bounded instability where innovation and renewal is possible.

  4. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    OpenAIRE

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...

  5. Analysis and lessons learned instituting an instant messaging reference service at an academic health sciences library: the first year.

    Science.gov (United States)

    Kipnis, Daniel G; Kaplan, Gary E

    2008-01-01

    In February 2006, Thomas Jefferson University went live with a new instant messaging (IM) service. This paper reviews the first 102 transcripts to examine question types and usage patterns. In addition, the paper highlights lessons learned in instituting the service. IM reference represents a small proportion of reference questions, but based on user feedback and technological improvements, the library has decided to continue the service.

  6. [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

  7. Lessons learned from a pharmacy practice model change at an academic medical center.

    Science.gov (United States)

    Knoer, Scott J; Pastor, John D; Phelps, Pamela K

    2010-11-01

    The development and implementation of a new pharmacy practice model at an academic medical center are described. Before the model change, decentralized pharmacists responsible for order entry and verification and clinical specialists were both present on the care units. Staff pharmacists were responsible for medication distribution and sterile product preparation. The decentralized pharmacists handling orders were not able to use their clinical training, the practice model was inefficient, and few clinical services were available during evenings and weekends. A task force representing all pharmacy department roles developed a process and guiding principles for the model change, collected data, and decided on a model. Teams consisting of decentralized pharmacists, decentralized pharmacy technicians, and team leaders now work together to meet patients' pharmacy needs and further departmental safety, quality, and cost-saving goals. Decentralized service hours have been expanded through operational efficiencies, including use of automation (e.g., computerized provider order entry, wireless computers on wheels used during rounds with physician teams). Nine clinical specialist positions were replaced by five team leader positions and four pharmacists functioning in decentralized roles. Additional staff pharmacist positions were shifted into decentralized roles, and the hospital was divided into areas served by teams including five to eight pharmacists. Technicians are directly responsible for medication distribution. No individual's job was eliminated. The new practice model allowed better alignment of staff with departmental goals, expanded pharmacy hours and services, more efficient medication distribution, improved employee engagement, and a staff succession plan.

  8. 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.

  9. Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

    Directory of Open Access Journals (Sweden)

    Timothy A. Mousseau

    2012-08-01

    Full Text Available Background: Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Methods: Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA. Findings: We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. Interpretation: These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

  10. 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...

  11. Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

    Science.gov (United States)

    Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

    2018-01-01

    Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

  12. Developing Pre-Service Teachers' Technological Pedagogical Content Knowledge for Teaching Mathematics with the Geometer's Sketchpad through Lesson Study

    Science.gov (United States)

    Meng, Chew Cheng; Sam, Lim Chap

    2013-01-01

    The purpose of this study was to develop pre-service secondary teachers' technological pedagogical content knowledge (TPACK) for teaching mathematics with The Geometer's Sketchpad (GSP) through Lesson Study (LS). Specifically, a single-group pretest-posttest design was employed to examine whether there was a significant difference in the…

  13. 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)

  14. 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.

  15. Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

    Science.gov (United States)

    Hill, Paul Armstrong; Hill, Ronald Paul

    2015-12-01

    Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Pre-service and in-service capacity building: Lessons learned from the Integrated Management of Childhood Illness (IMCI)

    International Nuclear Information System (INIS)

    Were, Wilson

    2014-01-01

    Background: Integrated management of childhood illness (IMCI) strategy was developed by the WHO and UNICEF in the mid-1990s as a strategy to reduce under-five mortality. Aimed at countries with mortalities >40/1000 live births, it has been adopted by more than 100 countries. The strategy aims not only to improve case management skills of health workers at the primary level health facilities, but also to strengthen health systems, and to improve home and community practices to prevent common childhood illnesses. The strategy has demonstrated success in enhancing health worker performance, improved quality of clinical care for sick children and low cost care per child correctly managed, improved nutrition status among children, and reduced child mortality where fully implemented. Lessons learnt from IMCI training: IMCI capacity building in both pre-service and in-service training has often been in increasing coverage of trained health workers. In-service training. Major obstacles with in-service training include the cost of a model reliant on centralised, tutor-based training, a shortage of experienced trainers, inadequate supply of training materials, poor follow-up and support supervision, frequent attrition of trained staff, and reaching few private practitioners. Other practical difficulties include releasing essential staff for off-site training, per diem, travel and accommodation costs, and reluctance to apply locally learned skills from centralised courses. To mitigate the challenges, countries responded with a number of strategies to increase coverage. Many countries shortened the IMCI course ranging from 5 to 7 days although the content was largely not reduced, and in some cases, was even increased. A meta-analysis that examined shortened IMCI courses demonstrated that the standard course was superior in terms of health work performance. Pre-service training. This was considered as a feasible solution to increase health system coverage by IMCI trained health

  17. 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.

  18. 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...

  19. 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.

  20. 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

  1. Lessons learned obtaining informed consent in research with vulnerable populations in community health center settings

    Directory of Open Access Journals (Sweden)

    Riden Heather E

    2012-11-01

    Full Text Available Abstract Background To improve equity in access to medical research, successful strategies are needed to recruit diverse populations. Here, we examine experiences of community health center (CHC staff who guided an informed consent process to overcome recruitment barriers in a medical record review study. Methods We conducted ten semi-structured interviews with CHC staff members. Interviews were audiotaped, transcribed, and structurally and thematically coded. We used NVivo, an ethnographic data management software program, to analyze themes related to recruitment challenges. Results CHC interviewees reported that a key challenge to recruitment included the difficult balance between institutional review board (IRB requirements for informed consent, and conveying an appropriate level of risk to patients. CHC staff perceived that the requirements of IRB certification itself posed a barrier to allowing diverse staff to participate in recruitment efforts. A key barrier to recruitment also included the lack of updated contact information on CHC patients. CHC interviewees reported that the successes they experienced reflected an alignment between study aims and CHC goals, and trusted relationships between CHCs and staff and the patients they recruited. Conclusions Making IRB training more accessible to CHC-based staff, improving consent form clarity for participants, and developing processes for routinely updating patient information would greatly lower recruitment barriers for diverse populations in health services research.

  2. The effectiveness of Concept Mapping Content Representation Lesson Study (ComCoReLS) model to improve skills of Creating Physics Lesson Plan (CPLP) for pre-service physics teacher

    Science.gov (United States)

    Purwaningsih, E.; Suyatno; Wasis; Prahani, B. K.

    2018-03-01

    This research is aimed to analyse the effectiveness of ComCoReLS (Concept Mapping Content Representation Lesson Study) model towards the improvement skills of Creating Physics Lesson Plan (CPLP) for pre-service physics teacher. This research used one group pre-test and post-test design on 12 pre-service physics teacher at University of Malang State (Indonesia) in academic year 2016/2017. Data collection was conducted through test and interview. Skills of creating physics lesson plan for pre-service physics teacher measurement were conducted through Physics Lesson Plan Evaluation Sheet (PLPES). The data analysis technique was done by using paired t-test and n-gain. The CoMCoReLS model consists of 5 phases, including (1) Preparation, (2) Coaching, (3) Guided Practice, (4) Independent Practice, and (5) Evaluation. In the first, second, third and fifth phases are done at University of Malang State, while the fourth phase (Independent Practice) is done in SMAN 1 Singosari, SMAN 2 Malang, SMA Lab UM, MAN 3 Malang. The results showed that there was a significant increase in skills of creating physics lesson plan for pre-service physics teacher at α = 5% and n-gain average of high category. Thus, the ComCoReLS model is effective for improving skills of creating physics lesson plan for pre-service physics teacher.

  3. 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.

  4. 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...

  5. 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...

  6. 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

  7. PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES.

    Science.gov (United States)

    Marsh, Kevin; Caro, J Jaime; Zaiser, Erica; Heywood, James; Hamed, Alaa

    2018-01-01

    Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences. The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported. The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

  8. Entertainment-Retail Centers in Hong Kong and Los Angeles: Trends and Lessons

    OpenAIRE

    Clara Irazabal; Surajit Chakravarty

    2007-01-01

    This paper seeks to answer the question of why Entertainment Retail Centers (ERCs) develop as they do and what we can expect from these centers of consumption in the near future. Beginning with a "network" view of cities, where cities are nodes in an integrated economic system, the paper examines the evolution of and recent trends in the design of Entertainment Retail Centers (ERCs) in Los Angeles and Hong Kong. The analysis is organized along four related themes - land use, transportation, u...

  9. 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 ...

  10. 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

  11. 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...

  12. 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...

  13. Lessons Learned from the Creation of a Center of Excellence in Low Vision and Vision Rehabilitation in Wenzhou, China

    Science.gov (United States)

    Marinoff, Rebecca; Heilberger, Michael H.

    2017-01-01

    A model Center of Excellence in Low Vision and Vision Rehabilitation was created in a health care setting in China utilizing an inter-institutional relationship with a United States optometric institution. Accomplishments of, limitations to, and stimuli to the provision of low vision and vision rehabilitation services are shared.

  14. Writing Effectively as Counseling Center Directors and Administrators: Lessons Learned from a 2-Minute Speech

    Science.gov (United States)

    Sevig, Todd; Bogan, Yolanda; Dunkle, John; Gong-Guy, Elizabeth

    2015-01-01

    Administrative writing is a crucial skill needed for the counseling center professional to be able to transmit knowledge and values for the rest of the campus community. This article highlights both conceptual and technical aspects of effective writing.

  15. 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,…

  16. 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.

  17. 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

  18. 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.)

  19. Reconstructing tuberculosis services after major conflict: experiences and lessons learned in East Timor.

    Directory of Open Access Journals (Sweden)

    Nelson Martins

    2006-10-01

    Full Text Available BACKGROUND: Tuberculosis (TB is a major public health problem in developing countries. Following the disruption to health services in East Timor due to violent political conflict in 1999, the National Tuberculosis Control Program was established, with a local non-government organisation as the lead agency. Within a few months, the TB program was operational in all districts. METHODS AND FINDINGS: Using the East Timor TB program as a case study, we have examined the enabling factors for the implementation of this type of communicable disease control program in a post-conflict setting. Stakeholder analysis was undertaken, and semi-structured interviews were conducted in 2003 with 24 key local and international stakeholders. Coordination, cooperation, and collaboration were identified as major contributors to the success of the TB program. The existing local structure and experience of the local non-government organisation, the commitment among local personnel and international advisors to establishing an effective program, and the willingness of international advisers and local counterparts to be flexible in their approach were also important factors. This success was achieved despite major impediments, including mass population displacement, lack of infrastructure, and the competing interests of organisations working in the health sector. CONCLUSIONS: Five years after the conflict, the TB program continues to operate in all districts with high notification rates, although the lack of a feeling of ownership by government health workers remains a challenge. Lessons learned in East Timor may be applicable to other post-conflict settings where TB is highly prevalent, and may have relevance to other disease control programs.

  20. Health services for Buruli ulcer control: lessons from a field study in Ghana.

    Directory of Open Access Journals (Sweden)

    Mercy M Ackumey

    2011-06-01

    Full Text Available BACKGROUND: Buruli ulcer (BU, caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue. The first phase of a BU prevention and treatment programme (BUPaT was initiated from 2005-2008, in the Ga-West and Ga-South municipalities in Ghana to increase access to BU treatment and to improve early case detection and case management. This paper assesses achievements of the BUPaT programme and lessons learnt. It also considers the impact of the programme on broader interests of the health system. METHODS: A mixed-methods approach included patients' records review, review of programme reports, a stakeholder forum, key informant interviews, focus group discussions, clinic visits and observations. PRINCIPAL FINDINGS: Extensive collaboration existed across all levels, (national, municipality, and community, thus strengthening the health system. The programme enhanced capacities of all stakeholders in various aspects of health services delivery and demonstrated the importance of health education and community-based surveillance to create awareness and encourage early treatment. A patient database was also created using recommended World Health Organisation (WHO forms which showed that 297 patients were treated from 2005-2008. The proportion of patients requiring only antibiotic treatment, introduced in the course of the programme, was highest in the last year (35.4% in the first, 23.5% in the second and 42.5% in the third year. Early antibiotic treatment prevented recurrences which was consistent with programme aims. CONCLUSIONS: To improve early case management of BU, strengthening existing clinics to increase access to antibiotic therapy is critical. Intensifying health education and surveillance would ultimately increase early reporting and treatment for all cases. Further research is needed to explain the role of environmental factors for BU contagion. Programme strategies reported in our study: collaboration

  1. Lessons and Perspectives on Balancing Research and Diversity-Oriented Service

    Science.gov (United States)

    Emanuel, R. E.

    2012-12-01

    Diversity among scientists is necessary to bring together the range of personal and professional perspectives required to address many grand challenges of research in the earth and environmental sciences. Despite gains in recent decades, African Americans and American Indians remain severely under-represented at the graduate level in the environmental sciences, posing an impediment to ethnic diversity in the ranks of professional scientists. For example, the US National Science Foundation reported that in one recent year African Americans received 1,041 (3%) and American Indians received 120 (0.4%) of the 33,284 science and engineering doctoral degrees granted in the US. These fractions are smaller than African American and American Indian representation among bachelor's degree recipients, and they are smaller than representation in the general US population. Lessons from multiple disciplines (chemistry, medicine and geoscience) suggest that group learning, longitudinal mentoring and networking opportunities are critical elements in the retention of under-represented minority students and their conversion to professionals in scientific fields. With this in mind, I have worked to incorporate these elements into my own research program, which moved recently from a predominantly undergraduate institution to a research extensive university. I discuss the outcomes, successes and challenges of a recent project engaging 14 students and 5 faculty mentors from 6 institutions, including 2 HBCUs, in a yearlong study of secondary ecosystem succession in North Carolina. I frame this discussion in the general context of my own experience, as an American Indian academic, balancing diversity-related service and more traditionally recognized forms of scholarship (i.e. teaching and research) at both predominantly undergraduate and research extensive universities.

  2. 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,...

  3. 10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center

    Directory of Open Access Journals (Sweden)

    Jenny T. Chen, MD

    2017-09-01

    Conclusion:. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

  4. Recruitment Challenges: Lessons from Senior Centers and Older African-American Participants in a Literacy Study

    Science.gov (United States)

    Ntiri, Daphne W.; Stewart, Merry

    2010-01-01

    This article reviews the challenges encountered in the recruitment of urban older African-Americans in a study to explore the effects of interactive educational intervention on functional health literacy and diabetes knowledge. Our methods included identification of challenges related to the individual characteristics of seniors' centers that…

  5. 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)

  6. 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

  7. City of Raleigh, Wilders Grove Service Center, Solid Waste Services Facility. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Robert [Jacobs Engineering, NC (United States); Black, Bill [City of Raleigh, NC (United States); Battle, Fred [City of Raleigh, NC (United States)

    2015-07-22

    Final Report for DOE Grant EE0002808. Grant award was for technology demonstration of geothermal energy systems. One of the major objectives identified for the demonstration portion of the grant was to prove the viability of Ground Source Heat Pump (GSHP) systems in significantly reducing energy usage of HVAC and domestic water heating systems compared to traditional systems. Data were monitored and conclusions drawn, including estimating payback timeframes and documenting lessons learned.

  8. 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...

  9. 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…

  10. Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

    Directory of Open Access Journals (Sweden)

    Reed Peter

    2012-12-01

    Full Text Available Abstract Background Growing interest in the promise of patient-centered care has led to numerous health care innovations, including the patient-centered medical home, shared decision-making, and payment reforms. How best to vet and adopt innovations is an open question. Washington State has been a leader in health care reform and is a rich laboratory for patient-centered innovations. We sought to understand the process of patient-centered care innovation undertaken by innovative health care organizations – from strategic planning to goal selection to implementation to maintenance. Methods We conducted key-informant interviews with executives at five health plans, five provider organizations, and ten primary care clinics in Washington State. At least two readers of each interview transcript identified themes inductively; final themes were determined by consensus. Results Innovation in patient-centered care was a strategic objective chosen by nearly every organization in this study. However, other goals were paramount: cost containment, quality improvement, and organization survival. Organizations commonly perceived effective chronic disease management and integrated health information technology as key elements for successful patient-centered care innovation. Inertia, resource deficits, fee-for-service payment, and regulatory limits on scope of practice were cited as barriers to innovation, while organization leadership, human capital, and adaptive culture facilitated innovation. Conclusions Patient-centered care innovations reflected organizational perspectives: health plans emphasized cost-effectiveness while providers emphasized health care delivery processes. Health plans and providers shared many objectives, yet the two rarely collaborated to achieve them. The process of innovation is heavily dependent on organizational culture and leadership. Policymakers can improve the pace and quality of patient-centered innovation by setting targets

  11. 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

  12. 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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Eric N. Wakaria

    2017-04-01

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

  15. Effects of the Original Versus Revised Bloom's Taxonomy on Lesson Planning Skills: A Turkish Study Among Pre-Service Teachers

    Science.gov (United States)

    Bümen, Nilay T.

    2007-07-01

    The original taxonomy of educational objectives, developed by Benjamin S.␣Bloom and his associates in the 1950s, was revised several decades later by a group of educationists and cognitive psychologists, who developed a revised taxonomy (RT). This article describes a Turkish study carried out among a group of pre-service teachers in order to compare the influence of the two systems on lesson planning skills. The results confirmed other studies that have indicated a number of advantages of the revised system over the earlier one.

  16. International academic service learning: lessons learned from students' travel experiences of diverse cultural and health care practices in morocco.

    Science.gov (United States)

    Kaddoura, Mahmoud; Puri, Aditi; Dominick, Christine A

    2014-01-01

    Academic service learning (ASL) is an active teaching-learning approach to engage students in meaningful hands-on activities to serve community-based needs. Nine health professions students from a private college and a private university in the northeastern United States volunteered to participate in an ASL trip to Morocco. The participants were interviewed to reflect on their experiences. This article discusses the lessons learned from students' ASL experiences regarding integrating ASL into educational programs. The authors recommend a paradigm shift in nursing and dental hygiene curricula to appreciate diversity and promote cultural competency, multidisciplinary teamwork, and ethics-based education. Copyright 2014, SLACK Incorporated.

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. A Worldwide Production Grid Service Built on EGEE and OSG Infrastructures Lessons Learnt and Long-term Requirements

    International Nuclear Information System (INIS)

    Shiers, J.; Dimou, M.; Mendez Lorenzo, P.

    2007-01-01

    Using the Grid Infrastructures provided by EGEE, OSG and others, a worldwide production service has been built that provides the computing and storage needs for the 4 main physics collaborations at CERN's Large Hadron Collider (LHC). The large number of users, their geographical distribution and the very high service availability requirements make this experience of Grid usage worth studying for the sake of a solid and scalable future operation. This service must cater for the needs of thousands of physicists in hundreds of institutes in tens of countries. A 24x7 service with availability of up to 99% is required with major service responsibilities at each of some ten T ier1 a nd of the order of one hundred T ier2 s ites. Such a service - which has been operating for some 2 years and will be required for at least an additional decade - has required significant manpower and resource investments from all concerned and is considered a major achievement in the field of Grid computing. We describe the main lessons learned in offering a production service across heterogeneous Grids as well as the requirements for long-term operation and sustainability. (Author)

  3. The Use of DOE Technologies at The World Trade Center Incident: Lessons Learned

    International Nuclear Information System (INIS)

    McCabe, B.; Kovach, J.; Carpenter, C.; Blair, D.

    2003-01-01

    In response to the attack of the World Trade Center (WTC) on September 11, 2001, the International Union of Operating Engineers (IUOE) National Hazmat Program (OENHP) assembled and deployed a HAZMAT Emergency Management Team (Team) to the disaster site (Site). The response team consisted of a Certified Industrial Hygienist and a rotating team of industrial hygienists, safety professionals, and certified HAZMAT instructors. Through research funded by the Department of Energy (DOE) Office of Environmental Management (EM) and managed by the National Energy Technology Laboratory (NETL), the IUOE conducted human factors assessments on baseline and innovative technologies during real-world conditions and served as an advocate at the WTC disaster site to identify opportunities for the use and evaluation of DOE technologies. From this work, it is clear that opportunities exist for more DOE technologies to be made readily available for use in future emergencies

  4. The Use of DOE Technologies at The World Trade Center Incident: Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    McCabe, B.; Kovach, J.; Carpenter, C.; Blair, D.

    2003-02-25

    In response to the attack of the World Trade Center (WTC) on September 11, 2001, the International Union of Operating Engineers (IUOE) National Hazmat Program (OENHP) assembled and deployed a HAZMAT Emergency Management Team (Team) to the disaster site (Site). The response team consisted of a Certified Industrial Hygienist and a rotating team of industrial hygienists, safety professionals, and certified HAZMAT instructors. Through research funded by the Department of Energy (DOE) Office of Environmental Management (EM) and managed by the National Energy Technology Laboratory (NETL), the IUOE conducted human factors assessments on baseline and innovative technologies during real-world conditions and served as an advocate at the WTC disaster site to identify opportunities for the use and evaluation of DOE technologies. From this work, it is clear that opportunities exist for more DOE technologies to be made readily available for use in future emergencies.

  5. 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.

  6. Indication and implementation of lipidapheresis, rheopheresis, or immunoadsorption (lessons learnt from Germany's largest apheresis center).

    Science.gov (United States)

    Heigl, Franz; Hettich, Reinhard; Lotz, Norbert; Reeg, Harduin; Eder, Bernadette; Steckholzer-Kroth, Karin; Browatzki, Michael; Harre, Kerstin; Arendt, Rainer

    2009-12-29

    Efficient modes of extracorporeal blood purification are available today for apheresis treatment of progressive atherosclerosis, autoimmune disease, or for improving hemorheology. Advanced technology and sophisticated care render apheresis treatment selective, safe and tolerable. Our task is to constantly update indications for apheresis based on best evidence available and good clinical practice, as well as, to determine how apheresis therapy can be made available to those in need or with otherwise refractory disease. Presenting examples of lipid apheresis, rheopheresis, or immunoadsorption for treatment of hypercholesterolemia, hyperlipoproteinemia (a), acute hearing loss, refractory or exacerbating multiple sclerosis, we highlight real world obstacles for implementation of treatment, resulting in still too many patients with proven or recommended indication left untreated. Based on the experience of the largest apheresis center in Germany, with more than 3,300 treatments per year, we depict the necessary structure for identification of patients, defining indication, referral, implementation of therapy, and reimbursement. Apheresis is unfamiliar to most patients and many practitioners or consultants. Nephrologists, performing >90% of apheresis treatments in Germany, have to form a network for referral comprising all regional care-givers, general practitioners as well as the respective specialists (mainly, cardiologists, endocrinologists, diabetologists, ORL specialists, neurologists, ophthalmologists, or rheumatologists), and insurances or other cost-bearing parties for offering a scientifically approved therapeutic regimen and comprehensive care. We have realized this concept in a high volume apheresis center acting in a closely knit network characterized by an unrelenting effort at ongoing medical education. As a consequence, we include approximately 10 times more patients with appropriate diagnoses in our apheresis program as compared to the national average

  7. 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…

  8. 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…

  9. 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...

  10. 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.

  11. 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.

  12. Developing Pre-Service Teachers' Capacity in Teaching Science with Technology through Microteaching Lesson Study Approach

    Science.gov (United States)

    Zhou, George; Xu, Judy; Martinovic, Dragana

    2017-01-01

    In order to effectively use technology in teaching, teacher candidates need to develop technology related pedagogical content knowledge through being engaged in a process of discussion, modeling, practice, and reflection. Based on the examination of teacher candidates' lesson plan assignments, observations of their microteaching performance, and…

  13. Supporting Pre-Service Teachers in Designing Technology-Infused Lesson Plans

    Science.gov (United States)

    Janssen, N.; Lazonder, A. W.

    2016-01-01

    The present study compared the effectiveness of two types of just-in-time support for lesson planning. Both types contained the same technological information but differed regarding pedagogical and content information. The first type presented this information separately (i.e., separate support); the second type presented this information in an…

  14. The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

    Science.gov (United States)

    Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

    2012-11-01

    On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

  15. 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…

  16. 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…

  17. 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...

  18. 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…

  19. A personalized mobile patient guide system for a patient-centered smart hospital: Lessons learned from a usability test and satisfaction survey in a tertiary university hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Jung, Se Young; Kim, Seok; Kim, Eunhye; Lee, Kee-Hyuck; Chung, Eunja; Hwang, Hee

    2016-07-01

    The present study focused on the design, implementation, and evaluation of a personalized mobile patient guide system that utilizes smart phones, indoor navigation technology and a hospital information system (HIS) to address the difficulties that outpatients face in finding hospital facilities, recognizing their daily treatment schedule, and accessing personalized medical and administrative information. The present study was conducted in a fully digitized tertiary university hospital in South Korea. We developed a real-time location-based outpatient guide system that consists of Bluetooth access points (APs) for indoor navigation, an Android-based guide application, a guide server, and interfaces with the HIS. A total of 33 subjects and 43 outpatients participated in the usability test (UT) and the satisfaction survey, respectively. We confirmed that the indoor navigation feature can be applied to outpatient departments with precision using a position error test. The participants in the UT completed each scenario with an average success rate of 67.4%. According to the results, we addressed the problems and made improvements to the user interface by providing users with context-based guidance information. The satisfaction rating of the system was high, with an average score of 4.0 out of 5.0, showing its utility as a patient-centered hospital service. The innovative mobile patient guide system for outpatients is feasible and can be successfully implemented to provide personalized information with high satisfaction. Additionally, the issues identified and lessons learned from our experiences regarding task scheduling, indoor navigation, and usability should be considered when developing the system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. The effectiveness of CCDSR learning model to improve skills of creating lesson plan and worksheet science process skill (SPS) for pre-service physics teacher

    Science.gov (United States)

    Limatahu, I.; Suyatno; Wasis; Prahani, B. K.

    2018-03-01

    In the previous research, CCDSR (Condition, Construction, Development, Simulation, and Reflection) learning model has been developed to improve science process skills for pre-service physics teacher. This research is aimed to analyze the effectiveness of CCDSR learning model towards the improvement skills of creating lesson plan and worksheet of Science Process Skill (SPS) for pre-service physics teacher in academic year 2016/2017. This research used one group pre-test and post-test design on 12 pre-service physics teacher at Physics Education, University of Khairun. Data collection was conducted through test and observation. Creating lesson plan and worksheet SPS skills of pre-service physics teacher measurement were conducted through Science Process Skill Evaluation Sheet (SPSES). The data analysis technique was done by Wilcoxon t-test and n-gain. The CCDSR learning model consists of 5 phases, including (1) Condition, (2) Construction, (3) Development, (4) Simulation, and (5) Reflection. The results showed that there was a significant increase in creating lesson plan and worksheet SPS skills of pre-service physics teacher at α = 5% and n-gain average of moderate category. Thus, the CCDSR learning model is effective for improving skills of creating lesson plan and worksheet SPS for pre-service physics teacher.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Directory of Open Access Journals (Sweden)

    Heather E Douglas

    2017-04-01

    Full Text Available Introduction: There is limited evidence of the benefits of information and communication technology (ICT to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  6. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  7. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  8. Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual Dashboards: Lessons Learned from Human-Centered Design.

    Science.gov (United States)

    Hartzler, Andrea L; Chaudhuri, Shomir; Fey, Brett C; Flum, David R; Lavallee, Danielle

    2015-01-01

    The collection of patient-reported outcomes (PROs) draws attention to issues of importance to patients-physical function and quality of life. The integration of PRO data into clinical decisions and discussions with patients requires thoughtful design of user-friendly interfaces that consider user experience and present data in personalized ways to enhance patient care. Whereas most prior work on PROs focuses on capturing data from patients, little research details how to design effective user interfaces that facilitate use of this data in clinical practice. We share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). We employed human-centered design (HCD) methods to create visual displays of PROs to support patient care and quality improvement. HCD aims to optimize the design of interactive systems through iterative input from representative users who are likely to use the system in the future. Through three major steps, we engaged health care professionals in targeted, iterative design activities to inform the development of a PRO Dashboard that visually displays patient-reported pain and disability outcomes following spine surgery. Design activities to engage health care administrators, providers, and staff guided our work from design concept to specifications for dashboard implementation. Stakeholder feedback from these health care professionals shaped user interface design features, including predefined overviews that illustrate at-a-glance trends and quarterly snapshots, granular data filters that enable users to dive into detailed PRO analytics, and user-defined views to share and reuse. Feedback also revealed important considerations for quality indicators and privacy-preserving sharing and use of PROs. Our work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient

  9. Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual Dashboards: Lessons Learned from Human-Centered Design

    Science.gov (United States)

    Hartzler, Andrea L.; Chaudhuri, Shomir; Fey, Brett C.; Flum, David R.; Lavallee, Danielle

    2015-01-01

    Introduction: The collection of patient-reported outcomes (PROs) draws attention to issues of importance to patients—physical function and quality of life. The integration of PRO data into clinical decisions and discussions with patients requires thoughtful design of user-friendly interfaces that consider user experience and present data in personalized ways to enhance patient care. Whereas most prior work on PROs focuses on capturing data from patients, little research details how to design effective user interfaces that facilitate use of this data in clinical practice. We share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). Methods: We employed human-centered design (HCD) methods to create visual displays of PROs to support patient care and quality improvement. HCD aims to optimize the design of interactive systems through iterative input from representative users who are likely to use the system in the future. Through three major steps, we engaged health care professionals in targeted, iterative design activities to inform the development of a PRO Dashboard that visually displays patient-reported pain and disability outcomes following spine surgery. Findings: Design activities to engage health care administrators, providers, and staff guided our work from design concept to specifications for dashboard implementation. Stakeholder feedback from these health care professionals shaped user interface design features, including predefined overviews that illustrate at-a-glance trends and quarterly snapshots, granular data filters that enable users to dive into detailed PRO analytics, and user-defined views to share and reuse. Feedback also revealed important considerations for quality indicators and privacy-preserving sharing and use of PROs. Conclusion: Our work illustrates a range of engagement methods guided by human-centered principles and design

  10. 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.

  11. Engaging stakeholders: lessons from the use of participatory tools for improving maternal and child care health services.

    Science.gov (United States)

    Ekirapa-Kiracho, Elizabeth; Ghosh, Upasona; Brahmachari, Rittika; Paina, Ligia

    2017-12-28

    Effective stakeholder engagement in research and implementation is important for improving the development and implementation of policies and programmes. A varied number of tools have been employed for stakeholder engagement. In this paper, we discuss two participatory methods for engaging with stakeholders - participatory social network analysis (PSNA) and participatory impact pathways analysis (PIPA). Based on our experience, we derive lessons about when and how to apply these tools. This paper was informed by a review of project reports and documents in addition to reflection meetings with the researchers who applied the tools. These reports were synthesised and used to make thick descriptions of the applications of the methods while highlighting key lessons. PSNA and PIPA both allowed a deep understanding of how the system actors are interconnected and how they influence maternal health and maternal healthcare services. The findings from the PSNA provided guidance on how stakeholders of a health system are interconnected and how they can stimulate more positive interaction between the stakeholders by exposing existing gaps. The PIPA meeting enabled the participants to envision how they could expand their networks and resources by mentally thinking about the contributions that they could make to the project. The processes that were considered critical for successful application of the tools and achievement of outcomes included training of facilitators, language used during the facilitation, the number of times the tool is applied, length of the tools, pretesting of the tools, and use of quantitative and qualitative methods. Whereas both tools allowed the identification of stakeholders and provided a deeper understanding of the type of networks and dynamics within the network, PIPA had a higher potential for promoting collaboration between stakeholders, likely due to allowing interaction between them. Additionally, it was implemented within a participatory action

  12. 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…

  13. 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

  14. 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

  15. 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)

  16. 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...

  17. 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...

  18. 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.

  19. Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

    Science.gov (United States)

    Desombre, T; Eccles, G

    1998-01-01

    This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

  20. 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.

  1. 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

  2. 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.

  3. Interrogating the Lesson Plan in a Pre-Service Methods Course: Evidence from a University in Kenya

    Science.gov (United States)

    Simwa, Kefa L.; Modiba, Maropeng

    2015-01-01

    The paper reports on research that examined how the content of a History methods course, taught in a university in Kenya, influenced student teachers' lesson planning and pedagogical skills. A lecture on a lesson plan, micro-teaching lesson plan documents and presentations were examined to determine student teachers' preparedness for teaching the…

  4. 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.

  5. Customer Information Driven After Sales Service Management: Lessons from Spare Parts Logistics

    NARCIS (Netherlands)

    M.N. Jalil (Muhammad)

    2011-01-01

    textabstractOver the years, after sales service business in capital goods and high tech sectors has experienced significant growth. The drivers for growth are higher service profits, increased competitions, and primary market contractions. The enablers for growth include information driven service

  6. 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

  7. Renewable Energy Services For Developing Countries - In support of the millennium development goals: recommended practice and key lessons

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    Almost 1.6 billion people currently live without electricity in developing countries. These people live in either remote rural areas that have no connection to electrical power grids, or urban areas with inadequate utility systems. The demand for energy in these countries is expected to grow with increases in population and living standards. The International Energy Agency (IEA) estimates that developing countries will need to double their electrical power output by 2020. Despite the growth in energy consumption, the number of people disadvantaged by a lack of modern energy services has remained relatively unchanged. The focus of the international donor community is clearly aimed at poverty alleviation in general, and specifically at achieving the targets known as the Millennium Development Goals (MDGs). Renewable energy technologies have a tremendous potential in providing energy services to developing countries and in helping achieve the MDGs. This document highlights how meeting the MDGs can be facilitated through a sustainable energy supply, and provides case studies from around the world to demonstrate that these technologies are applicable in real-life situations. Based on these cumulative experiences and in order for energy services to be delivered effectively, key lessons and recommendations are put forward with regard to policy, finance and implementation. (author)

  8. Ensuring the success of women faculty at AMCs: lessons learned from the National Centers of Excellence in Women's Health.

    Science.gov (United States)

    Morahan, P S; Voytko, M L; Abbuhl, S; Means, L J; Wara, D W; Thorson, J; Cotsonas, C E

    2001-01-01

    Since the early 1970s, the numbers of women entering medical school and, subsequently, academic medicine have increased substantially. However, women faculty have not advanced at the expected rate to senior academic ranks or positions of leadership. In 1996, to counter this trend, the U.S. Department of Health and Human Services (DHHS) Office on Women's Health included women's leadership as a required component of the nationally funded Centers of Excellence in Women's Health to identify effective strategies and initiate model programs to advance women faculty in academic medicine. The authors describe the experience of Centers at seven U.S. medical schools in initiating and sustaining leadership programs for women. The processes used for program formation, the current programmatic content, and program evaluation approaches are explained. Areas of success (e.g., obtaining support from the institution's leaders) and difficulties faced in maintaining an established program (such as institutional fiscal constraints and the diminishing time available to women to participate in mentoring and leadership activities) are reviewed. Strategies to overcome these and other difficulties (e.g., prioritize and tightly focus the program with the help of an advisory group) are proposed. The authors conclude by reviewing issues that programs for women in academic medicine will increasingly need to focus on (e.g., development of new kinds of skills; issues of recruitment and retention of faculty; and increasing faculty diversity).

  9. 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

  10. 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.

  11. 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…

  12. 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…

  13. 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…

  14. 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...

  15. 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...

  16. 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,…

  17. 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…

  18. 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

  19. 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...

  20. The attitudinal and cognitive effects of interdisciplinary collaboration on elementary pre-service teachers development of biological science related lesson plans

    Science.gov (United States)

    Mills, Jada Jamerson

    There is a need for STEM (science, technology, engineering, and mathematics) education to be taught effectively in elementary schools. In order to achieve this, teacher preparation programs should graduate confident, content strong teachers to convey knowledge to elementary students. This study used interdisciplinary collaboration between the School of Education and the College of Liberal Arts through a Learning-by-Teaching method (LdL): Lernen durch Lernen in German. Pre-service teacher (PST) achievement levels of understanding science concepts based on pretest and posttest data, quality of lesson plans developed, and enjoyment of the class based on the collaboration with science students. The PSTs enrolled in two treatment sections of EDEL 404: Science in the Elementary Classroom collaborated with science students enrolled in BISC 327: Introductory Neuroscience to enhance their science skills and create case-based lesson plans on neurothology topics: echolocation, electrosensory reception, steroid hormones, and vocal learning. The PSTs enrolled in the single control section of EDEL 404 collaborated with fellow elementary education majors to develop lesson plans also based on the same selected topics. Qualitative interviews of education faculty, science faculty, and PSTs provided depth to the quantitative findings. Upon lesson plan completion, in-service teachers also graded the two best and two worst plans for the treatment and control sections and a science reviewer graded the plans for scientific accuracy. Statistical analyses were conducted for hypotheses, and one significant hypothesis found that PSTs who collaborated with science students had more positive science lesson plan writing attitudes than those who did not. Despite overall insignificant statistical analyses, all PSTs responded as more confident after collaboration. Additionally, interviews provided meaning and understanding to the insignificant statistical results as well as scientific accuracy of

  1. 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.

  2. Lessons learned from hardware and software upgrades of IT-DB services

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    This talk gives an overview of recent changes in CERN database infrastructure. The presentation describes database service evolution, in particular new hardware & storage installation, integration with Agile infrastructure, complexity of validation strategy and finally the migration and upgrade process concerning the most critical database services.

  3. Can rewards for environmental services benefit the poor? Lessons from Asia

    NARCIS (Netherlands)

    Beria, L.; Joshi, J.

    2009-01-01

    Pro-poor rewards for environmental services (RES) link global priorities on poverty reduction and environmental sustainability. Emerging approaches to payment for environmental services vary in mechanism and form of payment. Rural poverty is multidimensional and the poverty syndromes vary with the

  4. Microteaching Writing on YouTube for Pre-Service Teacher Training: Lessons Learned

    Science.gov (United States)

    Sun, Yu-Chih

    2014-01-01

    The purpose of the study is to investigate how pre-service teachers adopt YouTube technology into their microteaching as part of their assignments. The participants were twelve Taiwanese pre-service teachers in a Teaching English to Speakers of Other Languages graduate program. They enrolled in a Second Language Writing course and worked in groups…

  5. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe

    NARCIS (Netherlands)

    Pelone, Ferruccio; Kringos, Dionne S.; Spreeuwenberg, Peter; de Belvis, Antonio G.; Groenewegen, Peter P.

    2013-01-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment

  6. How to achieve optimal organization of primary care service delivery at system level: Lessons from Europe

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; de Belvis, A.; Groenewegen, P.P.

    2013-01-01

    OBJECTIVE: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. DESIGN: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  7. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    NARCIS (Netherlands)

    Pelone, F.; Kringos, D.S.; Spreeuwenberg, P.; Belvis, A.G. de; Groenewegen, P.P.

    2013-01-01

    Objective: To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Design: Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data

  8. The use of observation on patients who self-harm: Lessons from a learning disability service

    Directory of Open Access Journals (Sweden)

    Peter Thomas Sandy

    2016-12-01

    Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in in-patient learning disability services.

  9. Lessons learned for spatial modelling of ecosystem services in support of ecosystem accounting

    NARCIS (Netherlands)

    Schroter, M.; Remme, R.P.; Sumarga, E.; Barton, D.N.; Hein, L.G.

    2015-01-01

    Assessment of ecosystem services through spatial modelling plays a key role in ecosystem accounting. Spatial models for ecosystem services try to capture spatial heterogeneity with high accuracy. This endeavour, however, faces several practical constraints. In this article we analyse the trade-offs

  10. Service user integration into social work education: lessons learned from nordic participatory action projects.

    Science.gov (United States)

    Angelin, Anna

    2015-01-01

    Service users have lacked substantial influence, access, and participation in social work education in Norway and Sweden. In this article the author presents comparative analyses of two participatory projects that have developed and implemented practices that integrate service users into academic social work education and empower service users. The Norwegian HUSK project and the Social Work as Mobilization and Entrepreneurship course, also known as the "Mobilization course," at Lund University in Sweden demonstrate collaboration between research, social work education, and service users. The conclusions focus on the importance of the empowering processes by including recognition and dialogue, co-learning in practice, and the use of neutral venues to ensure effective user participation. The inclusion of service users in social work education can improve both practice and education.

  11. 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.

  12. 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.

  13. [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.

  14. 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.

  15. Sustainable Free: Lessons Learned from the Launch of a Free Service Supporting Publishing in Art History

    Directory of Open Access Journals (Sweden)

    James Shulman

    2014-11-01

    Full Text Available Hilary Ballon and Mariet Westermann, writing about the struggles of publishing in art history noted that “It is a paradox of the digital revolution that it has never been easier to produce and circulate a reproductive image, and never harder to publish one.”  If publishing in general is in crisis because of the seismic re-ordering in a digital world, the field of art history is the extreme tail of the spectrum; rights holders are accustomed to licensing image content for limited edition print runs.  Given this particularly challenging corner of the publishing work, a project initiated by the Metropolitan Museum offers some hope of a collaborative way forward.  What sociological re-engineering enabled progress on this problem?  It is possible that there are other lessons here too, that might throw at least streaks of light on other process re-engineering provoked by digital innovation in publishing? This paper reviews how a leading repository of art (The Metropolitan Museum of Art and a non-profit intermediary (ARTstor created an alternative pathway to provide primary source content in support of image-intensive publishing.  This venture is framed in the context of a publishing system moving toward greater freedom and an aim to bring about ever lower (or no fees to readers.In general, providing academic content for free requires a re-structuring of a public release process – either of processed content or less processed content.   To the extent that processing adds value, it might be worth paying for.   This case study argues that there are places where community wide interests align, describes what it takes to keep them aligned, and explores what we did collectively to facilitate re-structuring.  The conclusion explores whether there are lessons for open access publishing more generally in the example of cross-subsidization among mission (and not only marketing driven organizations.

  16. Improving Preservice Teachers’ Self-Efficacy through Service Learning: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Carianne Bernadowski

    2013-07-01

    Full Text Available University students have been barraged with service learning opportunities both as course required and as volunteer opportunities in recent years. Currently, many universities now require students to participate in engaged learning as a graduation requirement. Situated in Bandura’s theory of self-efficacy, this study examines the effects service learning has on students teaching self-efficacy when required to participate in an activity (course connected, compared to when they chose to volunteer in service learning projects. As instructors of preservice teachers it is our commitment to prepare these students to their maximum potential. Identifying best practices for teacher preparation is an overarching goal of this study. A pre/post survey examined students’ self-perceptions for each service opportunity in regards to their perceived teaching self-efficacy. Results indicate that students’ self-efficacy improved when service learning was connected or imbedded in the context of learning and connected to a specific course. These findings indicate course connected service learning has a greater impact on preservice teachers’ perceptions of their ability to be effective future classroom teachers. Therefore course connected service learning can be viewed as a best practice in preservice teaching instruction.

  17. Network-Based Coordination of Civil-Service Training: Lessons from the Case of Estonia

    Directory of Open Access Journals (Sweden)

    Metsma Merilin

    2017-06-01

    Full Text Available The focus of this article is on the coordination of civil-service training in a decentralized civil-service system. The Estonian case is studied. The article investigates network-based coordination, analyzes the power sources of the central coordinator and discusses the opportunities and limitations of creating coherence through network-type cooperation. The article concludes that the key power sources for the central coordinator are financial, human and technical resources paired with knowledge, leadership and commitment. The case study shows that, in a decentralized civil service system, a common understanding on training and development can be fostered by intense collaboration through networks.

  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. Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

    Directory of Open Access Journals (Sweden)

    Dominique Somme

    2014-06-01

    Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion.Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons.Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

  20. Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

    Directory of Open Access Journals (Sweden)

    Dominique Somme

    2014-06-01

    Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion. Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons. Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

  1. 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

  2. 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.

  3. 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...

  4. 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...

  5. How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

    Science.gov (United States)

    Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

    2013-09-01

    To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

  6. Recruiting to cohort studies in specialist healthcare services: Lessons learned from clinical research nurses in UK cleft services.

    Science.gov (United States)

    Zucchelli, Fabio; Rumsey, Nichola; Humphries, Kerry; Bennett, Rhiannon; Davies, Amy; Sandy, Jonathan; Stock, Nicola Marie

    2018-03-01

    To explore the experiences of clinical research nurses recruiting patients in a large specialist care-based cohort study. Longitudinal studies are vital to better understand the aetiology and moderators of health conditions. This need is especially salient for congenital conditions, such as cleft lip and/or palate, where establishing large, comprehensive data sets from birth is vital to improve understanding and to inform interventions. Various barriers exist in recruiting patients to large cohort studies. The role of clinical research nurses embedded within health settings has grown over past decades to facilitate data collection, yet challenges remain. Qualitative descriptive study. Individual semi-structured interviews with 12 clinical research nurses based in 10 National Health Service cleft services across the UK, recruiting to the Cleft Collective Birth Cohort Study. Of seven emergent themes, three highlighted challenges to recruiting patients, another three described facilitative factors, and one theme overlapped challenges and facilitators. Challenges included the life circumstances of potential participants; language barriers; and limited clinical research nurse time for study. Facilitative factors included integrating research into clinical practice; patient information shared with clinical research nurses; and support from the university-based research study team. The theme "Method of data collection" related to both challenges and facilitators. The qualitative data from clinical research nurses recruiting to a large birth cohort study provide helpful practical detail for specialist healthcare teams, specialist nurses, clinical research nurses and researchers looking to optimise recruitment and data collection in longitudinal studies. The findings suggest the importance of specialist clinical services and research study teams cooperating to embed research into everyday clinical practice, without compromising care. This should facilitate patients

  7. Interdisciplinary knowledge translation: lessons learned from a mental health: fire service collaboration.

    Science.gov (United States)

    Henderson, Joanna L; Mackay, Sherri; Peterson-Badali, Michele

    2010-12-01

    Collaborative approaches are being increasingly advocated for addressing a variety of health, mental health and social needs for children, youth and families. Factors important for effective knowledge translation of collaborative approaches of service delivery across disciplines, however, have not been rigorously examined. TAPP-C: The Arson Prevention Program for Children is an intervention program for child and adolescent firesetters provided collaboratively by fire service and mental health professionals. The present study examined the adopter, innovation, and dissemination characteristics associated with TAPP-C implementation, protocol adherence and extent of collaboration by 241 community-based fire service professionals from communities across Ontario. Results revealed that dissemination factors are particularly important for understanding program implementation, adherence and cross-discipline collaboration. Moreover, the findings of this study show significant benefits to both within discipline (intra-disciplinary) and across discipline (interdisciplinary) knowledge translation strategies.

  8. 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

  9. 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...

  10. 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.

  11. 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.

  12. 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.

  13. Behavioural investigations into uncertainty perception in service exchanges: Lessons from dual-processing theory

    DEFF Research Database (Denmark)

    Kreye, Melanie

    2015-01-01

    by experience and knowledge. Based on dual-processing theory, this paper proposes an analysis method for assessing both explicit and implicit uncertainty perception depending on the individual’s use of tacit or explicit knowledge. Analysing two industrial case studies of service relationships, this paper...

  14. Improving Preservice Teachers' Self-Efficacy through Service Learning: Lessons Learned

    Science.gov (United States)

    Bernadowski, Carianne; Perry, Ronald; Del Greco, Robert

    2013-01-01

    University students have been barraged with service learning opportunities both as course required and as volunteer opportunities in recent years. Currently, many universities now require students to participate in engaged learning as a graduation requirement. Situated in Bandura's theory of self-efficacy, this study examines the effects service…

  15. Supportive Social Services for LGBT Youth: Lessons from the Safe Schools Movement

    Science.gov (United States)

    Russell, Stephen T.

    2010-01-01

    How do social services professionals identify and design supportive environments that promote the positive development of LGBT youth? Although there are extraordinary examples of individuals and programs that exist for the purpose of supporting LGBT youth and fostering their development, the work of documenting and empirically analyzing what works…

  16. Operational Space-Assisted Irrigation Advisory Services: Overview Of And Lessons Learned From The Project DEMETER

    Science.gov (United States)

    Osann Jochum, M. A.; Demeter Partners

    2006-08-01

    The project DEMETER (DEMonstration of Earth observation TEchnologies in Routine irrigation advisory services) was dedicated to assessing and demonstrating improvements introduced by Earth observation (EO) and Information and Communication Technologies (ICT) in farm and Irrigation Advisory Service (IAS) day-to-day operations. The DEMETER concept of near-real-time delivery of EO-based irrigation scheduling information to IAS and farmers has proven to be valid. The operationality of the space segment was demonstrated for Landsat 5-TM in the Barrax pilot zone during the 2004 and 2005 irrigation campaigns. Extra-fast image delivery and quality controlled operational processing make the EO-based crop coefficient maps available at the same speed and quality as ground-based data (point samples), while significantly extending the spatial coverage and reducing service cost. Leading-edge online analysis and visualization tools provide easy, intuitive access to the information and personalized service to users. First feedback of users at IAS and farmer level is encouraging. The paper gives an overview of the project and its main achievements.

  17. Ecosystem services for connecting actors – lessons learnt from a symposium

    NARCIS (Netherlands)

    Opdam, P.F.M.; Albert, Chr.; Fürst, C.; Grêt-Regamey, A.; Kleemann, J.; Parker, D.; Rosa, La D.; Schmidt, K.; Villamor, G.; Walz, A.

    2015-01-01

    This paper is a communication from the corresponding symposium at the Global Land Project Open Science Meeting, Berlin, March 2014. We explored the assumption that the ecosystem services-(ES) concept has the potential to support communication and collaboration between actors in land use planning.

  18. The use of observation on patients who self-harm: Lessons from a learning disability service

    Directory of Open Access Journals (Sweden)

    Peter T. Sandy

    2016-10-01

    Aim: To explore nurses' knowledge and understanding of the use of observation on patients who self-harm in a learning disability service in the United Kingdom. Design: and methods: This study adopted a qualitative approach, and utilised interpretative phenomenological analysis as a design and as a tool of analysis. The study was conducted in a secure learning disability service in the United Kingdom. Data were obtained from registered nurses using individual interviews (n = 20 and focus groups (n = 3 x 5 = 15. Data were analysed thematically using the principles of interpretative phenomenological analysis. Results: Three superordinate themes emerged from data analysis: 1 observation: its meaning, 2 observation: does it prevent self-harm? 3 Observation: making it work. Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in inpatient learning disability services.

  19. Integrated care services: lessons learned from the deployment of the NEXES project.

    Science.gov (United States)

    Hernández, Carme; Alonso, Albert; Garcia-Aymerich, Judith; Grimsmo, Anders; Vontetsianos, Theodore; García Cuyàs, Francesc; Altes, Anna Garcia; Vogiatzis, Ioannis; Garåsen, Helge; Pellise, Laura; Wienhofen, Leendert; Cano, Isaac; Meya, Montserrat; Moharra, Montserrat; Martinez, Joan Ignasi; Escarrabill, Juan; Roca, Josep

    2015-01-01

    To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The project demonstrated: (i) Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

  20. Organisational innovation in health services: lessons from the NHS treatment centres

    National Research Council Canada - National Science Library

    Gabbay, J

    2011-01-01

    ... design and methods References Index 103 133 147 149 155 165 v List of abbreviationsOrganisational innovation in health services List of abbreviations A&E ACAD DH DTC GP G-Supp NHS NIHR PCT PFI SDO SHA TC accident and emergency (department) Ambulatory Care and Diagnostic Centre Department of Health ('the Department') diagnosis and treatment centr...

  1. Exploring the service-oriented enterprise : Drawing lessons from a case study

    NARCIS (Netherlands)

    Janssen, M.F.W.H.A.

    2008-01-01

    The service-oriented enterprise (SOE) is often considered as the future model of organization. Yet there is little empirical research in this domain and limited insight into the benefits and disadvantages. In this paper we analyze a case study of a large, multinational banking company. This company

  2. Integrated care services: lessons learned from the deployment of the NEXES project

    Directory of Open Access Journals (Sweden)

    Carme Hernandez

    2015-03-01

    Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388. Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites. Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

  3. Integrated care services: lessons learned from the deployment of the NEXES project

    Directory of Open Access Journals (Sweden)

    Carme Hernandez

    2015-03-01

    Full Text Available Objectives: To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus.Setting: One health care sector in Spain (Barcelona (n = 11.382; six municipalities in Norway (Trondheim (n = 450; and one hospital in Greece (Athens (n = 388.Method: The four services were: (i Home-based long-term maintenance of rehabilitation effects (n = 337; (ii Enhanced Care for frail patients, n = 1340; (iii Home Hospitalization and Early Discharge (n = 2404; and Support for remote diagnosis (forced spirometry testing in primary care (Support (n = 8139. Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted.Results: The project demonstrated: (i Sustainability of training effects over time in chronic patients with obstructive pulmonary disease (p < 0.01; (ii Enhanced care and fewer hospitalizations in chronic respiratory patients (p < 0.05; (iii Reduced in-hospital days for all types of patients (p < 0.001 in Home Hospitalization/Early Discharge; and (iv Increased quality of testing (p < 0.01 for patients with respiratory symptoms in Support, with marked differences among sites.Conclusions: The four integrated care services showed high potential to enhance health outcomes with cost-containment. Change management, technological approach and legal issues were major factors modulating the success of the deployment. The project generated a business plan to foster service sustainability and health innovation. Deployment strategies require site-specific adaptations.

  4. 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.

  5. 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.

  6. Opportunities and barriers for smaller portions in food service: lessons from marketing and behavioral economics.

    Science.gov (United States)

    Riis, J

    2014-07-01

    This paper uses the frameworks and evidence from marketing and behavioral economics to highlight the opportunities and barriers for portion control in food service environments. Applying Kahneman's 'thinking fast and slow' concepts, it describes 10 strategies that can be effective in 'tricking' the consumer's fast cognitive system to make better decisions and in triggering the slow cognitive system to help prevent the fast system from making bad decisions. These strategies include shrinking defaults, elongating packages, increasing the visibility of small portions, offering more mixed virtue options, adding more small sizes, offering 'right-sized' standard portions, using meaningful size labels, adopting linear pricing, using temporal landmarks to push smaller portions and facilitating pre-commitment. For each of these strategies, I discuss the specific cost and revenue barriers that a food service operator would face if the strategy were adopted.

  7. Opportunities and barriers for smaller portions in food service: lessons from marketing and behavioral economics

    Science.gov (United States)

    Riis, J

    2014-01-01

    This paper uses the frameworks and evidence from marketing and behavioral economics to highlight the opportunities and barriers for portion control in food service environments. Applying Kahneman's ‘thinking fast and slow' concepts, it describes 10 strategies that can be effective in ‘tricking' the consumer's fast cognitive system to make better decisions and in triggering the slow cognitive system to help prevent the fast system from making bad decisions. These strategies include shrinking defaults, elongating packages, increasing the visibility of small portions, offering more mixed virtue options, adding more small sizes, offering ‘right-sized' standard portions, using meaningful size labels, adopting linear pricing, using temporal landmarks to push smaller portions and facilitating pre-commitment. For each of these strategies, I discuss the specific cost and revenue barriers that a food service operator would face if the strategy were adopted. PMID:25033960

  8. [Missed lessons, missed opportunities: a role for public health services in medical absenteeism in young people].

    Science.gov (United States)

    Vanneste, Y T M; van de Goor, L A M; Feron, F J M

    2016-01-01

    Young people who often miss school for health reasons are not only missing education, but also the daily routine of school, and social intercourse with their classmates. Medical absenteeism among students merits greater attention. For a number of years, in various regions in the Netherlands, students with extensive medical absenteeism have been invited to see a youth healthcare specialist. The MASS intervention (Medical Advice of Students reported Sick; in Dutch: Medische Advisering van de Ziekgemelde Leerling, abbreviated as M@ZL) has been developed by the West Brabant Regional Public Health Service together with secondary schools to address school absenteeism due to reporting sick. In this paper we discuss the MASS intervention and explain why attention should be paid by public health services to the problem of school absenteeism, especially absenteeism on health grounds.

  9. Microfinance Non-Financial Services: A Key for Poverty Alleviation? Lessons from Mexico\\ud

    OpenAIRE

    Biosca, Olga; Lenton, Pamela; Mosley, Paul

    2011-01-01

    Microfinance non-financial services have been recently reformulated as high quality demand-led programs. In the Mexican context, these are now voluntary, can have a cost for the borrower and are frequently supplied in partnership with specialized public or private agencies. Using primary data from a survey of clients of two credit-plus programs in Chiapas, this paper examines and compares the participation determinants and added impact of the training sessions on monetary poverty outcomes of ...

  10. Microfinance Non-Financial Services: A Key for Poverty Alleviation? Lessons from Mexico

    OpenAIRE

    Olga Biosca; Pamela Lenton; Paul Mosley

    2011-01-01

    Microfinance non-financial services have been recently reformulated as high quality demand-led programs. In the Mexican context, these are now voluntary, can have a cost for the borrower and are frequently supplied in partnership with specialized public or private agencies. Using primary data from a survey of clients of two credit-plus programs in Chiapas, this paper examines and compares the participation determinants and added impact of the training sessions on monetary poverty outcomes of ...

  11. The Service Review Committee: Royal College of Radiologists. Philosophy, role, and lessons to be learned

    International Nuclear Information System (INIS)

    Thind, R.; Barter, S.

    2008-01-01

    The Service Review Committee (SRC) was established by the Board of the Faculty of Clinical Radiology in 2000. At the time, the RCR identified a clear need to respond appropriately and swiftly to requests for review of service provision in clinical radiology departments where trusts were concerned about standards or performance issues. It was recognized by the College that the poorly performing radiologist is often part of a department that is itself dysfunctional, and that sub-optimal performance may often reflect inadequate management, lack of support, overwhelming workload, or inadequate facilities. Following the completion of a range of service reviews during its first 6 years, the SRC recognized that among the reviews there were recurring themes and causes for poorly functioning departments. The committee felt it appropriate to share these with the wider radiological community. In doing so, it is hoped that other departments may recognize their own problems at an early stage and take appropriate steps to prevent any escalation of difficulties

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

    Science.gov (United States)

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

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

  13. Using Public-Private Partnerships to Mitigate Disparities in Access to Genetic Services: Lessons from Wisconsin.

    Science.gov (United States)

    Senier, Laura; Kearney, Matthew; Orne, Jason

    This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin. We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program's capacity. We compare clinic operations to the conceptual models guiding program design. Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models. Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized. There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

  14. The slow search for solutions: Lessons from historical energy transitions by sector and service

    International Nuclear Information System (INIS)

    Fouquet, Roger

    2010-01-01

    This paper reviews past energy transitions by sector and service to identify features that may be useful for future transitions. Although often considered a single event, the transition from traditional energy sources to fossil fuels involved numerous services and sectors at different times between 1500 and 1920. The main economic drivers identified for energy transitions were the opportunities to produce cheaper or better energy services. The existence of a niche market willing to pay more for these characteristics enabled new energy sources and technologies to be refined gradually until they could compete with the incumbent energy source. Nevertheless, this implied that, on average, the whole innovation chain took more than 100 years and the diffusion phase nearly 50 years. In the same way, low-carbon energy sources and technologies offer an additional characteristic (i.e. low carbon impact), which might be able to develop gradually in a niche market until they can compete with fossil fuels. However, because of consumers' tendency to free-ride, a successful transition will need governments to provide protection of this niche market-possibly for decades. Based on past experiences, a complete transition to a low carbon economy is likely to be very slow.

  15. Can rewards for environmental services benefit the poor? Lessons from Asia

    Directory of Open Access Journals (Sweden)

    Beria Leimona

    2009-04-01

    Full Text Available Pro-poor rewards for environmental services (RES link global priorities on poverty reduction and environmental sustainability. Emerging approaches to payment for environmental services vary in mechanism and form of payment. Rural poverty is multidimensional and the poverty syndromes vary with the intensity of landscape use and management, with the solution to lack of access to markets, education and healthcare associated with loss of natural capital. RES mechanisms have to balance effectiveness and efficiency with fairness and pro-poor characteristics, with transaction costs as obstacles to both. The economic perspective on financial transfers needs to be balanced with the social and environmental paradigms of fairness. Our first hypothesis is that only under specific circumstances, actual cash incentive to individual participants of RES will contribute substantially to poverty alleviation of ES providers. The second hypothesis is that non-financial incentive to ES providers will contribute to reducing poverty by linking the community (participants and non-participants to access to capital types (human, social/political, natural, infrastructure and financial, such as microcredit. Review of key ratios of relative number and wealth of service providers and beneficiaries supports the first hypothesis and rejects the notion of widespread potential for reducing upstream rural poverty through individual cash payments. Results of community focus group discussions support the second hypothesis through context-specific preferences for the mechanisms by which RES can trigger conditions for sustainable development.

  16. 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…

  17. 'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services.

    Science.gov (United States)

    Robinson, Suzanne; Glasby, Jon; Allen, Kerry

    2013-11-01

    Public sector organisations are facing one of the most difficult financial periods in history and local decision-makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes - an equally complex and controversial issue. Drawing on local knowledge and best practice examples, this article highlights lessons and themes identified by those decommissioning care home services. We believe that such lessons are relevant to those making disinvestment decisions across public sector services, including health-care. The study employed semi-structured interviews with 12 Directors of Adult Social Services who had been highlighted nationally as having extensive experience of home closures. Interviews were conducted over a 2-week period in March 2011. Results from the study found that having local policy guidance that is perceived as fair and reasonable was advocated by those involved in home closures. Many local policies had evolved over time and had often been developed following experiences of home closures (both good and bad). Decisions to close care home services require a combination of strong leadership, clear strategic goals, a fair decision-making process, strong evidence of the need for change and good communication, alongside wider stakeholder engagement and support. The current financial challenge means that public sector organisations need to make tough choices on investment and disinvestment decisions. Any such decisions need to be influenced by what we know constitutes best practice. Sharing lessons and experiences within and between sectors could well inform and develop decision-making practices. © 2013 John Wiley & Sons Ltd.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. Recruitment of multiple stakeholders to health services research: Lessons from the front lines

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2010-05-01

    Full Text Available Abstract Background Self-administered surveys are an essential methodological tool for health services and knowledge translation research, and engaging end-users of the research is critical. However, few documented accounts of the efforts invested in recruitment of multiple different stakeholders to one health services research study exist. Here, we highlight the challenges of recruiting key stakeholders (policy-makers, clinicians, guideline developers to a Canadian Institutes of Health Research (CIHR funded health services research (HSR study aimed to develop an updated and refined version of a guideline appraisal tool, the AGREE. Methods Using evidence-based methods of recruitment, our goal was to recruit 192 individuals: 80 international guideline developers, 80 Canadian clinicians and 32 Canadian policy/decision-makers. We calculated the participation rate and the recruitment efficiency. Results We mailed 873 invitation letters. Of 838 approached, our participation rate was 29%(240 and recruitment efficiency, 19%(156. One policy-maker manager did not allow policy staff to participate in the study. Conclusions Based on the results from this study, we suggest that future studies aiming to engage similar stakeholders in HSR over sample by at least 5 times to achieve their target sample size and allow for participant withdrawals. We need continued efforts to communicate the value of research between researchers and end-users of research (policy-makers, clinicians, and other researchers, integration of participatory research strategies, and promotion of the value of end-user involvement in research. Future research to understand methods of improving recruitment efficiency and engaging key stakeholders in HSR is warranted.

  3. Recruitment of multiple stakeholders to health services research: lessons from the front lines.

    Science.gov (United States)

    Kho, Michelle E; Rawski, Ellen; Makarski, Julie; Brouwers, Melissa C

    2010-05-13

    Self-administered surveys are an essential methodological tool for health services and knowledge translation research, and engaging end-users of the research is critical. However, few documented accounts of the efforts invested in recruitment of multiple different stakeholders to one health services research study exist. Here, we highlight the challenges of recruiting key stakeholders (policy-makers, clinicians, guideline developers) to a Canadian Institutes of Health Research (CIHR) funded health services research (HSR) study aimed to develop an updated and refined version of a guideline appraisal tool, the AGREE. Using evidence-based methods of recruitment, our goal was to recruit 192 individuals: 80 international guideline developers, 80 Canadian clinicians and 32 Canadian policy/decision-makers. We calculated the participation rate and the recruitment efficiency. We mailed 873 invitation letters. Of 838 approached, our participation rate was 29%(240) and recruitment efficiency, 19%(156). One policy-maker manager did not allow policy staff to participate in the study. Based on the results from this study, we suggest that future studies aiming to engage similar stakeholders in HSR over sample by at least 5 times to achieve their target sample size and allow for participant withdrawals. We need continued efforts to communicate the value of research between researchers and end-users of research (policy-makers, clinicians, and other researchers), integration of participatory research strategies, and promotion of the value of end-user involvement in research. Future research to understand methods of improving recruitment efficiency and engaging key stakeholders in HSR is warranted.

  4. 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.

  5. 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.

  6. Open access to information bridges science and development in Amazonia: lessons of the SIAMAZONIA service

    International Nuclear Information System (INIS)

    Kalliola, Risto; Toivonen, Tuuli; Miyakawa, Victor; Mavila, Manuel

    2008-01-01

    Access to and availability of accurate information has often been stated to play an important role in sustainable environmental management. There is a growing trend of setting up internet-based information services to support the availability of relevant information. The current initiatives that aim to facilitate such information sharing through the web are still, however, often premature and unable to ensure constant flow of data from producers to users. We examine these common challenges by using as an example a network-based facility of biodiversity and environmental information about the Peruvian Amazon region called SIAMAZONIA. Launched in 2001, the service includes data provided by 13 different nodes. The experiences of this initiative have been both encouraging and confusing. A good professional level has been reached, but participation by large information holders is impeded. Participation is obviously considered an additional task rather than an attractive option for enhanced performance at the individual or institutional levels. This dilemma reflects a genuine problem in the modern scientific community, which still lacks agreed ways to reward those who share their data and results through the web. If these problems are solved, internet-based information sharing may become a vital resource for environmental management in Amazonia and also elsewhere

  7. Open access to information bridges science and development in Amazonia: lessons of the SIAMAZONIA service

    Energy Technology Data Exchange (ETDEWEB)

    Kalliola, Risto [Department of Geography, University of Turku, FI-20014 Turku (Finland); Toivonen, Tuuli [Department of Geography, University of Helsinki, FI-00014 Helsinki (Finland); Miyakawa, Victor; Mavila, Manuel [Instituto de Investigaciones de la AmazonIa Peruana, Apartado Postal 784, Iquitos (Peru)

    2008-07-15

    Access to and availability of accurate information has often been stated to play an important role in sustainable environmental management. There is a growing trend of setting up internet-based information services to support the availability of relevant information. The current initiatives that aim to facilitate such information sharing through the web are still, however, often premature and unable to ensure constant flow of data from producers to users. We examine these common challenges by using as an example a network-based facility of biodiversity and environmental information about the Peruvian Amazon region called SIAMAZONIA. Launched in 2001, the service includes data provided by 13 different nodes. The experiences of this initiative have been both encouraging and confusing. A good professional level has been reached, but participation by large information holders is impeded. Participation is obviously considered an additional task rather than an attractive option for enhanced performance at the individual or institutional levels. This dilemma reflects a genuine problem in the modern scientific community, which still lacks agreed ways to reward those who share their data and results through the web. If these problems are solved, internet-based information sharing may become a vital resource for environmental management in Amazonia and also elsewhere.

  8. Developing longitudinal qualitative designs: lessons learned and recommendations for health services research.

    Science.gov (United States)

    Calman, Lynn; Brunton, Lisa; Molassiotis, Alex

    2013-02-06

    Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.

  9. Nurturing social responsibility through community service-learning: Lessons learned from a pilot project.

    Science.gov (United States)

    Dharamsi, Shafik; Espinoza, Nancy; Cramer, Carl; Amin, Maryam; Bainbridge, Lesley; Poole, Gary

    2010-01-01

    Community service-learning (CSL) has been proposed as one way to enrich medical and dental students' sense of social responsibility toward people who are marginalized in society. We developed and implemented a new CSL option in the integrated medical/dental curriculum and assessed its educational impact. Focus groups, individual open-ended interviews, and a survey were used to assess dental students', faculty tutors' and community partners' experiences with CSL. CSL enabled a deeper appreciation for the vulnerabilities that people who are marginalized experience; students gained a greater insight into the social determinants of health and the related importance of community engagement; and they developed useful skills in health promotion project planning, implementation and evaluation. Community partners and faculty tutors indicated that equal partnership, greater collaboration, and a participatory approach to course development are essential to sustainability in CSL. CSL can play an important role in nurturing a purposeful sense of social responsibility among future practitioners. Our study enabled the implementation of an innovative longitudinal course (professionalism and community service) in all 4 years of the dental curriculum.

  10. Corporate governance of public health services: lessons from New Zealand for the state sector.

    Science.gov (United States)

    Perkins, R; Barnett, P; Powell, M

    2000-01-01

    New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted.

  11. Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

    Science.gov (United States)

    Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

    2006-01-01

    During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

  12. 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.

  13. 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

  14. Power supplies and equipment for military field research: lessons from the British Service Dhaulagiri Research Expedition 2016.

    Science.gov (United States)

    Howard, Matt; Bakker-Dyos, J; Gallagher, L; O'Hara, J P; Woods, D; Mellor, A

    2018-02-01

    The British Service Dhaulagiri Research Expedition (BSDMRE) took place from 27 March to 31 May 2016. The expedition involved 129 personnel, with voluntary participation in nine different study protocols. Studies were conducted in three research camps established at 3600, 4600 and 5140 m and involved taking and storing blood samples, cardiac echocardiography and investigations involving a balance plate. Research in this remote environment requires careful planning in order to provide a robust and resilient power plan. In this paper we aim to report the rationale for the choices we made in terms of power supply, the equipment used and potential military applicability. This is a descriptive account from the expedition members involved in planning and conducting the medical research. Power calculations were used to determine estimates of requirement prior to the expedition. The primary sources used to generate power were internal combustion engine (via petrol fuelled electric generators) and solar panels. Having been generated, power was stored using lithium-ion batteries. Special consideration was given to the storage of samples taken in the field, for which electric freezers and dry shippers were used. All equipment used functioned well during the expedition, with the challenges of altitude, temperature and transport all overcome due to extensive prior planning. Power was successfully generated, stored and delivered during the BSDMRE, allowing extensive medical research to be undertaken. The challenges faced and overcome are directly applicable to delivering military medical care in austere environments, and lessons learnt can help with the planning and delivery of future operations, training exercises or expeditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Achieving Smoke-Free Mental Health Services: Lessons from the Past Decade of Implementation Research

    Directory of Open Access Journals (Sweden)

    Jonathan Campion

    2013-09-01

    Full Text Available The culture of smoking by patients and staff within mental health systems of care has a long and entrenched history. Cigarettes have been used as currency between patients and as a patient management tool by staff. These settings have traditionally been exempt from smoke-free policy because of complex held views about the capacity of people with mental disorder to tolerate such policy whilst they are acutely unwell, with stakeholders’ continuing fierce debate about rights, choice and duty of care. This culture has played a significant role in perpetuating physical, social and economic smoking associated impacts experienced by people with mental disorder who receive care within mental health care settings. The past decade has seen a clear policy shift towards smoke-free mental health settings in several countries. While many services have been successful in implementing this change, many issues remain to be resolved for genuine smoke-free policy in mental health settings to be realized. This literature review draws on evidence from the international published research, including national audits of smoke-free policy implementation in mental health units in Australia and England, in order to synthesise what we know works, why it works, and the remaining barriers to smoke-free policy and how appropriate interventions are provided to people with mental disorder.

  16. 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.

  17. 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...

  18. 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...

  19. Operational, quality, and risk management in the transfusion service: lessons learned.

    Science.gov (United States)

    Goodnough, Lawrence Tim

    2012-07-01

    For general health care, the difference between quality and safety has been unclear for measurable patient outcomes. In contrast, in the transfusion service (TS), the relationship between quality and safety has been direct and demonstrable. Case studies are summarized to illustrate the relationship between operations, quality management, and risk management in the TS. In blood availability for elective surgery over 3 audited intervals, the incidence of patients undergoing elective surgery without available crossmatched blood that had been requested was 1:333, 1:328, and 1:225 for pre-quality improvement, post-quality improvement, and subsequent postintervention audit assessment, respectively. In event discovery reports (EDRs) over 2 years, incidence of biologic product deviation reports (Food and Drug Administration reportable) was successfully reduced from 60 biologic product deviation reports (12%) of 507 EDRs in 2009 to 42 (12%) of 336 EDRs in 2010. In wrong blood in tube, 102 specimens were identified (by a change in patient's ABO/Rh) from 176,711 type and screen/cross-match specimens received over a 5-year interval, detected either by previous patient record of ABO/Rh or by a second specimen for blood type confirmation implemented in our TS for the last 3 years. No known cases of "mismatched" red blood cell transfusion have occurred during this interval. There is an inverse relationship between resources/time expended on quality and risk management relative to volumes of operations in the TS. Laboratory-based initiatives that improve patient safety and clinical outcomes need to have resources aligned with the personnel and time required for quality management and risk management. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. 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

  1. 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.

  2. An adaptive case management system to support integrated care services: Lessons learned from the NEXES project.

    Science.gov (United States)

    Cano, Isaac; Alonso, Albert; Hernandez, Carme; Burgos, Felip; Barberan-Garcia, Anael; Roldan, Jim; Roca, Josep

    2015-06-01

    Extensive deployment and sustainability of integrated care services (ICS) constitute an unmet need to reduce the burden of chronic conditions. The European Union project NEXES (2008-2013) assessed the deployment of four ICS encompassing the spectrum of severity of chronic patients. The current study aims to (i) describe the open source Adaptive Case Management (ACM) system (Linkcare®) developed to support the deployment of ICS at the level of healthcare district; (ii) to evaluate its performance; and, (iii) to identify key challenges for regional deployment of ICS. We first defined a conceptual model for ICS management and execution composed of five main stages. We then specified an associated logical model considering the dynamic runtime of ACM. Finally, we implemented the four ICS as a physical model with an ICS editor to allow professionals (case managers) to play active roles in adapting the system to their needs. Instances of ICS were then run in Linkcare®. Four ICS provided a framework for evaluating the system: Wellness and Rehabilitation (W&R) (number of patients enrolled in the study (n)=173); Enhanced Care (EC) in frail chronic patients to prevent hospital admissions, (n=848); Home Hospitalization and Early Discharge (HH/ED) (n=2314); and, Support to remote diagnosis (Support) (n=7793). The method for assessment of telemedicine applications (MAST) was used for iterative evaluation. Linkcare® supports ACM with shared-care plans across healthcare tiers and offers integration with provider-specific electronic health records. Linkcare® successfully contributed to the deployment of the four ICS: W&R facilitated long-term sustainability of training effects (p<0.01) and active life style (p<0.03); EC showed significant positive outcomes (p<0.05); HH/ED reduced on average 5 in-hospital days per patient with a 30-d re-admission rate of 10%; and, Support, enhanced community-based quality forced spirometry testing (p<0.01). Key challenges for regional deployment

  3. [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.

  4. 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…

  5. Supporting teachers' technology integration in lesson plans

    NARCIS (Netherlands)

    Janssen, Noortje

    2017-01-01

    Lesson planning offers rich opportunities for teachers to consider and implement technology in the classroom. This dissertation investigated the design and effectiveness of supplementary information to assist pre-service teachers during the lesson planning process. Based on the Technological,

  6. 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

  7. 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…

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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)

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.

    Science.gov (United States)

    Gidengil, Courtney; Mangione-Smith, Rita; Bailey, L Charles; Cawthon, Mary Lawrence; McGlynn, Elizabeth A; Nakamura, Mari M; Schiff, Jeffrey; Schuster, Mark A; Schneider, Eric C

    2014-01-01

    We sought to explore the claims data-related issues relevant to quality measure development for Medicaid and the Children's Health Insurance Program (CHIP), illustrating the challenges encountered and solutions developed around 3 distinct performance measure topics: care coordination for children with complex needs, quality of care for high-prevalence conditions, and hospital readmissions. Each of 3 centers of excellence presents an example that illustrates the challenges of using claims data for quality measurement. Our Centers of Excellence in pediatric quality measurement used innovative methods to develop algorithms that use Medicaid claims data to identify children with complex needs; overcome some shortcomings of existing data for measuring quality of care for common conditions such as otitis media; and identify readmissions after hospitalizations for lower respiratory infections. Our experience constructing quality measure specifications using claims data suggests that it will be challenging to measure key quality of care constructs for Medicaid-insured children at a national level in a timely and consistent way. Without better data to underpin pediatric quality measurement, Medicaid and CHIP will have difficulty using some existing measures for accountability, value-based purchasing, and quality improvement both across states and within states. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  4. Engaging partners to initiate evaluation efforts: tactics used and lessons learned from the prevention research centers program.

    Science.gov (United States)

    Wright, Demia Sundra; Anderson, Lynda A; Brownson, Ross C; Gwaltney, Margaret K; Scherer, Jennifer; Cross, Alan W; Goodman, Robert M; Schwartz, Randy; Sims, Tom; White, Carol R

    2008-01-01

    The Centers for Disease Control and Prevention's (CDC's) Prevention Research Centers (PRC) Program underwent a 2-year evaluation planning project using a participatory process that allowed perspectives from the national community of PRC partners to be expressed and reflected in a national logic model. The PRC Program recognized the challenge in developing a feasible, useable, and relevant evaluation process for a large, diverse program. To address the challenge, participatory and utilization-focused evaluation models were used. Four tactics guided the evaluation planning process: 1) assessing stakeholders' communication needs and existing communication mechanisms and infrastructure; 2) using existing mechanisms and establishing others as needed to inform, educate, and request feedback; 3) listening to and using feedback received; and 4) obtaining adequate resources and building flexibility into the project plan to support multifaceted mechanisms for data collection. Participatory methods resulted in buy-in from stakeholders and the development of a national logic model. Benefits included CDC's use of the logic model for program planning and development of a national evaluation protocol and increased expectations among PRC partners for involvement. Challenges included the time, effort, and investment of program resources required for the participatory approach and the identification of whom to engage and when to engage them for feedback on project decisions. By using a participatory and utilization-focused model, program partners positively influenced how CDC developed an evaluation plan. The tactics we used can guide the involvement of program stakeholders and help with decisions on appropriate methods and approaches for engaging partners.

  5. 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.

  6. A Worldwide Production Grid Service Built on EGEE and OSG Infrastructures – Lessons Learnt and Long-term Requirements

    CERN Document Server

    Shiers, J; Dimou, M; CERN. Geneva. IT Department

    2007-01-01

    Using the Grid Infrastructures provided by EGEE, OSG and others, a worldwide production service has been built that provides the computing and storage needs for the 4 main physics collaborations at CERN's Large Hadron Collider (LHC). The large number of users, their geographical distribution and the very high service availability requirements make this experience of Grid usage worth studying for the sake of a solid and scalable future operation. This service must cater for the needs of thousands of physicists in hundreds of institutes in tens of countries. A 24x7 service with availability of up to 99% is required with major service responsibilities at each of some ten "Tier1" and of the order of one hundred "Tier2" sites. Such a service - which has been operating for some 2 years and will be required for at least an additional decade - has required significant manpower and resource investments from all concerned and is considered a major achievement in the field of Grid computing. We describe the main lessons...

  7. The ConocoPhillips Center for a Sustainable WE2ST (Water-Energy Education, Science, and Technology): Lessons Learned from an Innovative Research-Education-Outreach Center at Colorado School of Mines

    Science.gov (United States)

    Hogue, T. S.; Blaine, A. C.; Martin, A. C.

    2016-12-01

    , engaging in K-12 classroom activities and events, and by using websites and social media to share information. This presentation will highlight the successes and lessons learned as we enter the third year of this innovative model for a University Center.

  8. Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers.

    Science.gov (United States)

    Boas, Samuel J; Bishop, Tara F; Ryan, Andrew M; Shih, Sarah C; Casalino, Lawrence P

    2014-07-01

    In 2009, the American Recovery and Reinvestment Act apportioned $643 million for a Health Information Technology Extension Program, which established Regional Extension Centers (RECs) to support the implementation and use of electronic health records (EHRs). Little is known, however, about how RECs should assist in EHR implementation and how they should structure ongoing support. The purpose of this paper is to describe physicians' experiences with the Primary Care Information Project (PCIP), an REC run by the New York City Department of Health and Mental Hygiene. We interviewed 17 physicians enrolled in PCIP to understand the role of the EHRon quality of care and their experience with technical assistance from PCIP. All physicians stated that they felt that the EHR improved the quality of care they delivered to their patients particularly because it helped them track patients. All the physicians found technical assistance helpful but most wanted ongoing assistance months or years after they adopted the EHR. © 2013 Published by Elsevier Inc.

  9. 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

  10. 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...

  11. 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.

  12. 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

  13. 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.

  14. Improving Mathematics Teaching as Deliberate Practice through Chinese Lesson Study

    Science.gov (United States)

    Huang, Rongjin; Prince, Kyle M.; Barlow, Angela T.

    2017-01-01

    This study examined how a ninth grade teacher improved an Algebra I lesson through a lesson study approach. We used multiple data sources to investigate the improvement of the lesson towards student-centered mathematics instruction, perceived benefits of the teacher, and factors associated with the improvement of teaching. The lesson group…

  15. Results on Technical and Consultants Service Meetings on Lessons Learned from Operating Experience in Wet and Dry Spent Fuel Storage

    International Nuclear Information System (INIS)

    White, B.; Zou, X.

    2015-01-01

    Spent fuel storage has been and will continue to be a vital portion of the nuclear fuel cycle, regardless of whether a member state has an open or closed nuclear fuel cycle. After removal from the reactor core, spent fuel cools in the spent fuel pool, prior to placement in dry storage or offsite transport for disposal or reprocessing. Additionally, the inventory of spent fuel at many reactors worldwide has or will reach the storage capacity of the spent fuel pool; some facilities are alleviating their need for additional storage capacity by utilizing dry cask storage. While there are numerous differences between wet and dry storage; when done properly both are safe and secure. The nuclear community shares lessons learned worldwide to gain knowledge from one another’s good practices as well as events. Sharing these experiences should minimize the number of incidents worldwide and increase public confidence in the nuclear industry. Over the past 60 years, there have been numerous experiences storing spent fuel, in both wet and dry mediums, that when shared effectively would improve operations and minimize events. These lessons learned will also serve to inform countries, who are new entrants into the nuclear power community, on designs and operations to avoid and include as best practices. The International Atomic Energy Agency convened a technical and several consultants’ meetings to gather these experiences and produce a technical document (TECDOC) to share spent fuel storage lessons learned among member states. This paper will discuss the status of the TECDOC and briefly discuss some lessons learned contained therein. (author)

  16. 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

  17. 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 ...

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem?

    Science.gov (United States)

    Chrysou, Konstantina; Halat, Gabriel; Hoksch, Beatrix; Schmid, Ralph A; Kocher, Gregor J

    2017-04-20

    Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014. Data collection included details of treatment and outcome. Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. A total of 110 polytrauma patients with blunt chest injury were evaluated. 82 of them were males and median age was 48.5 years. Car accidents, falls from a height and motorbike accidents were the most common causes (>75%) for blunt chest trauma. Rib fractures, pneumothorax and pulmonary contusion were the most common chest injuries. Most patients (64.5%) sustained a serious chest injury (AIS thorax 3), 19.1% a severe chest injury (AIS thorax 4) and 15.5% a moderate chest injury (AIS thorax 2). 90% of patients with blunt chest trauma were treated conservatively. Chest tube insertion was indicated in 54.5% of patients. The need for chest tube was significantly higher among the AIS thorax 4 group in comparison to the AIS groups 3 and 2 (p < 0.001). Also, admission to the ICU was directly related to the severity of the AIS thorax (p < 0.001). The severity of chest trauma did not correlate with ICU length of stay, intubation days, complications or mortality. Although 84.5% of patients suffered from serious or even severe chest injury, neither in the conservative nor in the surgically treated group a significant impact of injury severity on ICU stay, intubation days, complications or mortality was observed. AIS

  8. 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.

  9. 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.

  10. 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...

  11. 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

  12. 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.

  13. 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…

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. [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

  1. 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.

  2. 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.

  3. 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.

  4. Implementing CBT for Traumatized Children and Adolescents after September 11: Lessons Learned from the Child and Adolescent Trauma Treatments and Services (CATS) Project

    Science.gov (United States)

    Journal of Clinical Child and Adolescent Psychology, 2007

    2007-01-01

    The Child and Adolescent Trauma Treatments and Services Consortium (CATS) was the largest youth trauma project associated with the September 11 World Trade Center disaster. CATS was created as a collaborative project involving New York State policymakers; academic scientists; clinical treatment developers; and routine practicing clinicians,…

  5. Cancer patient and survivor research from the cancer information service research consortium: a preview of three large randomized trials and initial lessons learned.

    Science.gov (United States)

    Marcus, Alfred C; Diefenbach, Michael A; Stanton, Annette L; Miller, Suzanne M; Fleisher, Linda; Raich, Peter C; Morra, Marion E; Perocchia, Rosemarie Slevin; Tran, Zung Vu; Bright, Mary Anne

    2013-01-01

    The authors describe 3 large randomized trials from the Cancer Information Service Research Consortium. Three web-based multimedia programs are being tested to help newly diagnosed prostate (Project 1) and breast cancer patients (Project 2) make informed treatment decisions and breast cancer patients prepare for life after treatment (Project 3). Project 3 also tests a telephone callback intervention delivered by a cancer information specialist. All participants receive standard print material specific to each project. Preliminary results from the 2-month follow-up interviews are reported for the initial wave of enrolled participants, most of whom were recruited from the Cancer Information Service (1-800-4-CANCER) telephone information program (Project 1: n =208; Project 2: n =340; Project 3: n =792). Self-reported use of the multimedia program was 51%, 52%, and 67% for Projects 1, 2, and 3, respectively. Self-reported use of the print materials (read all, most, or some) was 90%, 85%, and 83% for Projects 1, 2, and 3, respectively. The callback intervention was completed by 92% of Project 3 participants. Among those using the Cancer Information Service Research Consortium interventions, perceived usefulness and benefit was high, and more than 90% reported that they would recommend them to other cancer patients. The authors present 5 initial lessons learned that may help inform future cancer communications research.

  6. 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

  7. 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...

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

    International Nuclear Information System (INIS)

    Nasstrom, J.

    2003-01-01

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

  9. 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.

  10. 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

  11. Using Blended Teaching to Teach Blended Learning: Lessons Learned from Pre-Service Teachers in an Instructional Methods Course

    Science.gov (United States)

    Shand, Kristen; Farrelly, Susan Glassett

    2017-01-01

    In this study, we explore the design and delivery of a blended social studies teaching methods course to examine the elements of the blended design that pre-service teachers found most constructive. In focus groups at the completion of the course, pre-service teachers were asked to reflect on their experience in the blended course, identify the…

  12. A visualization and data-sharing tool for ecosystem service maps : Lessons learnt, challenges and the way forward

    NARCIS (Netherlands)

    Drakou, E. G.; Crossman, N.D.; Willemen, L.; Burkhard, B.; Palomo, I.; Maes, J.; Peedell, S.

    2015-01-01

    A plurality in methods, models, terminologies is used to assess, quantify, map and communicate ecosystem services (ES). The Thematic Working Groups on Mapping (TWG4) and Modeling ES (TWG5) of the Ecosystem Service Partnership (ESP), recent literature and expert workshops, have highlighted the need

  13. Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

    Science.gov (United States)

    Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

    2016-01-01

    This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

  14. Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre.

    Directory of Open Access Journals (Sweden)

    Deborah Kahan

    Full Text Available This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention.We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care.Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers.Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users.

  15. Learning from Our Own Lessons: Pre-Service Teachers' Narratives of Teaching as an Experiment

    Science.gov (United States)

    Wickstrom, Megan H.; Wilm, Stephanie; Mills, Emily; Johnson, Alexis; Leonard, Nicole; Larberg, Raegan

    2018-01-01

    Pre-service teachers need to develop habits of mind that allow them to grow as new teachers. This article describes an elementary mathematics methods course in which teaching as an experiment was used a framework for pre-service teachers to participate in action research by developing learning goals, observing and analyzing student thinking,…

  16. 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.

  17. 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)

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. Implementing US Department of Energy lessons learned programs. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    The DOE Lessons Learned Handbook is a two-volume publication developed to supplement the DOE Lessons Learned Standard (DOE-STD-7501-95) with information that will organizations in developing or improving their lessons learned programs. Volume 1 includes greater detail than the Standard in areas such as identification and documentation of lessons learned; it also contains sections on specific processes such as training and performance measurement. Volume 2 (this document) contains examples of program documents developed by existing lessons learned programs as well as communications material, functional categories, transmittal documents, sources of professional and industry lessons learned, and frequently asked questions about the Lessons Learned List Service.

  3. 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…

  4. 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.

  5. 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).

  6. 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.…

  7. 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...

  8. 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.

  9. Lessons from Early Medicaid Expansions Under Health Reform..

    Data.gov (United States)

    U.S. Department of Health & Human ServicesLessons from Early Medicaid Expansions Under Health Reform, Interviews with Medicaid Officials In a new study entitled Lessons from Early Medicaid Expansions Under...

  10. 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.

  11. Development and evaluation of SOA-based AAL services in real-life environments: a case study and lessons learned.

    Science.gov (United States)

    Stav, Erlend; Walderhaug, Ståle; Mikalsen, Marius; Hanke, Sten; Benc, Ivan

    2013-11-01

    The proper use of ICT services can support seniors in living independently longer. While such services are starting to emerge, current proprietary solutions are often expensive, covering only isolated parts of seniors' needs, and lack support for sharing information between services and between users. For developers, the challenge is that it is complex and time consuming to develop high quality, interoperable services, and new techniques are needed to simplify the development and reduce the development costs. This paper provides the complete view of the experiences gained in the MPOWER project with respect to using model-driven development (MDD) techniques for Service Oriented Architecture (SOA) system development in the Ambient Assisted Living (AAL) domain. To address this challenge, the approach of the European research project MPOWER (2006-2009) was to investigate and record the user needs, define a set of reusable software services based on these needs, and then implement pilot systems using these services. Further, a model-driven toolchain covering key development phases was developed to support software developers through this process. Evaluations were conducted both on the technical artefacts (methodology and tools), and on end user experience from using the pilot systems in trial sites. The outcome of the work on the user needs is a knowledge base recorded as a Unified Modeling Language (UML) model. This comprehensive model describes actors, use cases, and features derived from these. The model further includes the design of a set of software services, including full trace information back to the features and use cases motivating their design. Based on the model, the services were implemented for use in Service Oriented Architecture (SOA) systems, and are publicly available as open source software. The services were successfully used in the realization of two pilot applications. There is therefore a direct and traceable link from the user needs of the

  12. 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.

  13. 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

  14. 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

  15. Lessons Learned

    Directory of Open Access Journals (Sweden)

    Amanda Phelan BNS, MSc, PhD

    2015-03-01

    Full Text Available The public health nurses’ scope of practice explicitly includes child protection within their role, which places them in a prime position to identify child protection concerns. This role compliments that of other professions and voluntary agenices who work with children. Public health nurses are in a privileged position as they form a relationship with the child’s parent(s/guardian(s and are able to see the child in its own environment, which many professionals cannot. Child protection in Ireland, while influenced by other countries, has progressed through a distinct pathway that streamlined protocols and procedures. However, despite the above serious failures have occurred in the Irish system, and inquiries over the past 20 years persistently present similar contributing factors, namely, the lack of standardized and comprehensive service responses. Moreover, poor practice is compounded by the lack of recognition of the various interactional processes taking place within and between the different agencies of child protection, leading to psychological barriers in communication. This article will explore the lessons learned for public health nurses practice in safeguarding children in the Republic of Ireland.

  16. 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

  17. Facilitating and supporting HIV+ parenthood: Lessons for developing the advocate role of voluntary HIV support services workers.

    Science.gov (United States)

    Cane, Tam Pheona Chipawe

    2018-06-01

    Increasingly as people living with HIV (PLWHIV) aim to become parents, they engage with HIV voluntary services for support through either fertility or adoption services. Yet, little is known about the role of HIV support services workers in facilitating access to fertility treatment or child adoption. The purpose of this study was to explore the role of HIV support workers based in HIV voluntary organisations who have a key role helping PLWHIV in navigating relevant fertility and adoption processes. This was an exploratory qualitative study which involved interviewing six HIV support workers, from across the UK. Interviews were conducted using face to face interviews, recorded and transcribed. Findings revealed that HIV services support workers provide practical support in advocating service provision, and emotional and social support along the journey. They also face challenges in their role from health care professionals including information sharing and gatekeeping. The role of HIV support workers is important in facilitating access to resources and complex systems. HIV support workers should be recognised and as they are often a trusted professional to address stigma, discrimination and barriers to services. The study contributes to research seeking to understand the emerging needs and support requirements for people living with HIV seeking fertility and adoption. Further work in this area is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. 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.

  19. 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...

  20. 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

  1. Parenting and proximity to social services: Lessons from Los Angeles County in the community context of child neglect.

    Science.gov (United States)

    Maguire-Jack, Kathryn; Klein, Sacha

    2015-07-01

    Using a sample of 438 parents in Los Angeles County, CA, this study examines the role of proximity to social services in child neglect. In an extension of social disorganization theory, it seeks to understand the potential sources of support in neighborhoods for families. It uses ordinary least squares regression to examine driving distance from parents' residences to four types of services (child care, domestic violence, mental health/substance abuse, and poverty). The results show an association between proximity to mental health and substance abuse services and parents' self-reported neglectful behaviors. Additionally, higher levels of socioeconomic disadvantage (poverty, unemployment, and low education), having older children, respondents being male, and respondents being older parents are associated with higher levels of child neglect, while being white is associated with lower levels. Overall, the findings suggest a potentially protective role of geographic access to mental health and substance abuse services in child maltreatment. Additional research on the pathways through which proximity to services influences child neglect is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Understanding the Public Service Obligation in the Electricity Sector. Lessons for the Contracting Parties of the Energy Community Treaty

    Energy Technology Data Exchange (ETDEWEB)

    Karova, R. [Energy Community Secretariat, Vienna (Austria)

    2012-01-15

    The paper underlines that the EU energy acquis does not simply require the Contracting Parties to the Energy Community Treaty to liberalize their electricity markets, but it also provides for a 'safety net' to ensure the available of public services through the imposition of Public Service Obligations (PSO). Nevertheless, the paper points out that the present understanding of the PSOs in the Contracting Parties is not in compliance with the conditions provided byArtide 3 of the Electricity Directive. Therefore, it includes some policy recommendations and a proposal for introducing a duty of notification, which should be instructive for the Contracting Parties to improve their understanding of PSO in line with EU law, by thus effectively safeguarding the availability of public services in the electricity sector to their citizens without jeopardizing the effective electricity market liberalization.

  3. Contract for service to produce 50 tonnes sterifeed - lesson learned from semi-commercial scale test production

    International Nuclear Information System (INIS)

    Hassan Hamdani Mutaat; Mat Rasol Awang; Zainon Said; Irwan Md Arif; Alias K Sadeli

    2005-01-01

    A contract for service has been awarded to a local company to produce 50 tonnes Sterifeed in a period of 4 months commencing 3 September 2001. The production was for supplying enough feed for the testing of Sterifeed on cattle. Appointed contractor was required to manage the production, supply labours and provide transport for the full production operation of the plant. The production performance is discussed based on: the labour cost; supervision and control; and skill and training. This report discusses and evaluate the suitability of service for contract for the future commercial scale production. (Author)

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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…

  11. 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…

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. Increasing Culturally Diverse Meals in Head Start Using a Collaborative Approach: Lessons Learned for School Food Service Modifications

    Science.gov (United States)

    Hoffman, Jessica A.; Agrawal, Tara; Thompson, Douglas; Ferguson, Tyler; Grinder, AnnMarie; Carter, Sonia; Healey, Christine; Bhaumik, Urmi; Castaneda-Sceppa, Carmen

    2012-01-01

    Head Start's performance standards require that the nutrition programs "serve a variety of foods which consider cultural and ethnic preferences and which broaden the child's food experience" (Head Start Program Performance Standards and Other Regulations, 2006). In this study, food service modifications were made via a participatory…

  17. Lessons from native spruce forests in Alaska: managing Sitka spruce plantations worldwide to benefit biodiversity and ecosystem services

    Science.gov (United States)

    Robert L. Deal; Paul Hennon; Richard O' Hanlon; David D' Amore

    2014-01-01

    There is increasing interest worldwide in managing forests to maintain or improve biodiversity, enhance ecosystem services and assure long-term sustainability of forest resources. An important goal of forest management is to increase stand diversity, provide wildlife habitat and improve forest species diversity. We synthesize results from natural spruce forests in...

  18. A standards-based approach to quality improvement for HIV services at Zambia Defence Force facilities: results and lessons learned.

    Science.gov (United States)

    Kols, Adrienne; Kim, Young-Mi; Bazant, Eva; Necochea, Edgar; Banda, Joseph; Stender, Stacie

    2015-07-01

    The Zambia Defence Force adopted the Standards-Based Management and Recognition approach to improve the quality of the HIV-related services at its health facilities. This quality improvement intervention relies on comprehensive, detailed assessment tools to communicate and verify adherence to national standards of care, and to test and implement changes to improve performance. A quasi-experimental evaluation of the intervention was conducted at eight Zambia Defence Force primary health facilities (four facilities implemented the intervention and four did not). Data from three previous analyses are combined to assess the effect of Standards-Based Management and Recognition on three domains: facility readiness to provide services; observed provider performance during antiretroviral therapy (ART) and antenatal care consultations; and provider perceptions of the work environment. Facility readiness scores for ART improved on four of the eight standards at intervention sites, and one standard at comparison sites. Facility readiness scores for prevention of mother-to-child transmission (PMTCT) of HIV increased by 15 percentage points at intervention sites and 7 percentage points at comparison sites. Provider performance improved significantly at intervention sites for both ART services (from 58 to 84%; P improved at intervention sites and declined at comparison sites; differences in trends between study groups were significant for eight items. A standards-based approach to quality improvement proved effective in supporting healthcare managers and providers to deliver ART and PMTCT services in accordance with evidence-based standards in a health system suffering from staff shortages.

  19. Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International

    Science.gov (United States)

    Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

    2015-01-01

    In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the

  20. 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.

  1. 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.

  2. Improving the quality of health services organization structure by reengineering: circular design and clinical case impact in an academic medical center.

    Science.gov (United States)

    Lartin-Drake, J M; Curran, C; Gillis-Donovan, J; Kruger, N R; Ziegenfuss, J T; Ostrem, J; Zanotti, M

    1996-01-01

    Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.

  3. 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

  4. 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

  5. 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.…

  6. 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…

  7. 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...

  8. 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...

  9. 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...

  10. Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International

    OpenAIRE

    Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

    2015-01-01

    In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie ...

  11. Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

    Science.gov (United States)

    Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

    2016-01-01

    Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Laser Tracker Utilization Methodology in Measuring Truth Trajectories for INS Testing on 6 Degree of Freedom Table at the Marshall Space Flight Center's Contact Dynamics Simulation Laboratory with Lessons Learned

    Science.gov (United States)

    Leggett, Jared O.; Bryant, Thomas C.; Cowen, Charles T.; Clifton, Billy W.

    2018-01-01

    When performing Inertial Navigation System (INS) testing at the Marshall Space Flight Center's (MSFC) Contact Dynamics Simulation Laboratory (CDSL) early in 2017, a Leica Geosystems AT901 Laser Tracker system (LLT) measured the twist & sway trajectories as generated by the 6 Degree Of Freedom (6DOF) Table in the CDSL. These LLT measured trajectories were used in the INS software model validation effort. Several challenges were identified and overcome during the preparation for the INS testing, as well as numerous lessons learned. These challenges included determining the position and attitude of the LLT with respect to an INS-shared coordinate frame using surveyed monument locations in the CDSL and the accompanying mathematical transformation, accurately measuring the spatial relationship between the INS and a 6DOF tracking probe due to lack of INS visibility from the LLT location, obtaining the data from the LLT during a test, determining how to process the results for comparison with INS data in time and frequency domains, and using a sensitivity analysis of the results to verify the quality of the results. While many of these challenges were identified and overcome before or during testing, a significant lesson on test set-up was not learned until later in the data analysis process. It was found that a combination of trajectory-dependent gimbal locking and environmental noise introduced non-negligible noise in the angular measurements of the LLT that spanned the evaluated frequency spectrum. The lessons learned in this experiment may be useful for others performing INS testing in similar testing facilities.

  17. Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International.

    Science.gov (United States)

    Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

    2015-06-17

    In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014-up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI's 17 and PSI's 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations' operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential

  18. What Internet services would patients like from hospitals during an epidemic? Lessons from the SARS outbreak in Toronto.

    Science.gov (United States)

    Rizo, Carlos A; Lupea, Doina; Baybourdy, Homayoun; Anderson, Matthew; Closson, Tom; Jadad, Alejandro R

    2005-08-03

    International health organizations and officials are bracing for a pandemic. Although the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto did not reach such a level, it created a unique opportunity to identify the optimal use of the Internet to promote communication with the public and to preserve health services during an epidemic. The aim of the study was to explore patients' attitudes regarding the health services that might be provided through the Internet to supplement those traditionally available in the event of a future mass emergency situation. We conducted "mask-to-mask" surveys of patients at three major teaching hospitals in Toronto during the second outbreak of SARS. Patients were surveyed at the hospital entrances and selected clinics. Descriptive statistics and logistic regression models were used for the analysis. In total, 1019 of 1130 patients responded to the survey (90% overall response rate). With respect to Internet use, 70% (711/1019) used the Internet by themselves and 57% (578/1019) with the help of a friend or family member. Of the Internet users, 68% (485/711) had already searched the World Wide Web for health information, and 75% (533/711) were interested in communicating with health professionals using the Internet as part of their ongoing care. Internet users expressed interest in using the Web for the following reasons: to learn about their health condition through patient education materials (84%), to obtain information about the status of their clinic appointments (83%), to send feedback to the hospital about how to improve its services (77%), to access screening tools to help determine if they were potentially affected by the infectious agent responsible for the outbreak (77%), to renew prescriptions (75%), to consult with their health professional about nonurgent matters (75%), and to access laboratory test results (75%). Regression results showed that younger age, higher education, and English as a first

  19. 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.

  20. 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...

  1. 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...

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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

  8. The lessons drawn from accident simulation, consequences for the operation of the Crisis Technical Center of the Nuclear Safety and Protection Institut

    International Nuclear Information System (INIS)

    Manesse, D.; Ney, J.; Crabol, B.; Ginot, P.

    1989-07-01

    The aim of the work is to summarize the lessons drawn from planning and performing the nuclear accident simulation exercises. The analysis is focused on the simulation and foresight of the radiation effects. The simulation exercises allowed a progressive improvement of the technical survey organization, leading to an improvement of its availability to the authorities. The subjects which need to be taken into account are those related to the intervention actions, in order to obtain realistic situations, the actions related to public organizations, people and communication networks [fr

  9. Technical Challenges and Lessons from the Migration of the GLOBE Data and Information System to Utilize Cloud Computing Service

    Science.gov (United States)

    Moses, J. F.; Memarsadeghi, N.; Overoye, D.; Littlefield, B.

    2016-12-01

    The Global Learning and Observation to Benefit the Environment (GLOBE) Data and Information System supports an international science and education program with capabilities to accept local environment observations, archive, display and visualize them along with global satellite observations. Since its inception twenty years ago, the Web and database system has been upgraded periodically to accommodate the changes in technology and the steady growth of GLOBE's education community and collection of observations. Recently, near the end-of-life of the system hardware, new commercial computer platform options were explored and a decision made to utilize Cloud services. Now the GLOBE DIS has been fully deployed and maintained using Amazon Cloud services for over two years now. This paper reviews the early risks, actual challenges, and some unexpected findings as a result of the GLOBE DIS migration. We describe the plans, cost drivers and estimates, highlight adjustments that were made and suggest improvements. We present the trade studies for provisioning, for load balancing, networks, processing , storage, as well as production, staging and backup systems. We outline the migration team's skills and required level of effort for transition, and resulting changes in the overall maintenance and operations activities. Examples include incremental adjustments to processing capacity and frequency of backups, and efforts previously expended on hardware maintenance that were refocused onto application-specific enhancements.

  10. In Madagascar, Use Of Health Care Services Increased When Fees Were Removed: Lessons For Universal Health Coverage.

    Science.gov (United States)

    Garchitorena, Andres; Miller, Ann C; Cordier, Laura F; Ramananjato, Ranto; Rabeza, Victor R; Murray, Megan; Cripps, Amber; Hall, Laura; Farmer, Paul; Rich, Michael; Orlan, Arthur Velo; Rabemampionona, Alexandre; Rakotozafy, Germain; Randriantsimaniry, Damoela; Gikic, Djordje; Bonds, Matthew H

    2017-08-01

    Despite overwhelming burdens of disease, health care access in most developing countries is extremely low. As governments work toward achieving universal health coverage, evidence on appropriate interventions to expand access in rural populations is critical for informing policies. Using a combination of population and health system data, we evaluated the impact of two pilot fee exemption interventions in a rural area of Madagascar. We found that fewer than one-third of people in need of health care accessed treatment when point-of-service fees were in place. However, when fee exemptions were introduced for targeted medicines and services, the use of health care increased by 65 percent for all patients, 52 percent for children under age five, and over 25 percent for maternity consultations. These effects were sustained at an average direct cost of US$0.60 per patient. The pilot interventions can become a key element of universal health care in Madagascar with the support of external donors. Project HOPE—The People-to-People Health Foundation, Inc.

  11. The importance of understanding epidemiology in order to inform financial decisions: a lesson from the Scottish Home Oxygen Service.

    Science.gov (United States)

    Wood, R; Grant, I; Bain, M

    2012-11-01

    To ensure that decisions on the future planning of the Scottish Home Oxygen Service reflect population needs by examining the epidemiology of the main conditions that require home oxygen therapy and trends in their management. Analysis of routinely available vital event and health service data supplemented by published literature. Use of linked data to provide person-based analyses. Consideration of trends in key risk factors, disease incidence, prevalence and mortality for chronic neonatal lung disease, cystic fibrosis, chronic interstitial lung disease in adults and chronic obstructive pulmonary disease. Examination of trends in management of these conditions including hospital admissions, length of stay and re-admissions. The prevalence of all the conditions studied has increased in Scotland over recent years due to a combination of increased incidence, increased survival, more active case finding and demographic changes. There have been changes in management with trends towards shorter hospital stays. The clinical need for home oxygen therapy is likely to continue to increase over the next 10-20 years. It will encompass all age groups and a complex range of conditions. Public health needs to be proactive in providing relevant needs assessment information to ensure that planning within financial constraints is appropriately informed on population needs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  12. Technical Challenges and Lessons from the Migration of the GLOBE Data and Information System to Utilize Cloud Computing Service

    Science.gov (United States)

    Moses, John F.; Memarsadeghi, Nargess; Overoye, David; Littlefield, Brain

    2017-01-01

    The Global Learning and Observation to Benefit the Environment (GLOBE) Data and Information System supports an international science and education program with capabilities to accept local environment observations, archive, display and visualize them along with global satellite observations. Since its inception twenty years ago, the Web and database system has been upgraded periodically to accommodate the changes in technology and the steady growth of GLOBEs education community and collection of observations. Recently, near the end-of-life of the system hardware, new commercial computer platform options were explored and a decision made to utilize Cloud services. Now the GLOBE DIS has been fully deployed and maintained using Amazon Cloud services for over two years now. This paper reviews the early risks, actual challenges, and some unexpected findings as a result of the GLOBE DIS migration. We describe the plans, cost drivers and estimates, highlight adjustments that were made and suggest improvements. We present the trade studies for provisioning, for load balancing, networks, processing, storage, as well as production, staging and backup systems. We outline the migration teams skills and required level of effort for transition, and resulting changes in the overall maintenance and operations activities. Examples include incremental adjustments to processing capacity and frequency of backups, and efforts previously expended on hardware maintenance that were refocused onto application-specific enhancements.

  13. 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.

  14. 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.

  15. 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/

  16. Placing Human Behavior at the Center of the Fight to Eradicate Polio: Lessons Learned and Their Application to Other Life-Saving Interventions.

    Science.gov (United States)

    Guirguis, Sherine; Obregon, Rafael; Coleman, Michael; Hickler, Benjamin; SteelFisher, Gillian

    2017-07-01

    Today, acceptance of oral polio vaccine is the highest ever. Reaching this level of acceptance has depended on decades of engaging with communities, building trust amid extraordinary social contexts, and responding to the complex variables that trigger behavioral and social change. Drawing on both the successes and setbacks in the 28 years of the Global Polio Eradication Initiative (GPEI), this article articulates what happened when the GPEI began to pay more attention to the dynamics of human and social behavior change. Three particular lessons for other health and immunization programs can be drawn from the experience of GPEI: change begins from within (ie, success needs institutional recognition of the importance of human behavior), good data are not enough for good decision-making, and health workers are important agents of behavior change. These lessons should be harnessed and put into practice to build demand and trust for the last stages of polio eradication, as well as for other life-saving health interventions. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  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. What is the perceived impact of Alexander technique lessons on health status, costs and pain management in the real life setting of an English hospital? The results of a mixed methods evaluation of an Alexander technique service for those with chronic back pain.

    Science.gov (United States)

    McClean, Stuart; Brilleman, Sam; Wye, Lesley

    2015-07-28

    Randomised controlled trial evidence indicates that Alexander Technique is clinically and cost effective for chronic back pain. The aim of this mixed methods evaluation was to explore the role and perceived impact of Alexander Technique lessons in the naturalistic setting of an acute hospital Pain Management Clinic in England. To capture changes in health status and resource use amongst service users, 43 service users were administered three widely used questionnaires (Brief Pain Inventory, MYMOP and Client Service Resource Inventory) at three time points: baseline, six weeks and three months after baseline. We also carried out 27 telephone interviews with service users and seven face-to-face interviews with pain clinic staff and Alexander Technique teachers. Quantitative data were analysed using descriptive statistics and qualitative data were analysed thematically. Those taking Alexander Technique lessons reported small improvements in health outcomes, and condition-related costs fell. However, due to the non-randomised, uncontrolled nature of the study design, changes cannot be attributed to the Alexander Technique lessons. Service users stated that their relationship to pain and pain management had changed, especially those who were more committed to practising the techniques regularly. These changes may explain the reported reduction in pain-related service use and the corresponding lower associated costs. Alexander Technique lessons may be used as another approach to pain management. The findings suggests that Alexander Technique lessons can help improve self-efficacy for those who are sufficiently motivated, which in turn may have an impact on service utilisation levels.

  1. The Use of Lesson Study Combined with Content Representation in the Planning of Physics Lessons During Field Practice to Develop Pedagogical Content Knowledge

    Science.gov (United States)

    Juhler, Martin Vogt

    2016-08-01

    Recent research, both internationally and in Norway, has clearly expressed concerns about missing connections between subject-matter knowledge, pedagogical competence and real-life practice in schools. This study addresses this problem within the domain of field practice in teacher education, studying pre-service teachers' planning of a Physics lesson. Two means of intervention were introduced. The first was lesson study, which is a method for planning, carrying out and reflecting on a research lesson in detail with a learner and content-centered focus. This was used in combination with a second means, content representations, which is a systematic tool that connects overall teaching aims with pedagogical prompts. Changes in teaching were assessed through the construct of pedagogical content knowledge (PCK). A deductive coding analysis was carried out for this purpose. Transcripts of pre-service teachers' planning of a Physics lesson were coded into four main PCK categories, which were thereafter divided into 16 PCK sub-categories. The results showed that the intervention affected the pre-service teachers' potential to start developing PCK. First, they focused much more on categories concerning the learners. Second, they focused far more uniformly in all of the four main categories comprising PCK. Consequently, these differences could affect their potential to start developing PCK.

  2. 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

  3. 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…

  4. 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.

  5. 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

  6. 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

  7. Lessons Learned in Pilot Testing Specialty Consultations to Benefit Individuals with Lower Limb Loss

    Directory of Open Access Journals (Sweden)

    Christine Elnitsky

    2012-12-01

    Full Text Available Telerehabilitation technologies enable the delivery of rehabilitation services from providers to people with disabilities as well as specialty care consultations. This article discusses the barriers experienced when planning and pilot testing a telerehabilitation multi-site specialty consultation for specialists in their medical centers, and the lessons learned. The barriers included integration and participation, coordination across organizational units, and privacy and information security. Lessons learned included the need for collaboration across multiple departments, telerehabilitation equipment back-ups, and anonymous and private communication protocols. Despite delays resulting from coordination at multiple levels of a national organization, we developed a program plan and successfully implemented a pilot test of the southeast region program.  Specialty consultation using telerehabilitation delivery methods requires identifying provider preferences for technological features. Lessons learned could inform development of outpatient telerehabilitation for patients with amputations and studies of patients and providers involved in telerehabilitation.

  8. 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.

  9. The art and science of data curation: Lessons learned from constructing a virtual collection

    Science.gov (United States)

    Bugbee, Kaylin; Ramachandran, Rahul; Maskey, Manil; Gatlin, Patrick

    2018-03-01

    A digital, or virtual, collection is a value added service developed by libraries that curates information and resources around a topic, theme or organization. Adoption of the virtual collection concept as an Earth science data service improves the discoverability, accessibility and usability of data both within individual data centers but also across data centers and disciplines. In this paper, we introduce a methodology for systematically and rigorously curating Earth science data and information into a cohesive virtual collection. This methodology builds on the geocuration model of searching, selecting and synthesizing Earth science data, metadata and other information into a single and useful collection. We present our experiences curating a virtual collection for one of NASA's twelve Distributed Active Archive Centers (DAACs), the Global Hydrology Resource Center (GHRC), and describe lessons learned as a result of this curation effort. We also provide recommendations and best practices for data centers and data providers who wish to curate virtual collections for the Earth sciences.

  10. Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer: lessons from the experience of a high-volume center.

    LENUS (Irish Health Repository)

    Reynolds, John V

    2012-05-01

    Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed.

  11. [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.

  12. 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.

  13. Enabling the Use of Authentic Scientific Data in the Classroom--Lessons Learned from the AccessData and Data Services Workshops

    Science.gov (United States)

    Lynds, S. E.; Buhr, S. M.; Ledley, T. S.

    2007-12-01

    Enabling the Use of Authentic Scientific Data in the Classroom--Lessons Learned from the AccessData and Data Services Workshops Since 2004, the annual AccessData and DLESE Data Services workshops have gathered scientists, data managers, technology specialists, teachers, and curriculum developers to work together creating classroom- ready scientific data modules. Teams of five (one participant from each of the five professions) develop topic- specific online educational units of the Earth Exploration Toolbook (serc.carleton.edu/eet/). Educators from middle schools through undergraduate colleges have been represented, as have scientific data professionals from many organizations across the United States. Extensive evaluation has been included in the design of each workshop. The evaluation results have been used each year to improve subsequent workshops. In addition to refining the format and process of the workshop itself, evaluation data collected reveal attendees' experiences using scientific data for educational purposes. Workshop attendees greatly value the opportunity to network with those of other professional roles in developing a real-world education project using scientific data. Educators appreciate the opportunity to work directly with scientists and technology specialists, while researchers and those in technical fields value the classroom expertise of the educators. Attendees' data use experiences are explored every year. Although bandwidth and connectivity were problems for data use in 2004, that has become much less common over time. The most common barriers to data use cited now are discoverability, data format problems, incomplete data sets, and poor documentation. Most attendees agree that the most useful types of online documentation and user support for scientific data are step-by-step instructions, examples, tutorials, and reference manuals. Satellite imagery and weather data were the most commonly used types of data, and these were often

  14. [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.

  15. 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.

  16. Health communication: lessons from research.

    Science.gov (United States)

    Shanmugam, A V

    1981-01-01

    In discussing the lessons learned from research in the area of health communication, focus is on basic strategic issues; the scope of health communications in terms of audience, information, education and motivation approaces and India's satellite Instructional Television Experiment (SITE). Health communication is the process by which a health idea is transferred from a source, such as a primary health center, to a receiver, community, with the intention of changing the community's behavior. This involves the formulation of specific strategies for the conduct of health and family welfare communication. In the processs of health communication, it has been a common practice in India as well as in other developing countries to depend upon a plethora of communication media. Yet, despite maximum utilization of the mass media and interpersonal channels of communication, questions remain about the efficacy of the system in bringing about change. Thus, the need to draw upon lessons from research becomes obvious. Communication effectiveness researches have concentrated on 3 basic strategic issues: the question of physical reception of messages by the audience; interpretation or understanding of messages on the part of the audience in accordance with the intention of the communicator; and effectiveness of communication on the cognitive, affective and behavioral dimensions of the audience. Innumberable researches in communication have provided several lessons which have expanded the scope of health communication. This expansion can be observed in terms of audiences reached, information disseminated, education undertaken, and motivation provided. Research has identified several distinct groups to whom specific health messages have to be addressed. These include government and political elites, health and family welfare program administrators, and the medical profession and clinical staff. Information on health needs to include both the concept of health and the pertinent ideas

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. Children of War. [Lesson Plan].

    Science.gov (United States)

    Discovery Communications, Inc., Bethesda, MD.

    This lesson plan presents activities in which students read, analyze, and discuss excerpts from children's war diaries; and create a storyboard for a public service announcement on children's rights in wartime. It includes objectives, materials, procedures, extension activities, excerpts of children's war diaries, suggested readings, and web…

  2. 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

  3. Moving beyond the Reflectivity of Post-Lesson Mentoring Conferences in Teacher Education and Creating Learning/development Opportunities for Pre-Service Teachers

    Science.gov (United States)

    Ciavaldini-Cartaut, Solange

    2015-01-01

    This longitudinal case study suggests ways to move beyond the reflective process usually associated with post-lesson mentoring conferences by describing the modalities likely to generate real learning/development opportunities. Based on cultural-historical activity theories (CHAT) and using methodologies from sociodiscursive interactionism, this…

  4. 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.

  5. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    Science.gov (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. Forensic Archaeological Recovery of a Large-Scale Mass Disaster Scene: Lessons Learned from Two Complex Recovery Operations at the World Trade Center Site.

    Science.gov (United States)

    Warnasch, Scott C

    2016-05-01

    In 2006, unexpected discoveries of buried World Trade Center (WTC) debris and human remains were made at the World Trade Center mass disaster site. New York City's Office of Chief Medical Examiner (OCME) was given the task of systematically searching the site for any remaining victims' remains. The subsequent OCME assessment and archaeological excavation conducted from 2006 until 2013, resulted in the recovery of over 1,900 victims' remains. In addition, this operation demonstrated the essential skills archaeologists can provide in a mass disaster recovery operation. The OCME excavation data illustrates some of the challenges encountered during the original recovery effort of 2001/2002. It suggests that when understood within the larger site recovery context, certain fundamental components of the original recovery effort, such as operational priorities and activities in effect during the original recovery, directly or indirectly resulted in unsearched deposits that contained human remains. © 2016 American Academy of Forensic Sciences.

  11. 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.

  12. 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)

  13. 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.

  14. 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

  15. 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).

  16. 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.

  17. 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…

  18. 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.

  19. Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

    Science.gov (United States)

    Santamaria, Eric; de la Concha, Erika

    2016-10-01

    Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Blueprint for Sustainable Change in Diversity Management and Cultural Competence: Lessons From the National Center for Healthcare Leadership Diversity Demonstration Project.

    Science.gov (United States)

    Dreachslin, Janice L; Weech-Maldonado, Robert; Gail, Judith; Epané, Josué Patien; Wainio, Joyce Anne

    How can healthcare leaders build a sustainable infrastructure to leverage workforce diversity and deliver culturally and linguistically appropriate care to patients? To answer that question, two health systems participated in the National Center for Healthcare Leadership's diversity leadership demonstration project, November 2008 to December 2013. Each system provided one intervention hospital and one control hospital.The control hospital in each system participated in pre- and postassessments but received no preassessment feedback and no intervention support. Each intervention hospital's C-suite leadership and demonstration project manager worked with a diversity coach provided by the National Center for Healthcare Leadership to design and implement an action plan to improve diversity and cultural competence practices and build a sustainable infrastructure. Plans explored areas of strength and areas for improvement that were identified through preintervention assessments. The assessments focused on five competencies of strategic diversity management and culturally and linguistically appropriate care: diversity leadership, strategic human resource management, organizational climate, diversity climate, and patient cultural competence.This article describes each intervention hospital's success in action plan implementation and reports results of postintervention interviews with leadership to provide a blueprint for sustainable change.