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

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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.

Integration of leprosy services into the General Health Service in Sri Lanka: overcoming challenges to implementation in a remote district.

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Wijesinghe, Thushanthi S; Wijesinghe, Pushpa Ranjan

2013-01-01

Sri Lanka took a policy decision to integrate leprosy services into the general health services (GHS) in 1999. This paper aims to summarize the emergence of new, specific challenges and how they were overcome during the integration of leprosy services to the GHS in a remote, leprosy endemic district in Sri Lanka. In this article, the regional epidemiologist as the team leader describes the principles used for transition to an effective integrated model of leprosy services from a centralized leprosy control model in the district. In addition, rationale for integration is viewed from the epidemiological and operational perspectives. National and district leprosy epidemiological data from secondary sources are also reviewed for corroborating the effectiveness of integration. Challenges surfaced were mainly related to the transfer of ownership of the programme, selection of appropriate service providing institutions easily accessible to clients, sustainability of leprosy services at the GHS, ensuring participation of all stakeholders in capacity building programmes and co-ordination of patient care in the absence of a dermatologist in the district. An empowered district team leader with specified roles and responsibilities, his sound technical and managerial know how and ability to translate 'team work' concept to practice were found to be essential for successful implementation of integration. Decision-making powers at the district level and flexibility to introduce new, area-specific changes to the centrally prepared core activities of integration were also vital to overcome locally surfaced challenges.

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

Impact of a program of diagnostic imaging quality control in mammography centers of the Federal District, Brazil

Energy Technology Data Exchange (ETDEWEB)

Correa, Rosangela da Silveira; Ferreira, Rubemar de Souza [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN/CNEN-CO), Abadia de Goias, GO (Brazil)]. E-mail: rcorrea@cnen.gov.br; Peixoto, Joao Emilio [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Silver, Lynn Dee [New York Health Department, New York, NY (United States); Dias, Cintia Melazo [Comissao Nacional de Energia Nuclear (Diplan/CNEN), Braslia, DF (Brazil). Distrito do Planalto Central; Nogueira, Maria do Socorro [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Hwang, Suy Ferreira [Centro Regional de Ciencias Nucleares do Nordeste (CRCN/CNEN-NE), Recife, PE (Brazil)

2008-03-15

Objective: The present study was aimed at evaluating the quality and the impact of an intervention involving inspection and education in mammography centers of the Federal District, Brazil. Materials and methods: Forty one mammography centers in the Federal District were studied in the period between 2000 and 2002. The intervention involved an initial inspection followed by a training activity and notification of mammography centers by the Federal District Sanitary Vigilance authority. The imaging quality was compared before and after the intervention. Results: None of the 36 centers which completed the study reached more than 90% compliance with the standard imaging quality prior to the interventions, whereas ten were above 90% afterwards. Major improvements were observed in chassis maintenance, breast compression and visualization of microcalcifications. Conclusion: Despite the availability of a great number of mammography centers in the Federal District, most of them did not meet the required quality standards. The intervention has shown to be effective for improving the imaging quality, however a continued action is required to solve the remaining problems and increase the impact of the program. (author)

Cluster analysis of medical service resources at district hospitals in Taiwan, 2007-2011.

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Tseng, Shu-Fang; Lee, Tian-Shyug; Deng, Chung-Yeh

2015-12-01

A vast amount of the annual/national budget has been spent on the National Health Insurance program in Taiwan. However, the market for district hospitals has become increasingly competitive, and district hospitals are under pressure to optimize the use of health service resources. Therefore, we employed a clustering method to explore variations in input and output service volumes, and investigate resource allocation and health care service efficiency in district hospitals. Descriptive and cluster analyses were conducted to examine the district hospitals included in the Ministry of Health and Welfare database during 2007-2011. The results, according to the types of hospital ownership, suggested that the number of public hospitals has decreased and that of private hospitals increased; the largest increase in the number of district hospitals occurred when Taichung City was merged into Taichung County. The descriptive statistics from 2007 to 2011 indicated that 43% and 36.4% of the hospitals had 501-800 occupied beds and 101-200 physicians, respectively, and > 401 medical staff members. However, the number of outpatients and discharged patients exceeded 6001 and 90,001, respectively. In addition, the highest percentage of hospitals (43.9%) had 30,001-60,000 emergency department patients. In 2010, the number of patients varied widely, and the analysis of variance cluster results were nonsignificant (p > 0.05). District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency. Copyright © 2015. Published by Elsevier Taiwan.

Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

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Heywood, Peter; Harahap, Nida P

2009-04-16

During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been

Understanding the organisational culture of district health services: Mahalapye and Ngamiland health districts of Botswana.

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Nkomazana, Oathokwa; Mash, Robert; Phaladze, Nthabiseng

2015-11-30

Botswana has a shortage of health care workers, especially in primary healthcare. Retention and high performance of employees are closely linked to job satisfaction and motivation, which are both highest where employees' personal values and goals are realised. The aim of the study was to evaluate employees' personal values, and the current and desired organisational culture of the district health services as experienced by the primary health care workers. The study was conducted in the Ngamiland and Mahalapye health districts. This was a cross sectional survey. The participants were asked to select 10 values that best described their personal, current organisational and desired organisational values from a predetermined list. Sixty and 67 health care workers completed the survey in Mahalapye and Ngamiland districts, respectively. The top 10 prevalent organisational values experienced in both districts were: teamwork, patient satisfaction, blame, confusion, job insecurity, not sharing information and manipulation. When all the current values were assessed, 32% (Mahalapye) and 36% (Ngamiland) selected by health care workers were potentially limiting organisational effectiveness. The organisational values desired by health care workers in both districts were: transparency, professional growth, staff recognition, shared decision-making, accountability, productivity, leadership development and teamwork. The experience of the primary health care workers in the two health districts were overwhelmingly negative, which is likely to contribute to low levels of motivation, job satisfaction, productivity and high attrition rates. There is therefore urgent need for organisational transformation with a focus on staff experience and leadership development.

Convergence of PPTCT with RCH Services in a District Hospital, Haryana

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Puneet Bhagat

2014-03-01

Full Text Available Background: The integration of PPTCT and RCH activities is an important strategy for universal screening of ANC mothers through available government health infrastructure in a district. The objective of this study was to understand process and analyzing outcome of convergence of PPTCT & RCH services in a District Hospital. Methods: The study was a descriptive study conducted in district hospital, Gurgaon. Results: In the district hospital Gurgaon percentage of women counseled at ICTC has increased from 77% to 89.4% and percentage of women tested has increased from 75% to 87.8% during 2010 and 2011. However, not all women tested positive delivered at hospital. Only 6.7% women were knowing about transmission of HIV from mother to baby. About 60% ANC registration are delayed primarily due to lack of family support (71%. Majority of ANC women got HIV screening at district hospital due to non-availability of facility at CHC/PHC levels. About 58% of Institutional deliveries in the State are in private hospitals, but they still need to be involved in PPTCT. Conclusion: Currently, convergence of PPTCT and RCH services seems to be fragmented and at initial stage. Convergence need to be taken up at policy, planning, implementation, capacity building, resource mobilization and monitoring for success of the initiative in the state.

Convergence of PPTCT with RCH Services in a District Hospital, Haryana

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Puneet Bhagat

2014-03-01

Full Text Available Background: The integration of PPTCT and RCH activities is an important strategy for universal screening of ANC mothers through available government health infrastructure in a district. The objective of this study was to understand process and analyzing outcome of convergence of PPTCT & RCH services in a District Hospital. Methods: The study was a descriptive study conducted in district hospital, Gurgaon. Results: In the district hospital Gurgaon percentage of women counseled at ICTC has increased from 77% to 89.4% and percentage of women tested has increased from 75% to 87.8% during 2010 and 2011. However, not all women tested positive delivered at hospital. Only 6.7% women were knowing about transmission of HIV from mother to baby. About 60% ANC registration are delayed primarily due to lack of family support (71%. Majority of ANC women got HIV screening at district hospital due to non-availability of facility at CHC/PHC levels. About 58% of Institutional deliveries in the State are in private hospitals, but they still need to be involved in PPTCT. Conclusion: Currently, convergence of PPTCT and RCH services seems to be fragmented and at initial stage. Convergence need to be taken up at policy, planning, implementation, capacity building, resource mobilization and monitoring for success of the initiative in the state.

Understanding the organisational culture of district health services: Mahalapye and Ngamiland health districts of Botswana

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Oathokwa Nkomazana

2015-11-01

Full Text Available Background: Botswana has a shortage of health care workers, especially in primary healthcare. Retention and high performance of employees are closely linked to job satisfaction and motivation, which are both highest where employees’ personal values and goals are realised. Aim: The aim of the study was to evaluate employees’ personal values, and the current and desired organisational culture of the district health services as experienced by the primary health care workers. Setting: The study was conducted in the Ngamiland and Mahalapye health districts. Method: This was a cross sectional survey. The participants were asked to select 10 values that best described their personal, current organisational and desired organisational values from a predetermined list. Results: Sixty and 67 health care workers completed the survey in Mahalapye and Ngamiland districts, respectively. The top 10 prevalent organisational values experienced in both districts were: teamwork, patient satisfaction, blame, confusion, job insecurity, not sharing information and manipulation. When all the current values were assessed, 32% (Mahalapye and 36% (Ngamiland selected by health care workers were potentially limiting organisational effectiveness. The organisational values desired by health care workers in both districts were: transparency, professional growth, staff recognition, shared decision-making, accountability, productivity, leadership development and teamwork. Conclusions: The experience of the primary health care workers in the two health districts were overwhelmingly negative, which is likely to contribute to low levels of motivation, job satisfaction, productivity and high attrition rates. There is therefore urgent need for organisational transformation with a focus on staff experience and leadership development.

District heating service connections. Technical recommendations. 4. ed. Hausanschluesse an Fernwaermenetze. Technische Richtlinien

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

The fourth edition of the 'Technical regulations - district heating service connections' constitutes a completely revised version answering to the considerable developments and changes the house service sector experienced between 1975 and 1985. Analyses and practical experiences have proved to show that precision thermostats which, depending on the mode of lines and layout of the service system allow to spare central temperature control systems, still have a decisive influence on the design of district heating service stations. The revised chapter on steam line service connections focuses on problems concerning the metering of condensates and the connection of secondary water heating networks to steam lines. The reader finds an updated selection of diagrams as well as a revised appendix listing the AGFW codes of practice and recommendations, relevant DIN standards and relevant VDE/VDI recommendations.

Birthing Centers and Hospital Maternity Services

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... 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 ...

DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

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Max Joseph Herman

2009-12-01

Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

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...

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)

Community Based Social Audit of Health Services in Two Districts of ...

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

Community Based Social Audit of Health Services in Two Districts of ... The health system in Afghanistan has been chronically neglected during decades of war ... Organization for Women in Science for the Developing World (OWSD), IDRC is ...

Cost of delivering secondary-level health care services through public sector district hospitals in India

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Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Client-Centered Employee Assistance Services.

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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…

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

Tried & Tested. Ideas from Teacher Centers in the Southeast.

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Bohstedt, Jinx, Ed.; Eisenmann-Donahue, Pat, Ed.

Throughout the southeastern United States, teacher centers share much in common. The conceptual framework of teachers helping teachers inspires the development of resources and services which are similar whether the center serves a large district or only a few schools. Although the teacher centers share similar philosophies, concerns, successes,…

"Cedar Rapids Community School District v. Garret F.": School Districts Must Pay for Nursing Services under the IDEA.

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Russo, Charles J.

1999-01-01

In "Cedar Rapids Community School District v. Garrett F." (1999), the U.S. Supreme Court decided that continuous nursing constitutes a "related service" under the Individuals with Disabilities Education Act. The case involved a 16-year-old who has been paralyzed since early childhood. Cost per student could be $20,000 to…

Local business models for district heat production; Kaukolaemmoen paikalliset liiketoimintamallit

Energy Technology Data Exchange (ETDEWEB)

Hakala, L.; Pesola, A.; Vanhanen, J.

2012-12-15

Local district heating business, outside large urban centers, is a profitable business in Finland, which can be practiced with several different business models. In addition to the traditional, local district heating business, local district heat production can be also based on franchising business model, on integrated service model or on different types of cooperation models, either between a local district heat producer and industrial site providing surplus heat or between a local district heat producer and a larger district heating company. Locally available wood energy is currently utilized effectively in the traditional district heating business model, in which a local entrepreneur produces heat to consumers in the local area. The franchising model is a more advanced version of the traditional district heating entrepreneurship. In this model, franchisor funds part of the investments, as well as offers centralized maintenance and fuel supply, for example. In the integrated service model, the local district heat producer offers also energy efficiency services and other value-added services, which are based on either the local district heat suppliers or his partner's expertise. In the cooperation model with industrial site, the local district heating business is based on the utilization of the surplus heat from the industrial site. In some cases, profitable operating model approach may be a district heating company outsourcing operations of one or more heating plants to a local entrepreneur. It can be concluded that all business models for district heat production (traditional district heat business model, franchising, integrated service model, cooperative model) discussed in this report can be profitable in Finnish conditions, as well for the local heat producer as for the municipality - and, above all, they produce cost-competitive heat for the end-user. All the models were seen as viable and interesting and having possibilities for expansion Finland

School District (K-12) Pandemic Influenza Planning Checklist

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Centers for Disease Control and Prevention, 2009

2009-01-01

Local educational agencies (LEAs) play an integral role in protecting the health and safety of their district's staff, students and their families. The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed this checklist to assist LEAs in developing and/or improving plans to prepare…

Evaluation Report, District 24, Queens. Title I District Umbrella and Title I Open Enrollment Educational Services for Disadvantaged Pupils.

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New York Univ., NY. Center for Field Research and School Services.

During the 1971-1972 school year, the regular educational programs in District 24 were supplemented with special educational services funded under Title I of the 1965 Elementary and Secondary Education Act. This evaluation report treats the several programs funded under the following headings: Pre-Kindergarten Program, Strengthened Early Childhood…

Accounting Manual for Educational Service Districts in the State of Washington

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Lunghofer, Daniel S.

2010-01-01

This manual provides principles that are an integral part of the accounting requirements for educational service districts (ESDs) in the state of Washington. They are in conformance with generally accepted accounting principles, except where referenced in the ESD principles that follow. This manual provides guidance on the following topics:(1)…

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

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Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

2014-10-31

This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

ECONOMIC CONDITIONS AND PROSPECTS OF DEVELOPMENT OF THE MARKET OF RESORT AND RECREATIONAL SERVICES OF THE SOUTHERN FDERAL DISTRICT

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Oborin M. S.

2015-03-01

Full Text Available In article features of natural and medical potential, social and economic development of the Southern Federal District which are the main for development of medical and improving tourism are considered. The district borrows favorable natural and the economical geographical position influencing development of sanatorium activity. Positive dynamics of development of the market of sanatorium services of the Southern Federal District is based on the rich natural and medical capacity of the district, historical and social and economic features of development of this kind of activity in this region. Social and economic resources form possibility of development of the market of medical and improving and recreational services as such indicators of the population as mortality, birth rate and a natural increase, indicators of incidence of the population, its income and expenses have direct impact on formation of demand of the population on sanatorium services.

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

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

2009-06-01

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

Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

Directory of Open Access Journals (Sweden)

Kathryn Schnippel

Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

Demographic Differences in District-Level Policies Related to School Mental Health and Social Services--United States, 2012

Science.gov (United States)

Demissie, Zewditu; Brener, Nancy

2017-01-01

Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…

Clean Energy Application Centers: Annual Metrics Report for Fiscal Year 2012

Energy Technology Data Exchange (ETDEWEB)

Schweitzer, Martin [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2014-02-01

Between fiscal year (FY) 2010 and 2013, the U.S. Department of Energy (DOE) funded nine Clean Energy Application Centers (CEACs) with national coverage to promote and assist in transforming the market for Combined Heat and Power (CHP), Waste Heat to Power CHP, and district energy (DE) with CHP1. Prior to that, similar services were provided by eight Regional Application Centers (RACs). The key services that the CEACs provided were market assessments, education and outreach, and technical assistance. There were eight regional CEACs, each of which served a specific area of the country, and a separate center operated by the International District Energy Association (IDEA) which supported the regional centers with technical assistance, education, training, publicity, and outreach related to district energy with CHP. Oak Ridge National Laboratory (ORNL) has performed four previous studies of CEAC activities. The first one examined what the centers had done each year from the initiation of the program through FY 2008; the second addressed center activities for FY 2009; the third one focused on what was accomplished in FY 2010; and the fourth looked at the CEACs’ FY 2011 accomplishments, with a heightened emphasis on the adoption of CHP\\DE technologies and the activities thought to be most closely related to CHP/DE development and use. The most recent study, documented in this report, examines CEAC activities in FY 2012.

Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

Science.gov (United States)

2014-01-01

Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

Assessing Future Ecosystem Services: a Case Study of the Northern Highlands Lake District, Wisconsin

Directory of Open Access Journals (Sweden)

Garry D. Peterson

2003-12-01

Full Text Available The Northern Highlands Lake District of Wisconsin is in transition from a sparsely settled region to a more densely populated one. Expected changes offer benefits to northern Wisconsin residents but also threaten to degrade the ecological services they rely on. Because the future of this region is uncertain, it is difficult to make decisions that will avoid potential risks and take advantage of potential opportunities. We adopt a scenario planning approach to cope with this problem of prediction. We use an ecological assessment framework developed by the Millennium Ecosystem Assessment to determine key social and ecological driving forces in the Northern Highlands Lake District. From these, we describe three alternative scenarios to the year 2025 in which the projected use of ecological services is substantially different. The work reported in this paper demonstrates how scenarios can be developed for a region and provides a starting point for a participatory discussion of alternative futures for northern Wisconsin. Although the future is unknowable, we hope that the assessment process begun in this paper will help the people of the Northern Highlands Lake District choose the future path of their region.

[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

Lieutenant Chief Warden Districts

Data.gov (United States)

Vermont Center for Geographic Information — This dataset is a representation overlay of Lieutenant Chief Warden Districts (areas of responsibility). The Vermont Lieutenant Chief Warden Districts layer is part...

VT Data - Overlay District 20170419, Colchester

Data.gov (United States)

Vermont Center for Geographic Information — The following Overlay Districts are included in the data:General Development Four Commercial DistrictGeneral Development Four Openspace DistrictShoreland...

GEO-SPATIAL MODELING OF TRAVEL TIME TO MEDICAL FACILITIES IN MUNA BARAT DISTRICT, SOUTHEAST SULAWESI PROVINCE, INDONESIA

Directory of Open Access Journals (Sweden)

Nelson Sula

2018-03-01

Full Text Available Background: Health services are strongly influenced by regional topography. Road infrastructure is a key in access to health services. The geographic information system becomes a tool in modeling access to health services. Objective: To analyze geospatial data of the travel time to medical facilities in Muna Barat district, Southeast Sulawesi Province, Indonesia. Methods: This research used geospatial analysis with classification of raster data then overlaid with raster data such as Digital Elevation Modeling (DEM, Road of Vector data, and the point of Public Health Center (Puskesmas. Results: The result of geospatial analysis showed that the travel time to Puskesmas in Napano Kusambi and Kusambi sub districts is between 90-120 minutes, and travel time to the hospital in Kusambi sub district is required more than 2 hours. Conclusion: The output of this geospatial analysis can be an input for local government in planning infrastructure development in Muna Barat District, Indonesia.

Review of paediatric cardiology services in district general hospitals in the United Kingdom.

Science.gov (United States)

Andrews, Hannah; Singh, Yogen

2016-03-01

Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

Current situation of midwives in indonesia: Evidence from 3 districts in West Java Province

Science.gov (United States)

2010-01-01

Background The village midwife is a central element of Indonesia's strategy to improve maternal and child health and family planning services. Recently there has been concern that the midwives were not present in the villages to which they had been assigned. To determine the extent to which this was the case we conducted a field-based census and survey of village midwives in three districts in West Java Province, Indonesia. Findings In June 2009 we interviewed a random sample of village midwives from three districts - Ciamis, Garut and Sukabumi - in West Java Province. Trained interviewers visited all villages represented in the sample to interview the midwives. We also obtained information about the midwives and their professional activities in the last year. Thirty percent of village midwives had moved to another location in the 12 months between the end of 2008, when the sampling frame was constructed, and December 2009 when the survey was conducted; most had moved to a government health center or another village. Of those who were present, there was considerable variation between districts in age distribution and qualifications. The total number of services provided was modest, also with considerable variation between districts. The median number of deliveries assisted in the last year was 64; the amount and mix of family planning services provided varied between districts and were dominated by temporary methods. Conclusions Compared to an earlier survey in an adjacent province, the village midwives in these three districts were younger, had spent less time in the village and a higher proportion were permanent civil servants. A high proportion had moved in the previous year with most moving to a health center or another village. The decision to move, as well as the mix of services offered, seems to be largely driven by opportunities to increase their private practice income. These opportunities are greater in urban areas. As urbanization procedes the forces

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. ​

Langley Research Center Utility Risk from Future Climate Change

Science.gov (United States)

De Young, Russell J.; Ganoe, Rene

2015-01-01

The successful operation of NASA Langley Research Center (LaRC) depends on services provided by several public utility companies. These include Newport News Waterworks, Dominion Virginia Power, Virginia Natural Gas and Hampton Roads Sanitation District. LaRC's plan to respond to future climate change should take into account how these companies plan to avoid interruption of services while minimizing cost to the customers. This report summarizes our findings from publicly available documents on how each company plans to respond. This will form the basis for future planning for the Center. Our preliminary findings show that flooding and severe storms could interrupt service from the Waterworks and Sanitation District but the potential is low due to plans in place to address climate change on their system. Virginia Natural Gas supplies energy to produce steam but most current steam comes from the Hampton trash burning plant, thus interruption risk is low. Dominion Virginia Power does not address climate change impacts on their system in their public reports. The potential interruption risk is considered to be medium. The Hampton Roads Sanitation District is projecting a major upgrade of their system to mitigate clean water inflow and infiltration. This will reduce infiltration and avoid overloading the pump stations and treatment plants.

Measurement of Farmland Ecosystem Services Evaluation in Beidaihe District, Hebei Province, China

Directory of Open Access Journals (Sweden)

LIU Xiao-dan

2017-06-01

Full Text Available Farmland ecosystem is an important part of supporting and maintaining earth's life systems. It has the direct function value of providing agricultural product as well as the indirect function values of adjustment, support and culture. Chose the Beidaihe district in Hebei Province as the study region, the eco-system service functions were evaluated by ecological economics approach. The results showed that the indirect value was 1.09 times of the value direct in 2014. The farmland ecosystem not only had direct production function, but also had important ecological supporting functions. In the process of agricultural structure adjustment, the indirect functions should be given enough attention. The sort of values were production function > tourism function > carbon sequestration and oxygen release function > dispose of waste function > water conservation function > social security function > soil protection value > straw returning to field function > clean air function. In the process of accelerating the construction of modern agricultural park, vigorously developing ecological leisure agriculture, pushing forward the comprehensive utilization of crop straw, and actively developing ecological cycle of agriculture, the Beidaihe district should rationally adjust the use of farmland and focus on improving the values of indirect services to optimize service values. The study can be used as decision basis and scientific support for effective protection and sustainable utilization of farmland resources.

District nursing in Dominica

NARCIS (Netherlands)

Kolkman, PME; Luteijn, AJ; Nasiiro, RS; Bruney, [No Value; Smith, RJA; Meyboom-de Jong, B

1998-01-01

District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the

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.

Application of Service Oriented Architecture for Sensors and Actuators in District Heating Substations

Science.gov (United States)

Gustafsson, Jonas; Kyusakov, Rumen; Mäkitaavola, Henrik; Delsing, Jerker

2014-01-01

Hardwired sensor installations using proprietary protocols found in today's district heating substations limit the potential usability of the sensors in and around the substations. If sensor resources can be shared and re-used in a variety of applications, the cost of sensors and installation can be reduced, and their functionality and operability can be increased. In this paper, we present a new concept of district heating substation control and monitoring, where a service oriented architecture (SOA) is deployed in a wireless sensor network (WSN), which is integrated with the substation. IP-networking is exclusively used from sensor to server; hence, no middleware is needed for Internet integration. Further, by enabling thousands of sensors with SOA capabilities, a System of Systems approach can be applied. The results of this paper show that it is possible to utilize SOA solutions with heavily resource-constrained embedded devices in contexts where the real-time constrains are limited, such as in a district heating substation. PMID:25196165

The level and patterns of fertility among women in Kersa Demographic Surveillance and Health Research Center (KDS-HRC) Field site, Kersa District, East Ethiopia

OpenAIRE

Zelalem, Desalew; Semahegn, Agumasie; Tesfaye, Gezahegn; Sileshi, Balewgize

2015-01-01

Background Fertility is one of the three principal components of population dynamics. High fertility and rapid population growth exert negative influences on economic and social development. This study was aimed to estimate the level and trends of fertility among (15?49 years) old women in kersa demographic surveillance and health research center, kersa district Eastern Ethiopia. Methods The study was conducted at kersa demographic surveillance and health research center in kersa district, Ea...

Process Evaluation of Communitisation Programme in Public Sector Health Facilities, Mokokchung District, Nagaland, 2015.

Science.gov (United States)

Tushi, Aonungdok; Kaur, Prabhdeep

2017-01-01

Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

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

ECONOMIC CONDITIONS AND PROSPECTS OF DEVELOPMENT OF THE MARKET OF RESORT AND RECREATIONAL SERVICES OF THE SOUTHERN FDERAL DISTRICT

OpenAIRE

Oborin M. S.

2015-01-01

In article features of natural and medical potential, social and economic development of the Southern Federal District which are the main for development of medical and improving tourism are considered. The district borrows favorable natural and the economical geographical position influencing development of sanatorium activity. Positive dynamics of development of the market of sanatorium services of the Southern Federal District is based on the rich natural and medical capacity of the distri...

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...

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...

Getting down to Dollars and Cents: What Do School Districts Spend to Deliver Student-Centered Learning?

Science.gov (United States)

Miller, Lawrence J.; Gross, Betheny; Ouijdani, Monica

2012-01-01

In the era of No Child Left Behind and Race to the Top, school districts are under increasing pressure from policymakers to hold all students to high performance standards. In response, a growing number of schools are embracing the principles of student-centered learning (SCL). SCL is a contemporary approach that combines progressive and…

The district nursing and community matron services workforce: A scoping review in South London for the South London Nursing Network

OpenAIRE

Drennan, Vari

2014-01-01

This report presents both an overview of the issues influencing district nursing and community matron \\ud workforces and also a scoping of key issues in respect of workforce development in district nursing and\\ud community matron services in South London

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...

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.

Midwest Clean Energy Application Center

Energy Technology Data Exchange (ETDEWEB)

Cuttica, John; Haefke, Cliff

2013-12-31

The Midwest Clean Energy Application Center (CEAC) was one of eight regional centers that promoted and assisted in transforming the market for combined heat and power (CHP), waste heat to power (WHP), and district energy (DE) technologies and concepts throughout the United States between October 1, 2009 and December 31, 2013. The key services the CEACs provided included: Market Opportunity Analyses – Supporting analyses of CHP market opportunities in diverse markets including industrial, federal, institutional, and commercial sectors. Education and Outreach – Providing information on the energy and non-energy benefits and applications of CHP to state and local policy makers, regulators, energy end-users, trade associations and others. Information was shared on the Midwest CEAC website: www.midwestcleanergy.org. Technical Assistance – Providing technical assistance to end-users and stakeholders to help them consider CHP, waste heat to power, and/or district energy with CHP in their facility and to help them through the project development process from initial CHP screening to installation. The Midwest CEAC provided services to the Midwest Region that included the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.

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

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

Directory of Open Access Journals (Sweden)

Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

VT Data - Overlay District 20170710, South Burlington

Data.gov (United States)

Vermont Center for Geographic Information — Overlay data for the City of South Burlington included in this data:Flood Plain Overlay DistrictTraffic Overlay DistrictInterstate Highway Overlay DistrictScenic...

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...

Evaluating quality of health services in health centres of Zanjan district of Iran.

Science.gov (United States)

Mohammadi, Ali; Mohammadi, Jamshid

2012-01-01

To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

A Case Study of Key Stakeholders' Perceptions of the Learning Center's Effectiveness for English Learners at a District in Central California

Science.gov (United States)

Nava, Norma Leticia

2016-01-01

This qualitative study explored stakeholders' (administrators, teachers, and parents) perspectives of English learners in the learning center, a response to intervention model, at a school district in Central California. Research existed concerning the yearly academic growth of students in a learning center, but there was a lack of knowledge about…

Measuring unmet obstetric need at district level: how an epidemiological tool can affect health service organization and delivery.

Science.gov (United States)

Guindo, Gabriel; Dubourg, Dominique; Marchal, Bruno; Blaise, Pierre; De Brouwere, Vincent

2004-10-01

A national retrospective survey on the unmet need for major obstetric surgery using the Unmet Obstetric Need Approach was carried out in Mali in 1999. In Koutiala, the district health team decided to carry on the monitoring of the met need for several years in order to assess their progress over time. The first prospective study, for 1999, estimated that more than 100 women in need of obstetric care never reached the hospital and probably died as a consequence. This surprising result shocked the district health team and the resulting increased awareness of service deficits triggered operational measures to tackle the problem. The Unmet Obstetric Need study in Koutiala district was implemented without financial support and only limited external technical back-up. The appropriation of the study by the district team for solving local problems of access to obstetric care may have contributed to the success of the experience. Used as a health service management tool, the study and its results started a dialogue between the hospital staff and both health centre staff and community representatives. This had not only the effect of triggering consideration of coverage, but also of quality of obstetric care. Copyright 2004 Oxford University Press

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

[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.

An evaluation of public school district tobacco policies in St. Louis County, Missouri.

Science.gov (United States)

Barbero, Colleen; Moreland-Russell, Sarah; Bach, Laura E; Cyr, Julianne

2013-08-01

One way to address tobacco use by youth is for primary and secondary schools to adopt and implement comprehensive tobacco policies. The purpose of this study was to evaluate the comprehensiveness of tobacco policies in St. Louis County, Missouri public school districts. We evaluated the strength of tobacco policies from all 23 public school districts located in the county using the Center for Tobacco Policy Research's School Tobacco Policy Index, a standardized tool for rating school tobacco policies. The districts averaged a score of 24.4 of 40 possible points on the Index. Policies scored highest on the Tobacco-Free Environment domain and lowest on the Enforcement domain. Policies averaged about half of the total possible points for the Prevention and Treatment Services and Policy Organization domains. Despite more than a decade of efforts by the Centers for Disease Control and Prevention to improve school tobacco policies, this study shows that policies in St. Louis County districts have yet to meet the standard of comprehensiveness. It is recommended that schools adopt policies that are comprehensive and that address all domains of the School Tobacco Policy Index. © 2013, American School Health Association.

Process evaluation of communitisation programme in public sector health facilities, Mokokchung district, Nagaland, 2015

Directory of Open Access Journals (Sweden)

Aonungdok Tushi

2017-01-01

Full Text Available Background: Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced “Nagaland Communitisation of Public Institutions and Services Act” in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs, deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. Materials and Methods: The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC and four primary health centers (PHC were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Results: Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Conclusions: Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

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.

Public services on a district level. The environment closer to the people. More sustainability or not?

International Nuclear Information System (INIS)

De Boer, J.; Van Drunen, M.A.; Lammers, P.E.M.; Olsthoorn, A.A.

2000-01-01

One way to stimulate households in the Netherlands socially, culturally and economically is to provide them with technological services and tools that are economically and ecologically sound and contribute to sustainability. Every technological service or tool has social, cultural and economical stimuli. However, those incentives are not used systematically in the present Dutch environmental policy. Therefore, an important question in this study is whether those incentives can be used such that they can contribute to sustainability more than the performance level of the technology. In this study special attention is paid to the level on which the services and tools for households in a specific district are organized and provided and how it can contribute to sustainability. In chapter 2 the incentives for sustainable behavior of households are described. In chapter 3 three scenarios are introduced in which the district level is explained by comparing them with two other levels: the micro-level (per households) and the macro-level (per province, national, international). In chapter 4 the expectations with respect to the services and tools and sustainability for the three scenarios are evaluated. Examples of experiments and case studies are spread over the report. 61 refs

Fisheries Districts

Data.gov (United States)

Vermont Center for Geographic Information — The Fisheries districts data layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset...

Wastewater Districts

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Vermont Center for Geographic Information — The Wastewater districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...

Wildlife Districts

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Vermont Center for Geographic Information — The Wildlife Districts layer is part of a larger dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature...

New Mexico State Forestry Districts

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Earth Data Analysis Center, University of New Mexico — This dataset contains boundaries of the New Mexico Forestry Districts, plus the names of the district offices. It is in a vector digital structure digitized from a...

Warden Districts

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Vermont Center for Geographic Information — This dataset is a representation overlay of warden (areas of responsibility). The Vermont Warden Districts layer is part of a dataset that contains administrative...

Park Districts

Data.gov (United States)

Vermont Center for Geographic Information — The Parks Districts layer is part of a dataset contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes feature classes for...

Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka.

Science.gov (United States)

Vithana, Palatiyana Vithanage Sajeewanie Chiranthika; Ariyaratne, May; Jayawardana, Pl

2013-01-01

Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

VT Data - Overlay District 20070306, Marlboro

Data.gov (United States)

Vermont Center for Geographic Information — Cartographic version of overlay district (surface water buffer), Marlboro, Vermont. Base zoning districts are in a separate shapefile. Data were originally created...

Forestry Districts

Data.gov (United States)

Vermont Center for Geographic Information — The Forestry Districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This is a layer file which...

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.

Rural district hospitals - essential cogs in the district health system - and primary healthcare re-engineering.

Science.gov (United States)

le Roux, K W D P; Couper, I

2015-06-01

The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

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...

VT Data - Overlay District 20170228, Richmond

Data.gov (United States)

Vermont Center for Geographic Information — The following overlay districts are included in the data:Shoreline Protection OverlayFlood Hazard OverlayDetails about these overlay districts, as well as zoning...

Louisiana State Senate Districts from LEGIS source data, Geographic NAD83, LOSCO (2004) [la_senate_districts_LEGIS_2003

Data.gov (United States)

Louisiana Geographic Information Center — Louisiana State Senate Districts. The district boundaries are the result of legislative acts and redistricting. Reapportionment (redistricting) occurs during the...

Department of Agriculture, Food Safety and Inspection Service

Science.gov (United States)

... Standard Forms FSIS United States Department of Agriculture Food Safety and Inspection Service About FSIS District Offices Careers Contact Us Ask ... Reports Fact Sheets Food Defense and Emergency Response Food Safety Education FSIS ... Assistance Contact Centers Cooperative Agreements Email Subscription ...

Numerical modelling and experimental measurements for a low-temperature district heating substation for instantaneous preparation of DHW with respect to service pipes

International Nuclear Information System (INIS)

Brand, Marek; Thorsen, Jan Eric; Svendsen, Svend

2012-01-01

Traditional district heating (DH) systems are becoming uneconomic as the number of new and renovated buildings with reduced heating requirements increases. To keep DH competitive in the future, heat losses in DH networks need to be reduced. One option is to reduce the supply temperature of DH as much as possible. This requires a review and improvement of a DH network, in-house substations, and the whole domestic hot water (DHW) supply system, with the focus on user comfort, hygiene, overall cost and energy efficiency. This paper describes some practical approaches to the implementation of low-temperature district heating (LTDH) with an entry-to-substation temperature around 50 °C. To this end we developed a numerical model for an instantaneous LTDH substation that takes into consideration the effect of service pipes. The model has been verified and can be used for the further optimization of the whole concept as well for individual components. The results show that the way that the service pipe is operated has a significant effect on waiting time for DHW, heat loss, and overall cost. Furthermore, the service pipe should be kept warm by using a bypass in order to fulfil the comfort requirements for DHW instantaneously prepared. -- Highlights: ► Describes and justifies concept of low-temperature district heating with supply temperature of 50 °C. ► Focuses on DHW preparation in low-temperature district heating in-house substations, considering comfort and Legionella. ► Verified numerical model reports on dynamic performance of an in-house substation, considering operation of service pipes. ► Bypass is needed for instantaneous type of district heating substations to fulfil comfort requirements of users. ► The model developed can be used for future optimization of low-temperature substations and whole district heating networks.

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

Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

Directory of Open Access Journals (Sweden)

Asma Perveen

2017-09-01

Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

Louisiana State House Districts from LEGIS source data, Geographic NAD83, LOSCO (2004) [la_house_districts_LEGIS_2004

Data.gov (United States)

Louisiana Geographic Information Center — Louisiana State House Districts. The district boundaries are the result of legislative acts and redistricting. Reapportionment (redistricting) occurs during the next...

Abortion services in a high-needs district: a community-based model of care

Directory of Open Access Journals (Sweden)

Snook S

2013-06-01

Full Text Available INTRODUCTION: In 2009, a high-deprivation district health board in New Zealand set up a community-based abortion clinic in order to provide a local service and to avoid out-of-region referrals. The service offers medical abortions for women with pregnancies of up to 63 days' gestation, and surgical abortion with local anaesthetic for women with pregnancies of up to 14 weeks' gestation. AIM: To describe the services developed and assess safety and timeliness for the first year of community-based services. METHODS: An audit of clinical records for patients seen in 2010 was performed in order to obtain data on location of services, timeliness, safety and complications. RESULTS: Eighty-two percent of locally provided abortions in 2010 were medical abortions, completed on average less than two days after referral to the service. One percent of patients experienced haemorrhaging post abortion, and 4% had retained products. These rates are within accepted standards for an abortion service. DISCUSSION: This report illustrates that a community-based model of care can be both clinically and culturally safe, while providing a much-needed service to a high-needs population.

Metamorphosis: Texas District Opts for Learner-Centered Professional Learning

Science.gov (United States)

Ellinger, Alan; Launius, Keri; Scott, Annette

2017-01-01

Like many districts across the United States, Galveston, Texas, is focused on building a culture of excellence. The district is a study in contrasts. On one hand, it is laced with opulent vacation homes and resort hotels used by out-of-town owners. On the other, the median household income level is $28,895, with 22% of the population living below…

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

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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.

Teachers' Perspectives of Children's Mental Health Service Needs in Urban Elementary Schools

Science.gov (United States)

Williams, James Herbert; Horvath, Violet E.; Wei, Hsi-Sheng; Van Dorn, Richard A.; Jonson-Reid, Melissa

2007-01-01

This study uses a phenomenological approach to investigate elementary school teachers' perspectives on children's mental health service needs. Focus groups were conducted at two elementary schools with differing levels of available social services in a moderate-sized urban midwestern school district. Data collection centered on six prominent…

7 CFR 982.31 - Grower districts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Grower districts. 982.31 Section 982.31 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... importance of production in each district and the number of growers in each district; (2) the geographic...

Availability of human immunodeficiency virus prevention services in secondary schools in Kabarole District, Uganda

Directory of Open Access Journals (Sweden)

Jane Namuddu

2015-08-01

Full Text Available The aim of this study was to assess the level of availability of HIV prevention strategies in secondary schools in Kabarole district, Uganda in order to inform the design of interventions to strengthen HIV Prevention and psychosocial support. Quantitative and qualitative research methods were used in eight secondary schools in Kabarole district to establish available HIV prevention and psychosocial support services. Questionnaires were administered to 355 students 12-24 years old. In addition, 20 Key Informant interviews were held with education service providers. Quantitative data was analyzed using Epi-data and qualitative data were analyzed by thematic content analysis. Seven of the eight schools had at least one HIV prevention strategy. Two teachers in each of the five schools had been trained in HIV prevention. No school had a nurse trained in HIV prevention, care and support. Education service providers had limited knowledge of HIV prevention support and care of students living with HIV. We found out that students had knowledge on how one can acquire HIV. HIV prevention services reported by students in schools included: talks from teachers and guests (19%, drama with HIV prevention related messages (16%, peer education clubs (15%, workshops and seminars on HIV (8%, sensitization about HIV/AIDS (7%, guidance and counseling (6%, talking compounds- (5%, abstinence talks (6%, keeping students busy in sports (4%, straight talk (4%. Sixty three percent reported receiving HIV reading materials from various sources. Preventing HIV infection among students in schools is still demanding with limited interventions for students. Efforts to support school interventions should focus on including HIV Prevention in the school curriculum, working with peer educators as well as education service providers who spend much of the time with the students while at school.

Application of social network analysis in the assessment of organization infrastructure for service delivery: a three district case study from post-conflict northern Uganda.

Science.gov (United States)

Ssengooba, Freddie; Kawooya, Vincent; Namakula, Justine; Fustukian, Suzanne

2017-10-01

In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization networks-here referred to as infrastructure. The objective of this study was to assess the inter-organization infrastructure that supports the provision of selected health services in the reconstruction phase after conflict in northern Uganda. Applied social network analysis was used to establish the structure, size and function among organizations supporting the provision of (1) HIV treatment, (2) maternal delivery services and (3) workforce strengthening. Overall, 87 organizations were identified from 48 respondent organizations in the three post-conflict districts in northern Uganda. A two-stage snowball approach was used starting with service provider organizations in each district. Data included a list of organizations and their key attributes related to the provision of each service for the year 2012-13. The findings show that inter-organization networks are mostly focused on HIV treatment and least for workforce strengthening. The networks for HIV treatment and maternal services were about 3-4 times denser relative to the network for workforce strengthening. The network for HIV treatment accounted for 69-81% of the aggregated network in Gulu and Kitgum districts. In contrast, the network for workforce strengthening contributed the least (6% and 10%) in these two districts. Likewise, the networks supporting a young district (Amuru) was under invested with few organizations and sparse connections. Overall, organizations exhibited a broad range of functional roles in supporting HIV treatment compared to other services in the study. Basic information about the inter-organization setup (infrastructure)-can contribute to knowledge for building organization networks in more equitable ways. More connected organizations can be leveraged for faster communication and resource flow to boost the delivery of health services

Effect of service quality on coffee based economic cluster development on farmers and other stakeholders satisfaction in Bondowoso district

Directory of Open Access Journals (Sweden)

Lya Aklimawati

2015-04-01

Full Text Available Economic cluster approach can be used to enhance economic growth of a region by optimizing local resources. Coffee is one of plantation commodity which is developed in Bondowoso district through economic cluster model. Low quality coffee beans and inefficiency marketing system were the basic problems at farmer level that pushed for developing economic coffee cluster. The aim of this research was to analyze the effect of service quality on economic coffee cluster development toward farmers and stakeholders satisfaction. This research was carried out at Bondowoso District, East Java. Direct observation and interviews coffee farmers and stakeholders using closed questions was conducted in this study. Data collected consisted of primary and secondary data. The number of respondents were 47 stakeholders consisted of 5 bank officers, 5 officers from district plantation service, 2 officers from foresty company and 35 farmers. Respondens selection was based on convenience sampling method. Primary data was analyzed by using correlation and multiple linear regression analysis. The result showed that the relationship between dimensions of service quality with each other varies from weak to strong. Stakeholders satisfaction (included farmers on economic coffee cluster implementation was influenced significantly by tangible. While reliability, responsiveness, assurance and empathy had no effect on stakeholders satisfaction.

ACT250 Districts

Data.gov (United States)

Vermont Center for Geographic Information — The ACT 250 Districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...

Groundwater Managment Districts

Data.gov (United States)

Kansas Data Access and Support Center — This dataset outlines the location of the five Groundwater Management Districts in Kansas. GMDs are locally formed and elected boards for regional groundwater...

A Review of Telemedicine Services in Finland

DEFF Research Database (Denmark)

Khatri, Vikramajeet; Peterson, Carrie Beth; Kyriazakos, Sofoklis

2011-01-01

Telemedicine is gaining popularity due to the provision of ubiquitous health care services that is a fundamental need for every socialized society. In this paper, telemedicine services in Finland are discussed, as well as how they came into existence, how they are funded, evaluated, and what...... are their impacts on health care systems and society. Telemedicine services like teleradiology, telelaboratory, telepsychiatry and remote consultations, are being offered in all hospital districts. Primary health care centers in Finland are lacking telemedicine services, and are planning to have them. Electronic...

Reinstating district nursing: A UK perspective.

Science.gov (United States)

Morris, Hannah

2017-09-01

As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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.

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)

Bottleneck analysis at district level to illustrate gaps within the district health system in Uganda

Science.gov (United States)

Kiwanuka Henriksson, Dorcus; Fredriksson, Mio; Waiswa, Peter; Selling, Katarina; Swartling Peterson, Stefan

2017-01-01

ABSTRACT Background: Poor quality of care and access to effective and affordable interventions have been attributed to constraints and bottlenecks within and outside the health system. However, there is limited understanding of health system barriers to utilization and delivery of appropriate, high-impact, and cost-effective interventions at the point of service delivery in districts and sub-districts in low-income countries. In this study we illustrate the use of the bottleneck analysis approach, which could be used to identify bottlenecks in service delivery within the district health system. Methods: A modified Tanahashi model with six determinants for effective coverage was used to determine bottlenecks in service provision for maternal and newborn care. The following interventions provided during antenatal care were used as tracer interventions: use of iron and folic acid, intermittent presumptive treatment for malaria, HIV counseling and testing, and syphilis testing. Data from cross-sectional household and health facility surveys in Mayuge and Namayingo districts in Uganda were used in this study. Results: Effective coverage and human resource gaps were identified as the biggest bottlenecks in both districts, with coverage ranging from 0% to 66% for effective coverage and from 46% to 58% for availability of health facility staff. Our findings revealed a similar pattern in bottlenecks in both districts for particular interventions although the districts are functionally independent. Conclusion: The modified Tanahashi model is an analysis tool that can be used to identify bottlenecks to effective coverage within the district health system, for instance, the effective coverage for maternal and newborn care interventions. However, the analysis is highly dependent on the availability of data to populate all six determinants and could benefit from further validation analysis for the causes of bottlenecks identified. PMID:28581379

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...

The district nursing service: a national treasure.

Science.gov (United States)

Oldman, Crystal

2014-08-01

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

VT Data - Cons/Rec Overlay District 20110301, Winhall

Data.gov (United States)

Vermont Center for Geographic Information — Conservation and Recreatioal Protection overaly districts for the Town of Winhall, Vermont. Other overlay districts (Transfer of Development Rights, and Scenic...

Patient's perceptions about the service quality of public hospitals located at District Kohat.

Science.gov (United States)

Aman, Bakhtiar; Abbas, Faisal

2016-01-01

To determine patients' perception regarding service and quality of healthcare at public-sector institutions. The descriptive quantitative study was conducted in Kohat district, Pakistan, between July and December 2014, and focussed on 30 variables to assess the participants' perceptions of the actual healthcare service quality delivered. SERVQUAL instrument was used to measure the reliability and cronbach alpha was calculated to measure the reliability and validity of the instrument. A total of 200 questionnaires were distributed and 157(78.5%) were received back fully filled. Of them, 105(67%) were men and 52(33%) were women.The mean value of Assurance parameter was 3.05±0.88, indicating trust in public hospitals was high as they had experienced and capable doctors. On the other hand, the lowest mean value of 2.61±0.84 was for Empathy, highlighting the fact that public hospitals lacked the ability to handle patients' problem properly, services were not offered in time and they were short of staff. Public hospitals were largely seen as failing to deliver quality service.

Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

Science.gov (United States)

Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

2015-01-28

To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

Return on Educational Investment: 2014. A District-by-District Evaluation of U.S. Educational Productivity

Science.gov (United States)

Boser, Ulrich

2014-01-01

In 2011, the Center of American Progress (CAP) released the first-ever attempt to evaluate the productivity of almost every major school district in the country. That project developed a set of relatively simple productivity metrics in order to measure the achievement that a school district produces relative to its spending, while controlling for…

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.

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

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.

The expanded program on immunization service delivery in the Dschang health district, west region of Cameroon: a cross sectional survey

Directory of Open Access Journals (Sweden)

Walter Ebile Akoh

2016-08-01

Full Text Available Abstract Background Vaccination is the most effective intervention strategy, and the provision of vaccination at fixed posts and outreach posts is a backbone of a sustainable vaccination system in developing countries. Access to immunization services is still limited in Cameroon. Several health districts in the west region have recorded new epidemic outbreaks, including the occurrence of a wild polio virus epidemic outbreak in 2013. The aim of this study was to assess immunization service delivery in one of the largest health districts in the west region of Cameroon; the Dschang Health district. Methods It was a cross sectional study conducted in 2013, in 42 health facilities covering 18 health areas in the Dschang Health District. Data were collected with questionnaires administered to health personnel face to face and an observation grid was used to assess resources and tools. Data were entered and analyzed in Epi Info. Results A total of 42 health facilities were assessed and 77 health personnel were interviewed. Overall, 29 (69.0 % health facilities organized one vaccination session monthly, 2 (4.8 % organized an outreach within the last 3 months prior to the study, 15 (35.7 % did not have a vaccination micro plan, 24 (32.9 % health personnel had not been supervised for at least the last 6 months prior to the study, 7 (16.7 % health facilities did not have a functional refrigerator, 1 (2.4 % did not have a vaccine carrier, 23 (54.8 % did not have a means of transport (vehicle or motorcycle and 12 (28.6 % did not have an EPI guideline. The knowledge of health personnel on vaccine and cold chain management, and on diseases of the EPI under epidemiological surveillance was found to be limited. Conclusion The frequency and strategic provision of immunization services in the Dschang Health district is inadequate. Resource availability for an adequate provision of immunization services is insufficient. The knowledge of health personnel

A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

Directory of Open Access Journals (Sweden)

Dzuba Ilana

2005-12-01

Full Text Available Abstract Background Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. Methods Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions to assess the perspectives of women, providers, policy makers and community members. Results There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services

Utilization of Antenatal HealthCare Services among Fishermen Population in Kanchipuram District, Tamil Nadu: A Cross-sectional Study.

Science.gov (United States)

Danasekaran, Raja; Raja, Pavithra; Ranganathan, Karnaboopathy

2017-01-01

Considering the global and national level commitments in improving the maternal health as well as reducing the maternal mortality, assessment of factors influencing the delivery of antenatal healthcare services becomes essential. The aim is to assess the utilization of antenatal health services and to identify the factors influencing their utilization among women of fishermen population in Kanchipuram district, Tamil Nadu. The cross-sectional study was carried out among the mothers in Kovalam area of Kanchipuram district. Details were collected using a pretested questionnaire and analyzed using statistical software. The study included 284 mothers, of which 35% were illiterates. Nearly 60.21% have got registered with the Government sector, 59.51% of the mothers had three or more antenatal visits, 64.08% have received two doses of tetanus toxoid, and 73.24% have taken iron and folic acid tablets. Factors which were identified to have statistically significant association with better utilization of antenatal health services were age >30 years, higher educational status, skilled workers, those having their first child, and higher socioeconomic class. This study has reported the fact that antenatal healthcare services were not utilized fully by the community and the fishermen population being a special group has to be given the needed attention from the healthcare delivery system.

Isomorphism in Provision of Culture: The Case of Municipalities in Istanbul and Their Cultural Centers

Directory of Open Access Journals (Sweden)

Ayça İnce

2017-01-01

Full Text Available Regardless of the diminishing budgets for investment in the cultural sphere, especially at the municipality level. Since 2000, 61 cultural centers have been opened in Istanbul alone. In spite of the growing cultural and artistic diversity and Turkish society's various demands in cultural services, of Turkish cultural policies on a local, city, and national level serves as a starting point for investigating how isomorphism transpires to the provision of cultural services on the level of Istanbul's district municipalities. This study not only explains the role of district municipalities in the cultural field of Istanbul, but also argues that three interconnected concepts—democratization, professionalization, and marketization—promote cultural convergence.

Solid Waste Management Districts

Data.gov (United States)

Vermont Center for Geographic Information — The Solid waste management districts layer is part of a dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. This dataset...

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.

NM Property Tax Districts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...

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

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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.

Promptness of FY 2002 Second Quarter DoD Payments to the US Treasury for District of Columbia Water and Sewer Services

National Research Council Canada - National Science Library

2002-01-01

.... Public Law 106-554 requires the inspector general of each Federal agency that receives water and sewer services from the District of Columbia to report to the Congressional Appropriations Committees...

THE EFFECTS OF A DONOR SUPPORT ON DISTRICT HEALTH SERVICE UTILIZATION IN ENUGU STATE, NIGERIA

Directory of Open Access Journals (Sweden)

2016-11-01

Full Text Available Health outcomes are poor in the developing world, hence donor organizations usually support health care delivery system of developing countries. In 2005, Enugu State commenced implementation of District Health System with a unitarised healthcare delivery structure. The aim of this study is to evaluate the effect of the PATHS programme (DFID support on the District Health service utilization in Enugu State. Seventy seven supported public primary health care facilities constituted the study population, while same number of non-supported ones were selected randomly as the control health facilities. Retrospective Intervention study technique was used. The study period was the last six months of the PATHS programme in the state (January to June, 2008. The study revealed among other findings that the support by DFID to Enugu State health sector through the PATHS programme resulted in significant increase in district health service utilization, as demonstrated in increased outpatient attendance from 15052 to 73336 (percentage increase of 387.22%, Chi square = 279.11, P and lt;0.0001 and delivery of babies from 647 to 1052 (percentage increase of 62.60%, Chi square = 32.08, P and lt;0.0001 in the supported health facilities. For control facilities, outpatient attendance increased from 8216 to 35126 (percentage increase of 327.50%, Chi square of 233.76, P and lt; 0.0001 and delivery from 370 to 441 (percentage increase of 19.19%, Chi square = 4.60, P and lt;0.47. The difference between the study and control facilities\\' outpatient attendance became wider after the intervention. The out-patient attendance increased significantly in both the study and control facilities after the intervention. Deliveries increased significantly in the supported facilities, while the increase in the control facilities was not significant.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

Science.gov (United States)

Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

2016-01-01

Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

Directory of Open Access Journals (Sweden)

John Odaga

2016-05-01

Full Text Available Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs. The Community and District Empowerment for Scale-up (CODES project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

Science.gov (United States)

Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

2016-01-01

Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

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 ...

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

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...

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…

Report on the establishment and operation of the Federal Energy Regulatory Commission's Daycare Center

Energy Technology Data Exchange (ETDEWEB)

1991-09-16

We have completed an inspection of the Federal Energy Regulatory Commission's (FERC) Daycare Center (Center). The purpose of the inspection was to review for efficiency, economy and compliance with laws and regulations, FERC's establishment and operation of the Center. The inspection objectives were to review: (1) FERC's compliance with Federal laws and requirements of the General Services Administration and the District of Columbia; (2) the source and amount of funds for establishing and operating the Center; and (3) the organizational relationships between FERC, the Center and the contractor operating the Center.

Allegheny County Council Districts

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset portrays the boundaries of the County Council Districts in Allegheny County. The dataset is based on municipal boundaries and City of Pittsburgh ward...

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.

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.

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.

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

Directory of Open Access Journals (Sweden)

Mihiretu Alemayehu Arba

Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

Science.gov (United States)

Arba, Mihiretu Alemayehu; Darebo, Tadele Dana; Koyira, Mengistu Meskele

2016-01-01

The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones. A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively. Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery. The use of institutional delivery service is low in the study

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.

NM School District Boundaries

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The dataset represents the boundaries of all public school districts in the state of New Mexico. The source for the data layer is the New Mexico Public Education...

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.

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...

The VISA Center: An Interdisciplinary Collaboration Serving Students Suspended from School for Violent or Aggressive Behavior, Substance Abuse, or Weapons Possession

Science.gov (United States)

Shulman, Lawrence; Maguin, Eugene

2017-01-01

The University at Buffalo School of Social Work established the VISA Center (the acronym stands for "vision, integrity, service, and accountability") in collaboration with the school district of Buffalo, New York. With funding from the New York State Education Department, a university on-campus center was set up to serve 30 students at a…

The cost of the district hospital: a case study in Malawi.

Science.gov (United States)

Mills, A J; Kapalamula, J; Chisimbi, S

1993-01-01

Described in an analysis of the cost to the Ministry of Health of providing district health services in Malawi, with particular emphasis on the district hospital. District resource allocation patterns were assessed by carefully disaggregating district costs by level of care and hospital department. A strikingly low proportion of district recurrent costs was absorbed by salaries and wages (27-39%, depending on the district) and a surprisingly high proportion by medical supplies (24-37%). The most expensive cost centre in the hospital was the pharmacy. A total of 27-39% of total recurrent costs were spent outside the hospital and 61-73% on hospital services. The secondary care services absorbed 40-58% of district recurrent costs. Unit costs by hospital department varied considerably by district, with one hospital being consistently the most expensive and another the cheapest. A total of 3-10 new outpatients could be treated for the average cost of 1 inpatient-day, while 34-55 could be treated for the average cost of 1 inpatient. The efficiency of hospital operations, the scope for redistributing resources districtwide, and the costing methodology are discussed.

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…

Health Care Reform Bureaucracy In The District Merauke In Perspective Agency Theory

Directory of Open Access Journals (Sweden)

Samel W. Ririhena

2015-04-01

Full Text Available Abstract Reforms are demands to improve services especially health services to the community in Merauke. The purpose of writing is to analyze the theory of agency in order to verify the health care bureaucracy reformas Merauke district which includes reform of the bureaucracy adverse selection and moral hazard. This study used a qualitative approach and data collection is done by using interviews and intervieuw based on interactive model of Milles and Huberman. The results showed that the reform of health care bureaucracy in Merauke not running optimally and the problem of adverse selection and moral hazard is still happening in the agency relationship between the Department of Health and the Health Center.

Exploring the ethos of district nursing, 1885-1985.

Science.gov (United States)

Madsen, Wendy

2013-06-01

The history of district nursing in Australia explored in this paper reveals a continuity in the essential values held by district nurses for over a century. These nurses practised holistic, family-centred nursing from the very origins of district nursing service. The events surrounding the establishment of Community Health Centres in the 1970s challenged district nurses to reconsider their role, while at the same time reconfirming their essential ethos. These values that underpinned district nursing practice and challenges to these values are examined in this paper.

Malaria control at the district level in Africa: the case of the muheza district in northeastern Tanzania

DEFF Research Database (Denmark)

Alilio, Martin S; Kitua, Andrew; Njunwa, Kato

2004-01-01

transmission and incidence over time; use of facility-based care services for malaria; patients' access to professional advice; the trend of treatment failure over time of sulfadoxine-pyrimethamine and chloroquine; survival rates of severe cases at the district hospital; a district malaria control strategy......An assessment was done in Tanzania to determine the extent to which the primary health care services have contributed to reducing the burden of malaria since the system was initiated in the 1980s. Seven descriptive processes and outcome indicators of effectiveness were used: changes of malaria...

Estimating Implementation and Operational Costs of an Integrated Tiered CD4 Service including Laboratory and Point of Care Testing in a Remote Health District in South Africa

Science.gov (United States)

Cassim, Naseem; Coetzee, Lindi M.; Schnippel, Kathryn; Glencross, Deborah K.

2014-01-01

Background An integrated tiered service delivery model (ITSDM) has been proposed to provide ‘full-coverage’ of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing 600 samples/day and serving >100 or >200 health-clinics, respectively. The objective of this study was to establish costs of existing and ITSDM-tiers 1, 2 and 3 in a remote, under-serviced district in South Africa. Methods Historical health-facility workload volumes from the Pixley-ka-Seme district, and the total volumes of CD4 tests performed by the adjacent district referral CD4 laboratories, linked to locations of all referring clinics and related laboratory-to-result turn-around time (LTR-TAT) data, were extracted from the NHLS Corporate-Data-Warehouse for the period April-2012 to March-2013. Tiers were costed separately (as a cost-per-result) including equipment, staffing, reagents and test consumable costs. A one-way sensitivity analyses provided for changes in reagent price, test volumes and personnel time. Results The lowest cost-per-result was noted for the existing laboratory-based Tiers- 4 and 5 ($6.24 and $5.37 respectively), but with related increased LTR-TAT of >24–48 hours. Full service coverage with TAT cost-per-result of $32.32 and $15.88 respectively. A single district Tier-3 laboratory also ensured ‘full service coverage’ and Implementing a single Tier-3/community laboratory to extend and improve delivery of services in Pixley-ka-Seme, with an estimated local ∼12–24-hour LTR-TAT, is ∼$2 more than existing referred services per-test, but 2–4 fold cheaper than implementing eight Tier-2/POC-hubs or providing twenty-seven Tier-1/POCT CD4 services. PMID:25517412

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,…

A Quantitative Assessment of an Outsourced Agricultural Extension Service in the Umzimkhulu District of KwaZulu-Natal, South Africa

Science.gov (United States)

Lyne, Michael C.; Jonas, Nomonde; Ortmann, Gerald F.

2018-01-01

Purpose: This study evaluates the impact of an outsourced extension service delivered by Lima Rural Development Foundation (Lima) in the Umzimkhulu district of South Africa. The evaluation is conducted at both the household and program levels. Design/methodology/approach: Household impacts were estimated using two-stage regression with…

[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.

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

Science.gov (United States)

Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

2017-10-01

Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

Directory of Open Access Journals (Sweden)

D Pillay

2017-10-01

Full Text Available Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ, Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities. Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective

New Mexico Property Tax Districts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...

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.

78 FR 38287 - Bitterroot National Forest, Darby Ranger District, Como Forest Health Project

Science.gov (United States)

2013-06-26

... DEPARTMENT OF AGRICULTURE Forest Service Bitterroot National Forest, Darby Ranger District, Como Forest Health Project AGENCY: Forest Service. ACTION: Notice; Correction. SUMMARY: The Department of Agriculture (USDA), Forest Service, Bitterroot National Forest, Darby Ranger District published a document in...

Reaction to "Observations on School District and Service Consolidation in Michigan." Working Paper #17 by David Arsen. Working Paper #18

Science.gov (United States)

Shakrani, Sharif M.

2011-01-01

The author's "School District Consolidation Study in 10 Michigan Counties" study was published in August, 2010 by The Education Policy Center at Michigan State University. It was intended to measure the financial impact of consolidation of schools at the county level akin to other states like Virginia, Florida and Maryland. The study was…

Financial Management: Measurement of Water Usage by DoD Components Serviced by the District of Columbia Water and Sewer Authority

National Research Council Canada - National Science Library

2002-01-01

Who Should Read This Report and Why? This report should be read by DoD managers who have a direct interest in, or are in need of information about the accuracy of the measurement of water usage by DoD Components serviced by the District...

Smallholder agricultural technology development in Soroti district ...

African Journals Online (AJOL)

Mo

National Agricultural Advisory and Development Services (NAADS) in Soroti district. The study shows that .... important additions are HIV/AIDS, basic principles of nutrition ... in supplying inputs to farmers and technology delivery, while the .... Table 3. Social differentiation of NAADS and FFS groups in Soroti district 2004.

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.

PLANNING OF SECONDARY SCHOOL LOCATION AT SUBCENTRE OF MEDAN SELAYANG SERVICE BASED ON GEOGRAPHIC INFORMATON SYSTEM

Directory of Open Access Journals (Sweden)

Mansyur Hidayat Pasaribu

2017-09-01

Full Text Available his research aimed to solve the problem of requirement of facility and infrastructure of high school education year 2030 at 4 sub-districts in sub department of Medan Selayang. By knowing the number of junior high school student we can calculate requirement of middle school infrastructure needed. The need for secondary school building infrastructure at the Medan Selayang service sub-center in 2030 is calculated based on the number of population aged 0-4 years in 2016 as users of secondary education services in the planning year. The need for the number of new school units based on the maximum capacity of study groups available in each school in the study area, the lack of learning groups is met through new classroom addition programs and the addition of new school units. With the population of middle school age in 2030 in four districts amounting to 33,299, it is required to provide 1 unit of new school in Medan Baru sub-district, 1 unit of new school in Medan Selayang sub-district, 2 units of new school in Medan Tuntungan sub-district. The lack of study group in Medan Baru sub-district can be fulfilled by adding new classroom based on the availability of school land. Planning of school location in the addition of new school unit based on spatial analysis using geographic information system application. Method of research used is descriptive method quantitatively. Quantitative analysis done By using Geographic Information System. Analysis is done based on the factors that influence the selection of school location which consists of service coverage factors, distribution pattern factors, accessibility factors and land use factors. From the results of analysis based on spatial data found sowed that the area has not been served in the region Planning. This underserved area became a zone in the determination of secondary school location planning at the Medan Selayang service sub-center.

Allegheny County School District Boundaries

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates the school district boundaries within Allegheny County If viewing this description on the Western Pennsylvania Regional Data Center’s open...

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...

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...

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.

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

District Energy Windsor

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-07-01

This paper presents a summary of how District Energy Windsor operates. It includes a system site map and reasons why it is advantageous to get connected to a district heating system. District Energy Windsor is a division of the Windsor Utilities Commission. It was developed in 1996 and was the first in North America to supply both heating and cooling requirements. It supplies nearly 2 million square feet of heating and cooling for Windsor's city centre. The district energy system produces hot water or chilled water at a central plant. Energy is then piped out to buildings in the area, including the Art Gallery of Windsor, the Royal Bank Business Centre, the Windsor Justice Facility, the Windsor Casino, and Northwind Windsor. The energy, which is transferred through heat exchangers, is used for space heating, domestic hot water heating, and air conditioning. The 8 reasons for getting connected are: (1) less management costs, (2) lower energy costs, (3) lower level of risk management, (4) stable energy rates, (5) better use of building space, (6) reliable service, (7) reduced expansion costs, and (8) a cleaner environment. District heating improves air quality through reduced carbon dioxide and nitrogen oxide emissions. In addition, fuel delivery and storage are eliminated. figs.

VT Data - Overlay District 20170802, Shelburne

Data.gov (United States)

Vermont Center for Geographic Information — The following Overlay Districts are included in the data:Lakeshore Conservation OverlyNeighborhood OverlayVillage Design Review OverlayVillage Core OverlayWater...

VT Data - Overlay District 20170407, Burlington

Data.gov (United States)

Vermont Center for Geographic Information — The following Overlay District Data is included:Design Review OverlayInstitutional Core Campus OverlayRH Density Bonus OverlayNatural Resource Protection OverlayRL...

Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania.

Science.gov (United States)

Mvundura, Mercy; Lorenson, Kristina; Chweya, Amos; Kigadye, Rosemary; Bartholomew, Kathryn; Makame, Mohammed; Lennon, T Patrick; Mwangi, Steven; Kirika, Lydia; Kamau, Peter; Otieno, Abner; Murunga, Peninah; Omurwa, Tom; Dafrossa, Lyimo; Kristensen, Debra

2015-05-28

Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. Copyright © 2015 Elsevier Ltd. All

Maternal and Neonatal Health Knowledge, Service Quality and Utilization: Findings from a Community Based Quasi-experimental Trial in Arghakhanchi District of Nepal.

Science.gov (United States)

Shrestha, J R; Manandhar, D S; Manandhar, S R; Adhikari, D; Rai, C; Rana, H; Poudel, M; Pradhan, A

2015-01-01

As part of the Partnership for Maternal and Newborn Health Project (PMNH), HealthRight International collaborated with Mother and Infant Research Activities (MIRA) to conduct operations research in Arghakhanchi district of Nepal to explore the intervention impact of strengthening health facility, improving community facility linkages along with Community Based Newborn Care Program (CB-NCP) on Maternal Neonatal Care (MNC) service quality, utilization, knowledge and care seeking behavior. This was a quasi-experimental study. Siddahara, Pokharathok, Subarnakhal,Narpani Health Posts (HPs) and Thada Primary Health Care Center(PHCC)in Electoral Constituency-2 were selected as intervention sites and Arghatosh, ,Argha, Khana, Hansapur HPs and Balkot PHCC in Electoral Constituency-1 were chosen as controls. The intervention started in February 2011 and was evaluated in August 2013. To compare MNC knowledge and practice in the community, mothers of children aged 0-23 months were selected from the corresponding Village Development Committees(VDCs) by a two stage cluster sampling design during both baseline (July 2010) and endline (August, 2013) assessments. The difference in difference analysis was used to understand the intervention impact. Local resource mobilization for MNC, knowledge about MNC and service utilization increased in intervention sites. Though there were improvements, many effects were not significant. Extensive trainings followed by reviews and quality monitoring visits increased the knowledge, improved skills and fostered motivation of health facility workers for better MNC service delivery. MNC indicators showed an upsurge in numbers due to the synergistic effects of many interventions.

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...

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

Science.gov (United States)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

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

Analysis the Development of Mother and Infant Health in Sampang District Hospital

Directory of Open Access Journals (Sweden)

Rukmini Rukmini

2016-01-01

Full Text Available Background: The hospital have a strategic role in efforts to reduce maternal and infant mortality. This study aimed to determine the development of maternal and infant health services carried out in Sampang District hospital between 2010 and May 2012. Methods: The quantitative study with ecology design carried out in Sampang District hospital east Java Province Indonesia in 2012. The collection of secondary data such as coverage of maternal and infant health care in the period of 2010 to May 2012, as well as qualitative data collection with in depth interview to the Head of Service, Obstetrics and Gynecology Specialist Doctors and midwives. Data were analyzed descriptively. Result: In Sampang District hospital in period 2010 – May 2012 showed, an increase in maternal and child health services, where an increase in the handling of complications of pregnancy, normal delivery or Sectio Caesar and management of newborn complications and maternal and neonatal deaths are relatively increased . The coverage of family planning services was still low and the vast majority was IUD. Conclusion: The maternal and child health services in Sampang District hospital in period of 2010 – May 2012, showed an increase in the quantity of service coverage. The majority cases of delivery in hospitals were referral cases and complications. Howefer, the number of Sectio Caesar, maternal and neonatal mortality were still high. Recommendation: Sampang District Health Offi ce and Sampang District Hospital should create a policis and programs to reduce neonatal mortality in an integrated, continuous with proper implementation of standard procedures at every level of service, supported by well trained human resources, infrastructure and adequate fi nancing.

Decentralization in Zambia: resource allocation and district performance.

Science.gov (United States)

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or

Can sonographers offer an accurate upper abdominal ultrasound service in a district general hospital?

International Nuclear Information System (INIS)

Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.

2003-01-01

Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service

NM Property Tax Districts November 2010

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...

NM Property Tax Districts December 2013

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico tax district "OUT" categories and incorporated/municipal "IN" categories as identified on the "Certificate of Tax...

An Excel Spreadsheet Model for States and Districts to Assess the Cost-Benefit of School Nursing Services.

Science.gov (United States)

Wang, Li Yan; O'Brien, Mary Jane; Maughan, Erin D

2016-11-01

This paper describes a user-friendly, Excel spreadsheet model and two data collection instruments constructed by the authors to help states and districts perform cost-benefit analyses of school nursing services delivered by full-time school nurses. Prior to applying the model, states or districts need to collect data using two forms: "Daily Nurse Data Collection Form" and the "Teacher Survey." The former is used to record daily nursing activities, including number of student health encounters, number of medications administered, number of student early dismissals, and number of medical procedures performed. The latter is used to obtain estimates for the time teachers spend addressing student health issues. Once inputs are entered in the model, outputs are automatically calculated, including program costs, total benefits, net benefits, and benefit-cost ratio. The spreadsheet model, data collection tools, and instructions are available at the NASN website ( http://www.nasn.org/The/CostBenefitAnalysis ).

School-Based Health Centers

Science.gov (United States)

... care group, such as a community health center, hospital, or health department. A few are run by the school district itself. Centers often get money from charities and the government so they can give care ...

Analysis of Business Center Implementation in Banyumas Regency

Directory of Open Access Journals (Sweden)

Lina Rifda Naufalin

2017-06-01

Full Text Available The research aims to help the development of business center as an entrepreneurship laboratory for vocational students in order to increase the number of young entrepreneurs in Indonesia. This study is also  to find out how the implementation of the existing Business Center program in SMK Banyumas District viewed from the aspects of learning, economics, organizational, and capital. Research method used qualitative method and techniques of collecting data used observation and interview. The place of research is in Vocational School 1 Purwokerto and Vocational School 2 Purwokerto. The sampling technique was purposive sampling technique. Validity of data in this research used data triangulation.The result of the research shows that the learning aspect of the implementation of the business center is effective because it becomes the student training center. Economic aspect of the business center is effective to carry out the activities of selling goods, goods production and service, business because it is supported by qualified human resources and internal audits conducted regularly. The aspect of the capital of the business center can be managed effectively.

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data.

Science.gov (United States)

Saxena, Deepak; Vangani, Ruchi; Mavalankar, Dileep V; Thomsen, Sarah

2013-03-06

Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3) carried out during 2007-2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes - Institutional delivery, antenatal care (ANC), and use of modern contraception - and selected intermediary and structural determinants of health using multiple logistic regression. Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste) has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic education and infrastructural development to begin to remove the structural causes

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

Directory of Open Access Journals (Sweden)

Dileep V. Mavalankar

2013-03-01

Full Text Available Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Methods: Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3 carried out during 2007–2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes – Institutional delivery, antenatal care (ANC, and use of modern contraception – and selected intermediary and structural determinants of health using multiple logistic regression. Results: Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Discussion and conclusions: Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic

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

An improved model for provision of rural community-based health rehabilitation services in Vhembe District, Limpopo Province of South Africa

Directory of Open Access Journals (Sweden)

Rudzani E. Luruli

2016-03-01

Full Text Available Background: In 1991, Riakona Community Rehabilitation Programme initiated community-based rehabilitation (CBR in the Vhembe District of Limpopo Province. Subsequently, the South African government adopted the programme. Aim: The aim of the study was to suggest an improvement in the model of providing CBR services. Setting: The study was conducted in six rehabilitation centres located in hospitals in the Vhembe District in Limpopo Province of South Africa. Method: A mixed-mode research design with qualitative and quantitative elements was used to conduct the study. Content analysis, the chi-square test for Goodness of Fit and the Kruskal–Wallis and Mann–Whitney non-parametric tests were conducted. Results: The key determinants of client satisfaction with the services that the community rehabilitation workers rendered included provision of assistive devices and the adoption of a holistic approach to their work. Overall, satisfaction per domain for each one of the five domains of satisfaction scored less than 90%. More than 80% of clients were satisfied with empathy (83% and assurance (80% domains. Tangibles, reliability and responsiveness domains had scores of 78%, 72% and 67%, respectively. These results, together with the reasoning map of conceptual framework description, were used as the building blocks of the CBR model. Conclusion: The improved CBR model is useful for putting the programme into practice. This is particularly so for the CBR managers in the districts of the Limpopo Province. Keywords: client satisfaction, disability, community-based rehabilitation, community rehabilitation worker

Allegheny County Magisterial Districts Outlines (2015)

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset shows the magisterial districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data portal...

IDEA Clean Energy Application Center

Energy Technology Data Exchange (ETDEWEB)

Thornton, Robert P. [International District Energy Association, Westborough, MA (United States)

2013-12-20

The DOE Clean Energy Application Centers were launched with a goal of focusing on important aspects of our nation’s energy supply including Efficiency, Reliability and Resiliency. Clean Energy solutions based on Combined Heat & Power (CHP), District Energy and Waste Heat Recovery are at the core of ensuring a reliable and efficient energy infrastructure for campuses, communities, and industry and public enterprises across the country. IDEA members which include colleges and universities, hospitals, airports, downtown utilities as well as manufacturers, suppliers and service providers have long-standing expertise in the planning, design, construction and operations of Clean Energy systems. They represent an established base of successful projects and systems at scale and serve important and critical energy loads. They also offer experience, lessons learned and best practices which are of immense value to the sustained growth of the Clean Energy sector. IDEA has been able to leverage the funds from the project award to raise the visibility, improve the understanding and increase deployment CHP, District Energy and Waste Heat Recovery solutions across the regions of our nation, in collaboration with the regional CEAC’s. On August 30, 2012, President Obama signed an Executive Order to accelerate investments in industrial energy efficiency (EE), including CHP and set a national goal of 40 GW of new CHP installation over the next decade IDEA is pleased to have been able to support this Executive Order in a variety of ways including raising awareness of the goal through educational workshops and Conferences and recognizing the installation of large scale CHP and district energy systems. A supporting key area of collaboration has involved IDEA providing technical assistance on District Energy/CHP project screenings and feasibility to the CEAC’s for multi building, multi-use projects. The award was instrumental in the development of a first-order screening

School District Size and the Deployment of Personnel Resources.

Science.gov (United States)

Daft, Richard L.; Becker, Selwyn W.

1978-01-01

The administrative component was found to receive a smaller proportion of salaries in large districts, while clerical and maintenance service proportions increased, producing a net effect of larger overhead costs in this study of high school districts in the midwestern U.S. (KR)

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

Family-Focused Preschool: Tiny Elma School District Offers Birth-to-Kindergarten Services in Hopes of Starting Families on an Education-First Course.

Science.gov (United States)

Steineger, Melissa

1996-01-01

Describes the Elma School District (Washington) birth-to-kindergarten program. One-fourth of the 100 students in the program are developmentally delayed. Family-focus elements include parent volunteers, home visits, class visitations, parenting information dissemination, parent-teacher conferences, referral to social services, and intervention.…

[Emergency service utilization and athletic injuries--data collection from the Fulda district].

Science.gov (United States)

Raschka, C; Witzel, K

1996-06-01

Throughout the period of one year all sports accidents, which implied the need of medical services (n = 59), in the district of Fulda with 195,000 inhabitants were analysed. The bulk of the accidents took place during soccer matches (37.3%). The share of women was 25.4%. A repeated trauma was registered in 69.5% of the cases. 16% of the casualties received outpatient treatment. The ambulance was already at the site of the accident in 35.6% of the cases. The greater part of the accidents happened in the afternoon (57.6%). The accident was caused due to another athlete in 44.1% of the accidents. An ambulance with a doctor on board was needed four times, because the injury demanded treatment by an internist. The principle measure of first aid, taken by the ambulance men, was the positioning of the injured limb on a splint (n = 44). The incidence of sports accidents with need for medical service is 30/100,000 inhabitants. The part of sports accidents in relation to all ambulance actions is 2.3% (internal medicine only 0.18% and surgery only 15.3%). The percentage of sports accidents demanding a doctor in relation to all rescues with the need for a doctor is 0.3%.

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

National Research Council Canada - National Science Library

Bridges, W

1997-01-01

...; procuring those services using Federal Acquisition Regulation (FAR) contracts. It also plans to centralize the payment process at the Defense Finance and Accounting Service-Indianapolis Center (DFAS...

Energy Assessment of Automated Mobility Districts

Energy Technology Data Exchange (ETDEWEB)

Chen, Yuche [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-08-03

Automated vehicles (AVs) are increasingly being discussed as the basis for on-demand mobility services, introducing a new paradigm in which a fleet of AVs displace private automobiles for day-to-day travel in dense activity districts. This project examines such a concept to displace privately owned automobiles within a region containing dense activity generators (jobs, retail, entertainment, etc.), referred to as an automated mobility district (AMDs). The project reviews several such districts including airport, college campuses, business parks, downtown urban cores, and military bases, with examples of previous attempts to meet the mobility needs apart from private automobiles, some with automated technology and others with more traditional transit based solutions. The issues and benefits of AMDs are framed within the perspective of intra-district, inter-district, and border issues, and the requirements for a modeling framework are identified to adequately reflect the breadth of mobility, energy, and emissions impact anticipated with AMDs.

Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial.

Science.gov (United States)

Waiswa, Peter; O'Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Henriksson, Dorcus Kiwanuka; Katahoire, Anne Ruhweza; Ssegujja, Eric; Mbonye, Anthony K; Peterson, Stefan Swartling

2016-03-11

Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement context-specific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices. By increasing the District Health Management Teams' capacity to prioritize and implement context-specific solutions, and empowering communities to

Upper Blackstone Water Pollution Abatement District Chief Operator Recognized for Outstanding Service

Science.gov (United States)

Joseph Nowak, a resident of Ware Mass. and Chief Operator of the Upper Blackstone Water Pollution Abatement District (District) in Milbury, Mass., was honored by EPA with a 2016 Regional Wastewater Treatment Plant Operator of the Year Excellence Award.

A cost function analysis of child health services in four districts in Malawi.

Science.gov (United States)

Johns, Benjamin; Munthali, Spy; Walker, Damian G; Masanjala, Winford; Bishai, David

2013-05-10

Recent analyses show that donor funding for child health is increasing, but little information is available on actual costs to deliver child health care services. Understanding how unit costs scale with service volume in Malawi can help planners allocate budgets as health services expand. Data on facility level inputs and outputs were collected at 24 health centres in four districts of Malawi visiting a random sample of government and a convenience sample of Christian Health Association of Malawi (CHAM) health centres. In the cost function, total outputs, quality, facility ownership, average salaries and case mix are used to predict total cost. Regression analysis identifies marginal cost as the coefficient relating cost to service volume intensity. The marginal cost per patient seen for all health centres surveyed was US$ 0.82 per additional patient visit. Average cost was US$ 7.16 (95% CI: 5.24 to 9.08) at government facilities and US$ 10.36 (95% CI: 4.92 to 15.80) at CHAM facilities per child seen for any service. The first-line anti-malarial drug accounted for over 30% of costs, on average, at government health centres. Donors directly financed 40% and 21% of costs at government and CHAM health centres, respectively. The regression models indicate higher total costs are associated with a greater number of outpatient visits but that many health centres are not providing services at optimal volume given their inputs. They also indicate that CHAM facilities have higher costs than government facilities for similar levels of utilization. We conclude by discussing ways in which efficiency may be improved at health centres. The first option, increasing the total number of patients seen, appears difficult given existing high levels of child utilization; increasing the volume of adult patients may help spread fixed and semi-fixed costs. A second option, improving the quality of services, also presents difficulties but could also usefully improve performance.

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...

Boise geothermal district heating system

Energy Technology Data Exchange (ETDEWEB)

Hanson, P.J.

1985-10-01

This document describes the Boise geothermal district heating project from preliminary feasibility studies completed in 1979 to a fully operational system by 1983. The report includes information about the two local governments that participated in the project - the City of Boise, Idaho and the Boise Warm Springs Water District. It also discusses the federal funding sources; the financial studies; the feasibility studies conducted; the general system planning and design; design of detailed system components; the legal issues involved in production; geological analysis of the resource area; distribution and disposal; the program to market system services; and the methods of retrofitting buildings to use geothermal hot water for space heating. Technically this report describes the Boise City district heating system based on 170/sup 0/F water, a 4000 gpm production system, a 41,000 foot pipeline system, and system economies. Comparable data are also provided for the Boise Warm Springs Water District. 62 figs., 31 tabs.

UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

Directory of Open Access Journals (Sweden)

Atik Triratnawati

2006-06-01

Full Text Available The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to underutilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting, strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation. To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective.

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)

Depolarization in Delivering Public Services? Impacts of Minimum Service Standards (MSS on the Quality of Health Services in Indonesia

Directory of Open Access Journals (Sweden)

Mohammad Roudo

2016-03-01

Full Text Available Abstract. Some scholars argue that decentralization policy tends to create polarization, i.e. an increase of inequality/disparity among districts. To deal with this problem, Minimum Service Standards (MSS were introduced as a key strategy in decentralizing Indonesia. In this research, we tried to find out through MSS performance measurements whether imposing standards can be effective in a decentralized system by seeking its impacts on polarization/depolarization in the delivery of public services, specifically in the health sector. This question is basically a response to the common criticism that decentralization is good to create equality between central government and local governments but often does not work to achieve equality among local governments. Using self-assessment data from a sample of 54 districts from 534 districts in Indonesia, from 2010 to 2013, we found that the existence of depolarization in the delivery of public services could potentially occur among regions by reducing the gap between their public service performance and the targets of MSS. We acknowledge that there are weaknesses in the validity of the self-assessment data, caused by a lack of knowledge and skills to execute the self-assessment according to the official guidelines, by the overrating of target achievements, as well as the lack of data from independent sources to confirm the self-assessment outcomes. We also acknowledge that differences in financial capacity are still the main determinant why one district is more successful in achieving the MSS targets compared to other districts. Keywords. Decentralization, Public Service, Minimum Standard Service

Spatial analyses identify the geographic source of patients at a National Cancer Institute Comprehensive Cancer Center.

Science.gov (United States)

Su, Shu-Chih; Kanarek, Norma; Fox, Michael G; Guseynova, Alla; Crow, Shirley; Piantadosi, Steven

2010-02-01

We examined the geographic distribution of patients to better understand the service area of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, a designated National Cancer Institute (NCI) comprehensive cancer center located in an urban center. Like most NCI cancer centers, the Sidney Kimmel Comprehensive Cancer Center serves a population beyond city limits. Urban cancer centers are expected to serve their immediate neighborhoods and to address disparities in access to specialty care. Our purpose was to learn the extent and nature of the cancer center service area. Statistical clustering of patient residence in the continental United States was assessed for all patients and by gender, cancer site, and race using SaTScan. Primary clusters detected for all cases and demographically and tumor-defined subpopulations were centered at Baltimore City and consisted of adjacent counties in Delaware, Pennsylvania, Virginia, West Virginia, New Jersey and New York, and the District of Columbia. Primary clusters varied in size by race, gender, and cancer site. Spatial analysis can provide insights into the populations served by urban cancer centers, assess centers' performance relative to their communities, and aid in developing a cancer center business plan that recognizes strengths, regional utility, and referral patterns. Today, 62 NCI cancer centers serve a quarter of the U.S. population in their immediate communities. From the Baltimore experience, we might project that the population served by these centers is actually more extensive and varies by patient characteristics, cancer site, and probably cancer center services offered.

Improving district heating in Kiev

International Nuclear Information System (INIS)

Salminen, P.

2000-01-01

The district heating modernisation project currently under way in Kiev, the capital of the Ukraine, is the largest project of its type financed by the World Bank. The budget for the five-year project is some USD 250 million of which USD 200 million is financed by the World Bank loan. The target of the project is to improve the city's district heating system, which is owned and operated by Kyivenergo. Consultancy services for the Project Implementation Unit are being provided by Electrowatt-Ekono and financed by the Finnish government

Situation of the Kinh poor and minority women and their use of the Maternal Care and Family Planning Service in Nam Dong Mountainous District, Thuathien-Hue Province, Vietnam.

Science.gov (United States)

Vo Van, T; Hoat, L N; Jan van Schie, T

2004-01-01

This study aimed to determine the barriers to the use of maternal care and family planning (MCFP) services by the disadvantaged Kinh people and Katu ethnic minority people in the remote and mountainous area of Nam Dong District in Central Vietnam. A survey was conducted using a random sample of 420 mothers with at least one child under the age of 5 years. These data were supplemented by interviews with key informants, focus group discussions and observations. Many barriers were identified. The difficulty of the terrain made travel to healthcare centers difficult. The cost of treatment was a barrier for the poorest people. The quality of the services and facilities, as well as the management of these services was perceived to be unsatisfactory. Traditional practices were often described as being contrary to the doctor's advice, and were presented as the reason for unsafe and unassisted home deliveries. Communication was difficult because of the minority languages of the client groups, the prevalence of illiteracy, and the absence of mass communication in this region. Finally, consulting a male healthcare worker was reported to bring the women shame. There is an urgent need for the MCFP services to build both clinical capacity and health promotion activities in a way that is gender sensitive, cognisant of traditional practices and accessible by both illiterate and minority language speaking people.

Residents’ Willingness to Pay for Household Kitchen Waste Separation Services in Haidian and Dongcheng Districts, Beijing City

Directory of Open Access Journals (Sweden)

Yalin Yuan

2014-12-01

Full Text Available This paper reports a contingent valuation study on household kitchen waste separation (HKWS services via willingness to pay (WTP conducted in the Haidian and Dongcheng districts of Beijing city in 2013. This study focuses on a real program to understand households’ attitudes toward HKWS and to estimate the value of HKWS services. The results of this study revealed that 41.4% agreed to accept the proposed price of HKWS services, while 42.2% refused to pay, but with a positive attitude toward the HKWS program. In addition, respondents’ WTP for proposed HKWS services is significantly related to the level of bid price and their gender, age and education experience. Attitudinal factors that affect resident WTP were also found. For example, respondents who perceive themselves as having a higher ability to conduct HKWS at the source are more willing to pay for their HKWS services, while respondents who complain of the inconvenience of conducting HKWS show negative WTP. The results also showed that on average each household is willing to pay about US$1.44 per month for HKWS services, which is based on 327 respondents after excluding 64 (16.4% of all sample who indicated complete opposition to the HKWS program.

Developing a district energy system in a competitive urban market

Energy Technology Data Exchange (ETDEWEB)

Mitola, J.P. [Unicom Thermal Technologies, Chicago, IL (United States)

1995-09-01

In two year`s time, Unicorn Thermal Technologies has grown into one of the largest district cooling systems of 25,000 tons with a 1996 plan to grow to 40,000 tons. This growth is attributed to the development and implementation of a marketing and sales plan based on thorough market research and innovative marketing and sales strategies, and the consistent implementation of those strategies. The beginning of the sales effort was focused around the company`s first district cooling facility, However, it quickly grew into a much broader vision as market acceptance increased. Although the district energy industry has often based its message on being a low cost energy provider, market research and early sales experience indicated that customers choose district cooling as a value added service. As customers began to reserve capacity in the first plant, the idea that district cooling is a value added service and not a commodity energy product was continually reinforced through marketing communications. Although this analysis is a review of developing a district energy system in a competitive urban market, it purposely avoids a long winded discussion of head to head competition.

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.

The Effect of the Minimum Compensating Cash Balance on School District Investments.

Science.gov (United States)

Dembowski, Frederick L.

Banks are usually reimbursed for their checking account services either by a fixed service charge or by requiring a minimum or minimum-average compensating cash balance. This paper demonstrates how to determine the optimal minimum balance for a school district to maintain in its account. It is assumed that both the bank and the school district use…

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.

Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

Science.gov (United States)

Lang'at, Evaline; Mwanri, Lillian

2015-06-27

Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

Metabolic monitoring in New Zealand district health board mental health services.

Science.gov (United States)

Staveley, Aimee; Soosay, Ian; O'Brien, Anthony J

2017-11-10

To audit New Zealand district health boards' (DHBs) metabolic monitoring policies in relation to consumers prescribed second-generation antipsychotic medications using a best practice guideline. Metabolic monitoring policies from DHBs and one private clinic were analysed in relation to a best practice standard developed from the current literature and published guidelines relevant to metabolic syndrome. Fourteen of New Zealand's 20 DHBs currently have metabolic monitoring policies for consumers prescribed antipsychotic medication. Two of those policies are consistent with the literature-based guideline. Eight policies include actions to be taken when consumers meet criteria for metabolic syndrome. Four DHBs have systems for measuring their rates of metabolic monitoring. There is no consensus on who is clinically responsible for metabolic monitoring. Metabolic monitoring by mental health services in New Zealand reflects international experience that current levels of monitoring are low and policies are not always in place. Collaboration across the mental health and primary care sectors together with the adoption of a consensus guideline is needed to improve rates of monitoring and reduce current rates of physical health morbidities.

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.

Context matters: Successes and challenges of intrapartum care scale-up in four districts of Afghanistan.

Science.gov (United States)

Tappis, Hannah; Koblinsky, Marge; Winch, Peter J; Turkmani, Sabera; Bartlett, Linda

2016-01-01

Reducing preventable maternal mortality and achieving Sustainable Development Goal targets for 2030 will require increased investment in improving access to quality health services in fragile and conflict-affected states. This study explores the conditions that affect availability and utilisation of intrapartum care services in four districts of Afghanistan where mortality studies were conducted in 2002 and 2011. Information on changes in each district was collected through interviews with community members; service providers; and district, provincial and national officials. This information was then triangulated with programme and policy documentation to identify factors that affect the coverage of safe delivery and emergency obstetric care services. Comparison of barriers to maternal health service coverage across the four districts highlights the complexities of national health policy planning and resource allocation in Afghanistan, and provides examples of the types of challenges that must be addressed to extend the reach of life-saving maternal health interventions to women in fragile and conflict-affected states. Findings suggest that improvements in service coverage must be measured at a sub-national level, and context-specific service delivery models may be needed to effectively scale up intrapartum care services in extremely remote or insecure settings.

Allegheny County Voting District (2016) Web Map

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This webmap demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...

Allegheny County Voting District (2015) Web Map

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This webmap demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...

Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities.

Science.gov (United States)

Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek

2017-07-01

The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ2 tests were used to evaluate possible differences in service delivery by type of health facility. Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

7 CFR 1900.3 - State, district, and county office employees.

Science.gov (United States)

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false State, district, and county office employees. 1900.3 Section 1900.3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF...

Towards understanding citizens trust in local government authorities in social service provision: A case of education service in Maswa district Tanzania

Directory of Open Access Journals (Sweden)

Robert Makorere

2012-09-01

Full Text Available The paper stresses on understanding citizens’ trust to local government authorities in the provision of social services, the case of education service in Maswa district. The paper discloses that majority of respondents of 82.2% of total respondents were not involved in full council meetings, although the meetings are supposed to be open to the public and all information that is presented there is public information which includes proposed plans and budgets as well as quarterly progress reports. This shows that there are problems in primary education. Moreover, due to various problems that still exist in primary education in the area under study, they created a sense of distrust between citizens to local government and local leaders to be specific including Village Executive Officers, Ward Executive Officers and councilors since majority of the respondents revealed that they are lazy harass people. This makes people to be reluctant to participate in development activities include refusing to contribute financially in various development initiatives since they do not see importance of their local leaders so they decide to take their own decisions.

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

Management of district hospitals--exploring success.

Science.gov (United States)

Couper, Ian D; Hugo, Jannie F M

2005-01-01

The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world. A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-functioning district hospitals in two districts in South Africa. Thirteen themes were identified, integrated into three clusters, namely 'Teams working together for a purpose', 'Foundational framework and values' and 'Health Service and the community'. Teamwork and teams was a dominant theme. Teams working together are held together by the cement of good relationships and are enhanced by purposeful meetings. Unity is grown through solving difficult problems together and commitment to serving the community guides commitment towards each other, and towards patients and staff. Open communication and sharing lots of information between people and teams is the way in which these things happen. The structure and systems that have developed over years form the basis for teamwork. The different management structures and processes are developed with a view to supporting service and teamwork. A long history of committed people who hand over the baton when they leave creates a stable context. The health service and community theme cluster describes how integration in the community and community services is important for these managers. There is also a focus on involving community representatives in the hospital development and governance. Capacity building for staff is seen in the same spirit of serving people and thus serving staff, all aimed at reaching out to people in need in the community. The three clusters and thirteen themes and the relationships between them are described in detail through diagrams and narrative in the article. Much can be learned from the experience of these managers. The key issue is the development of a team in the hospital, a team with a unified vision of giving

Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania.

Science.gov (United States)

Ishengoma, Deus S; Kamugisha, Mathias L; Rutta, Acleus S M; Kagaruki, Gibson B; Kilale, Andrew M; Kahwa, Amos; Kamugisha, Erasmus; Baraka, Vito; Mandara, Celine I; Materu, Godlisten S; Massaga, Julius J; Magesa, Stephen M; Lemnge, Martha M; Mboera, Leonard E G

2017-01-23

Roll-out and implementation of antiretroviral therapy (ART) necessitated many countries in Sub-Saharan Africa to strengthen their national health laboratory systems (NHLSs) to provide high quality HIV diagnostic and supportive services. This study was conducted to assess the performance of health laboratories in provision of HIV diagnostic and supportive services in eight districts (from four regions of Iringa, Mtwara, Tabora and Tanga), after nine years of implementation of HIV/AIDS care and treatment plan in Tanzania. In this cross-sectional study, checklists and observations were utilized to collect information from health facilities (HFs) with care and treatment centres (CTCs) for HIV/AIDS patients; on availability of laboratories, CTCs, laboratory personnel, equipment and reagents. A checklist was also used to collect information on implementation of quality assurance (QA) systems at all levels of the NHLS in the study areas. The four regions had 354 HFs (13 hospitals, 41 Health Centres (HCs) and 300 dispensaries); whereby all hospitals had laboratories and 11 had CTCs while 97.5 and 61.0% of HCs had both laboratories and CTCs, respectively. Of the dispensaries, 36.0 and 15.0% had laboratories and CTCs (mainly in urban areas). Thirty nine HFs (12 hospitals, 21 HCs and six dispensaries) were assessed and 56.4% were located in urban areas. The assessed HFs had 199 laboratory staff of different cadres (laboratory assistants = 35.7%; technicians =32.7%; attendants = 22.6%; and others = 9.1%); with >61% of the staff and 72.3% of the technicians working in urban areas. All laboratories were using rapid diagnostic tests for HIV testing. Over 74% of the laboratories were performing internal quality control and 51.4% were participating in external QA programmes. Regional and district laboratories had all key equipment and harmonization was maintained for Fluorescence-Activated Cell Sorting (FACS) machines. Most of the biochemical (58.0%) and haematological

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.

Financial Management: Promptness of FY 2002 Third Quarter DoD Payments to the Department of the Treasury for District of Columbia Water and Sewer Services

National Research Council Canada - National Science Library

2002-01-01

... the agency's promptness in paying the District of Columbia for water and sewer services. The audit reports must be submitted to the House and Senate Appropriations Committees within 15 days of the start of each quarter...

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

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…

Outsourcing Special Education Services

Science.gov (United States)

McKenzie, Anne S.; Bishop, Anna M.

2009-01-01

The Lower Pioneer Valley Educational Collaborative, organized in 1974, consists of seven school districts legally bound in a governance structure. Although the member districts are located in Hampden County, Massachusetts, the collaborative provides educational programs and services to school districts and municipalities throughout western…

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.

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.

Soil and Water Conservation Districts of New Mexico

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The New Mexico Soil and Water Conservation District (SWCD) shapefile includes forty-seven boudaries which cover each SWCD throughout the State.

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...

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...

Primary health services at district level in South Africa: a critique of the primary health care approach

Directory of Open Access Journals (Sweden)

Dookie Sunitha

2012-07-01

Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

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

The path dependence of district manager decision-space in Ghana

Science.gov (United States)

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-01-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970–85); (2) Strengthening District Health Systems Initiative (1986–93); (3) health sector reform planning and creation of the Ghana Health Service (1994–96) and (4) health sector reform implementation (1997–2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of

The path dependence of district manager decision-space in Ghana.

Science.gov (United States)

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-04-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970-85); (2) Strengthening District Health Systems Initiative (1986-93); (3) health sector reform planning and creation of the Ghana Health Service (1994-96) and (4) health sector reform implementation (1997-2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has

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.

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

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.

7 CFR 947.32 - Districts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Districts. 947.32 Section 947.32 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... consideration to (1) the relative importance of new areas of production, (2) changes in the relative position of...

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.

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.

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...

Improving child survival through a district management strengthening and community empowerment intervention: early implementation experiences from Uganda.

Science.gov (United States)

Katahoire, Anne Ruhweza; Henriksson, Dorcus Kiwanuka; Ssegujja, Eric; Waiswa, Peter; Ayebare, Florence; Bagenda, Danstan; Mbonye, Anthony K; Peterson, Stefan Swartling

2015-08-19

The Community and District Empowerment for Scale-up (CODES) project pioneered the implementation of a comprehensive district management and community empowerment intervention in five districts in Uganda. In order to improve effective coverage and quality of child survival interventions CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. This paper presents early implementation experiences in five pilot districts and lessons learnt during the first 2 years of implementation. This qualitative study was comprised of 38 in-depth interviews with members of the District Health Teams (DHTs) and two implementing partners. These were supplemented by observations during implementation and documents review. Thematic analysis was used to distill early implementation experiences and lessons learnt from the process. All five districts health teams with support from the implementing partners were able to adopt the UNICEF tools and to develop district health operational work plans that were evidence-based. Members of the DHTs described the approach introduced by the CODES project as a more systematic planning process and very much appreciated it. Districts were also able to implement some of the priority activities included in their work plans but limited financial resources and fiscal decision space constrained the implementation of some activities that were prioritized. Community dialogues based on Citizen Report Cards (CRC) increased community awareness of available health care services, their utilization and led to discussions on service delivery, barriers to service utilization and processes for improvement. Community dialogues were also instrumental in bringing together service users, providers and leaders to discuss problems and

Evaluation in School Districts; Organizational Perspectives. CSE Monograph Series in Evaluation, 10.

Science.gov (United States)

Bank, Adrianne, Ed.; Williams, Richard C., Ed.

This monograph focuses on educational evaluation and how it occurs within a specific setting--school districts' central administrative offices--examining the relationships between evaluation activities and district organizational features that impinge upon such activities. The various chapter authors worked with the Center for the Study of…

Chelsea, Pimlico and Belgravia District Nursing Association 1930-1939: A case study.

Science.gov (United States)

Bliss, Julie

2017-07-02

The case study explores how the expansion of the health services during the interwar period impacted upon the status of district nursing and examines how being a voluntary service shaped district nursing associations. A range of primary sources were used; the Association Annual Reports, the Medical Officer for Health Annual Reports for the Borough of Chelsea, the Ministry of Health records, the archives of the Queen's Nursing Institute (QNI) and the Borough of Chelsea Council Minutes. The Medical Officer for Health Reports and the Council minutes identify efforts to improve environmental factors that impacted upon health. These primary sources briefly note the contribution of the Association suggesting that it was integral to the health care provision but considered a constant. The impact of changes to the 1932 Sunday Entertainments Act provide an interesting juxtaposition between the acknowledged value of district nursing and the constant struggle to fundraise in order to provide home nursing. Throughout the 1930s the Association experienced staff shortages and challenges regarding recruitment. The complexities of payment for municipal health services following the 1929 Local Government Act contributed to the staffing challenges. The move to a block grant in 1938 provided increased stability with regards to income. The case study identifies a contradiction regarding the esteem and value placed upon district nursing associations providing home nursing and the constant challenge of resources. District nursing services face similar challenges and this is the 130 th anniversary of the Queen's Nursing Institute.

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

Science.gov (United States)

Habte, Feleke; Demissie, Meaza

2015-11-17

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

Utilization of maternal health care services among indigenous women in Bangladesh: A study on the Mru tribe.

Science.gov (United States)

Islam, Rakibul M

2017-01-01

Despite startling developments in maternal health care services, use of these services has been disproportionately distributed among different minority groups in Bangladesh. This study aimed to explore the factors associated with the use of these services among the Mru indigenous women in Bangladesh. A total of 374 currently married Mru women were interviewed using convenience sampling from three administrative sub-districts of the Bandarban district from June to August of 2009. Associations were assessed using Chi-square tests, and a binary logistic regression model was employed to explore factors associated with the use of maternal health care services. Among the women surveyed, 30% had ever visited maternal health care services in the Mru community, a very low proportion compared with mainstream society. Multivariable logistic regression analyses revealed that place of residence, religion, school attendance, place of service provided, distance to the service center, and exposure to mass media were factors significantly associated with the use of maternal health care services among Mru women. Considering indigenous socio-cultural beliefs and practices, comprehensive community-based outreach health programs are recommended in the community with a special emphasis on awareness through maternal health education and training packages for the Mru adolescents.

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...

The contribution of district clinical specialist team

African Journals Online (AJOL)

2 Tshwane District Health Services, Gauteng Department of Health, South Africa .... assurance managers conducted monthly scoring of antenatal records at delivery ... Clinical audit and health system strengthening are part of DCSTs' scope.

Allegheny County Voting District Boundaries (Spring 2017 - present)

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County.If viewing this description on the Western Pennsylvania Regional Data Center’s open data...

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...

Role of Puskesmas Leader in Development of UKBM in Purbalingga District

Directory of Open Access Journals (Sweden)

Aryo Ginanjar

2016-06-01

Full Text Available Background: Implementation of Puskesmas function as the center of society empowerment was done through thedevelopment of UKBM in work region of Puskesmas. This research aims to know the role of Puskesmas leader in PurbalinggaDistrict, Central Java Province in the implementation of Puskesmas function as the the center of society empowermentthrough development of UKBM. Role of Puskesmas leader that were analyzed in this research were role of motivation,communication, leadership, guidance, observation and supervision. Methods: The mainsubject of this research were7 leaders of Puskesmas in Purbalingga District. The supporting subject were 7 people worked as Health Promotor in 7Puskesmas and 1 person worked as Head of Society Empowerment and Health Promotion Divition Purbalingga District.Research type is descriptive with qualitative approach. Results of indepth interview, observation, and document analysisshowed that the knowledgeof the Puskesmas leader in Purbalingga District concerning Puskesmas function as the center ofsociety empowrement represent the Health Paradigm through facilities in the form of UKBM as the active participation fromsociety to increase health degree of Indonesian society. Results: The role of Puskesmas leader in aspects of motivation, communication, guidance, supervise, and development of UKBM had been done well. The leadership role was applied bythe combination of Democratic and Autoritary style of leadership. The difference of the role between Puskesmas leadersfrom medical background and nonmedical background was found insupervision aspect. Conclusion: Department of Healthneeds to undertake human resource development in the health center which has a dual leadership with the workload sothat the role of supervision has not run optimally.

Risk of low birthweight in social districts of Copenhagen

DEFF Research Database (Denmark)

Lund, R; Modvig, J; Hilden, J

1999-01-01

The purpose of this survey was to investigate the small-area variations in low birthweight within social services districts in Copenhagen and the relation of such variations to the socioeconomic characteristics of the district. The study was based on register data and included all live-born single...... on births to women living in the city of Copenhagen from 1987-90. We found a statistically significant association between district and risk of newborns being small-for-gestational age (SGA). This association was independent of adjustment for maternal age and parity. Only part of the association...

Urban Greening as part ofDistrict Energy Services

OpenAIRE

MELIN, Sébastien

2017-01-01

Work carried out during this master’s thesis is about urban greening and its close integration with district energy systems. Urban greening is the fact to develop green infrastructures (parks, street trees, ...) instead of grey infrastructures (buildings, roads, ...) in cities. Despite that the actual economic value of green infrastructure is less appreciated at first glance and very difficult to valorize, urban greening has many undeniable advantages such as reducing pollution and heat islan...

A Survey Study of Cryptosporidium Infection in Children under 10 Years Old Referred to the Health Care Centers of Hamadan District in 2013

Directory of Open Access Journals (Sweden)

M. Asadi

2014-10-01

Full Text Available Introduction & Objective: Cryptosporidium is one of the most important zoonotic and oppor-tunistic protozoa and can cause diarrhea in those with impaired immune systems, as well as the children. Considering the high sensitivity of children against infection caused by crypto-sporidium, its zoonotic nature and lack of treatment, this study aimed to determine the prevalence of cryptosporidium infection in children under 10 years old, referred to the health care centers of Hamadan district. Materials & Methods: This study was conducted in 2013 on 420 children (222 males and 198 females, who were referred to urban and rural health care centers in Hamadan district. Stool samples were examined using formalin-ether method and modified Ziehl-Neelsen staining technique. The results were analyzed with chi-square test. Results: Of the 420 children studied, 2 individuals (0.47% (A 16-month-old boy and a 6-year-old girl were infected with cryptosporidium spp. The infection was observed only in rural areas and in children that were in direct contact with the animals. Conclusion: The results of this study showed a presence of cryptosporidium in rural areas compared to urban areas and in children in contact with animals. Therefore it is necessary to promote the public health awareness of rural population. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 211-217

REGIONAL DEVELOPMENT WITHIN THE RUHR DISTRICT – FROM THE FORMALLY CENTRE OF THE COAL AND STEAL INDUSTRY TO A CENTRE OF TERTIARY SERVICES

Directory of Open Access Journals (Sweden)

Dieter Anhuf

2008-09-01

Full Text Available Regional development within the Ruhr district – from the formally centre of the coal and steel industry to a centre of tertiary services. The Ruhrgebiet (Ruhr district is an urban agglomeration in the western part of Germany with a population of approximately 5.3 Million, covering an area of 4.435 km². It’s part of the metropolitan area of Rhine-Ruhr with more than 10 Million inhabitants living in an area of about 10.000 km².The black coal resources, deposited during the carboniferous area form the natural backbone for the development of the largest region of coal, iron, and steel industry in Europe. The economy of the Ruhrgebiet was unidirectional dominated for more than 150 years by four heavy industry sectors, black coal, steel, chemical industry and energy production. But later, when petroleum and natural gas and cheaper imported black coal conquered the German market and, as well, steel could be produced at a reduced rate elsewhere in the world the booming producing industry quasi collapsed. Thus, the Region is characterized by an above average unemployment since the mid 70ies. More than 50% of the 1 Million jobs in the region were lost, while only 300.000 new jobs could be added within the service sector between 1980 and 2002. The economic and social structural change within the Ruhr district is primarily based on the expansion of services like advertisement, science, development, transport logistics, consulting, and design. But also the cultural and tourist branches are characterized by growing figures. The BIP, produced within the Ruhrgebiet, is about 26% of the BIP of North-Rhine-Westphalia or 6% of Germany’s BIP. In comparison, the metropolitan area of São Paulo produces 17% of the national BIP of Brazil.

Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India

Directory of Open Access Journals (Sweden)

Shailbala Patil

2014-01-01

Full Text Available Background : Konkan coast of India is geographically distinct and its pattern of blindness has never been mapped. Aim : To study the prevalence and causes of blindness and cataract surgical services in Sindhudurg district of West Coast. Subjects : Individual aged > 50 years. Materials and Methods: Rapid assessment of avoidable blindness used to map blindness pattern in the district. Statistical analysis: SPSS version 19. Results: Amongst those examined 1415 (51.7% had visual acuity (VA >20/60, 924 (33.8%, confidence interval (C.I 30.5%-36.8% had VA 20/200-<20/60(visual impairment, 266 (9.7%, C.I. 6.1%-13.3% had VA < 20/200-20/400 (severe visual impairment and 132 (4.8%, C. I. 1.1%-8.5% had VA < 20/400 (blindness by WHO standards. There was no significant gender difference in prevalence of blindness, but blindness and visual impairment was more in older and rural residing individuals. Amongst those with presenting vision < 20/200 in better eye, 309 (82.4% had cataract, 36 (9.7% had corneal scars, 13 (3.5% had diabetic retinopathyand 3 (0.8% had glaucoma. Cataract surgical coverage for the district was only 30.5%; 32% for males and 28.4% for females. Unable to afford, lack of knowledge and lack of access to services were the commonest barriers responsible for cataract patients not seeking care. Amongst those who had undergone cataract surgery, only 50% had visual acuity ≥ 20/60.46.9% of the population had spectacles for near, but only 53.3% of the population had presenting near vision < N10. Conclusion : Cataract, refractive errors and diabetes were significant causes of visual impairment and blindness.

Metro Council Districts, 2004, East Baton Rouge Parish, Louisiana

Data.gov (United States)

Louisiana Geographic Information Center — This is a graphical polygon dataset depicting the polygon boundaries of the twelve (12) Metropolitan Council Districts within the Parish of East Baton Rouge. The...

United States Congressional Districts from LEGIS source data, Geographic NAD83, LOSCO (2004) [us_congress_LEGIS_2001

Data.gov (United States)

Louisiana Geographic Information Center — United States Congressional Districts. The district boundaries are the result of legislative acts and redistricting. Reapportionment (redistricting) occurs during...

Application of an intermediate LWR for electricity production and hot-water district heating

International Nuclear Information System (INIS)

1983-05-01

The objective of the study is to evaluate the technical and economic feasibility of a 400 MWe Consolidated Nuclear Steam System (CNSS) for supplying district heat to the Minneapolis/St. Paul area. A total of three CNSS reactor sites, located various distances from the Minneapolis-St. Paul area load center, are evaluated. The distance from the load center is determined by the credited safety features of the plant design. Each site is also evaluated for three different hot water supply/return temperatures providing a total of nine CNSS study cases. The cost of district heat delivered to the load center is determined for each case

Mapping crime levels and court efficiency per magisterial district in South Africa.

CSIR Research Space (South Africa)

Schmitz, Peter MU

2002-12-01

Full Text Available the South African Police Service (SAPS) were reclassified into the six major categories used by DoJ, and the crime levels per magisterial district were calculated, imported into a Geographic Information System (GIS) and mapped per magisterial district...

Mapping crime levels and court efficiency per magisterial district in South Africa

CSIR Research Space (South Africa)

Schmitz, Peter MU

2002-12-01

Full Text Available the South African Police Service (SAPS) were reclassified into the six major categories used by DoJ, and the crime levels per magisterial district were calculated, imported into a Geographic Information System (GIS) and mapped per magisterial district...

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

Trees in the small city retail business district: comparing resident and visitor perceptions

Science.gov (United States)

Kathleen L. Wolf

2005-01-01

Many small cities and towns are located near resource lands, and their central business districts serve both residents and visitors. Such quasi-rural retail centers face competitive challenges from regional shopping malls, online purchasing, and big box discount retailers. District merchants must strategically enhance their market...

Implementation of a new 'community' laboratory CD4 service in a rural health district in South Africa extends laboratory services and substantially improves local reporting turnaround time.

Science.gov (United States)

Coetzee, L M; Cassim, N; Glencross, D K

2015-12-16

The CD4 integrated service delivery model (ITSDM) provides for reasonable access to pathology services across South Africa (SA) by offering three new service tiers that extend services into remote, under-serviced areas. ITSDM identified Pixley ka Seme as such an under-serviced district. To address the poor service delivery in this area, a new ITSDM community (tier 3) laboratory was established in De Aar, SA. Laboratory performance and turnaround time (TAT) were monitored post implementation to assess the impact on local service delivery. Using the National Health Laboratory Service Corporate Data Warehouse, CD4 data were extracted for the period April 2012-July 2013 (n=11,964). Total mean TAT (in hours) was calculated and pre-analytical and analytical components assessed. Ongoing testing volumes, as well as external quality assessment performance across ten trials, were used to indicate post-implementation success. Data were analysed using Stata 12. Prior to the implementation of CD4 testing at De Aar, the total mean TAT was 20.5 hours. This fell to 8.2 hours post implementation, predominantly as a result of a lower pre-analytical mean TAT reducing from a mean of 18.9 to 1.8 hours. The analytical testing TAT remained unchanged after implementation and monthly test volumes increased by up to 20%. External quality assessment indicated adequate performance. Although subjective, questionnaires sent to facilities reported improved service delivery. Establishing CD4 testing in a remote community laboratory substantially reduces overall TAT. Additional community CD4 laboratories should be established in under-serviced areas, especially where laboratory infrastructure is already in place.

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

Chelsea, Pimlico and Belgravia District Nursing Association 1930-1939::A case study

OpenAIRE

Bliss, Julie

2017-01-01

The case study explores how the expansion of the health services during the interwar period impacted upon the status of district nursing and examines how being a voluntary service shaped district nursing associations. A range of primary sources were used; the Association Annual Reports, the Medical Officer for Health Annual Reports for the Borough of Chelsea, the Ministry of Health records, the archives of the Queen's Nursing Institute (QNI) and the Borough of Chelsea Council Minutes.The Medi...

Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

Science.gov (United States)

Schoevers, Johan; Jenkins, Louis

2015-04-21

Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

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

Assessment of oral health promotion services offered as part of maternal and child health services in the Tshwane Health District, Pretoria, South Africa

Directory of Open Access Journals (Sweden)

Yolanda Kolisa

2016-04-01

Full Text Available Objectives: The study aimed to assess the oral health promotion services provided as part of the maternal and child health (MCH services in the Tshwane Health District, Pretoria, South Africa. Methods: The research design was a descriptive cross-sectional study using a modified standard questionnaire. The population was drawn from the parents/caregivers (PCGs and the MCH nurses at seven clinics during June 2012 and June 2013 in Pretoria. Results: The nurses’ response rate was 83%; average age of 37 years. The majority of the nurses (65% were females; 60% were professional nurses. Most (63% of the nurses reported that they provided oral health education (OHE services. A shortage of dental education materials (43%, staff time (48%, and staff training (52% were large constraints to nurses providing OHE. The majority of PCGs (n = 382; mean age 31.5 years had a low education level (76%. About 55% of PCGs received information on children’s oral health from the television and 35% at the MCH clinics. PCGs beliefs were worrying as about 38% believed primary dentition is not important and need not be saved. Conclusion: There is evidence of minimal integration of OHE at MCH sites. Parents’ beliefs are still worrying as a significant number do not regard the primary dentition as important. The MCH site remains an important easily accessible area for integration of oral health services with general health in complementing efforts in prevention of early childhood caries. Keywords: Oral health; Promotion integration

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

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Sumarsono Soemardjo

2014-07-01

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

2014 Mid-Atlantic Telehealth Resource Center Annual Summit

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Katharine Hsu Wibberly

2013-12-01

Full Text Available The Mid-Atlantic Resource Center (MATRC; http://www.matrc.org/ advances the adoption and utilization of telehealth within the MATRC region and works collaboratively with the other federally funded Telehealth Resource Centers to accomplish the same nationally. MATRC offers technical assistance and other resources within the following mid-Atlantic states: Delaware, District of Columbia, Kentucky, Maryland, North Carolina, Pennsylvania, Virginia and West Virginia.   The 2014 MATRC Summit “Adding Value through Sustainable Telehealth” will be held March 30-April 1, 2014, at the Fredericksburg Expo & Conference Center, Fredericksburg, VA. The Summit will explore how telehealth adds value to patients, practitioners, hospitals, health systems, and other facilities. Participants will experience a highly interactive program built around the case history of “Mr. Doe” as he progresses through the primary care, inpatient hospitalization, and post-discharge environments. The Summit will conclude with a session on financial and business models for providing sustainable telehealth services.   For further information and registration, visit: http://matrc.org/component/content/article/2-uncategorised/80-mid-atlantic-telehealth-resource-summit-2014    

A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

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Shamim Haider

2014-03-01

Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

A rapid assessment of service deliveries at Anganwadi Centres in Ranchi district of Jharkhand

Directory of Open Access Journals (Sweden)

Shamim Haider

2014-03-01

Full Text Available Introduction: Proper functioning of Anganwadi Centres (AWCs are important for better service delivery which will lead to healthy mother and child , and ultimately better development of human resources in order to build a healthy and productive nation. Objectives: To assess the functioning of AWCs. 2 To measure the quantitative gap in coverage of beneficiaries. 3 To find out bottlenecks in proper service delivery of AWCs. Methods: Randomly selected 50 AWCs in Ranchi district were surveyed during July 2012 to September 2012. Semi-structured questionnaire was used to collect information from Anganwadi workers (AWWs. Existing records at AWCs were also accessed to collect data.  Statistical analysis: Frequency distribution and chi - square test were done. Results: 3941(>73% out of 5387 eligible children aged 6-71 months were enrolled at AWCs and 3870(97.45% enrolled children were availing food under Supplementary Nutrition Programme (SNP. Growth charts were available and properly maintained at all AWCs however; regular health check-up of all children was done in only 5(10% AWCs. Pre-School Education (PSE materials, mainly in form of charts and posters were available at 47(94% AWCs. More than 90% pregnant & lactating women were enrolled at AWCs and almost all centres were providing maternal health services like Ante natal care (ANC and Tetanus Toxoid (TT to them. Only 955 (33% out of 2859 eligible adolescent girls were enrolled in AWCs. Iron-Folic Acid (IFA supplementations to pregnant women were available at 25 (50% AWCs. Conclusions:  Though coverage and supplementary nutrition of children is good; poor coverage, lack of health education and supplementary nutrition of adolescent girls is a matter of concern. Low honorarium, excess workload and poor infrastructure of AWCs are main impediment in proper service delivery.

Allegheny County Voting District Boundaries (Spring 2015 - Spring 2016)

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...

Allegheny County Voting District Boundaries (Fall 2016 - Spring 2017)

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates municipal voting districts in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data...

Production System Analysis of Brem Processing Unit (Case Study: The Industrial Centers of Brem in Kaliabu and Bancong Village, Madiun District

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Ardaneswari Dyah Pitaloka Citraresmi

2014-10-01

Full Text Available The purpose of this study was to determine the condition, the priorities, and the strategy development policy of the brem Madiun production system as an effort to increase the brem Madiun production system. The samples which are used were the brem industries at industrial centers of brem in Kaliabu and Bancong Village at Madiun District. The main instrument to collect the data was a questionnaire for 21 respondents of business leaders. Data analysis method which is used was Analytical Hierarchy Process (AHP. The results showed that the sequence of factors causing the decline of brem’s production capacity were the final product (0,477, capital (0,244, raw materials (0,123, human resources (0,088, the tools and machinery (0,041, and the method (0,026. Benchmarks for goals to be achieved by the production system were the effectiveness of brem Madiun (0,548, productivity (0,227, efficiency (0,138, and quality (0,087. Strategies that can be done on developing the brem industry in Madiun are provision of venture capital to support the administrations, improvement of licensing services, improvement of joint venture accessibility on infrastructure production, supporting on marketing, improvement of human resources quality (coaching and training, development of product, improvement of business management, and development on network of business partnership respectively. After the several strategies development policy was formulated based on existing condition, then the performance of the brem Madiun production system can be improved. Keywords : Brem, Production System Analysis, Strategy Formulation

District heating in sequential energy supply

International Nuclear Information System (INIS)

Persson, Urban; Werner, Sven

2012-01-01

Highlights: ► European excess heat recovery and utilisation by district heat distribution. ► Heat recovery in district heating systems – a structural energy efficiency measure. ► Introduction of new theoretical concepts to express excess heat recovery. ► Fourfold potential for excess heat utilisation in EU27 compared to current levels. ► Large scale excess heat recovery – a collaborative challenge for future Europe. -- Abstract: Increased recovery of excess heat from thermal power generation and industrial processes has great potential to reduce primary energy demands in EU27. In this study, current excess heat utilisation levels by means of district heat distribution are assessed and expressed by concepts such as recovery efficiency, heat recovery rate, and heat utilisation rate. For two chosen excess heat activities, current average EU27 heat recovery levels are compared to currently best Member State practices, whereby future potentials of European excess heat recovery and utilisation are estimated. The principle of sequential energy supply is elaborated to capture the conceptual idea of excess heat recovery in district heating systems as a structural and organisational energy efficiency measure. The general conditions discussed concerning expansion of heat recovery into district heating systems include infrastructure investments in district heating networks, collaboration agreements, maintained value chains, policy support, world market energy prices, allocation of synergy benefits, and local initiatives. The main conclusion from this study is that a future fourfold increase of current EU27 excess heat utilisation by means of district heat distribution to residential and service sectors is conceived as plausible if applying best Member State practice. This estimation is higher than the threefold increase with respect to direct feasible distribution costs estimated by the same authors in a previous study. Hence, no direct barriers appear with

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.

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...

A STUDY OF MEASLES VACCINATION COVERAGE BY LOT QUALITY ASSURANCE SAMPLING TECHNIQUE AND FACTORS RELATED TO NON-VACCINATION IN BELLARY DISTRICT

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A Karinagannanavar

2013-12-01

Full Text Available Background: Measles is a leading cause of childhood morbidity and mortality accounting for nearly half the global burden of vaccine preventable deaths. In 2007, there were 197000 measles deaths globally nearly 540 deaths every day or 22 deaths per hour. According to NFHS-3 2005 – 06 total measles vaccination coverage in Karnataka was 72%. Objectives: 1 To find out measles vaccination coverage in Bellary District. 2 To know the reasons for non-vaccination. Material and Methods:   A Cross sectional study was conducted from May 2010 to April 2011 at areas covered by PHC/PHU of Bellary district by using Lot Quality Assurance Sampling (LQAS method. Total sample size was 1007(53X19. Bellary district has 47 primary health centers (PHC and 6 primary health units (PHU, all of which were studied in which each PHC/PHU is considered as a lot. The data was collected from parents of children aged 12-23 months using a pretested semi structured questionnaire. Results: Out of 53 PHC’s/PHU’s we accepted 41 (77.35% and vaccination coverage in these lots was considered as more than 85% and overall coverage in Bellary district was 69.41% and  53.62% had received Vitamin A supplementation. The reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects & lack of health services. Conclusion: Measles vaccination coverage was 69.41% and the reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects and lack of health services.

A STUDY OF MEASLES VACCINATION COVERAGE BY LOT QUALITY ASSURANCE SAMPLING TECHNIQUE AND FACTORS RELATED TO NON-VACCINATION IN BELLARY DISTRICT

Directory of Open Access Journals (Sweden)

A Karinagannanavar

2013-09-01

Full Text Available Background: Measles is a leading cause of childhood morbidity and mortality accounting for nearly half the global burden of vaccine preventable deaths. In 2007, there were 197000 measles deaths globally nearly 540 deaths every day or 22 deaths per hour. According to NFHS-3 2005 – 06 total measles vaccination coverage in Karnataka was 72%. Objectives: 1 To find out measles vaccination coverage in Bellary District. 2 To know the reasons for non-vaccination. Material and Methods:   A Cross sectional study was conducted from May 2010 to April 2011 at areas covered by PHC/PHU of Bellary district by using Lot Quality Assurance Sampling (LQAS method. Total sample size was 1007(53X19. Bellary district has 47 primary health centers (PHC and 6 primary health units (PHU, all of which were studied in which each PHC/PHU is considered as a lot. The data was collected from parents of children aged 12-23 months using a pretested semi structured questionnaire. Results: Out of 53 PHC’s/PHU’s we accepted 41 (77.35% and vaccination coverage in these lots was considered as more than 85% and overall coverage in Bellary district was 69.41% and  53.62% had received Vitamin A supplementation. The reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects & lack of health services. Conclusion: Measles vaccination coverage was 69.41% and the reasons for non vaccination were lack of awareness, ignorance, ill health of the child, fear of side effects and lack of health services.

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…

78 FR 18966 - Publication of Fiscal Year 2012 Service Contract Inventory

Science.gov (United States)

2013-03-28

... COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA Publication of Fiscal Year 2012 Service Contract Inventory AGENCY: Court Services and Offender Supervision Agency for the District of Columbia. ACTION: Notice of Public Availability of FY 2012 Service Contract Inventory. SUMMARY...

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.

Pengaruh Sistem Manajemen Iso 9001:2008 Terhadap Pelayanan Kefarmasian Di Puskesmas Kabupaten Sleman

OpenAIRE

Aji Wibowo, Much Ilham Novalisa; Munawaroh, Siti; Purnama, Cahya

2015-01-01

The vision of health development organized by the district health center is achieving district healthy. The need for improving the quality of health services in health centers contained in the WHO Annual Report 2008 under the title "Primary Health Care, Now More Than Ever". The efforts to improve the quality of services in health centers is ISO 9001:2008 certification at the International level. ISO 9001 certification is expected to improve the quality of pharmacy services at health centers. ...

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…

Establishment of a Community-Based Mental Health Center in Yazd: A Short Report

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Golrasteh Kholasehzadeh

2016-10-01

Full Text Available About 40 years ago, the mental health services providing strategies have been dramatically changed worldwide. As well as, it is considered as a new revolution in mental health and named as community-based mental health movement. Moreover, mental health centers in Iran have been established in order to make a change in urban community-based mental health (CMHC. The first CMHC was founded in Tehran 16th district in 2010. In Yazd, it was established in 2010. In this article, the steps for establishment of the first CMHC were described.

36 CFR 27.3 - Seashore District.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Seashore District. 27.3 Section 27.3 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR CAPE...' studio, for appropriate small scale home occupations as the making and selling of traditional Cape Cod...

Report of the Fourth District Economists' Roundtable

OpenAIRE

Michael F. Bryan; John B. Martin

1994-01-01

A summary of the 1994 forecasts for real output and inflation presented by 15 members of the Fourth District Economists' Roundtable at their January 1994 meeting, highlighting the measurement of service sector prices and the role of small businesses in creating jobs.

7 CFR 1210.501 - Realignment of districts.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Realignment of districts. 1210.501 Section 1210.501 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING..., Hutchinson, Roberts, Hemphill, Oldham, Potter, Carson, Gray, Wheeler, Deaf Smith, Randall, Armstrong, Donley...

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…

Client perspective assessment of women?s satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia

OpenAIRE

Dewana, Zeritu; Fikadu, Teshale; G/ Mariam, Abebe; Abdulahi, Misra

2016-01-01

Background A woman?s satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women?s satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women?s towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zon...

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...

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

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

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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.

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.

78 FR 64530 - Resource Advisory Council to the Boise District, Public Meeting

Science.gov (United States)

2013-10-29

..., at the Boise District Office, located at 3948 S. Development Avenue, Boise, Idaho, beginning at 9:00... Specialist and RAC Coordinator, BLM Boise District, 3948 Development Ave., Boise, ID 83705, Telephone (208... telecommunications device for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1- 800-877-8339...

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

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Sachin S Mumbare

2011-01-01

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

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.

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,…

Enhancing assertiveness in district nurse specialist practice.

Science.gov (United States)

Green, Julie

2016-08-02

District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.

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

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...

Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

Directory of Open Access Journals (Sweden)

Joharifard Shahrzad

2012-12-01

Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

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...

Capacity of Health Facilities to Manage Hypertension in Mukono and Buikwe Districts in Uganda: Challenges and Recommendations.

Science.gov (United States)

Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K; Mukose, Aggrey; Van Geertruyden, Jean-Pierre; Nuwaha, Fred

2015-01-01

The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5, 1.9%) indicated that they

Capturing district nursing through a knowledge-based electronic caseload analysis tool (eCAT).

Science.gov (United States)

Kane, Kay

2014-03-01

The Electronic Caseload Analysis Tool (eCAT) is a knowledge-based software tool to assist the caseload analysis process. The tool provides a wide range of graphical reports, along with an integrated clinical advisor, to assist district nurses, team leaders, operational and strategic managers with caseload analysis by describing, comparing and benchmarking district nursing practice in the context of population need, staff resources, and service structure. District nurses and clinical lead nurses in Northern Ireland developed the tool, along with academic colleagues from the University of Ulster, working in partnership with a leading software company. The aim was to use the eCAT tool to identify the nursing need of local populations, along with the variances in district nursing practice, and match the workforce accordingly. This article reviews the literature, describes the eCAT solution and discusses the impact of eCAT on nursing practice, staff allocation, service delivery and workforce planning, using fictitious exemplars and a post-implementation evaluation from the trusts.

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia.

Science.gov (United States)

Madsen, Wendy

2009-10-01

To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. Historical analysis. The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

Science.gov (United States)

Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

Directory of Open Access Journals (Sweden)

Moreira Philippe

2007-11-01

Full Text Available Abstract Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Health care Providers Needs About Malaria Control Program in Puskesmas Kisam Tinggi, South Ogan Komering Ulu District

Directory of Open Access Journals (Sweden)

Maya Arisanti

2015-11-01

Full Text Available Background: Malaria is an infectious disease that is still a health problem in Indonesia, which can cause death, especially in high-risk groups such as infants, toddlers, pregnant women and can directly lead to anemia and decreased work productivity. South Ogan Komering Ulu District was one of the endemic areas in South Sumatera Province. In a previous study in the District South Ogan Komering Ulu County Superior Data AMI found that high and low knowledge society related to malaria and most of respondents have not received counseling. Objective:The purpose of this study was to determine the needs of health care providers in malaria control programs. Methods:Data collected through in-depth interviews. Informant interviews are two people responsible for malaria at the health department, the head of health centers and two people responsible for malaria in health centers. Results: The results showed that the needs required by the health care providers to improve health care services, especially malaria is a need for laboratory equipment (microscope, reagents, and rapid diagnostic test, the need for microscopic power, the need for malaria drugs that are still effective, procurement of mosquito nets, education malaria to the community, and training needs for existing microscopic officer. Conclusion: The need of health care providers is the fulfillment of the malaria supplies equipment, laboratory personnel and training that support the ability of health care providers. With the fulfillment of the provider of health services to the community are expected to be performing well. Recommendation:Budget is needed to support supplier equipment & training.

District nursing workforce planning: a review of the methods.

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Reid, Bernie; Kane, Kay; Curran, Carol

2008-11-01

District nursing services in Northern Ireland face increasing demands and challenges which may be responded to by effective and efficient workforce planning and development. The aim of this paper is to critically analyse district nursing workforce planning and development methods, in an attempt to find a suitable method for Northern Ireland. A systematic analysis of the literature reveals four methods: professional judgement; population-based health needs; caseload analysis and dependency-acuity. Each method has strengths and weaknesses. Professional judgement offers a 'belt and braces' approach but lacks sensitivity to fluctuating patient numbers. Population-based health needs methods develop staffing algorithms that reflect deprivation and geographical spread, but are poorly understood by district nurses. Caseload analysis promotes equitable workloads but poorly performing district nursing localities may continue if benchmarking processes only consider local data. Dependency-acuity methods provide a means of equalizing and prioritizing workload but are prone to district nurses overstating factors in patient dependency or understating carers' capability. In summary a mixed method approach is advocated to evaluate and adjust the size and mix of district nursing teams using empirically determined patient dependency and activity-based variables based on the population's health needs.

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.

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

District cool water distribution; Reseau urbain et distribution d`eau glacee

Energy Technology Data Exchange (ETDEWEB)

Schabaillie, D. [Ste Climespace (France)

1997-12-31

The city of Paris has developed several district cool water distribution networks (Climespace) for air conditioning purposes, one in the Halles district (central Paris) linked with the Louvre museum, one in the Opera district (with large department stores) and one in the east of paris (Bercy). Each of these networks has a cool water production plant, the one at the Halles producing also hot water and safety electric power. The characteristics of the equipment (heat pumps, refrigerating machinery, storage...) are described. The pipes are laid in the city sewage network, and the cool carrier is water. The various networks are centrally supervised at the Halles center

Barriers to utilization of postnatal care at village level in Klaten district, central Java Province, Indonesia.

Science.gov (United States)

Probandari, Ari; Arcita, Akhda; Kothijah, Kothijah; Pamungkasari, Eti Poncorini

2017-08-07

Maternal health remains a persisting public health challenge in Indonesia. Postnatal complications, in particular, are considered as maternal health problems priority that should be addressed. Conducting adequate care for postnatal complications will improve the quality of life of mothers and babies. With the universal health coverage implementation, the Indonesian government provides free maternal and child health services close to clients at the village level, which include postnatal care. Our study aimed to explore barriers to utilization of postnatal care at the village level in Klaten district, Central Java Province, Indonesia. A qualitative study was conducted in March 2015 - June 2016 in Klaten district, Central Java, Indonesia. We selected a total of 19 study participants, including eight mothers with postnatal complications, six family members, and five village midwives for in-depth interviews. We conducted a content analysis technique on verbatim transcripts of the interviews using open code software. This study found three categories of barriers to postnatal care utilization in villages: mother and family members' health literacy on postnatal care, sociocultural beliefs and practices, and health service responses. Most mothers did not have adequate knowledge and skills regarding postnatal care that reflected how they lacked awareness and practice of postnatal care. Inter-generational norms and myths hindered mothers from utilizing postnatal care and from having adequate nutritional intake during the postnatal period. Mothers and family members conducted unsafe self-treatment to address perceived minor postnatal complication. Furthermore, social power from extended family influenced the postnatal care health literacy for mother and family members. Postnatal care in the village lacked patient-centered care practices. Additionally, midwives' workloads and capacities to conduct postnatal information, education and counseling were also issues. Despite the

75 FR 71047 - Federal Benefit Payments Under Certain District of Columbia Retirement Plans

Science.gov (United States)

2010-11-22

...) For the Police and Firefighters Plan, military service as defined in section 4-607 of the DC Code..., under the retirement plans for District of Columbia teachers, police officers, and firefighters..., police officers, and firefighters in effect as of June 29, 1997, referred to as the ``District Retirement...

The situation of district heating, district cooling and energy supply in Hungary

International Nuclear Information System (INIS)

Sigmond, Gy.

2009-01-01

District heating represents with 650.000 heated dwellings approximately 15% of the Hungarian residential heating market. Since 1990 there is stagnation at the number of connected dwellings because erection of large settlements with prefab buildings has been stopped, and latter ones represent more than 75% of the dwelling heating market. During the same period, residential heat demand shrunk by 33%, because metering of hot water consumption resulted in changing consumer habits, and because of slowly but step by step refurbishment of buildings and heating systems. In Hungary district heating is present in all large and most of the medium size cities, in 92 cities together. Out of them, there is also a single village with a local district heating system, which heats more than 60% of cottages. The capacity os systems is spreading to a large extent. Approximately 36-36% of all heated dwellings are in Budapest and in 10 large cities in the country, while 148 of the total 202 systems have less than 10 MW capacities. In the fuel structure of district heating it is characteristic the overwhelming role of natural gas consumption, which has exceeded 80% already. Only a few numbers of heating power plants are fuelled by crown coal. The use of renewables is growing continuous, but, together with waste and waste energy, it amounts merely 8% of the total fuel use. Oil consumption is negligible. Currently the most promising DH-market is the service sector (public buildings and commercial consumers). DH-companies can sell their surplus supply capacities on the competitive market. Residential market can be preserved only with better legal conditions and with improving of demand side management. The industrial heat market can be gained when the erection of new power plants will be harmonized with industrial development in the frame of territorial planning. District cooling is just at the beginning in Hungary. Many new commercial and office buildings are erected with air conditioning

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…

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

District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia

NARCIS (Netherlands)

van Bergen, J. E.

1995-01-01

A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the

Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study

Science.gov (United States)

Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

2011-01-01

Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168

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.

U.S. Department of Energy Pacific Region Clean Energy Application Center (PCEAC)

Energy Technology Data Exchange (ETDEWEB)

Lipman, Tim [Univ. of California, Berkeley, CA (United States); Kammen, Dan [Univ. of California, Berkeley, CA (United States); McDonell, Vince [Univ. of California, Irvine, CA (United States); Samuelsen, Scott [Univ. of California, Irvine, CA (United States); Beyene, Asfaw [San Diego State Univ., CA (United States); Ganji, Ahmad [San Francisco State Univ., CA (United States)

2013-09-30

) at San Diego State University and San Francisco State University. The center also worked with a wide range of affiliated groups and industry, government, NGO, and academic stakeholders to conduct a series of CHP education and outreach, project technical support, and related activities for the Pacific region. Key PCEAC tasks have included: - Preparing, organizing and conducting educational seminars on various aspects of CHP - Conducting state baseline assessments for CHP - Working with state energy offices to prepare state CHP action plans - Providing technical support services including CHP/district energy project feasibility screenings - Working with state agencies on CHP policy development - Developing additional CHP educational materials The primary specific services that PCEAC has offered include: - A CHP “information clearinghouse “ website: http://www.pacificcleanenergy.org - Site evaluations and potential projects screenings - Assessment of CHP status, potential, and key issues for each state - Information and training workshops - Policy and regulatory guidance documents and other interactions These services were generally offered at no cost to client groups based on the DOE funding and additional activities supported by the California Energy Commission, except for the in-kind staff resources needed to provide input data and support to PCEAC assessments at host sites. Through these efforts, the PCEAC reached thousands of end-users and directly worked with several dozen organizations and potential CHP “host sites” from 2009-2013. The major activities and outcomes of PCEAC project work are described.

A Convergence of Energy and Talent: External Support Boosts New York District's Literacy Initiative

Science.gov (United States)

Murphy, Mike; Sykut, Linda

2013-01-01

This article describes the collaborative efforts of the Webster Central School District in New York, USA, and the Learning Forward's Center for Results consultants, in the fall of 2010 in a focus to improve the elementary literacy program. The School District realized it was vital to have a strong, sustained foundation of professional and student…

System-level determinants of immunization coverage disparities among health districts in Burkina Faso: a multiple case study.

Science.gov (United States)

Haddad, Slim; Bicaba, Abel; Feletto, Marta; Taminy, Elie; Kabore, Moussa; Ouédraogo, Boubacar; Contreras, Gisèle; Larocque, Renée; Fournier, Pierre

2009-10-14

Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso. A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team. The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks). The discourse on factors that determine the performance or

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

Science.gov (United States)

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could

Knowledge and perception of extension workers towards ict utilization in agricultural extension service delivery in Gazipur district of Bangladesh

Directory of Open Access Journals (Sweden)

F.A. Prodhan

2014-12-01

Full Text Available The primary purpose of the study was to assess the extent of knowledge and perception of extension workers towards ICT utilization and to determine the relationship between the selected characteristics of the respondents and knowledge and perception of extension workers towards ICT utilization in extension service delivery. The study was conducted in Gazipur district and comprised proportionate random sample of 90 extension workers from five upazila of Gazipur district. A pre-tested interview schedule was used to collect data from the respondents. To measure the knowledge on ICT utilization 35 statements were selected regarding 7 ICT with five possible answer of each tools and a score of one was given to the right answer and zero to the wrong answer alternatively to measure the perception of the respondents rated each of 10 statements ICT utilization in agriculture on a 5-point Likert type scale and the total of these ratings formed perception index. The result of the study showed that out of seven ICT tools the knowledge of extension workers was highest in case of MS Word this was followed by internet/ web service and the lowest knowledge was found in case of Geographical Information System. It is observed that an overwhelming majority (88.9% of agricultural extension workers in the study area had low to medium knowledge towards ICT utilization. Findings reveal that the respondents had top most perception on the ICT utilization in respect of ‘Extension work can be greatly enhanced by ICT’ followed by on ‘The benefits of ICT use outweigh the financial burden involved’. The result also indicated that more than fourth-fifth (84.4% of the respondents had medium to high perception towards ICT utilization. There were significant relationship between service experience and use of the information sources of the respondents with their knowledge towards ICT utilization conversely innovativeness, cosmopoliteness and job satisfaction of the

Implementation and acceptability of strategies instituted for engaging men in family planning services in Kibaha district, Tanzania.

Science.gov (United States)

Msovela, Judith; Tengia-Kessy, Anna

2016-11-21

Men as the main decision makers in most of African families have an important role to play towards acceptance of family planning methods. This study sought to identify strategies used to engage men in family planning services and determine the extent to which men in Kibaha district in Tanzania accept these interventions. We conducted a cross sectional study using both quantitative and qualitative techniques. We used a questionnaire to interview a random sample of 365 of currently married or cohabiting men who had at least one child under the age of five years. We further conducted in-depth interviews with health workers involved in delivering reproductive health services as well as community dispensers of family planning commodities. Descriptive analysis was used to determine the extent to which men were engaged in family planning services. The data from the indepth interviews were analysed manually according to the predetermined themes, guided by the grounded theory to identify the existing strategies used to encourage male involvement in family planning services. According to the key informants, strategies that are used to encourage men to engage in family planning services include invitations through their spouses, either verbally or by using partner notification cards, incorporating family planning messages during monthly meetings and community outreach reproductive health programs. Of 365 men responding to the questionnaire, only 31 (8.4%) said they were invited to accompany their spouses to family planning clinics. Among them, 71% (22/31) visited family planning clinics. A third (32%) of the respondents had heard of community health meetings and only 20.7% of them attended these meetings. More than a third (12/34) of men who attended these meeting asserted that family planning messages targeting men featured in the agenda and subsequently half of them visited health facilities for family planning services. Existing strategies such as invitations to clinics

Health system's barriers hindering implementation of public-private partnership at the district level: a case study of partnership for improved reproductive and child health services provision in Tanzania.

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Kamugumya, Denice; Olivier, Jill

2016-10-21

Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. This case study was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods. A stakeholder analysis was conducted to understand power distribution and the interests of local actors to engage non-state actors. In total 30 in-depth interviews were conducted with key informants that were identified from a stakeholder mapping activity. The initial data analysis guided further data collection in an iterative process. The provision of Reproductive and Child Health Services was used as a context. This study draws on the decision-space framework. Study findings reveal several forms of informal partnerships, and the untapped potential of non-state actors. Lack of formal contractual agreements with private providers including facilities that receive subsidies from the government is argued to contribute to inappropriate distribution of risk and reward leading to moral hazards. Furthermore, findings highlight weak capacity of governing bodies to exercise oversight and sanctions, which is acerbated by weak accountability linkages and power differences. Disempowered Council Health Services Board, in relation to engaging non-state actors, is shown to impede PPP initiatives. Effective PPP policy implementation at a local level depends on the capacity of local government officials to make choices that would embrace relational elements dynamics in strategic plans. Orientation towards collaborative efforts that create value and enable its distribution is argued to

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

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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

All Aboard!: In One Iowa District, All Teachers and Principals Are on the Same Journey

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Hansen, Deb; Anderson, Colleen; Munger, Linda; Chizek, Mitzi

2013-01-01

Collaborative learning teams are improving teacher practice and student learning results in the Dallas Center-Grimes Community School District near Des Moines, Iowa. Since 2009, all teachers and principals in the district have participated in collaborative learning teams to study a process known as assessment for learning, in which formative…

Effects of demand-side incentives in improving the utilisation of delivery services in Oyam District in northern Uganda: a quasi-experimental study.

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Massavon, William; Wilunda, Calistus; Nannini, Maria; Majwala, Robert Kaos; Agaro, Caroline; De Vivo, Emanuela; Lochoro, Peter; Putoto, Giovanni; Criel, Bart

2017-12-19

We evaluated the effects and financial costs of two interventions with respect to utilisation of institutional deliveries and other maternal health services in Oyam District in Uganda. We conducted a quasi-experimental study involving intervention and comparable/control sub-counties in Oyam District for 12 months (January-December 2014). Participants were women receiving antenatal care, delivery and postnatal care services. We evaluated two interventions: the provision of (1) transport vouchers to women receiving antenatal care and delivering at two health centres (level II) in Acaba sub-county, and (2) baby kits to women who delivered at Ngai Health Centre (level III) in Ngai sub-county. The study outcomes included service coverage of institutional deliveries, four antenatal care visits, postnatal care, and the percentage of women 'bypassing' maternal health services inside their resident sub-counties. We calculated the effect of each intervention on study outcomes using the difference in differences analysis. We calculated the cost per institutional delivery and the cost per unit increment in institutional deliveries for each intervention. Overall, transport vouchers had greater effects on all four outcomes, whereas baby kits mainly influenced institutional deliveries. The absolute increase in institutional deliveries attributable to vouchers was 42.9%; the equivalent for baby kits was 30.0%. Additionally, transport vouchers increased the coverage of four antenatal care visits and postnatal care service coverage by 60.0% and 49.2%, respectively. 'Bypassing' was mainly related to transport vouchers and ranged from 7.2% for postnatal care to 11.9% for deliveries. The financial cost of institutional delivery was US$9.4 per transport voucher provided, and US$10.5 per baby kit. The incremental cost per unit increment in institutional deliveries in the transport-voucher system was US$15.9; the equivalent for the baby kit was US$30.6. The transport voucher scheme

Time, costs and farmers’ perceptions: The case of livestock service delivery in tamilnadu

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G kathiravan

2011-10-01

Full Text Available A study was undertaken in southern peninsular State of India, the Tamil Nadu State, (i to ascertain the time costs of animal health care and bovine breeding services, and (ii to comprehend the perceptions of farmers on the livestock services rendered by different service providers. The districts of the state were categorized as 'Livestock Developed' (LD and 'Livestock Under Developed' (LUD based on initial base line developed. Travel, waiting and service time were among the primary non-price factors that affected service quality. Average travel time was highest for visiting the public veterinary centre in both LUD (23.05 min. and LD (21.32 min. districts. Waiting time with regard to veterinarians providing home services in LUD districts was highest (23.01 min., followed by public veterinary centre services at LUD districts (22.35 min., home services by para-veterinarians (22.01 min. and public veterinary centre services at LD districts (20.10 min.. Both travel and waiting time were much higher in case of breeding services compared to curative services, which could be due to the fact that the farmers preferred Artificial Insemination (AI over its close substitute, the natural service. However, the service time was relatively less in case of insemination services vis-à-vis curative services both in LUD and LD districts. The quality perceptions of farmers on livestock services revealed that the home services rendered by veterinarians as the best one (0.83, followed by private veterinary clinics (0.75, home services by para-veterinarians (0.74, public veterinary centres (0.64 and co-operative veterinary centres (0.48. [Vet. World 2011; 4(5.000: 209-212

Knowledge, attitudes and acceptability to provider-initiated HIV testing and counseling: patients' perspectives in Moshi and Rombo Districts, Tanzania.

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Manongi, Rachel; Mahande, Michael; Njau, Bernard

2014-10-01

Provider-initiated HIV testing and counseling (PITC) is referred to as routine testing in a clinical setting as part of a standard programme of medical services. PITC is initiated in order to avoid missed opportunities for people to get tested for HIV. While advocated as a strategy, there is dearth of information on patients' views on PITC in a number of districts in Tanzania. The objective of this study was to assess the knowledge, attitude and acceptability to PITC services among patients attending health care facilities in rural and urban settings in Kilimanjaro region A total of 12 focus group discussions (FGDs) were conducted with 99 (73 female and 26 male) patients enrolled into out-patient clinics in 8 (2 hospitals and 6 primary care centers) health facilities in Moshi Urban and Rombo districts in northern Tanzania. The study explored on knowledge, attitudes and acceptability of PITC, perceived benefits and barriers of PITC, and ethical issues related to PITC. Interviews were audio taped, transcribed, translated, and analyzed using Non-numerical Unstructured Data Indexing and Theorizing (NUDIST) software. Knowledge about PITC services was generally low. Compared to men, women had a more positive attitude towards PITC services, because of its ability to identify and treat undiagnosed HIV cases. HIV stigma was regarded as a major barrier to patients' uptake of PITC. Institutional factors such as lack of supplies and human resources were identified as barriers to successful provision of PITC. In conclusion, the findings highlight both opportunities and potential barriers in the successful uptake of PITC, and underscore the importance of informed consent, counseling and confidentiality and the need for specific strategies on advocacy for the service.

Does mental health service integration affect compulsory admissions?

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André I. Wierdsma

2009-09-01

Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.

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

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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.

A ward without walls? District nurses' perceptions of their workload management priorities and job satisfaction.

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Stuart, Elaine Haycock; Jarvis, Alison; Daniel, Katie

2008-11-01

To explore district nurses' workload management, job satisfaction and the challenges they face. This paper reports qualitative findings from a qualitative and quantitative study to identify a district nursing perspective on use of time, challenges and work satisfaction. District nursing is under increasing pressure because of the increasing shift to care in the community, early hospital discharge and changes in demography with an ageing population and more people with chronic illnesses. Qualitative. The study took place in one Scottish Health Board and data were collected in February and March 2005. The qualitative approach involved a total of 31 district nurses and senior managers in focus group discussions or individual interviews. Three main themes were identified: (1) the priorities of district nurses and their views on work unrelated to 'hands on' clinical care, (2) aspects of district nursing considered stressful and (3) district nurses' job satisfaction. District nurses and managers agree that caring work with patients is the priority for the service and provides job satisfaction. Many nurses feel overwhelmed by their workload and have little control over the admission of patients to their caseload; they are mainly demand led and therefore reactive care providers. A culture of long hours has developed as district nurses struggle to meet the needs of patients. Feeling devalued lowers satisfaction and Agenda for Change is perceived as de-valuing the skills of community nurses. More clerical support is required so district nurses can deliver care to patients. District nurses can better represent their workload and how it is managed through expressing the nature of assessing risk and caring for patients as opposed to defining patients care needs by medical diagnoses. Extending the hours of the full district nursing service would benefit patients and staff.

Value and Service Quality Assessment of the National Health Insurance Scheme in Ghana: Evidence from Ashiedu Keteke District.

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Nsiah-Boateng, Eric; Aikins, Moses; Asenso-Boadi, Francis; Andoh-Adjei, Francis-Xavier

2016-09-01

Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to provide financial access to health care for all residents. This article analyzed claims reimbursement data of the NHIS to assess the value of the benefit package to the insured and responsiveness of the service to the financial needs of health services providers. Medical claims data reported between January 1, 2010, and December 31, 2014, were retrieved from the database of Ashiedu Keteke District Office of the National Health Insurance Authority. The incurred claims ratio, promptness of claims settlements, and claims adjustment rate were analyzed over the 5-year period. In all, 644,663 medical claims with a cost of Ghana cedi (GHS) 11.8 million (US $3.1 million) were reported over the study period. The ratio of claims cost to contributions paid increased from 4.3 to 7.2 over the 2011-2013 period, and dropped to 5.0 in 2014. The proportion of claims settled beyond 90 days also increased from 26% to 100% between 2011 and 2014. Generally, the amount of claims adjusted was low; however, it increased consistently from 1% to about 4% over the 2011-2014 period. The reasons for claims adjustments included provision of services to ineligible members, overbilling of services, and misapplication of diagnosis related groups. There is increased value of the NHIS benefit package to subscribers; however, the scheme's responsiveness to the financial needs of health services providers is low. This calls for a review of the NHIS policy to improve financial viability and service quality. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

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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…

Area health education centers and health science library services.

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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.

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

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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…

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.

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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.

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

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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.

CLASSIFICATION AND COMPLEX STATE VALUE OF SHOPPING CENTERS: PROJECT-ORIENTED APPROACH

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Юрій Павлович РАК

2016-02-01

Full Text Available Was done the analysis of projects objects of trade and entertainment centers from the perspective of improving the life safety and is proposed the definition of "Trade and entertainment center", "Trade and entertainment center" and "Complex value of trade and entertainment center." A classification of shopping centers on the classification criteria and the criteria are characterized by increased security status and attractiveness of their operation. The classification of trade and entertainment centers on the criteria of classification features were made. It characterizes the security situation and will increase the attractiveness of their operation. In the nearest future the most secure and modern TEC will be those buildings who will have unique qualities such as safety systems, excellent customer service, and thus by a high level of trust (the client to the mall. The important role will play those TEC, who have clearly formed value oriented project management, including communication values using innovative methods and models. Trade and entertainment centers as an organization are included in the complex process of interaction management. They being both as an enterprise that serves the public and satisfying a great range of his interests and architectural site, which is leased and increases the business attractiveness of the district of TEC location. This duality of the essence of TEC center makes difficult to assess the effectiveness of its security.

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

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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.

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

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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.

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

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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.

The use of acuity and frailty measures for district nursing workforce plans.

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David, Ami; Saunders, Mary

2018-02-02

This article discusses the use of Quest acuity and frailty measures for community nursing interventions to quantify and qualify the contributions of district nursing teams. It describes the use of a suite of acuity and frailty tools tested in 8 UK community service trusts over the past 5years. In addition, a competency assessment tool was used to gauge both capacity and capability of individual nurses. The consistency of the results obtained from the Quest audits offer significant evidence and potential for realigning community nursing services to offer improvements in efficiency and cost-effectiveness. The National Quality Board (NQB) improvement resource for the district nursing services ( NQB, 2017 ) recommends a robust method for classifying patient acuity/frailty/dependency. It is contended the Quest tools and their usage articulated here offer a suitable methodology.

Hazard risk and vulnerability assessment : Regional District of Nanaimo : final report

International Nuclear Information System (INIS)

2006-06-01

A Hazard Risk and Vulnerability Assessment (HRVA) is a mandated regulatory requirement in British Columbia that requires local authorities to prepare emergency plans that reflect the local authority's assessment of the relative risk of occurrence and the potential impact on people and property of the hazards, emergencies or disasters that could affect the jurisdictional area for which the local authority has responsibility. This report constituted an HRVA for the Regional District of Nanaimo, British Columbia. It presented the study scope and methodology and provided an overview of the Regional District of Nanaimo. This included information on the setting, demographics, and economy. Next, it discussed social vulnerability; critical response and recovery facilities; and critical infrastructure such as water, energy, telecommunications and transportation. A summary of the Regional District of Nanaimo's response capabilities that were considered when assessing the Regional District's overall risk to the hazards was also presented. Response capabilities were discussed with reference to fire and rescue; police; ambulance; and search and rescue. Emergency support and preparedness organizations were also identified. These included the Emergency Coordination Centre, environmental services, emergency social services, amateur radio and health authorities. Last, 33 hazards that could affect the Regional District of Nanaimo were identified and discussed. The study identified the following hazards as high risk: flooding; forest fires and wildland urban interface fires; and human diseases and pandemic. It was recommended that the advancement of business continuity planning in the Regional District of Nanaimo would help to reduce the impact of a possible human disease and pandemic risk outbreak affecting the population. 75 refs., 25 figs., 14 tabs., 2 appendices

Heat-pump-centered integrated community energy systems: system development summary

Energy Technology Data Exchange (ETDEWEB)

Calm, J.M.

1980-02-01

An introduction to district heating systems employing heat pumps to enable use of low-temperature energy sources is presented. These systems operate as thermal utilities to provide space heating and may also supply space cooling, service-water heating, and other thermal services. Otherwise-wasted heat from industrial and commercial processes, natural sources including solar and geothermal heat, and heat stored on an annual cycle from summer cooling may be effectively utilized by the systems described. These sources are abundant, and their use would conserve scarce resources and reduce adverse environmental impacts. More than one-quarter of the energy consumed in the United States is used to heat and cool buildings and to heat service water. Natural gas and oil provide approximately 83% of this energy. The systems described show potential to reduce net energy consumption for these services by 20 to 50% and to allow fuel substitution with less-scarce resources not practical in smaller, individual-building systems. Seven studies performed for the system development phase of the Department of Energy's Heat-Pump-Centered Integrated Community Energy Systems Project and to related studies are summarized. A concluding chapter tabulates data from these separately published studies.

[Sanitary service of West Special Military District on the eve and in the first days of the Great Patriotic War of 1941-1945].

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Shelepov, A M; Ishutin, O S; Leonik, S I

2011-06-01

This article evaluates military and political situation in the world and operational-strategic environment on the West Theater of operations on the eve of the Great Patriotic War (1941-1945). We analyze structure and overall condition of sanitary service of West Special Military District of the Workers and Peasants Red Army and causes of failure of mobilization, organization and deployment of military units and establishments from the beginning of aggression of Fascist Germany to the Soviet Union.

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

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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.

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.

Initial Assessment and Modeling Framework Development for Automated Mobility Districts: Preprint

Energy Technology Data Exchange (ETDEWEB)

Hou, Yi [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Young, Stanley E [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Garikapati, Venu [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Chen, Yuche [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zhu, Lei [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-02-07

Automated vehicles (AVs) are increasingly being discussed as the basis for on-demand mobility services, introducing a new paradigm in which a fleet of AVs displaces private automobiles for day-to-day travel in dense activity districts. This paper examines a concept to displace privately owned automobiles within a region containing dense activity generators (jobs, retail, entertainment, etc.), referred to as an automated mobility district (AMD). This paper reviews several such districts, including airports, college campuses, business parks, downtown urban cores, and military bases, with examples of previous attempts to meet the mobility needs apart from private automobiles, some with automated technology and others with more traditional transit-based solutions. The issues and benefits of AMDs are framed within the perspective of intra-district, inter-district, and border issues, and the requirements for a modeling framework are identified to adequately reflect the breadth of mobility, energy, and emissions impact anticipated with AMDs

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)

District heating and cooling systems for communities through power plant retrofit distribution network. Final report, September 1, 1978-May 31, 1979

Energy Technology Data Exchange (ETDEWEB)

None

1979-10-01

This Final Report (Volume 2) of Phase 1 of District Heating for Communities Through Power Plant Retrofit Distribution Network contains 3 tasks: (1) Demonstration Team; (2) Identify Thermal Energy Sources and Potential Service Areas; and (3) Energy Market Analysis. Task 2 consists of estimating the thermal load within 5 and 10 miles of Public Service Electric and Gas Company steam power plants, Newark, New Jersey; estimating the costs of supplying thermal services to thermal loads of varying densities; a best case economic analysis of district heating for single-family homes; and some general comments on district-heating system design and development. Task 3 established the potential market for district heating that exists within a 5-mile radius of the selected generating stations; a sample of the questionnaire sent to the customers are shown. (MCW)

Council Districts

Data.gov (United States)

Town of Cary, North Carolina — View the location of the Town of Cary’s four Town Council districts.Please note that one district, District A, is split into two geo-spatial areas. One area is in...

Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience.

Science.gov (United States)

Cockcroft, Anne; Khan, Amir; Md Ansari, Noor; Omer, Khalid; Hamel, Candyce; Andersson, Neil

2011-12-21

In rebuilding devastated health services, the government of Afghanistan has provided access to basic services mainly by contracting with non-government organisations (NGOs), and more recently the Strengthening Mechanism (SM) of contracting with Provincial Health Offices. Community-based information about the public's views and experience of health services is scarce. Field teams visited households in a stratified random sample of 30 communities in two districts in Kabul province, with health services mainly provided either by an NGO or through the SM and administered a questionnaire about household views, use, and experience of health services, including payments for services and corruption. They later discussed the findings with separate community focus groups of men and women. We calculated weighted frequencies of views and experience of services and multivariate analysis examined the related factors. The survey covered 3283 households including 2845 recent health service users. Some 42% of households in the SM district and 57% in the NGO district rated available health services as good. Some 63% of households in the SM district (adjacent to Kabul) and 93% in the NGO district ordinarily used government health facilities. Service users rated private facilities more positively than government facilities. Government service users were more satisfied in urban facilities, if the household head was not educated, if they had enough food in the last week, and if they waited less than 30 minutes. Many households were unwilling to comment on corruption in health services; 15% in the SM district and 26% in the NGO district reported having been asked for an unofficial payment. Despite a policy of free services, one in seven users paid for treatment in government facilities, and three in four paid for medicine outside the facilities. Focus groups confirmed people knew payments were unofficial; they were afraid to talk about corruption. Households used government health

Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience

Directory of Open Access Journals (Sweden)

Cockcroft Anne

2011-12-01

Full Text Available Abstract Background In rebuilding devastated health services, the government of Afghanistan has provided access to basic services mainly by contracting with non-government organisations (NGOs, and more recently the Strengthening Mechanism (SM of contracting with Provincial Health Offices. Community-based information about the public's views and experience of health services is scarce. Methods Field teams visited households in a stratified random sample of 30 communities in two districts in Kabul province, with health services mainly provided either by an NGO or through the SM and administered a questionnaire about household views, use, and experience of health services, including payments for services and corruption. They later discussed the findings with separate community focus groups of men and women. We calculated weighted frequencies of views and experience of services and multivariate analysis examined the related factors. Results The survey covered 3283 households including 2845 recent health service users. Some 42% of households in the SM district and 57% in the NGO district rated available health services as good. Some 63% of households in the SM district (adjacent to Kabul and 93% in the NGO district ordinarily used government health facilities. Service users rated private facilities more positively than government facilities. Government service users were more satisfied in urban facilities, if the household head was not educated, if they had enough food in the last week, and if they waited less than 30 minutes. Many households were unwilling to comment on corruption in health services; 15% in the SM district and 26% in the NGO district reported having been asked for an unofficial payment. Despite a policy of free services, one in seven users paid for treatment in government facilities, and three in four paid for medicine outside the facilities. Focus groups confirmed people knew payments were unofficial; they were afraid to talk about

District health information system assessment: a case study in iran.

Science.gov (United States)

Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab

2013-03-01

Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

Directory of Open Access Journals (Sweden)

Wilbroad Mutale

Full Text Available INTRODUCTION: There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. METHODOLOGY: The Better Health Outcome through Mentoring and Assessment (BHOMA project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. RESULTS: Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58% and highest in Luangwa district (77%. Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively. Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02. Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04 and service readiness (coeff 0.54, p = 0.03. CONCLUSION: The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

Science.gov (United States)

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery

KAJIAN STRATEGI DAN PROGRAM PERBAIKAN OPERASIONALISASI DARI MILK DISTRICT MODEL NESTLÉ DI JAWA TIMUR

Directory of Open Access Journals (Sweden)

Bambang Ali Nugroho

2012-06-01

Full Text Available The objective of this study was to explore the improvement of Nestle milk district model in East Java. Secondary data on dairy development in East Java was used to analyse internal and external factors. SWOT analysis method was used to evaluate existing condition of dairy development in East Java and to build a recomended strategy to improve milk district model. In simplest terms, setting up a milk district involved: a negotiating agreements with farmers for twice-daily collection of their milk, b installing chilling centers in the larger community and collection points in the villages or adapting existing collection infrastructure, c arranging transportation from collection centers to the district’s factory, and d implementing a program to improve milk quality. In reality building a milk district model is not core business or core competence of Nestle but its something absolutely necessary to be introduced. After this program have been introduced, the smallscale dairy farmers were capable to organise themselves to produce freshmilk. Nestle have introduced various insentive systems to support smallscale dairy farmers capacity to guarantee that they have self responsability in dairy farming activities have positive impacts on productivity, quality product and product safety, that all that aspects will give benefit to Nestle. (Key words: Milk district model, Dairy farmer, Dairy cooperative, Milk processing industry, Strategy, Program

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...

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...

More care out of hospital? A qualitative exploration of the factors influencing the development of the district nursing workforce in England.

Science.gov (United States)

Drennan, Vari M

2018-01-01

Objectives Many countries seek to improve care for people with chronic conditions and increase delivery of care outside of hospitals, including in the home. Despite these policy objectives in the United Kingdom, the home visiting nursing service workforce, known as district nursing, is declining. This study aimed to investigate the factors influencing the development of district nursing workforces in a metropolitan area of England. Methods A qualitative study in a metropolitan area of three million residents in diverse socio-economic communities using semi-structured interviews with a purposive sample of senior nurses in provider and commissioning organizations. Thematic analysis was framed by theories of workforce development. All participants reported that the context for the district nursing service was one of major reorganizations in the face of wider National Health Service changes and financial pressures. The analysis identified five themes that can be seen to impact the ways in which the district nursing workforce was developed. These were: the challenge of recruitment and retention, a changing case-mix of patients and the requirement for different clinical skills, the growth of specialist home visiting nursing services and its impact on generalist nursing, the capacity of the district nursing service to meet growing demand, and the influence of the short-term service commissioning process on the need for long-term workforce development. Conclusion There is an apparent paradox between health policies which promote more care within and closer to home and the reported decline in district nursing services. Using the lens of workforce development theory, an explanatory framework was offered with factors such as the nature of the nursing labour market, human resource practices, career advancement opportunities as well as the contractual context and the economic environment.

Design and safety aspects of nuclear district heating reactors

International Nuclear Information System (INIS)

Brogli, R.; Mathews, D.; Pelloni, S.

1989-01-01

Extensive studies on the rationale, the potential and the technology of nuclear district heating have been performed in Switzerland. Beside economics the safety aspects were of primary importance. Due to the high costs to transport heat the heating reactor tend to be small and therefore, minimally staffed and located close to population centers. Stringed safety rules are therefore applying. Gas cooled reactors are well suited as district heating reactors since they have due to their characteristics several inherent features, significant safety margins and a remarkable radioactivity retention potential. Some ways to mitigate the effects of water ingress and graphite corrosion are under investigation. (author). 5 refs, 3 figs

Food Security Problems in Borabu Division, Nyamira District ...

African Journals Online (AJOL)

Food Security Problems in Borabu Division, Nyamira District. ... Finally, the paper highlights some of the major problems associated with land use for instance, labour shortages, lack of credit facilities, type of farm implements used, overutilization of land, limited extension services, and extinction of indigenous crops. Last but ...

Retention of health workers in Malawi: perspectives of health workers and district management.

Science.gov (United States)

Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

2009-07-28

Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

Retention of health workers in Malawi: perspectives of health workers and district management

Directory of Open Access Journals (Sweden)

MacLachlan Malcolm

2009-07-01

Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

PENGEMBANGAN DISTRICT HEALTH COMMITTEE (Studi Kasus di Kabupaten Kutai Kartanegara dan Bojonegoro

Directory of Open Access Journals (Sweden)

Setia Pranata

2012-11-01

Full Text Available Development of health could not be conducted by the government itself but needs active participation from various sectors. District/municipality governments should mobilize potential resources in the areas so the actively involved in the development of health. Hence the district/municipality governments urge to facilitate development of District Health Committee (DHC as a media composed of all parties that actively involved in the development of health. This is in accordance to the Ministry of Health Letter Number 004/Menkes/SK/I/2003 on policy and strategies on decentralization in health. The study aimed to determine policy about DHC, to facilitate for development DHC and to determine dynamics in the developmentof DHC in Kutai Kartanegara District, East Kalimantan Province and Bojonegoro District, East Java Province. Data were collected by depth interview from staffs at District Health Offices, Health Proffesion Organizations, Non Government Organizations, academics, and the social organizations. Results showed in Kutai Kartanegara District there was institution named District Health Assembly. The institution was formed by the requirement from Asian Development Bank, the funding agency to Decentralized Health Service (DHS Project in Kutai Kartanegara District. The institution has not yet functioned properly and its existence was not socialized widely. In Bojonegoro District, the DHC was thought as an ideal condition in the development of health which existence is needed by some institutions. As the District Health Office was not sure for it hence the development of DHC was assumed not in need. Key words: development of health, District Health Committee, District Health Assembly

District profile: the shoe fits at Northampton.

Science.gov (United States)

1980-04-18

An old county town that has retained its individuality through all the changes of the last three centuries, and is expanding vigorously to meet the challenge of the next--that is Northampton. The health services of the district reflect the town, and draw strength, as they always have done, from close links with the community they serve.

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.

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.

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.

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...

CVP Service Area

Data.gov (United States)

California Natural Resource Agency — Federal Water Contract Service Area boundaries are incorporated boundaries of districts having contracts with the U.S. Bureau of Reclamation (Reclamation), within...

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

State and non-state mental health service collaboration in a South African district: a mixed methods study.

Science.gov (United States)

Janse van Rensburg, André; Petersen, Inge; Wouters, Edwin; Engelbrecht, Michelle; Kigozi, Gladys; Fourie, Pieter; van Rensburg, Dingie; Bracke, Piet

2018-05-01

The Life Esidimeni tragedy in South Africa showed that, despite significant global gains in recognizing the salience of integrated public mental health care during the past decade, crucial gaps remain. State and non-state mental health service collaboration is a recognized strategy to increase access to care and optimal use of community resources, but little evidence exist about how it unfolds in low- to middle-income countries. South Africa's Mental Health Policy Framework and Strategic Plan 2013-20 (MHPF) underlines the importance of collaborative public mental health care, though it is unclear how and to what extent this happens. The aim of the study was to explore the extent and nature of state and non-state mental health service collaboration in the Mangaung Metropolitan District, Free State, South Africa. The research involved an equal status, sequential mixed methods design, comprised of social network analysis (SNA) and semi-structured interviews. SNA-structured interviews were conducted with collaborating state and non-state mental health service providers. Semi-structured interviews were conducted with collaborating partners and key stake holders. Descriptive network analyses of the SNA data were performed with Gephi, and thematic analysis of the semi-structured interview data were performed in NVivo. SNA results suggested a fragmented, hospital centric network, with low average density and clustering, and high authority and influence of a specialist psychiatric hospital. Several different types of collaborative interactions emerged, of which housing and treatment adherence a key point of collaboration. Proportional interactions between state and non-state services were low. Qualitative data expanded on these findings, highlighting the range of available mental health services, and pointed to power dynamics as an important consideration in the mental health service network. The fostering of a well-integrated system of care as proposed in the MHPF requires

Service use and unmet service needs in grandparents raising grandchildren.

Science.gov (United States)

Yancura, Loriena A

2013-01-01

Most in-depth studies of grandparents raising grandchildren use samples recruited from service providers, so little is known about those who do not use formal services. A sample of 200 grandparents registered with a public school district completed a survey on service use and unmet service needs. Of the 131 who did not use services, 82 reported unmet service needs, and 49 reported no needs. Those with unmet needs were younger, more likely to be Native Hawaiian, and less likely to receive public assistance. These findings indicate that some grandparents are falling through the cracks of the service provision network.

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)

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

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.

Assessment of coverage of preventive treatment and insecticide-treated mosquito nets in pregnant women attending antenatal care services in 11 districts in Mozambique in 2011: the critical role of supply chain.

Science.gov (United States)

Salomão, Cristolde; Sacarlal, Jahit; Gudo, Eduardo Samo

2017-05-25

Malaria during pregnancy is associated with poor maternal and pregnancy outcome and the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) and distribution of insecticide-treated mosquito nets (ITNs) to all pregnant women attending antenatal care (ANC) services. This study was conducted with the aim to assess the uptake of IPTp and ITNs in pregnant women attending ANC services and correlate with ANC attendance and frequency of stock-outs in 22 health facilities Mozambique. A cross-sectional study was conducted between July and December 2011 in 22 health units in 11 districts situated in 11 provinces in Mozambique. Two health facilities were selected per district (one urban and one rural). Data were collected by reviewing logbooks of antenatal consultations as well as from monthly district reports. During the period under investigation, a total of 23,524 pregnant women attended their 1st antenatal care visits, of which 12,775 (54.3%) and 7581 (32.2%) received one and two doses of IPTp, respectively. In regard to ITNs, a total of 16,436 (69.9%) pregnant women received ITNs. Uptake of IPTp and ITNs by pregnant women at ANC services was higher in southern Mozambique and lower in districts situated in the northern part of the country. Stock-outs of SP and ITNs were reported in 50.0% (11/22) and 54.5% (12/22) of the health facilities, respectively. Coverage of IPTp and ITN in health facilities with stock-outs of SP and ITNs was much lower as compared to health facilities with no stock-outs. Altogether, data from this study shows that coverage of the 2nd dose of IPTp, as well as ITNs, was low in pregnant women attending ANC services in Mozambique. In addition, this data also shows that stock-outs of SP and ITNs were frequent and led to lower coverage of IPTp and ITN, representing a serious barrier for the accomplishment of targets. In conclusion, this study recommends that

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

Science.gov (United States)

Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

2016-01-01

Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

Science.gov (United States)

Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

Implementation of gas district cooling and cogeneration systems in Malaysia; Mise en oeuvre de systemes de gas district cooling et de cogeneration en Malaisie

Energy Technology Data Exchange (ETDEWEB)

Haron, S. [Gas District Cooling, M, Sdn Bhd (Malaysia)

2000-07-01

With its energy demand in the early 1990's growing at a high rate due to the country's strong economic growth, Malaysia studied various options to improve the efficiency of its energy use. Since its natural gas reserves are almost four times that of its crude oil reserves, efforts were therefore centered on seeking ways to boost the use of natural gas to mitigate the growing domestic energy need. PETRONAS, the national oil company, subsequently studied and chose the District Cooling System using natural gas as the primary source of fuel. The Kuala Lumpur City Center development, which houses the PETRONAS Twin Towers, was subsequently chosen as the first project to use the Gas District Cooling (GDC) System. To acquire the technology and implement this project, PETRONAS created a new subsidiary, Gas District Cooling (Malaysia) Sendirian Berhad (GDC(M)). In the process of improving the plant's efficiency, GDC(M) discovered that the GDC system's efficiency and project economics would be significantly enhanced if its is coupled to a Cogeneration system. Having proven the success of the GDC/Cogeneration system, GDC(M) embarked on a campaign to aggressively promote and seek new opportunities to implement the system, both in Malaysia-and abroad. Apart from enhancing efficiency of energy use, and providing better project economics, the GDC/Cogeneration system also is environment friendly. Today, the GDC/Cogeneration systems is the system of choice for several important developments in Malaysia, which also includes the country's prestigious projects such as the Kuala Lumpur International Airport and the New Federal Government Administrative Center in Putrajaya. (author)

Doing Business with Entrepreneurial America: Protecting School District Interests.

Science.gov (United States)

McCord, Robert S.; Mattocks, T. C.; Kops, Gerald

This paper attempts to identify benchmark considerations when entertaining the question of private management of public school facilities. Management possibilities include contracting for services and charter conversion. The paper also highlights elements of contract law pertinent to formal agreements made between school districts and private…

Comparing the Age-Friendliness of Different Neighbourhoods Using District Surveys: An Example from Hong Kong.

Science.gov (United States)

Wong, Moses; Chau, Pui Hing; Cheung, Francis; Phillips, David R; Woo, Jean

2015-01-01

To address the age-friendliness of living environment in cities, the World Health Organization (WHO) launched the "Age-friendly cities" (AFC) initiative in 2005. To date, however, no universal standard tool for assessing age-friendliness of a community has been agreed. Two quantitative studies on AFC conducted in two Hong Kong districts-Sha Tin and Tuen Mun-were compared. A total of 801 residents aged ≥50 years were interviewed using structured questionnaires based on the WHO's AFC criteria. District-wide differences in age-friendliness were compared on the basis of eight domain scores. Multiple linear regression was used to examine associations with demographic and socio-economic characteristics. The provision of services and amenities was also compared to help explain the difference in domain scores. Variations in mean domain scores were observed in both districts. Sha Tin showed significantly lower scores in outdoor spaces and buildings, transportation, social participation, respect and social inclusion, civic participation and employment, communication and information, as compared with Tuen Mun. Although a significantly higher score on the housing domain was observed in Sha Tin, differences in community and health services domains were insignificant. Socio-demographic factors, such as age group, gender, area of residence, type of housing, experience of elderly care, employment status, self-rated health and income, were associated with domain scores. However, variations in services and amenities provision appeared not to be strongly associated with district-wide difference in domain scores. District differences in public opinions towards age-friendly characteristics were observed in this study. Except for two of the eight domains, Sha Tin had significantly lower scores than Tuen Mun. Some socio-demographic indicators seemed predictive to the differences. Paradoxically, Sha Tin had better services and infrastructure and higher socio-economic status, but lower

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.

Review of final-year medical students' rural attachment at district ...

African Journals Online (AJOL)

2013-11-15

Nov 15, 2013 ... This paper presents the first phase of an ongoing quality ... a rural district hospital can provide unique learning opportunities for students if the ..... Peabody C, Block A, Jain S. Multi-disciplinary service learning: a medico-legal.

Role of Puskesmas Leader in Development of UKBM in Purbalingga District

OpenAIRE

Ginanjar, Aryo; Intiasari, Arih Diyaning; Wiyoto, A. R Siswanto Budi

2016-01-01

Background: Implementation of Puskesmas function as the center of society empowerment was done through thedevelopment of UKBM in work region of Puskesmas. This research aims to know the role of Puskesmas leader in PurbalinggaDistrict, Central Java Province in the implementation of Puskesmas function as the the center of society empowermentthrough development of UKBM. Role of Puskesmas leader that were analyzed in this research were role of motivation,communication, leadership, guidance, obser...

Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.

Science.gov (United States)

Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H

2011-01-01

The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

Science.gov (United States)

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

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.

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)

Utilization of Health Information System at District Level in Jimma ...

African Journals Online (AJOL)

Therefore, in-service training and updating of staff involved in health information system (HIS) at district, strengthening health information system inputs, timely and concrete feedbacks with establishment of functional health management information system (HMIS). KEY WORDS: Health Management Information System, ...