WorldWideScience

Sample records for services doe department

  1. Department of Education (DOE)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is to assist the U.S. Department of Education in its obligation to ensure that applicants for student financial assistance under Title...

  2. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

    2013-09-01

    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  3. Scientific Services Department

    International Nuclear Information System (INIS)

    SSD in the South Western Region employs more than 200 people, of which 90% are scientists or engineers. Their purpose is to understand and clarify the extensive technical issues which arise during the operation of many different types of plant spread over a wide area of Southern England and South Wales. Priority is given to work in terms of its potential value to the Board. This brochure illustrates some aspects of the work of SSD. Based at Regional Headquarters in Bristol, the Department undertakes 'on site' inspection followed by more thorough laboratory examinations for the diagnosis of faults, and carries out selected research activities. Most of this effort is directed towards the three nuclear sites and four large conventional power stations in the Region. (author)

  4. Department of Energy (DOE) summary

    International Nuclear Information System (INIS)

    2001-01-01

    An overview was provided of the Generation IV Initiative to evaluate candidate technology concepts for a new generation of nuclear power plants. DOE presented the Generation IV goals, road map effort, and concept evaluation. The formation was discussed of a Near-Term Deployment Working Group (NTDG) formed to identify actions and evaluate options necessary for DOE to support new plants. DOE has established a Nuclear Energy Research Advisory Committee (NERAC) to provide independent evaluation and feedback on the establishment of goals and objectives and progress in evaluating candidate nuclear energy concepts. DOE has also established a Generation IV Road map NERAC Subcommittee (GRNS) to serve as an advisory group in establishing the road map along with a Road map integration Team (RIT). Candidate technologies must be deployable by 2030. Nuclear systems are expected to meet sustainability goals (resource inputs, waste outputs, and nonproliferation), safety and reliability goals (operating maintainability excellence, limiting core damage risk, and reduced need for emergency response), and economic goals (reduced life-cycle costs and risk to capital). Criteria and metrics for each goal are being developed by an Evaluation Methodology Group (EMG), RIT, and the GRNS. DOE plans to evaluate ail candidate concepts equally without prejudice toward existing technologies (e.g., light-water reactors) but recognizes that most primary energy generators are likely to be fission based. DOE is presently considering 94 concepts. The output of the Generation IV Program is expected to be a research and development plan to support future commercialization of the best concepts

  5. Baby doe redux? The Department of Health and Human Services and the Born-Alive Infants Protection Act of 2002: a cautionary note on normative neonatal practice.

    Science.gov (United States)

    Sayeed, Sadath A

    2005-10-01

    previable births may need modification. More worrisome, threatened aggressive investigations of alleged EMTALA violations at the soft edges of viability, where futility remains a matter of debate, jeopardize the normative ethical practice of offering discretionary palliative care. The DHHS sent its other instruction to state child protective services agencies responsible for implementing CAPTA regulations; it reiterates the limited situations in which physicians may withhold medical treatment from infants and reemphasizes the local role of "individuals within health care facilities" to notify authorities of suspected infractions. Its real import, however, is insistence on local execution of legal remedies to prevent nontreatment decisions deemed impermissible by the 1984 Baby Doe rules. Because this new directive encourages governmental oversight of treatment decisions involving imperiled newborns, a period of benign regulatory neglect seems to be over. The federal CAPTA rules arguably remove quality-of-life considerations from the decision-making calculus and therefore may conflict with the best-interests paradigm advocated by the American Academy of Pediatrics and NRP. How courts will respond to the DHHS interpretation of EMTALA and CAPTA under the BAIPA remains unclear. Federal courts have yet to authoritatively examine alleged EMTALA violations involving newborn treatment decisions at the limits of viability. The Wisconsin Supreme Court has permitted an EMTALA claim to go to trial where physicians allegedly did not screen or resuscitate a 22-week newborn delivered in an emergency department, and a lower appellate court has relied on CAPTA to hold that parents do not possess the right to choose against resuscitating an extremely premature newborn. The Texas Supreme Court recently granted physicians the paternalistic prerogative to resuscitate imperiled newborns without attention to parental preference under a common law doctrine of "emergent circumstances." These

  6. DOE [Department of Energy] Epidemiologic Research Program

    International Nuclear Information System (INIS)

    1990-01-01

    The objective of the Department of Energy (DOE) Epidemiologic Research Program is to determine the human health effects resulting from the generation and use of energy, and of the operation of DOE facilities. The program is divided into seven general areas of activity; the Radiation Effects Research Foundation (RERF) which supports studies of survivors of the atomic weapons in Hiroshima and Nagasaki, mortality and morbidity studies of DOE workers, studies on internally deposited alpha emitters, medical/histologic studies, studies on the aspects of radiation damage, community health surveillance studies, and the development of computational techniques and of databases to make the results as widely useful as possible. Excluding the extensive literature from the RERF, the program has produced 340 publications in scientific journals, contributing significantly to improving the understanding of the health effects of ionizing radiation exposure. In addition, a large number of public presentations were made and are documented elsewhere in published proceedings or in books. The purpose of this bibliography is to present a guide to the research results obtained by scientists supported by the program. The bibliography, which includes doctoral theses, is classified by laboratory and by year and also summarizes the results from individual authors by journal

  7. DOE (Department of Energy) Epidemiologic Research Program

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The objective of the Department of Energy (DOE) Epidemiologic Research Program is to determine the human health effects resulting from the generation and use of energy, and of the operation of DOE facilities. The program is divided into seven general areas of activity; the Radiation Effects Research Foundation (RERF) which supports studies of survivors of the atomic weapons in Hiroshima and Nagasaki, mortality and morbidity studies of DOE workers, studies on internally deposited alpha emitters, medical/histologic studies, studies on the aspects of radiation damage, community health surveillance studies, and the development of computational techniques and of databases to make the results as widely useful as possible. Excluding the extensive literature from the RERF, the program has produced 340 publications in scientific journals, contributing significantly to improving the understanding of the health effects of ionizing radiation exposure. In addition, a large number of public presentations were made and are documented elsewhere in published proceedings or in books. The purpose of this bibliography is to present a guide to the research results obtained by scientists supported by the program. The bibliography, which includes doctoral theses, is classified by laboratory and by year and also summarizes the results from individual authors by journal.

  8. Psychiatric service users' experiences of emergency departments

    DEFF Research Database (Denmark)

    Carstensen, Kathrine; Lou, Stina; Jensen, Lotte Groth

    2017-01-01

    Background: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users’ experiences regarding general EDs is limited. Aim: To identify and summarize current, qualitative evidence rega...... the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users’ needs are more likely to be recognized and accommodated....

  9. Improving Motivation in the Service Department

    OpenAIRE

    Sosingot-Sundström, Sevarine

    2015-01-01

    The objective of this study is to improve motivation of the employees in the Service Department. What motivates employees in this century beyond the normal norms of job security and money. The study is based on improving the motivation of the Service Department of Company X. This research was based on the service’s department low score in motivation after the results of the 2012 annual staff survey. The research aims to find out the cause(s) for the low motivation and also find a solution tha...

  10. Evaluating Service Quality in Universities: A Service Department Perspective

    Science.gov (United States)

    Smith, Gareth; Smith, Alison; Clarke, Alison

    2007-01-01

    Purpose: The purpose of the study is to report on an in-depth exploration of service quality in an Information Technology service department in a Higher Education Institute (HEI) and to evaluate the instrument used. Design/methodology/approach: The study surveys customers using the SERVQUAL instrument, which is one of the most widely used and…

  11. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    This Department of Energy (DOE) technical standards list (TSL) has been prepared by the Office of Nuclear Safety Policy and Standards (EH-31) on the basis of currently available technical information. Periodic updates of this TSL will be issued as additional information is received on standardization documents being issued, adopted, or canceled by DOE. This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listings of current DOE technical standards, non-Government standards that have been adopted by DOE, other standards-related documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  12. Evaluation of service quality of hospital outpatient department services.

    Science.gov (United States)

    Chakravarty, Abhijit

    2011-07-01

    It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

  13. DOE standard: The Department of Energy Laboratory Accreditation Program administration

    International Nuclear Information System (INIS)

    1998-12-01

    This technical standard describes the US Department of Energy Laboratory Accreditation Program (DOELAP), organizational responsibilities, and the accreditation process. DOELAP evaluates and accredits personnel dosimetry and radiobioassay programs used for worker monitoring and protection at DOE and DOE contractor sites and facilities as required in Title 10, Code of Federal Regulations, Part 835, Occupational Radiation Protection. The purpose of this technical standard is to establish procedures for administering DOELAP and acquiring accreditation

  14. Does Peacetime Military Service Affect Crime?

    DEFF Research Database (Denmark)

    Albæk, Karsten; Leth-Petersen, Søren; le Maire, Christian Daniel

    Draft lottery data combined with Danish longitudinal administrative records show that military service can reduce criminal activity for youth offenders who enter service at ages 19-22. For this group property crime is reduced for up to five years from the beginning of service, and the effect...... is therefore not only a result of incapacitation while enrolled. We find no effect of service on violent crimes. We also find no effect of military service on educational attainment and unemployment, but we find negative effects of service on earnings. These results suggest that military service does...

  15. Does Peacetime Military Service Affect Crime

    DEFF Research Database (Denmark)

    Albæk, Karsten; Leth-Petersen, Søren; le Maire, Daniel

    Draft lottery data combined with Danish longitudinal administrative records show that military service can reduce criminal activity for youth offenders who enter service at ages 19-22. For this group property crime is reduced for up to five years from the beginning of service, and the effect...... is therefore not only a result of incapacitation while enrolled. We find no effect of service on violent crimes. We also find no effect of military service on educational attainment and unemployment, but we find negative effects of service on earnings. These results suggest that military service does...

  16. 50 CFR 86.61 - What process does the Service use to select projects for grants?

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What process does the Service use to....61 What process does the Service use to select projects for grants? The Service's Division of Federal... SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION...

  17. 77 FR 5012 - Environmental Protection Agency, Department of Health and Human Services and Department of...

    Science.gov (United States)

    2012-02-01

    ..., Department of Health and Human Services and Department of Agriculture; Memorandum of Understanding Regarding... Memorandum of Understanding (MOU). The MOU will support and encourage cooperation and communication between... Department of Human Services (HHS) and the U.S. Department of Agriculture (USDA). HHS's Centers for Disease...

  18. 77 FR 43369 - Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department...

    Science.gov (United States)

    2012-07-24

    ..., a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department, Including On... Including Remote Workers in New York Reporting to Miamisburg, OH; Lexisnexis, a Subsidiary of Reed Elsevier... subsidiary of Reed Elsevier, Inc., Customer Service Department and Fulfillment Department, including on-site...

  19. DOE standard: The Department of Energy Laboratory Accreditation Program for radiobioassay

    International Nuclear Information System (INIS)

    1998-12-01

    This technical standard describes the US Department of Energy Laboratory Accreditation Program (DOELAP) for Radiobioassay, for use by the US Department of Energy (DOE) and DOE Contractor radiobioassay programs. This standard is intended to be used in conjunction with the general administrative technical standard that describes the overall DOELAP accreditation process--DOE-STD-1111-98, Department of Energy Laboratory Accreditation Program Administration. This technical standard pertains to radiobioassay service laboratories that provide either direct or indirect (in vivo or in vitro) radiobioassay measurements in support of internal dosimetry programs at DOE facilities or for DOE and DOE contractors. Similar technical standards have been developed for other DOELAP dosimetry programs. This program consists of providing an accreditation to DOE radiobioassay programs based on successful completion of a performance-testing process and an on-site evaluation by technical experts. This standard describes the technical requirements and processes specific to the DOELAP Radiobioassay Accreditation Program as required by 10 CFR 835 and as specified generically in DOE-STD-1111-98

  20. NPP Engineering and Servicing / Design Analysis Department

    International Nuclear Information System (INIS)

    Sik, J.

    2006-01-01

    The article provides an overview of the activities of the SKODA JS's Design Analysis Department performed recently in the fields of reactor physics, shielding physics, thermal hydraulics and mechanical structure stresses and life analysis. (orig.)

  1. Does Peacetime Military Service Affect Crime?

    DEFF Research Database (Denmark)

    Albæk, Karsten; Leth-Petersen, Søren; le Maire, Daniel

    2017-01-01

    Draft lottery data combined with Danish longitudinal administrative records show that military service can reduce criminal activity for youth offenders. For this group, property crime is reduced, and our results indicate that the effect is unlikely to be the result of incapacitation only. We find...... no effect of military service on violent crime, on educational attainment, or on employment and earnings, either in the short run or in the long run. These results suggest that military service does not upgrade productive human capital directly, but rather affects criminal activity through other channels (e...

  2. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    Ngulup

    The principal records management unit within the Department of Corporate Services ... ies services (15), Finance and Accounting (3); however, only 59 participated in it. Data col- ...... records and public-sector financial management.

  3. Customer service in appliance sales departments of selected ...

    African Journals Online (AJOL)

    Customer service in appliance sales departments of selected prominent retail outlets: store manager, ... A single measurement of customers' perception of service quality in various stores however suggested ... AJOL African Journals Online.

  4. Radiation exposures for DOE [Department of Energy] and DOE contractor employees, 1988

    International Nuclear Information System (INIS)

    Merwin, S.E.; Traub, R.J.; Millet, W.H.

    1990-12-01

    This is the 21st in a series of annual radiation exposure reports published by the Department of Energy (DOE) or its predecessors. This report summarizes the radiation exposures received at DOE and DOE contractor facilities in 1988. Radiation exposures to both employees and visitors are included. Trends in radiation exposures are evaluated by comparing the doses received in 1988 to those received in previous years. The significance of the doses is addressed by comparing them to the DOE limits and by correlating the doses to health risks based on risk estimates from expert groups. This report represents a significant advancement from previous reports because it is the first for which detailed exposure data are available for each individual monitored at a DOE facility. This reports contains information on different types of radiation doses, such as penetrating, shallow, and neutron doses. It also contains analysis of exposures by age, sex, and occupation of the exposed individuals. This report is the first of any federal organization that presents such detailed exposure data. The purpose of this report is to disseminate information regarding radiation exposures received at US Department of Energy (DOE) and DOE contractor facilities. The primary purpose of this practice is to ensure that the DOE occupational dose limits are not exceeded and that as low as reasonably achievable (ALARA) goals are met. A secondary purpose, however, is to provide information that can be used by other organizations and individuals who wish to collect and analyze such information. This information may be useful for estimating the effect of changing dose limits on operations at DOE facilities, determining the progress of DOE with respect to the ALARA principle, or, in combination with epidemiological information, assisting researchers in determining whether or not low doses of ionizing radiation are harmful. 23 refs., 20 figs., 23 tabs

  5. Alaska Department of Health and Social Services

    Science.gov (United States)

    marijuana means for Alaska and you. Careline: 1-877-266-HELP (4357) Alaska's Tobacco Quitline Learn the Twitter Find us on Facebook Quicklinks Alaska Opioid Policy Task Force "Spice" Synthetic Marijuana Health Information Alaska State Plan for Senior Services, FY 2016-FY 2019 Get health insurance at

  6. Administrative Services Division - Alaska Department of Law

    Science.gov (United States)

    accounting practices and procedures. JoAnn Pelayo Finance Officer Email: joann.pelayo@alaska.gov Tel: (907 @alaska.gov Tel: (907) 465-3674 Fiscal and Accounting Provide centralized fiscal and accounting functions for , inter-departmental payments for core services, payroll accounting adjustments and oversight, and grant

  7. DOE (Department of Energy) Epidemiologic Research Program: Selected bibliography

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The objective of the Department of Energy (DOE) Epidemiologic Research Program is to determine the human health effects resulting from the generation and use of energy, and from the operation of DOE facilities. The program has been divided into seven general areas of activity: the Radiation Effects Research Foundation (RERF) which supports studies of survivors of the atomic weapons in Hiroshima and Nagasaki, mortality and morbidity studies of DOE workers, studies on internally deposited alpha emitters, medical/histologic studies, studies on the genetic aspects of radiation damage, community health surveillance studies, and the development of computational techniques and of databases to make the results as widely useful as possible. Excluding the extensive literature from the RERF, the program has produced 380 publications in scientific journals, contributing significantly to improving the understanding of the health effects of ionizing radiation exposure. In addition, a large number of public presentations were made and are documented elsewhere in published proceedings or in books. The purpose of this bibliograhpy is to present a guide to the research results obtained by scientists supported by the program. The bibliography, which includes doctoral theses, is classified by national laboratory and by year. Multi-authored studies are indicated only once, according to the main supporting laboratory.

  8. Assessing the physical service setting: a look at emergency departments.

    Science.gov (United States)

    Steinke, Claudia

    2015-01-01

    To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

  9. DOE technical standards list. Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listing of current DOE technical standards, non-Government standards that have been adopted by DOE, other Government documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  10. 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 ...

  11. Assessing STD Partner Services in State and Local Health Departments.

    Science.gov (United States)

    Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

    2018-02-07

    State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

  12. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    This technical standards list (TSL) was prepared for use by personnel involved in the selection and use of US DOE technical standards and other government and non-government standards. This TSL provides listings of current DOE technical standards, non-government standards that have been adopted by DOE, other government documents in which DOE has a recorded interest, and cancelled DOE technical standards. Standards are indexed by type in the appendices to this document. Definitions of and general guidance for the use of standards are also provided.

  13. DynCorp Tricities Services, Inc. Hanford fire department FY 1998 annual work plan

    International Nuclear Information System (INIS)

    Good, D.E.

    1997-01-01

    The mission of the Hanford Fire Department (HFD) is to support the safe and timely cleanup of the Hanford site by providing fire suppression, fire prevention, emergency rescue, emergency medical service, and hazardous materials response; and to be capable of dealing with and terminating emergency situations which could threaten the operations, employees, or interest of the U.S. Department of Energy operated Hanford site. This includes response to surrounding fire departments/districts under mutual aid and state mobilization agreements and fire fighting, hazardous materials, and ambulance support to Washington Public Power Supply System (Supply System) and various commercial entities operating on site through Requests for Service from DOE-RL. This fire department also provides site fire marshal overview authority, fire system testing and maintenance, respiratory protection services, building tours and inspections, ignitable and reactive waste site inspections, prefire planning, and employee fire prevention education. This plan provides a program overview, program baselines, and schedule baseline

  14. Modelling a radiology department service using a VDL integrated approach.

    Science.gov (United States)

    Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

    2009-01-01

    The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

  15. IT Service Departments Struggle to Adopt a Service-Oriented Philosophy

    OpenAIRE

    Aileen Cater-Steel

    2009-01-01

    Many IT service departments are adopting IT service management best practice frameworks such as the IT Infrastructure Library (ITIL) to improve the quality of service to customers. This study reports on recent surveys and case studies of organizations which have embarked on IT service management improvement. It highlights specific difficulties experienced by organizations. Six factors were found to be critical in achieving an effective service-oriented philosophy. The factors are support from...

  16. Previous utilization of service does not improve timely booking in ...

    African Journals Online (AJOL)

    Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study ... Journal Home > Vol 24, No 3 (2010) > ... Results: Past experience on antenatal care service utilization did not come out as a predictor for ...

  17. Service quality of hospital outpatient departments: patients' perspective.

    Science.gov (United States)

    Zarei, Ehsan

    2015-01-01

    Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

  18. DOE's foreign research reactor transportation services contract: Perspective and experience

    International Nuclear Information System (INIS)

    Patterson, John

    1997-01-01

    DOE committed to low- and moderate-income countries participating in the foreign research reactor spent fuel returns program that the United States government would provide for the transportation of the spent fuel. In fulfillment of that commitment, DOE entered into transportation services contracts with qualified, private-sector firms. NAC will discuss its experience as a transportation services provider, including range of services available to the foreign reactors, advantages to DOE and to the foreign research reactors, access to contract services by high income countries and potential advantages, and experience with initial tasks performed under the contract. (author)

  19. Product-line administration: a framework for redefining medical record department services.

    Science.gov (United States)

    Postal, S N

    1990-06-01

    Product-line administration is a viable approach for managing medical records services in an environment that demands high quantity and quality service levels. Product-line administration directs medical record department team members to look outside of the department and seek input from the customers it is intended to serve. The feedback received may be alarming at first, as the current state of products usually reveals a true lack of customer input. As the planning, defining, managing, and marketing phases are implemented, the road will not be easy and rewards will be slow to come. Product-line administration does not provide quick fixes, but it does provide long-term problem resolution as products are refined and new products developed to meet customer needs and expectations. In addition to better meeting the needs of the department's external customers, the department's internal customers' needs and expectations will be addressed. The participative management approach will help nurture each team member's creativity. The team members will have the opportunity to reach their full potential while reaping the rewards and benefits of providing products and services that meet the needs and expectations of all department customers. The future of the health care industry promises more changes as the country moves toward some form of prospective payment in the ambulatory setting. Reactive management and the constant struggle to catch up can no longer be accepted as a management approach. It is imperative that the medical record department be viewed as a business with product lines composed of quality products. The planning, defining, managing, and marketing components of product-line administration afford responsiveness to the current situation and the development of quality products that will ensure that medical record departments are prepared for the future.

  20. Needs assessment for fire department services and resources for the Los Alamos National Laboratory, Los Alamos, New Mexico. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-15

    This report has been developed in response to a request from the Los Alamos National Laboratory (LANL) to evaluate the need for fire department services so as to enable the Laboratory to plan effective fire protection and thereby: meet LANL`s regulatory and contractual obligations; interface with the Department of Energy (DOE) and other agencies on matters relating to fire and emergency services; and ensure appropriate protection of the community and environment. This study is an outgrowth of the 1993 Fire Department Needs Assessment (prepared for DOE) but is developed from the LANL perspective. Input has been received from cognizant and responsible representatives at LANL, DOE, Los Alamos County (LAC) and the Los Alamos Fire Department (LAFD).

  1. The Frederic Joliot hospital department; Le service hospitalier Frederic Joliot

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

  2. [Services portfolio of a department of endocrinology and clinical nutrition].

    Science.gov (United States)

    Vicente Delgado, Almudena; Gómez Enterría, Pilar; Tinahones Madueño, Francisco

    2011-03-01

    Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

  3. How Does PCSI Help Deliver Integrated Services?

    Centers for Disease Control (CDC) Podcasts

    This podcast describes how PCSI strengthens collaborative work across disease areas and integrates services that are provided by related programs, especially prevention activities related to HIV/AIDS, viral hepatitis, other sexually transmitted diseases (STDs), and tuberculosis (TB) at the client level.

  4. Evaluation of emergency department nursing services and patient satisfaction of services.

    Science.gov (United States)

    Mollaoğlu, Mukadder; Çelik, Pelin

    2016-10-01

    To identify nursing services and assess patient satisfaction in patients who present to the emergency department. Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. This is a descriptive study. Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form. Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%). The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department. We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues.

  5. DOE [Department of Energy]-Nuclear Energy Standards Program annual assessment, FY 1990

    International Nuclear Information System (INIS)

    Williams, D.L. Jr.

    1990-11-01

    To meet the objectives of the programs funded by the Department of Energy (DOE)-Nuclear Energy (NE) Technology Support Programs, the Performance Assurance Project Office (PAPO) administers a nuclear standards program and related activities and fosters the development and application of standards. This standards program is carried out in accordance with the principles in DOE Order 1300.2, Department of Energy Standards Program, December 18, 1980. The purposes of this effort, as set forth in three subtasks, are to (1) manage the NE Standards Program, (2) manage the development and maintenance of NE standards, and (3) operate an NE Standards Information Program. This report assesses the Performance Assurance Project Office (PAPO) activities in terms of the objectives of the Department of Energy-Nuclear Energy (DOE-NE) funded programs. To meet these objectives, PAPO administers a nuclear standards program and related activities and fosters the development and application of standards. This task is carried out in accordance with the principles set forth in DOE Order 1300.2, Department of Energy Standards Program, December 18, 1980, and DOE memorandum, Implementation of DOE Orders on Quality Assurance, Standards, and Unusual Occurrence Reporting for Nuclear Energy Programs, March 3, 1982, and with guidance from the DOE-NE Technology Support Programs. 1 tab. (JF)

  6. How Does PCSI Help Deliver Integrated Services?

    Centers for Disease Control (CDC) Podcasts

    2009-12-07

    This podcast describes how PCSI strengthens collaborative work across disease areas and integrates services that are provided by related programs, especially prevention activities related to HIV/AIDS, viral hepatitis, other sexually transmitted diseases (STDs), and tuberculosis (TB) at the client level.  Created: 12/7/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 12/7/2009.

  7. Quality assurance plan: Prepared for the state of Florida, Department of Health and rehabilitative Services, Office of Laboratory Services, Water Certification Program

    International Nuclear Information System (INIS)

    1992-02-01

    This quality assurance plan is for use in ongoing operations in the General Electric Neutron Devices Department. General Electric operates the Department of Energy (DOE) facility in Largo, Florida. All work covered by this quality assurance plan is in support of the operations of the wastewater pretreatment facility operated by GENDD at the DOE facility in Largo, Florida. As a Florida State certified laboratory we will follow Health and Rehabilitation Services (HRS) or HRS approved standard methods, successfully participate in HRS or HRS approved performance evaluation studies, and will maintain Quality Assurance Documentation as outlined in this plan or its subsequent revisions

  8. 78 FR 13743 - Department of State FY11 Service Contract Inventory

    Science.gov (United States)

    2013-02-28

    ... DEPARTMENT OF STATE [Public Notice 8207] Department of State FY11 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory... Act, Public Law 111-117, requires Department of State, and other civilian agencies, to submit an...

  9. Does Service Innovation Matter in High-Tech Industry

    Directory of Open Access Journals (Sweden)

    Chao-Hung Wang

    2014-05-01

    Full Text Available Service innovation has been found to be a major driver of innovation performance in service contexts. But this issue raises questions concerning the extent to which the relationship between market orientation and innovation performance holds in the high-tech industry. Relatively little research has examined how market orientation contributes to innovation performance through service innovation. We here report an empirical study of 235 Taiwanese high-tech firms to examine the influence of market orientation on service innovation and innovation performance. A noteworthy finding is that the impacts of customer orientation and competitor orientation on innovation performance are fully mediated by service innovation. However, service innovation does only partially mediate the relationship between inter-functional orientation and innovation performance. The findings of this study should help managers consider appropriate service innovation in high-tech industry.

  10. The DOE fellows program-a workforce development initiative for the US department of energy

    Energy Technology Data Exchange (ETDEWEB)

    Lagos, Leonel E. [Applied Research Center, Florida International University, 10555 West Flagler St, EC2100, Miami, Florida (United States)

    2013-07-01

    The US Department of Energy Office of Environmental Management (DOE-EM) oversees one of the largest and most technically challenging cleanup programs in the world. The mission of DOE-EM is to complete the safe cleanup of the environmental legacy from five decades of nuclear weapons development and government-sponsored nuclear energy research. Since 1995, Florida International University's Applied Research Center (FIU-ARC) has supported the DOE-EM mission and provided unique research capabilities to address some of these highly technical and difficult challenges. This partnership has allowed FIU-ARC to create a unique infrastructure that is critical for the training and mentoring of science, technology, engineering, and math (STEM) students and has exposed many STEM students to 'hands-on' DOE-EM applied research, supervised by the scientists and engineers at ARC. As a result of this successful partnership between DOE and FIU, DOE requested FIU-ARC to create the DOE-FIU Science and Technology Workforce Development Initiative in 2007. This innovative program was established to create a 'pipeline' of minority STEM students trained and mentored to enter DOE's environmental cleanup workforce. The program was designed to help address DOE's future workforce needs by partnering with academic, government and private companies (DOE contractors) to mentor future minority scientists and engineers in the research, development, and deployment of new technologies and processes addressing DOE's environmental cleanup challenges. Since its inception in 2007, the program has trained and mentored 78 FIU STEM minority students. Although, the program has been in existence for only six years, a total of 75 internships have been conducted at DOE National Laboratories, DOE sites, DOE Headquarters and field offices, and DOE contractors. Over 100 DOE Fellows have participated in the Waste Management (WM) Symposia since 2008 with a total of 84 student

  11. The DOE fellows program-a workforce development initiative for the US department of energy

    International Nuclear Information System (INIS)

    Lagos, Leonel E.

    2013-01-01

    The US Department of Energy Office of Environmental Management (DOE-EM) oversees one of the largest and most technically challenging cleanup programs in the world. The mission of DOE-EM is to complete the safe cleanup of the environmental legacy from five decades of nuclear weapons development and government-sponsored nuclear energy research. Since 1995, Florida International University's Applied Research Center (FIU-ARC) has supported the DOE-EM mission and provided unique research capabilities to address some of these highly technical and difficult challenges. This partnership has allowed FIU-ARC to create a unique infrastructure that is critical for the training and mentoring of science, technology, engineering, and math (STEM) students and has exposed many STEM students to 'hands-on' DOE-EM applied research, supervised by the scientists and engineers at ARC. As a result of this successful partnership between DOE and FIU, DOE requested FIU-ARC to create the DOE-FIU Science and Technology Workforce Development Initiative in 2007. This innovative program was established to create a 'pipeline' of minority STEM students trained and mentored to enter DOE's environmental cleanup workforce. The program was designed to help address DOE's future workforce needs by partnering with academic, government and private companies (DOE contractors) to mentor future minority scientists and engineers in the research, development, and deployment of new technologies and processes addressing DOE's environmental cleanup challenges. Since its inception in 2007, the program has trained and mentored 78 FIU STEM minority students. Although, the program has been in existence for only six years, a total of 75 internships have been conducted at DOE National Laboratories, DOE sites, DOE Headquarters and field offices, and DOE contractors. Over 100 DOE Fellows have participated in the Waste Management (WM) Symposia since 2008 with a total of 84 student

  12. 77 FR 27263 - Computer Matching Between the Selective Service System and the Department of Education

    Science.gov (United States)

    2012-05-09

    ... SELECTIVE SERVICE SYSTEM Computer Matching Between the Selective Service System and the Department of Education AGENCY: Selective Service System. Action: Notice. In accordance with the Privacy Act of... of Participating Agencies The Selective Service System (SSS) and the Department of Education (ED). 2...

  13. 34 CFR 692.30 - How does a State administer its community service-learning job program?

    Science.gov (United States)

    2010-07-01

    ...-learning job program? 692.30 Section 692.30 Education Regulations of the Offices of the Department of... Administer Its Community Service-Learning Job Program? § 692.30 How does a State administer its community service-learning job program? (a)(1) Each year, a State may use up to 20 percent of its allotment for a...

  14. Radionuclide traceability for U.S. Department of Energy Environmental Management Radioanalytical Services

    International Nuclear Information System (INIS)

    Morton, J.S.; McIntyre, T.I.

    2001-01-01

    In 1999, the Department of Energy Office of Environmental Management (DOE-EM) National Analytical Management Program (NAMP) established a Radiological Traceability Program (RTP) as a new initiative for the radioanalytical activities related to the environmental programs conducted throughout the DOE complex. The National Analytical Management Program entered into an interagency agreement with the National Institute of Standards and Technology (NIST) to establish traceability to the national standard for DOE-EM radioanalytical activities through the NIST/reference laboratory concept as described in ANSI N42.23-1996. Using the criteria established by the RTP, NAMP named two DOE-EM laboratories as reference or secondary laboratories and established a program with NIST that demonstrated the concept of traceability. In order to gain and maintain traceability to NIST, each reference laboratory must meet the performance criteria as defined by the RTP and NAMP. Traceability to NIST is tiered down to each radioanalytical laboratory (monitor or service) that successfully participates in the performance-evaluation programs offered by the reference laboratories. Essential to the RTP is the demonstration that the reference laboratories can produce performance-testing (PT) materials of high quality as well as analyze/verify the radionuclide concentration to the required accuracy and precision. Elements of the RTP and the program requirements of NIST and the reference laboratories are presented. (author)

  15. Assessing the Idaho Transportation Department's customer service performance.

    Science.gov (United States)

    2011-10-23

    This report assesses customer satisfaction with the Idaho Transportation Department. It also compares and contrasts the results of customer satisfaction surveys conducted for the Idaho Transportation Department with the results from other state trans...

  16. 43 CFR 44.23 - How does the Department certify payment computations?

    Science.gov (United States)

    2010-10-01

    ... Certified Public Accountant, or an independent public accountant, that the statement has been audited in... guidelines that State auditors, independent Certified Public Accountants, or independent public accountants... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false How does the Department certify payment...

  17. 76 FR 9399 - Department of State FY10 Service Contract Inventory

    Science.gov (United States)

    2011-02-17

    ... DEPARTMENT OF STATE [Public Notice 7321] Department of State FY10 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY10. Section 743 of Division C of the FY 2010 Consolidated Appropriations Act, Public Law 111-117...

  18. 77 FR 5614 - Department of State FY11 Service Contract Inventory

    Science.gov (United States)

    2012-02-03

    ... DEPARTMENT OF STATE [Public Notice 7785] Department of State FY11 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory.../ . Section 743 of Division C of the FY 2010 Consolidated Appropriations Act, Public Law 111-117, requires...

  19. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

  20. Final Report for DOE Project: Portal Web Services: Support of DOE SciDAC Collaboratories

    Energy Technology Data Exchange (ETDEWEB)

    Mary Thomas, PI; Geoffrey Fox, Co-PI; Gannon, D; Pierce, M; Moore, R; Schissel, D; Boisseau, J

    2007-10-01

    Grid portals provide the scientific community with familiar and simplified interfaces to the Grid and Grid services, and it is important to deploy grid portals onto the SciDAC grids and collaboratories. The goal of this project is the research, development and deployment of interoperable portal and web services that can be used on SciDAC National Collaboratory grids. This project has four primary task areas: development of portal systems; management of data collections; DOE science application integration; and development of web and grid services in support of the above activities.

  1. Evaluation and compilation of DOE [Department of Energy] waste package test data

    International Nuclear Information System (INIS)

    Interrante, C.; Escalante, E.; Fraker, A.; Plante, E.

    1989-10-01

    This report summarizes evaluations by the National Institute of Standards and Technology (NIST) of Department of Energy (DOE) activities on waste packages designed for containment of radioactive high-level nuclear waste (HLW) for the six month period February 1988 through July 1988. Activities for the DOE Materials Characterization Center are reviewed for the period January 1988 through June 1988. A summary is given of the Yucca Mountain, Nevada disposal site activities. Short discussions relating to the reviewed publications are given and complete reviews and evaluations are included. 20 refs., 1 fig., 1 tab

  2. 76 FR 8402 - Public Availability of the Department of Veterans Affairs FY 2010 Service Contract Inventory

    Science.gov (United States)

    2011-02-14

    ... DEPARTMENT OF VETERANS AFFAIRS Public Availability of the Department of Veterans Affairs FY 2010 Service Contract Inventory AGENCY: Department of Veterans Affairs. ACTION: Notice of public availability... Consolidated Appropriations Act of 2010 (Pub. L. 111-117), Department of Veterans Affairs (VA) is publishing...

  3. Customer service in appliance sales departments of selected ...

    African Journals Online (AJOL)

    Store managers firstly judged tangible evidence of the service offering in their own stores; consumers' perception of the service quality (N=296) in retail stores was subsequently investigated immediately after closure of a sales deal; and salespeople's recommendations (based on their personal experience) to augment the ...

  4. Records management and service delivery: the case of Department ...

    African Journals Online (AJOL)

    This article explores the role of records management in the delivery of public service in ... to the Corporate Services Division at the Ministry of Health headquarters. ... delays in access and use of records; lack of a elaborate electronic records ...

  5. Implementing Relative Ranking Evaluation Framework at Department of Energy (DOE) installations

    International Nuclear Information System (INIS)

    Sharma, S.K.; Williamson, D.; Treichel, L.C.; James, L.M.

    1996-01-01

    The US Department of Energy (DOE) Office of Environmental Restoration (EM-40) has developed the Relative Ranking Evaluation Framework (RREF) to help categorize release sites, facilities and buildings requiring restoration or decommissioning. Based on this framework, a computer tool, the Relative Rank Evaluation Program (RREP) has been developed to evaluate release sites, facilities and buildings, and to manage information pertaining to relative ranking evaluations. The relative ranking information is being used by both Headquarters and field project managers, and other environmental personnel responsible for planning, executing and evaluation environmental restoration activities at DOE installations. External stakeholders, such as representatives of federal and state regulatory agencies, local governments and communities in the vicinity of current and formerly used DOE installations may use this data to review proposed and planned activities

  6. ABC estimation of unit costs for emergency department services.

    Science.gov (United States)

    Holmes, R L; Schroeder, R E

    1996-04-01

    Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

  7. 76 FR 79221 - Penske Logistics, LLC, Customer Service Department General Motors and Tier Finished Goods...

    Science.gov (United States)

    2011-12-21

    ..., Customer Service Department General Motors and Tier Finished Goods/Finished Goods Division; a Subsidiary of... Manpower El Paso, TX; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance... should read Penske Logistics, LLC, Customer Service Department, General Motors and Tier Finished Goods...

  8. 78 FR 977 - Public Availability of the Department of Transportation FY 2012 Service Contract Inventory

    Science.gov (United States)

    2013-01-07

    ... Service Contract Inventory AGENCY: Department of Transportation. ACTION: Notice of Public Availability of FY 2012 Service Contract Inventories. SUMMARY: In accordance with Section 743 of Division C of the Consolidated Appropriations Act of 2010, Public Law 111-117, Department of Transportation is publishing this...

  9. 31 CFR 223.22 - Fees for services of the Treasury Department.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Fees for services of the Treasury Department. 223.22 Section 223.22 Money and Finance: Treasury Regulations Relating to Money and Finance... BUSINESS WITH THE UNITED STATES § 223.22 Fees for services of the Treasury Department. (a) Fees shall be...

  10. Wackenhut Services, Incorporated: Report from the DOE Voluntary Protection Program onsite review, August 10--14, 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    This report summarizes the Department of Energy Voluntary Protection Program (DOE-VPP) Review Team`s findings from the five-day onsite evaluation of Wackenhut Services, Inc. (WSI) at Savannah River Site (SRS), conducted August 10-14, 1998. The site was evaluated against the program requirements contained in US Department of Energy Voluntary Protection Program, Part 1: Program Elements to determine its success in implementing the five DOE-VPP tenets. The Team determined that WSI has met in varying degrees, all the tenets of the DOE-VPP. In every case, WSI programs and procedures exceed the level or degree necessary for compliance with existing standards, DOE Orders, and guidelines. In addition, WSI has systematically integrated their occupational safety and health (OSH) program into management and work practices at all levels. WSI`s efforts toward implementing the five major DOE-VPP tenets are summarized.

  11. Wackenhut Services, Incorporated: Report from the DOE Voluntary Protection Program onsite review, August 10-14, 1998

    International Nuclear Information System (INIS)

    1999-05-01

    This report summarizes the Department of Energy Voluntary Protection Program (DOE-VPP) Review Team's findings from the five-day onsite evaluation of Wackenhut Services, Inc. (WSI) at Savannah River Site (SRS), conducted August 10-14, 1998. The site was evaluated against the program requirements contained in US Department of Energy Voluntary Protection Program, Part 1: Program Elements to determine its success in implementing the five DOE-VPP tenets. The Team determined that WSI has met in varying degrees, all the tenets of the DOE-VPP. In every case, WSI programs and procedures exceed the level or degree necessary for compliance with existing standards, DOE Orders, and guidelines. In addition, WSI has systematically integrated their occupational safety and health (OSH) program into management and work practices at all levels. WSI's efforts toward implementing the five major DOE-VPP tenets are summarized

  12. The United States Department of Energy (DOE) Computerized Accident/Incident Reporting System (CAIRS)

    International Nuclear Information System (INIS)

    Briscoe, G.J.

    1993-01-01

    The Department of Energy's (DOE) Computerized Accident/Incident Reporting System (CAIRS) is a comprehensive data base containing more than 50,000 investigation reports of injury/illness, property damage and vehicle accident cases representing safety data from 1975 to the present for more than 150 DOE contractor organizations. A special feature is that the text of each accident report is translated using a controlled dictionary and rigid sentence structure called Factor Relationship and Sequence of Events (FRASE) that enhances the ability to retrieve specific types of information and to perform detailed analyses. DOE summary and individual contractor reports are prepared quarterly and annually. In addition, ''Safety Performance Profile'' reports for individual organizations are prepared to provide advance information to appraisal teams, and special topical reports are prepared for areas of concern such as an increase in the number of security injuries or environmental releases. The data base is open to all DOE and Contractor registered users with no access restrictions other than that required by the Privacy Act

  13. DOE (Department of Energy) natural phenomena guidelines flood design and evaluation

    International Nuclear Information System (INIS)

    McCann, M.W.; Savy, J.B.

    1989-01-01

    Design and evaluation guidelines for DOE (Department of Energy) facilities subjected to earthquake, wind/tornado, and flood have been developed and presented in UCRL-15910 (Ref.1). This paper summarizes Chapter 6 of UCRL-15910 describing the philosophy and procedures for the design or evaluation of facilities for flood. The flood design and evaluation guidelines seek to ensure that DOE facilities satisfy the performance goals described in UCRL-15910. The guidelines are applicable to new and existing construction; however, in the evaluation of existing facilities, fewer design options may be available to satisfy the performance goals. Evaluation of the flood design for a facility consists of: (1) defining the design basis flood (DBFL), (2) evaluating site conditions (e.g., facility location, location of openings and doorways), and (3) assessing flood design strategies (e.g., build above DBFL levels, harden the site)

  14. Status of the U.S. Department of Energy (DOE) Government to Government Program in Russia

    International Nuclear Information System (INIS)

    Olascoaga, M.T.

    1996-01-01

    The US-Russian Government-to-Government Program of Cooperation on Nuclear Material Protection, Control, and Accounting (MPC ampersand A) evolved from the Nunn-Lugar Cooperative Threat Reduction Program. In 1995, the US Department of Energy (DOE) assumed responsibility as the executive agent for implementation of the Government-to-Government MPC ampersand A Program, followed by the programmatic responsibility for funding. The Russian Program initially emphasized limited exchanges, demonstrations, and upgrades at low-enriched uranium (LEU) fuel fabrication facility at Elektrostal in 1994. The program has expanded to include upgrades at nuclear facilities across Russia, development of the Russian Methodological Training Center (RMTC) in Obninsk; and cooperation with Gosatomnadzor, the Russian Federal Nuclear Radiation and Safety Authority. This paper describes the overall program including program objectives, approach, and US-Russian participation, with an emphasis on DOE-GAN cooperation

  15. Modeling factors influencing the demand for emergency department services in ontario: a comparison of methods

    OpenAIRE

    Meaney Christopher; Moineddin Rahim; Agha Mohammad; Zagorski Brandon; Glazier Richard Henry

    2011-01-01

    Abstract Background Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions...

  16. TRANSCOM: The US Department of Energy (DOE) system for tracking shipments

    International Nuclear Information System (INIS)

    Boes, K.S.; Joy, D.S.; Pope, R.B.; Thomas, T.M.; Lester, P.B.

    1994-01-01

    The US Department of energy (DOE) Transportation Management Division (TMD) has developed a system which allows communications with and near real-time tracking of high-visibility shipments of hazardous materials. This system, which is known as TRANSCOM (Transportation Tracking and Communications System), is currently in operation. This paper summarizes the current status of TRANSCOM, its history, the experience associated with its use, and the future plans for its growth and enhancement. during the first half of fiscal year (FY) 1994, 38 shipments were tracked by the TRANSCOM system. These shipments included two Mark-42 spent fuel shipments, one BUSS cask shipment, and one waterway shipment (the Seawolf shipment)

  17. 78 FR 70584 - ATOS IT Solutions & Services, Inc., Billing and Collections Department, Including Workers Whose...

    Science.gov (United States)

    2013-11-26

    ...) Wages are Reported Through Siemens IT Solutions and Services, Mason, Ohio; Amended Certification... Solutions & Services, Inc., Billing and Collections Department, Mason, Ohio. The workers are engaged in... workers separated from employment at the Mason, Ohio location of ATOS IT Solutions & Services, Inc...

  18. Department

    African Journals Online (AJOL)

    USER

    2016-09-20

    Sep 20, 2016 ... Department of Biological and Environmental Sciences, Kibabii University. Abstract. This study ... Key Words: Climate Change, Regional Circulation Model, PRECIS, Bungoma County ... by different computer models is much.

  19. Reciprocal Allocation Method in Service Departments. The Case of a Production Enterprise

    Science.gov (United States)

    Papaj, Ewelina

    2017-12-01

    The main aim of this article is to indicate the role of reciprocal allocation method in the process of costs calculation. In the environment of nowadays companies, often taking very complex organisational forms, the existence of service departments becomes of great importance. Although, as far as management accounting processes are concerned, which lead to identifying the product cost, the service departments' costs come out to be of minor importance. This article means to prove that the service departments' costs and their reliable settlement are a desirable source of information about the products. This work consists of two parts. First of them features theoretical considerations and a critical analysis of subject literature. In the latter part, the service departments' costs calculation will be presented, basing on reciprocal services in a production enterprise from chemical industry.

  20. 42 CFR 59.4 - How does one apply for a family planning services grant?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How does one apply for a family planning services... GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.4 How does one apply for a family planning services grant? (a) Application for a grant under this subpart shall...

  1. An example of a DOE [Department of Energy]/university partnership: South Carolina Pilot Center

    International Nuclear Information System (INIS)

    Albenesius, E.L.

    1990-01-01

    A consortium of educational institutions in South Carolina proposed to the U.S. Department of Energy (DOE) in July 1989 a working partnership for mutual improvement of technical capability in the environmental restoration and waste management fields. The institutions forming the consortium are Clemson University, the University of South Carolina, the Medical University of South Carolina, and South Carolina State College. A major component of the partnership is applied research closely coupled with the problems and issues of the Savannah River site regarding demonstration of waste management processes and concepts of disposal and disposal site closure. A primary benefit to DOE from this partnership is expected to be improved public perception of the actions being taken by DOE to protect the public, particularly in areas of environmental restoration and waste management. It is evident at the Savannah River site that this is a key factor in successfully achieving the site's mission. The strength of the interest of the South Carolina institutions in developing initiatives in waste management forecasts a healthy long-term prospect for the partnership. The State of South Carolina has established a hazardous waste research fund of approximately $650 thousand annually for research by the partnership universities to seek better ways to maintain a healthy environment and to reduce, dispose of, or store waste products safely

  2. PUBLIC COMMENT ON THE DEPARTMENT OF HEALTH AND HUMAN SERVICES 2018 FEDERAL PHYSICAL ACITIVTY GUIDELINES

    Science.gov (United States)

    Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...

  3. A System Architecture and Migration Plan for the Student Services Department of the Marine Corps Institute

    National Research Council Canada - National Science Library

    Evers

    1997-01-01

    ... to a client server based, open information system for the Marine Corps Institute (MCI). The primary objective of this thesis is to develop the technology architecture required to support the information systems of the Student Services Department (SSD...

  4. Kepuasan Kerja Karyawan Food And Beverage Service Department di Hotel Grand Tjokro Pekanbaru

    OpenAIRE

    Lestari, Delia Putri; Ibrahim, Mariaty

    2016-01-01

    The purpose of this research is how employee satisfaction Food and Beverage Service Department in work and how efforts to improve employee job satisfaction Food and Beverage Service Department in Grand Tjokro Hotel.This research was used descriptive quantitatif method to describe the issues. The sample used in this research was 7 people. Quesionnaires, interviews, and observations were used to collect the research data.The results of this research indicate that based on the research results o...

  5. 31 CFR 19.610 - What procedures does the Department of the Treasury use in suspension and debarment actions?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false What procedures does the Department of the Treasury use in suspension and debarment actions? 19.610 Section 19.610 Money and Finance...) General Principles Relating to Suspension and Debarment Actions § 19.610 What procedures does the...

  6. Change of offices for HR Department - disrupted service during the last week of February 2013

    CERN Multimedia

    2013-01-01

    HR Department would like to inform that, due to office renovation work, a number of HR Services currently located on the ground, first and second floors of Building 5 will move to temporary offices as from late February.   The removals will take place from Friday 22 until Tuesday 26 February 2013 inclusive and during this period, telephone and e-mail contact may be disrupted. The following services will be relocated to: Building 510  – ground floor (until mid-June) Head of Department and Deputy Office of the Head of HR Department Group Leaders and Partners Diversity Office HR Legal Section Building 652 – Prefab/Algeco (until September) Human Resources Advisors and assistants Staff Recruitment Service Fellows & Apprentices Service Students & Associates Service Temporary office numbers will be available in the CERN phonebook. Any emergencies during the removals may be addressed to Lynda.Leroux@cern.ch Thank you in advance for your understanding. HR Head O...

  7. 75 FR 47631 - Swets Information Services, Operations Department, Information Technology Group, Marketing Group...

    Science.gov (United States)

    2010-08-06

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,668] Swets Information Services, Operations Department, Information Technology Group, Marketing Group, Finance Group, Runnemede..., Information Technology (IT) Group, Marketing Group and the Finance Group into one entity instead of...

  8. DOE (Department of Energy) natural phenomena guidelines earthquake design and evaluation

    International Nuclear Information System (INIS)

    Short, S.A.; Murray, R.C.; Kennedy, R.P.

    1989-01-01

    Design and evaluation guidelines for DOE (Department of Energy) facilities subjected to earthquake, wind/tornado, and flood have been developed. This paper describes the philosophy and procedures fr the design or evaluation of facilities for earthquake ground shaking. The guidelines are intended to meet probabilistic-based performance goals expressed in terms of annual probability of exceedance of some level of structural damage. Meeting performance goals can be accomplished by specifying hazard probabilities of exceedance along with seismic behavior evaluation procedures in which the level of conservatism introduced is controlled such that desired performance can be achieved. Limited inelastic behavior is permitted by permitting demand determined from elastic response spectrum analyses to exceed capacity by an allowable inelastic demand-capacity ratio specified in the guidelines for different materials and construction

  9. 49 CFR 17.7 - How does the Secretary communicate with state and local officials concerning the Department's...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false How does the Secretary communicate with state and local officials concerning the Department's programs and activities? 17.7 Section 17.7 Transportation Office of the Secretary of Transportation INTERGOVERNMENTAL REVIEW OF DEPARTMENT OF TRANSPORTATION...

  10. Species richness alone does not predict cultural ecosystem service value

    Science.gov (United States)

    Graves, Rose A.; Pearson, Scott M.; Turner, Monica G.

    2017-01-01

    Many biodiversity-ecosystem services studies omit cultural ecosystem services (CES) or use species richness as a proxy and assume that more species confer greater CES value. We studied wildflower viewing, a key biodiversity-based CES in amenity-based landscapes, in Southern Appalachian Mountain forests and asked (i) How do aesthetic preferences for wildflower communities vary with components of biodiversity, including species richness?; (ii) How do aesthetic preferences for wildflower communities vary across psychographic groups?; and (iii) How well does species richness perform as an indicator of CES value compared with revealed social preferences for wildflower communities? Public forest visitors (n = 293) were surveyed during the summer of 2015 and asked to choose among images of wildflower communities in which flower species richness, flower abundance, species evenness, color diversity, and presence of charismatic species had been digitally manipulated. Aesthetic preferences among images were unrelated to species richness but increased with more abundant flowers, greater species evenness, and greater color diversity. Aesthetic preferences were consistent across psychographic groups and unaffected by knowledge of local flora or value placed on wildflower viewing. When actual wildflower communities (n = 54) were ranked based on empirically measured flower species richness or wildflower viewing utility based on multinomial logit models of revealed preferences, rankings were broadly similar. However, designation of hotspots (CES values above the median) based on species richness alone missed 27% of wildflower viewing utility hotspots. Thus, conservation priorities for sustaining CES should incorporate social preferences and consider multiple dimensions of biodiversity that underpin CES supply. PMID:28320953

  11. The Suffolk County Department of Social Services Performance Study. An Executive Summary.

    Science.gov (United States)

    Spottheim, David; Wilson, George R.

    The logic and methodology applied in a management science approach to performance and staff utilization in the Client Benefits (CBA) and Community Service (CSA) divisions of the Suffolk County (New York) Department of Social Services (SCDSS) are described. Using a blend of classical organization theory and management science techniques, the CBA…

  12. EXCEPTIONAL CLOSURE OF VARIOUS HR DEPARTEMENT SERVICES ON 20 AND 21 SEPTEMBER 2007

    CERN Document Server

    HR Department

    2007-01-01

    Due to a group training event, the following services will be exceptionally closed on Thursday 20 and Friday 21 September 2007 : installation service (removals, cars, diplomatic privileges), school fees, Personnel Records Office (including attestations), French visas; duty travel, leave, reinstallation indemnity, unemployment benefit, tax information and social affairs. The French and Swiss cards service will remain open as usual, from 8:30 to 12:30. Thank you for your understanding. HR Department HR-SPS Group

  13. EXCEPTIONAL CLOSURE OF VARIOUS HR DEPARTMENT SERVICES ON 20 AND 21 SEPTEMBER 2007

    CERN Document Server

    *Beyond was established as CIC Productions to produce the television series Beyond 2000 for the Seven Network in Australia,

    2007-01-01

    Due to a group training event, the following services will be exceptionally closed on Thursday 20 and Friday 21 September 2007: installation service (removals, cars, diplomatic privileges), school fees, Personnel Records Office (including attestations), French visas; duty travel, leave, reinstallation indemnity, unemployment benefit, tax information and social affairs. The French and Swiss cards service will remain open as usual, from 8:30 to 12:30. Thank you for your understanding. HR Department HR-SPS Group

  14. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In working...

  15. Natural hazard losses: A DOE (Department of Energy) perspective. Injury and property damage experience from natural phenomena hazards Department of Energy 1943-1989

    International Nuclear Information System (INIS)

    Hill, J.R.

    1989-01-01

    This presentation provides a perspective of DOE losses during the past 46 years even though loss data was not readily available for all DOE operations. As such this paper is considered preliminary and more work is needed to provide an informed view of all DOE losses. Review of the reported historical losses has provided an opportunity to create an awareness of the extent and location of a wide variety of natural phenomena hazards that have caused damage at most DOE sites. Some suggestions and observations to consider are: (1) mitigation strategies may achieve greatest reductions in wind damage; (2) most damage has occurred to conventional construction; (3) lightning damage review may provide insight for design standards change; (4) flood damage occurred where least expected. Through this awareness, the author hopes we are encouraged to provide our ideas and our professional skills for a Decade of Natural Hazard Reduction in the Department of Energy

  16. Does better access to FPs decrease the likelihood of emergency department use?

    Science.gov (United States)

    Mian, Oxana; Pong, Raymond

    2012-01-01

    Abstract Objective To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Design Population-based telephone survey. Setting Ontario. Participants A total of 8502 Ontario residents aged 16 years and older. Main outcome measures Emergency department use in the 12 months before the survey. Results Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use. PMID:23152473

  17. Modeling factors influencing the demand for emergency department services in ontario: a comparison of methods

    Directory of Open Access Journals (Sweden)

    Meaney Christopher

    2011-08-01

    Full Text Available Abstract Background Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Methods Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS during our study interval (2003-2005 are obtained from the National Ambulatory Care Reporting System (NACRS. Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS which provides individual level medical, socio-demographic, psychological and behavioral information for

  18. Modeling factors influencing the demand for emergency department services in Ontario: a comparison of methods.

    Science.gov (United States)

    Moineddin, Rahim; Meaney, Christopher; Agha, Mohammad; Zagorski, Brandon; Glazier, Richard Henry

    2011-08-19

    Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS) during our study interval (2003-2005) are obtained from the National Ambulatory Care Reporting System (NACRS). Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS) which provides individual level medical, socio-demographic, psychological and behavioral information for investigating predictors of increased emergency

  19. The perceived impact of an emergency department immediate reporting service: An exploratory survey

    International Nuclear Information System (INIS)

    Snaith, Beverly; Hardy, Maryann

    2013-01-01

    Background: Immediate reporting, commonly referred to as a ‘hot reporting’, has been advocated as a method of effectively supporting clinical decision making. However, its implementation nationally has been limited with poor understanding of its value in practice. Method: A cross sectional attitudinal survey was distributed to emergency department clinicians (medical and nursing staff) and radiographers to explore perceptions of an immediate reporting service in terms of its influence on professional role and autonomy, patient care and service quality. Results: A total of 87 (n = 87/155; 56.1%) completed questionnaires were returned. The findings suggest that significant support for immediate reporting exists. Immediate reporting is believed to improve service quality, reduce clinical errors and provide opportunity for image interpretation skills development. However, responses were not consistent across clinical professions and staff grades. Conclusion: The immediate reporting of emergency department images is perceived to benefit patient, emergency department clinicians and hospital organisation

  20. Interprofessional collaboration between general physicians and emergency department services in Belgium: a qualitative study

    OpenAIRE

    Karam, Marlène; Tricas, Sandra Maria; Darras, Elisabeth; Macq, Jean

    2016-01-01

    Introduction: The use of emergency department (ED) services has known a significant rise in the past decade. Organizational factors, such as the models of after-hours primary medical care services, and the shortage of general practitioners (GPs) could explain this phenomena. But also demographic and societal elements combined with the problem of patient’s ‘inappropriate visits to the ED. In order to ensure continuity of care for patients, collaboration between GPs and EDs becomes increasingly...

  1. Determining relevant financial statement ratios in Department of Defense service component general fund financial statements

    OpenAIRE

    Koetter, Nicholas J.; Krause, Daniel J.; Liptak, Carl S.

    2014-01-01

    Approved for public release; distribution is unlimited Department of Defense (DOD) service components are dedicating significant financial and human resources toward achieving unqualified opinions on audits of their financial statements. The DOD has endeavored to produce auditable financial statements as mandated in the Chief Financial Officers Act of 1990. In December of 2013, the United States Marine Corps became the first service component to achieve an unqualified audit opinion on its ...

  2. Using Excel's Solver Function to Facilitate Reciprocal Service Department Cost Allocations

    Science.gov (United States)

    Leese, Wallace R.

    2013-01-01

    The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated and theoretically incorrect direct or step-down methods. This article illustrates how Excel's Solver…

  3. 76 FR 4725 - Apria Healthcare Customer Service Department; Fourteen Locations in Missouri Cameron, Cape...

    Science.gov (United States)

    2011-01-26

    ... services to India. The amended notice applicable to TA-W-73,676 is hereby issued as follows: ``All workers... and Clinton, MO; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance... Department of Labor issued a Certification of Eligibility to Apply for Worker Adjustment Assistance on August...

  4. 77 FR 14600 - Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract...

    Science.gov (United States)

    2012-03-12

    ... DEPARTMENT OF VETERANS AFFAIRS Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract Inventory AGENCY: Department of Veterans Affairs. ACTION: Notice of... Affairs (VA) is publishing this notice to advise the public of the availability of the FY 2011 Service...

  5. Where does the customer fit in a service operation?

    Science.gov (United States)

    Chase, R B

    1978-01-01

    While management skills can improve service systems, a manager is better off if he or she first has a clear understanding of the operating characteristics that set one service system apart from another. This author offers one view of services, which, if followed, results in a "rational approach to the rationalization" of services. His view, quite simply, is that the less direct contact the customer has with the service system, the greater the potential of the system to operate at peak efficiency. And, conversely, where the direct customer contact is high, the less the potential that exists to achieve high levels of efficiency. This distinction between high- and low-contact systems provides a basis for classifying service production systems that can enable the manager to develop a more effective service operation.

  6. Environmental Survey preliminary report, Department of Energy (DOE) activities at Santa Susana Field Laboratories, Ventura County, California

    Energy Technology Data Exchange (ETDEWEB)

    1989-02-01

    This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) activities at the Santa Susana Field Laboratories Site (DOE/SSFL), conducted May 16 through 26, 1988. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by an private contractor. The objective of the survey is to identify environmental problems and areas of environmental risk associated with DOE activities at SSFL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at SSFL, and interviews with site personnel. 90 refs., 17 figs., 28 tabs.

  7. Does Service Innovation Matter in High-Tech Industry?

    OpenAIRE

    Wang, Chao-Hung

    2014-01-01

    Service innovation has been found to be a major driver of innovation performance in service contexts. But this issue raises questions concerning the extent to which the relationship between market orientation and innovation performance holds in the high-tech industry. Relatively little research has examined how market orientation contributes to innovation performance through service innovation. We here report an empirical study of 235 Taiwanese high-tech firms to examine the influence of mark...

  8. The Department of Defense's Civilian Human Capital Strategic Plan Does Not Meet Most Statutory Requirements

    National Research Council Canada - National Science Library

    Farrell, Brenda S

    2008-01-01

    To examine the extent to which DOD's civilian human capital strategic plan addresses congressional reporting requirements, we obtained and analyzed the "Department of Defense Civilian Human Capital...

  9. Radiological dose assessment of Department of Energy Pinellas Plant waste proposed for disposal at Laidlaw Environmental Services of South Carolina, Inc

    International Nuclear Information System (INIS)

    Socolof, M.L.; Lee, D.W.

    1996-05-01

    The U.S. Department of Energy (DOE) Pinellas Plant in Largo, FL is proposing to ship and dispose of hazardous sludge, listed as F006 waste, to the Laidlaw Environmental Services of South Carolina, Inc. (Laidlaw) treatment, storage, and disposal facility in Pinewood, South Carolina. This sludge contains radioactive tritium in concentrations of about 28 pCi/g. The objective of this study is to assess the possible radiological impact to workers at the Laidlaw facility and members of the public due to the handling, processing, and burial of the DOE waste containing tritium

  10. Radiological dose assessment of Department of Energy Pinellas Plant waste proposed for disposal at Laidlaw Environmental Services of South Carolina, Inc.

    Energy Technology Data Exchange (ETDEWEB)

    Socolof, M.L.; Lee, D.W.

    1996-05-01

    The U.S. Department of Energy (DOE) Pinellas Plant in Largo, FL is proposing to ship and dispose of hazardous sludge, listed as F006 waste, to the Laidlaw Environmental Services of South Carolina, Inc. (Laidlaw) treatment, storage, and disposal facility in Pinewood, South Carolina. This sludge contains radioactive tritium in concentrations of about 28 pCi/g. The objective of this study is to assess the possible radiological impact to workers at the Laidlaw facility and members of the public due to the handling, processing, and burial of the DOE waste containing tritium.

  11. Does e-HRM lead to better HRM service?

    NARCIS (Netherlands)

    Bondarouk, Tanya; Harms, Rainer; Lepak, David

    2017-01-01

    Electronic Human Resource Management (e-HRM) is often assumed to increase HRM service quality. This paper empirically examines the relationship between e-HRM and HRM service quality and addresses two calls from recent e-HRM studies, namely to highlight (i) the importance of the interplay between

  12. Technology Acceptance among Pre-Service Teachers: Does Gender Matter?

    Science.gov (United States)

    Teo, Timothy; Fan, Xitao; Du, Jianxia

    2015-01-01

    This study examined possible gender differences in pre-service teachers' perceived acceptance of technology in their professional work under the framework of the technology acceptance model (TAM). Based on a sample of pre-service teachers, a series of progressively more stringent measurement invariance tests (configural, metric, and scalar…

  13. Species richness alone does not predict cultural ecosystem service value

    Science.gov (United States)

    Rose A. Graves; Scott M. Pearson; Monica G. Turner

    2017-01-01

    Sustaining biodiversity and ecosystem services are common conservation goals. However, understanding relationships between biodiversity and cultural ecosystem services (CES) and determining the best indicators to represent CES remain crucial challenges. We combined ecological and social data to compare CES value of wildflower communities based on observed...

  14. Executive Selection in Government Agencies: An Analysis of the Department of the Navy and Immigration and Naturalization Services Senior Executive Service Selection Processes

    National Research Council Canada - National Science Library

    Jordan, Mark

    2001-01-01

    .... The Senior Executive Service (SES) selection process for the Department of the Navy (DON) is analyzed and compared to the SES selection process used by the Immigration and Naturalization Service...

  15. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered. PMID:27683645

  16. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Based on the students' perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered.

  17. Therapeutic hypothermia following out-of-hospital cardiac arrest; does it start in the emergency department?

    Science.gov (United States)

    Galloway, R; Sherren, P B

    2010-12-01

    The use of therapeutic hypothermia after cardiac arrest is a well-practised treatment modality in the intensive care unit (ICU). However, recent evidence points to advantages in starting the cooling process as soon as possible after the return of spontaneous circulation (ROSC). There are no data on implementation of this treatment in the emergency department. A telephone survey was conducted of the 233 emergency departments in the UK. The most senior available clinician was asked if, in cases where they have a patient with a ROSC after an out-of-hospital cardiac arrest, would therapeutic hypothermia be started in the emergency department. Of the 233 hospitals called, 230 responded, of which 35% would start cooling in the emergency department. Of this 35%, over half (56%) said the decision to start cooling was made by the emergency physician before consultation with the ICU. Also, of the 35% who would begin cooling in the emergency department, 55% would cool only for ventricular fibrillation/ventricular tachycardia, 66% would monitor temperature centrally, and 14% would use specialised cooling equipment. There is often a delay in getting patients to ICU from the emergency department, and thus the decision not to start cooling in the emergency department may impact significantly on patient outcome. The dissemination of these data may persuade emergency physicians that starting treatment in the emergency department is an appropriate and justifiable decision that is becoming a more accepted practice throughout the UK.

  18. 42 CFR 59.7 - What criteria will the Department of Health and Human Services use to decide which family...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and in what amount? 59.7... FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.7 What criteria will the...

  19. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    OpenAIRE

    Langabeer, James R.; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-01-01

    Introduction Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. T...

  20. Fire Department Emergency Response

    International Nuclear Information System (INIS)

    Blanchard, A.; Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services

  1. Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

    Science.gov (United States)

    Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

    2014-01-01

    We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

  2. Does mental health service integration affect compulsory admissions?

    Directory of Open Access Journals (Sweden)

    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.

  3. Comprehensive services delivery and emergency department use among chronically homeless adults.

    Science.gov (United States)

    Moore, David T; Rosenheck, Robert A

    2017-05-01

    Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites. Multiple imputation was used to account for missing data and differential rates of attrition between the cohorts. Longitudinal models were constructed to compare ED use between the 2 groups during the first year after initiation of CICH services. A mediation analysis was performed to determine the relative contributions of being housed, the receipt of outpatient services, and health status to group differences in ED utilization. Participants receiving CICH services were significantly less likely to report ED use (odds ratio = 0.78, 95% confidence interval [0.65, 0.93]) in the year after program entry. Decreased ED use was primarily mediated by decreased homelessness-not by increased access to other services or health status. This suggests that becoming housed is a key driver of reduced ED utilization and that efforts to provide housing for homeless adults may result in significantly decreased ED use. Further research is needed to determine the long-term effects of housing on health status and to develop services to improve health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Problems and solutions in application of IEEE standards at Savannah River Site, Department of Energy (DOE) nuclear facilities

    International Nuclear Information System (INIS)

    Lee, Y.S.; Bowers, T.L.; Chopra, B.J.; Thompson, T.T.; Zimmerman, E.W.

    1993-01-01

    The Department of Energy (DOE) Nuclear Material Production Facilities at the Savannah River Site (SRS) were designed, constructed, and placed into operation in the early 1950's, based on existing industry codes/standards, design criteria, analytical procedures. Since that time, DOE has developed Orders and Polices for the planning, design and construction of DOE Nuclear Reactor Facilities which invoke or reference commercial nuclear reactor codes and standards. The application of IEEE reactor design requirements such as Equipment Qualification, Seismic Qualification, Single Failure Criteria, and Separation Requirement, to non-reactor facilities has been a problem since the IEEE reactor criteria do not directly confirm to the needs of non-reactor facilities. SRS Systems Engineering is developing a methodology for the application of IEEE Standards to non-reactor facilities at SRS

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

    Science.gov (United States)

    2013-12-03

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

  6. 76 FR 66940 - Privacy Act of 1974; Department of Homeland Security/United States Secret Service-004 Protection...

    Science.gov (United States)

    2011-10-28

    ... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary [Docket No. DHS-2011-0083] Privacy Act of 1974; Department of Homeland Security/United States Secret Service--004 Protection Information System... Security (DHS)/United States Secret Service (USSS)-004 System name: DHS/USSS-004 Protection Information...

  7. 20 CFR 1010.210 - In which Department job training programs do covered persons receive priority of service?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false In which Department job training programs do... job training programs do covered persons receive priority of service? (a) Priority of service applies to every qualified job training program funded, in whole or in part, by the Department, including: (1...

  8. A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits.

    Science.gov (United States)

    Hällfors, Eerik; Saku, Sami A; Mäkinen, Tatu J; Madanat, Rami

    2018-03-01

    Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service. During a 2-month period, we gathered information on every call received by the consultation phone service from patients with TJAs within 90 days of the index TJA procedure. Patients were followed for 2 weeks after making a call to detect major complications and self-initiated ED visits. Data were collected from electronic medical charts regarding age, gender, type of surgery, date of discharge, and length of hospital stay. We analyzed 288 phone calls. Calls were mostly related to medication (41%), wound complications (17%), and mobilization issues (15%). Most calls were resolved in the phone consultation. Few patients (13%) required further evaluation in the ED. The consultation service failed to detect the need for an ED visit in 2 cases (0.7%) that required further care. The consultation phone service clearly benefitted patients with TJAs. The service reduced the number of unnecessary ED visits and functioned well in detecting patients who required further care. Most postoperative concerns were related to prescribed medications, wound complications, and mobilization issues. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Quality assurance programs developed and implemented by the US Department of Energy`s Analytical Services Program for environmental restoration and waste management activities

    Energy Technology Data Exchange (ETDEWEB)

    Lillian, D.; Bottrell, D. [Dept. of Energy, Germntown, MD (United States)

    1993-12-31

    The U.S. Department of Energy`s (DOE`s) Office of Environmental Restoration and Waste Management (EM) has been tasked with addressing environmental contamination and waste problems facing the Department. A key element of any environmental restoration or waste management program is environmental data. An effective and efficient sampling and analysis program is required to generate credible environmental data. The bases for DOE`s EM Analytical Services Program (ASP) are contained in the charter and commitments in Secretary of Energy Notice SEN-13-89, EM program policies and requirements, and commitments to Congress and the Office of Inspector General (IG). The Congressional commitment by DOE to develop and implement an ASP was in response to concerns raised by the Chairman of the Congressional Environment, Energy, and Natural Resources Subcommittee, and the Chairman of the Congressional Oversight and Investigations Subcommittee of the Committee on Energy and Commerce, regarding the production of analytical data. The development and implementation of an ASP also satisfies the IG`s audit report recommendations on environmental analytical support, including development and implementation of a national strategy for acquisition of quality sampling and analytical services. These recommendations were endorsed in Departmental positions, which further emphasize the importance of the ASP to EM`s programs. In September 1990, EM formed the Laboratory Management Division (LMD) in the Office of Technology Development to provide the programmatic direction needed to establish and operate an EM-wide ASP program. In January 1992, LMD issued the {open_quotes}Analytical Services Program Five-Year Plan.{close_quotes} This document described LMD`s strategy to ensure the production of timely, cost-effective, and credible environmental data. This presentation describes the overall LMD Analytical Services Program and, specifically, the various QA programs.

  10. 78 FR 23550 - Department of Energy's (DOE) Participation in Development of the International Energy...

    Science.gov (United States)

    2013-04-19

    ... building energy codes by periodically reviewing the technical and economic basis of the voluntary building... and modification of such codes. (42 U.S.C. 6836(b)) B. Background The IECC serves as a model building... building energy codes is through participation in the IECC development process. DOE participates in the ICC...

  11. 31 CFR 19.615 - How does the Department of the Treasury notify a person of a suspension or debarment action?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false How does the Department of the Treasury notify a person of a suspension or debarment action? 19.615 Section 19.615 Money and Finance...) General Principles Relating to Suspension and Debarment Actions § 19.615 How does the Department of the...

  12. Linking departmental priorities to knowledge management: the experiences of Santa Cruz County's Human Services Department.

    Science.gov (United States)

    Lindberg, Arley

    2012-01-01

    Federal welfare reform, local service collaborations, and the evolution of statewide information systems inspired agency interest in evidence-informed practice and knowledge sharing systems. Four agency leaders, including the Director, Deputy Director, Director of Planning and Evaluation, and Staff Development Program Manager championed the development of a learning organization based on knowledge management throughout the agency. Internal department restructuring helped to strengthen the Planning and Evaluation, Staff Development, and Personnel units, which have become central to supporting knowledge sharing activities. The Four Pillars of Knowledge framework was designed to capture agency directions in relationship to future knowledge management goals. Featuring People, Practice, Technology and Budget, the framework links the agency's services, mission and goals to the process of becoming a learning organization. Built through an iterative process, the framework was created by observing existing activities in each department rather than being designed from the top down. Knowledge management can help the department to fulfill its mission despite reduced resources. Copyright © Taylor & Francis Group, LLC

  13. Department of Energy (DOE) transportation system for nuclear materials and the role of state law enforcement agencies

    International Nuclear Information System (INIS)

    Jones, J.M.; Hoover, T.W.

    1978-01-01

    The Department of Energy has been assigned the responsibility for the safe and secure movement of strategic quantities of government-owned special nuclear material as well as classified material. To accomplish this mission, a transportation system has been developed which takes advantage of advanced technology and other features to reduce vulnerability to terrorists. The system consists of a careful balance of specially-trained personnel, procedures and sophisticated equipment. These, in combination, generally allow the system to be self-sufficient. However, should the need arise, DOE will request assistance from state law enforcement agencies. The primary contact for assistance is the state police or highway patrol. DOE, with the assistance of Sandia Laboratories, has surveyed state police agencies throughout the nation. A data base has been created which includes the results of these surveys and a numerical description of DOE transportation routes. This data base, along with a ''Response'' model developed by Sandia Laboratories, allows projections of officer availability to be made for all of DOE's routes. This paper will describe the DOE Transportation System, the role of state law enforcement agencies in support of the system, the nationwide state policy survey, and the operation of the response computer model

  14. Activity-based costing of security services for a Department of Energy nuclear site

    International Nuclear Information System (INIS)

    Togo, D.F.

    1997-01-01

    Department of Energy (DOE) nuclear facilities are being encouraged to reduce costs but the accounting data typically in use by the financial organizations at these laboratories cannot easily be used to determine which security activities offer the best reduction in cost. For example, labor costs have historically been aggregated over various activities, making it difficult to determine the true costs of performing each activity. To illustrate how this problem can be solved, a study was performed applying activity-based costing (ABC) to a hypothetical DOE facility. ABC is a type of cost-accounting developed expressly to determine truer costs of company activities. The hypothetical facility was defined to have features similar to those found across the DOE nuclear complex. ABC traced costs for three major security functions - Protective Force Operations, Material Control and Accountability, and Technical Security - to various activities. Once these costs had been allocated, we compared the cost of three fictitious upgrades: (1) an improvement in training or weapons that allows the protective force to have better capabilities instead of adding more response forces; (2) a change in the frequency of inventories; and (3) a reduction in the annual frequencies of perimeter sensor tests

  15. Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

    Science.gov (United States)

    Worku, Mesfin; Loha, Eskindir

    2017-06-27

    Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

  16. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    OpenAIRE

    Derek Mohammed; Ronda Mariani

    2014-01-01

    This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the...

  17. Leave management for promoting organisational efficiency in the Department of Correctional Services and the Department of Home Affairs : Pretoria region / Mathews Tibane Moleki

    OpenAIRE

    Moleki, Mathews Tibane

    2014-01-01

    The framework of this study is based on the reforms of human resource leave management in the field of public administration for the South African public sector. The researcher’s interest lies in the increasing complexity of leave management development pertaining to policy-making, administrative processes and efficiency in the South African public sector. This study aimed to assess leave management at the Department of Correctional Services (DCS) and the Department of Home Affairs (DHA). The...

  18. Perceptions of Value-Congruence with One's Department Chair: Does Match Matter?

    Science.gov (United States)

    Virick, Meghna; Strage, Amy

    2016-01-01

    Although studies have examined numerous factors that predict junior faculty success, previous research has paid little attention to the role played by department chairs. Drawing on theory from person-environment fit theory and value congruence, we sought to examine the implication of a match versus mismatch between faculty members and their chairs…

  19. Does public service performance affect top management turnover?

    OpenAIRE

    Boyne, George A.; James, Oliver; John, Peter; Petrovsky, Nicolai

    2010-01-01

    Political and organizational theories suggest that the turnover of chief executives and other members of senior management teams are likely to be influenced by public service performance. We use a panel data set of 148 English local governments over 4 years to test this proposition. The empirical results show that performance has a negative effect on turnover, but that this effect is weaker for chief executives than for members of their senior management teams. In addition, top team turnover ...

  20. Italian water service's competitive tendering: does any tender design exist?

    International Nuclear Information System (INIS)

    Antonioli, B.

    2006-01-01

    During the last two decades, the procurement of public services has been engaged a process of intensive change, both at the local and national level, particularly in Europe. In Italy, recent developments of legislative framework are aimed to adopt competitive tenders both for service's concession or private partner selection. Economists and operators generally agree about the effectiveness of auctions for the concession's contracting out. Otherwise, the agreement is weaker if the question is how to prepare the auction: bidding market a la Demsetz, beauty contests or hybrid forms? In other words, more attention should be devoted to the analysis of reference market and to auction's design. The aim of this paper is to verify, starting from the analysis of auction realized between 1998 and 2005, the real designing of the auctions other than the presence of an idea of industrial policy for water services. Results highlights that tenders are few, poorly designed and scarcely effective. To be more precise, results remark the lack of foresight of industrial policy and, more generally, the necessity to reflect on the real possibility of the competition for thc market in the water sector, characterized by an high degree of economical and social complexity [it

  1. Designing services for frequent attenders to the emergency department: a characterisation of this population to inform service design.

    Science.gov (United States)

    Jacob, Rebecca; Wong, Mai Luen; Hayhurst, Catherine; Watson, Peter; Morrison, Cecily

    2016-08-01

    Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders. Results showed an increase in frequent attendance from 2.59% to 4.12% over 8 years. Moderate frequent attenders accounted for 97%. Of the 100 frequent attenders studied, 45% had medically unexplained symptoms (MUS), associated with younger age (p0.05). In conclusion, the ED is a useful hub for identifying frequent attenders with MUS, particularly among moderate frequent attenders; service design for this group should consider a 'whole-systems approach' with integration between primary and secondary care, including specialist liaison psychiatry services where appropriate. © 2016 Royal College of Physicians.

  2. The impact of a temporary ice-rink on an emergency department service.

    LENUS (Irish Health Repository)

    Clarke, Heather J

    2012-02-03

    BACKGROUND: A temporary ice-rink opened close to Cork city for 6 weeks from 30 November 2003. During this time, a number of patients presented to the local emergency departments with ice-skating-related injuries. We documented these injuries. METHODS: All patients presenting to emergency departments in Cork city with ice-skating-related complaints were included. Information on age and sex, mechanism of injury, diagnosis, follow-up\\/disposition and ambulance service utilization was recorded. RESULTS: One hundred and twenty-five ice-rink-related attendances were reported at Cork emergency departments, representing 1.25% of total attendances. One hundred and twenty-three patients presented with skating-related injuries and two with medical complaints occurring at the ice-rink: 70.8% were female patients and 29.2% were male patients. In the 4-14-year age group, however, 48.5% were girls and 51.5% were boys. Most injuries were directly due to falls; 5.6% were due to skate blades. The commonest site of injury was the upper limb. Fractures and dislocations accounted for 53.9% of injuries, with 20.5% of these requiring orthopaedic admission. Lacerations and digital injuries accounted for 7.1%, with 11% of these required admission for surgery. One minor head injury was reported. 38.1% had soft tissue injuries. Fifteen patients were transported by ambulance. These attendances represented a minimum overall cost of 77,510 euro to the local health service. CONCLUSIONS: A temporary ice-rink had a significant impact on local emergency departments. Currently, there is no specific legislation in Ireland relating to public health and safety in ice-rinks. We recommend consultation with local public bodies before opening such facilities, and appropriate regulation.

  3. 76 FR 66937 - Privacy Act of 1974; Department of Homeland Security/United States Secret Service-003 Non...

    Science.gov (United States)

    2011-10-28

    ... 1974; Department of Homeland Security/United States Secret Service--003 Non-Criminal Investigation... Security/United States Secret Service--003 Non-Criminal Investigation Information System.'' As a result of... Secret Service, 245 Murray Lane SW., Building T-5, Washington, DC 20223. For privacy issues please...

  4. 49 CFR 40.403 - Must a service agent notify its clients when the Department issues a PIE?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Must a service agent notify its clients when the... Must a service agent notify its clients when the Department issues a PIE? (a) As a service agent, if... clients, in writing, about the issuance, scope, duration, and effect of the PIE. You may meet this...

  5. The 1991 Department of the Army Service Response Force exercise: Procedural Guide SRFX-91

    Energy Technology Data Exchange (ETDEWEB)

    Madore, M.A.; Thomson, R.S.; Haffenden, R.A.; Baldwin, T.E.; Meleski, S.A.

    1991-09-01

    This procedural guide was written to assist the US Army in planning for a chemical emergency exercise at Tooele Army Depot in Utah. The roles of various members of the emergency response community are described for various accident scenarios, and the relationships between the various responders are identified. For the June 1991 exercise at Tooele, the emergency response community includes the command structure at Tooele Army Depot; the US Army Service Response Force and other Department of Defense agencies; emergency response personnel from Tooele, Salt Lake, and Utah counties and municipal governments; the Utah Comprehensive Emergency Management Agency and other state agencies; and various federal agencies.

  6. DOE Closeout Report from SUNY Albany High Energy Physics to Department of Energy Office of Science.

    Energy Technology Data Exchange (ETDEWEB)

    Ernst, Jesse [SUNY Albany; Jain, Vivek

    2014-08-15

    A report from the SUNY Albany Particle Physics Group summarizing our activities on the ATLAS experiment at the Large Hadron Collider. We summarize our work: on data analysis projects, on efforts to improve detector performance, and on service work to the experiment.

  7. Commercial Vehicle Safety Alliance (CVSA)/Department of Energy (DOE) cooperative agreement final report

    International Nuclear Information System (INIS)

    Slavich, Antoinette; Daust, James E.

    1999-01-01

    This S and T product is a culmination of the activities, including research of the Commercial Vehicle Safety Alliance (CVSA) in developing and implementing inspection procedures and the out-of-service criteria for states and tribes to use when inspecting HRCQ and Transuranic shipments of radioactive materials. The report also contains the results of a pilot study to test the procedures

  8. Increasing off-service resident productivity while on their emergency department rotation using shift cards.

    Science.gov (United States)

    Chakravarthy, Bharath; Posadas, Emerson; Ibrahim, Deena; McArthur, Kurt; Osborn, Megan; Hoonpongsimanont, Wirachin; Wong, Andrew; Lotfipour, Shahram

    2015-04-01

    Differences in productivity between off-service residents rotating in the emergency department (ED) and their emergency medicine (EM) resident counterparts have never been directly quantified. We sought to quantify the difference between off-service residents rotating in the ED and their EM resident counterparts. We also sought to find whether shift cards could be used to increase the productivity of off-service residents rotating in the ED. This is a prospective cohort study conducted at an urban, tertiary, Level I trauma center. We implemented the use of shift cards for off-service residents during their EM rotation. Completion of the shift card involved recording patients seen and their dispositions, procedures done, and documenting a learned bedside teaching point from their shift that day. Productivity was measured in terms of patients seen per hour (PPH) and relative value units per hour (RVU/h). Off-service residents showed a productivity of 0.529 PPH (95% confidence interval [CI] 0.493-0.566) and 1.40 RVU/h (95% CI 1.28-1.53) prior to implementation of shift cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95% CI 0.584-0.663, p = 0.001) and 1.77 RVU/h (95% CI 1.64-1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI 0.918-1.02) and 3.01 RVU/h (95% CI 2.83-3.19). Shift cards can be used to foster motivation for off-service residents rotating in the ED, and is a simple and cost-effective method to improve system-based practices and utilization of resources. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    International Nuclear Information System (INIS)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all

  10. US Department of Energy DOE Nevada Operations Office, Nevada Test Site: Underground safety and health standards

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The Nevada Test Site Underground Safety and Health Standards Working Group was formed at the direction of John D. Stewart, Director, Nevada Test Site Office in April, 1990. The objective of the Working Group was to compile a safety and health standard from the California Tunnel Safety Orders and OSHA for the underground operations at the NTS, (excluding Yucca Mountain). These standards are called the NTS U/G Safety and Health Standards. The Working Group submits these standards as a RECOMMENDATION to the Director, NTSO. Although the Working Group considers these standards to be the most integrated and comprehensive standards that could be developed for NTS Underground Operations, the intent is not to supersede or replace any relevant DOE orders. Rather the intent is to collate the multiple safety and health references contained in DOE Order 5480.4 that have applicability to NTS Underground Operations into a single safety and heath standard to be used in the underground operations at the NTS. Each portion of the standard was included only after careful consideration by the Working Group and is judged to be both effective and appropriate. The specific methods and rationale used by the Working Group are outlined as follows: The letter from DOE/HQ, dated September 28, 1990 cited OSHA and the CTSO as the safety and health codes applicable to underground operations at the NTS. These mandated codes were each originally developed to be comprehensive, i.e., all underground operations of a particular type (e.g., tunnels in the case of the CTSO) were intended to be adequately regulated by the appropriate code. However, this is not true; the Working Group found extensive and confusing overlap in the codes in numerous areas. Other subjects and activities were addressed by the various codes in cursory fashion or not at all.

  11. What does resilience mean for urban water services?

    Directory of Open Access Journals (Sweden)

    Åse Johannessen

    2017-03-01

    Full Text Available Disasters and climate change impacts, as well as increased water demand, pose serious risks to the provision of sustainable urban water services, e.g., drinking water, sanitation, and safe drainage, especially in cities. These challenges call for a transition toward improved water management, including considerations of "resilience." However, because the resilience concept has multidisciplinary origins it is open to multiple interpretations, which poses a challenge to understanding and operationalizing the concept. We explore how resilience thinking can be translated into urban water practice to develop the conceptual understanding of transitions toward sustainability. The study is based on a literature review, interviews with water experts, as well as four case studies in South Africa, India, Sweden, and the Philippines. We identify seven key principles or attributes of urban water resilience and the related transition process. We find that resilience building needs to discern between and manage three levels (i.e., socioeconomic, external hazard considerations, and larger social-ecological systems to be sustainable. In addition, we find that human agency is a strong driver of transition processes, with a certain level of risk awareness and risk perception providing one threshold and a certain capacity for action to implement measures and reorganize in response to risks being another. The difficulty of achieving "knowledge to action" derives from the multiple challenges of crossing these two types of identified thresholds. To address long-term trends or stressors, we find an important role for social learning to ensure that the carrying capacity of urban water services is not exceeded or unwanted consequences are created (e.g., long-term trends like salinization and water depletion. We conclude that the resilience term and related concepts add value to understanding and addressing the dynamic dimension of urban water transitions if the key

  12. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

    Science.gov (United States)

    Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

    2016-11-01

    Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  13. Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department?

    Science.gov (United States)

    Thamburaj, Ravi; Sivitz, Adam

    2013-01-01

    Diagnostic ultrasounds by emergency medicine (EM) and pediatric emergency medicine (PEM) physicians have increased because of ultrasonography training during residency and fellowship. The availability of ultrasound in radiology departments is limited or difficult to obtain especially during nighttime hours. Studies have shown that EM physicians can accurately perform goal-directed ultrasound after appropriate training. The goal of this study was to compare the length of stay for patients receiving an ultrasound to confirm intrauterine pregnancies. The hypothesis of this study is that a bedside ultrasound by a trained EM/PEM physician can reduce length of stay in the emergency department (ED) by 1 hour. This was a case cohort retrospective review for patients aged 13 to 21 years who received pelvic ultrasounds in the ED during 2007. Each patient was placed into 1 of 2 groups. Group 1 received bedside ultrasounds done by institutionally credentialed EM/PEM attending physicians. Group 2 received radiology department ultrasound only. Each group had subanalysis done including chief complaint, time of presentation, time to completion of ultrasound, length of stay, diagnosis, and disposition. Daytime was defined as presentation between 7 AM and 9 PM when radiology ultrasound technologists were routinely available. We studied 330 patients, with 244 patients (74%) in the bedside ultrasound group. The demographics of both groups showed no difference in age, presenting complaints, discharge diagnoses, and ultimate disposition. Group 1 had a significant reduction (P ultrasound compared with group 2 (mean, 82 minutes [range, 1-901 minutes] vs 149 minutes [range, 7-506 minutes]) and length of stay (142 [16-2268] vs. 230 [16-844]). Of those presenting during the day (66%), group 1 showed a significant reduction in length of stay (P ultrasound by trained EM/PEM physicians produced a significant reduction in length of stay in the ED, regardless of radiology ultrasound technologist

  14. The Department of Energy (DOE) research program in structural analysis of vertical-axis wind turbines

    Science.gov (United States)

    Sullivan, W. N.

    The Darrieus-type Vertical Axis Wind Turbine (VAWT) presents a variety of unusual structural problems to designers. The level of understanding of these structural problems governs, to a large degree, the success or failure of today's rotor designs. A survey is presented of the technology available for rotor structural design with emphasis on the DOE research program now underway. Itemizations are included of the major structural issues unique to the VAWT along with discussion of available analysis techniques for each problem area. It is concluded that tools are available to at least approximately address the most important problems. However, experimental data for confirmation is rather limited in terms of volume and the range of rotor configurations tested.

  15. Does alcohol contribute to accident and emergency department attendance in elderly people?

    Science.gov (United States)

    van der Pol, V; Rodgers, H; Aitken, P; James, O; Curless, R

    1996-01-01

    OBJECTIVE: To evaluate the possible contribution of alcohol to presentation of elderly subjects at a hospital accident and emergency (A&E) department. METHODS: 105 patients aged 70 years and over who attended the department were interviewed by a single observer using a structured questionnaire based on previously validated general population surveys. Details of alcohol consumption within the previous 24 hours were recorded. Usual consumption of alcohol in the preceding 12 months was estimated by the quantity frequency method. Alcohol dependence was screened for by the CAGE questionnaire. An assessment of disability was made using the Barthel index. Breath alcohol was measured. RESULTS: In only 2% of attenders was alcohol thought to be a contributory factor. Breath alcohol measurements were technically unsatisfactory in this age group. Regular drinkers were functionally and socially more independent than non-regular drinkers. Drinking patterns in this age group may partly be determined by the physical ability to obtain alcohol. CONCLUSIONS: Alcohol was not found to be a major factor in A&E attendance in elderly people. PMID:8832344

  16. SPA (Solus per Aqua) service industry: An entrepeneurship opportunity to beauty education department

    Science.gov (United States)

    Marwiyah, Apriyani, Delta

    2018-03-01

    Beauty industry grows vastly in the scope of regional, national, or international. Beauty industry includes Spa service. It becomes one of the choices where the urban citizen can use it to release their stress and relax their mind. This business grows as the development of technology. Spa industry should be able to provide the best service for physical and mental therapy, it will make the user of the service can be freed from their business and stress in the respective time to be healthies, more beautiful, and able to do their activity maximally. Spa treatment consists of hair creambath, facial treatment, manicure-pedicure, scrub treatment, foot spa, aromatherapy, and body treatment with traditional cosmetics which are easy to get in Indonesia. Beauty education is one of the programs in Home Economics Department of Engineering Faculty of UNNES. This program was established to produce graduates in beauty fields as Vocational High School teachers with bachelor (S1) qualification. The graduates suppose to be excellent, professional, skillful, and care to the environment, culture, and social condition around them. It prepares them as teachers of beauty (in formal and non- formal education). Besides, it also prepared them to have professional competence in production fields of beauty service with adaptive, creative, and innovative which can be entrepreneurs who are able to create job vacancies for others. Beauty education used KKNI- based curriculum, which is oriented to Industry and Working Fields with UNNES' Conservation basis. It provided the students a chance to practive their knowledge in working internship program, study field trip, and teaching practice program. The industry of Spa service provides a big chance to become an entrepreneur, create a working field, and help the government reduce unemployment number, whether from beauty education graduates or from vocational high school students

  17. Financial Services and the Internet: What Does Cyberspace Mean for the Financial Services Industry?

    Science.gov (United States)

    Birch, David; Young, Michael A.

    1997-01-01

    More than 30 million households own PCs and more than 20% of these use PCs to manage their finances. This article examines the Internet and financial services, consumer needs, and differentiation in service products and predicts future trends in retail financial services (cheaper niche products, cross-border selling, selling knowledge, payments,…

  18. Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services.

    Science.gov (United States)

    Nieuwsma, Jason A; Jackson, George L; DeKraai, Mark B; Bulling, Denise J; Cantrell, William C; Rhodes, Jeffrey E; Bates, Mark J; Ethridge, Keith; Lane, Marian E; Tenhula, Wendy N; Batten, Sonja V; Meador, Keith G

    2014-12-01

    Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

  19. Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

    Directory of Open Access Journals (Sweden)

    James Robert Langabeer

    2016-11-01

    Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

  20. DEPARTMENT OF ENERGY (DOE) MANAGEMENT OF THE HANFORD WASTE TREATMENT and IMMOBILIZATION PLANT

    International Nuclear Information System (INIS)

    SHRADER, T.A.

    2005-01-01

    The US Department of Energy Office of River Protection is currently overseeing the construction of the new Hanford Site Waste Treatment and Immobilization Plant (more commonly referred to as the Waste Treatment Plant). In December 2000, a contract was awarded to Bechtel National, Inc. for the design, construction, and commissioning of the $5.8 billion facility to treat and vitrify a significant portion of the waste currently stored in large underground tanks on the Hanford Site. As the owner, the Office of River Protection has developed an organization to oversee the design, construction, and commissioning of the facility. A Federal Project Director is responsible for all aspects of the project, including safety, design, construction, commissioning; and the baseline (scope, cost, and schedule). The Project Director reports to the Manager of the Office of River Protection and recommends changes to the contract requirements, safety basis documents, or the baseline. Approximately 30 engineers, scientists, and other support personnel have been assigned to a unique organization that supports the Federal Project Director in providing oversight of each phase of the project (i.e., design, construction, and commissioning). The organization includes an Engineering Division, a Programs and Projects Division, a Safety Authorization Basis Team, and an Operations and Commissioning Team. This organization is unique within the Department of Energy and provides a focused team to resolve issues of safety, cost, schedule, technical design changes, and construction. This paper will describe this team and show how the Office of River Protection utilizes this oversight team to manage this complex, accelerated project. The size and technical complexity of the facility poses unique challenges for safety, permitting, commissioning, engineering, and baseline control. A robust training and qualification program has been developed that will insure the Departmental personnel working closely

  1. Does Orthopaedic Outpatient Care Reduce Emergency Department Utilization After Total Joint Arthroplasty?

    Science.gov (United States)

    Chaudhary, Muhammad Ali; Lange, Jeffrey K; Pak, Linda M; Blucher, Justin A; Barton, Lauren B; Sturgeon, Daniel J; Koehlmoos, Tracey; Haider, Adil H; Schoenfeld, Andrew J

    2018-05-22

    Emergency department (ED) visits after elective surgical procedures are a potential target for interventions to reduce healthcare costs. More than 1 million total joint arthroplasties (TJAs) are performed each year with postsurgical ED utilization estimated in the range of 10%. We asked whether (1) outpatient orthopaedic care was associated with reduced ED utilization and (2) whether there were identifiable factors associated with ED utilization within the first 30 and 90 days after TJA. An analysis of adult TRICARE beneficiaries who underwent TJA (2006-2014) was performed. TRICARE is the insurance program of the Department of Defense, covering > 9 million beneficiaries. ED use within 90 days of surgery was the primary outcome and postoperative outpatient orthopaedic care the primary explanatory variable. Patient demographics (age, sex, race, beneficiary category), clinical characteristics (length of hospital stay, prior comorbidities, complications), and environment of care were used as covariates. Logistic regression adjusted for all covariates was performed to determine factors associated with ED use. We found that orthopaedic outpatient care (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68-0.77) was associated with lower odds of ED use within 90 days. We also found that index hospital length of stay (OR, 1.07; 95% CI, 1.04-1.10), medical comorbidities (OR, 1.16; 95% CI, 1.08-1.24), and complications (OR, 2.47; 95% CI, 2.24-2.72) were associated with higher odds of ED use. When considering that at 90 days, only 3928 patients sustained a complication, a substantial number of ED visits (11,486 of 15,414 [75%]) after TJA may be avoidable. Enhancing access to appropriate outpatient care with improved discharge planning may reduce ED use after TJA. Further research should be directed toward unpacking the situations, outside of complications, that drive patients to access the ED and devise interventions that could mitigate such behavior. Level III

  2. DOC/WSNSO [Department of Commerce/Weather Service Nuclear Support Office] operational support to Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Mueller, P.

    1989-01-01

    The National Weather Service (NWS) is an agency of the Department of Commerce. The NWS has hundreds of weather offices throughout the United States. The Weather Service Nuclear Support Office (WSNSO) is a highly specialized unit of NWS that provides direct support to the U.S. Department of Energy's (DOE's) underground nuclear testing program. The WSNSO has been associated with the DOE for >33 yr. As a result of the unique relationship with the DOE, all WSNSO emergency response meteorologists and meteorological technicians are allowed access to classified material. Meteorological phenomena play a significant role during a Federal Radiological Monitoring and Assessment Center (FRMAC) event, and WSNSO meteorologists provide direct support to ARAC. The marriage of state-of-the-art computer systems together with proven technology provides the on-scene WSNSO meteorologist with essentially a portable fully equipped, fully functional, advanced NWS weather station. The WSNSO's emergency response personnel and hardware are at the ready and can be mobilized within 2 h. WSNSO can provide on-scene weather forecasts and critical weather data collection whenever and wherever necessary

  3. 25 CFR 170.935 - How does a direct service tribe begin the alternative dispute resolution process?

    Science.gov (United States)

    2010-04-01

    ....935 How does a direct service tribe begin the alternative dispute resolution process? (a) To begin the ADR process, a direct service tribe must write to the BIA Regional Director or the Chief of BIA... 25 Indians 1 2010-04-01 2010-04-01 false How does a direct service tribe begin the alternative...

  4. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    Directory of Open Access Journals (Sweden)

    Derek Mohammed

    2014-04-01

    Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

  5. Hesitation and error: Does product placement in an emergency department influence hand hygiene performance?

    Science.gov (United States)

    Stackelroth, Jenny; Sinnott, Michael; Shaban, Ramon Z

    2015-09-01

    Existing research has consistently demonstrated poor compliance by health care workers with hand hygiene standards. This study examined the extent to which incorrect hand hygiene occurred as a result of the inability to easily distinguish between different hand hygiene solutions placed at washbasins. A direct observational method was used using ceiling-mounted, motion-activated video camera surveillance in a tertiary referral emergency department in Australia. Data from a 24-hour period on day 10 of the recordings were collected into the Hand Hygiene-Technique Observation Tool based on Feldman's criteria as modified by Larson and Lusk. A total of 459 episodes of hand hygiene were recorded by 6 video cameras in the 24-hour period. The observed overall rate of error in this study was 6.2% (27 episodes). In addition an overall rate of hesitation was 5.8% (26 episodes). There was no statistically significant difference in error rates with the 2 hand washbasin configurations. The amelioration of causes of error and hesitation by standardization of the appearance and relative positioning of hand hygiene solutions at washbasins may translate in to improved hand hygiene behaviors. Placement of moisturizer at the washbasin may not be essential. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  6. United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

    International Nuclear Information System (INIS)

    Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

    2016-01-01

    The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

  7. An Investigation of Social Factors Affecting on Personnel Job Satisfaction of Remedial Service Insurance Department

    Directory of Open Access Journals (Sweden)

    Sayyed Yaser Ebrahimian Jolodar

    2012-01-01

    Full Text Available Because of the paramount importance of job satisfaction and due to its main consequences such as reduction of work absence and resignation, personnel promotion and society‟s health, and more importantly, its role in achievement of organization goals, this study aimed at investigating the effects of six social factors including personnel‟s belief, salary and benefits, participation in organizational decision-making, sense of job security, interaction with colleagues and meeting the basic needs of personnel on job satisfaction. The statistical population of this study was the personnel of Remedial Service Insurance Department in Sari and the questionnaire was distributed among them. The results showed that there is a significant and positive correlation among all these factors and they have meaningful effects on personnel job satisfaction based on multiple regression analysis. Furthermore, findings revealed that personnel‟s belief about their job has the most effects on job satisfaction.

  8. Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

    Science.gov (United States)

    Ryan, Timothy; Specht, Jessica; Smith, Sarah; DelGaudio, John M

    2016-09-01

    Analyze the correlation between online-based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department. Retrospective cross sectional. Tertiary academic institution. All available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero-order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores. There were no statistically significant correlations between time spent with the patient (r = 0.391, P = .208) and overall provider scores (r = 0.193, P = .508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items "probability of recommending the provider" (r = -0.122, P = .666) and "trust in provider" (r = -0.025, P = .929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P = .014), listening for Healthgrades.com (r = 0.981, P ≤ .001), and trust in the provider for the PGPSS (r = 0.971, P ≤ .001). This study suggests that online-based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better-informed decisions regarding their health care. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  9. The haven of the self-service store: A study of the fruit and vegetable department's influence on chain equity

    DEFF Research Database (Denmark)

    Bech-Larsen, Tino

    -equity, by the creation of stronger relations and positive shopping experiences. In this respect a number of measures, as fx service management and direct marketing programmes, have been instigated. Most of these developments have concentrated on the peripheral spheres of the purchase decision situation. A more recent...... perception of the fruit & vegetable department can lead to an increased chain-equity and c) the factors in the fruit & vegetable department that determine the perception of this department....

  10. Quality assurance programs developed and implemented by the US Department of Energy's Analytical Services Program for environmental restoration and waste management activities

    International Nuclear Information System (INIS)

    Lillian, D.; Bottrell, D.

    1993-01-01

    The U.S. Department of Energy's (DOE's) Office of Environmental Restoration and Waste Management (EM) has been tasked with addressing environmental contamination and waste problems facing the Department. A key element of any environmental restoration or waste management program is environmental data. An effective and efficient sampling and analysis program is required to generate credible environmental data. The bases for DOE's EM Analytical Services Program (ASP) are contained in the charter and commitments in Secretary of Energy Notice SEN-13-89, EM program policies and requirements, and commitments to Congress and the Office of Inspector General (IG). The Congressional commitment by DOE to develop and implement an ASP was in response to concerns raised by the Chairman of the Congressional Environment, Energy, and Natural Resources Subcommittee, and the Chairman of the Congressional Oversight and Investigations Subcommittee of the Committee on Energy and Commerce, regarding the production of analytical data. The development and implementation of an ASP also satisfies the IG's audit report recommendations on environmental analytical support, including development and implementation of a national strategy for acquisition of quality sampling and analytical services. These recommendations were endorsed in Departmental positions, which further emphasize the importance of the ASP to EM's programs. In September 1990, EM formed the Laboratory Management Division (LMD) in the Office of Technology Development to provide the programmatic direction needed to establish and operate an EM-wide ASP program. In January 1992, LMD issued the open-quotes Analytical Services Program Five-Year Plan.close quotes This document described LMD's strategy to ensure the production of timely, cost-effective, and credible environmental data. This presentation describes the overall LMD Analytical Services Program and, specifically, the various QA programs

  11. National Centers for Environmental Prediction-Department of Energy (NCEP-DOE) Atmospheric Model Intercomparison Project (AMIP)-II Reanalysis (Reanalysis-2)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NCEP-DOE Atmospheric Model Intercomparison Project (AMIP-II) reanalysis is a follow-on project to the "50-year" (1948-present) NCEP-NCAR Reanalysis Project....

  12. When Does Service-Learning Work? Contact Theory and Service-Learning Courses in Higher Education

    Science.gov (United States)

    Conner, Jerusha; Erickson, Joseph

    2017-01-01

    Service-learning experiences have the potential to improve participants' attitudes and values toward those whom they serve, but if the experience is poorly designed or poorly implemented, it runs the risk of reinforcing stereotypes and deficit perspectives of the intended beneficiaries of service. This study examines the extent to which Contact…

  13. Ready or not: does household preparedness prevent absenteeism among emergency department staff during a disaster?

    Science.gov (United States)

    Mercer, Mary P; Ancock, Benedict; Levis, Joel T; Reyes, Vivian

    2014-01-01

    During major disasters, hospitals experience varied levels of absenteeism among healthcare workers (HCWs) in the immediate response period. Loss of critical hospital personnel, including Emergency Department (ED) staff, during this time can negatively impact a facility's ability to effectively treat large numbers of ill and injured patients. Prior studies have examined factors contributing to HCW ability and willingness to report for duty during a disaster. The purpose of this study was to determine if the degree of readiness of ED personnel, as measured by household preparedness, is associated with predicted likelihood of reporting for duty. Additionally, the authors sought to elucidate other factors associated with absenteeism among ED staff during a disaster. ED staff of five hospitals participated in this survey-based study, answering questions regarding demographic information, past disaster experience, household disaster preparedness (using a novel,15-point scale), and likelihood of reporting to work during various categories of disaster. The primary outcome was personal predicted likelihood of reporting for duty following a disaster. A total of 399 subjects participated in the study. ED staffs were most likely to report for duty in the setting of an earthquake (95 percent) or other natural disaster, followed by an epidemic (90 percent) and were less likely to report for work during a biological, chemical, or a nuclear event (63 percent). Degree of household preparedness was determined to have no association with an ED HCW's predicted likelihood of reporting for duty. Factors associated with predicted absenteeism varied based on type of disaster and included having dependents in the home, female gender, past disaster relief experience, having a spouse or domestic partner, and not owning pets. Having dependents in the home was associated with predicted absenteeism for all disaster types (OR 0.30-0.66). However, when stratified by gender, the presence of

  14. Services Provided to Military Dependents Who Are "Mentally Gifted" in the US Department of Defense (DoDEA) Schools

    Science.gov (United States)

    Bugaj, Stephen J.

    2013-01-01

    The US Department of Defense Education Activity (DoDEA) is a federal agency that provides educational services to military dependents in 12 foreign countries, seven states, Cuba, and Puerto Rico. Perhaps due to its restricted audience, the general public has limited knowledge of DoDEA services; moreover, empirical information about these services…

  15. 75 FR 44280 - Notice of Intent to Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2010-07-28

    ... DEPARTMENT OF THE INTERIOR National Park Service Notice of Intent to Repatriate Cultural Items: U... Museum of Natural History, New York City, NY AGENCY: National Park Service, Interior. ACTION: Notice..., ethnographic materials, technology and architecture indicate that the prehistoric peoples of the upper Verde...

  16. 76 FR 43718 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National...

    Science.gov (United States)

    2011-07-21

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

  17. 76 FR 7232 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Dinosaur...

    Science.gov (United States)

    2011-02-09

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

  18. Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

    Science.gov (United States)

    Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

    2018-05-09

    Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

  19. Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

    Science.gov (United States)

    Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

    2011-02-01

    To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

  20. Department of Energy report on fee for spent nuclear fuel storage and disposal services

    International Nuclear Information System (INIS)

    1980-10-01

    Since the July 1978 publication of an estimated fee for storage and disposal, several changes have occurred in the parameters which impact the spent fuel fee. DOE has mounted a diversified program of geologic investigations that will include locating and characterizing a number of potential repository sites in a variety of different geologic environments with diverse rock types. As a result, the earliest operation date of a geologic repository is now forecast for 1997. Finally, expanded spent fuel storage capabilities at reactors have reduced the projected quantities of fuel to be stored and disposed of. The current estimates for storage and disposal are presented. This fee has been developed from DOE program information on spent fuel storage requirements, facility availability, facility cost estimates, and research and development programs. The discounted cash flow technique has used the most recent estimates of cost of borrowing by the Federal Government. This estimate has also been used in calculating the Federal charge for uranium enrichment services. A prepayment of a percentage of the storage portion of the fee is assumed to be required 5 years before spent fuel delivery. These funds and the anticipated $300 million in US Treasury borrowing authority should be sufficient to finance the acquisition of storage facilities. Similarly, a prepayment of a percentage of the disposal portion would be collected at the same time and would be used to offset disposal research and development expenditures. The balance of the storage and disposal fees will be collected upon spent fuel delivery. If disposal costs are different from what was estimated, there will be a final adjustment of the disposal portion of the fee when the spent fuel is shipped from the AFR for permanent disposal. Based on current spent fuel storage requirements, at least a 30 percent prepayment of the fee will be required

  1. 78 FR 68041 - Memorandum of Understanding Between the Department of Energy and U.S. Fish and Wildlife Service...

    Science.gov (United States)

    2013-11-13

    ... (with Canada, Japan, Mexico, and Russia) for the protection of a shared migratory bird resource. Each of... Agencies to Protect Migratory Birds AGENCY: Office of Health, Safety and Security, Department of Energy... purpose of the MOU is to strengthen migratory bird conservation through enhanced collaboration between DOE...

  2. HIV Services Provided by STD Programs in State and Local Health Departments - United States, 2013-2014.

    Science.gov (United States)

    Cuffe, Kendra M; Esie, Precious; Leichliter, Jami S; Gift, Thomas L

    2017-04-07

    The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD

  3. Services quality in emergency department of Nemazee Hospital: Using SERVQUAL model

    Directory of Open Access Journals (Sweden)

    Maryam Gholami

    2016-10-01

    Full Text Available Introduction: Patient satisfaction is crucial to the long-run success in health care center. With regard to the highest patients’ referral to the emergency department and the existing challenges due to the patient’s need to urgent care, we aimed to evaluate health care services quality in this unit to find out whether the patients have different expectations from health care providers and if they perceive some dimensions of care more important than others. Method: The SERVQUAL scale method was used in this cross-sectional study on 100 patients in June 2015. Patient satisfaction questionnaire based on SERVQUAL model was evaluated with high content validity and the reliability was 0.97 and 0.81. The data collected were analyzed using SPSS, version 20.0 (IBM, USA. Statistical analyses included descriptive statistics, paired and independence sample t-test and ANOVA at the significance level 0.05. Results:The results showed that the quality gap in all dimensions was significant (P<0.001. The largest quality gap was related to responsiveness (-1.08 and the lowest belonged to assurance (-0.8. Demographic characteristics were analyzed and the number of referrals was significant in tangibility and assurance dimensions (P = 0.04; also, in all cases the patients’ expectations (total Mean=4.35 were higher than their perception (total Mean = 3.295. Conclusion: In order to improve emergency services, it is recommended that the hospital management should provide appropriate facilities, reduce waiting time, increase in attention to ordering system based on the patients’ condition, and improve the behavior of health care personnel to patient is placed on the agenda of hospital management.

  4. Interpersonal influence among public health leaders in the United States department of health and human services.

    Science.gov (United States)

    Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J

    2012-02-17

    In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

  5. Airport level of service: A model according to departing passengers’ perceptions at a small-sized airport

    Directory of Open Access Journals (Sweden)

    Max Well Elias Gonçalves

    2017-04-01

    Full Text Available Purpose: This study proposes a conceptual model of level of service evaluation to a small-sized airport with a focus on departing passengers. Design/Methodology: The variables selected to compose the model were chosen according to their adequacy to departing passengers and the airport’s characteristics. A survey was conducted, and, posteriorly, exploratory factor analysis was used in order to verify the adequacy of the conceptual model proposed and also to improve it according to the results obtained. Findings: The results show that the level of service of the airport is composed of three dimensions: airport characteristics, passenger processing, and prices. The relative importance of the dimensions according to their contribution to the composition of the airport’s overall level of service was also determined. Originality/value: The paper combines theoretical and practical findings in a model for level of service evaluation to a small-sized airport from an air transportation management perspective.

  6. Does better access to FPs decrease the likelihood of emergency department use? Results from the Primary Care Access Survey.

    Science.gov (United States)

    Mian, Oxana; Pong, Raymond

    2012-11-01

    To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Population-based telephone survey. Ontario. A total of 8502 Ontario residents aged 16 years and older. Emergency department use in the 12 months before the survey. Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Deborah Kahan

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

  9. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

    2018-03-20

    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  10. An overview of public health service health-related activities as they relate to the Department of Energy's environmental restoration program

    International Nuclear Information System (INIS)

    Kocher, P.L.; Bashor, M.M.

    1991-01-01

    The Agency for Toxic Substances and Disease Registry (ATSDR) was created by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as an agency of the Public Health Service. Under the Superfund Amendments and Reauthorization Act of 1986 (SARA; CERCLA as amended), the public health responsibilities of ATSDR were greatly expanded. Among the responsibilities are (1) preparing health assessments for each site proposed for or listed on the National Priorities List (NPL) established by the US Environmental Protection Agency; (2) conducting epidemiologic and other health studies around NPL sites; (3) establishing registries of exposed individuals; (4) establishing health surveillance programs; (5) developing toxicological profiles for hazardous substances; (6) performing health and emergency response consultations; and (7) performing other health-related activities (e.g., health education). In October 1990, ATSDR signed a memorandum of understanding (MOU) with the Department of Energy (DOE) headquarters requiring that DOE operations offices sign interagency agreements (IAGs) with ATSDR for its conduct of 104(i) health activities at DOE sites. These activities include health assessments, related health studies such as surveillance programs, epidemiologic studies, and registries of exposed persons, and toxicological profiles of hazardous substances unique to DOE sites. ATSDR's studies will focus more on an assessment of the health risk to human populations residing in and around DOE sites than on an evaluation of the health risk to workers on site. Nevertheless, CERCLA, the MOU, and site-specific IAGs authorize ATSDR's access to health and environmental data concerning each site. The IAGs contemplate that ATSDR work closely with DOE operations offices in their implementation of their respective environmental restoration programs

  11. Does Sexual Assault Nurse Examiner (SANE) Training Affect Attitudes of Emergency Department Nurses Toward Sexual Assault Survivors?

    Science.gov (United States)

    Nielson, Mary Hugo; Strong, Linda; Stewart, Julie G

    2015-01-01

    There are over 243,800 female sexual assaults in the United States annually. Of those who seek healthcare services after being sexually assaulted, 90% present to hospitals. Unfortunately, care and services for women who have been sexually assaulted are inconsistent. Increased burnout, frustration, and feelings of inadequacy can lead healthcare providers to exhibit personal biases or negative attitudes toward their patients. The Joint Commission, responsible for accreditation of healthcare organizations, has stated that nurses must provide competent care to all patients. Therefore, Sexual Assault Nurse Examiner (SANE) training needs to be available for emergency department (ED) nurses who care for patients who have been sexually assaulted. A survey using the Attitude Toward Rape Victims Scale was sent to 1503 ED nurses throughout the United States, from the Emergency Nursing Association's mailing list. The results of the survey showed that there was a significant difference in attitudes toward the patients between SANE-trained emergency nurses and those without training. This study also showed that 35.5% of hospitals represented by the respondents did not have SANE services available for adult patients who had been sexually assaulted, and furthermore, 85.5% of the respondents who cared for adult patients who had been sexually assaulted were not SANE trained. The negative attitudes held toward such patients as found in this study, coupled with a lack of training provides evidence that ED nurses may benefit from education related to appropriate treatment for patients who have been sexually assaulted. As evidence-based practice becomes the gold standard of care, ensuring that nurses are properly trained to care for all patients must be the goal.

  12. Interpersonal influence among public health leaders in the United States Department of Health and Human Services

    Directory of Open Access Journals (Sweden)

    Jenine K. Harris

    2012-02-01

    Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

  13. How Much Time Do Unhospitalized Patients Applying for Emergency Services Stay in Emergency Department

    Directory of Open Access Journals (Sweden)

    Mansur Kürsad Erkuran

    2013-12-01

    Full Text Available INTRODUCTION: The patients applying to a emergency service may stay longer than necessary for diagnosis, monitoring and treatment. This can be due to the inadequacy of the treatment performed in emergency department or to the absence of the required unit in the hospital. In this study, we analyzed the waiting period of the patients who have not been hospitalized. METHODS: The patients applying to Bolu İzzet Baysal Public Hospital Emergency Unit between 24.11.2009 and 25.08.2011 have been studied regarding their application date, the season, and their waiting period in the emergency unit. The data have been analyzed using the statistics software Package for the Social Sciences (SPSS, Inc., Chicago, IL, version 17.0 for Windows. The chi-square χ2 test has been used for the determination of the percentage distribution and significance and p<0,05 has been considered significant. RESULTS: 4215 patients applying to Bolu İzzet Baysal Public Hospital Emergency Unit between 24.11.2009 and 25.08.2011 and monitored without hospitalization have been studied. The patients mainly presented during spring (p<0.05. The application occurred more often between 20.00 PM – 23.59 PM (p<0.005. The mean duration of the accept-standby of the patients in emergency unit was 09±12 (minimum 0 minute, maximum 130 minutes. The patients waited 0,26 ±70 minutes in emergency unit examination (minimum 0 minute, maximum 1292 minutes. The total waiting time in emergency unit was 52 ±100 minutes (minimum 10, maximum 1435 minutes. DISCUSSION AND CONCLUSION: In this study, we observed that the duration of the hospitalization in emergency unit is longer than the ideal duration.

  14. Detection and correction of prescription errors by an emergency department pharmacy service.

    Science.gov (United States)

    Stasiak, Philip; Afilalo, Marc; Castelino, Tanya; Xue, Xiaoqing; Colacone, Antoinette; Soucy, Nathalie; Dankoff, Jerrald

    2014-05-01

    Emergency departments (EDs) are recognized as a high-risk setting for prescription errors. Pharmacist involvement may be important in reviewing prescriptions to identify and correct errors. The objectives of this study were to describe the frequency and type of prescription errors detected by pharmacists in EDs, determine the proportion of errors that could be corrected, and identify factors associated with prescription errors. This prospective observational study was conducted in a tertiary care teaching ED on 25 consecutive weekdays. Pharmacists reviewed all documented prescriptions and flagged and corrected errors for patients in the ED. We collected information on patient demographics, details on prescription errors, and the pharmacists' recommendations. A total of 3,136 ED prescriptions were reviewed. The proportion of prescriptions in which a pharmacist identified an error was 3.2% (99 of 3,136; 95% confidence interval [CI] 2.5-3.8). The types of identified errors were wrong dose (28 of 99, 28.3%), incomplete prescription (27 of 99, 27.3%), wrong frequency (15 of 99, 15.2%), wrong drug (11 of 99, 11.1%), wrong route (1 of 99, 1.0%), and other (17 of 99, 17.2%). The pharmacy service intervened and corrected 78 (78 of 99, 78.8%) errors. Factors associated with prescription errors were patient age over 65 (odds ratio [OR] 2.34; 95% CI 1.32-4.13), prescriptions with more than one medication (OR 5.03; 95% CI 2.54-9.96), and those written by emergency medicine residents compared to attending emergency physicians (OR 2.21, 95% CI 1.18-4.14). Pharmacists in a tertiary ED are able to correct the majority of prescriptions in which they find errors. Errors are more likely to be identified in prescriptions written for older patients, those containing multiple medication orders, and those prescribed by emergency residents.

  15. Managing the Service Supply Chain in the Department of Defense: Opportunities and Challenges

    National Research Council Canada - National Science Library

    Apte, Uday; Ferrer, Geraldo; Lewis, Ira; Rendon, Rene

    2006-01-01

    ...% of total DoD procurement dollars) on services. In recent years, the DoD has spent more on services than on supplies, equipment and goods, even considering the high value of weapon systems and large military items...

  16. 77 FR 24990 - Public Availability of the Department of Labor FY 2011 Service Contract Inventory

    Science.gov (United States)

    2012-04-26

    ... INFORMATION CONTACT: Questions regarding the service contract inventory should be directed to Gladys M. Bailey in the DOL/ Office of Acquisition Management Services on (202) 693-7244 or bailey.gladys@dol.gov...

  17. A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments

    OpenAIRE

    Cooke, M. W.; Allan, T. F.; Wilson, S.

    1999-01-01

    AIM: To determine whether there were any changes in attendance at accident and emergency departments that could be related to international football matches (Euro96 tournament). METHOD: Fourteen accident and emergency departments (seven adjacent to and seven distant from a Euro96 venue) provided their daily attendance figures for a nine week period: three weeks before, during, and after the tournament. The relation between daily attendance rates and Euro96 football matches was assessed ...

  18. Department of Defense Use of Commercial Cloud Computing Capabilities and Services

    Science.gov (United States)

    2015-11-01

    models (Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service ( SaaS )), and four deployment models (Public...NIST defines three main models for cloud computing: IaaS, PaaS, and SaaS . These models help differentiate the implementation responsibilities that fall...and SaaS . 3. Public, Private, Community, and Hybrid Clouds Cloud services come in different forms, depending on the customer’s specific needs

  19. Customer Service Analysis : Case: Sky Club Department of Yeti Airlines, Nepal

    OpenAIRE

    Chiluwal, Debendra

    2014-01-01

    In recent year, competition in business field is significantly growing and an organization cannot focus only on price but also they have to focus on customer service and satisfaction level. The objective of this thesis is to find out the level of customer service experience and satisfaction and provide suggestions for the future development. Customer service and customer satisfaction are relates to each other. Therefore, good customer service can get high level of customer satisfaction. A hig...

  20. 75 FR 45606 - Department of Commerce Measuring and Enhancing Services Trade Data Conference

    Science.gov (United States)

    2010-08-03

    ... decision-making, policy planning, and is relevant for trade agreements in support of increased US services... business and public policy decision-making. DOC will accept registrations on a first-come-first-served... services, accounting for intangible assets, and accuracy of service price indices. The target audience for...

  1. An Evaluation of Service Quality in Higher Education: Marmara and Nigde Omer Halisdemir Universities' Department of Education Students

    Science.gov (United States)

    Ada, Sefer; Baysal, Z. Nurdan; Erkan, Senem Seda Sahenk

    2017-01-01

    The purpose of this research is to evaluate the quality service in higher education in Marmara and Nigde Omer Halisdemir Universities' department of education students. This study was prepared using a screening model from quantitative research methods. The sample of this research comprised 886 university students attending the higher education…

  2. 76 FR 76032 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2011-12-06

    ... proposed changes to the Schedule of Fees for Consular Services (Schedule) for nonimmigrant visa and border... (Machine-Readable Visas or MRVs) and adult Border Crossing Cards (BCCs). The rule also provides new tiers... these visas under the current cost structure. The Department endeavors to recover the cost of providing...

  3. 78 FR 78380 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort...

    Science.gov (United States)

    2013-12-26

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

  4. 78 FR 78378 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant...

    Science.gov (United States)

    2013-12-26

    ... Repatriation Act (NAGPRA), 25 U.S.C. 3003, of the completion of an inventory of human remains under the control....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant... Historic Site has completed an inventory of human remains, in consultation with the appropriate Indian...

  5. Assessment of Service Members Knowledge and Trust of the Department of Veterans Affairs

    Science.gov (United States)

    2015-06-12

    www.va.gov/health/aboutVHA.asp. 24 Veterans Benefits Administration, “About VBA ,” last updated December 18, 2014, accessed May 10, 2015, http...Department of Veterans Affairs, 2014. Veterans Benefits Administration. “About VBA .” Last updated December 18, 2014. Accessed May 10, 2015. http...OIF Operation Iraqi Freedom VA Department of Veterans Affairs VA OIG Department of Veterans Affairs Office of Inspector General VBA Veterans Benefits

  6. [Outpatient care in emergency departments and primary care services : A descriptive analysis of secondary data in a rural hospital].

    Science.gov (United States)

    Seeger, I; Rupp, P; Naziyok, T; Rölker-Denker, L; Röhrig, R; Hein, A

    2017-09-01

    The use of emergency departments in German hospitals has been increasing in recent years. Emergency care provided by primary care services ("Bereitschaftsdienstpraxis") or a hospital emergency departments (EDs) is the subject of current discussions. The purpose of this study was to determine the reasons that outpatients with lower treatment urgency consult the ED. Further, the effects of the cooperation between primary care services and the ED will be examined. The study was an exploratory secondary data analysis of data from the hospital information system and a quality management survey of a basic and standard care clinic in a rural area. All patients classified as 4 and 5 according to the emergency severity index (ESI), both four weeks before and after the primary care services and ED visit, were included in the study. During the two survey periods, a total of 1565 outpatient cases were treated, of which 962 cases (61%) were triaged ESI 4 or 5. Of these patients, 324 were surveyed (34%). Overall, 276 cases (85%) visited the ED without contacting a physician beforehand, 161 of the cases (50%) reported an emergency as the reason. In 126 cases (39%) the symptoms lasted more than one day. One-third of all outpatient admissions (537 cases, 34%) visited the ED during the opening hours of the general practitioner. More than 80% of the surviving cases visited the ED without physician contact beforehand. The most common reason for attending the ED was, "It is an emergency." The targeted control of the patients by integrating the primary care service into the ED does not lead to an increased number of cases in the primary care service, but to a subjective relief of the ED staff.

  7. 75 FR 64710 - Availability of the Fiscal Year 2009 Department of Defense Services Contracts Inventory

    Science.gov (United States)

    2010-10-20

    ... DEPARTMENT OF DEFENSE Office of the Secretary Availability of the Fiscal Year 2009 Department of... National Defense Authorization Act for Fiscal Year 2008 (NDAA 08) section 807, the Office of the Director, Defense Procurement and Acquisition Policy, Office of Program Acquisition and Strategic Sourcing (DPAP...

  8. Development of guidance for preparing treatability variance petitions from the RCRA Land Disposal Restrictions for DOE [Department of Energy] mixed-waste streams

    International Nuclear Information System (INIS)

    Harms, T.; Scheuer, N.; Martin, R.; Van Epp, T.; Triplett, M.

    1990-01-01

    In response to the Department of Energy's (DOE) anticipated need for variances from the Resource Conservation and Recovery Act (RCRA) Land Disposal Restriction (LDR) treatment requirements, a treatability variance guidance document is being prepared for use by DOE facilities and operations offices. The guidance document, although applicable to non-mixed hazardous waste streams, provides specific guidance regarding radioactive mixed-waste streams. Preparation of the guidance manual has involved developing an overview of the Land Disposal Restrictions, as well as an overview of the petition preparation process. The DOE internal review requirements are specifically addressed in the manual. Specific data requirements and engineering analyses are also described. A discussion of EPA's criteria for granting a treatability variance is also provided. A checklist for completeness of the petition is provided. Model language for use in DOE treatability variance petitions will be provided in a petition for a DOE waste stream as an appendix to the document

  9. Commercial Methodologies for Acquiring Consulting Services: Can Department of Defense Contracting Activities Follow Suit?

    National Research Council Canada - National Science Library

    Clarke, Will

    2001-01-01

    .... The objective of this thesis is to ascertain the best pre-award commercial practices for acquiring CS and draw conclusions and make recommendations for employing these proven methods in future Department of Defense (DoD) procurements...

  10. U.S. Department of Energy (DOE)--Surface Biogeochemical Research (SBR) 6th Annual PI Meeting: Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    Hazen Ed., T.C.

    2011-04-11

    On behalf of the Subsurface Biogeochemical Research (SBR) program managers in the Climate and Environmental Sciences Division (CESD), Office of Biological and Environmental Research (BER), welcome to the 2011 SBR Principal Investigators meeting. Thank you in advance for your attendance and your presentations at this year's meeting. As the events in Japan continue to unfold, we are all reminded that the research we perform on radionuclide behavior in the environment has implications beyond legacy waste cleanup and in fact has its place in the discussion on the expanded use of nuclear power. As in the past, there are three broad objectives to the Principal Investigators meeting: (1) to provide opportunities to share research results and promote interactions among the SBR scientists and other invited guests; (2) to evaluate the progress of each project within the program; and (3) to showcase the scientific expertise and research progress over the past year to senior managers within the DOE Office of Science, the technology offices within DOE, and other invited attendees from other Federal Agencies. This past year has seen a few significant changes within BER and within the SBR program. In November, our Associate Director for BER, Anna Palmisano, retired from Federal service. Just this month, Dr. Sharlene Weatherwax (Division Director for Biological Systems Sciences) has been named as the new Associate Director for BER. In August, BER welcomed Dr. Gary Geernaert as the new Division Director for CESD. Gary joins the division from Los Alamos National Laboratory with a background in atmospheric science. Within the SBR program, a new Strategic Plan was completed last June (currently posted on the SBR and the Office of Science website). The new strategic plan is intended to foster integration within the Environmental Systems Science portion of the BER budget that includes both SBR and Terrestrial Ecosystem Sciences (TES). Both these programs share a goal of advancing a

  11. Relationships among providing maternal, child, and adolescent health services; implementing various financial strategy responses; and performance of local health departments.

    Science.gov (United States)

    Issel, L Michele; Olorunsaiye, Comfort; Snebold, Laura; Handler, Arden

    2015-04-01

    We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations. We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

  12. Managing the Service Supply Chain in Department of Defense: Implications for the Program Management Infrastructure

    National Research Council Canada - National Science Library

    Rendon, Rene G; Apte, Uday

    2007-01-01

    .... In fact, in recent years, the DoD has spent more on services than on supplies, equipment and goods, even considering the high value of weapon systems and large military items (Camm, Blickstein & Venzor, 2004...

  13. A Model of a Tacit Knowledge Transformation for the Service Department in a Manufacturing Company: A Case Study

    Directory of Open Access Journals (Sweden)

    Dudek Adam

    2016-01-01

    Full Text Available This article elaborates on the development of a dedicated model of a tacit knowledge transformation for the service department in a manufacturing company. The four main components of the tacit knowledge transformation process are formulated: (1 tacit knowledge source identification, (2 tacit knowledge acquisition, (3 tacit knowledge determination and formalization, and (4 knowledge classification. The proposed model is illustrated by examples on the use of the methods: automatic recognition of speech, natural language processing, and automatic object recognition in the tacit knowledge transformation process in order to obtain a formalized procedure for the service department in a manufacturing company. This is followed by a discussion of the results of the research experiments.

  14. Communication and Work Development as a Change Management Tool in the In-flight Customer Service Department : Case Finnair

    OpenAIRE

    Hölttä, Katri

    2011-01-01

    The challenges and changes in the air transport sector have increased the need for radical changes also in the airlines organizations. Finnair has chosen to be a quality airline to focus on operations into customer-orientation and delivering improved customer experience to its customers. The objective of this thesis is to find development suggestions to the In-flight customer service department how to develop communication and work development to be used as a change management tool. The study...

  15. Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study.

    Science.gov (United States)

    Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

    2016-01-01

    Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. "Management and empowerment of human resources'' (weight = 0.465) and "requirements and facilities" (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country's hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards

  16. Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

    International Nuclear Information System (INIS)

    Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

    2016-01-01

    Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. “Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step

  17. Role of Department of Defense Policies in Identifying Traumatic Brain Injuries Among Deployed US Service Members, 2001-2016.

    Science.gov (United States)

    Agimi, Yll; Regasa, Lemma Ebssa; Ivins, Brian; Malik, Saafan; Helmick, Katherine; Marion, Donald

    2018-05-01

    To examine the role of Department of Defense policies in identifying theater-sustained traumatic brain injuries (TBIs). We conducted a retrospective study of 48 172 US military service members who sustained their first lifetime TBIs between 2001 and 2016 while deployed to Afghanistan or Iraq. We used multivariable negative binomial models to examine the changes in TBI incidence rates following the introduction of Department of Defense policies. Two Army policies encouraging TBI reporting were associated with an increase of 251% and 97% in TBIs identified following their implementation, respectively. Among airmen, the introduction of TBI-specific screening questions to the Post-Deployment Health Assessment was associated with a 78% increase in reported TBIs. The 2010 Department of Defense Directive Type Memorandum 09-033 was associated with another increase of 80% in the likelihood of being identified with a TBI among soldiers, a 51% increase among sailors, and a 124% increase among Marines. Department of Defense and service-specific policies introduced between 2006 and 2013 significantly increased the number of battlefield TBIs identified, successfully improving the longstanding problem of underreporting of TBIs.

  18. 42 CFR 137.206 - Why does the IHS need this information?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Why does the IHS need this information? 137.206 Section 137.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Health Status Reports § 137.206 Why does the IHS...

  19. Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

    Science.gov (United States)

    Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

    2014-01-01

    The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).

  20. Provision of utility support services to the US Department of Energy San Francisco Operations Office. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The main purpose of this project was to provide to DOE/SAN continuing, follow-up support to realize savings from a number of alternate supply arrangements that had already been and/or were expected to be identified under the original project. This expected continuation of these efforts is demonstrated by certain of the tasks that are spelled out in the Statement of Work. For example: Evaluate and propose alternative options and methods for improving efficiency, reducing cost, and making effective use of the energy supplies and facilities under various conditions of use; Provide engineering and economic analysis and recommendations for utility-related facilities and service issues, such as high voltage discounts, ownership of facilities, etc.; Assist in developing strategy and documentation in support of negotiating utility contracts and modifications thereto. In addition, the follow-on contract provided for monitoring and intervening in rate cases that had particular relevance to the DOE/SAN laboratories.

  1. 76 FR 32358 - Meeting of the Defense Department Advisory Committee on Women in the Services (DACOWITS)

    Science.gov (United States)

    2011-06-06

    ... give the Committee a briefing on the results of their Workplace and Gender Relations survey... restrict the service of female members and the plans for a new Working Group on women's issues. The meeting... FY11 NDAA. --Receive briefing from Defense Manpower Data Center on survey results on 2010 workplace and...

  2. Wind Vision: A New Era for Wind Power in the United States (Highlights); U.S. Department of Energy (DOE), NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-03-01

    This is a four-part Wind Vision project, consisting of Wind Vision Highlights, Executive Summary, a Full Report, and Appendix. The U.S. Department of Energy (DOE) Wind Program, in close cooperation with the wind industry, led a comprehensive analysis to evaluate future pathways for the wind industry. The Wind Vision report updates and expands upon the DOE's 2008 report, 20% Wind Energy by 2030, and defines the societal, environmental, and economic benefits of wind power in a scenario with wind energy supplying 10% of national end-use electricity demand by 2020, 20% by 2030, and 35% by 2050.

  3. VARIOUS SPEECH SEQUENCES OF ENGLISH DEPARTMENT STUDENTS IN DOING REQUEST VIA SHORT MESSAGE SERVICE

    Directory of Open Access Journals (Sweden)

    Ike Revita

    2015-09-01

    Full Text Available Interaction, if not wisely considered, may be very risky. The unwise utterances may lead to misunderstanding. When this happens, pragmatic failure is of great possibility occur. This writing is aimed at describing the some variations of speech seqeunces in doing request and the reasons of using each variation. The data are the request uttered by English Department students Andalas University to their friends, their lecturer and vice versa at the campus. Data are collected by observational method, interviewing and note-taking technique. To analyze the data, pragmatic and referential identity method is used. The result of analysis is naratively and descriptively presented. Having been related to the concept of speech act of request (Revita, 2008 and context (Yule, 1986, it is found that there are four variations of speech sequence when English Department students do request. They are (a (1 1 in 1; (b 2 in 1; (c 3 in 1; and (d multi acts in 1. The choice of these variations is basically based on several reasons, namely (i social; (iipsychological; (iii cultural ; and (iv religious aspect.

  4. Does size matter? An investigation of how department size and other organizational variables influence on publication productivity and citation impact

    Energy Technology Data Exchange (ETDEWEB)

    Aksnes, D.W.; Rørstad, K.; Piro, F.N.

    2016-07-01

    In this study, we investigate whether university department size is important in determining publication productivity and citation impact. Drawing on a unique dataset containing a variety of different variables at department levels, we are able to provide a richer picture of the research performance than what typically has been the case in many previous studies. In addition to analyzing the basic question of how size relates to scientific performance, we address whether the funding profile of the departments plays a role, whether the scientific performance is influenced by the composition of the academic personnel (in terms of gender, academic positions, recruiting personnel and the share of doctoral degree holders). The study shows that virtually no size effect can be identified and highly productive and highly cited units are found among both small, medium and large departments. For none of the organizational variables we are able to identify statistically significant relationships in respect to research performance at an overall level. We conclude that the productivity and citation differences at the level of departments cannot generally be explained by the selected variables for department size, funding structure and the composition of scientific personnel. (Author)

  5. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department

    Directory of Open Access Journals (Sweden)

    Cholada Kittipittayakorn

    2016-01-01

    Full Text Available Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries’ healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES and agent-based simulation (ABS to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department.

  6. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department.

    Science.gov (United States)

    Kittipittayakorn, Cholada; Ying, Kuo-Ching

    2016-01-01

    Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries' healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department.

  7. US Department of Energy (DOE)/Gosatomnadzor (GAN) of Russia project at the Petersburg Nuclear Physics Institute (PNPI)

    International Nuclear Information System (INIS)

    Baranov, I.A.; Konoplev, K.A.; Hauser, G.C.

    1997-01-01

    This paper presents a summary of work accomplished within the scope of the DOE-Gosatomnadzor (GAN) Agreement to reduce vulnerability to theft of direct-use nuclear materials in Russia. The DOE-GAN agreement concerns the Russian Academy of Science B.P. Konstantinov Petersburg Nuclear Physics Institute (PNPI), located 45 kilometers from St. Petersburg. The PNPI operates facilities to research basic nuclear physics. Current world conditions require particular attention to the issue of Material Protection, Control, and Accounting (MPC ampersand A) of nuclear materials. The long-term plan to increase security at the facility is outlined, including training, physical protection upgrades, and material control and accountability. 4 figs

  8. Licensing strategy for deployment of commercial technologies procured through a service contract in DOE-owned facilities

    International Nuclear Information System (INIS)

    Bloom, J.W.

    1998-01-01

    The US Department of Energy's Hanford Tank Farm Remediation System (TWRS) is responsible for the safe storage of waste in 177 underground waste storage tanks. TWRS is also responsible for the cleanup and final closure of these tanks. In the performance of this mission TWRS has historically designed its own equipment. The safety of the equipment for deployment in TWRS facilities has been assured through the development of detailed engineering specifications and close QA/QC monitoring during fabrication and testing. In order to address the complex and costly cleanup mission Hanford is looking for ways to apply private sector technologies to the cleanup mission. The Hanford Tanks Initiative (HTI) is a five year, EM 30/50 expense-funded project with a primary objective of demonstrating the extent to which the Hanford Tank Waste Remediation System (TWRS) tanks can be cleaned using commercially available technologies. To accomplish this objective, in August 1996 HTI issued a Request for Proposal (RFP) for services to remove the hard heel waste from tank 241-C-106, following retrieval of the majority of the waste by sluicing. While certain specification guidance was provided in the RFP such as, must be capable of operation in a flammable gas environment, the RFP was careful in avoiding language that would place limitations on the technologies that industry could provide. The challenge for HTI was to develop a licensing strategy that would provide maximum flexibility to the technology vendors while meeting the stringent documentation requirements of the US Department of Energy (DOE). This strategy must also provide assurance that the technology can be shown to be within the TWRS authorization basis and be safely deployed. A 35-step process (Figure 1) was developed by HTI to accomplish this objective

  9. Licensing strategy for deployment of commercial technologies procured through a service contract in DOE-owned facilities

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, J.W.

    1998-05-05

    The US Department of Energy`s Hanford Tank Farm Remediation System (TWRS) is responsible for the safe storage of waste in 177 underground waste storage tanks. TWRS is also responsible for the cleanup and final closure of these tanks. In the performance of this mission TWRS has historically designed its own equipment. The safety of the equipment for deployment in TWRS facilities has been assured through the development of detailed engineering specifications and close QA/QC monitoring during fabrication and testing. In order to address the complex and costly cleanup mission Hanford is looking for ways to apply private sector technologies to the cleanup mission. The Hanford Tanks Initiative (HTI) is a five year, EM 30/50 expense-funded project with a primary objective of demonstrating the extent to which the Hanford Tank Waste Remediation System (TWRS) tanks can be cleaned using commercially available technologies. To accomplish this objective, in August 1996 HTI issued a Request for Proposal (RFP) for services to remove the hard heel waste from tank 241-C-106, following retrieval of the majority of the waste by sluicing. While certain specification guidance was provided in the RFP such as, must be capable of operation in a flammable gas environment, the RFP was careful in avoiding language that would place limitations on the technologies that industry could provide. The challenge for HTI was to develop a licensing strategy that would provide maximum flexibility to the technology vendors while meeting the stringent documentation requirements of the US Department of Energy (DOE). This strategy must also provide assurance that the technology can be shown to be within the TWRS authorization basis and be safely deployed. A 35-step process (Figure 1) was developed by HTI to accomplish this objective.

  10. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Health and Human Services – ASPR

    Energy Technology Data Exchange (ETDEWEB)

    Schey, Steve [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-06-01

    This report focuses on the Department of Health and Human Services, Assistant Secretary for Preparedness and Response fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agency’s fleet. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  11. Relationships between Personal Traits, Emotional Intelligence, Internal Marketing, Service Management, and Customer Orientation in Korean Outpatient Department Nurses.

    Science.gov (United States)

    Kim, Bogyun; Lee, Jia

    2016-03-01

    Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. Factors associated with customer orientation were identified as conscientiousness from personal traits (β = .37, p marketing from environmental characteristics (β = .21, p = .001). Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction. Copyright © 2015. Published by Elsevier B.V.

  12. Communication from the Legal Service and the HR Department: 2005 INCOME TAX DECLARATION

    CERN Document Server

    2006-01-01

    1) Avis d'impôt sent by the French Centre des Impôts Members of the personnel residing in France have received (or are about to receive) a document issued by their local Centre des Impôts (CDI) entitled «Avis d'impôt - Impôt sur les revenus de 2005». The document states in particular that: 'The declaration form you have filed indicates no income for 2005. Please note that this avis d'impôt does not constitute substantiation of the absence of any income. You have been in receipt of income from international organisations or diplomatic or consular missions that is exempt from taxation in France. Indicate this income at the bottom of this avis d'impôt.'1) This document must not be returned to your CDI. It is intended for French administrative bodies and agencies wishing to obtain information on your tax position in France. If a French body or agency (e.g. the Family Allowances Fund) requests you to provide it with information on the income you have declared to the tax authorities, you must indicate i...

  13. Reengineering of the business process in the Serbian post's department for express parcel service

    Directory of Open Access Journals (Sweden)

    Lazarević Dragan M.

    2015-01-01

    Full Text Available In this paper the model that solves the problem of exceeding time limit in the system of express parcel shipping in the Post of Serbia is described. The existing principle of the organization of the area serving is explained, as well as the problem of exceeding time limit that appears and leads to the delay of the service to the user. Two approaches for problem solving are suggested. The reengineering of the existing business processes is carried out to some extent through these two approaches, and will be presented by BPMN notation. The first approach is based on the use of the fuzzy set theory, i.e. fuzzy logical systems, while the other one is based on the use of algorithm 'zoning-routing'.

  14. Developing computer systems to support emergency operations: Standardization efforts by the Department of Energy and implementation at the DOE Savannah River Site

    International Nuclear Information System (INIS)

    DeBusk, R.E.; Fulton, G.J.; O'Dell, J.J.

    1990-01-01

    This paper describes the development of standards for emergency operations computer systems for the US Department of Energy (DOE). The proposed DOE computer standards prescribe the necessary power and simplicity to meet the expanding needs of emergency managers. Standards include networked UNIX workstations based on the client server model and software that presents information graphically using icons and windowing technology. DOE standards are based on those of the computer industry although Proposed DOE is implementing the latest technology to ensure a solid base for future growth. A case of how these proposed standards are being implemented is also presented. The Savannah River Site (SRS), a DOE facility near Aiken, South Carolina is automating a manual information system, proven over years of development. This system is generalized as a model that can apply to most, if not all, Emergency Operations Centers. This model can provide timely and validated information to emergency managers. By automating this proven system, the system is made easier to use. As experience in the case study demonstrates, computers are only an effective information tool when used as part of a proven process

  15. Radiographer emergency department hot reporting: An assessment of service quality and feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, Maryann [Division of Radiography, School of Health Studies, University of Bradford, Trinity Road, Bradford, West Yorkshire BD5 0BB (United Kingdom)], E-mail: m.l.hardy1@bradford.ac.uk; Spencer, Nicholas; Snaith, Beverly [Mid Yorkshire Hospitals NHS Trust, Radiology Department, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG (United Kingdom)

    2008-11-15

    Purpose: Radiographer reporting has been implemented widely as cold reporting. This study aimed to compare hot and cold reports by the same radiographer to establish whether there was any significant difference in the diagnostic outcome. Method: Three experienced radiographers reported 1618 musculoskeletal trauma cases over a 3 month period. These cases were stratified for age (0-17 years; 18-50 years; 51 years+) and a random sample of 400 cases selected (95% confidence interval, 90% power) for delayed reporting. Both reports were independently compared by 2 experienced film readers. Results: Radiographs and notes on 391 (97.8%; n = 391/400) cases were located (age range 3 months to 97 years) for cold reporting. The diagnostic outcome of the reports was concordant in 357 cases (91.3%; n = 357/391) and discrepant in 34 cases (8.7%; n = 34/391). Logistic regression performed on age stratified discrepancies indicated that paediatric cases had increased odds of receiving discrepant reports (OR = 3.34; p = 0.005; 95% CI [1.44-7.74]). Hot and cold report agreement was high ({kappa} = 0.87). McNemar's test demonstrated no significant difference in the report discrepancies (p = 0.189). Conclusion: No significant difference was demonstrated between the diagnostic outcome of radiographer hot reports, issued whilst working within the trauma radiography department at time of patient attendance, and cold reports.

  16. Radiographer emergency department hot reporting: An assessment of service quality and feasibility

    International Nuclear Information System (INIS)

    Hardy, Maryann; Spencer, Nicholas; Snaith, Beverly

    2008-01-01

    Purpose: Radiographer reporting has been implemented widely as cold reporting. This study aimed to compare hot and cold reports by the same radiographer to establish whether there was any significant difference in the diagnostic outcome. Method: Three experienced radiographers reported 1618 musculoskeletal trauma cases over a 3 month period. These cases were stratified for age (0-17 years; 18-50 years; 51 years+) and a random sample of 400 cases selected (95% confidence interval, 90% power) for delayed reporting. Both reports were independently compared by 2 experienced film readers. Results: Radiographs and notes on 391 (97.8%; n = 391/400) cases were located (age range 3 months to 97 years) for cold reporting. The diagnostic outcome of the reports was concordant in 357 cases (91.3%; n = 357/391) and discrepant in 34 cases (8.7%; n = 34/391). Logistic regression performed on age stratified discrepancies indicated that paediatric cases had increased odds of receiving discrepant reports (OR = 3.34; p = 0.005; 95% CI [1.44-7.74]). Hot and cold report agreement was high (κ = 0.87). McNemar's test demonstrated no significant difference in the report discrepancies (p = 0.189). Conclusion: No significant difference was demonstrated between the diagnostic outcome of radiographer hot reports, issued whilst working within the trauma radiography department at time of patient attendance, and cold reports

  17. Successful implementation of the National Environmental Policy Act (NEPA) at a US Department of Energy (DOE) site: Environmental assessment preparation - a case study

    International Nuclear Information System (INIS)

    Haagenstad, T.; Ladino, A.

    1997-01-01

    The U.S. Department of Energy (DOE) at Los Alamos National Laboratory (LANL) implements the requirements of the National Environmental Policy Act (NEPA) using a NEPA Compliance Team. The NEPA Compliance Team (Team) is composed of DOE Los Alamos Area Office (LAAO) and LANL employees that combine to create quality improvements in the DOE NEPA compliance process at both LAAO and LANL. A major focus of quality improvement has been in the area of Environmental Assessment (EA) documentation preparation. The NEPA Team within LANL's Ecology Group (ESH-20) is the organization responsible for preparing the EA documentation on behalf of DOE. DOE and LANL team in an interdisciplinary process to prepare review, and complete EAs using the technical expertise of individuals throughout the DOE and LANL. This approach has demonstrated significant time and cost savings as well as EA document quality improvements. The process used to prepare an EA for the Low Energy Demonstration Accelerator (LEDA) is presented as an example of a successful approach to implementing NEPA. The LEDA EA is used as a case study example to demonstrate how an integrated and interdisciplinary approach to conducting a NEPA analysis yields extremely successful results. The LEDA EA was prepared on an extremely aggressive schedule with tight cost constraints. The ESH-20 NEPA Team was successful in providing a critical link between the DOE decision-makers and the LEDA project representatives within LANL. As the technical scope of the LEDA project changed during the preparation of the EA, by emphasizing an interdisciplinary approach, the Team was able to quickly assess the implications and potential impacts through open communications with the various subject matter experts while maintaining a pace consistent with the EA schedule demands

  18. Geospatial field applications within United States Department of Agriculture, Veterinary Services.

    Science.gov (United States)

    FitzMaurice, Priscilla L; Freier, Jerome E; Geter, Kenneth D

    2007-01-01

    Epidemiologists, veterinary medical officers and animal health technicians within Veterinary Services (VS) are actively utilising global positioning system (GPS) technology to obtain positional data on livestock and poultry operations throughout the United States. Geospatial data, if acquired for monitoring and surveillance purposes, are stored within the VS Generic Database (GDB). If the information is collected in response to an animal disease outbreak, the data are entered into the Emergency Management Response System (EMRS). The Spatial Epidemiology group within the Centers for Epidemiology and Animal Health (CEAH) has established minimum data accuracy standards for geodata acquisition. To ensure that field-collected geographic coordinates meet these minimum standards, field personnel are trained in proper data collection procedures. Positional accuracy is validated with digital atlases, aerial photographs, Web-based parcel maps, or address geocoding. Several geospatial methods and technologies are under investigation for future use within VS. These include the direct transfer of coordinates from GPS receivers to computers, GPS-enabled digital cameras, tablet PCs, and GPS receivers preloaded with custom ArcGIS maps - all with the objective of reducing transcription and data entry errors and improving the ease of data collection in the field.

  19. Detecting child abuse based on parental characteristics: Does The Hague Protocol cause parents to avoid the Emergency Department?

    NARCIS (Netherlands)

    Diderich, H.M.; Fekkes, M.; Dechesne, M.; Buitendijk, S.E.; Oudesluys-Murphy, A.M.

    2015-01-01

    Objectives: The Hague Protocol is used by professionals at the adult Emergency Departments (ED) in The Netherlands to detect child abuse based on three parental characteristics: (1) domestic violence, (2) substance abuse or (3) suicide attempt or self-harm. After detection, a referral is made to the

  20. Efficacy of hospital in the home services providing care for patients admitted from emergency departments: an integrative review.

    Science.gov (United States)

    Varney, Jane; Weiland, Tracey J; Jelinek, George

    2014-06-01

    Increases in emergency department (ED) demand may compromise patient outcomes, leading not only to overcrowding in the ED, increased ED waiting times and increased ED length of stay, but also compromising patient safety; the risk of adverse events is known to rise in the presence of overcrowding. Hospital in the home (HiTH) services may offer one means of reducing ED demand. This integrative review sought to assess the efficacy of admission-avoidance HiTH services that admit patients directly from the ED. Papers published between 1995 and 2013 were identified through searches of Medline, CINAHL and Google. English-language studies that assessed the efficacy of a HiTH service and that recruited at least one-third of the participants directly from the ED were included in the review. A HiTH service was considered one that provided health professional support to patients at home for a time-limited period, thus avoiding the need for hospitalization. Twenty-two articles met the inclusion criteria for this review. The interventions were diverse in terms of the clinical interventions delivered, the range and intensity of health professional input and the conditions treated. The studies included in the review found no effect on clinical outcomes, rates of adverse events or complications, although patient satisfaction and costs were consistently and favourably affected by HiTH treatment. Given evidence suggesting that HiTH services which recruit patients directly from the ED contribute to cost-savings, greater patient satisfaction and safety and efficacy outcomes that are at least equivalent to those associated with hospital-based care, the expansion of such programmes might therefore be considered a priority for policy makers.

  1. Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

    Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

  2. Department of Energy – Office of Science Pacific Northwest Site Office Environmental Monitoring Plan for the DOE-SC PNNL Site

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, Sandra F.; Meier, Kirsten M.; Barnett, J. Matthew; Bisping, Lynn E.; Poston, Ted M.; Rhoads, Kathleen

    2011-12-21

    The Pacific Northwest Site Office (PNSO) manages the contract for operations at the U.S. Depart¬ment of Energy Office of Science (DOE-SC) Pacific Northwest National Laboratory (PNNL) Site in Richland, Washington. Radiological operations at the DOE-SC PNNL Site expanded in 2010 with the completion of facilities at the Physical Sciences Facility. As a result of the expanded radiological work at the site, the Washington State Department of Health (WDOH) has required that offsite environmental surveillance be conducted as part of the PNNL Site Radioactive Air Emissions License. The environ¬mental monitoring and surveillance requirements of various orders, regulations, and guidance documents consider emission levels and subsequent risk of negative human and environmental impacts. This Environmental Monitoring Plan (EMP) describes air surveillance activities at the DOE-SC PNNL Site. The determination of offsite environmental surveillance needs evolved out of a Data Quality Objectives process (Barnett et al. 2010) and Implementation Plan (Snyder et al. 2010). The entire EMP is a compilation of several documents, which include the Main Document (this text), Attachment 1: Sampling and Analysis Plan, Attachment 2: Data Management Plan, and Attachment 3: Dose Assessment Guidance.

  3. CORRELATION BETWEEN SERVICE QUALITY AND PATIENT LOYALTY AT OUTPATIENT DEPARTMENT IN SPECIALITY EYE HOSPITAL OF SOUTH SUMATERA PROVINCE

    Directory of Open Access Journals (Sweden)

    Adelina Fitri

    2016-03-01

    Full Text Available Background: The increasing number of hospitals in Indonesia, which is managed by the government and private demand to provide giving the level of care, professionalism and the maximum of competence to reflect the best quality of service. Quality gives special encouragement for company to understand customer expectations which in turn can increase customer satisfaction and create customer loyalty. The objective of the study is analyse correlation between service quality and patient loyalty Method: This study used a survey of analytical methods, with the cross-sectional approach. The samples in this study were patients who were treated in outpatient installation specialty eye hospital South Sumatera Province with total 102 people based on inclusion criteria. The Sampling was taken by proportions random sampling. The data analysis was performed in univariate and bivariate statistical fisher-exact test. The data were presented in p-value, prevalence ratio(PR and 95% confidence intervals (CI. Results: Generally 46.2% respondent who are loyal aged 41-64 years, 32.3% graduate from primary school and 80.6% have distance >5 KM from hospital. From the bivariate analyzes relating to patients loyalty in specialty eye hospital South Sumatera Province are access to services (95% CI 4.3 PR (1.293-14.300 and officer interaction with patients (95% CI 6.786 PR (2.140-21.515, whereas safety (95% CI PR 1.248(0.281-5.540, convenience (95% CI PR 4.136 (1.201-14.246 and waiting times (95% CI PR 1.951 (0.259-14.717 does not have a correlation with patient loyalty. Conclusion: The loyalty of patients in Specialty Eyes Hospital South Sumatera Province have been affected by access to services and officer interaction with the patient.

  4. Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs.

    Science.gov (United States)

    Cameron, Christian Blake; Nair, Vinay; Varma, Manu; Adams, Martha; Jhaveri, Kenar D; Sparks, Matthew A

    2016-06-23

    Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a "favorable group" of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an "unfavorable group" of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value in faculty blogging effort.

  5. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2007-01-01

    led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...... not adequately support complex clinical work. While the CPOMR can be used for patients with few, simple problems who are admitted for only a short time, the CPOMR is not useful for patients with a complex set of problems or for patients admitted for longer periods of time. This is in accordance with criticism...

  6. Patients' experience of care and treatment outcome at the Department of Clinical Oral Physiology, Dental Public Service in Stockholm.

    Science.gov (United States)

    Christidis, Nikolaos; Smedberg, Erica; Hägglund, Helene; Hedenberg-Magnusson, Britt

    2010-01-01

    Chronic pain conditions in the craniofacial region are common in the adult population with a prevalence of approximately 10%. They are included in the generic term temporomandibular disorders (TMD) and accompanied by restricted mouth opening capacity, chewing difficulties, headache and neck pain. These pain conditions cause psychological suffering, impaired social relations, and recurrent sick leave, subsequently leading to frequent use of health care, medication and consequently to a decreased quality of life. Approximately 25% of children have signs of TMD and girls are shown to be more affected than boys. These signs increase with age and in the adult population the prevalence is approximately 38-40%, also here with a higher frequency in women than in men. This study comprised 198 patients who answered an anonymous questionnaire after termination of their treatment. The study aimed to investigate the activity at the department of clinical oral physiology at the Folktandvården Eastman Institute in Stockholm, Sweden, regarding the patients and their cause of care-seeking, as well as the patients' subjective experiences of the specialist care and the treatment outcome. As a secondary aim the purpose was to investigate how/if the clinicians at the department of clinical oral physiology reached their intention of being "curious", "considerate" and "accessible". The results from this study show that the majority of the patients (57.1%) were referred from the dental public service in Stockholm. 71.7% of the patients were young women between the ages of 11 and 20. The main causes of care-seeking were temporomandibular joint clickings, followed by limited jaw movement, headache and orofacial pain. Further, an immense majority of the patients (89.9%) were very satisfied with their treatment as well as the treatment outcome. These results indicate that the clinicians at the department reached their intention of being "curious", "considerate"and "accessible", which also

  7. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments.

    Science.gov (United States)

    Zeller, Scott; Calma, Nicole; Stone, Ashley

    2014-02-01

    Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus

  8. Pacific Northwest Laboratory annual report for 1989 to the DOE (Department of Energy) Office of Energy Research - Part 4: Physical Sciences

    Energy Technology Data Exchange (ETDEWEB)

    Toburen, L.H.; Stults, B.R.; Mahaffey, J.A.

    1990-04-01

    This 1989 Annual Report from Pacific Northwest Laboratory (PNL) to the US Department of Energy (DOE) describes research in environment, safety, and health conducted during fiscal year 1989. The report again consists of five parts, each in a separate volume. This volume contains 20 papers. Part 4 of the Pacific Northwest Laboratory Annual Report of 1989 to the DOE Office of Energy Research includes those programs funded under the title Physical and Technological Research.'' The Field Task Program Studies reported in this document are grouped by budget category and each Field Task proposal/agreement is introduced by an abstract that describes the projects reported in that section. These reports only briefly indicate progress made during 1989. 74 refs., 29 figs., 6 tabs.

  9. Department of Energy (DOE) system for the transportation of strategic quantities of special nuclear material (SQ SNM)

    International Nuclear Information System (INIS)

    Dickason, D.P.

    1978-01-01

    Since 1947 DOE and its predecessor agencies, AEC and ERDA, have moved nuclear materials by a variety of commercial and government transportation modes. In the late 1960's world-wide terrorism and other dissident activities prompted the then-AEC to review its procedures for safeguarding SNM. These reviews resulted in immediate and long-range programs for improvement of overall safeguards. Domestic transportation of completed nuclear weapons and SNM used in the weapons program was selected for special consideration. In the early 1970's AEC started the development of a Safe Secure Trailer (SST) to transport nuclear weapons and nuclear components and the development and installation of a high frequency (HF) communications system to assure continuous radio contact between selected highway and rail shipments and Headquarters, Albuquerque Operations (ALO). Late 1974 AEC directed ALO to develop a transportation system to extend weapons-level protection to all AEC SQ SNM shipments and to consolidate, manage, and operate this system. As of September 1976 all SQ SNM was being transported in the Safe Secure DOE (then ERDA) transportation safeguards system, composed of the following principal elements: (1) Transport equipment consisting of Safe Secure Trailers and specially modified towing tractors; Safe Secure Railcars and specially modified escort coaches; and specially designed highway escort vehicles. (2) An automated high-frequency digital radio system that enables continuous communications between the transporting equipment and central control. (3) A courier force that operates all transport equipment (except aircraft and rail power units) and mobile communications equipment; provides armed protection for shipments; and assures proper safety en route. (4) A central Headquarters staff that plans, executes, and controls shipments and directs, manages, and operates the system

  10. The effects of workforce-shaping tools on retirement: the case of the Department of Defense civil service.

    Science.gov (United States)

    Asch, Beth J; Haider, Steven J; Zissimopoulos, Julie M

    2009-11-01

    Apriority area for the public health workforce research agenda is the study of the public health labor market and how wages and benefits affect workforce outcomes, including recruiting, retention, and retirement. This study provides an example of such a study for the Department of Defense civil service workforce. We analyze the financial incentives to retire that are specifically embedded in the retirement system and how different workforce-shaping policies would affect these incentives. The study then uses a recently estimated model of the effects of financial incentives on retirement behavior among defense civilians to predict how these workforce-shaping tools would affect retirement behavior. We find that buyouts, retention incentives, and other workforce-shaping tools have a sizable effect on predicted retirement behavior and therefore, could be useful policies to help manage retirement outflows.

  11. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

    Science.gov (United States)

    Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

    2009-04-01

    The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

  12. IT services in a completely digitized radiological department: value and benefit of an in-house departmental IT group

    International Nuclear Information System (INIS)

    Treitl, M.; Wirth, S.; Lucke, A.; Rieger, J.; Pfeifer, K.J.; Reiser, M.; Villain, S.

    2005-01-01

    To analyze the benefit of a departmental IT group in comparison to support by hospital IT groups or system manufacturers in a completely digitized radiological department. The departmental IT group comprises a fulltime IT specialist, two student assistants and four clinical employees participating 1 day/week. For 18 months IT problems were quantified and specified according to urgency, responsibility and affected system by use of an intranet-based reporting system. For each IT service provider the performance and duration of problem solution was evaluated. In 18 months 3,234 IT problems emerged. 88.7% were solved by the departmental IT group. In 474 cases (14.7%) a solution within 2 h was required. The departmental IT group solved 35.8% within 30 min, system manufacturers needed 18 h 38 min in mean. The departmental IT group solved 90.2% of the problems within a time limit. System manufacturers met the limit in 60.1% with a mean duration of 7 days 21 h. In 6.7% of the cases, support by system manufacturers was indispensable. A considerable proportion of IT problems in completely digitized radiological departments can be solved by a departmental IT group, providing a fast and cost-efficient first-level IT support with effective prevention of major breaks in the workflow. In a small number of cases support by system manufacturers remains necessary. (orig.)

  13. COGME 1995 Physician Workforce Funding Recommendations for Department of Health and Human Services' Programs. Council on Graduate Medical Education, 7th Report.

    Science.gov (United States)

    Council on Graduate Medical Education.

    This report presents specific recommendations to the Department of Health and Human Services and Congress from the Council on Graduate Medical Education that address Medicare's direct and indirect graduate medical education (GME) payments and the monies allocated by the Public Health Service that is targeted toward physician education and primary…

  14. Child, Caregiver, and Family Characteristics Associated with Emergency Department Use by Children Who Remain at Home after a Child Protective Services Investigation

    Science.gov (United States)

    Schneiderman, Janet U.; Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

    2012-01-01

    Objectives: To examine emergency department (ED) use among children involved with child protective services (CPS) in the US but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method: We analyzed data on 4,001 children in the National Survey of Child and…

  15. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients’ evaluations of the effectiveness of treatments

    Science.gov (United States)

    Aazh, Hashir; Moore, Brian C. J.; Lammaing, Karen; Cropley, Mark

    2016-01-01

    Abstract Objective: To assess patients’ judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Design: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). Study sample: The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. Results : The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. Conclusion: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT. PMID:27195947

  16. The Use of Telemental Health to Meet the Mental Health Needs of Women Using Department of Veterans Affairs Services.

    Science.gov (United States)

    Moreau, Jessica L; Cordasco, Kristina M; Young, Alexander S; Oishi, Sabine M; Rose, Danielle E; Canelo, Ismelda; Yano, Elizabeth M; Haskell, Sally G; Hamilton, Alison B

    Women veterans are a growing segment of Department of Veterans Affairs (VA) users with distinct mental health needs and well-documented barriers to care. Telemental health holds much promise for reducing barriers to mental health care. We assessed VA stakeholders' perceptions of telemental health's appropriateness and potential to address the mental health needs of women veteran VA users. We conducted semistructured qualitative interviews with 40 key leadership and clinical stakeholders at VA medical centers and associated outpatient clinics. Transcripts were summarized in a template of key domains developed based on the interview guide, and coded for topics relevant to women's mental health needs and telehealth services. Telemental health was perceived to increase access to mental health care, including same-gender care and access to providers with specialized training, especially for rural women and those with other limiting circumstances. Respondents saw women veterans as being particularly poised to benefit from telemental health, owing to responsibilities associated with childcare, spousal care, and elder caregiving. Interviewees expressed enthusiasm for telemental health's potential and were eager to expand services, including women-only mental health groups. Implementation challenges were also noted. Overall, our stakeholders saw telemental health as a good fit for helping to address the perceived needs of women veterans, especially in addressing the geographical barriers experienced by rural women and those with a limited ability to travel. These findings can help to inform gender-tailored expansion of telemental health within and outside of the VA. Published by Elsevier Inc.

  17. Social workers and unemployment: Factors associated with using employment-promoting practices in Israeli Municipal Departments of Social Services.

    Science.gov (United States)

    Levin, Lia; Sefati, Noga

    2018-04-23

    Unemployment is a harsh social phenomenon with far reaching negative implications. Unemployed individuals often seek assistance from social workers working in Municipal Departments of Social Services around the world. However, little to no research exists on the factors involved in social workers' choice to engage in employment-promoting practices (EPP). The current study aimed to tackle this gap of knowledge, providing initial conclusions about the relationship between social workers' attitudes towards unemployment, their knowledge regarding EPP, the extent to which they perceive their organisations as endorsing EPP and their actual implementation. The main research question dealt with the extent to which each of the examined factors, in itself or in combination with others, would be the best predictor of social workers' utilisation of EPP. The study sample consisted of 163 social workers in Israel with varied experience in working with the unemployed, all working in public sector social services. Structural equation modelling performed on the attained data revealed that knowledge, skills and perceived organisational endorsement of EPP were positively associated with implementation of EPP. Contrary to the hypothesised, attitudes towards unemployment were not associated with the implementation of such practices. At the same time, professional training and seniority were associated with EPP only through the mediation of perceived organisational endorsement. Ultimately, perceived organisational endorsement of EPP emerged as the most influential factor involved in social workers' decision to carry out EPP with their service-users. Consequences of these findings for social work education, supervision, research and policy making are discussed, referring to the local Israeli context as well as its possible international inferences. © 2018 John Wiley & Sons Ltd.

  18. Clinical Profile and Sex Differences in Brazilian Children and Adolescents Receiving Psychiatric Services in the Emergency Department.

    Science.gov (United States)

    Tonezer, Jordana; Muller, Thomaz; Rocha, Gibsi Possapp; Recondo, Rogéria; Nogueira, Eduardo Lopes; Spanemberg, Lucas

    2015-06-27

    We present a survey of sex differences and socio-demographic and clinical variables in children and adolescents receiving a psychiatric consultation service in an emergency department (ED). This observational, retrospective, and cross-sectional study included all records of patients (age, services in an ED in a 4-year period (January 2010 to December 2013). Two hundred fifty-nine records of children and adolescents were located. The mean age of the participants was 14.19 years, and most subjects were female (59.5%) and had private health insurance (83.7%). Most participants (87.4%) were accompanied by their parents. The main complaints were suicide attempts (21.8%) and psychomotor agitation/aggressiveness (21.8%). Unipolar depression (37.8%) and adjustment, reactive, and anxiety disorders (13.7%) were the most prevalent diagnoses. Most patients received an indication of psychiatric hospitalization (51.7%). Females had more suicide attempts than males (28.3% vs 12.4%) and less psychomotor agitation/aggressiveness than males (15.5% vs 31.4%). Females also exhibited more unipolar depression (47.6% vs 23.5%), fewer psychotic disorders (4.2% vs 16.3%), and substance use/misuse (1.4% vs 13.3%) than males. Males needed more psychiatric medication during evaluation (37.9% vs 19.2%). This survey of the profile of pediatric patients evaluated by a psychiatric service in an ED in Brazil was the first of its kind. The large percentage of patients referred for hospitalization highlights the importance of specialized psychiatry care for this age group in this facility, which is a common entry point for mental health care.

  19. To share or not to share: thats the question! When does sharing of HR services maximize perceived HR service value?

    NARCIS (Netherlands)

    Meijerink, Jeroen Gerard; Hofman, Erwin; Hemels, Hinse

    2011-01-01

    Nowadays, organizations can rely on a variety of delivery channels for offering HR services to employees, such as HR shared service centres, embedded HR professionals or electronic HRM. However, when should organizations opt for one of the many HR delivery channels that are at their disposal to

  20. Does decreased access to emergency departments affect patient outcomes? Analysis of acute myocardial infarction population 1996-2005.

    Science.gov (United States)

    Shen, Yu-Chu; Hsia, Renee Y

    2012-02-01

    We analyze whether decreased emergency department (ED) access results in adverse patient outcomes or changes in the patient health profile for patients with acute myocardial infarction (AMI). We merge Medicare claims, American Hospital Association annual surveys, Medicare hospital cost reports, and location information for 1995-2005. We define four ED access change categories and estimate a ZIP Code fixed-effects regression models on the following AMI outcomes: mortality rates, age, and probability of percutaneous transluminal coronary angioplasty (PTCA) on day of admission. We find a small increase in 30-day to 1-year mortality rates among patients in communities that experience a 30-minute increases, we find a substantial increase in long-term mortality rates, a shift to younger ages (suggesting that older patients die en route), and a higher probability of immediate PTCA. Most of the adverse effects disappear after the transition years. Deterioration in geographic access to ED affects a small segment of the population, and most adverse effects are transitory. Policy planners can minimize the adverse effects by providing assistance to ensure adequate capacity of remaining EDs, and facilitating the realignment of health care resources during the critical transition periods. © Health Research and Educational Trust.

  1. Detecting child abuse based on parental characteristics: does the Hague Protocol cause parents to avoid the emergency department?

    Science.gov (United States)

    Diderich, Hester M; Fekkes, Minne; Dechesne, Mark; Buitendijk, Simone E; Oudesluys-Murphy, Anne Marie

    2015-04-01

    The Hague Protocol is used by professionals at the adult Emergency Departments (ED) in The Netherlands to detect child abuse based on three parental characteristics: (1) domestic violence, (2) substance abuse or (3) suicide attempt or self-harm. After detection, a referral is made to the Reporting Center for Child Abuse and Neglect (RCCAN). This study investigates whether implementing this Protocol will lead parents to avoid medical care. We compared the number of patients (for whom the Protocol applied) who attended the ED prior to implementation with those attending after implementation. We conducted telephone interviews (n = 14) with parents whose children were referred to the RCCAN to investigate their experience with the procedure. We found no decline in the number of patients, included in the Protocol, visiting the ED during the 4 year implementation period (2008-2011). Most parents (n = 10 of the 14 interviewed) were positive and stated that they would, if necessary, re-attend the ED with the same complaints in the future. ED nurses and doctors referring children based on parental characteristics do not have to fear losing these families as patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. 50 CFR 18.125 - What criteria does the Service use to evaluate Letter of Authorization requests?

    Science.gov (United States)

    2010-10-01

    ... AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION, TRANSPORTATION, SALE... and opportunity for public comment. (c) The requirement for notice and public comment in paragraph (b... risk to the well-being of the species or stock of polar bear or Pacific walrus. ...

  3. 50 CFR 18.115 - What criteria does the Service use to evaluate Letter of Authorization requests?

    Science.gov (United States)

    2010-10-01

    ... AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION, TRANSPORTATION, SALE... after notice and opportunity for public comment. (c) The requirement for notice and public comment in... significant risk to the well-being of species or stocks of walruses or polar bears. ...

  4. Integration of U.S. Department of Energy (DOE) contractor installations for the purpose of optimizing treatment, storage, and disposal of low-level radioactive waste (LLW)

    International Nuclear Information System (INIS)

    Lucas, M.; Gnoose, J.; Coony, M.; Martin, E.; Piscitella, R.

    1998-02-01

    The US Department of Energy (DOE) manages a multibillion dollar environmental management (EM) program. In June 1996, the Assistant Secretary of Energy for EM issued a memorandum with guidance and a vision for a ten year planning process for the EM Program. The purpose of this process, which became known as the Accelerated Cleanup: Focus on 2006, is to make step changes within the DOE complex regarding the approach for making meaningful environmental cleanup progress. To augment the process, Assistant Secretary requested the site contractors to engage in an effort to identify and evaluate integration alternatives for EM waste stream treatment, storage, and disposal (TSD) that would parallel the 2006 Plan. In October 1996, ten DOE contractor installations began the task of identifying alternative opportunities for low level radioactive waste (LLW). Cost effective, efficient solutions were necessary to meet all requirements associated with storing, characterizing, treating, packaging, transporting, and disposing of LLW while protecting the workers' health and safety, and minimizing impacts to the environment. To develop these solutions, a systems engineering approach was used to establish the baseline requirements, to develop alternatives, and to evaluate the alternatives. Key assumptions were that unique disposal capabilities exist within the DOE that must be maintained; private sector disposal capability for some LLW may not continue to exist into the foreseeable future; and decisions made by the LLW Team must be made on a system or complex wide basis to fully realize the potential cost and schedule benefits. This integration effort promoted more accurate waste volume estimates and forecasts; enhanced recognition of existing treatment, storage, and disposal capabilities and capacities; and improved identification of cost savings across the complex

  5. Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

    Science.gov (United States)

    Thatte, Nandita; Choi, Yoonjoung

    2015-04-01

    Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be

  6. The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

    Science.gov (United States)

    Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

    2015-01-01

    To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an

  7. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

    Science.gov (United States)

    Barlow, S E; Dietz, W H

    1998-09-01

    The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents. The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations. The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families

  8. Regional estimates of ecological services derived from U.S. Department of Agriculture conservation programs in the Mississippi Alluvial Valley

    Science.gov (United States)

    Faulkner, Stephen P.; Baldwin, Michael J.; Barrow, Wylie C.; Waddle, Hardin; Keeland, Bobby D.; Walls, Susan C.; James, Dale; Moorman, Tom

    2010-01-01

    The Mississippi Alluvial Valley (MAV) is the Nation?s largest floodplain and this once predominantly forested ecosystem provided significant habitat for a diverse flora and fauna, sequestered carbon in trees and soil, and stored floodwater, sediments, and nutrients within the floodplain. This landscape has been substantially altered by the conversion of nearly 75% of the riparian forests, predominantly to agricultural cropland, with significant loss and degradation of important ecosystem services. Large-scale efforts have been employed to restore the forest and wetland resources and the U.S. Department of Agriculture (USDA) Wetlands Reserve Program (WRP) and Conservation Reserve Program (CRP) represent some of the most extensive restoration programs in the MAV. The objective of the WRP is to restore and protect the functions and values of wetlands in agricultural landscapes with an emphasis on habitat for migratory birds and wetland-dependent wildlife, protection and improvement of water quality, flood attenuation, ground water recharge, protection of native flora and fauna, and educational and scientific scholarship.

  9. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

    Science.gov (United States)

    Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

  10. Realizing what's essential: a case study on integrating electronic journal management into a print-centric technical services department.

    Science.gov (United States)

    Dollar, Daniel M; Gallagher, John; Glover, Janis; Marone, Regina Kenny; Crooker, Cynthia

    2007-04-01

    To support migration from print to electronic resources, the Cushing/Whitney Medical Library at Yale University reorganized its Technical Services Department to focus on managing electronic resources. The library hired consultants to help plan the changes and to present recommendations for integrating electronic resource management into every position. The library task force decided to focus initial efforts on the periodical collection. To free staff time to devote to electronic journals, most of the print subscriptions were switched to online only and new workflows were developed for e-journals. Staff learned new responsibilities such as activating e-journals, maintaining accurate holdings information in the online public access catalog and e-journals database ("electronic shelf reading"), updating the link resolver knowledgebase, and troubleshooting. All of the serials team members now spend significant amounts of time managing e-journals. The serials staff now spends its time managing the materials most important to the library's clientele (e-journals and databases). The team's proactive approach to maintenance work and rapid response to reported problems should improve patrons' experiences using e-journals. The library is taking advantage of new technologies such as an electronic resource management system, and library workflows and procedures will continue to evolve as technology changes.

  11. Nighttime assaults: using a national emergency department monitoring system to predict occurrence, target prevention and plan services

    Directory of Open Access Journals (Sweden)

    Bellis Mark A

    2012-09-01

    Full Text Available Abstract Background Emergency department (ED data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults. Methods A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172 over a three-year period (31st March 2008 to 30th March 2011 to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting. Results Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P 2 = 0.918; P  Conclusions To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.

  12. Does a hostel's managing agency determine the access to psychiatric services of its residents?

    Science.gov (United States)

    Lucas, B; Audini, B; Chisholm, D; Knapp, M; Lelliott, P

    1998-10-01

    This study examines the effect of managing agency (local authority, private or voluntary) on the use of other health and social care services by residents in mental health hostels and group homes with different levels of staffing in England and Wales. The sample comprised 1323 residents in 275 facilities in eight districts. The measures of service use were number of days in hospital and number of other service contacts. There were highly significant differences between facilities with similar levels of staffing managed by different agencies. Residents in the voluntary sector used fewer community services overall; residents in low-staffed local authority facilities used more services than those in similar facilities managed by other agencies. These differences were not easily explained by differences in the social or clinical characteristics of residents. This suggests that there may be organisational factors, e.g. hostel staff, knowledge of services, which influence access to and use of community services.

  13. Point of care technology or standard laboratory service in an emergency department: is there a difference in time to action? A randomised trial

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Borch, Anders; Brandslund, Ivan

    2011-01-01

    services. However, the question is if the time to clinical action is also reduced if a decisive laboratory answer is available during the first contact between the patient and doctor. The present study addresses this question: Does a laboratory answer, provided by POCT to the doctor who first attends...

  14. How does innovation work within the developmental network state? New data on public-private agreements in a U.S. Department of Energy laboratory

    Directory of Open Access Journals (Sweden)

    Matthew R. Keller

    Full Text Available Abstract The value of the Department of Energy (DOE-owned national laboratories to the U.S. national innovation system has long been a subject of debate. Advocates have drawn attention to the central role of the labs in the development of technologies including advanced batteries, solar energy breakthroughs, imaging technologies, and various IT endeavors, among others. Critics have recurrently suggested that the labs’ innovative capacities have been undermined by a lack of engagement with commercial firms and managerial tactics. Perhaps surprisingly, what has often been missing from the debate is a thorough review of data on the public-private partnerships in which the labs engage with private firms. This paper draws on heretofore non-public data on one type of contractual arrangement - Work-For-Others (WFO agreements - in which the labs perform contract work for private firms. We review 10 years of WFO data for a single DOE laboratory. Our analysis provides an initial picture of the surprisingly diverse geography and array of firms that employed the labs as contract R&D providers, as well as of key characteristics of these agreements. Although our data capture only a single laboratory’s agreements, the findings reinforce the importance of looking at the complex, overlapping network of programs within the U.S. federal system that support private sector innovation.

  15. The Problem of Women in the Department:  Sex and Gender Discrimination in the 1960s United States Foreign Diplomatic Service

    OpenAIRE

    McKenzie, Beatrice Loftus

    2015-01-01

    Alison Palmer, a United States Foreign Service Officer from 1959 to 1981, brought a gender equity complaint against the U.S. State Department in the late 1960s and then led a class action lawsuit by female officers that lasted until 2010.  Examining the records of Palmer’s grievances against the Department of State reveals linkages between gender, sex, and race in the U.S. Foreign Service.  U.S. Ambassadors to three African nations justified their rejection of her from their staffs by stating...

  16. 2011 Oregon Department of Geology and Mineral Industries (DOGAMI) Lidar: US Forest Service (FS) Newberry Study Area

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Oregon Department of Geology & Mineral Industries (DOGAMI) contracted with Watershed Sciences, Inc. to collect high resolution topographic LiDAR data for...

  17. 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

  18. 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

  19. How Does Service Quality Lead to Loyalty in the Hotel Industry in Iran

    OpenAIRE

    Alireza Tafreshi Motlagh; Ehsan Sadeh; Sina Sadeh; Hamidreza Jafari; Jafar Azizi Morovat; Amir Enaamzadeh

    2013-01-01

    This is a fact that loyal customers not only use the services of the hotel frequently but also suggest the services to other potential clients. It is obvious that loyal customers can guarantee the life of the business in the hotel industry. The theoretical background of the loyalty in the hotel industry indicates that loyalty is a consequence of hotel service quality. The main purpose of this study is to investigate how the service quality ends in loyalty in hotel industry in Iran. Review on ...

  20. The career cost: does it pay for a military pilot to leave the service for the airlines?

    OpenAIRE

    Hodges, Jeffrey A.

    2015-01-01

    Approved for public release; distribution is unlimited The military is experiencing a pilot retention problem that is getting worse. The government spends millions of dollars training pilots in the most advanced aircraft in the world, only to watch them leave for the commercial airline industry at the first opportunity. As airline pilot hiring continues to improve, military pilots will depart the services for the assumed increase in financial compensation of the airlines. This thesis compa...

  1. Application of rapid read-out cleaning indicators for improved process control in hospital sterile services departments.

    Science.gov (United States)

    Nugent, P G; Modi, T; McLeod, N; Bock, L J; Smith, C; Poolman, T M; Warburton, R; Meighan, P; Wells, P; Sutton, J M

    2013-05-01

    Heightened awareness of the importance of cleaning has led to an emphasis on automated systems for the decontamination of re-usable medical devices. The authors have previously described an enzymatic indicator system, based on thermostable adenylate kinases (tAK), for quantitative monitoring of automated cleaning processes within hospital sterile services departments (SSDs). To evaluate tAK indicators for routine process monitoring across a range of SSDs with different cleaning chemistries and different automated washer disinfectors (AWDs). tAK indicator devices and alternative industry test indicators were included in five independent cleaning cycles in each of eight different AWDs. Residual tAK post wash was determined by a coupled luciferase assay using a modified hygiene monitoring system. In all cases, with the exception of a single test, the alternative indicators showed that cleaning had been adequate. They were not able to discriminate between the performance of different processes. In contrast, the tAK indicators were able to resolve differences in the performance of processes across the different SSDs. Where the tAK indicators identified cleaning to the limits of detection of the assay, this demonstrated a log10 enzyme removal factor of >5.69. The results suggest that tAK indicators are suitable for providing improved process control for automated cleaning processes, being able to distinguish between wash performance in different hospital settings and between individual process runs. This technology is believed to be a useful addition to routine AWD performance qualification when used as a daily or weekly test. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Does neuroticism explain variations in care service use for mental health problems in the general population?

    NARCIS (Netherlands)

    ten Have, M; Oldehinkel, A; Vollebergh, W; Ormel, J

    Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder;

  3. Does Service-Learning Increase Student Learning?: A Meta-Analysis

    Science.gov (United States)

    Warren, Jami L.

    2012-01-01

    Research studies reflect mixed results on whether or not service-learning increases student learning outcomes. The current study seeks to reconcile these findings by extending a meta-analysis conducted by Novak, Markey, and Allen (2007) in which these authors examined service-learning and student learning outcomes. In the current study, 11…

  4. Does ownership affect the variability of the production process? Evidence from international courier services

    NARCIS (Netherlands)

    Hsieh, C.; Lazzarini, S.G.; Nickerson, J.A.; Laurini, M.

    2010-01-01

    A firm often must ensure that products or services it produces match customer expectations. We define variability as any deviation in a production process yielding products or services whose attributes differ from the firm's stated target specifications. Firms pursuing products marked by low

  5. Frontline employees' intercultural competence: Does it impact customers' evaluations of intercultural service encounters?

    NARCIS (Netherlands)

    Hoefnagels, A.H.J.M.; Bloemer, J.M.M.; Pluymaekers, M.

    2014-01-01

    Globalization has led to an exponential growth of intercultural service encounters. In view of the importance of customer-orientation in services, we investigate the effect of the frontline employee’s intercultural competence on customer’s affective and cognitive evaluations of intercultural

  6. The distribution of maternity services across rural and remote Australia: does it reflect population need?

    Science.gov (United States)

    Rolfe, Margaret I; Donoghue, Deborah Anne; Longman, Jo M; Pilcher, Jennifer; Kildea, Sue; Kruske, Sue; Kornelsen, Jude; Grzybowski, Stefan; Barclay, Lesley; Morgan, Geoffrey Gerard

    2017-02-23

    Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need. Health facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility. Catchment exclusions: metropolitan areas, populations above 25,000 or below 1,000, and a non-birthing facility within the catchment of one with birthing. Catchments were attributed with population-based characteristics representing need: population size, births, demographic factors, socio-economic status, and a proxy for isolation - the time to the nearest facility providing a caesarean section (C-section). Facilities were dichotomised by service level - those providing birthing services (birthing) or not (no birthing). Birthing services were then divided by C-section provision (C-section vs no C-section birthing). Analysis used two-stage univariable and multivariable logistic regression. There were 259 health facilities identified after exclusions. Comparing services with birthing to no birthing, a population is more likely to have a birthing service if they have more births, (adjusted Odds Ratio (aOR): 1.50 for every 10 births, 95% Confidence Interval (CI) [1.33-1.69]), and a service offering C-sections 1 to 2 h drive away (aOR: 28.7, 95% CI [5.59-148]). Comparing the birthing services categorised by C-section vs no C-section, the likelihood of a facility having a C-section was again positively associated with increasing catchment births and with travel time to another service offering C-sections. Both models demonstrated significant associations with jurisdiction but not socio

  7. Hospital customer service in a changing healthcare world: does it matter?

    Science.gov (United States)

    Howard, J

    1999-01-01

    The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of the patient population. Employers and health plans such as HMOs are demanding better service and higher quality care, and hospitals are trying to tackle reimbursement cutbacks, streamline services, and serve a diverse population. Hospitals have begun to realize that to overcome these obstacles and meet the needs of the health care plans and consumers, they must focus on the demands of the customer. Customer service initiatives increase patient satisfaction and loyalty and overall hospital quality, and many hospitals have found that consumer demands can be met through initiating and maintaining a customer service program. This article describes how the administrator can create, implement, and manage customer service initiatives within the hospital.

  8. Putting your human resource department to work for you.

    Science.gov (United States)

    McConnell, C R

    1991-06-01

    As a staff function, human resources is organized as a service activity. Service activities render no patient care; they do not advance the work of the organization. However, they support the performance of the organization's work and in a practical sense become necessary. For example, if a pure service, such as building maintenance, did not exist, the facility's physical plant would gradually self-destruct. Similarly, without human resources to see to the maintenance of the work force, the overall suitability and capability of that work force will steadily erode. Recognize human resources for what it is--an essential service function required to help the organization run as efficiently as possible. Learn what the HR department does, and especially learn why the department does what it does. Provide input to the human resource department. Forge a continuing working relationship with the HR department, making it clear that you expect service from this essential service department. Challenge the HR department to do more, to do better, and to continually improve service--and put the human resource department to work for you and your employees.

  9. An Empirical Study of the Management and Oversight of Medical Services Acquisition within the Department of Defense

    Science.gov (United States)

    2009-12-01

    Services Q517 Pharmacology Services Q518 Physical Medicine & Rehabilitation Services Q519 Psychiatry Services Q520 Podiatry Services Q521...755,026 3,571,700 4,744,901 11,550,581 20,770,527 Q520 Podiatry Services 0 0 86,520 130,495 156,928 373,943 Q521 Pulmonary Services 0 0 131,666...1,289,888 1,220,701 2,254,564 3,001,237 8,599,189 Q519 Psychiatry Services 575,836 671,572 1,469,172 6,449,197 6,437,165 15,602,942 Q520 Podiatry

  10. Arthropod genomics research in the United States Department of Agriculture-Agricultural Research Service: Applications of RNA interference and CRISPR gene editing technologies in pest control

    Science.gov (United States)

    The Agricultural Research Service (ARS) is the intramural research agency of the United States Department of Agriculture (USDA) which addresses basic scientific questions and develops applied solutions to a range of agricultural problems, and in doing so protects national food security and supports ...

  11. The influence of service quality on satisfaction: Does gender really matter?

    Directory of Open Access Journals (Sweden)

    See Ying Kwok

    2016-03-01

    Full Text Available Purpose: This study examining the influence of service quality on satisfaction and to investigate whether satisfaction varies between male and female in response to the perceived service quality in the Malaysian tourism context. Design/methodology/approach: The population of the study is tourists travelling to Malaysia. A sample was drawn using a multi-stage sampling method and 301 completed questionnaires were analysed with structural equation modelling. Findings: The findings show that service quality is positively associated to satisfaction and the relationship is found to be moderated by gender. Additionally, the findings also show that the service quality perceived by women is found to influence the satisfaction level greater than that of men’s in the tourism context. Research limitations/implications: Other demographic variables, such age, culture, education level, and income must also be considered in future study and when developing marketing strategies. Practical implications: The gender differences is significant moderator between service quality and satisfaction in tourism context. Tourism service providers who target on women’s market are recommended to allocate more resources and attention on the important aspects namely, reliability, considerability and empathy and tangiblility aspects in order to increase the satisfaction level among female tourists. Originality/value: The findings validates the findings of previous studies by examining the moderator role of gender in the relationship between service quality and satisfaction in Malaysian context.

  12. AFCOMS (Air Force Commissary Service): Does this SOA Need an Executive Development Program?

    Science.gov (United States)

    1985-03-01

    ll)NALHuKAU U STADARS 19,l liii I0 󈧽 AAfR WAR COLLG RESEARCH REPORT LZ? e lNo. AU-AWC-35-011 - N4 AFCOMS: DOES THIS SQA NEED AN EXECUTIVE cm...high incidence of safety and physical security violations. Serious deficiencies existed in the financial management area. Accounting errors were not

  13. Does empowering resident families or nursing home employees in decision making improve service quality?

    Science.gov (United States)

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

  14. Does local government staff perceive digital communication with citizens as improved service?

    DEFF Research Database (Denmark)

    Berger, Jesper Bull; Hertzum, Morten; Schreiber, Trine

    2016-01-01

    Digital communication between government and citizens is pivotal to e-government. The Danish e-government initiative Digital Post aims to digitize all communications between government and citizens. We surveyed local government staff about how Digital Post affects the service delivered to citizens....... As much as 82% of the 448 respondents considered digital communication with citizens using Digital Post a good idea, yet 47% reported concrete incidents in which they perceived a decrease in service with Digital Post. This result shows the importance of distinguishing between the overall service...... relationship and the concrete incidents of which the service consists. We discuss interactions between the relationship level and the incident level of Digital Post on the basis of a content analysis of the respondents' incident descriptions....

  15. How Western Does Business: An Explanation of Western's Products and Services

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-10-01

    The mission of the Western Area Power Administration is to market and deliver reliable, renewable, cost-based hydroelectric power and related services. This guide provides an overview of Western’s history and how Western carries out that mission and provides electrical, transmission and ancillary services. It also discusses how we develop plans for marketing our most valuable resources—long-term firm capacity and energy.

  16. What does dependency on community mental health services mean? A conceptual review with a systematic search.

    Science.gov (United States)

    Bonavigo, Tommaso; Sandhu, Sima; Pascolo-Fabrici, Elisabetta; Priebe, Stefan

    2016-04-01

    Although community mental health services aim to support patients' autonomy and independence, they have repeatedly been criticised for making patients dependent. Yet, it remains often unclear what exactly is meant with dependency in this context. This review aimed to identify the meaning of the term dependency on community services in the literature. A systematic search and conceptual review of papers where dependency is used in the context of community mental health services. Narrative synthesis was used to identify thematic concepts linked to dependency in these settings. Fifteen papers met the inclusion criteria. The analysis identified five different concepts of dependency on community mental health services: dislocation from the outside world; inflexibility and lack of freedom; obligation as resentment or appreciation; living with or without meaningful activities; and security. The findings suggest that, distinct from the exclusively negative connotation of the term dependency in a conventional medical context, dependency on community mental health services contains both negative and positive aspects. The different aspects might guide the future evaluation of the care provided in such services.

  17. 48 CFR 2937.103-70 - Department of Labor checklist to aid analysis and review of requirements for service contracts.

    Science.gov (United States)

    2010-10-01

    ... provide for adequate monitoring of contractor performance? (3) Is the statement of work written so that it... contract? (4) Will the contractor be evaluating a competitor's work? (5) Does the contract allow the...

  18. 75 FR 14111 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-03-24

    ... using business rules that allowed the model to project unit costs for future years. The calculation of...SS), the activity-based costing model that the Department used to determine the fees for consular... , the Department chose to develop and use an activity-based costing (ABC) model to determine the true...

  19. High Biodiversity of Green Infrastructure Does Not Contribute to Recreational Ecosystem Services

    Directory of Open Access Journals (Sweden)

    Daria Sikorska

    2017-02-01

    Full Text Available Urban lakes, especially those of natural origin, provide ecosystem services, recreation being one of the most important and highly valued by city dwellers. Fulfilling the needs of city residents to relax and have contact with nature has become a priority in urbanized areas and has been proven to positively affect people’s health and well-being. The recreational potential of water bodies was identified to be the most important aspect of ecosystem services to the residents of the neighboring areas. An assessment of recreational ecosystem services (RES provisioning to society based on the real time spent by the citizens and housing values in the urban–rural gradient revealed that the economic benefits of lakes differ in urbanized, suburban and rural landscapes. The growth of cities has led to an increased population density in the surroundings of ecologically valuable areas, resulting in higher pressure from visitors seeking recreational areas. Along with urbanization, the impoverishment of ecosystem functions takes place, limiting their capability to provide ecosystem services. In this work, the provisioning of recreational ecosystem services of 28 floodplain lakes located along the urban–rural gradient of the Warsaw agglomeration was assessed. The relationship between the ecological value of the water bodies, measured using naturalness indices, and the recreational ecosystem services they can provide was assessed. The results showed that the floodplain lakes located along the urban–rural gradient are of great importance to the citizens due to their recreational potential. The provisioning of recreational ecosystem services is poorly connected with the ecological characteristics of the floodplain lakes. Only hemeroby was significantly correlated with provisioning, and there was no relationship with factors such as naturalness of vegetation or water quality, demonstrating that public preference was not generally influenced by high

  20. The haven of the self-service store: A study of the fruit and vegetable department's influence on customer attitudes towards food chain stores

    DEFF Research Database (Denmark)

    Bech-Larsen, Tino

    2000-01-01

    of these developments have concentrated on the peripheral spheres of the purchase decision situation. More recently retail managers have concentrated their efforts on the departments believed to be most important to customers' overall shopping experience and attitudes towards the store. So far, academic studies...... self-service stores. With an outset in broad range theories of consumer choice and environmental psychology, this paper discusses a number of reasons why the fruit and vegetable department can be one of the keys to chain differentiation and creation of positive customer attitudes to the store. Also...... the paper describes the results of two empirical studies (a focus group and a survey), which explore customer-perceived quality dimensions of the fruit and vegetable department and the extent to which these dimensions influence customer attitudes towards the department and towards the store in general....

  1. Employment of personnel of a security service company does not require the consent of the works council

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    If a company or institution hires personnel of a security service company to protect its premises, this kind of employment does not mean the company carries on temporary employment business. Within the purview of section 99, sub-section 1 of the BetrVG (Works Constitution Act), the security service personnel is not 'employed' in the proper sense even if the security tasks fulfilled by them are done at other times by regular employees of the company or institution. The court decision also decided that the Works Council need not give consent to employment of foreign security personnel. Federal Labour Court, decision dated May 5, 1992 - 1 ABR 78/91. (orig./HP) [de

  2. Employment of security personnel of a security service company does not need approval by the works council

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    If a company or institution hires personnel of a security service company to protect its premises, this kind of employment does not mean the company carries on temporary employment business. Within the purview of section 99, sub-secion 1 of the BetrVG (Works Constitution Act), the security service personnel is not 'employed' in the proper sense even if the security tasks fulfilled by them are done at other times by regular employees of the company or institution. The court decision also decided that the Works Council need not give consent to employment of foreign security personnel. The court decision was taken for settlement of court proceedings commenced by Institute of Plasma Physics in Garching. (Federal Labour Court, decision dated November 28, 1989 - 1 ABR 90/88). (orig./HP) [de

  3. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    National Research Council Canada - National Science Library

    Apte, Aruna U; Apte, Uday M; Rendon, Rene G

    2008-01-01

    .... Specifically, we studied the current management practices in such areas as life cycle approach, project management, organization/ management structure, and training provided to services acquisition personnel...

  4. Pacific Northwest Laboratory annual report for 1989 to the DOE (Department of Energy) Office of Energy Research - Part 3: Atmospheric Sciences

    Energy Technology Data Exchange (ETDEWEB)

    1990-06-01

    This 1989 Annual Report from Pacific Northwest Laboratory (PNL) to the US Department of Energy (DOE) describes research in environment, safety, and health conducted during fiscal year 1989. The report again consists of five parts, each in a separate volume. This volume contains research in the atmospheric sciences. Currently, the broad goals of atmospheric research at PNL are to describe and predict the nature and fate of atmospheric contaminants and to develop an understanding of the atmospheric processes contributing to their distribution on local, regional, continental, and global scales in the air, in clouds, and on the surface. The redistribution and long-range transport of transformed contaminants passing through clouds is recognized as a necessary extension of our research to even larger scales in the future. Eventually, large-scale experiments on cloud processing and redistribution of contaminants will be integrated into the national program on global change, investigating how energy pollutants affect aerosols and clouds and the transfer of radiant energy through them. As the significance of this effect becomes clear, its global impact on climate will be studied through experimental and modeling research. The description of ongoing atmospheric research at PNL is organized in terms of the following study areas: atmospheric studies in complex terrain, large-scale atmospheric transport and processing of emissions, and climate change. This report describes the progress in FY 1989 in each of these areas. A divider page summarizes the goals of each area and lists project titles that support research activities. 9 refs., 2 figs., 3 tabs.

  5. Moderate Temperature Dense Phase Hydrogen Storage Materials within the US Department of Energy (DOE H2 Storage Program: Trends toward Future Development

    Directory of Open Access Journals (Sweden)

    Scott McWhorter

    2012-05-01

    Full Text Available Hydrogen has many positive attributes that make it a viable choice to augment the current portfolio of combustion-based fuels, especially when considering reducing pollution and greenhouse gas (GHG emissions. However, conventional methods of storing H2 via high-pressure or liquid H2 do not provide long-term economic solutions for many applications, especially emerging applications such as man-portable or stationary power. Hydrogen storage in materials has the potential to meet the performance and cost demands, however, further developments are needed to address the thermodynamics and kinetics of H2 uptake and release. Therefore, the US Department of Energy (DOE initiated three Centers of Excellence focused on developing H2 storage materials that could meet the stringent performance requirements for on-board vehicular applications. In this review, we have summarized the developments that occurred as a result of the efforts of the Metal Hydride and Chemical Hydrogen Storage Centers of Excellence on materials that bind hydrogen through ionic and covalent linkages and thus could provide moderate temperature, dense phase H2 storage options for a wide range of emerging Proton Exchange Membrane Fuel Cell (PEM FC applications.

  6. Radiological health review of the Draft Environmental Impact Statement (DOE/EIS-0026-D) Waste Isolation Pilot Plant, US Department of Energy. Report EEG-3

    International Nuclear Information System (INIS)

    Neill, R.H.; Channell, J.K.; Wofsy, C.; Greenfield, M.A.

    1979-08-01

    This review of radiological health considerations contains a number of concerns, questions and recommendations that should be addressed by the Department of Energy in the final Environmental Impact Statement (EIS) for the Waste Isolation Pilot Plant (WIPP). Using the assumptions contained in the Draft Environmental Impact Statement (DEIS), the Environmental Evaluation Group (EEG) calculated a number of radiation doses and the results were found to be in general agreement with those presented in the DEIS. The doses resulting from the operational and long-range releases from WIPP to the general population are no more than a fraction of existing radiation doses to the public. However, there are a number of technical considerations in the assessment of radiation exposure that were not adequately evaluated in the DEIS. They are discussed in this review. A number of additional dosage estimates have been identified that need to be calculated by both DOE and EEG. As the DEIS did not contain estimates of the amounts of radioactivity to be permanently located in the repository, it was necessary to calculate these amounts. Health effects, transportation, waste acceptance criteria, site evaluation, site selection criteria, operational exposure, the experimental waste program, long term radiation releases, retrievability, and decommissioning are the categories of the DEIS which were evaluated

  7. DOE/CEC [Department of Energy/Commission of the European Communities] workshop on critical evaluation of radiobiological data to biophysical modeling

    International Nuclear Information System (INIS)

    1988-01-01

    The Department of Energy's Office of Health and Environmental Research and the Commission of the European Communities (CEC) Radiation Protection Program support the majority of Research in the Field of Radiobiological Modeling. This field of science develops models based on scientifically sound principles to predict biological response (at the cellular, molecular, and animal level) to exposure to low level ionizing radiation. Biophysical models are an important tool for estimating response of ionizing radiation at low doses and dose rates. Generally speaking, the biophysical models can be classified into two groups: (1) mechanistic models and (2) phenomenological models. Mechanistic models are based on some assumptions about the physical, chemical, or biological mechanisms of action in association with radiobiological data whereas the phenomenological models are based solely on available experimental data on radiobiological effects with less emphasis on mechanisms of action. There are a number of these models which are being developed. Since model builders rely on radiobiological data available in the literature either to develop mechanistic or phenomenological models, it is essential that a critical evaluation of existing radiobiological data be made and data that is generally considered good and most appropriate for biophysical modeling be identified. A Workshop jointly sponsored by the DOE and the CEC was held at Oak Ridge, Tennessee from June 23--25, 1988, to review the data available from physical and chemical, cellular and molecular and animal studies with ionizing radiation

  8. Does a voucher program improve reproductive health service delivery and access in Kenya?

    Science.gov (United States)

    Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

    2015-05-23

    Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

  9. Designing, Implementing, and Evaluating a Department-Wide Service-Learning Program for English Language Learners in Morocco

    Science.gov (United States)

    Seilstad, Brian

    2014-01-01

    This article describes the theoretical and pedagogical background and results from the first semester of a service-learning program for English learners at a public Moroccan university and the local high school. This study fills a gap in the literature related to service-learning practice and outcomes in Morocco and the Arab world in general. The…

  10. Does the Organization Matter? A Multilevel Analysis of Organizational Effects in Homeless Service Innovations

    Science.gov (United States)

    Cronley, Courtney; Patterson, David A.

    2012-01-01

    This study examined the effects of organizational culture on staff members' use of management information systems ("N" = 142) within homeless service organizations ("N" = 24), using a multilevel model. The Organizational Social Context Questionnaire was used to measure organizational culture, defined by three sub-constructs: (1) proficiency, (2)…

  11. Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?

    Science.gov (United States)

    Song, Xiaolei; Zou, Guanyang; Chen, Wen; Han, Siqi; Zou, Xia; Ling, Li

    2017-01-01

    To describe the self-reported health status and service utilisation of employed, retired and unemployed migrants in Guangzhou, a megacity in southern China. A cross-sectional study adapted from the National Health Service Survey was conducted between September and December in 2014. Based on the distribution of occupation of migrants, multistage sampling was used to recruit individuals. Logistic regression was applied to explore the factors influencing their service utilisation. Of 2906 respondents, 76.6% were employed, 9.2% retired and 14.2% unemployed. Only 8.1% reported having an illness in the previous 2 weeks, and 6.5% reported having been hospitalised in the previous year. Employed migrants had the lowest recent physician consultation rate (3.4%) and the lowest annual hospitalisation rate (4.5%) (P rates (6.8% and 14.5% respectively, P employed (1.5%) and unemployed migrants (3.4%) (P gender, employment status remained significant in explaining the recent two-week treatment-seeking behaviour of migrants (P Employed migrants make the least use of health services. © 2016 John Wiley & Sons Ltd.

  12. Job involvement of primary healthcare employees: does a service provision model play a role?

    Science.gov (United States)

    Koponen, Anne M; Laamanen, Ritva; Simonsen-Rehn, Nina; Sundell, Jari; Brommels, Mats; Suominen, Sakari

    2010-05-01

    To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.

  13. Does Classroom Management Coursework Influence Pre-service Teachers' Perceived Preparedness or Confidence?

    Science.gov (United States)

    O'Neill, Sue; Stephenson, Jennifer

    2012-01-01

    There has been conjecture that completing focused coursework units on classroom management during pre-service teacher preparation might lead to increased feelings of preparedness and confidence. This study reports the preparedness in managing specific problem behaviours, familiarity, and confidence in using management strategies and models of…

  14. Does co-creation impact public service delivery? The importance of state and governance traditions

    NARCIS (Netherlands)

    Voorberg, Willem; Bekkers, Victor; Flemig, Sophie; Timeus, Krista; Tõnurist, Piret; Tummers, L.G.

    2017-01-01

    Co-creation in public service delivery requires partnerships between citizens and civil servants. The authors argue that whether or not these partnerships will be successful depends on state and governance traditions (for example a tradition of authority sharing or consultation). These traditions

  15. Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia.

    Science.gov (United States)

    Tippett, Vivienne C; Toloo, Ghasem Sam; Eeles, David; Ting, Joseph Y S; Aitken, Peter J; Fitzgerald, Gerard J

    2013-02-01

    To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003-04. The study involved a 10-year (2000-01 to 2009-10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean=149.8, 95% CI: 137.3-162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an 'appropriate use' public awareness program.

  16. 2011 U.S. Department of Agriculture- Natural Resources Conservation Service (USDA-NRCS) Topographic Lidar: North West Connecticut

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Earth Eye collected LiDAR data for approximately 1,703 square kilometers that partially cover the Connecticut counties of Litchfield and Fairfield. The nominal pulse...

  17. 2010 U.S. Department of Agriculture- Natural Resources Conservation Service (USDA-NRCS) Topographic Lidar: Eastern Connecticut

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Earth Eye collected LiDAR data for approximately 4,589 square kilometers that partially cover the Connecticut counties of Hartford, Tolland, Windham, Middlesex and...

  18. Progress in the utilization of antenatal and delivery care services in Bangladesh: where does the equity gap lie?

    Science.gov (United States)

    Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us; Uddin, Jalal; Enemark, Ulrika

    2016-07-29

    Universal access to health care services does not automatically guarantee equity in the health system. In the post Millennium Development Goals (MDGs) era, the progress towards universal access to maternal health care services in a developing country, like Bangladesh requires an evaluation in terms of equity lens. This study, therefore, analysed the trend in inequity and identified the equity gap in the utilization of antenatal care (ANC) and delivery care services in Bangladesh between 2004 and 2011. The data of this study came from the Bangladesh Demographic and Health Survey. We employed rate ratio, concentration curve and concentration index to examine the trend in inequity of ANC and delivery care services. We also used logistic regression models to analyse the relationship between socioeconomic factors and maternal health care services. The concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 with a greater decline in urban area. There was almost no change in the concentration index for ANC services from medically trained providers during this period. We also found a decreasing trend in inequity in the utilization of both health facility delivery and skilled birth assistance but this trend was again more pronounced in urban area compared to rural area. The concentration index for C-section delivery decreased by about 33 % over 2004-2011 with a similar rate in both urban and rural areas. Women from the richest households were about 3 times more likely to have 4+ ANC visits, delivery at a health facility and skilled birth assistance compared to women from the poorest households. Women's and their husbands' education were significantly associated with greater use of maternal health care services. In addition, women's exposure to mass media, their involvement in microcredit programs and autonomy in healthcare decision-making appeared as significant predictors of using some of these health care services. Bangladesh faces not only a

  19. Does Head Start differentially benefit children with risks targeted by the program's service model?

    Science.gov (United States)

    Miller, Elizabeth B; Farkas, George; Duncan, Greg J

    Data from the Head Start Impact Study ( N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program's comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children's pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed.

  20. Does organic school food service provide more healthy eating environments than their non organic counterparts?

    DEFF Research Database (Denmark)

    He, Chen; Mikkelsen, Bent Egberg

    Organic food strategies are increasingly developing within European school food services at the same time as these services are being involved in measures aiming at promoting healthy eating at school and counter acting obesity. Schools have an important role to play in teaching children fundamental...... as sustainable consumption strategies are contributing to shaping the future school food culture. It is therefore imperative to study how these changes in agendas influences each other and to study the associations between healthy eating and organic supply strategies at school....... life skills, including good food habits according to a number of authoritative policy papers from Council of Europe, the WHO and the EU platform. Although there are great national differences, European school food culture seems to be in a transitional state in which both healthy eating as well...

  1. Does leadership style of modern matrons contribute to safer and more effective clinical services?

    Science.gov (United States)

    Hill, Barry

    2017-03-30

    At the time of writing, the author was a modern matron in a surgical division of an NHS teaching hospital in London. This article considers the differences between leadership and management, and discusses the skills required by modern matrons to lead safe and successful clinical services. It also examines three leadership styles - transactional, transformational and situational - and their relevance to the role of modern matron.

  2. Does radiography advanced practice improve patient outcomes and health service quality? A systematic review.

    Science.gov (United States)

    Hardy, Maryann; Johnson, Louise; Sharples, Rachael; Boynes, Stephen; Irving, Donna

    2016-06-01

    To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Using the World Health Organization definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs, and data were systematically extracted using electronic data extraction pro forma. 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n = 7) focusing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The articles were generally considered to be of low-to-moderate quality, with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, the included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No articles reported data relating to time to diagnosis, time to recovery or patient mortality. Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality.

  3. Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

    Science.gov (United States)

    Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

    2015-01-01

    Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management.

  4. Does integrated care lead to both improved service quality and lower care cost

    Science.gov (United States)

    Waldeyer, Regina; Siegel, Achim; Daul, Gisela; Gaiser, Karin; Hildebrandt, Helmut; Köster, Ingrid; Schubert, Ingrid; Stunder, Brigitte; Stützle, Yvonne

    2010-01-01

    Purpose and context ‘Gesundes Kinzigtal’ is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The management company and its contracting partners (the physicians’ network in the region and two statutory health insurers) strive to reach a higher quality of care at a lower overall cost as compared with the German standard. During its first two years of operation (2006–2007), the Kinzigtal project achieved surprisingly positive financial results compared with its reference value. To gain independent evidence on the quality aspects of the system, the management company and its partners provided a remarkable budget for its evaluation by independent scientific institutions. Case description and data sources We will present interim results of a population-based controlled cohort study. In this study, quality of care is checked by relying on health and service quality indicators that have been constructed from health insurers’ administrative data (claims data). Interim results are presented for the intervention region (Kinzigtal area) and the control region (the rest of Baden-Württemberg, i.e., Southwest Germany). Preliminary conclusions and discussion The evaluation of ‘Gesundes Kinzigtal’ is in full progress. Until now, there is no evidence that the surprisingly positive financial results of the Kinzigtal system have been achieved at the expense of care quality. Rather, Gesundes Kinzigtal Integrated Care seems to be about to increasingly realize comparative advantages regarding health service quality (in comparison to the control region).

  5. Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

    Directory of Open Access Journals (Sweden)

    Wei-Teng Yang

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52% and delays (42%, 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0% and longer delays (presentation to diagnosis: 45% versus 0% than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  6. Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

    Science.gov (United States)

    Yang, Wei-Teng; Gounder, Celine R; Akande, Tokunbo; De Neve, Jan-Walter; McIntire, Katherine N; Chandrasekhar, Aditya; de Lima Pereira, Alan; Gummadi, Naveen; Samanta, Santanu; Gupta, Amita

    2014-01-01

    Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  7. Local Geographic Variation of Public Services Inequality: Does the Neighborhood Scale Matter?

    Science.gov (United States)

    Wei, Chunzhu; Cabrera-Barona, Pablo; Blaschke, Thomas

    2016-01-01

    This study aims to explore the effect of the neighborhood scale when estimating public services inequality based on the aggregation of social, environmental, and health-related indicators. Inequality analyses were carried out at three neighborhood scales: the original census blocks and two aggregated neighborhood units generated by the spatial “k”luster analysis by the tree edge removal (SKATER) algorithm and the self-organizing map (SOM) algorithm. Then, we combined a set of health-related public services indicators with the geographically weighted principal components analyses (GWPCA) and the principal components analyses (PCA) to measure the public services inequality across all multi-scale neighborhood units. Finally, a statistical test was applied to evaluate the scale effects in inequality measurements by combining all available field survey data. We chose Quito as the case study area. All of the aggregated neighborhood units performed better than the original census blocks in terms of the social indicators extracted from a field survey. The SKATER and SOM algorithms can help to define the neighborhoods in inequality analyses. Moreover, GWPCA performs better than PCA in multivariate spatial inequality estimation. Understanding the scale effects is essential to sustain a social neighborhood organization, which, in turn, positively affects social determinants of public health and public quality of life. PMID:27706072

  8. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    National Research Council Canada - National Science Library

    Apte, Aruna; Apte, Uday; Rendon, Rene G

    2008-01-01

    .... In fact, even considering the high value of weapon systems and large military items purchased in recent years, the DoD has spent more on services than on supplies, equipment and goods (Camm, Blickstein & Venzor, 2004...

  9. Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies.

    Science.gov (United States)

    Donovan, Catherine V; Markiewicz, Milissa; Horney, Jennifer A

    2014-05-28

    In 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina. A survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring. Of 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009. Following a system-wide review of preparedness in North Carolina, the state's regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

  10. The States Training and Education Program (STEP): A success story of Department of Energy (DOE) interacting with other state and federal agencies

    International Nuclear Information System (INIS)

    Kouba, S.C.; Eaton, O.W.

    1990-01-01

    DOE facilities, if not already faced with the need, could be confronted with the necessity of or request to train civil authorities near DOE facilities. SARA Title 3 and the recent high visibility of DOE safety programs have prompted civil authorities to seek out specialized emergency response training for their community's first responders. In 1988, the states through which the DOE is scheduled to transport transuranic (TRU) waste for disposal at the Waste Isolation Pilot Plant expressed the concerns that their fire, medical, and law enforcement personnel were not prepared to handle an accident involving shipments of TRU waste. In response, the DOE authorized their contractor, Westinghouse Electric Corporation, to develop and deliver a training program to emergency responders along the transportation routes to mitigate this specific institutional concern. The lessons learned by DOE and Westinghouse in creating, coordinating, and delivering this program could be modified to apply to the concerns of governmental jurisdictions, including adjoining DOE facilities

  11. A Correlation Study between Student Performance in Food and Beverage Services Course and Internship in F&B Department of Hospitality Business

    OpenAIRE

    Dexter R. Buted; Sevillia S. Felicen; Abigail I. Manzano

    2014-01-01

    One of the biggest challenges hospitality educators face today is determining clear goals and objectives for the curriculum to the constantly changing needs of the industry. It is crucial to close the gap between what is taught to students and what the industry expects from the graduates being hired. This study aimed to assess the relationship between the performance of the students on Food and Beverage Services Course and their internship performance in Food and Beverage department in differ...

  12. Does the company's economic performance affect access to occupational health services?

    Science.gov (United States)

    Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

    2009-09-02

    In Finland like in many other countries, employers are legally obliged to organize occupational health services (OHS) for their employees. Because employers bear the costs of OHS it could be that in spite of the legal requirement OHS expenditure is more determined by economic performance of the company than by law. Therefore, we explored whether economic performance was associated with the companies' expenditure on occupational health services. We used a prospective design to predict expenditure on OHS in 2001 by a company's economic performance in 1999. Data were provided by Statistics Finland and expressed by key indicators for profitability, solidity and liquidity and by the Social Insurance Institution as employers' reimbursement applications for OHS costs. The data could be linked at the company level. Regression analysis was used to study associations adjusted for various confounders. Nineteen percent of the companies (N = 6 155) did not apply for reimbursement of OHS costs in 2001. The profitability of the company represented by operating margin in 1999 and adjusted for type of industry was not significantly related to the company's probability to apply for reimbursement of the costs in 2001 (OR = 1.00, 95%CI: 0.99 to 1.01). Profitability measured as operating profit in 1999 and adjusted for type of industry was not significantly related to costs for curative medical services (Beta -0.001, 95%CI: -0.00 to 0.11) nor to OHS cost of prevention in 2001 (Beta -0.001, 95%CI: -0.00 to 0.00). We did not find a relation between the company's economic performance and expenditure on OHS in Finland. We suppose that this is due to legislation obliging employers to provide OHS and the reimbursement system both being strong incentives for employers.

  13. When Does an Immigrant with HIV Represent an Excessive Demand on Canadian Health or Social Services?

    Directory of Open Access Journals (Sweden)

    KEDNAPA THAVORN

    2010-01-01

    Full Text Available The Canadian Immigration and Refugee Protection Act of 2001 outlines conditions under which individuals may be granted or denied admission to Canada. The Act stipulates that applications for residence will be rejected if their health is expected to generate excessive demand on Canadian health or social services. The purpose of this paper is to derive a statistical definition of excessive demand and to apply that threshold to persons with HIV who are seeking admission to Canada. The paper demonstrates that the current threshold used by Citizenship and Immigration Canada is much lower than the thresholds that may be derived statistically.

  14. How does public service motivation among teachers affect student performance in schools?

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Heinesen, Eskil; HolmPedersen, Lene

    2014-01-01

    using an objective outcome measure (the students' academic performance in their final examinations). Combining survey data and administrative register data in a multilevel data set, we are able to control very robustly for the specific characteristics of the students (n = 5,631), the schools (n = 85......The literature expects public service motivation (PSM) to affect performance, but most of the existing studies of this relationship use subjective performance data and focus on output rather than outcome. This article investigates the association between PSM and the performance of Danish teachers...

  15. Joint-Service Integration: An Organizational Culture Study of the United States Department of Defense Voluntary Education System

    Science.gov (United States)

    Benson, Martin K.

    2010-01-01

    The purpose of the descriptive case study with a multiple case framework was to (a) describe the organizational cultures of education programs and leaders in the United States (U.S.) Department of Defense (DoD) voluntary education system on Oahu, Hawaii; (b) determine if an overlapping common organizational culture exists; and (c) assess the…

  16. 75 FR 28188 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-05-20

    ... allow a consular officer to waive the physical appearance of an applicant in the J-1 visa class, but... Department of State visa adjudicator to both determine whether the employment falls under the E-3 program...'' increase for petition-based employment visas, and stated that adjudication of these petition-based visa...

  17. Analysis of Government Accountability Office and Department of Defense Inspector General Reports and Commercial Sources on Service Contracts

    Science.gov (United States)

    2010-06-01

    Acquisition Research Program BIM Building Information Modeling COR Contracting Officer Representative DoD Department of Defense FPDS...WBS), performance work statements (PWS) and statement of work (SOW), market research, budget and cost estimates, determining contract type, and...contracting within this project. The recurrent best practices in contracting among all sources emphasized planning, defining requirements, market research

  18. 77 FR 18907 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2012-03-29

    ... to recover the costs of ``allocating visas'' described in section 203(c) of the Immigration and... Statement of Federal Accounting Standards (SFFAS), available at http://www.fasab.gov/pdffiles/sffas-4.pdf... advances in automation making it easier to verify U.S. immigration status. As such, the Department will...

  19. Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

    Science.gov (United States)

    Xie, Zhenzhen; Or, Calvin

    2017-01-01

    The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

  20. DOE Coal Gasification Multi-Test Facility: fossil fuel processing technical/professional services

    Energy Technology Data Exchange (ETDEWEB)

    Hefferan, J.K.; Lee, G.Y.; Boesch, L.P.; James, R.B.; Rode, R.R.; Walters, A.B.

    1979-07-13

    A conceptual design, including process descriptions, heat and material balances, process flow diagrams, utility requirements, schedule, capital and operating cost estimate, and alternative design considerations, is presented for the DOE Coal Gasification Multi-Test Facility (GMTF). The GMTF, an engineering scale facility, is to provide a complete plant into which different types of gasifiers and conversion/synthesis equipment can be readily integrated for testing in an operational environment at relatively low cost. The design allows for operation of several gasifiers simultaneously at a total coal throughput of 2500 tons/day; individual gasifiers operate at up to 1200 tons/day and 600 psig using air or oxygen. Ten different test gasifiers can be in place at the facility, but only three can be operated at one time. The GMTF can produce a spectrum of saleable products, including low Btu, synthesis and pipeline gases, hydrogen (for fuel cells or hydrogasification), methanol, gasoline, diesel and fuel oils, organic chemicals, and electrical power (potentially). In 1979 dollars, the base facility requires a $288 million capital investment for common-use units, $193 million for four gasification units and four synthesis units, and $305 million for six years of operation. Critical reviews of detailed vendor designs are appended for a methanol synthesis unit, three entrained flow gasifiers, a fluidized bed gasifier, and a hydrogasifier/slag-bath gasifier.

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

    Directory of Open Access Journals (Sweden)

    Chaiporn Pongpisanrat

    2017-03-01

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

  2. Water Services in the Buenos Aires Metropolitan Area: How Does State Regulation Work?

    Directory of Open Access Journals (Sweden)

    Mariela Verónica Rocca

    2014-08-01

    Full Text Available This article deals with the State regulation of drinking water and sanitation services in the Metropolitan Area of Buenos Aires. Its main objective is to identify the continuities and ruptures in State regulation during the transition from private management (1993-2006 to renationalisation and State management (2006 onwards. The concept of “State capacities” (both administrative and relational is used to assess regulatory performance. For the administrative capacities, the correspondence between the design and resources of the agencies, as well as the differences between their formal functions and actual practices, is examined. For the relational capacities, the policies of the National Government and its interaction with both the water and sanitation companies and the regulatory and control agencies are considered. The analysis is based on official documents, legislation and statistics, company balance sheets and reports, newspaper articles and semi-structured interviews.

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

    Science.gov (United States)

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

    2013-03-01

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

  4. Internal audit assurance or consulting services rendered on governance: How does one decide?

    Directory of Open Access Journals (Sweden)

    Naomi Wilkinson

    2015-04-01

    Full Text Available The concept of organisational governance maturity and what exactly this entails is still perceived as somewhat of a mystery to most and, as a result, internal auditing find themselves in a dilemma when deciding which services to deliver in this regard. The objective of this article was to develop an organisational governance maturity framework that could be used as a measurement tool to assist internal auditing in this dilemma. A preliminary organisational governance maturity framework was developed based on the most relevant literature. A case study was conducted to obtain feedback on the preliminary framework from key stakeholders in the organisation. The results indicated that the framework significantly contributed to the determining and continuous monitoring of governance maturity; both for management and internal auditing.

  5. Does economic crisis affect prevention services? An Italian region as a study case

    Directory of Open Access Journals (Sweden)

    Corrado De Vito

    2014-06-01

    Full Text Available Background: The Latium Region in Italy is currently under pressure from national government to achieve economic consolidation of regional health services and is subject to a formal regional recovery plan.Methods: Using recognized health indicators together with a government assessment tool, we evaluate the impact of the economic downturn on the health of the Latium Region population.Results: We find that healthcare spending in the Latium Region needs to become more efficient by improving primary healthcare and by restoring efficiency in hospitals.Conclusions: Prevention activities should not only be defended in the current financial and economic crisis, but also streamlined and strengthened.

  6. Using Goals, Feedback, Reinforcement, and a Performance Matrix to Improve Customer Service in a Large Department Store

    Science.gov (United States)

    Eikenhout, Nelson; Austin, John

    2005-01-01

    This study employed an ABAC and multiple baseline design to evaluate the effects of (B) feedback and (C) a package of feedback, goalsetting, and reinforcement (supervisor praise and an area-wide celebration as managed through a performance matrix, on a total of 14 various customer service behaviors for a total of 115 employees at a large…

  7. 78 FR 34131 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2013-06-06

    ..., USDA Forest Service Law Enforcement seized a hide robe from Flora's daughter that had been collected by Flora at the Falls Creek Rock Shelters. Subsequently, in 2009, Bureau of Land Management Law Enforcement..., Cambridge, MA, and by the University of Colorado Museum of Natural History, Boulder, CO. In February 2009...

  8. 78 FR 64265 - Hours of Service of Drivers: U.S. Department of Defense (DOD); Application for Exemption

    Science.gov (United States)

    2013-10-28

    ... break provision of the Agency's hours-of-service (HOS) regulations for commercial motor vehicle (CMV... requirements in Sec. 395.3(a)(3)(ii). SDDC states that it requires continuous attendance and surveillance of... surveillance. Inspecting carrier facilities and corporate headquarters for compliance with DOD and DOT...

  9. 78 FR 48927 - Hours of Service of Drivers: U.S. Department of Defense (DOD); Application for Exemption

    Science.gov (United States)

    2013-08-12

    ... the minimum 30-minute rest break provision of the Agency's hours-of-service (HOS) regulations for... rest break requirements, provided they do not perform any other work during the break. FMCSA requests... reasons for denying or granting the application and, if granted, the name of the person or class of...

  10. 78 FR 70313 - Privacy Act of 1974; Department of Homeland Security U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2013-11-25

    ... performing or working on a contract, service, grant, cooperative agreement, or other assignment for DOS, when...; Date of Birth; Gender; A-Number; Social Security number; Immigration Status; Date of Arrival in the U.S... disclosure made to such agencies, entities, and persons is reasonably necessary to assist in connection with...

  11. The Students Satisfaction Oriented: Academic Service Improvement Strategy, Department of Aquatic Resources Management, Bogor Agricultural University, Indonesia

    Science.gov (United States)

    Widaryanti; Daryanto, Arief; Fauzi, Anas Miftah

    2016-01-01

    Higher education institutions must have a strategy change management in the increasingly competitive business environment. A continous performance improvement should be made accordingly. This study was conducted with the case of MSP-IPB, to analyze the priority of academic services improvement which were oriented in student satisfaction. This…

  12. The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department.

    Science.gov (United States)

    Brown, Alison; Santilli, Mario; Scott, Belinda

    2015-12-01

    Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data. The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks. Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks. The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines. The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management. The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  13. The Library Work Order Processing System: A New Approach to Motivate Employees and to Increase Production in the Technical Service Department of Mercer County Community College Library. Applied Educational Research and Evaluation.

    Science.gov (United States)

    Sim, Yong Sup

    After reviewing the current movement toward job enrichment, a system was designed for the technical services department of the Mercer County Community College Library. The Library Work Order Processing System, as tried between January and March, 1974, was designed to permit each worker more variety of jobs. The technical services department was…

  14. How does substrate roughness affect the service life of a superhydrophobic coating?

    Science.gov (United States)

    Zhang, Xin; Mo, Jiliang; Si, Yifan; Guo, Zhiguang

    2018-05-01

    Although the development of superhydrophobic coatings is rapidly maturing, issues related to their low mechanical durability persist. In this context, the effect of substrate roughness on the service life of superhydrophobic coatings was studied. In this study, superhydrophobic coatings were fabricated on sandpapers of different roughness and reciprocating wear tests were conducted. The wear-resistance number of the superhydrophobic coating, defined as the maximum number of friction cycles after which the superhydrophobic surface started to lose its superhydrophobicity, increased from 50 to 24,000 with an increase in the substrate roughness from 2000 CW to 240 CW (CW is defined as the number of particles arranged in an inch), while it decreased from 24,000 to 17,000 with a further increase in the substrate roughness from 240 CW to 60 CW. Observations of the surface structure and wear analyses indicated that the superhydrophobic material infiltrated the spaces between the sand grains, and the rough peaks could consequently protect the superhydrophobic material during the wear tests. However, this protection weakens when the substrate roughness increases or decreases beyond certain values. Furthermore, these phenomena and results were also verified by applying the superhydrophobic coatings to different types of common substrates.

  15. Does performance evaluation help public managers? A Balanced Scorecard approach in urban waste services.

    Science.gov (United States)

    Guimarães, Bernardo; Simões, Pedro; Marques, Rui Cunha

    2010-12-01

    The urban waste market has evolved significantly in the past decades, which among other changes, has led to the creation of new utilities and new business models. However, very few things have changed for the users. Urban waste collection remains mainly under the responsibility of local authorities and the charges paid by the users in most countries are very low compared to the provision costs. This situation forces the injection of public money into the system, encouraging the 'quiet-life' within the utilities and, therefore, inefficiency. The present study intends to analyze the potential for the application of the Balanced Scorecard (BSc) methodology into the waste utilities. After a comprehensive revision of the urban waste sector in Portugal, the methodology of BSc and its application in local public services is described and discussed. Focusing on implementation rather than on strategy, a set of performance indicators is proposed to be utilized in the different management models of waste utilities in Portugal: the municipalities, semi-autonomous utilities, municipal companies and mixed companies. This implementation is then exemplified through four case studies, one for each type of utility. This paper provides a flexible framework proposal to be applied to waste utilities operating both in Portugal and abroad. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Does a TV Public Service Advertisement Campaign for Suicide Prevention Really Work?

    Science.gov (United States)

    Song, In Han; You, Jung-Won; Kim, Ji Eun; Kim, Jung-Soo; Kwon, Se Won; Park, Jong-Ik

    2017-05-01

    One of the critical measures in suicide prevention is promoting public awareness of crisis hotline numbers so that individuals can more readily seek help in a time of crisis. Although public service advertisements (PSA) may be effective in raising the rates of both awareness and use of a suicide hotline, few investigations have been performed regarding their effectiveness in South Korea, where the suicide rate is the highest among OECD countries. The goal of this study was to evaluate the effectiveness of a television PSA campaign. We analyzed a database of crisis phone calls compiled by the Korean Ministry of Health and Welfare to track changes in call volume to a crisis hotline that was promoted in a TV campaign. We compared daily call counts for three periods of equal length: before, during, and after the campaign. The number of crisis calls during the campaign was about 1.6 times greater than the number before or after the campaign. Relative to the number of suicide-related calls in the previous year, the number of calls during the campaign period surged, displaying a noticeable increase. The findings confirmed that this campaign had a positive impact on call volume to the suicide hotline.

  17. Services Acquisition in the Department of Defense: Analysis of Operational and Performance Data to Identify Drivers of Success

    Science.gov (United States)

    2015-03-24

    improving the disclosure of CPARS program office Audit results (Black et al., 2014, pp. 48–49). Acquisition Research Program Graduate School of...improving the disclosure of CPARS program office audit results (Black et al., 2014, pp. 44–49). Recommendations Based on our conclusions, we identified...Fitzsimmons, J. A., & Fitzsimmons, M. J. (2006). Service management: Operations, strategy, and information technology (5th ed.). New York, NY: McGraw -Hill

  18. The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments.

    Science.gov (United States)

    Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D

    2010-09-01

    In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

    Science.gov (United States)

    Fung, Russell; Hyde, Jensen Hart; Davis, Mike

    2018-01-01

    The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

  20. The strengths and weaknesses of the transformational change management process in the South African department of correctional services: A critical analysis

    Directory of Open Access Journals (Sweden)

    Mbongeni A. Mdletye

    2014-12-01

    Full Text Available Change management research has become a critical focus area for change scholars because of the low success rate in change implementation. This exposition of how the transformational change process has been managed at the Department of Correctional Service was meant to show managers, particularly in the said department, that unless managers pay serious attention to certain critical aspects which must form part of the change management process, no real change would be attained. This becomes critical if one considers that there is still a long way to go in the process of transformation to the philosophy of rehbilitation, namely transforming correctional centres to effective institutions of offender rehabilitation. There is currently limited literature on organisational change approaches that are people-oriented. The available literature seems to focus more on the technical aspects (hard issues such as structures, systems and practices in terms of change management at the expense of people issues (soft issues such as the human factors. It has been argued that the neglect of people issues in the management of organisational change processes is responsible for the high failure rate in change implementation. For purposes of contextualising transformational change management within the setting of the Department of Correctional Services, an extensive literature study was undertaken. This was followed by an empirical analysis of data collected through survey questionnaires from correctional officials and offenders respectively. The research established that there were strong and weak points in the DCS transformational change management process from the perspective of both research participants.

  1. Minutes of the coordination workshop on DOE nuclear data program services via the internet

    International Nuclear Information System (INIS)

    Smith, D.L.; Dunford, C.L.

    1996-11-01

    This workshop was convened to explore what is currently being done in the area of data dissemination via the Internet and to examine ways that future activities in this area within the U.S. nuclear data programs can be better coordinated. Overview talks on the current status, from both the national and international perspectives, were provided. Following these, there were presentations on specific activities in the area of Internet data dissemination which are taking place at seven different institutions. Institutions represented at this meeting were asked to provide written summaries of their programs before the meeting. The talks included actual demonstrations of the electronic methodologies which are under development at these laboratories, and they highlighted the richness and creativity of these programs. This information proved to be very useful in the ensuing general discussions. The main issues that were addressed at this meeting were: (i) how to adapt to rapid evolution of data management and dissemination technologies, (ii) how to provide outside users with some sense of unity in the U.S. nuclear data program and to develop consistent, user-friendly ways to access data without discouraging individual initiatives and the richness which comes from diversity, (iii) how to maintain quality control over the information and services provided, (iv) how to progress in a era of very restrictive budgets, (v) how to effectively merge the nuclear structure and nuclear reaction data dissemination activities while at the same time recognizing and respecting their inherent differences, (vi) how to organize the stewardship of nuclear data and the processes of nuclear data dissemination in an efficient, technically advanced and yet cost effective manner, and (vii) how the data processing tasks should be allocated between server and client computers

  2. Referrer satisfaction as a quality criterion: developing an questionnaire for measuring the quality of services provided by a radiology departement

    International Nuclear Information System (INIS)

    Kubik-Huch, R.A.; Duerselen, L.; Otto, R.; Rexroth, M.; Porst, R.; Szucs, T.

    2005-01-01

    Purpose: To develop a questionnaire for measuring referring physician satisfaction and to conduct a pilot study in which this questionnaire is given to all physicians referring patients to the authors' radiology department. Materials and Methods: After qualitative pre-testing and adjustment of the prototype questionnaire, data were collected using the finalized standardized questionnaire comprising 29 indicators rated on a 4-point ordinal scale mailed with a personalized cover letter to the total referring physician population of a radiology department (n=727). The replies, rated 1-4, were entered into a data entry mask for statistical analysis. Results: The response rate was 33.8%. the indicators with the highest satisfaction rating were the range of examinations offered ('very satisfied': 79.3% mean 3.79), the quality of the technical equipment used for MRI and CT (79.3%, 3.79) and mammography (82.5%, 3.82), and the quality of the images yielded by these procedures (74.5%, 3.73 and 82.2%, 3.83). Dissatisfaction was relatively high with the indicators 'time to receipt of the written report (28.3% 'not very satisfied' or 'not at all satisfied', mean 2.97), 'time to receipt of the X-ray images' (18.2%, 3.07) and 'availability of previous findings' (20.9%, 3.05); satisfaction was higher among external referring physicians (p<0.05). Physicians rated the importance of these three indicators as relatively high ('very important': 62.4%, 54.3% and 49.6%). Other indicators showing a similar level of dissatisfaction were 'car parking availability' (24.1%, 3.01), 'patient waiting time' (27.4%, 2.87) and 'patient environment' (21.2%, 2.99), although these factors were rated as less important ('very important': 33.0%, 33.7% and 40.4%). Conclusion: This questionnaire constitutes a standardized validated instrument for assessing referring physician satisfaction with a radiology department. The data from this pilot study highlight areas for potential improvement. Deployment of

  3. DoD (Department of Defense) Advertising Mix Test. Comparison of Joint-Service with Service-Specific Strategies and Levels of Funding,

    Science.gov (United States)

    1987-07-01

    Change: A Critical Analysis of Theoretical Approaches. New York. Kotler , P. 1975. Marketing for Nonprofit Organizations. Prentice-Han, New Jersey... Kotler , P. and S.J. Levy. 1969. Broadening the Concept of Marketing . Journal of Marketing . (Jan), 19- 33. Kotler , P. and B. Zaltman. 1971. Social...Military Services were confronted with some of the most challenging In total, 72 media markets (i.e., collections of aspects of this experiment. It was

  4. Internet Presentation of Departments of Pediatric Surgery in Germany and Their Compliance with Recommended Criteria for Promoting Services and Offering Professional Information for Patients.

    Science.gov (United States)

    Farhat, Naim; Zoeller, Christoph; Petersen, Claus; Ure, Benno

    2016-08-01

    Introduction The presentation of health institutions in the internet is highly variable concerning marketing features and medical information. We aimed to investigate the structure and the kind of information provided on the Web sites of all departments of pediatric surgery in Germany. Furthermore, we aimed to identify the degree to which these Web sites comply with internet marketing recommendations for generating business. Method The Web sites of all pediatric surgery units referred to as departments on the official Web site of the German Society of Pediatric Surgery (GSPS) were assessed. The search engine Google was used by entering the terms "pediatric surgery" and the name of the city. Besides general data eight content characteristics focusing on ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, contact details, and medical information were evaluated according to published recommendations. Results A total of 85 departments of pediatric surgery were included. On Google search results 44 (52%) ranked number one and 34 (40%) of the department's homepages were accessible directly through the homepage link of the GSPS. A link to own digital and/or social media was offered on 11 (13%) homepages. Nine sites were multilingual. The most common navigation bar item was clinical services on 74 (87%) homepages. Overall, 76 (89%) departments presented their doctors and 17 (20%) presented other staff members with images of doctors on 53 (62%) and contact data access from the homepage on 68 (80%) Web sites. On 25 (29%) Web sites information on the medical conditions treated were presented, on 17 (20%) details of treating concepts, and on 4 (5%) numbers of patients with specific conditions treated in the own department per year. Conclusion We conclude that numerous of the investigated online presentations do not comply with recommended criteria for offering professional information for patients and for promoting

  5. 77 FR 35475 - Internal Revenue Service

    Science.gov (United States)

    2012-06-13

    ... contributions, consideration does not include de minimis goods or services. It also provides guidance on how..., maintenance, and purchase of services to provide information. Approved: June 6, 2012. Allan Hopkins, Tax... DEPARTMENT OF THE TREASURY Internal Revenue Service Proposed Collection; Comment Request for...

  6. Eight months of emergency services by ambulance (with doctor on board) of the Emergency Department of Prato, Italy.

    Science.gov (United States)

    Olia, P M; Mollica, T V; Querci, A

    2002-11-01

    The aim of the present study was to analyse the types of calls attended by the authors in their ambulance, assigned to one sector of the urban area of Prato. We analysed 1060 consecutive calls carried out by our ambulance; 33 calls (3.1%), cancelled for various reasons, were excluded from statistical analysis. The calls regarded 1027 patients, 549 (53.5%) males and 478 (46.5%) females. 46% of calls concerned non trauma cases, 17% trauma cases and 7.2% transfers between hospitals. Calls in the non trauma group were for dyspnea (16.7%), unconsciousness (16.6%), chest pain (11.8%), cerebrovascular pathology (7.7%), mental disorders (7.1%), abdominal pain (5.1%), use of psychotropic substances (4%) and convulsions (3.2%). Support to patients with terminal cancer accounted for 2.3% of cases, metabolic disorders 2.2%, hypertensive events 2.1%, tachycardia 1.9%, vertigo 1.9%, allergies 1%, obstetric pathology 0.5% and cardiorespiratory resuscitation 2,2%. Thirteen point seven percent were miscellaneous, including poisonings, migraines, haemorrhages and flu syndromes. Trauma cases included road accidents (62.6%), falls (27%), aggression (6.9%), work-related accidents (3.5%). The percentage of trauma cases (17%) was similar to that reported for a Swedish urban area (20%). Cases of cardiorespiratory resuscitation were 1.65% of our calls, compared to 1.73% and 1.8% reported in Northeastern Germany and Taiwan. Although prehospital emergency medical services are organised differently in different countries, our data suggest that emergency medical services in our area have a percentage distribution of case types similar to services in other countries.

  7. PENTINGNYA PERANAN SKILL DAN MENU KNOWLEDGE WAITER/WAITERS TERHADAP KEPUASAN PELANGGAN DI FOOD AND BEVERAGE SERVICE DEPARTEMENT

    Directory of Open Access Journals (Sweden)

    Fitria Earlike AS

    2016-11-01

    Full Text Available The Background of this research from the topic is the lack of waiter/ waitress�s skills and menu knowledge when doing the food and beverage services. The purpose of this research is to know the importance of waiter /waitress�s skills and menu knowledge toward guest satisfaction. Method of the research was descriptive qualitative which was collected data by using interview, observation, documentation, quitionare and study of literature. The rusult shows that guests� satisfaction are decreased and proved by the respondents quitionare result which shows that the guests are not satified with the waiter/ waitress skills and menu knowledge.

  8. Referrer satisfaction as a quality criterion: developing an questionnaire for measuring the quality of services provided by a radiology department

    International Nuclear Information System (INIS)

    Kubik-Huch, R.A.; Duerselen, L.; Otto, R.; Rexroth, M.; Porst, R.; Szucs, T.

    2005-01-01

    Purpose: to develop a questionnaire for measuring referring physician satisfaction and to conduct a pilot study in which this questionnaire is given to all physicians referring patients to the authors' radiology department. Materials and methods: after qualitative pre-testing and adjustment of the prototype questionnaire, data were collected using the finalized standardized questionnaire comprising 29 indicators rated on a 4-point ordinal scale mailed with a personalized cover letter to the total referring physician population of a radiology department (n = 727). The replies, rated 1-4, were entered into a data entry mask for statistical analysis. Results: the response rate was 33.8%. The indicators with the highest satisfaction rating were the range of examinations offered (''very satisfied'': 79.3% mean 3.79), the quality of the technical equipment used for MRI and CT (79.3%, 3.79) and mammography (82.5%, 3.82), and the quality of the images yielded by these procedures (74.5%, 3.73 and 82.2%, 3.83). Dissatisfaction was relatively high with the indicators ''time to receipt of the written report'' (28.3% ''not very satisfied'' or ''not at all satisfied'', mean 2.97), ''time to receipt of the X-ray images'' (18.2%, 3.07) and ''availability of previous findings'' (20.9%, 3.05); satisfaction was higher among external referring physicians (p < 0.05). Physicians rated the importance of these three indicators as relatively high (''very important'': 62.4%, 54.3% and 49.6%). Other indicators showing a similar level of dissatisfaction were ''car parking availability'' (24.1%, 3.01), ''patient waiting time'' (27.4%, 2.87) and ''patient environment'' (21.2%, 2.99), although these factors were rated as less important (''very important'': 33.0%, 33.7% and 40.4%). (orig.)

  9. Division I Student Athletes' Perceptions: How Well Does the Athletic Department Promote Student Athlete Development in an Urban-Serving University?

    Science.gov (United States)

    Vermillion, Mark

    2014-01-01

    The purpose of the research was to identify student athletes' perceptions of their athletic department regarding student development. Student athletes from a Division I athletic department were surveyed (n = 369) in order to monitor their development. Regression analyses, which included respondent's sport, gender, classification, reports of abuse,…

  10. Recognition difference and improvement direction of the radiological technologists and patient against medical service in department radiology - Inchon area in the object

    International Nuclear Information System (INIS)

    An, Sung Min; Kim, Sung Chul

    2006-01-01

    Satisfaction of the patient against the medical service in department of radiology and it evaluated the different recognition of radiological technologist and patient, and investigates it's improvement direction. It sent the reply the above the which is a usual result in question result of the most that, the receipt process it was complicated in the portion which is insufficient. 'The receipt process is complication', 'waiting time is long' and ' don't radiation protection for patient and guardian'. Also these a facts was recognizing patients and radiological technologist all. And the effort of the radiological technologist is necessary with the method which reduces a recognition difference. The periodical medical service satisfaction investigates and must endeavor in reform measure preparation

  11. When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services.

    Science.gov (United States)

    Moore, Megan; Cristofalo, Margaret; Dotolo, Danae; Torres, Nicole; Lahdya, Alexandra; Ho, Leyna; Vogel, Mia; Forrester, Mollie; Conley, Bonnie; Fouts, Susan

    2017-04-01

    The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10). Eight major social work roles were identified: investigator, gatekeeper, resource broker, care coordinator, problem solver, crisis manager, advocate, discharge planner. Analyses revealed a complex interplay between ED social work services and multi-layered contexts. Using a social-ecological framework, we identified the interactions between micro or individual level factors, mezzo or local system level factors and macro environmental and systemic factors that play a role in ED interactions and patient services. Macro-level contextual influences were socio-structural forces including socioeconomic barriers to health, social hierarchies that reflected power differentials between providers and patients, and distrust or bias. Mezzo-level forces were limited resources, lack of healthcare system coordination, a challenging hierarchy within the medical model and the pressure to discharge patients quickly. Micro-level factors included characteristics of patients and social workers, complexity of patient stressors, empathic strain, lack of closure and compassion. All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker

  12. A Study on the Relationship between Customer Satisfaction and Employee Service Delivery at Sutera Sanctuary Lodges’s Front Office Department at Kinabalu Park, Kundasang, Sabah, Malaysia

    Directory of Open Access Journals (Sweden)

    Alaska Adrian Kalasa

    2014-01-01

    Full Text Available The purpose of this study is focused on the customer service delivery by staff of front office department of Sutera Sanctuary Lodges, at Kinabalu Park, Kundasang, and Sabah, Malaysia. It will look into the attitude, skills and knowledge of the staff on customer service delivery and its effect on customer satisfaction. There are gaps that were identified from the findings; the front line staff has English language issues. The low rating for knowledge and skills in their work area are a concern. As a three (3 Orchid rated lodges operation the standard and quality should not be compromised. There is a positive relationship of customer satisfaction and employee service delivery. Rating of poor service delivery has been noted in the survey in anticipating guests need with 1% below expectation, Speed and efficiency of check-in process with 1% rated below expectation, welcoming and greeting with 11% below expectation. This includes courtesy, helpfulness of staff and grooming all rated 4% in below expectation.

  13. The association between in-service sexual harassment and post-traumatic stress disorder among Department of Veterans Affairs disability applicants.

    Science.gov (United States)

    Murdoch, Maureen; Polusny, Melissa A; Hodges, James; Cowper, Diane

    2006-02-01

    The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants. The study was a cross-sectional survey. Of 4,918 eligible veterans, 3,337 (68%) returned surveys. Nonresponse bias appeared to be minimal. After adjustment for other reported traumas, women's reported in-service sexual harassment severity was significantly associated with PTSD symptom severity (p men and for in-service sexual assault among the women. Men showed no association between in-service sexual harassment and PTSD (p = 0.33), although power was low for this test. Sexual harassment significantly contributed to female veterans' PTSD symptoms; its contribution to men's symptoms was unclear. We discuss mechanisms through which sexual harassment might affect PTSD symptom severity, including the possibility that sexual harassment sometimes meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, definition of a criterion A stressor.

  14. Memorandum from the HR Department and the Legal Service concerning income tax declarations for 2006 in SWITZERLAND

    CERN Document Server

    2007-01-01

    As the Swiss authorities have yet to make known their instructions on how to complete the income tax declaration forms for 2006, members of the CERN personnel who have received or may receive an income tax declaration form must request an extension of the deadline for returning the form to their tax office. Canton of Geneva Declaration forms must be returned by 31 March. An extension to 30 June can be obtained by telephone (stating your tax number) by calling 022 327 49 00 before 31 March. Canton of Vaud Declaration forms must be returned by 15 March. An extension to 15 June can be obtained by telephone (stating your tax number) by calling 021 316 00 00 before 15 March. Canton of Valais Declaration forms must be returned by 31 March. An extension to 31 July can be obtained from the relevant tax office. Please contact the HR Department for further information. Canton of Fribourg Declaration forms must be returned by 31 March. Requests for extensions should be submitted in writing (stating your tax num...

  15. Health-hazard-evaluation report HETA 87-376-2018, US Department of Justice, United States Marshals Service, Washington, DC

    Energy Technology Data Exchange (ETDEWEB)

    Reh, C.M.; Klein, M.K.

    1990-03-01

    In response to a request from the United States Marshals Service (SIC-9221) in Washington, D.C. for assistance in testing the effect of renovations to the ventilation system of their indoor firing range, lead (7439921) exposures were measured during handgun qualifying sessions. Each qualifying session of firing consisted of 60 rounds fired in 10 to 12 minutes. Personal breathing zone air samples were taken from three shooters and the range officer. Lead exposure concentrations measured were 2073, 1786, 172, and 142 micrograms of lead per cubic meter of air (microg/cu m). Eight hour time weighted average concentrations were calculated to be 194, 167, 101, and 13microg/cu m, respectively. The three shooters were therefore overexposed to lead. Bulk sampling of the sand from the bullet trap indicated it to be contaminated, containing 41% lead by weight. The authors concluded that a health hazard existed from exposure to lead. The authors recommended changes to improve the ventilation system. Following modification of the system, tests were again conducted and 11 of the 12 samples taken were below the limits of detection for the method used. The authors conclude that after modification, a hazard did not exist during qualifying sessions. The authors recommend specific measures to protect personnel from exposure to lead.

  16. United States Department of Agriculture-Agricultural Research Service research programs on microbes for management of plant-parasitic nematodes.

    Science.gov (United States)

    Meyer, Susan L F

    2003-01-01

    Restrictions on the use of conventional nematicides have increased the need for new methods of managing plant-parasitic nematodes. Consequently, nematode-antagonistic microbes, and active compounds produced by such organisms, are being explored as potential additions to management practices. Programs in this area at the USDA Agricultural Research Service investigate applied biocontrol agents, naturally occurring beneficial soil microbes and natural compounds. Specific research topics include use of plant growth-promoting rhizobacteria and cultural practices for management of root-knot and ring nematodes, determination of management strategies that enhance activity of naturally occurring Pasteuria species (bacterial obligate parasites of nematodes), studies on interactions between biocontrol bacteria and bacterial-feeding nematodes, and screening of microbes for compounds active against plant-parasitic nematodes. Some studies involve biocontrol agents that are active against nematodes and soil-borne plant-pathogenic fungi, or combinations of beneficial bacteria and fungi, to manage a spectrum of plant diseases or to increase efficacy over a broader range of environmental conditions. Effective methods or agents identified in the research programs are investigated as additions to existing management systems for plant-parasitic nematodes.

  17. [Consultation in a baby clinic of the PMI (mother and infant welfare service): a survey in a French department].

    Science.gov (United States)

    Fanello, Serge; Hassani, Anne; Meunier, Brice; Dagorne, Carole; Parot, Elsa

    2007-01-01

    A dual survey carried out amongst the users and the professionals of PMI showed that proximity, the range of advice available, the exchanges on parenthood, and the assessment of the child's physical and mental progress and of his/her development are the key elements that parents are looking for. It is also noted that the majority of these parents deliberately consult these services. The objectives when consulting vary, going from a model based on the body and physical abilities, found especially in lower and disadvantaged groups, to one emphasising the child's psychological aspect and potential, which is the prerogative of the middle and higher classes. Indeed, although the PMI is particularly aimed at families in difficulties, all the social classes are now represented among the users. The primary role of prevention of PMI means that few parents go there specifically for the treatment of a medical disease. The majority of families maintain a parallel follow-up with another medical professional, usually a general practitioner with whom the PMI has very little contact. Given the decrease in the current medical demography and the governmental directives aimed at improving care in the prenatal period, the prospect of a closer working relationship between these two parties involved in infant welfare would seem to be a way of the future.

  18. Exploring the relationship between costs and quality. Does the joint evaluation of costs and quality alter the rankings of Danish hospital departments?

    DEFF Research Database (Denmark)

    Hvenegaard, Anne; Nielsen Arendt, Jacob; Street, Andrew

    2011-01-01

    vascular departments, we estimate fixed effect models for costs (linear) and quality (logistic). We consider two quality measures; mortality and wound complications. To assess whether the joint evaluation of costs and quality affects the ranking of departments, we construct joint confidence regions......OBJECTIVE: The purpose is to evaluate the relationship between costs and quality and to assess whether the joint evaluation of costs and quality affects the ranking of hospital departments relative to comparison based on costs alone. METHODS: Using patient level data for 3,754 patients in six...... for each pair of departmental effects for costs and quality using a bootstrap method and rank departments according to their cost-effectiveness ratio. The findings are used to evaluate a theory of a U-shaped cost/quality relationship. RESULTS: The association between cost and quality differs depending...

  19. The DOE/DHHS memorandum of understanding: The DOE perspective

    International Nuclear Information System (INIS)

    Goldsmith, R.

    1991-01-01

    On March 27, 1990, Secretary James D. Watkins established an Office of Health under the Assistant Secretary for Environment, Safety and Health. All epidemiologic activities throughout the department were consolidated into this office as part of an Office of Epidemiology and Health Surveillance (OEHS) with specific responsibilities for occupational and community health surveillance. The mission and functions of the OEHS include the conduct of epidemiologic studies at US Department of Energy (DOE) facilities, nearby communities, and other populations. These studies comprise retrospective mortality studies of DOE contractor workers, hypothesis-generating studies related to the potential health effects of energy production and use, ecologic studies of off-site populations, quick-response investigations of suspected disease clusters, and others as needed. In addition, OEHS is responsible for providing procedures, technical support, and other resources for the conduct of DOE-sponsored epidemiologic research studies to be managed outside of DOE, including analytic studies to be managed by the Department of Health and Human Service (HHS) under a memorandum of understanding (MOU), dose-reconstruction studies, and studies related to DOE facilities to be conducted through state health departments

  20. 20 CFR 652.207 - How does a State meet the requirement for universal access to services provided under the Act?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does a State meet the requirement for universal access to services provided under the Act? 652.207 Section 652.207 Employees' Benefits EMPLOYMENT... exercising this discretion, a State must meet the Act's requirements. (b) These requirements are: (1) Labor...

  1. CDBG Public Services Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...

  2. Impact of presumed service-connected diagnosis on the Department of Veterans Affairs healthcare utilization patterns of Vietnam-Theater Veterans: A cross-sectional study.

    Science.gov (United States)

    Fried, Dennis A; Rajan, Mangala; Tseng, Chin-Lin; Helmer, Drew

    2018-05-01

    During the Vietnam War, the US military sprayed almost 20 million gallons of Agent Orange (AO), an herbicide contaminated with dioxin, over Vietnam. Approximately, 2.7 million US military personnel may have been exposed to AO during their deployment. Ordinarily, veterans who can demonstrate a nexus between a diagnosed condition and military service are eligible for Department of Veterans Affairs (VA) service-connected disability compensation. Vietnam Veterans have had difficulty, however, establishing a nexus between AO exposure and certain medical conditions that developed many years after the war. In response, VA has designated certain conditions as "presumed service connected" for Vietnam Veterans who were present and possibly exposed. Veterans with any of these designated conditions do not have to document AO exposure, making it easier for them to access the VA disability system. The extent to which VA healthcare utilization patterns reflect easier access afforded those with diagnosed presumptive conditions remains unknown. In this cross-sectional study, we hypothesized that Vietnam Veterans with diagnosed presumptive conditions would be heavier users of the VA healthcare system than those without these conditions. In our analysis of 85,699 Vietnam Veterans, we used binary and cumulative logit multivariable regression to assess associations between diagnosed presumptive conditions and VA healthcare utilization in 2013. We found that diagnosed presumptive conditions were associated with higher odds of 5+ VHA primary care visits (OR = 2.01, 95% CI: 1.93-2.07), 5+ specialty care visits (OR = 2.11, 95% CI: 2.04-2.18), emergency department use (OR = 1.22, 95% CI: 1.11-1.34), and hospitalization (OR = 1.23, 95% CI: 1.17-1.29). Consistent with legislative intent, presumptive policies appear to facilitate greater VA system utilization for Vietnam Veterans who may have been exposed to AO.

  3. Impact of presumed service-connected diagnosis on the Department of Veterans Affairs healthcare utilization patterns of Vietnam-Theater Veterans

    Science.gov (United States)

    Fried, Dennis A.; Rajan, Mangala; Tseng, Chin-lin; Helmer, Drew

    2018-01-01

    Abstract During the Vietnam War, the US military sprayed almost 20 million gallons of Agent Orange (AO), an herbicide contaminated with dioxin, over Vietnam. Approximately, 2.7 million US military personnel may have been exposed to AO during their deployment. Ordinarily, veterans who can demonstrate a nexus between a diagnosed condition and military service are eligible for Department of Veterans Affairs (VA) service-connected disability compensation. Vietnam Veterans have had difficulty, however, establishing a nexus between AO exposure and certain medical conditions that developed many years after the war. In response, VA has designated certain conditions as “presumed service connected” for Vietnam Veterans who were present and possibly exposed. Veterans with any of these designated conditions do not have to document AO exposure, making it easier for them to access the VA disability system. The extent to which VA healthcare utilization patterns reflect easier access afforded those with diagnosed presumptive conditions remains unknown. In this cross-sectional study, we hypothesized that Vietnam Veterans with diagnosed presumptive conditions would be heavier users of the VA healthcare system than those without these conditions. In our analysis of 85,699 Vietnam Veterans, we used binary and cumulative logit multivariable regression to assess associations between diagnosed presumptive conditions and VA healthcare utilization in 2013. We found that diagnosed presumptive conditions were associated with higher odds of 5+ VHA primary care visits (OR = 2.01, 95% CI: 1.93–2.07), 5+ specialty care visits (OR = 2.11, 95% CI: 2.04–2.18), emergency department use (OR = 1.22, 95% CI: 1.11–1.34), and hospitalization (OR = 1.23, 95% CI: 1.17–1.29). Consistent with legislative intent, presumptive policies appear to facilitate greater VA system utilization for Vietnam Veterans who may have been exposed to AO. PMID:29742706

  4. How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

    Science.gov (United States)

    Wang, Manli; Tao, Hongbing

    2017-09-26

    Objectives : Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design : This research is a cross-sectional study. Methods : In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures : The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t -tests and X² tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results : A total of 56.49% of respondents were from surgical departments. The PPRs for "teamwork within units" and "organizational

  5. Aerial sightings of bowhead whales and other marine mammals by the US Department of the Interior's Minerals Management Service, 1979 - 2006, in the Bering, Chukchi and Beaufort Seas (NODC Accession 0014906)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Minerals Management Service (MMS), previously Bureau of Land Management, has funded fall bowhead whale aerial surveys in this area each year since 1978, using a...

  6. 41 CFR 102-75.105 - What responsibility does the Department of the Interior have if it determines that minerals in...

    Science.gov (United States)

    2010-07-01

    ... the Department of the Interior have if it determines that minerals in the land are unsuitable for disposition under the public land mining and mineral leasing laws? 102-75.105 Section 102-75.105 Public... Interior have if it determines that minerals in the land are unsuitable for disposition under the public...

  7. The DOE/NOAA meteorological program at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    George, D.H.

    1996-01-01

    The National Oceanic and Atmospheric Administration (NOAA) Air Resources Laboratory (ARL) has recently upgraded the U.S. Department of Energy's (DOE's) Idaho National Engineering Laboratory (INEL) Meteorological Measuring Network. This has allowed the entire service system to be modernized

  8. How Does the PAC Respond to Changes in the Payment Rate

    Data.gov (United States)

    U.S. Department of Health & Human Services — How Does the Volume of Post-Acute Care Respond to Changes in the Payment Rate Measure the effect of changes from 1997 to 2001 in Medicares payment rates for skilled...

  9. The Department of Veterans Health Administration Office of Nursing Service, "transforming nursing in a national healthcare system: an example of transformation in action".

    Science.gov (United States)

    Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena

    2011-01-01

    The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.

  10. Hospital-Based Emergency Department Visits With Dental Conditions: Impact of the Medicaid Reimbursement Fee for Dental Services in New York State, 2009-2013.

    Science.gov (United States)

    Rampa, Sankeerth; Wilson, Fernando A; Wang, Hongmei; Wehbi, Nizar K; Smith, Lynette; Allareddy, Veerasathpurush

    2018-06-01

    Hospital-based emergency department (ED) visits for dental problems have been on the rise. The objectives of this study are to provide estimates of hospital-based ED visits with dental conditions in New York State and to examine the impact of Medicaid reimbursement fee for dental services on the utilization of EDs with dental conditions. New York State Emergency Department Database for the year 2009-2013 and Health Resources and Services Administration's Area Health Resource File were used. All ED visits with diagnosis for dental conditions were selected for analysis. The present study found a total of 325,354 ED visits with dental conditions. The mean age of patient was 32.4 years. A majority of ED visits were made by those aged 25-44 years (49%). Whites comprised 52.1% of ED visits. Proportion of Medicaid increased from 22% (in 2009) to 41.3% (in 2013). For Medicaid patients, the mean ED charges and aggregated ED charges were $811.4 and $88.1 million, respectively. Eleven counties had fewer than 4 dentists per 10,000 population in New York State. High-risk groups identified from the study are those aged 25-44 years, uninsured, covered by Medicaid and private insurance, and residing in low-income areas. The study highlights the need for increased Medicaid reimbursement for dentists and improves access to preventive dental care especially for the vulnerable groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

    Science.gov (United States)

    Dinh, Michael M; Muecke, Sandy; Berendsen Russell, Saartje; Chalkley, Dane; Bein, Kendall J; Muscatello, David; Nagaraj, Guruprasad; Paoloni, Richard; Ivers, Rebecca

    2016-01-01

    The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW. Patients that presented to EDs by ambulance between January 2010 and December 2014 were included. Patients dead on arrival, transferred from another hospital, or planned ED presentations were excluded. A total of 10.8 million ED attendances were identified of which 2.6 million (23%) were transported to ED by ambulance. The crude rate of ambulance transportations to EDs across all ages increased by 3.0% per annum over the five years with the highest rate observed in those 85 years and over (620.5 presentations per 1,000 population). There was an increase in the proportion of category 1 and 2 (life-threatening or potentially life-threatening) cases from 18.1% to 24.0%. Demand for ambulance services appears to be driven by older patients presenting with higher acuity problems. Alternative models of acute care for elderly patients need to be planned and implemented to address these changes.

  12. Are trends in billing for high-intensity emergency care explained by changes in services provided in the emergency department? An observational study among US Medicare beneficiaries

    Science.gov (United States)

    Burke, Laura G; Wild, Robert C; Orav, E John; Hsia, Renee Y

    2018-01-01

    Objective There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). Design, setting and participants Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012. Outcomes measures Billing intensity was defined by emergency physician evaluation and management (E&M) codes. We tested for overall trends in high-intensity billing (E&M codes 99285, 99291 and 99292) and in services provided over time using linear regression models, adjusting for patient characteristics. Additionally, we tested for time trends in rates of admission to the hospital and to the intensive care unit (ICU). Next, we classified outpatient visits into 39 diagnosis categories and analysed the change in proportion of high-intensity visits versus the change in number of services. Finally, we quantified the extent to which trends in high-intensity billing are explained by changes in patient demographics and services provided in the ED using multivariable modelling. Results High-intensity visits grew from 45.8% of 671 103 visits in 2006 to 57.8% of 629 010 visits in 2012 (2.0% absolute increase per year; 95% CI 1.97% to 2.03%) as did the mean number of services provided for admitted (1.28 to 1.41; +0.02 increase in procedures per year; 95% CI 0.018 to 0.021) and discharged ED patients (7.1 to 8.6; +0.25 increase in services per year; 95% CI 0.245 to 0.255). There was a reduction in hospital admission rate from 40.1% to 35.9% (−0.68% per year; 95% CI −0.71% to −0.65%; Pbilled as high intensity

  13. Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis.

    Science.gov (United States)

    Sheehan, Barbara; Nigrovic, Lise E; Dayan, Peter S; Kuppermann, Nathan; Ballard, Dustin W; Alessandrini, Evaline; Bajaj, Lalit; Goldberg, Howard; Hoffman, Jeffrey; Offerman, Steven R; Mark, Dustin G; Swietlik, Marguerite; Tham, Eric; Tzimenatos, Leah; Vinson, David R; Jones, Grant S; Bakken, Suzanne

    2013-10-01

    Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

    Science.gov (United States)

    Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

    2015-01-01

    An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

  15. How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

    Science.gov (United States)

    Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

    2015-01-01

    This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

  16. Developing World-Class Customer Service at Navy Field Contracting Activities: An Assessment of the FISC San Diego Regional Contracts Department

    National Research Council Canada - National Science Library

    Allen, Robert

    1997-01-01

    .... The thesis defines world-class customer service and then describes various aspects of service quality including the customer's perspective on service, how service is delivered, how to effectively...

  17. Analysis of environment, safety, and health (ES{ampersand}H) management systems for Department of Energy (DOE) Defense Programs (DP) facilities

    Energy Technology Data Exchange (ETDEWEB)

    Neglia, A. V., LLNL

    1998-03-01

    The purpose of this paper is to provide a summary analysis and comparison of various environment, safety, and health (ES&H) management systems required of, or suggested for use by, the Departrnent of Energy Defense Programs` sites. The summary analysis is provided by means of a comparison matrix, a set of Vean diagrams that highlights the focus of the systems, and an `End Gate` filter diagram that integrates the three Vean diagrams. It is intended that this paper will act as a starting point for implementing a particular system or in establishing a comprehensive site-wide integrated ES&H management system. Obviously, the source documents for each system would need to be reviewed to assure proper implementation of a particular system. The matrix compares nine ES&H management systems against a list of elements generated by identifying the unique elements of all the systems. To simplify the matrix, the elements are listed by means of a brief title. An explanation of the matrix elements is provided in Attachment 2 entitled, `Description of System Elements.` The elements are categorized under the Total Quality Management (TQM) `Plan, Do, Check, Act` framework with the added category of `Policy`. (The TQM concept is explained in the `DOE Quality Management implementation Guidelines,` July 1997 (DOE/QM- 0008)). The matrix provides a series of columns and rows to compare the unique elements found in each of the management systems. A `V` is marked if the element is explicitly identified as part of the particular ES&H management system. An `X` is marked if the element is not found in the particular ES&H management system, or if it is considered to be inadequately addressed. A `?` is marked if incorporation of the element is not clear. Attachment I provides additional background information which explains the justification for the marks in the matrix cells. Through the Vean diagrams and the `End Gate` filter in Section 3, the paper attempts to pictorially display the focus of

  18. 25 CFR 26.30 - Does the Job Training Program provide part-time training or short-term training?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Does the Job Training Program provide part-time training or short-term training? 26.30 Section 26.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.30 Does the Job Training...

  19. Follow-up study of the health experience of U.S. Department of Energy (DOE) workers exposed to >=50mSv (5 rems) per year

    International Nuclear Information System (INIS)

    Fry, S.A.; Hudson, D.R.H.; Robie, D.M.; Lushbaugh, C.C.; Rudnick, S.A.; Shy, C.M.

    1982-01-01

    In 1978, the U.S. Department of Energy initiated a study of its employees reported to have equalled or exceeded the current occupational limit of 50 mSv per year since 1947. The 3200 employees under study were involved in the post-mining and pre-waste disposal phases of the nuclear fuel cycle. The objective of the study is to identify any excess mortality or morbidity in these employees and to determine whether or not any such increase is attributable to occupational exposure to radiation. Standardized mortality ratios will be developed for all and specific causes by comparing the age and sex adjusted mortality rates in the cohort initially with similarly adjusted rates in the general U.S. population. Exploratory analysis of these parameters, based on currently available data, has shown deficits in the cohort of deaths due to all causes, all malignant neoplasms and diseases of the circulatory system. (U.K.)

  20. Emergency Department Management of a Myasthenia Gravis Patient with Community-Acquired Pneumonia: Does Initial Antibiotic Choice Lead to Cure or Crisis?

    Science.gov (United States)

    Van Berkel, Megan A; Twilla, Jennifer D; England, Bryan S

    2016-02-01

    Myasthenic crisis is a rare, yet serious condition that carries a 3%-8% mortality rate. Although infection is a common cause of decompensation in myasthenia gravis, several antibiotics classes have also been associated with an exacerbation. Selecting antibiotics can be a daunting clinical task and, if chosen inappropriately, can carry significant deleterious consequences. Not only do clinicians have to focus on treating the underlying infection appropriately, but avoiding antibiotics that may potentiate a myasthenic crisis is also vital. An 85-year-old female with a history of myasthenia gravis presented to the emergency department (ED) with increasing generalized weakness and shortness of breath. Clinical work-up was consistent with a community-acquired pneumonia (CAP) diagnosis. Her medical history included a myasthenia gravis exacerbation shortly after receiving moxifloxacin for CAP. After reviewing the patient's allergies, as well as potential antibiotic triggers, the decision was made to treat with tigecycline. The patient responded well to tigecycline therapy and was deemed stable for discharge on day 4 of hospitalization. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Evaluation of the myasthenia gravis patient frequently originates in the ED. It is important for clinicians to be able to distinguish between an underlying illness and a myasthenic crisis. In the event of an infectious process causing clinical deterioration in a myasthenia patient, optimal antibiotic selection becomes paramount. This patient case highlights the addition of tigecycline to the armamentarium of therapies available to treat myasthenia gravis patients presenting to the emergency department with CAP. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. US Department of Energy Portsmouth annual environmental report for 1996

    International Nuclear Information System (INIS)

    1997-09-01

    The Portsmouth plant is one of two U.S. Department of Energy (DOE)-owned, contractor-managed uranium enrichment facilities in operation. As of July 1, 1993, responsibility for implementing environmental compliance at the facility was split between DOE, as site owner, and the United States Enrichment Corporation (USEC), a government-owned corporation formed by the National Energy Policy Act of 1992, to operate the nation's uranium enrichment business. The management contractor for DOE is Lockheed Martin Energy Systems (formerly Martin Marietta Energy Systems), which is responsible for waste management, environmental restoration, removal of highly enriched uranium (HEU), and operation of nonleased facilities at the Portsmouth Gaseous Diffusion Plant (DOE/PORTS). Lockheed Martin Utility Services (formerly Martin Marietta Utility Services) provides management services for USEC. The Nuclear Regulatory Commission will assume direct oversight of USEC operations in 1997. Until then, DOE will provide oversight of nuclear safety and safeguards and security. DOE/PORTS is located on about six square miles in Pike County, Ohio. The County has approximately 24,250 residents. The total population within 50 miles of the plant is about 900,000. The main process at PORTS has been the separation of uranium isotopes through gaseous diffusion. Uranium is no longer enriched by DOE at PORTS. The uranium enrichment production operation facilities at the site are leased to USEC and are managed and operated by Lockheed Martin Utility Services

  2. US Department of Energy Portsmouth annual environmental report for 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-09-01

    The Portsmouth plant is one of two U.S. Department of Energy (DOE)-owned, contractor-managed uranium enrichment facilities in operation. As of July 1, 1993, responsibility for implementing environmental compliance at the facility was split between DOE, as site owner, and the United States Enrichment Corporation (USEC), a government-owned corporation formed by the National Energy Policy Act of 1992, to operate the nation`s uranium enrichment business. The management contractor for DOE is Lockheed Martin Energy Systems (formerly Martin Marietta Energy Systems), which is responsible for waste management, environmental restoration, removal of highly enriched uranium (HEU), and operation of nonleased facilities at the Portsmouth Gaseous Diffusion Plant (DOE/PORTS). Lockheed Martin Utility Services (formerly Martin Marietta Utility Services) provides management services for USEC. The Nuclear Regulatory Commission will assume direct oversight of USEC operations in 1997. Until then, DOE will provide oversight of nuclear safety and safeguards and security. DOE/PORTS is located on about six square miles in Pike County, Ohio. The County has approximately 24,250 residents. The total population within 50 miles of the plant is about 900,000. The main process at PORTS has been the separation of uranium isotopes through gaseous diffusion. Uranium is no longer enriched by DOE at PORTS. The uranium enrichment production operation facilities at the site are leased to USEC and are managed and operated by Lockheed Martin Utility Services.

  3. RESPONSE OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN PROTECTING CIVILIAN AMERICANS IN JAPAN DURING THE FUKUSHIMA NUCLEAR CRISIS.

    Science.gov (United States)

    Simon, Steven L; Coleman, C Norman; Noska, Michael A; Bowman, Thomas

    2012-05-01

    Following the earthquake and tsunami in northern Japan on 11 March 2011, and the ensuing damage to the Fukushima Daiichi nuclear power plant complex, a request by the U.S. Ambassador to Japan to the U.S. Department of Health and Human Services (DHHS) Assistant Secretary for Preparedness and Response (ASPR) resulted in deployment of a five-person team of subject matter experts to the U.S. Embassy. The primary purpose of the deployment was to provide the U.S. Embassy in Tokyo with guidance on health and medical issues related to potential radiation exposure of U.S. citizens in Japan, including employees of the U.S. Department of State at consulates in Japan and American citizens living in or visiting Japan. At the request of the Government of Japan, the deployed health team also assisted Japanese experts in their public health response to the radiation incident. Over a three-week period in Japan and continuing for weeks after their return to the U.S., the team provided expertise in the areas of medical and radiation oncology, health physics, assessment of radiation dose and cancer risk, particularly to U.S. citizens living in Tokyo and the surrounding areas, food and water contamination and the acceptable limits, countermeasures to exposure such as potassium iodide (KI), the use of KI and an offered donation from the United States, evacuation and re-entry issues, and health/emergency-related communication strategies. This paper describes the various strategies used and observations made by the DHHS team during the first two months after the Fukushima crisis began.

  4. Does comorbid chronic pain affect posttraumatic stress disorder diagnosis and treatment? Outcomes of posttraumatic stress disorder screening in Department of Veterans Affairs primary care.

    Science.gov (United States)

    Outcalt, Samantha D; Hoen, Helena Maria; Yu, Zhangsheng; Franks, Tenesha Marie; Krebs, Erin E

    2016-01-01

    Because posttraumatic stress disorder (PTSD) is both prevalent and underrecognized, routine primary care-based screening for PTSD has been implemented across the Veterans Health Administration. PTSD is frequently complicated by the presence of comorbid chronic pain, and patients with both conditions have increased symptom severity and poorer prognosis. Our objective was to determine whether the presence of pain affects diagnosis and treatment of PTSD among Department of Veterans Affairs (VA) patients who have a positive PTSD screening test. This retrospective cohort study used clinical and administrative data from six Midwestern VA medical centers. We identified 4,244 VA primary care patients with a positive PTSD screen and compared outcomes for those with and without a coexisting pain diagnosis. Outcomes were three clinically appropriate responses to positive PTSD screening: (1) mental health visit, (2) PTSD diagnosis, and (3) new selective serotonin reuptake inhibitor (SSRI) prescription. We found that patients with coexisting pain had a lower rate of mental health visits than those without pain (hazard ratio: 0.889, 95% confidence interval: 0.821-0.962). There were no significant differences in the rate of PTSD diagnosis or new SSRI prescription between patients with and without coexisting pain.

  5. List of DOE radioisotope customers with summary of radioisotope shipments, FY 1986

    International Nuclear Information System (INIS)

    Lamar, D.A.

    1988-01-01

    Data were collected and compiled on radioisotopes produced and sold by Department of Energy (DOE) facilities, and on services rendered by DOE facilities. Compiled data were published and distributed in the document list of DOE Radioisotope Customers with Summary of Radioisotope Shipments, FY 1986, PNL-6361, October 1987. The DOE facilities that supplied information for the compilation were Argonne National Laboratory, Brookhaven National Laboratory, Hanford Engineering Development Laboratory, Idaho National Engineering Laboratory, Los Alamos National Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratory, Savannah River Plant, and UNC Nuclear Industries, Inc. (Hanford). The data provided were reported in several different ways: (1) a list of radioisotopes and services provided by each facility; (2) a list of radioisotope customers, the supplying DOE facility, and the radioisotope or service provided to each customer; and (3) a list of the quantity and value of each radioisotope or service sold by each DOE facility. The sales information covered foreign customers, domestic private customers, and domestic DOE customers

  6. Utilization of maternal health care services in the department of Matagalpa, Nicaragua Utilización de los servicios de salud materna en el departamento de Matagalpa, Nicaragua

    Directory of Open Access Journals (Sweden)

    Lindsey Ann Lubbock

    2008-08-01

    Full Text Available OBJECTIVES: To better understand the individual and community factors and perceptions that influence women's health care-seeking behaviors during pregnancy in order to increase women's utilization of maternal health services. METHODS: This study investigates the logistical and sociocultural barriers influencing women's utilization of maternal health services through 37 semi-structured in-depth interviews with women from the department of Matagalpa, Nicaragua. RESULTS: Results reveal that delays in seeking health care during pregnancy are influenced not only by poor access to care and economic barriers but also by individual and community knowledge and acceptance of maternal health services. Partner support, previous maternal health care experiences, and the degree of communication with other women and health workers affect women's decisions to seek care. CONLUSIONS: Evidence suggests that in order to improve maternal health outcomes in this region, interventions must be targeted at a hierarchy of levels: individual, household, and community.OBJETIVOS: Mejorar el conocimiento sobre las percepciones y los factores personales y comunitarios que influyen en la búsqueda de atención médica durante el embarazo, con vistas a aumentar la utilización de los servicios de salud materna. MÉTODOS: Mediante 37 entrevistas semiestructuradas en profundidad aplicadas a mujeres del departamento de Matagalpa, Nicaragua, se investigaron las barreras logísticas y socioculturales que influyen en la utilización de los servicios de salud materna. RESULTADOS: Los resultados muestran que sobre la demora en la búsqueda de atención sanitaria durante el embarazo influyeron no solo el escaso acceso y las barreas económicas, sino también el conocimiento individual y comunitario sobre los servicios de salud materna y su grado de aceptación. El apoyo de la pareja, el haber recibido atención médica durante embarazos previos y el grado de comunicación con otras

  7. How does a servant leader fuel the service fire? A multilevel model of servant leadership, individual self identity, group competition climate, and customer service performance.

    Science.gov (United States)

    Chen, Zhijun; Zhu, Jing; Zhou, Mingjian

    2015-03-01

    Building on a social identity framework, our cross-level process model explains how a manager's servant leadership affects frontline employees' service performance, measured as service quality, customer-focused citizenship behavior, and customer-oriented prosocial behavior. Among a sample of 238 hairstylists in 30 salons and 470 of their customers, we found that hair stylists' self-identity embedded in the group, namely, self-efficacy and group identification, partially mediated the positive effect of salon managers' servant leadership on stylists' service performance as rated by the customers, after taking into account the positive influence of transformational leadership. Moreover, group competition climate strengthened the positive relationship between self-efficacy and service performance. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  8. Characterization of sexual abuse cases valued in the emergency services and outpatient consultation of a first-level hospital institution in the department of Cauca, 2007 - 2015

    Directory of Open Access Journals (Sweden)

    Gloria Cerón Hernández

    2017-08-01

    Full Text Available Introduction: Sexual abuse affects millions of children and adolescents and it impacts on their physical and mental health. Objective: To characterize the cases of sexual abuse valued in the emergency services and external consultation of a hospital institution of first level in the department of Cauca between 2007 and 2015. Materials and methods: A descriptive, retrospective study of victims of sexual abuse attended in external consultation/emergencies was made. Temporal and sociodemographic variables of the victim/aggressor and the context where the event occurred were selected. The analysis was done in Epi Info. Measures of central tendency, dispersion, proportions and reasons were calculated. The relationship between variables was assessed by using the Fischer test. Results: 77% of the victims were women, 23% men, at ages between 2 to 16 years and 100% were students. The act was committed by a single aggressor. Besides, in 93.0% of the cases, the act was perpetrated by acquaintances, of whom 42.9% were family members. Conclusions: Despite the control and regulation measures, the results suggest that sexual abuse takes place at very early ages. The aggressor is almost always a commonly known person with consanguineous bond, which facilitates the perpetuation of the act towards the family nucleus through deceit, blackmail or threat.

  9. The Effects of Management Information System toward Decision Making in Food and Beverage Service Department in X Resorts and Hotels Bandung

    Directory of Open Access Journals (Sweden)

    Agung Gita Subakti

    2015-11-01

    Full Text Available In an organization, decision making hold an important role. That is why a decision made by managers should be a final decision that should be done by their subordinates or those who are related with the organization. In the effort to increase the quality of management information system, a research was held in X Resorts and Hotels Bandung to analyze management information system in the relation to decision making especially in Food and Beverage Service Department and recommendation of how to handle the problem occurred. From the questioner with data analyzing technique of spearman rank gained correlation result 0,84, with determination coefficient 71% which means the management information system has 71% level of influence to decision making, meanwhile the rest of the result (29% shows other factors, which also were related with the decision making other than management information system. To solve with the problem, it is recommended that X Resorts and Hotels decrease the level of information product error in management information used and fasten the delivery of provided information.

  10. [Financial analysis of a department of general surgery in a French hospital. The new "fee-for-service" reimbursement system results in a high deficit for emergency care].

    Science.gov (United States)

    Burdy, G; Dalban-Sillas, B; Leclerc, C; Bonnaventure, F; Roullet Audy, J-C; Frileux, P

    2009-10-01

    The aim of this study was to perform a detailed analysis of income and expense in a department of general surgery in a French hospital under the new system of funding based on a "fee-for-service" principle. All hospital stays of year 2006 were analysed retrospectively. The conditions of admission (elective vs. emergency), the principal diagnosis, and surgical procedures were examined. We determined hospital costs and the reimbursement for every admission. One thousand nine hundred and eighty-five hospitalizations generated an income of 8Meuros with a deficit of 1.3Meuros. The 775 elective admissions generated 50% of the income and 13% of the deficit (178,562euros). Seven hundred and forty-nine emergency admissions generated 45% of the income and 82% of deficit (1.1Meuros). Four hundred and sixty-one admissions for endoscopy generated 5% of the income and 5% of the deficit (67,249euros). Hospital stays of less than two days (the minimum duration of stay for total reimbursement) caused a loss of 122,624euros. Length of hospital stay below the lower limit caused a loss of 42,850euros. Elective surgical activity in digestive surgery can generate a balanced budget provided the length of hospital stay is reduced to the minimum, sometimes to the detriment of patient comfort. Emergency admissions result in a large deficit between cost and reimbursement; this fact may lead hospitals to avoid emergency activity in the future unless appropriate remedial measures are taken.

  11. Assessing Healthcare Utilization for Influenza-like Illness at an Emergency Department and a Student Health Service during the 2009–2010 H1N1 Pandemic

    Directory of Open Access Journals (Sweden)

    Ruchi Bhandari

    2013-01-01

    Full Text Available Estimates of healthcare utilization during an influenza pandemic are needed in order to plan for the allocation of staff and resources. The aim of this study was to assess the number, age, and arrival time of patients with influenza-like-illness (ILI, and associations between their symptoms during the 2009–2010 H1N1 pandemic. We conducted a cross-sectional analysis of electronic health records from the student health service (SHS and an emergency department (ED in Morgantown, West Virginia, between January 2009 and December 2010. During the 2009–2010 H1N1 pandemic, patient arrivals at SHS and ED varied over the week. SHS patients arrived early in the week and primarily in the afternoon. ED patient arrivals were more evenly distributed, with busier evenings and weekends. Those with fever were more likely to experience cough, sore throat, vomiting/nausea, chills, congestion, headache, and body-ache. These results can assist health professionals in preparing for an influenza pandemic.

  12. Effectiveness of the VOICES/VOCES sexually transmitted disease/human immunodeficiency virus prevention intervention when administered by health department staff: does it work in the "real world"?

    Science.gov (United States)

    Neumann, Mary Spink; O'Donnell, Lydia; Doval, Alexi San; Schillinger, Julia; Blank, Susan; Ortiz-Rios, Elizabeth; Garcia, Trinidad; O'Donnell, Carl R

    2011-02-01

    Prevention providers wonder whether benefits achieved in the original, researcher-led, efficacy trials of interventions are replicated when the intervention is delivered in real-world settings by their agency's staff. A replication study was conducted at 2 public sexually transmitted disease (STD) clinics (New York City and San Juan, PR). Using a controlled trial design, intervention (VOICES/VOCES) and comparison conditions (regular clinic services) were assigned in alternating 4-week blocks. Trained agency staff delivered the intervention. Effectiveness was assessed for incident STDs, redemption of coupons for condoms at neighborhood location after the visit, and improved knowledge and attitudes about STDs and condoms. A total of 3365 patients were recruited, completed the protocol, and followed through STD surveillance systems for an average of 17 months. Of 397 with an incident infection, 226 (13.4%) were among those enrolled during comparison blocks; 171 were among those in the intervention condition (10.2%). Controlling for site and gender, participants enrolled during intervention blocks were significantly less likely to have an incident STD reported to the surveillance system (hazard ratio, 0.78; 95% confidence interval, 0.64-0.96). Intervention block participants scored higher on scales of STD knowledge (4.89 vs. 3.87, P VOCES redeemed condoms (P < 0.05). Positive effects were more consistent in New York, which may be related to fidelity of implementation. A packaged human immunodeficiency virus prevention intervention can be delivered by agencies, with benefits similar to those achieved in the research setting.

  13. Department of Defense perspective

    International Nuclear Information System (INIS)

    Devine, R.

    1985-01-01

    This paper examines radiation instrumentation from the Department of Defense perspective. Radiation survey instruments and calibration, or RADIAC, as it is called in the services, while administratively falling under the Assistant Secretary of Defense for Atomic Energy, has generally been managed at a lower level. The Naval Electronics Systems Command and Army Signal Corp are the two principles in the Department of Defense for RADIAC. The actions of the services are coordinated through the tri-service RADIAC working group, which meets about every year and a half. Several points from this organization are highlighted

  14. OFFSHORING OF IT AND IT-ENABLED SERVICES: how far does India benefit from Its outsourcing industry

    Directory of Open Access Journals (Sweden)

    ANINDYA BHATTACHARYA

    2007-07-01

    Full Text Available The literature on services offshoring typically focuses on the extent of job losses in the homecountry. The impact on recipient countries is rarely examined in the western debate onoffshore outsourcing. The purpose of this paper is to analyze the impact of offshoring ininformation technology (IT and IT-enabled services (ITES, including business processoutsourcing (BPO, on employment creation and technology diffusion/innovation gap inIndia. The paper concludes that being a service industry, the IT/ITES sector cannot beexpected to solve India’s massive unemployment problem. India needs to build laborintensive,manufactured products, not just services, in order to create jobs for millions ofeducated but unemployed young Indians. Concerning technology diffusion/innovation gap, inspite of impressive progress achieved by Indian service providers, they continue to lag behindin high-end areas that call for creativity and innovation such as inventing innovative businessproducts, and creating new global markets for such products.

  15. Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

    Directory of Open Access Journals (Sweden)

    Hameed W

    2018-05-01

    Full Text Available Waqas Hameed, Muhammad Ishaque, Xaher Gul, Junaid-ur-Rehman Siddiqui, Sharmeen Hussain, Wajahat Hussain, Aftab Ahmed, Asma Balal Strategy Department, Marie Stopes Society, Karachi, Sindh, Pakistan Purpose: Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods: A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO clinics, social franchise (SF centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results: Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality and perception-based (satisfaction questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality. Conclusion: Our study indicates signs of courtesy bias and possibly the Hawthorne effect in

  16. S. 1030: A bill to authorize private sector participation in providing products and services to support Department of Energy defense waste cleanup and modernization missions, introduced in the US Senate, One Hundred Second Congress, First Session, May 9, 1991

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    This bill was introduced into the US Senate on May 9, 1991 to authorize private sector participation in providing products and services to support Department of Energy defense waste cleanup and modernization. Congress finds that the management and cleanup of nuclear and hazardous waste and the modernization of Department of Energy facilities must be pursued expeditiously in order to protect the health and safety of the public and workers

  17. Pathway To Low-Carbon Lignite Utilization; U.S. Department of Energy (DOE) National Energy Technology Laboratory (NETL) Cooperative Agreement No. DE-FE0024233

    Energy Technology Data Exchange (ETDEWEB)

    Kay, John [Univ. of North Dakota, Grand Forks, ND (United States); Stanislowski, Joshua [Univ. of North Dakota, Grand Forks, ND (United States); Tolbert, Scott [Univ. of North Dakota, Grand Forks, ND (United States); Fiala, Nathan [Univ. of North Dakota, Grand Forks, ND (United States); Patel, Nikhil [Univ. of North Dakota, Grand Forks, ND (United States); Laumb, Jason [Univ. of North Dakota, Grand Forks, ND (United States)

    2017-05-31

    typically used. Their performance was good, and they may be good candidates for medium-pressure gasifiers, but much more scale-up work is needed. Next-generation power cycles are currently being developed and show promise for high efficiency, and the utilization of supercritical CO2 to drive a turbine could significantly increase cycle efficiency over traditional steam cycles. The EERC evaluated pressurized oxy-combustion technology from the standpoint of CO2 purification. If impurities can be removed, the costs for CO2 capture can be lowered significantly over postcombustion capture systems. Impurity removal consisted of a simple water scrubber referred to as the DeSNOx process. The process worked well, but corrosion management is crucial to its success. A model of this process was constructed. Finally, an integrated gasification combined-cycle (IGCC) system model, developed by the Massachusetts Institute of Technology (MIT), was modified to allow for the modeling of membrane systems in the IGCC process. This modified model was used to provide an assessment of the costs of membrane use at full scale. An economic estimation indicated a 14% reduction in cost for CO2 separation over the SELEXOL™ process. This subtask was funded through the EERC–DOE Joint Program on Research and Development for Fossil Energy-Related Resources Cooperative Agreement No. DE-FE0024233. Nonfederal sponsors for this project were the North Dakota Industrial Commission, Basin Electric Power Cooperative, and Allete, Inc. (including BNI Coal and Minnesota Power).

  18. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

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

  19. 41 CFR 105-68.610 - What procedures does the General Services Administration use in suspension and debarment actions?

    Science.gov (United States)

    2010-07-01

    ..., consistent with principles of fundamental fairness. (a) For suspension actions, we use the procedures in this... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What procedures does the... Public Contracts and Property Management Federal Property Management Regulations System (Continued...

  20. Does Implementation of Biomathematical Models Mitigate Fatigue and Fatigue-related Risks in Emergency Medical Services Operations? A Systematic Review

    Science.gov (United States)

    2018-01-11

    Background: Work schedules like those of Emergency Medical Services (EMS) personnel have been associated with increased risk of fatigue-related impairment. Biomathematical modeling is a means of objectively estimating the potential impacts of fatigue...

  1. Does restaurant performance meet customers' expectations? An assessment of restaurant service quality using a modified DINESERV approach

    OpenAIRE

    Marković, Suzana; Raspor, Sanja; Šegarić, Klaudio

    2010-01-01

    The purpose of this study is to determine restaurant service quality. The aims are to: (a) assess customers’ expectations and perceptions, (b) establish the significance of difference between perceived and expected service quality, (c) identify the number of dimensions for expectations and perceptions scales of modified DINESERV model, (d) test the reliability of the applied DINESERV model. The empirical research was conducted using primary data. The questionnaire is based on Stevens et al. (...

  2. Epidemiologic research programs at the Department of Energy: Looking to the future

    International Nuclear Information System (INIS)

    1994-01-01

    The secretary of the Department of Energy (DOE) asked the National Research Council in 1989 to establish a Committee on Radiation Epidemiological Research Programs to provide scientific advice on the current status and future direction of DOE's epidemiologic research program. This report is in response to a request from the National Research Council committee to provide advice regarding the future directions of OEHS's epidemiologic research. This report begins with some of the background leading to the current activities of OEHS. In 1990, a committee (the Secretarial Panel for the Evaluation of Epidemiological Research Activities, or SPEERA) established by the secretary of the DOE recommended that DOE enter into a memorandum of understanding (MoU) with the Department of Health and Human Services that outlined the responsibilities of the two departments regarding epidemiologic research. The present report points out that the implementation of the SPEERA recommendations and the MoU by DOE have raised issues that have not been satisfactorily resolved

  3. 20 CFR 1002.73 - Does service in the uniformed services have to be an employee's sole reason for leaving an...

    Science.gov (United States)

    2010-04-01

    ... services. For example, if the employee is required to report to an out of State location for military training and he or she spends off-duty time during that assignment moonlighting as a security guard or... or she used some of the time away from the job to do something other than attend the military...

  4. The effect of relational constructs on customer referrals and number of services purchases from a multi-service provider: Does age of a relationship matter?

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); P.C. Verhoef (Peter); J.C. Hoekstra (Janny)

    2002-01-01

    textabstractThe authors examine the effect of relational constructs (e.g., satisfaction, trust, and affective and calculative commitment) on customer referrals and the number of services purchased, as well as the moderating effect of age of the relationship on these relationships. The research

  5. How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China

    Directory of Open Access Journals (Sweden)

    Tang Shenglan

    2010-05-01

    Full Text Available Abstract Background Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS is being developed since 2003. Although there is concern about whether the NCMS will influence the serious situation of inequity in health service utilization in rural China, there is only limited evidence available. This paper aims to assess the utilisation of outpatient and inpatient services among different income groups and provinces under NCMS in rural China. Methods Using multistage sampling processes, a cross-sectional household survey including 6,147 rural households and 22,636 individuals, was conducted in six counties in Shandong and Ningxia Provinces, China. Chi-square test, Poisson regression and log-linear regression were applied to analyze the association between NCMS and the utilization of outpatient and inpatient services and the length of stay for inpatients. Qualitative methods including individual interview and focus group discussion were applied to explain and complement the findings from the household survey. Results NCMS coverage was 95.9% in Shandong and 88.0% in Ningxia in 2006. NCMS membership had no significant association with outpatient service utilization regardless of income level and location. Inpatient service utilization has increased for the high income group under NCMS, but for the middle and low income, the change was not significant. Compared with non-members, NCMS members from Ningxia used inpatient services more frequently, while members from Shandong had a longer stay in hospital. High medical expenditure, low reimbursement rate and difference in NCMS policy design between regions were identified as the main reasons for the differences in health service utilization. Conclusions Outpatient service utilization has not significantly changed under NCMS. Although utilization of inpatient service in general

  6. How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China.

    Science.gov (United States)

    Yu, Baorong; Meng, Qingyue; Collins, Charles; Tolhurst, Rachel; Tang, Shenglan; Yan, Fei; Bogg, Lennart; Liu, Xiaoyun

    2010-05-10

    Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS) is being developed since 2003. Although there is concern about whether the NCMS will influence the serious situation of inequity in health service utilization in rural China, there is only limited evidence available. This paper aims to assess the utilisation of outpatient and inpatient services among different income groups and provinces under NCMS in rural China. Using multistage sampling processes, a cross-sectional household survey including 6,147 rural households and 22,636 individuals, was conducted in six counties in Shandong and Ningxia Provinces, China. Chi-square test, Poisson regression and log-linear regression were applied to analyze the association between NCMS and the utilization of outpatient and inpatient services and the length of stay for inpatients. Qualitative methods including individual interview and focus group discussion were applied to explain and complement the findings from the household survey. NCMS coverage was 95.9% in Shandong and 88.0% in Ningxia in 2006. NCMS membership had no significant association with outpatient service utilization regardless of income level and location.Inpatient service utilization has increased for the high income group under NCMS, but for the middle and low income, the change was not significant. Compared with non-members, NCMS members from Ningxia used inpatient services more frequently, while members from Shandong had a longer stay in hospital.High medical expenditure, low reimbursement rate and difference in NCMS policy design between regions were identified as the main reasons for the differences in health service utilization. Outpatient service utilization has not significantly changed under NCMS. Although utilization of inpatient service in general has increased under NCMS, people with high income tend to benefit

  7. DOE and the United States enrichment market

    International Nuclear Information System (INIS)

    Rutkowski, E.E.

    1993-01-01

    The US Department of Energy (DOE) and its predecessors have exerted a predominant influence in the uranium enrichment services industry since 1969, when it began to sell its services to private industry under a Requirement-Type Contract (RTC). After almost 25 years of providing these services to utilities throughout the world, DOE is now preparing to hand over responsibility to the emerging US Enrichment Corporation (USEC), which was created by the 1992 Energy Bill and will begin its tenure on July 1, 1993. DOE has had some notable successes, including revenue generation of about $25 billion from its domestic and foreign sales since 1969. Annual revenues from civilian dollars over the next several years. However, most of the sales attributed to these revenues took place in 1986-more than six years ago. Presently, US utility commitments are decreasing significantly; to date, US utilities have committed less than two percent of their total FY2002 enrichment requirements to DOE. In spite of the fact that DOE has enjoyed some success, its past actions, or sometimes inactions, have often been steeped in controversy that resulted in customer alienation and dissatisfaction. It is the legacy of past DOE contracting practices, increased competition, and massive contractual terminations, that USEC will inherit from DOE. Therefore, it is relevant to consider the major issues that have fashioned the current US market and resulted in USEC's initial position in the marketplace

  8. Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

    Science.gov (United States)

    2010-01-01

    Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services. PMID:21062460

  9. Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

    Directory of Open Access Journals (Sweden)

    Qureshi Asma M

    2010-11-01

    Full Text Available Abstract Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. Results In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00 relative to private non-franchises. Service use was significantly associated with training (P = 0.00, franchise affiliation (P = 0.01, providers' years of family planning experience (P = 0.02 and the number of trained staff working at government owned clinics (P = 0.00. In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00. Conclusions These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.

  10. Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

    Science.gov (United States)

    Qureshi, Asma M

    2010-11-09

    To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client volume, and training in family planning. Regression models are used to compute the association between training and service use in franchise versus private non-franchise clinics. In franchise clinic networks, staff are 6.5 times more likely to receive family planning training (P = 0.00) relative to private non-franchises. Service use was significantly associated with training (P = 0.00), franchise affiliation (P = 0.01), providers' years of family planning experience (P = 0.02) and the number of trained staff working at government owned clinics (P = 0.00). In this setting, nurses are significantly less likely to receive training compared to doctors (P = 0.00). These findings suggest that franchises recruit and train various cadres of health workers and training maybe associated with increased service use through improvement in quality of services.

  11. DOE management

    International Nuclear Information System (INIS)

    Rezendes, V.S.

    1991-07-01

    This paper reports that GAO, as well as the Department of Energy's Inspector General, have pointed out the need for major improvement in the University of California's management of the three DOE laboratories-Lawrence Livermore, Los Alamos, and Lawrence Berkeley- and DOE oversight of that management effort. GAO found problems with University of California controls over laboratory operations, such as managing property, protecting classified documents, and ensuring that subcontractors are not subject to foreign influence, which might lead to transfers of nuclear technology to foreign influence, which might lead to transfers of nuclear technology or materials to foreign countries. In addition, clauses in the University of California contracts hamper DOE's ability to effectively manage the laboratories. DOE has addressed many of the specific problems that GAO identified and has tried to improve overall contract management. Negotiations with the University of California to extend the laboratory contracts will present another opportunity for DOE to take a firm stance on the need for management improvements. Having appropriate procedures and resources in place would also help DOE carry out its administration of contracts

  12. 30 CFR 285.1000 - What activities does this subpart regulate?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What activities does this subpart regulate? 285.1000 Section 285.1000 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... Activities § 285.1000 What activities does this subpart regulate? (a) This subpart provides the general...

  13. 30 CFR 206.62 - Does MMS protect information I provide?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Does MMS protect information I provide? 206.62 Section 206.62 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT PRODUCT VALUATION Indian Oil § 206.62 Does MMS protect information I provide? The MMS will keep...

  14. Services Supply Chain in the Department of Defense: A Comparison of Acquisition Management Practices in the Army, Navy, and Air Force

    Science.gov (United States)

    2010-08-23

    characteristics also lead to differences in the marketing of services ( Lovelock , 1992; Hutt & Speh, 1998). Given these differences in the production and...Press. Lovelock , C. H. (1992). Are services really different? In C. H. Lovelock (Ed.), Managing services (2nd ed., pp. 1-8). Englewood Cliffs, NJ

  15. Metallurgy Department

    DEFF Research Database (Denmark)

    Risø National Laboratory, Roskilde

    The activities of the Metallurgy Department at Risø during 1981 are described. The work is presented in three chapters: General Materials Research, Technology and Materials Development, Fuel Elements. Furthermore, a survey is given of the department's participation in international collaboration...

  16. Does "Enhanced Support" for Offenders Effectively Reduce Custodial Violence and Disruption? An Evaluation of the Enhanced Support Service Pilot.

    Science.gov (United States)

    Camp, Jake; Joy, Kerry; Freestone, Mark

    2018-01-01

    This study aimed to examine the effectiveness of The Enhanced Support Service (ESS) pilot in reducing custodial violence and disruption, and the associated costs, by observing the behavioural change of the 35 service users who participated in ESS intervention within its first 22 months of operation. Frequencies of recorded incidents of aggressive behaviours, self-harming behaviours, noncompliance, and positive behaviours were counted from routine administrative systems using a coding structure developed in previous studies. The count data were analysed using nonparametric tests and Poisson regression models to derive an Incident Rate Ratio (IRR). Findings suggest the ESS is associated with a reduction in aggressive behaviours and noncompliance, with medium to large effect sizes ( r = .31-.53); however, it was not associated with a reduction in deliberate self-harm or increased positive behaviours. The Poisson models revealed that levels of pre-intervention behaviour, intervention length, intervention completion, and service location had varying effects on postintervention behaviour, with those who completed intervention demonstrating more favourable outcomes. The ESS service model was associated with a reduction in behaviour that challenges, which has implications for the reduction in associated social, economic, and political costs-as well as the commissioning of interventions and future research in this area.

  17. Does Higher Education Service Quality Effect Student Satisfaction, Image and Loyalty? A Study of International Students in Malaysian Public Universities

    Science.gov (United States)

    Ali, Faizan; Zhou, Yuan; Hussain, Kashif; Nair, Pradeep Kumar; Ragavan, Neethiahnanthan Ari

    2016-01-01

    Purpose: The purpose of this study is to investigate the effect of Malaysian public universities' service quality on international student satisfaction, institutional image and loyalty. Design/methodology/approach: A total number of 400 questionnaires were distributed to international students, selected using convenience sampling technique, at…

  18. Radiopharmaceutical prescription in nuclear medicine departments; La prescription medicale des radiopharmaceutiques au sein d'un service de medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Biechlin-Chassel, M.L. [Radiopharmacie, service de pharmacie, Centre hospitalier de Chambery, 73 - Chambery (France); Lao, S. [Service de medecine nucleaire, CHU-Hopital de l' Archet, 06 - Nice (France); Bolot, C. [Service de pharmacie, hospices civiles de Lyon, groupement hospitalier Est, 69 - Bron (France); Francois-Joubert, A. [Service de medecine nucleaire, centre hospitalier de Chambery, 73 - Chambery (France)

    2010-11-15

    In France, radiopharmaceutical prescription is often discussed depending to which juridical structure the nuclear medicine department is belonging. According to current regulation, this prescription is an obligation in a department linked to hospital with a pharmacy department inside. But situation remains unclear for independent nuclear medicine departments where physicians are not constrained to prescribe radiopharmaceuticals. However, as radiographers and nurses are only authorized to realize theirs acts in front of a medical prescription, one prescription must be realized. Nowadays, computerized prescription tools have been developed but only for radiopharmaceutical drugs and not for medical acts. In the aim to achieve a safer patient care, the prescription regulation may be applied whatever differences between nuclear medicines departments. (authors)

  19. Does Head Start differentially benefit children with risks targeted by the program’s service model?☆

    Science.gov (United States)

    Miller, Elizabeth B.; Farkas, George; Duncan, Greg J.

    2015-01-01

    Data from the Head Start Impact Study (N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program’s comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children’s pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed. PMID:26379369

  20. Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?

    OpenAIRE

    Dutta, Mousumi; Husain, Zakir

    2012-01-01

    In recent years universal health coverage has become an important issue in developing countries. Successful introduction of such a social security system requires knowledge of the relationship between socio-economic status and usage of health care services. This paper examines this relationship, and analyzes the impact of introducing health insurance into the model, using data for India, a major developing country with poor health outcomes. In contrast to similar works undertaken for develope...

  1. Case Study: Does training of private networks of Family Planning clinicians in urban Pakistan affect service utilization?

    OpenAIRE

    Qureshi, Asma M

    2010-01-01

    Abstract Background To determine whether training of providers participating in franchise clinic networks is associated with increased Family Planning service use among low-income urban families in Pakistan. Methods The study uses 2001 survey data consisting of interviews with 1113 clinical and non-clinical providers working in public and private hospitals/clinics. Data analysis excludes non-clinical providers reducing sample size to 822. Variables for the analysis are divided into client vol...

  2. Does Acculturation and Stigma Affect Hmong Women’s Attitudes Toward and Willingness to Seek Counseling Services?

    Directory of Open Access Journals (Sweden)

    Maiteng Lor

    2017-12-01

    Full Text Available Although the Hmong have resided in the United States since the 1970s, there has been limited research exploring the effect of acculturation and stigma on the Hmong community and their perspective of mental health services. This study investigated the relationship between Hmong women’s level of acculturation, perception of stigma, and the expression of attitudes toward professional psychological help and willingness to see a counselor. The 222 Hmong women completed a Demographic Questionnaire Form (DQF, the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA, then the Stigma for Receiving Psychological Help (SSRPH, the Attitudes Toward Seeking Professional Psychological Help-Short Form (SSRPH-SF, and finally, the Willingness to See a Counselor questionnaire (WSC. Almost 86% of the Hmong women were between 18 and 35 years old, and 96.4% lived in the United States for 20 or more years and almost 53% practice Shamanism. Data analysis of the research hypotheses found that there was a weak positive significant correlation between acculturation and willingness to seek services. Additionally, the relationship between acculturation and attitudes toward counseling services, expression of attitudes and perception of stigma was statistically significant. However, the relationships between the other study variables: perception of stigma and acculturation, expression of attitudes and acculturation, and acculturation and willingness were not statistically significant. The findings of this study will enhance our understanding of Hmong women and their views of counseling.

  3. Survey of Recipients of WAP Services Assessment of Household Budget and Energy Behaviors Pre to Post Weatherization DOE

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, Bruce Edward [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rose, Erin M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hawkins, Beth A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    This report presents results from the national survey of weatherization recipients. This research was one component of the retrospective and Recovery Act evaluations of the U.S. Department of Energy s Weatherization Assistance Program. Survey respondents were randomly selected from a nationally representative sample of weatherization recipients. The respondents and a comparison group were surveyed just prior to receiving their energy audits and then again approximately 18 months post-weatherization. This report focuses on budget issues faced by WAP households pre- and post-weatherization, whether household energy behaviors changed from pre- to post, the effectiveness of approaches to client energy education, and use and knowledge about thermostats.

  4. Services Supply Chain in the Department of Defense: Comparison and Analysis of Acquisition Management in the Army, Navy, and Air Force

    Science.gov (United States)

    2010-05-01

    the marketing of services ( Lovelock , 1992; Hutt & Spec, 1998). Given these differences in the production and marketing of services as opposed to...8(1), 45-57. Hutt, M.D., & Speh, T.W. (1998). Business marketing (6th ed.). New York: Dryden Press. Lovelock , C.H. (1992). Are services really...different? In C.H. Lovelock (Ed.), Managing services (2nd ed.) (pp. 1-8). Englewood Cliffs, NJ: Prentice-Hall. Metters, R., King-Metters, K., & Pullman

  5. 31 CFR 256.52 - How does FMS issue a payment?

    Science.gov (United States)

    2010-07-01

    ... requirement for payment by EFT is appropriate, FMS will issue a payment by check. The Voucher for Payment must... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How does FMS issue a payment? 256.52... SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE OBTAINING PAYMENTS FROM THE JUDGMENT FUND...

  6. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    Science.gov (United States)

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  7. What does the literature suggest about what carers need from mental health services for their own wellbeing? A Systematic Review.

    Science.gov (United States)

    Susanti, Herni; Lovell, Karina; Mairs, Hilary

    2018-02-01

    The aim of this study was to examine prior studies relating to carers' needs from mental health services for their own wellbeing. A systematic approach was adopted for the literature review. The databases searched included MEDLINE, PSycINFO, EMBASE, and CINAHL, involving the use of search terms such as carers, mental health, and needs. The search was conducted in April 2012 and updated in December 2015. In total, 40 published papers were included in the review and were subsequently assessed for quality. For the data synthesis, a thematic analysis approach was employed to integrate the quantitative and qualitative evidence relating to carers' needs. Twenty-five of the reviewed studies were qualitative, 12 were quantitative, and 3 were mixed. Four major carer needs emerged from the synthesis: (1) holistic wellbeing of service users, (2) holistic wellbeing of carers, (3) supportive attitudes of professionals, and (4) carer involvement. All four of these needs, in fact, revolved around the carers' ill relatives. The studies reviewed suggest that while carers of people suffering from mental illness have a range of needs, they generally fail to offer straightforward information about their own needs. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  8. From Cascade to Bottom-Up Ecosystem Services Model: How Does Social Cohesion Emerge from Urban Agriculture?

    Directory of Open Access Journals (Sweden)

    Anna Petit-Boix

    2018-03-01

    Full Text Available Given the expansion of urban agriculture (UA, we need to understand how this system provides ecosystem services, including foundational societal needs such as social cohesion, i.e., people’s willingness to cooperate with one another. Although social cohesion in UA has been documented, there is no framework for its emergence and how it can be modeled within a sustainability framework. In this study, we address this literature gap by showing how the popular cascade ecosystem services model can be modified to include social structures. We then transform the cascade model into a bottom-up causal framework for UA. In this bottom-up framework, basic biophysical (e.g., land availability and social (e.g., leadership ecosystem structures and processes lead to human activities (e.g., learning that can foster specific human attitudes and feelings (e.g., trust. These attitudes and feelings, when aggregated (e.g., social network, generate an ecosystem value of social cohesion. These cause-effect relationships can support the development of causality pathways in social life cycle assessment (S-LCA and further our understanding of the mechanisms behind social impacts and benefits. The framework also supports UA studies by showing the sustainability of UA as an emergent food supplier in cities.

  9. DOE's energy data base (EDB) versus other energy-related data bases: a comparative analysis

    International Nuclear Information System (INIS)

    Robinson, J.; Hu, M.

    1981-02-01

    The release of the DOE Energy Data Base to commercial services in 1980 raised an immediate question in the minds of some searchers: how does this new data base fit into the spectrum of already-available data bases. Because the authors have been closely associated with the Department of Energy's RECON system and its data bases for several years, as trainers and as editor of the DOE/RECON Newsletter, the question was of great interest and we decided to investigate it

  10. Transition and Transfer of Remediated Formerly Utilized Sites Remedial Action Program (FUSRAP) Sites from U.S. Army Corps of Engineers (USACE) to U.S. Department of Energy (DOE)

    Energy Technology Data Exchange (ETDEWEB)

    Carpenter, Cliff [U.S. Department of Energy, Office of Legacy Management; Castillo, Darina [U.S. Department of Energy, Office of Legacy Management; Fatherly, Nicki [U.S. Army Corps of Engineers; Miller, Michele [Navarro Research and Engineering

    2016-03-06

    The US Department of Energy (DOE) expects to receive the transfer of 10 FUSRAP Sites from the US Army Corps of Engineers (USACE) over the next 10 years; however, the timing of the transfers is highly dependent upon federal funding of the ongoing remedial actions. When remediation for each site is complete and the 2-year operations and maintenance period has concluded, each site will transfer from USACE to DOE for long-term surveillance and maintenance (LTS&M). US DOE’s Office of Legacy Management (LM) will accept program responsibility for these sites and conduct LTS&M activities required to maintain protectiveness, preserve site-specific knowledge, and retain the cleanup and stewardship records while keeping stakeholders informed. Since the last FUSRAP site transfer occurred in 2007, LM in coordination with USACE intends to establish a transition process to promote the seamless transfer of sites from the time when the first record of decision is signed to the completion of FUSRAP activities. The approach to transfer active FUSRAP sites to completed sites status has been historically outlined in foundational documents such as the 1999 Memorandum of Understanding and supporting letters of agreement between the two agencies. As more complex FUSRAP sites are completed, this transition process will provide a model between the two agencies to communicate future long-term care liabilities. Ultimately, the FUSRAP transition process is structured to acquire and preserve site knowledge and information necessary for protecting the environment and public health. As of 2015, LM has transitioned and accepted programmatic responsibility for over 90 sites. From LM’s perspective, successful transition of any site includes understanding the long-term environmental liabilities. LM uses site transition framework requirements from past transitions to develop site-specific transition plans. Site-specific transition plans are developed by LM in coordination with USACE and executed

  11. [Mission woman: a survey on the perception of the "Service of Welcome and Listening" offered in the Emergency Department at the San Camillo Hospital in Rome by women victims of violence].

    Science.gov (United States)

    Vender, Cristian; Zicca, Anna; Parasole, Tiziana; Delle Fratte, Roberta; Battilana, Daniela; Mitello, Lucia

    2014-01-01

    The project Mission Woman was set up to describe how the service offered by the Emergency Department of the Hospital San Camillo-Forlanini in Rome was perceived by women victims ( or supposed to be) of violence. The objective of this investigation is to frame clients' perception about the service offered by staff in terms of sensitivity, recognition and management of the issue. The access to the Emergency Room is the first contact of the client with a helping relationship which goes beyond the simple provision of medical care. A questionnaire devised for the purpose was filled in by women who have asked for help to the Service "Door Woman" . The Service "Door Woman", set up in 2009, aimed to welcome and listen women victims of violence with the collaboration of different operators in the emergency department: nurses, doctors, psychologists and social workers. The project developed within the Hospital S. Camillo-Forlanini is managed by both professionals of the Emergency Department together with the Charity "Be Free". The service is open 24/7, all year, the clients could be women or children and could receive assistance or medical, nursing, psychosocial and legal counselling. The triage nurses are those who through their expertise could first identify the victims of violence and to introduce them in the path. Despite the level of injuries, who access to the Emergency Room for single or repeated events of violence, may have decided to claim in court and not hide seeking.. The research aims to understand what are the theoretical and practical deficiencies of staff in the management of a issue which is not only medical but also social and legal, as well as structural and organizational weaknesses of the service.

  12. 38 CFR 45.205 - Professional and technical services.

    Science.gov (United States)

    2010-07-01

    ... or technical discipline. For example, drafting of a legal document accompanying a bid or proposal by... technical services. 45.205 Section 45.205 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... technical services. (a) The prohibition on the use of appropriated funds, in § 45.100(a), does not apply in...

  13. 38 CFR 45.300 - Professional and technical services.

    Science.gov (United States)

    2010-07-01

    ... technical discipline. For example, drafting or a legal document accompanying a bid or proposal by a lawyer... technical services. 45.300 Section 45.300 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Professional and technical services. (a) The prohibition on the use of appropriated funds, in § 45.100(a), does...

  14. Sexual Assault and Sexual Harassment in the U.S. Military: Volume 2. Estimates for Department of Defense Service Members from the 2014 RAND Military Workplace Study

    Science.gov (United States)

    2016-01-01

    sexual assault reporting. Such models would provide insight into the character- istics of the service members who experience these events ( age , pay grade...service members and who met Study Design and Analysis Approach 5 the study inclusion criteria requiring that they be age 18 or older , below the rank...to encour- age someone who experienced sexual assault both to report it (93.5 percent) and to seek counseling (93.9 percent). There were no service or

  15. Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

    Science.gov (United States)

    Hsu, Pi-Fem

    2014-12-01

    Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

  16. 76 FR 59170 - Hartford Financial Services, Inc., Corporate/EIT/CTO Database Management Division, Hartford, CT...

    Science.gov (United States)

    2011-09-23

    ... in activities related to the supply of financial services. Specifically, the workers provide information technology support for the firm's financial services such as insurance protection and investment... Department's findings that The Hartford Financial Services, Inc. does not produce an article within the...

  17. Department o

    African Journals Online (AJOL)

    USER

    2016-10-31

    Oct 31, 2016 ... Department of Urban and Regional Planning, University of Ibadan, Oyo State, Nigeria. 2 ... Geospatial techniques were used for this study; data from primary and secondary source ... development, for instance, Nigeria cities .... (road network, road medians and water ..... Countries: A Case Study of Nigeria.

  18. Electronics department

    International Nuclear Information System (INIS)

    1979-01-01

    This report summarizes the activities in 1978 of some of the groups within the Electronics Department. The work covered includes plant protection and operator studies, reliability techniques, application of nuclear techniques to mineral exploration, applied laser physics, computing and, lastly, research instrumentation. (author)

  19. 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...

  20. Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

    Science.gov (United States)

    Day, Ed; Mitcheson, Luke

    2017-08-01

    Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

  1. Black youth's personal involvement in the HIV/AIDS issue: does the public service announcement still work?

    Science.gov (United States)

    Keys, Truman R; Morant, Kesha M; Stroman, Carolyn A

    2009-03-01

    Recent public service announcements (PSAs) directed toward Black youth utilize various formats and appeals to stimulate a motivated cognitive process that engenders personal involvement in the HIV/AIDS issue. The Elaboration Likelihood Model (ELM) by Petty and Cacioppo argues that engagement with messages that consist of substantive content causes the audience member to critically analyze the message, which can produce awareness and attitude change. An efficient way to add emphasis to the message and seize the attention of the target audience is to insert the message into an entertainment context. Our study attempted to analyze the impact of the peripheral cue, character appeal, on audience members' attitude change in response to analyzing high- and low-involvement message content. A2 x 4 factorial design was used, with message involvement (high/low) and character appeal (White/Black and celebrity/noncelebrity) as independent variables. The findings showed that celebrity status is the salient factor, with source perception inducing attitude change as a main effect or in an interaction effect with high- and low message content.

  2. How Does Paying for Ecosystem Services Contribute to Sustainable Development? Evidence from Case Study Research in Germany and the UK

    Directory of Open Access Journals (Sweden)

    Kristin Nicolaus

    2014-05-01

    Full Text Available Payments for ecosystem services (PES are currently being discussed as one of the most promising tools in environmental and sustainability governance. However, much criticism has been voiced against overly optimistic assumptions of PES’ management potential towards sustainability. Several contributions to the debate show that PES fail both in reducing poverty and strengthening social justice. Additionally, they neglect problems of deliberation in decision-making, as well as the legitimacy of the applied environmental practices. Our empirical investigation on participatory and deliberative structures in already existing PES initiated by non-state actors contributes to the latter body of research. Based on the assumption that playing an active part in scheme design facilitates the consideration of justice and fairness, our case studies from Germany and the UK. present interesting results on the involvement of conflicting interests and their argumentation in the design process. Summing up these findings, we conclude that paying for ES rarely contributes to sustainable development in and of itself, but deliberatively designed schemes provide a formal setting to take aspects of justice into account.

  3. Traumatic Brain Injury service (TBI) Service

    Data.gov (United States)

    Department of Veterans Affairs — This Service provides access to Tramatic Brain injury patient data consult notes. The service also provides one write service method writeNote. The Service supports...

  4. 42 CFR 137.401 - What role does Tribal consultation play in the IHS annual budget request process?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What role does Tribal consultation play in the IHS annual budget request process? 137.401 Section 137.401 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF...-GOVERNANCE Secretarial Responsibilities Budget Request § 137.401 What role does Tribal consultation play in...

  5. Developing a Strategy To Educate County Departments of Social Services in the Type of Referrals Needed for a Residential Child Caring Agency.

    Science.gov (United States)

    Keevert, Helen

    The focus of a child caring facility had changed from caring exclusively for orphans to serving a broader population of abandoned, abused, and neglected children. Because no effective marketing tool existed within this child caring agency to make agency identification and information readily accessible to county departments of social services…

  6. Place of death among older Americans: does state spending on home- and community-based services promote home death?

    Science.gov (United States)

    Muramatsu, Naoko; Hoyem, Ruby L; Yin, Hongjun; Campbell, Richard T

    2008-08-01

    The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them. To examine whether states' spending on home- and community-based services (HCBS) affects place of death, taking into consideration county health care resources and individuals' family, sociodemographic, and health factors. Using exit interview data from respondents in the Health and Retirement Study born in 1923 or earlier who died between 1993 and 2002 (N = 3362), we conducted discrete-time survival analysis of the risk of end-of-life nursing home relocation to examine whether states' HCBS spending would delay or prevent end-of-life nursing home admission. Then we ran logistic regression analysis to investigate the HCBS effects on place of death separately for those who relocated to a nursing home and those who remained in the community. Living in a state with higher HCBS spending was associated with lower risk of end-of-life nursing home relocation, especially among people who had Medicaid. However, state HCBS support was not directly associated with place of death. States' generosity for HCBS increases the chance of dying at home via lowering the risk of end-of-life nursing home relocation. State-to-state variation in HCBS spending may partly explain variation in home deaths. Our findings add to the emerging encouraging evidence for continued efforts to enhance support for HCBS.

  7. Energy efficiency public service advertising campaign

    Energy Technology Data Exchange (ETDEWEB)

    Gibson-Grant, Amanda [Advertising Council, New York, NY (United States)

    2015-06-12

    The Advertising Council (“the Ad Council”) and The United States Department of Energy (DOE) created and launched a national public service advertising campaign designed to promote energy efficiency. The objective of the Energy Efficiency campaign was to redefine how consumers approach energy efficiency by showing that saving energy can save homeowners money.

  8. United States Department of Agriculture Forest Service 1996 annual report wetlands research related to the Pen Branch restoration effort on the Savannah River site

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, E.A. [Westinghouse Savannah River Company, Aiken, SC (United States); Kolka, R.K. [USDA Forest Service, Charleston, SC (United States); Trettin, C.C. [USDA Forest Service, Charleston, SC (United States)

    1997-01-01

    This report documents the role of the USDA Forest Service and their collaborators (SRTC, SREL, and several universities) in wetlands monitoring and research on the Savannah River Site. This report describes the rationales, methods, and results (when available) of these studies and summarizes and integrates the available information through 1996.

  9. DOE Robotics Project

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    This document provide the bimonthly progress reports on the Department of Energy (DOE) Robotics Project by the University of Michigan. Reports are provided for the time periods of December 90/January 91 through June 91/July 91. (FI)

  10. The use of key indicators as a foundation for knowledge management: the experiences of Monterey County's Social and Employment Services Department.

    Science.gov (United States)

    Lindberg, Arley

    2012-01-01

    While effective knowledge management practices are commonly sought by organizations, facilitating the use and ongoing engagement in these practices can be challenging. To this end, one agency developed a strategy for institutionalizing their knowledge management functions by appointing a team responsible for monitoring and implementing knowledge management functions, and creating a report for use as a tool by departments agency-wide. Aimed at increasing transparency both within the agency and with the surrounding community, the report provides an overview of individual departments' programs, goals, recent caseload trends, and latest achievements. The report is made available online and accessible by the general public. This case study describes the development of this team and report, as well as lessons learned and future knowledge management goals for the agency. Copyright © Taylor & Francis Group, LLC

  11. Prepositioned Stocks: DOD has Addressed Required Reporting Elements but Needs to Develop a Department-Wide Policy and Joint Service Approach

    Science.gov (United States)

    2016-04-01

    prepositioned stock information and indicate where that information resides. DOD has made limited progress in developing a department-wide strategic...assistance, and disaster relief. Prepositioned stocks have played an important role in supporting operations in Iraq and Afghanistan, but these operations...problem areas. These officials also indicated that the shortfalls in prepositioned stocks to be reported in the fiscal year 2015 report might be

  12. The Federal Civil Service Workforce: Assessing the Effects on Retention of Pay Freezes, Unpaid Furloughs, and Other Federal-Employee Compensation Changes in the Department of Defense

    Science.gov (United States)

    2014-01-01

    of the 2011–2013 pay freeze, the unpaid furloughs in 2013, a wave of retirements of the baby - boom generation, and recent proposals by lawmakers to...CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND...Department of Defense (DoD). These pay actions on top of a wave of baby -boomer retirements and various proposals by lawmakers to reduce federal compensation

  13. [The influence of counseling for patients with cancer on their discharge from the palliative care support department of the community health care service of Minoh City Hospital].

    Science.gov (United States)

    Suita, Tomoko; Kato, Rika; Fujita, Misao; Hidaka, Kumi; Iijima, Shohei

    2014-12-01

    Counseling for patients with cancer by a certified nurse in palliative care began in April 2011 in Minoh City Hospital. Counseling was provided immediately after a patient was informed by the treating physician of a primary diagnosis of cancer, a metastatic recurrence, or a decision to terminate cancer therapy. We examined the patient's support system after the counseling ended. The number of patients receiving end-of-life support with home or hospital care rapidly increased from 118 prior to the program's beginning to 186. The number of patients counseled was comparable to the rapid increase in their number(n=68). New cases in the outpatient department comprised 59% of all patients, of which, 45% began supportive counseling, with 43%of them ultimately returning home. Of the new cases receiving counseling in the hospital, 34%eventually returned home after discharge, and the highest percentage of discharges were to a palliative care unit or hospice program (48%). The initiation of counseling in the outpatient department allowed us to provide sufficient time to make decisions about appropriate places for end-of-life care. Cooperation with the patients' physicians was necessary to provide counseling from the outpatient department. Our findings suggest the importance of sharing the patients' medical and social information among the staff when necessary.

  14. Evaluation of an authority innovation-decision: brief alcohol intervention for pregnant women receiving women, infants, and children services at two Illinois health departments.

    Science.gov (United States)

    Moise, Imelda K; Green, David; Toth, Janine; Mulhall, Peter F

    2014-06-01

    Despite the availability of clinical tools and evidence-based screening recommendations, there has been little discussion regarding screening of prenatal alcohol exposure in community-based settings, including adoption and implementation. This study's aim is to evaluate and validate--through surveys and focus groups--obstacles and challenges that shape efficacious implementation of the BAI at two Illinois health departments. Results suggest that BAI implementation is facilitated by staff perceptions of its benefits, readiness to implement the intervention, and organizational support for it. Limitations of the management information system, ambiguous screening questions, and high case-loads present barriers to effective BAI implementation.

  15. DOE handbook electrical safety

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    Electrical Safety Handbook presents the Department of Energy (DOE) safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety guidance and information for DOE installations to effect a reduction or elimination of risks associated with the use of electrical energy. The objectives of this handbook are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

  16. Review of Department of Energy HEPA filter test activities

    International Nuclear Information System (INIS)

    McIntyre, J.A.

    1993-01-01

    Filter Test Facilities (FTFs) and the FTF Technical Support Group (TSG) continue to provide services to the Department of Energy (DOE). Additional tasks relating to the HEPA filter cycle have been added to the TSG. The tasks include the quality assessment review for the in-place testing of HEPA filters at DOE sites and the formation of an in-place testing standards writing group. Summary of ongoing FTFs and TSG activities for FY 1990-FY 1992 including the technical input for implementation of the High Flow Alternative Test System (HFATS), update of the DOE Standards, the status of the quality assessment review and in-place testing standards writing group are discussed

  17. Does access to general dental treatment affect the number and complexity of patients presenting to the acute hospital service with severe dentofacial infections?

    Science.gov (United States)

    Bowe, Conor M; Gargan, Mary Louise; Kearns, Gerard J; Stassen, Leo F A

    2015-01-01

    This is a retrospective study to review the treatment and management of patients presenting with odontogenic infections in a large urban teaching hospital over a four-year period, comparing the number and complexity of odontogenic infections presenting to an acute general hospital in two periods, as follows: Group A (January 2008 to March 2010) versus Group B (April 2010 to December 2011). The background to the study is 'An alteration in patient access to primary dental care instituted by the Department of Health in April 2010'. a) to identify any alteration in the pattern and complexity of patients' presentation with odontogenic infections following recent changes in access to treatment via the Dental Treatment Services Scheme (DTSS) and the Dental Treatment Benefit Scheme (DTBS) in April 2010; and, b) to evaluate the management of severe odontogenic infections. Data was collated by a combination of a comprehensive chart review and electronic patient record analysis based on the primary discharge diagnosis as recorded in the Hospital In-Patient Enquiry (HIPE) system. Fifty patients were admitted to the National Maxillofacial Unit, St James's Hospital, under the oral and maxillofacial service over a four-year period, with an odontogenic infection as the primary diagnosis. There was an increased number of patients presenting with odontogenic infections during Group B of the study. These patients showed an increased complexity and severity of infection. Although there was an upward trend in the numbers and complexity of infections, this trending did not reach statistical significance. The primary cause of infection was dental caries in all patients. Dental caries is a preventable and treatable disease. Increased resources should be made available to support access to dental care, and thereby lessen the potential for the morbidity and mortality associated with serious odontogenic infections. The study at present continues as a prospective study.

  18. Opinion of the IRSN on serviceability of the 900 MWe reactor vessel - Answers to demands of the Nuclear Permanent Department of December 2005 - Mechanical aspect

    International Nuclear Information System (INIS)

    2010-05-01

    As three demands had been made to EDF in December 2005 regarding the serviceability and more particularly the mechanical behaviour of the 900 MWe reactor vessels, this report discusses the evolution brought to models and proposed by EDF to correct the defect plasticity and take residual stresses into account. This discussion notably concerns the defect height and length range, and the admissible residual stress, but also the use of safety coefficients, transient application, fluence and the brittle-ductile transition temperature. This report from the French Nuclear Safety and Radioprotection Institute (IRSN) outlines the failure risks associated to the vessel in some specific nuclear power stations. Recommendations are made regarding the residual stress amplitude, the risk of fracture by cleavage, and actions to correct fracture risk margins on vessels which do not comply with regulatory criteria

  19. Greening the Department of Energy through waste prevention, recycling, and Federal acquisition. Strategic plan to implement Executive Order 13101

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-11-01

    This Plan provides strategies and milestones to implement Executive Order 13101, Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, and to achieve the new Secretarial goals for 2005 and 2010. It serves as the principal Secretarial guidance to Department of Energy (DOE) Headquarters, Field Offices, and laboratory and contractor staff to improve sanitary waste prevention, recycling, and the purchase and use of recycled content and environmentally preferable products and services in the DOE.

  20. Hazard-evaluation and technical-assistance report No. TA-76-54, Department of the Interior, National Park Service: Cave study

    International Nuclear Information System (INIS)

    Gunter, E.P.; Meyer, C.R.

    1978-05-01

    In response to a request from the Department of the Interior, a medical evaluation was made of employees working in eight caves in the National Park System. Concern was directed at possible radon-daughter radiation exposures. Cave employees were given a questionnaire requesting past occupational exposure as well as past pulmonary history and tobacco consumption. Only a few of 35 comparisons within NIOSH had any consistent abnormality of significance. No widespread pulmonary cytological abnormalities were found in the cohort. The authors conclude that there is no apparent respiratory effect at the time. They recommend routine monitoring of cave employees older than 40 to 45 years of age who are cigarette smokers and who have worked in caves for more than 5 years. Those over 45 years of age and employed in caves for 5 years or more should receive high priority for monitoring regardless of smoking status. The authors recommend that all employees be encouraged to stop smoking, that a general preemployment physical be given including baseline sputum cytology and chest x-ray studies, that a yearly examination be given with laboratory studies on the aforementioned high risk individuals, and that cave air should not be used for air conditioning

  1. Asthma Medication Ratio Predicts Emergency Depart...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

  2. Radiation exposures for DOE and DOE contractor employees, 1987

    International Nuclear Information System (INIS)

    1989-10-01

    This report is one of series of annual reports provided by the US Department of Energy (DOE) summarizing occupational radiation exposures received by DOE and DOE contractor employees. These reports provide an overview of radiation exposures received each year, as well as identification of trends in exposures being experienced over the years. 5 figs., 30 tabs

  3. Theoretical physics department, june 96-may 98 status report; Service de physique theorique, rapport d`activite juin 1996 - mai 1998

    Energy Technology Data Exchange (ETDEWEB)

    1998-12-31

    This status report presents the work done at SPhT (service de physique theorique, CEA) from june 96 to may 98. The topics have been classified into 3 themes: - statistical physics, - mathematical physics and field theory, - astrophysics, nuclear and particle physics. In the first theme relevant contributions have been made to phase transitions, correlated electronic systems, polymers, membranes, proteins, disordered systems and out of equilibrium processes. The second theme collects various works, some works dedicated to aleatory matrices and quantum chaos aim at developing investigation methods, other works like cord theories use these methods. As for the third theme, the recent discovery of the fluctuations of background cosmological radiation has fomented a great activity at SPhT. Mean field approximation and effective strength have been the starting point of research in the field of nuclear structure. High energy quantum chromodynamics has been applied to deep inelastic scattering where the proton structure is studied through electron-proton collisions. A list of all the publications made by SPhT is given. (A.C.)

  4. 42 CFR 137.325 - What does a Self-Governance Tribe do if it wants to perform a construction project under section...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What does a Self-Governance Tribe do if it wants to..., DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Project Assumption Process § 137.325 What does a Self-Governance Tribe do if it wants to perform a construction project under section...

  5. Broadband Radio Service (BRS) and Educational Broadband Service (EBS) Transmitters

    Data.gov (United States)

    Department of Homeland Security — The Broadband Radio Service (BRS), formerly known as the Multipoint Distribution Service (MDS)/Multichannel Multipoint Distribution Service (MMDS), is a commercial...

  6. [The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care].

    Science.gov (United States)

    Brusaferro, Silvio; Marcolongo, Adriano; Schiava, Flavio; Bggio, Luca; Betta, Alberto; Buzzo, Armando; Cinquetti, Sandro; Coin, Paulo; Dal Fior, Tina; De Battisti, Fabio; De Marchi, Chiara; De Noni, Lucia; Donatoni, Luigi; Ferraresso, Anna; Gallo, Giovanni; Gallo, Lorenza; Gallo, Tolinda; Gottardello, Lorena; Menegon, Tiziana; Minuzzo, Michele; Paussi, Gianna; Pinna, Clara; Poli, Albino; Rossato, Luigi; Sbrogliò, Luca; Simeoni, Josef; Speccini, Manuela; Stoppato, Ugo; Superbi, Piero; Tardivo, Stefano; Urdich, Alessandro; Valsecchi, Massimo; Zamparo, Manuela

    2008-01-01

    A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.

  7. 10 CFR 1021.200 - DOE planning.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false DOE planning. 1021.200 Section 1021.200 Energy DEPARTMENT... Decisionmaking § 1021.200 DOE planning. (a) DOE shall provide for adequate and timely NEPA review of DOE... accordance with 40 CFR 1501.2 and this section. In its planning for each proposal, DOE shall include adequate...

  8. Remedial action plan for the inactive uranium processing site at Naturita, Colorado. DOE responses to comments from U.S. Nuclear Regulatory Commission and Colorado Department of Public Health and Environment

    International Nuclear Information System (INIS)

    1998-01-01

    This report contains responses by the US Department of Energy to comments from the US Nuclear Regulatory Commission and the Colorado Department of Public Health and Environment on the Naturita remedial action plan. This was done in an attempt to clarify information. The site is an inactive uranium processing site at Naturita, Colorado

  9. Citizen Contributions to the Closure of High-Level Waste (HLW) Tanks 18 and 19 at the Department of Energy's (DOE) Savannah River Site (SRS) - 13448

    Energy Technology Data Exchange (ETDEWEB)

    Lawless, W.F. [Paine College, Departments of Math and Psychology, 1235 15th Street, Augusta, GA 30901 (United States)

    2013-07-01

    Citizen involvement in DOE's decision-making for the environmental cleanup from DOE's management of its nuclear wastes across the DOE complex has had a positive effect on the cleanup of its SRS site, characterized by an acceleration of cleanup not only for the Transuranic wastes at SRS, but also for DOE's first two closures of HLW tanks, both of which occurred at SRS. The Citizens around SRS had pushed successfully for the closures of Tanks 17 and 20 in 1997, becoming the first closures of HLW tanks under regulatory guidance in the USA. However, since then, HLW tank closures ceased due to a lawsuit, the application of new tank clean-up technology, interagency squabbling between DOE and NRC over tank closure criteria, and finally and almost fatally, from budget pressures. Despite an agreement with its regulators for the closure of Tanks 18 and 19 by the end of calendar year 2012, the outlook in Fall 2011 to close these two tanks had dimmed. It was at this point that the citizens around SRS became reengaged with tank closures, helping DOE to reach its agreed upon milestone. (authors)

  10. [Recruiting and Personal Development in Surgical Departments of Large Referral Centers - Current Practice and Options for Improvement from Industry and Service Business].

    Science.gov (United States)

    Homayounfar, K; König, S; Rabe, C; Beck-Broichsitter, B; Lützen, U; Ghadimi, M B; Schmidt, C

    2017-12-01

    Background Cut-throat competition, cost pressure, generation Y, shortage of qualified staff and feminisation influence human resources management in visceral surgery. The assessment of the current situation by chief surgeons (CS) as well as proof of transferability of strategies from industry and service business (ISB) have not yet been investigated. Material and Methods The CS of university hospitals and large referral centres (> 800 beds) were interviewed (n = 100) on the basis of a standardised questionnaire including 43 items. Closed questions were designed with a 5-point Likert scale and their analysis was presented as means (MW) and standard deviations (±). Ten human resources manager (HMR) of ISB were invited to participate in 45-minute telephone interviews. Results Thirty-seven CS participated in the survey, 15 of whom were full professors. Unsolicited applications (100%), job advertisements (78%) and direct approaches to final year students (78%) were the most common ways of recruitment. Only 17% of CS used a standardised form for preparation. Professional expertise (MW 2.2 ± 0.9), social skills (MW 1.9 ± 0.6) and excellent German language skills (MW 1.8 ± 0.8) were named as important qualifications for employment, while references and certificates were regarded as being less important (MW 3.2 ± 0.9). Personal development was regarded as important (MW 1.1 ± 0.2), but a defined period for residency was not guaranteed (MW 3.0 ± 1.5). Transparent selection criteria for career opportunities (MW 2.5 ± 1.1) and different career models (MW 2.7 ± 1.2) were only rarely available. Six HRM participated in the interviews. Active head-hunting (75%), Internet platforms (75%), presentations at conferences (75%), as well as hiring trainees (50%), job advertisements (50%) and social media (50%) were established options to find qualified employees. Professional and management careers were often separate career paths, while

  11. Information management problems relating to numeric data base services for DOE. QEI report 9413 (Interim report for Phase II of QEI project 4191)

    International Nuclear Information System (INIS)

    Kuipers, J.W.; Thorpe, R.W.

    1979-01-01

    Problems of numeric data are examined as these relate to the question of possible steps toward implementation of an integrated national information system for DOE. It is proposed that DOE make policy and organization changes in order to centralize and upgrade information management as a particular responsibility for the oversight of DOE-wide information requirements. Eight points to be emphasized in such a program are set forth

  12. 42 CFR 51.7 - Eligibility for protection and advocacy services.

    Science.gov (United States)

    2010-10-01

    .... 51.7 Section 51.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic... rights. This restriction does not prevent a P&A system from representing clients in commitment or...

  13. Consolidating Pre-Service Physics Teachers' Subject Matter Knowledge Using Didactical Reconstructions

    Science.gov (United States)

    Mäntylä, T.; Nousiainen, M.

    2014-01-01

    In the Department of Physics, University of Helsinki, there are advanced physics courses designed for the needs of pre-service physics teachers. The starting point is that after introductory and intermediate physics courses, pre-service physics teachers know laws and definitions but the knowledge is quite fragmented and does not form coherent…

  14. Enabling department-scale supercomputing

    Energy Technology Data Exchange (ETDEWEB)

    Greenberg, D.S.; Hart, W.E.; Phillips, C.A.

    1997-11-01

    The Department of Energy (DOE) national laboratories have one of the longest and most consistent histories of supercomputer use. The authors summarize the architecture of DOE`s new supercomputers that are being built for the Accelerated Strategic Computing Initiative (ASCI). The authors then argue that in the near future scaled-down versions of these supercomputers with petaflop-per-weekend capabilities could become widely available to hundreds of research and engineering departments. The availability of such computational resources will allow simulation of physical phenomena to become a full-fledged third branch of scientific exploration, along with theory and experimentation. They describe the ASCI and other supercomputer applications at Sandia National Laboratories, and discuss which lessons learned from Sandia`s long history of supercomputing can be applied in this new setting.

  15. Energy infrastructure of the United States and projected siting needs: Scoping ideas, identifying issues and options. Draft report of the Department of Energy Working Group on Energy Facility Siting to the Secretary

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    A Department of Energy (DOE) Working Group on Energy Facility Siting, chaired by the Policy Office with membership from the major program and staff offices of the Department, reviewed data regarding energy service needs, infrastructure requirements, and constraints to siting. The Working Group found that the expeditious siting of energy facilities has important economic, energy, and environmental implications for key Administration priorities.

  16. 1995 Department of Energy Records Management Conference

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    The Department of Energy (DOE) Records Management Group (RMG) provides a forum for DOE and its contractor personnel to review and discuss subjects, issues, and concerns of common interest. This forum will include the exchange of information, and interpretation of requirements, and a dialog to aid in cost-effective management of the DOE Records Management program. Issues addressed by the RMG may result in recommendations for DOE-wide initiatives. Proposed DOE-wide initiatives shall be, provided in writing by the RMG Steering Committee to the DOE Records Management Committee and to DOE`s Office of ERM Policy, Records, and Reports Management for appropriate action. The membership of the RMG is composed of personnel engaged in Records Management from DOE Headquarters, Field sites, contractors, and other organizations, as appropriate. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  17. What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

    OpenAIRE

    Zhang, Yan; Tang, Wenxi; Zhang, Liang

    2017-01-01

    Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

  18. 30 CFR 250.195 - What notification does MMS require on the production status of wells?

    Science.gov (United States)

    2010-07-01

    ... the well in a production status. You must confirm oral notification by telefax or e-mail within those... production status of wells? 250.195 Section 250.195 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT... Information and Reporting Requirements § 250.195 What notification does MMS require on the production status...

  19. 21 CFR 1.378 - What criteria does FDA use to order a detention?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false What criteria does FDA use to order a detention? 1.378 Section 1.378 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ENFORCEMENT REGULATIONS Administrative Detention of Food for Human or Animal Consumption...

  20. 21 CFR 1.242 - What does assignment of a registration number mean?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false What does assignment of a registration number mean? 1.242 Section 1.242 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GENERAL ENFORCEMENT REGULATIONS Registration of Food Facilities Additional Provisions § 1...