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. 78 FR 2711 - Hours of Service of Drivers: U.S. Department of Energy (DOE); Application for Exemption

    Science.gov (United States)

    2013-01-14

    ... materials. Section 395.1(q) allows drivers who are required by Sec. 397.5 to attend a motor vehicle...-service (HOS) regulations for commercial motor vehicle drivers. The exemption would enable DOE's contract... radioactive materials to be treated similarly to drivers of shipments of explosives. The exempted drivers...

  3. 78 FR 32700 - Hours of Service of Drivers: U.S. Department of Energy (DOE); Application for Exemption

    Science.gov (United States)

    2013-05-31

    ... provision of the Agency's hours-of-service (HOS) regulations for commercial motor vehicle drivers. The... transportation of security-sensitive radioactive materials to be treated similarly to drivers of shipments of... radioactive materials to be treated the same as drivers transporting explosives, as provided in Sec. 395.1(q...

  4. 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.

  5. 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…

  6. 77 FR 43369 - Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department...

    Science.gov (United States)

    2012-07-24

    ... Employment and Training Administration Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department...; Lexisnexis, a Subsidiary of Reed Elsevier Customer Service Department and Fulfillment Department, Including..., 2012, applicable to workers of Lexisnexis, a subsidiary of Reed Elsevier, Inc., Customer Service...

  7. 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.

  8. Reciprocal service department cost allocation and decision making

    OpenAIRE

    Franklin Lowenthal; Massoud Malek

    2005-01-01

    In a manufacturing company, certain departments can be characterized as production departments and others as service departments. Examples of service departments are purchasing, computing services, repair and maintenance, security, food services, and so forth. The costs of such service departments must be allocated to the production departments, which in turn will allocate them to the product. It is known that one can view the cost allocation problem as an absorbing Markov process, with the ...

  9. 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.

  10. 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...

  11. 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...

  12. National study of emergency department observation services.

    Science.gov (United States)

    Wiler, Jennifer L; Ross, Michael A; Ginde, Adit A

    2011-09-01

    The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. The authors analyzed the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Characteristics of EDs with observation units (OUs) were compared to those without, and patients with a disposition of ED observation were compared to those with a "short-stay" (observational analysis. An estimated 1,746 U.S. EDs (36%) reported having OUs, of which 56% are administratively managed by ED staff. Fifty-two percent of hospitals with ED-managed OUs are in an urban location, and 89% report ED boarding, compared to 29 and 65% of those that do not have an OU. The admission rate is 38% at those with ED-managed OUs and 15% at those without OUs. Of the 15.1% of all ED patients who are kept in the hospital following an ED visit, one-quarter are kept for either a short-stay admission (1.8%) or an ED observation admission (2.1%). Most (82%) ED observation patients were discharged from the ED. ED observation patients were similar to short-stay admission patients in terms of age (median = 52 years for both, interquartile range = 36 to 70 years), self-pay (12% vs. 10%), ambulance arrival (37% vs. 36%), urgent/emergent triage acuity (77% vs. 74%), use of ≥1 ED medication (64% vs.76%), and the most common primary chief complaints and primary diagnoses. Over one-third of U.S. EDs have an OU. Short-stay admission patients have similar characteristics as ED observation patients and may represent an opportunity for the growth of OUs. © 2011 by the Society for Academic Emergency Medicine.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    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.

  14. 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...

  15. Psychiatric service users' experiences of emergency departments

    DEFF Research Database (Denmark)

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

    2017-01-01

    regarding service users’ experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. Methods: A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title...

  16. 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.

  17. 49 CFR 40.401 - How does the Department notify employers and the public about a PIE?

    Science.gov (United States)

    2010-10-01

    ... public about a PIE? 40.401 Section 40.401 Transportation Office of the Secretary of Transportation... How does the Department notify employers and the public about a PIE? (a) The Department maintains a.... (b) When the Director issues a PIE, he or she adds to the List the name and address of the service...

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

    African Journals Online (AJOL)

    This research investigated the customer service in appliance sales departments in prominent retail stores in Tshwane, RSA in three phases to involve different role players. Store managers firstly judged tangible evidence of the service offering in their own stores; consumers' perception of the service quality (N=296) in retail ...

  19. Federally Qualified Health Center Substitution of Local Health Department Services.

    Science.gov (United States)

    Snider, Jeremy W; Bekemeier, Betty R; Conrad, Douglas A; Grembowski, David E

    2017-10-01

    Strategic and budgetary considerations have shifted local health departments (LHDs) away from safety net clinical services and toward population-focused services. Federally Qualified Health Centers (FQHCs) play an increasing role in the safety net, and may complement or substitute for LHD clinical services. The authors examined the association between FQHC service levels in communities and the presence of specific LHD clinical services in 2010 and 2013. Data from LHD surveys and FQHC service data were merged for 2010 and 2013. Multivariate regression and instrumental variable methods were used to examine FQHC service levels that might predict related LHD service presence or discontinuation from 2010 to 2013. There were modest reductions in LHD service presence and increases in FQHC service volume over the time period. LHD primary care and dental service presence were inversely associated with higher related FQHC service volume. LHD prenatal care service presence, as well as a measure of change in general service approach, were not significantly associated with FQHC service volume. LHDs were less likely to provide certain clinical services where FQHCs provide a greater volume of services, suggesting a substitution effect. However, certain clinical services, such as prenatal care, may complement the public health mission-and LHDs may be strategically placed to continue to deliver these services. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. 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.

  1. Provision Of Low Vision Service In The Department Of ...

    African Journals Online (AJOL)

    Provision Of Low Vision Service In The Department Of Ophthalmology University Of Calabar Teaching Hospital. B Ekpenyong, O Ndukwe. Abstract. No Abstract Keywords: Low vision services, Residual vision, Low vision assessment, Retinal dystrophies. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

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

    Energy Technology Data Exchange (ETDEWEB)

    Good, D.E.

    1997-08-19

    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.

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

    Science.gov (United States)

    2011-01-26

    ... Employment and Training Administration Apria Healthcare Customer Service Department; Fourteen Locations in... Healthcare, Customer Service Department, Thirteen Locations in Missouri: Cameron, Cape Girardeau, Columbia... Healthcare, Customer Service Department. The Clinton, Missouri location provided data entry services in the...

  4. 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.

  5. Does Helicopter Emergency Care Service Improve Blunt Trauma Mortality

    Science.gov (United States)

    1991-01-01

    NUMBERS Does Helicopter Emergency Care Service Improve Blunt Trauma Mortality 6. AUTHOR(S) Kenneth Duane Oefinger, Major 7. PERFORMING ORGANIZATION NAME...8217 = ’:" ’ _’ -. " 9 DOES HELICOPTER EMERGENCY CARE SE,’RV-E . IMPROVE BLUNT TRAUMA MORTALITY BY Major Kenneth Duane Oefina, USAF NC 4991 38 ,-ages Masters of...helicopter should be dispatched. This would allow for the monitoring of effective utilization of the hospital service. DOES HELICOPTER EMERGENCY CARE SERVICE

  6. Proposing a competitive intelligence (CI framework for Public Service departments to enhance service delivery

    Directory of Open Access Journals (Sweden)

    Nisha Sewdass

    2012-02-01

    Full Text Available Background: The aim of public service departments in South Africa is to improve service delivery through the transformation and improvement of human resources and the improvement of service delivery practices. Furthermore, it is important for the public service sector in South Africa to improve the quality of its service delivery, not only by comparing its performance with other sectors within South Africa but also by positioning itself amongst the best in the world. This can be achieved by benchmarking with other global industries and by implementing the most recent competitive intelligence strategies, tools and techniques. The environment of the public service organisations consists of competitive forces that impact the functioning of these organisations.Objectives: This article focuses on proposing competitive intelligence-related strategies, tools and techniques for gathering and analysing information in the public service departments in South Africa in order to enhance service delivery.Method: The study was qualitative in nature and was divided into two components, namely, (1 theoretical – through an extensive review of the literature and (2 empirical – an ethnographic study at the chosen public service department, the Department of Home Affairs (DHA. Ethnographic interviews with management-level staff, focus groups and document analysis were used to obtain adequate information to determine the current state of public service delivery in South Africa.Results: The results of the study was the development of a new competitive intelligencerelated framework for gathering and analysing information, and it represents a formal and systematic process of informing managers in public service departments about critical issues that these departments face or are likely to experience in future.Conclusion: The strategic planning tools and techniques of this framework will fill the gap that exists in public service departments. Once this framework has

  7. Impact of a Teaching Service on Emergency Department Throughput

    Directory of Open Access Journals (Sweden)

    Courtney M. Smalley

    2014-03-01

    Full Text Available Introduction: There are 161 emergency medicine residency programs in the United States, many of which have medical students rotating through the emergency department (ED. Medical students are typically supervised by senior residents or attendings while working a regular shift. Many believe that having students see and present patients prolongs length of stay (LOS, as care can be delayed. Our institution implemented a unique method of educating medical students while in the ED with the creation of a teaching service, whose primary goal is education in the setting of clinical care. The objective of this study was to explore the effect of the teaching service on efficiency by describing LOS and number of patients seen on shifts with and without a teaching service. Methods: This was a retrospective chart review performed over a 12-month period of visits to an urban academic ED. We collected data on all patients placed in a room between 14:00 and 19:59, as these were the hours that the teaching shift worked in the department. We categorized shifts as 1 a teaching service with students (TWS; 2 a teaching service without students (TWOS; and 3 no teaching service (NTS. LOS and median number of patients seen on days with a teaching service, both with and without students (TWS and TWOS, was compared to LOS on days without a teaching service (NTS.Results: The median LOS on shifts with a dedicated teaching service without students (TWOS was 206 minutes, while the median LOS on shifts with a teaching service with students (TWS was 220 minutes. In comparison, the median LOS on shifts when no teaching service was present (NTS was 202.5 minutes. The median number of patients seen on shifts with the teaching service with students (TWS was 44, identical to the number seen on shifts when the teaching service was present without students (TWOS. When the teaching service was absent (NTS, the median number of patients seen was 40. Conclusion: A teaching service in

  8. Impact of a teaching service on emergency department throughput.

    Science.gov (United States)

    Smalley, Courtney M; Jacquet, Gabrielle A; Sande, Margaret K; Heard, Kennon; Druck, Jeffrey

    2014-03-01

    There are 161 emergency medicine residency programs in the United States, many of which have medical students rotating through the emergency department (ED). Medical students are typically supervised by senior residents or attendings while working a regular shift. Many believe that having students see and present patients prolongs length of stay (LOS), as care can be delayed. Our institution implemented a unique method of educating medical students while in the ED with the creation of a teaching service, whose primary goal is education in the setting of clinical care. The objective of this study was to explore the effect of the teaching service on efficiency by describing LOS and number of patients seen on shifts with and without a teaching service. This was a retrospective chart review performed over a 12-month period of visits to an urban academic ED. We collected data on all patients placed in a room between 14:00 and 19:59, as these were the hours that the teaching shift worked in the department. We categorized shifts as 1) a teaching service with students (TWS); 2) a teaching service without students (TWOS); and 3) no teaching service (NTS). LOS and median number of patients seen on days with a teaching service, both with and without students (TWS and TWOS), was compared to LOS on days without a teaching service (NTS). The median LOS on shifts with a dedicated teaching service without students (TWOS) was 206 minutes, while the median LOS on shifts with a teaching service with students (TWS) was 220 minutes. In comparison, the median LOS on shifts when no teaching service was present (NTS) was 202.5 minutes. The median number of patients seen on shifts with the teaching service with students (TWS) was 44, identical to the number seen on shifts when the teaching service was present without students (TWOS). When the teaching service was absent (NTS), the median number of patients seen was 40. A teaching service in the ED is a novel educational model for medical

  9. Proposing a competitive intelligence (CI framework for Public Service departments to enhance service delivery

    Directory of Open Access Journals (Sweden)

    Nisha Sewdass

    2012-07-01

    Objectives: This article focuses on proposing competitive intelligence-related strategies, tools and techniques for gathering and analysing information in the public service departments in South Africa in order to enhance service delivery. Method: The study was qualitative in nature and was divided into two components, namely, (1 theoretical – through an extensive review of the literature and (2 empirical – an ethnographic study at the chosen public service department, the Department of Home Affairs (DHA. Ethnographic interviews with management-level staff, focus groups and document analysis were used to obtain adequate information to determine the current state of public service delivery in South Africa. Results: The results of the study was the development of a new competitive intelligencerelated framework for gathering and analysing information, and it represents a formal and systematic process of informing managers in public service departments about critical issues that these departments face or are likely to experience in future. Conclusion: The strategic planning tools and techniques of this framework will fill the gap that exists in public service departments. Once this framework has been implemented, it could assist these departments to improve service delivery to its citizens.

  10. 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.

  11. 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).

  12. Does Limiting Oral Contrast Decrease Emergency Department Length of Stay?

    Directory of Open Access Journals (Sweden)

    Erik Barton

    2012-12-01

    Full Text Available Introduction: The purpose of this study was to examine the impact on emergency department (EDlength of stay (LOS of a new protocol for intravenous (IV-contrast only abdominal/pelvic computedtomography (ABCT compared to historical controls.Methods: This was a retrospective case-controlled study performed at a single academic medicalcenter. Patients ≥ 18 undergoing ABCT imaging for non-traumatic abdominal pain were included inthe study. We compared ED LOS between historical controls undergoing ABCT imaging with PO/IVcontrast and study patients undergoing an IV-contrast-only protocol. Imaging indications were thesame for both groups and included patients with clinical suspicion for appendicitis, diverticulitis, smallbowel obstruction, or perforation. We identified all patients from the hospital’s electronic storehouse(imaging code, ordering department, imaging times, and we abstracted ED LOS and dispositionfrom electronic medical records.Results: Two hundred and eleven patients who underwent PO/IV ABCT prep were compared to 184patients undergoing IV-contrast only ABCT prep. ED LOS was shorter for patients imaged with theIV-contrast only protocol (4:35 hrs vs. 6:39 hrs, p < 0.0001.Conclusion: Implementation of an IV-contrast only ABCT prep for select ED patients presentingfor evaluation of acute abdominal pain significantly decreased ED LOS.

  13. 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.)

  14. [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.

  15. 76 FR 38550 - Technical Standard DOE-STD-1095-2011, Department of Energy Laboratory Accreditation for External...

    Science.gov (United States)

    2011-07-01

    ... CFR Part 835 Technical Standard DOE-STD-1095-2011, Department of Energy Laboratory Accreditation for...: Notification of updated Technical Standard. SUMMARY: The Department of Energy (DOE or the Department) is issuing Technical Standard DOE-STD-1095-2011, Department of Energy Laboratory Accreditation for External...

  16. Does Young Age Merit Increased Emergency Department Trauma Team Response?

    Directory of Open Access Journals (Sweden)

    Holmes, James F.

    2013-11-01

    Full Text Available ntroduction: To determine if increased trauma team response results in alterations in resource use in a population of children<6 years, especially in those least injured. Methods: We conducted a retrospective before and after study of children <6 years sustaining blunt trauma and meeting defined prehospital criteria. We compared hospitalization rates and missed injuries (injuries identified after discharge from the emergency department/hospital among patients with and without an upgraded trauma team response. We compared the computed tomography (CT rate and laboratory testing rate among minimally injured patients (Injury Severity Score [ISS] 6. Results: We enrolled 352 patients with 180 (mean age 2.7 ± 1.5 years in the upgrade cohort and 172 (mean age 2.6 ± 1.5 years in the no-upgrade cohort. Independent predictors of hospital admission in a regression analysis included: Glasgow Coma Scale <14 (odds ratio [OR]=11.4, 95% confidence interval [CI] 2.3, 56, ISS (OR=1.55, 95% CI 1.33, 1.81, and evaluation by the upgrade trauma team (OR=5.66, 95% CI 3.14, 10.2. In the 275 patients with ISS < 6, CT (relative risk=1.34, 95% CI 1.09, 1.64 and laboratory tests (relative risk=1.71, 95% CI 1.39, 2.11 were more likely to be obtained in the upgrade cohort as compared to the no-upgrade cohort. We identified no cases of a missed diagnosis. Conclusion: Increasing the trauma team response based upon young age results in increased resource use without altering the rate of missed injuries. In hospitals with ED physicians capable of evaluating and treating injured children, increasing ED trauma team resources solely for young age of the patient is not recommended. [West J Emerg Med. 2013;14(6:569–575.

  17. 25 CFR 900.193 - Does FTCA coverage extend to individuals who provide health care services under a personal...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA coverage extend to individuals who provide health care services under a personal services contract providing services in a facility that is owned, operated, or constructed under the jurisdiction of the IHS? 900.193 Section 900.193 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND...

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

    Science.gov (United States)

    2012-02-03

    ... Department of State FY11 Service Contract Inventory AGENCY: Department of State. ACTION: Notice of the release of the Department of State FY11 Service Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY11 and its analysis of the FY10 inventory. They are...

  19. 78 FR 13743 - Department of State FY11 Service Contract Inventory

    Science.gov (United States)

    2013-02-28

    ... Department of State FY11 Service Contract Inventory AGENCY: Department of State. ACTION: Notice of the release of the Department of State FY11 Service Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY12 and its analysis of the FY11 inventory. They are...

  20. 76 FR 9399 - Department of State FY10 Service Contract Inventory

    Science.gov (United States)

    2011-02-17

    ... Department of State FY10 Service Contract Inventory AGENCY: Department of State. ACTION: Notice of the release of the Department of State FY10 Service 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...

  1. 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.

  2. 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.

  3. Variation in local health department primary care services as a function of health center availability.

    Science.gov (United States)

    Wright, Brad; Nice, Andrew J

    2015-01-01

    We aim to gain a clearer understanding of the effect of colocated federally qualified health centers (FQHCs) on the delivery of primary care and preventive services by local health departments (LHDs). We collected data from the 2010 National Association of County & City Health Officials Profile of Local Health Departments, the 2010 Uniform Data System, and the 2011 Area Resource File. Forty-eight states, excluding Rhode Island and Hawaii. The analytic sample contained data on 2107 LHDs across the country. We modeled 4 measures of primary care activity for each LHD: provision of screening for (1) heart disease, (2) diabetes, and (3) hypertension, and (4) provision of comprehensive primary care. Local health departments in counties with an FQHC grantee have, on average, 32% lower odds of providing hypertension screening, but having an FQHC grantee in the county does not influence LHDs' primary care provision or screening for heart disease or diabetes. However, in an alternate model examining FQHC delivery sites per capita, each site is associated with a decrease in the odds of LHDs providing primary care (4% lower odds) or screening for heart disease (2% lower odds), diabetes, or hypertension (both 1% lower odds). Local health departments are more involved in disease screening than the provision of primary care. However, larger LHDs are more likely to provide both screening and primary care. Our current study provides evidence that the availability of an FQHC in the same county as an LHD partially explains the variation in LHDs' provision of primary care services. Local health departments with colocated FQHCs can focus on more traditional public health activities, while LHDs in areas without an FQHC may find that ensuring access to care is more challenging, possibly leading LHDs to directly provide primary care services.

  4. IT-Driven Customer Service or Customer-Driven IT Service: Does IT Matter?

    DEFF Research Database (Denmark)

    Damsgaard, J.; Hørlück, J.; Jensen, Christian Søndergaard

    2005-01-01

    IT service and customer service into one powerful business development department. The creation of a central department had been extremely successful during the radical changes that Nykredit had been forced into during the 1990s. But could the success of the past be extended into the future? The public...

  5. 25 CFR 900.195 - Does FTCA coverage extend to the contractor's health care practitioners providing services to...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA coverage extend to the contractor's health care practitioners providing services to private patients on a fee-for-services basis when such personnel (not the self-determination contractor) receive the fee? 900.195 Section 900.195 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND...

  6. 76 FR 79221 - Penske Logistics, LLC, Customer Service Department General Motors and Tier Finished Goods...

    Science.gov (United States)

    2011-12-21

    ... Employment and Training Administration Penske Logistics, LLC, Customer Service Department General Motors and... workers of Penske Logistics, LLC, Customer Service Department, a subsidiary of General Electric/Penske... correct name of the worker group department of the subject firm should read Penske Logistics, LLC...

  7. 77 FR 27263 - Computer Matching Between the Selective Service System and the Department of Education

    Science.gov (United States)

    2012-05-09

    ... From the Federal Register Online via the Government Publishing Office SELECTIVE SERVICE SYSTEM Computer Matching Between the Selective Service System and the Department of Education AGENCY: Selective... Selective Service System (SSS) and the Department of Education (ED). 2. Purpose of the Match The purpose of...

  8. Health services use associated with emergency department closure

    DEFF Research Database (Denmark)

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

    2011-01-01

    OBJECTIVE: To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. METHOD: A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed......, 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...

  9. 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.

  10. First civil service examination for nurses at the Administrative Department of Public Service.

    Science.gov (United States)

    Brasileiro, Danilo Fernandes; Sanna, Maria Cristina

    2015-01-01

    to describe the results of the first national public service examination for nurses conducted by the Administrative Department of Public Service between 1941 and 1942. historical-documentary research with a quantitative approach. 155 candidates registered, aged between 21 and 35 years old, 141 (91%) of whom were female. A total of 120 candidates passed the practical exam. Of these, 116 took the written qualification exam. In the end, 107 were approved, 74 (69.1%) of whom were temporary public nurses, 59 (55.1%) Anna Nery Nursing School alumni, and 10 among the first 20 twenty became involved with the Brazilian Association of Nursing later. although the exam legitimized the meritbased culture in the staff selection in the area of Brazilian nursing, egalitarian criteria were mitigated, especially regarding the grades applied to different kinds of exams. This resulted in a significant number of temporary nurses approved.

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

    African Journals Online (AJOL)

    Ngulup

    Abstract. This article explores the role of records management in the delivery of public service in. Botswana with specific reference to the Corporate Services Division at the Ministry of. Health headquarters. This study used the case study approach and was complemented by triangulation of both quantitative and qualitative ...

  12. Nations first federal combined solar power purchase launched by EPA, Forest Service, Energy Department and GSA

    Science.gov (United States)

    SAN FRANCISCO - The U.S. Environmental Protection Agency, U.S. Forest Service, Department of Energy and General Services Administration announced the first ever federal partnership to purchase solar power. This action follows President Obama's order

  13. 39 CFR 602.2 - Office of Licensing, Philatelic and Retail Services Department.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office of Licensing, Philatelic and Retail... OTHER THAN PATENTS § 602.2 Office of Licensing, Philatelic and Retail Services Department. In accordance with the foregoing policy, the Postal Service Office of Licensing, Philatelic and Retail Services...

  14. 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.

  15. Department of Health and Human Services Semiannual Regulatory Agenda

    Science.gov (United States)

    2010-12-20

    ... regulations. It will modify the dispensing requirements for buprenorphine and buprenorphine combination...), USDA/CVB (Center for Veterinary Biologics), and the Department of Defense (DOD)/United States Army... Veterinary Medicine, Room 101, (MPN-4, HFV-232), 7519 Standish Place, Rockville, MD 20855 Phone: 240 276-9242...

  16. Availability of gynecologic services in the department of veterans affairs.

    Science.gov (United States)

    Seelig, Michelle D; Yano, Elizabeth M; Bean-Mayberry, Bevanne; Lanto, Andy B; Washington, Donna L

    2008-01-01

    The optimum approach to providing the Congressionally mandated gender-specific services for which women veterans are eligible is unknown. We evaluated onsite availability of gynecologic services, clinic type and staffing arrangements, and the impact of having a gynecology clinic (GYN) and/or an obstetrician gynecologist (OBGYN) routinely available. We analyzed data from the 2001 national VHA Survey of Women Veterans Health Programs and Practices (n = 136 sites; response rate, 83%). We assessed availability of gynecologic services, and evaluated differences in availability by clinic type (designated women's health provider in primary care [PC], separate women's health clinic for primary care [WHC], and/or separate GYN) and staffing arrangements (OBGYN routinely involved versus not). Out of 133 sites, 77 sites (58%) offered services through a GYN and 56 sites (42%) did not have GYN. Seventy-two (54%) sites had a WHC. More sites with an OBGYN provided endometrial biopsies (91% vs. 20%), IUD insertion (85% vs. 14%), infertility evaluation (56% vs. 23%), infertility treatment (25% vs. none), gynecologic surgery (65 vs. 28%), p gynecologic surgery 2.3 (1.0-5.4). As the VA develops strategic plans for accommodating the growing number of women veterans, leaders should consider focusing on establishing WHC for primary care and routine availability of OBGYN or other qualified clinicians, rather than establishing separate GYN.

  17. 75 FR 67998 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Chattahoochee...

    Science.gov (United States)

    2010-11-04

    ... Completion: U.S. Department of Agriculture, Forest Service, Chattahoochee-Oconee National Forests.... Department of Agriculture, Forest Service, Chattahoochee-Oconee National Forests, Gainesville, GA. The human... Creek Confederacy. Based on a review of the archeology, ethnography and history of the region, officials...

  18. Current and planned shared service arrangements in Wisconsin local and tribal health departments.

    Science.gov (United States)

    Madamala, Kusuma; Young, Nancy; Young, Dustin; Giese, Lieske; Brandenberg, Terry; Zahner, Susan

    2014-01-01

    The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin. An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place. Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness. There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

  19. Does Ownership Matter for Service Delivery Value? An Examination of Citizens’ Service Satisfaction

    OpenAIRE

    Hodgkinson, Ian R.; Hughes, Paul; Hughes, Mathew; Glennon, Russ

    2016-01-01

    The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Governments across the world outsource service delivery to external agents, but does ownership matter for service delivery value? Though theory points to clear ownership differences on effectiveness, there remains limited empirical evidence of the impact of ownership on citizens’ satisfaction. Focusing on local authorities in England, we draw o...

  20. 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.

  1. 78 FR 17349 - Public Availability of Department of Commerce FY2012 Service Contract Inventory

    Science.gov (United States)

    2013-03-21

    ... Office of the Secretary Public Availability of Department of Commerce FY2012 Service Contract Inventory... Service Contract Inventories. SUMMARY: In accordance with Section 743 of Division C of the Consolidated... public of the availability of the Fiscal Year (FY) 2012 Service Contract Inventory and a report that...

  2. 77 FR 12798 - Public Availability of Department of Commerce FY2011 Service Contract Inventory

    Science.gov (United States)

    2012-03-02

    ... Office of the Secretary Public Availability of Department of Commerce FY2011 Service Contract Inventory... Service Contract Inventories. ] SUMMARY: In accordance with Section 743 of Division C of the Consolidated... public of the availability of the Fiscal Year (FY) 2011 Service Contract Inventory and a report that...

  3. 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.

  4. 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...

  5. 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...

  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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Swets Information Services, Operations Department, Information Technology Group, Marketing Group, Finance Group, Runnemede, NJ; Amended Certification Regarding Eligibility To Apply for Worker Adjustment Assistance In...

  8. 75 FR 18857 - Privacy Act of 1974; Department of Homeland Security Citizenship and Immigration Services...

    Science.gov (United States)

    2010-04-13

    ... SECURITY Office of the Secretary Privacy Act of 1974; Department of Homeland Security Citizenship and... Security system of records notice titled, ``Department of Homeland Security Citizenship and Immigration... efficient and secure processing of information to aid the Citizenship and Immigration Services Ombudsman in...

  9. Cooperative Agreement Between the United States Department of the Interior and the State of Florida Department of Agriculture and Consumer Services Division of Forestry

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — An agreement for assistance with forest fire detection, suppression and presuppression services on wildlife refuge lands by the Florida Division of Forestry. The...

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

    Science.gov (United States)

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

    2017-04-04

    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.

  11. Medical Services: Department of Defense Veterinary/Medical Laboratory Food Safety and Quality Assurance Program

    Science.gov (United States)

    1995-02-01

    See notes 7 & 8) 0 per ml (See note 7) 0 per ml (See note 7) Buttermilk and acidophilus milk ≤10 per gram Cottage cheese ≤10 per gram ≤10 per gram...Department of Agriculture , Agricultural Marketing Service, Dairy Division, Room 2750–South, P.O. Box 96456, Washington, DC 20090–6456. DLAR 4155.26/AR...Code USDA U.S. Department of Agriculture USDC U.S. Department of Commerce USPHS U.S. Public Health Service Section II Terms Aerobic plate count Method

  12. 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

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

    CERN Multimedia

    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

  14. Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites.

    Science.gov (United States)

    Dement, John M; Ringen, Knut; Welch, Laura S; Bingham, Eula; Quinn, Patricia

    2009-09-01

    The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004. A cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates. Six hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR = 0.93, 95% CI = 0.86-1.01), indicating a "healthy worker effect." However, significantly excess mortality was observed for all cancers (SMR = 1.28, 95% CI = 1.13-1.45), lung cancer (SMR = 1.54, 95% CI = 1.24-1.87), mesothelioma (SMR = 5.93, 95% CI = 2.56-11.68), and asbestosis (SMR = 33.89, 95% CI = 18.03-57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR = 1.92, 95% CI = 1.02-3.29). DOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. (c) 2009 Wiley-Liss, Inc.

  15. Provision of Personal Healthcare Services by Local Health Departments: 2008-2013.

    Science.gov (United States)

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2015-09-01

    The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008-2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. The mean number of personal healthcare services provided by LHDs did not change significantly in 2008-2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services' share of revenue and per capita expenditures (b=0.57, phealthcare services is associated with lower per capita expenditures. LHDs, especially those serving healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  16. 75 FR 44280 - Notice of Intent to Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2010-07-28

    .... Officials of the American Museum of Natural History and the U.S. Department of Agriculture, Forest Service.... Officials of the American Museum of Natural History and the U.S. Department of Agriculture, Forest Service... National Park Service Notice of Intent to Repatriate Cultural Items: U.S. Department of Agriculture, Forest...

  17. 20 CFR 1002.168 - If the employee's coverage was terminated at the beginning of or during service, does his or her...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false If the employee's coverage was terminated at the beginning of or during service, does his or her coverage have to be reinstated upon reemployment? 1002.168 Section 1002.168 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND TRAINING SERVICE, DEPARTMENT OF LABOR...

  18. 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

  19. 76 FR 43718 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National...

    Science.gov (United States)

    2011-07-21

    ... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National Forest, Silver City, NM and Field Museum of Natural History, Chicago, IL AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture, Forest Service, Gila...

  20. 78 FR 59953 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Coconino National...

    Science.gov (United States)

    2013-09-30

    ... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service... Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service... with representatives of the Hopi Tribe of Arizona. History and Description of the Remains In 1941...

  1. 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

    ... Department of Health and Human Services use to decide which family planning services projects to fund and in... 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...

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

    Science.gov (United States)

    2015-06-12

    OIF Operation Iraqi Freedom VA Department of Veterans Affairs VA OIG Department of Veterans Affairs Office of Inspector General VBA Veterans Benefits...reorganization into the three administrations: Veterans Health Administration (VHA), Veterans Benefits Administration ( VBA ) and National Cemetery...features. VBA also implemented a similar program in coordination with DoD called eBenefits which allows Veterans, Service Members and their families to

  3. Emergency department and inpatient health care utilization among patients who require interpreter services.

    Science.gov (United States)

    Njeru, Jane W; St Sauver, Jennifer L; Jacobson, Debra J; Ebbert, Jon O; Takahashi, Paul Y; Fan, Chun; Wieland, Mark L

    2015-05-29

    Limited English proficiency is associated with health disparities and suboptimal health outcomes. Although Limited English proficiency is a barrier to effective health care, its association with inpatient health care utilization is unclear. The aim of this study was to examine the association between patients with limited English proficiency, and emergency department visits and hospital admissions. We compared emergency department visits and hospitalizations in 2012 between patients requiring interpreter services and age-matched English-proficient patients (who did not require interpreters), in a retrospective cohort study of adult patients actively empanelled to a large primary health care network in a medium-sized United States city (n = 3,784). Patients who required interpreter services had significantly more Emergency Department visits (841 vs 620; P ≤ .001) and hospitalizations (408 vs 343; P ≤ .001) than patients who did not require interpreter services. On regression analysis the risk of a first Emergency Department visit was 60% higher for patients requiring interpreter services than those who did not (unadjusted hazard ratio [HR], 1.6; 95% confidence interval (CI), 1.4-1.9; P interpreter services had higher rates of inpatient health care utilization compared with patients who did not require an interpreter. Further research is required to understand factors associated with this utilization and to develop sociolinguistically tailored interventions to facilitate appropriate health care provision for this population.

  4. 20 CFR 1002.60 - Does USERRA cover an individual attending a military service academy?

    Science.gov (United States)

    2010-04-01

    ... service academies: The United States Military Academy (West Point, New York), the United States Naval... military service academy? 1002.60 Section 1002.60 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR... Uniformed Services § 1002.60 Does USERRA cover an individual attending a military service academy? Yes...

  5. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Science.gov (United States)

    2010-04-01

    ... 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 with each recipient, you, the social services worker must: (a) Assess the general employability of the...

  6. Creation of a United States Emergency Medical Services Administration Within the Department of Homeland Security

    Science.gov (United States)

    2012-03-01

    Surge Capacity for Terrorist Bombings ; Challenges and Proposed Solutions,” U.S. Department of Health and Human Services, Center for Disease Control...reauthorization/safetea_bill_t2.htm#sec2003. 65 R. Berne , Emergency Medical Services: The Forgotten First Responder (Center for Catastrophic Preparedness and...751 restaurant patrons with salmonella bacteria poisoning; the first World Trade bombings (1993)—injuring 1,042 and killing six; the Alfred A. Murrah

  7. 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 ...

  8. 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…

  9. Institutional Effectiveness Assessment Process, 1993-94. Executive Summary. Hospitality and Service Occupations Division, Cosmetology Department.

    Science.gov (United States)

    South Seattle Community Coll., Washington.

    A study was conducted to evaluate student and student employer satisfaction with the services provided by the South Seattle Community College (SSCC) Cosmetology Department. Specifically, the study gathered data related to four outcomes: that students receive an educational experience allowing them to meet their goals; that former and current…

  10. 76 FR 27164 - Extension of Accreditation Agreement With Colorado Department of Human Services Under the...

    Science.gov (United States)

    2011-05-10

    ..., and concluding to its satisfactory performance through the Department's ongoing monitoring and yearly... all of its responsibilities, and will use the Adoptions Tracking System and the Hague complaint... training, travel and meeting attendance in advance of receiving any fees for its services as an accrediting...

  11. 75 FR 64710 - Availability of the Fiscal Year 2009 Department of Defense Services Contracts Inventory

    Science.gov (United States)

    2010-10-20

    ... of the Secretary Availability of the Fiscal Year 2009 Department of Defense Services Contracts... 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/PASS) will make available to the...

  12. Exploring Intercollegiate Athletic Department-Community Partnerships through the Lens of Community Service Organizations

    Science.gov (United States)

    Svensson, Per G.; Huml, Matthew R.; Hancock, Meg G.

    2014-01-01

    Institutions of higher education are increasingly engaging in partnerships with local communities. Within a sport context, the creation of the NCAA CHAMPS/Life Skills Program has emphasized partnerships between athletic departments and local community service organizations (CSOs). Prior studies, however, have used student-athletes rather than the…

  13. RECIPROCAL ALLOCATION METHOD IN SERVICE DEPARTMENTS. THE CASE OF A PRODUCTION ENTERPRISE

    Directory of Open Access Journals (Sweden)

    Ewelina PAPAJ

    2017-10-01

    Full Text Available 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 analy-sis of subject literature. In the latter part, the service departments’ costs calculation will be presented, basing on recipro-cal services in a production enterprise from chemical industry.

  14. 49 CFR 40.403 - Must a service agent notify its clients when the Department issues a PIE?

    Science.gov (United States)

    2010-10-01

    ... Department issues a PIE? 40.403 Section 40.403 Transportation Office of the Secretary of Transportation... Must a service agent notify its clients when the Department issues a PIE? (a) As a service agent, if the Department issues a PIE concerning you, you must notify each of your DOT-regulated employer...

  15. 77 FR 11584 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National...

    Science.gov (United States)

    2012-02-27

    .... Department of Agriculture, Forest Service, Gila National Forest, and the Field Museum of Natural History in... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Gila National Forest, Silver City, NM, and Field Museum of Natural History, Chicago, IL AGENCY: National Park...

  16. 78 FR 34128 - Notice of Inventory Completion: U.S. Department of Agriculture, U.S. Forest Service, San Juan...

    Science.gov (United States)

    2013-06-06

    ... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, U.S. Forest Service...: The U.S. Department of Agriculture (USDA), Forest Service, San Juan National Forest has completed an... Pueblo of Texas; and the Zuni Tribe of the Zuni Reservation, New Mexico. History and description of the...

  17. 77 FR 39506 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Tongass National...

    Science.gov (United States)

    2012-07-03

    ... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service...: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Tongass National Forest, has.... History and Description of the Remains On an unknown date prior to 1987, human remains representing, at...

  18. 78 FR 34131 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2013-06-06

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest.... SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, San Juan National Forest, in... National Park Service is not responsible for the determinations in this notice. History and Description of...

  19. 77 FR 11571 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2012-02-27

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service, Gila National Forest, Silver City, NM; Arizona State Museum, University of Arizona, Tucson, AZ... control of the U.S. Department of Agriculture, Forest Service, Gila National Forest, Silver City, NM, and...

  20. What Parents Want: Does Provider Knowledge of Written Parental Expectations Improve Satisfaction in the Emergency Department?

    Science.gov (United States)

    Zoltowski, Kathleen S W; Mistry, Rakesh D; Brousseau, David C; Whitfill, Travis; Aronson, Paul L

    2016-01-01

    Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey. At ED disposition, all groups completed a 3-item satisfaction survey, scored using 5-point Likert scales (1 = very poor, 5 = very good). The primary outcome was rating of "overall care." Secondary outcomes included likelihood of recommending the ED and staff sensitivity to concerns. Proportions were compared by chi-square test. A total of 304 subjects were enrolled. The proportion of parents rating 5 of 5 for overall care did not differ among the baseline, control, and intervention groups (74.8% vs 73.2% vs 69.2%, P = .56). The proportion of parents rating 5 of 5 also did not differ for likelihood of recommending the ED (77.7% vs 72.2% vs 70.2%, P = .45) or staff sensitivity to concerns (78.6% vs 78.4% vs 78.8%, P = .71). For nonurgent pediatric ED visits, clinician knowledge of written parental expectations does not improve parental satisfaction. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. Assessing Delivered Services Quality in Emergency Department of Imam Reza Hospital, Tabriz, Iran: 2011

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2015-08-01

    Full Text Available Background and objectives: The satisfaction of emergency department (ED patients is considered as an important indicator of hospitals quality. This study aimed to evaluate service quality (SQ from patients’ perspective in  ED. Material and Methods: A cross-sectional study was conducted with 120 admitted patients in emergency department of Imam Reza hospital of Tabriz University of Medical Sciences in 2011. Service Quality was measured using researcher-developed questionnaire. Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0. 827. A measure of service quality was derived by combining the relative importance and actual performance of ED staffs. Service Quality was calculated using SQ = 10–(Importance×Performance. Independent Samples Test and Analysis of Variance were conducted to compare SQ score between categorical variables. Data were analyzed using the SPSS-17 statistical package. Results: From the customers’ point of view, the average service quality score was 8.77 of 10. Furthermore, confidentiality, dignity and availability achieved the highest and of nutritional services, safety, cost and continuity of care got the lowest SQ scores from the patients’ perspective. Conclusion : Improving quality of delivered care in ED depends on the understanding of the current situation and its weaknesses. It is possible to improve quality of delivered care by implementing effective interventions according to the results of study findings and by considering focus on dimensions which have worst quality.

  2. Does rural residence limit access to mental health services?

    Science.gov (United States)

    Hardy, Cindy L; Kelly, Karen D; Voaklander, Don

    2011-01-01

    Rural residence may reduce access to specialized mental health services. The objective of this study was to examine the role of rural residence in relation to service utilization. Using Canadian data collected in 2002, service use was examined as a function of the presence of anxiety or mood disorders and rural/urban residence. Use of four different types of professional mental health services was examined in relation to rural residence and additional demographic, social, and health status factors known to predict use of services. Data were obtained from Statistics Canada's Canadian Mental Health Survey Cycle 1.2. Rural residence was defined as living in a rural community with a population of 1000 or less. For all participants, associations between the presence of anxiety or mood disorders, rural/urban residence, and any service use or use of specialized mental health services (psychiatry and psychology) were examined. For participants who had used professional services, associations were examined between 17 predictor variables, including location of residence, and the use of four types of service providers (family doctor or GP; nurse, social worker, counsellor, or psychotherapist; psychiatrist; or psychologist). Predictors included demographic, social, and health status variables. Cross-tabulated counts and adjusted odds ratios with 99% confidence intervals based on bootstrapped variance estimates were used to evaluate predictors. Among the total sample (n = 35 140), 7.9% had used professional mental health services in the previous year. Among people who were likely to have had anxiety or mood disorders, rural or urban residence was not differentially related to past-year use of any professional services or specialized mental health services. Multivariate logistic regression was used to model factors predicting past year use of four different types of professional services. Location of residence was not a significant predictor of service utilization. Age, sex

  3. Safety Issues at the DOE Test and Research Reactors. A Report to the U.S. Department of Energy.

    Science.gov (United States)

    National Academy of Sciences - National Research Council, Washington, DC. Commission on Physical Sciences, Mathematics, and Resources.

    This report provides an assessment of safety issues at the Department of Energy (DOE) test and research reactors. Part A identifies six safety issues of the reactors. These issues include the safety design philosophy, the conduct of safety reviews, the performance of probabilistic risk assessments, the reliance on reactor operators, the fragmented…

  4. Psychiatric service users' experiences of emergency departments: a CERQual review of qualitative studies.

    Science.gov (United States)

    Carstensen, Kathrine; Lou, Stina; Groth Jensen, Lotte; Konstantin Nissen, Nina; Ortenblad, Lisbeth; Pfau, Margarete; Vedel Ankersen, Pia

    2017-05-01

    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. To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title/abstract identified 57 studies and, after full text assessment, nine studies were included. The included studies were critically appraised using CASP. Thematic synthesis was applied for data extraction and identification of findings. The CERQual approach was utilized to assess the confidence of the findings. The results of the review showed moderate confidence in the findings that service users experience meeting caring and judgmental ED staff, and that waiting times and a stressful environment are integral to their ED experiences. In contrast, low-to-very low confidence was seen in the findings that service users experience having their symptoms ignored and that EDs are used due to a lack of alternatives. A companion may improve service users experience and outcome of ED visits. Service users experience stress and discomfort in the ED. Service users highly appreciate knowing staff who can ease 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.

  5. 25 CFR 20.602 - How does the Bureau verify eligibility for social services?

    Science.gov (United States)

    2010-04-01

    ... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.602 How does the Bureau verify eligibility for social services? (a) You, the applicant, are the primary source of information... to your social services worker any changes in circumstances that may affect your eligibility or the...

  6. Focus on: ORBIS International Flying Eye Hospital, Department of Technical Services.

    Science.gov (United States)

    Prausnitz, M R; Cordero, I; Levenson, A

    1995-01-01

    The ORBIS International Flying Eye Hospital is dedicated to restoring sight to the blind through medical education programs in developing countries. The modification of a DC-10 aircraft to house a teaching hospital for ophthalmic surgery involved a variety of engineering challenges to satisfy standards for both hospital and aircraft safety. The Technical Services Department maintains all medical equipment on the aircraft, encountering situations not found in traditional clinical engineering departments. Technical education is also an important part of the ORBIS biomedical engineering program. Future plans include expansion of existing technical training efforts, as well as using technology to improve the medical education program as a whole.

  7. 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.

  8. 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...

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

    NARCIS (Netherlands)

    Bondarouk, Tatiana; 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

  10. Textbook Access and Affordability through Academic Library Services: A Department Develops Strategies to Meet the Needs of Students

    Science.gov (United States)

    Eighmy-Brown, Melissa; McCready, Kate; Riha, Emily

    2017-01-01

    In the spring of 2015, the University of Minnesota Libraries formed the Content Services department, which is comprised of Interlibrary Loan, Publishing Services, and the Copyright Permissions Service. These three service points, as well as additional Library units, work together with campus partners to save students money on their course…

  11. A history of U.S. Department of Agriculture Forest Service forest survey, 1830-2004

    Science.gov (United States)

    Vernon J. LaBau; James T. Bones; Neal P. Kingsley; H. Gyde Lund; W. Brad Smith

    2007-01-01

    This article provides a summary of a new report on the history of the Forest Survey (Forest Inventory) in the United States as it evolved within the U.S. Department of Agriculture Forest Service over a period of more than 100 years. It draws on the writings of several authors who have published on various aspects of the Forest Survey program. It reviews nine ground-...

  12. DOE KSU EV Site Operator Program. [United States Department of Energy (DOE) Kansas State University (KSU) Electric Vehicle (EV)

    Energy Technology Data Exchange (ETDEWEB)

    Hague, J.R.; Steinert, R.A.; Nissen-Pfrang, T.

    1992-01-01

    Kansas State University, with funding from federal, state, public, and private companies, is participating in the DOE Electric Vehicle Site Operator Program. Kansas State is demonstrating, testing, and evaluating electric of hybrid vehicle technology. This will provide organizations the opportunity to examine the latest EHV prototypes under actual operating conditions. KSU proposes to purchase one (1) electric or hybrid van and four(4) electric cars during the first two years of this five-year program. KSU has purchased one G-Van built by Conceptor Industries, Toronto, Canada and has initiated a procurement order to purchase two (2) Soleq 1992 Ford EVcort station wagons. This quarter's report describes ongoing public relations activities and meetings as well as presenting performance data for the electric vehicles. (GHH)

  13. Benchmarking US Department of Veterans Affairs dermatologic services: results from a national survey.

    Science.gov (United States)

    Krause, L Kendall; Townsend, Leilani; Orser, Michael L; Mulhausen, Jennifer; Duke, Jodi; Waxweiler, Weston T; Dellavalle, Robert P

    2012-03-01

    How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature. We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA. Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed. Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained dermatology residents (72%) and medical students (80%). One third of services reported significant research involvement. Qualitative analysis revealed the academic environment, patient population, and decreased business management responsibilities as the 3 most commonly cited advantages to VA employment. The most commonly listed disadvantages included low salaries, bureaucracy, and lack of resources. The survey data were self-reported and not independently verified. Not all services returned the survey. Outpatient VA dermatology services accomplish significant primary care and preventive services (eg, sun safety counseling, skin cancer screening, and treatment). However, the small number of dedicated dermatology services, their irregular geographic distribution, and the lack of staffing and resources may adversely affect optimal patient care. Dermatologist responses regarding the positive and negative aspects of working in the VA system may lead to improved management strategies to better retain and recruit dermatologists to provide patient care, medical education, and medical research despite dramatically lower dermatologist salaries within the VA system compared with private practice. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Fire Department Emergency Response

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A. [Westinghouse Savannah River Company, AIKEN, SC (United States); 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.

  15. 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.

  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

    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

  17. 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.

  18. 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

    2017-10-31

    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.

  19. 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...

  20. 77 FR 51562 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2012-08-24

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest.... SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Coconino National Forest, in.... 3005, of the intent to repatriate cultural items located at the Natural History Museum of Utah and...

  1. 77 FR 52055 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2012-08-28

    ... National Park Service Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest.... SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Coconino National Forest, in.... 3005, of the intent to repatriate cultural items in the possession of the Natural History Museum of Los...

  2. 77 FR 68824 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Tongass National...

    Science.gov (United States)

    2012-11-16

    ... Inventory Completion: U.S. Department of Agriculture, Forest Service, Tongass National Forest, Juneau, AK..., Interior. ACTION: Notice. SUMMARY: The U.S. Department of Agriculture (USDA), Forest Service, Tongass... in consultation with representatives of Douglas Indian Association. History and Description of the...

  3. 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.

  4. MyHealtheVet Service

    Data.gov (United States)

    Department of Veterans Affairs — This service provides web services used to obtain MyHealtheVet related data. The service does not support multiple Vista sites data access. Users of this service are...

  5. Role of out of hours primary care service in limiting inappropriate access to emergency department.

    Science.gov (United States)

    Posocco, Andrea; Scapinello, Maria Paola; De Ronch, Irene; Castrogiovanni, Francesco; Lollo, Gianluca; Sergi, Guglielmo; Tomaselli, Iginio; Tonon, Loris; Solmi, Marco; Pescador, Daniele; Battistuz, Elena; Traversa, Stefano; Zambianco, Vincenzo; Veronese, Nicola

    2017-05-25

    Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013. Out of 5217 patients accessing the OOH service, 408 referrals were included in our analysis. 45.3% (185) of the referrals were admitted to hospital or the short-stay unit, 26 patients (=6.4%) were discharged as non-urgent outgoing codes after no specialist consultation or test, suggesting inappropriate referrals, and, of the remaining 197 (=48%), only 10 did not undergo any investigation or consultation. Significant determinants of admission were: age ≥65 years (OR = 2.619; 95% CI 1.528-4.491, p service seems to play an effective gate-keeping role limiting ED access. Determinants of admission to hospital suggest some simple interventions that could improve the adequacy of ED referral from OOH service.

  6. 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

  7. Rural telemedicine infrastructure and services in the Department of Cauca, Colombia.

    Science.gov (United States)

    Rendón, Alvaro; Martínez, Andrés; Dulcey, María F; Seoane, Joaquín; Shoemaker, Richard G; Villarroel, Valentín; López, Diego M; Simó, Javier

    2005-08-01

    The development of telemedicine programs for the public health network of the Department of Cauca, Colombia, (Department is the major political and territorial division of the country. The Department of Cauca is located on the Pacific coast in the southwest of the country.) would make it possible to satisfy many identified needs such as medical coordination, continuing education, epidemiologic surveillance, patient referral and counterreferral, and an end to the feeling of isolation among professionals who work in rural health centers. Nevertheless, geographic, economic, and social difficulties, and the lack of a telecommunication infrastructure in areas with these characteristics present a challenge of such magnitude that the majority of existing telemedicine projects in Colombia have been centered in urban or other areas which present fewer difficulties. In the municipality of Silvia, the University of Cauca has established a prototype network using the "Hispano-American Health Link" (EHAS in Spanish) program technologies, which uses very high frequency (VHF) and wireless fidelity, (WiFi, a set of standards for wireless local area networks) radio systems for the deployment of low-cost voice and data networks. Over this network information access and exchange services have been developed, in order to meet the needs identified above. The objectives were to obtain information about the development of the project's activities and their possible impact. Project telecommunication network and information services are described, and the results and conclusions of the first evaluation are presented.

  8. 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.

  9. Memorandum of Understanding between the Alaska Department of Fish and Game, Alaska Department of Natural Resources , U.S. Forest Service and U.S. Department of the Interior Bureau of Sport Fisheries and Wildlife : Chickaloon Flats Management Agreement

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Chickaloon Flats, as per the attached legal description and map involving forty-eight thousand acres, more or less, are recognized by the agreement participants...

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

    Science.gov (United States)

    2013-04-19

    ... Technologies Office, Mailstop EE-2J, 1000 Independence Avenue SW., Washington, DC 20585-0121, Telephone: (202... of the General Counsel, Forrestal Building, Mailstop GC-71, 1000 Independence Ave. SW., Washington... Code Council (ICC). As a participant in this process, DOE considers and evaluates concepts to be...

  11. 34 CFR 692.80 - How does a State administer its community service work-study program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false How does a State administer its community service work... Its Community Service Work-Study Program? § 692.80 How does a State administer its community service work-study program? When administering its community service work-study program, a State must follow...

  12. "Does the Organization of Plastic Surgery Units into Independent Departments Affect Academic Productivity?"

    Science.gov (United States)

    Loewenstein, Scott N; Duquette, Stephen; Valsangkar, Nakul; Avula, Umakanth; Lad, Neha; Socas, Juan; Flores, Roberto L; Sood, Rajiv; Koniaris, Leonidas G

    2017-07-12

    There is an increased push for plastic surgery units in the United States to become independent departments administered autonomously rather than as divisions of a multispecialty surgery department. The purpose of this research was to determine if there are any quantifiable differences in the academic performance of departments versus divisions. Using a list of the plastic surgery units affiliated with The American Council of Academic Plastic Surgeons (ACAPS), unit websites were queried for departmental status and to obtain a list of affiliated faculty. Academic productivity was then quantified using the SCOPUS database. National Institute of Health (NIH) funding was determined through the Research Portfolio Online Reporting Tools database. Plastic surgery departments were comparable to divisions in academic productivity, evidenced by a similar number of publications per faculty (38.9 versus 38.7; p=0.94), number of citations per faculty (692 versus 761; p=0.64), H-indices (9.9 versus 9.9; p=0.99), and NIH grants (3.25 versus 2.84; p=0.80), including RO1 grants (1.33 versus 0.84; p=0.53). There was a trend for departments to have a more equitable male to female ratio (2.8 versus 4.1; p=0.06), and departments trained a greater number of integrated plastic surgery residents (9.0 versus 5.28; p=0.03). This study demonstrates that the academic performance of independent plastic surgery departments is generally similar to divisions, but with nuanced distinctions.

  13. 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.

  14. 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.

  15. 77 FR 68821 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis...

    Science.gov (United States)

    2012-11-16

    ... 3ST12 and 3ST26, on private property, by Don Williams, USDA-Forest Service Geologist, also in Stone... Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis National Forests... Agriculture (USDA), Forest Service, Ozark-St. Francis National Forests has completed an inventory of human...

  16. 78 FR 11677 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Apache-Sitgreaves...

    Science.gov (United States)

    2013-02-19

    ... Agriculture (USDA), Forest Service, Apache-Sitgreaves National Forests and the Field Museum of Natural History... National Park Service Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Apache-Sitgreaves National Forests, Springerville, AZ, and the Field Museum of Natural History, Chicago...

  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

    ... Service, Dinosaur National Monument, Dinosaur, CO AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Dinosaur National Monument, Dinosaur... culturally affiliated with the human remains may contact Dinosaur National Monument. Disposition of the human...

  18. Diversity in the ministry of chaplaincy in the South African Department of Correctional Services

    Directory of Open Access Journals (Sweden)

    Maake J. Masango

    2016-05-01

    Full Text Available This article gives an overview of diversity in the South African Department of Correctional Services and how it challenges the ministry of chaplains. The diversity is manifest in the religious affiliations of inmates, crime categories, various categories of offenders, and programmes and services as unpacked in this article. This article precisely aims to shed light on how the chaplaincy functions within the framework of corrections in South Africa and how the diversity of the inmates’ population impacts on its theory and praxis. The Authors delineate the role that chaplains have to play to remain relevant to the correctional environment and accentuate the required empathic and non-judgmental stance by spiritual care personnel. Religious flexibility and adaptability is essential, as chaplains are managers of all religious activities. The article provides solid insights into what being a correctional chaplain in South Africa entails.

  19. Comparison of access to services in rural emergency departments in Quebec and British Columbia.

    Science.gov (United States)

    Fleet, Richard; Audette, Louis-David; Marcoux, Jérémie; Villa, Julie; Archambault, Patrick; Poitras, Julien

    2014-11-01

    Although emergency departments (EDs) in Canada's rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged. The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities (using the rural and small town definition from Statistics Canada). Data were collected from ministries of health, local health authorities, and ED statistics. A telephone interview was administered to collect denominative user data statistics and determine the status of services. British Columbia has more rural EDs (n  =  34) than Quebec (n  =  26). EDs in Quebec have higher volumes (19,310 versus 7,793 annual visits). With respect to support services, 81% of Quebec rural EDs have a 24/7 on-call general surgeon compared to 12% for British Columbia. Nearly 75% of Quebec rural EDs have 24/7 access to computed tomography versus only 3% for British Columbia. Rural EDs in Quebec are also supported by a greater proportion of intensive care units (88% versus 15%); however, British Columbia appears to have more medevac aircraft/helicopters than Quebec. The results suggest that major differences exist in access to support services in rural EDs in British Columbia and Quebec. A nationwide study is justified to address this issue of variability in rural and remote health service delivery and its impact on interfacility transfers and patient outcomes.

  20. Changes in Emergency Department Geriatric Services in Quebec and Correlates of These Changes.

    Science.gov (United States)

    McCusker, Jane; Vadeboncoeur, Alain; Cossette, Sylvie; Veillette, Nathalie; Ducharme, Francine; Minh Vu, Thien Tuong; Ciampi, Antonio; Cetin-Sahin, Deniz; Belzile, Eric

    2017-07-01

    To describe changes in geriatric emergency department (ED) services from 2006 (T1) to 2013/14 (T2), associated factors, and outcomes. Two-wave survey design. Province of Quebec, Canada. Lead nurses and physicians at 57 EDs that participated in both the T1 and T2 surveys. Changes over time in ED geriatric services, observed naturalistically. Survey questionnaires assessed: ED geriatric services (11 items) and nursing and geriatric staffing resources. Key administrative data indicators for ED bed visits for T1 and T2 for ages 75 and over included: volume of ED visits; length of ED stay; admission rate; and 30-day return visits. There was a significant overall increase in the number ED geriatric services, from mean 2.8 (SD 2.2) at T1 to mean 6.0 (SD 2.0) at T2. EDs were clustered into 3 groups based on their T1 and T2 geriatric service scores: "early adopters" (n = 12); "late adopters" (n = 27); "non-adopters" (n = 18). Group membership was associated with three T1 variables: availability of a geriatric nurse clinician, a lower ratio of nurses to ED beds, and longer ED stays. There were significant overall increases between T1 and T2 in number of ED bed visits and ED length of stay among those aged 75 and over, decreases in hospitalization rates, but no change in ED return visits. There were no differential changes in the key indicators among the three ED clusters. Overall, ED geriatric services improved in Quebec from 2006 to 2013/14. EDs with a geriatric nurse clinician, relatively fewer nursing resources, and longer ED stays improved more quickly. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Benchmarking as a tool for the improvement of health services' supply departments.

    Science.gov (United States)

    Dacosta-Claro, Ivan; Lapierre, Sophie D

    2003-11-01

    This paper presents a benchmarking study carried out on the supply departments of Quebec's health services. The paper begins with the definition of a methodology to collect the information needed, both environmental (to enable institutions to be sorted into homogenous groups) and performance related. The analysis of indicators and the data envelopment analysis (DEA) models allowed classification of each hospital's performance and explained the operational approaches used, either at a general level or for each subprocess of the supply chain. It was observed that important economies of scale may be achieved with better co-ordination and with the regrouping of the supplying activities, both for purchasing management and central store management. The study showed that the best performance of central store services comes with flexible administrative structures, by receiving packages as small as possible and by using employees from the lowest range of the hierarchy. Purchasing services should employ highly qualified and well-paid staff. Although such services are relatively small with respect to their purchase volume, they show a higher activity rate. As a result of the discovered performing strategies, the possible economies range from 20% to 30% of the actual supply-chain management cost.

  2. Higher Education Department Chairs and Academic Human Resource Decision Making: Does Unionization Matter?

    Science.gov (United States)

    Dzwik, Leigh Settlemoir

    2017-01-01

    The purpose of this study was to assess faculty unionization's impact on academic human resource decision making for department chairs. The academic human resource decisions included in the study were: academic hiring; re-employment, promotion and tenure; other faculty evaluation decisions; and discipline and discharge. The first purpose of this…

  3. 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…

  4. 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.

  5. 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.

  6. Domestic violence, poverty, and social services: does location matter?

    Science.gov (United States)

    Hetling, Andrea; Zhang, Haiyan

    2010-01-01

    Objective. This study investigates whether or not domestic violence agencies are located in areas of need. Recent research indicates that community economic disadvantage is a risk factor for intimate partner violence, but related questions regarding the geographic location of social service agencies have not been investigated.Methods. Using Connecticut as a case study, we analyze the relationship of agency location and police-reported domestic violence incidents and assaults using OLS regression and correcting for spatial autocorrelation.Results. The presence of an agency within a town has no relationship with the rates of domestic violence. However, regional patterns are evident.Conclusion. Findings indicate that programs are not geographically mismatched with need, but neither are programs located in towns with higher rates of incidents or assaults. Future research and planning efforts should consider the geographic location of agencies.

  7. 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

  8. 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.

  9. 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.

  10. New health and safety initiatives at the Department of Energy (DOE)

    Science.gov (United States)

    Ziemer, Paul L.

    1993-01-01

    This document touches on some of the more important lessons learned and the more noteworthy initiatives DOE has put into motion in the last three years to protect the health and safety of our contractor employees. What we have learned in the process should come as no surprise to those of you who have been working in the field: (1) that management commitment to safety and health is critical to a successful program; (2) that meaningful employee participation in all aspects of the program enhances its effectiveness at every level; and (3) that the dedication and expertise of medical and occupational safety and health professionals are needed if the challenging problems presented by the complex and technologically advanced environment at DOE facilities are to be overcome. I believe that we have made a good beginning in the long and arduous task of building an Occupational Safety and Health Program that will serve as a model for others, and I can assure you that we intend to continue our efforts to protect every worker within the complex from occupational injury and disease.

  11. 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,…

  12. Mortality of older construction and craft workers employed at department of energy (DOE) nuclear sites: follow-up through 2011.

    Science.gov (United States)

    Ringen, Knut; Dement, John; Welch, Laura; Bingham, Eula; Quinn, Patricia; Chen, Anna; Haas, Scott

    2015-02-01

    The Building Trades National Medical Screening Program (BTMed) was established in 1996 to provide occupational medicine screening examinations for construction workers who have worked at US Department of Energy nuclear sites. Workers participating in BTMed between 1998 and 2011 were followed to determine their vital status and mortality experience through December 31, 2011. The cohort includes 18,803 BTMed participants and 2,801 deaths. Cause-specific Standardized Mortality Ratios (SMRs) were calculated based on US death rates. Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, COPD, and asbestosis. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including after 1980. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. Continued medical surveillance is important. © 2014 Wiley Periodicals, Inc.

  13. Does the Ecosystem Service Concept Reach its Limits in Urban Environments?

    Directory of Open Access Journals (Sweden)

    Simone A. Beichler

    2017-06-01

    Full Text Available There is a rapidly growing body of literature on the theory about the ecosystem service concept and the practical assessment of ecosystem services in different contexts ranging from natural to urban environments. Yet, where does the concept reach its limits? This paper critically reflects the application of the ecosystem service concept in urban environments illustrating the handling of urban structures (incl. built-up areas and the risk that the normative principle of the concept could be missed. It is shown that in theory urban structures refer to a variety of ecosystem concepts. As a starting point for ecosystem service assessments, these could be classified into natural, managed, constructed and overbuilt systems. Since ecosystem service concepts do not directly refer to a specific ecosystem definition, but to biophysical structures and processes, all of these classes could be included. However, the dependency on context and scale makes a differentiation in practical ecosystem services assessment challenging. We conclude that the ecosystem service concept does not reach its limits in urban environments, but urban environments represent an extreme case characterized by multifunctionality and a high degree of modification that enables to uncover research challenges applying in any environment. There is a need for a more transparent reporting of theoretical and methodological assumptions to facilitate the comparability between ecosystem service assessments. Comprehensive approaches that consider multiple ecosystem services and include human input, human modification, the ecosystem status as well as their interactions are required to understand the spatial relations between ecosystem services delivered by different ecosystems.

  14. The federal market for ESCO services: How does it measure up?

    Energy Technology Data Exchange (ETDEWEB)

    Hopper, Nicole; Goldman, Charles; Birr, Dave

    2004-05-17

    The federal market has been a source of strong energy service company (ESCO) industry growth over the last decade as traditional MUSH markets municipal/state governments, universities, schools and hospitals have matured. Federal alternative financing programs Utility Energy Services Contracts (UESC) and Department of Energy (DOE) Super, Army and Air Force Energy Savings Performance Contracts (ESPC) have enabled this growth, but recent events threaten the ESPC programs. We compare the federal and MUSH markets by analyzing {approx} ;1550 completed projects and interviewing ESCO representatives. Federal ESPC market activity is estimated at {approx} ;$1.6 billion (B) over 10-15 years; activity in 2002 was {approx} ;$230 million (M). MUSH markets have produced {approx} ; $12-16B in projects over 20 years, and {approx} ;$0.8-1.0B in 2002. Federal sector projects have longer average contract terms than MUSH (14 vs. 9.5 years respectively). Federal projects are larger (median costs are $1.85M vs. $0.98M for MUSH), but costs per square foot are lower (median costs are $2.08/ft2 vs. $2.93/ft2 for MUSH), and annual energy savings are higher (18 vs. 14 kBtu/ft2). Non-energy savings are more often counted in federal projects (58 percent vs. 35 percent of MUSH projects) but when counted represent a higher proportion of savings in MUSH projects. Median payback times in the federal market are shorter than MUSH (7.7 vs. 8.8 years) and calculated net economic benefits of 214 federal projects amount to {approx} ;$550M, compared to {approx} ;$1.2B for 965 MUSH projects.

  15. Differences in access to services in rural emergency departments of Quebec and Ontario.

    Directory of Open Access Journals (Sweden)

    Richard Fleet

    Full Text Available Rural emergency departments (EDs are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers.Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario.All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013. There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001 and most the consultant support and ICU (92% vs 31%, p < .0001. Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers.Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

  16. An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

    Science.gov (United States)

    Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

    2014-01-01

    Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

  17. Customer satisfaction in a large urban fire department emergency medical services system.

    Science.gov (United States)

    Persse, David E; Jarvis, Jeffrey L; Corpening, Jerry; Harris, Bobbie

    2004-01-01

    The purpose of this study was to determine if emergency medical services (EMS) customer satisfaction could be assessed using telephone-survey methods. The process by which customer satisfaction with the EMS service in a large, fire department-based EMS system is reported, and five month results are presented. Ten percent of all patients transported during the period of October 15, 2001, through March 15, 2002, were selected for study. In addition, during the same period, all EMS incidents in which a patient was not transported were identified for contact. Customer-service representatives contacted patients via telephone and surveyed them from prepared scripts. A total of 88,528 EMS incidents occurred during the study period. Of these, 53,649 resulted in patient transports and 34,879 did not. Ten percent of patients transported (5,098) were selected for study participation, of which 2,498 were successfully contacted; of these, 2,368 (94.8%) reported overall satisfaction with the service provided. Of the 34,879 incidents without transport, only 5,859 involved patients who were seen but not transported. All of these patients were selected for study. Of these, 2,975 were successfully contacted, with 2,865 (96.3%) reporting overall satisfaction. The most common reason given for nonsatisfaction in both groups was the perception of a long response time. It is possible to conduct a survey of EMS customer satisfaction using telephone-survey methods. Although difficulties exist in contacting patients, useful information is made available with this method. Such surveys should be an integral part of any EMS system's quality-improvement efforts. In this survey, the overwhelming majority of patients, both transported and not transported, were satisfied with their encounter with EMS.

  18. An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol.

    Science.gov (United States)

    Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

    2014-10-01

    Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS-EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Curtailment of well child services by a local health department: impact on rural 2-year-olds.

    OpenAIRE

    Alexander, C S; Klassen, A C

    1986-01-01

    The impact of changes in the delivery of well child health services by a rural health department on the reported health status, immunization status, and patterns of health care use is evaluated for poor children born in 1981, when well child clinic services were reduced. Using birth certificate records, all 1981 resident births were enumerated for the case county in Maryland and for a demographically similar comparison county that had continued to operate health department well child clinics....

  20. 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.

  1. Impact of Hurricane Ike on the call volumes of Houston Fire Department emergency medical services.

    Science.gov (United States)

    Cooper, Elise; Langabeer, James R; Alqusairi, Diaa; Persse, David

    2012-01-01

    Little is known about the capacity and activity of emergency medical services (EMS) during large-scale disasters. This article provides a case study of the role of EMS in one large urban city during a major hurricane. The authors analyzed changes in call volume data from the City of Houston Fire Department's EMS during Hurricane Ike. Descriptive and statistical analyses are used to explain surges and statistical differences in volumes. Demand for EMS care can increase approximately 40 percent during surges in the disaster cycle, placing extreme burdens on system capacity and workload. The largest increase in demand came from respiratory problems, falls, and chest pains, with the largest decrease in calls from motor vehicle accidents. A strategy for managing surges in prehospital care from major disasters is a requirement for modern EMS.

  2. Post-harvest entomology research in the United States Department of Agriculture-Agricultural Research Service.

    Science.gov (United States)

    Throne, James E; Hallman, Guy J; Johnson, Judy A; Follett, Peter A

    2003-01-01

    This is a review of current post-harvest entomology research conducted by the Agricultural Research Service, the research branch of the US Department of Agriculture. The review covers both durable and perishable commodities. Research on biochemistry, genetics, physiology, monitoring and control of insects infesting stored grain, dried fruits and nuts, and processed commodities is reviewed. Research on development of quarantine treatments, particularly for fruit flies, is also reviewed, including research on thermal and irradiation treatments and a discussion of risk management for quarantine pests. Two areas of research are covered more extensively: a project to map the genome of the red flour beetle, Tribolium castaneum, and the use of near-infrared spectroscopy for detection of hidden infestations in grain, quantification of insect fragments in food, determination of quality in dried fruits, identification of insect species and age-grading insects. Future research directions are identified.

  3. The Frequency of Hypertension Crises in the Emergency Medical Service Department in Tuzla

    Science.gov (United States)

    Salkic, Sabina; Ljuca, Farid; Batic-Mujanovic, Olivera; Brkic, Selmira; Mesic, Dzenita; Mustafic, Sehveta

    2013-01-01

    ABSTRACT Objectives: The aim of this study was to evaluate a frequency and clinical presentation of hypertension crises due to age, gender, duration and seriousness at Emergency Medical Service Department of the “Dr Mustafa Šehovic” Health Care Center Tuzla. Methods: The research was conducted in the period between November 2009 and April 2010 and involved 180 examinees of both genders, aging between 30 and 80 years of age with the diagnosis of arterial hypertension. The examinees were divided into two groups: control group consisting of examinees without hypertension crisis (95 examinees) and experimental group consisting of examinees with hypertensive crisis (85 examinees). Descriptive statistical methods were used in the statistical data processing. Results: The research results showed that there had been significantly more female examinees than the male ones (60% vs. 40%; p=0.007). The average age of male examinees was 55.83±11.06 years of age, and the average age of female examinees was 59.41±11.97 years of age. The hypertension crisis frequency was 47.22%, where the hypertensive urgencies were statistically significantly more present than the hypertensive emergencies (16.47%vs.83.53%; phypertensive crisis (49.41%) appeared in the period between 6.00 p.m. and 11.59 p.m. The largest number of emergency group examinees (69.01%) had been treated for arterial hypertension for ten years, and the examinees from the emergency group (42.86%) had been treated for 10, 11 and 20 years. The average blood pressure value at the hypertensive crisis examinees was 204.82/126.58 mmHg. Conclusions: The frequency of hypertensive crises in the Emergency Medical Service Department is high and it reaches 47.22%. Hypertensive urgencies were significantly more present in terms of statistics than the hypertensive emergencies (83.53% vs. 16.47%; p<0.0001). PMID:25568505

  4. 77 FR 59658 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Walnut...

    Science.gov (United States)

    2012-09-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: U.S. Department of the Interior, National Park... contemporaneous with the site. Individuals were found lying in extended, supine positions, with the exception of...

  5. 76 FR 70739 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-11-15

    ... Immigration Services-015 Electronic Immigration System- 2 Account and Case Management System of Records AGENCY... Immigration Services-015 Electronic Immigration System-2 Account and Case Management System of Records.'' This system of records will allow the Department of Homeland Security/U.S. Citizenship and Immigration...

  6. 76 FR 60070 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-09-28

    ... Immigration Services 015 Electronic Immigration System- 2 Account and Case Management System of Records AGENCY... Immigration Services 015 Electronic Immigration System-2 Account and Case Management System of Records.'' This system of records will allow the Department of Homeland Security/U.S. Citizenship and Immigration...

  7. 77 FR 68819 - Notice of Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis...

    Science.gov (United States)

    2012-11-16

    ... Inventory Completion: U.S. Department of Agriculture, Forest Service, Ozark-St. Francis National Forests... Agriculture (USDA), Forest Service, Ozark-St. Francis National Forests has completed an inventory of human... (Wichita, Keechi, Waco & Tawakonie), Oklahoma. History and Description of the Remains In 1970 and 1971...

  8. 77 FR 47415 - Privacy Act of 1974; Department of Homeland Security U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2012-08-08

    ..., 110 Stat. 2105 (1996); Title IV, Subtitle A, of Illegal Immigration Reform and Immigrant... Immigration Services (USCIS)--004--Systematic Alien Verification for Entitlements (SAVE) Program System of..., ``Department of Homeland Security/United States Citizenship and Immigration Services--004-- Systematic Alien...

  9. 77 FR 14600 - Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract...

    Science.gov (United States)

    2012-03-12

    ... Management Service, in the Office of Acquisition, Logistics, and Construction at (202) 461-6918, or email... Inventory AGENCY: Department of Veterans Affairs. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance with Section 743 of Division C of the Consolidated...

  10. Comparison between visual analysis and microscope assessment of surgical instrument cleanliness from sterile service departments.

    Science.gov (United States)

    Lipscomb, I P; Sihota, A K; Keevil, C W

    2008-01-01

    Modern hospital sterile service departments (SSDs) routinely inspect instruments visually to assess the degree of contamination present after the washer/disinfector cycle. We aimed to test the effectiveness and reliability of this method. Surgical instrument sets were obtained from nine anonymous National Health Service (NHS) Primary Care Trust SSDs to investigate the efficacy of 'in-place' cleaning procedures. The instruments were first inspected visually, followed by a novel technique called episcopic differential interference contrast microscopy. This was combined with a sensitive fluorescent reagent, SYPRO Ruby, to rapidly visualise and assess contamination levels on the medical devices. The application of a Contamination Index (0-4) for both proteinaceous and non-proteinaceous deposits on the surface allowed quantitative assessment. Close correlation was seen for simple instruments between visual assessment and microscopic analysis. For more complex instruments, however, there was a marked difference between the two assessment techniques and the microscopy procedure showed areas of proteinaceous and non-proteinaceous crystalline soiling that was difficult or impossible to see by eye. Visual assessment of cleaning is fraught with possible error. This survey shows how large amounts of contamination could pass undetected using such antiquated methods. The new methodology applied in the assessment of surface contamination is rapid and generally applicable and could be used more widely for routine monitoring of instrument cleanliness.

  11. Effects of Medication Reconciliation Service Provided by Student Pharmacists in a Tertiary Care Emergency Department

    Directory of Open Access Journals (Sweden)

    Arinzechukwu Nkemdirim Okere

    2013-01-01

    Full Text Available Objective: The primary objective of this case study was to evaluate the impact of a medication reconciliation service (MRS provided by student pharmacists in an emergency department (ED. Methods: Eligible patients were assigned to two groups, MRS or non-MRS. Patients in the MRS group were seen by student pharmacists while the non-MRS group followed usual care. As part of the services provided by the student pharmacists, medication reconciliation was provided under the supervision of a clinical pharmacist. At the conclusion of their ED visit, patients were asked to complete a survey addressing knowledge of medications, confidence in medication taking and patient satisfaction. To evaluate the impact of provision of MRS by student pharmacists on readmission rates in the ED, the electronic health records of the institution were queried for subsequent inpatient hospitalizations and ED visits. Results: Based on the study, patients in MRS group were more likely to be satisfied with the education provided to them in the ED (p=0.016 and had greater confidence in taking their medications (p=0.03. Sixty days post ED visit MRS group readmissions were significantly lower compared to non-MRS group (P= 0.047. Conclusions: Students' participation in the provision of medication reconciliation led to reduction of readmission in the tertiary care ED, improved patient satisfaction and confidence in medication use.   Type: Case Study

  12. Effects of Medication Reconciliation Service Provided by Student Pharmacists in a Tertiary Care Emergency Department

    Directory of Open Access Journals (Sweden)

    Michael Swanoski, PharmD

    2013-01-01

    Full Text Available Objective: The primary objective of this case study was to evaluate the impact of a medication reconciliation service (MRS provided by student pharmacists in an emergency department (ED.Methods: Eligible patients were assigned to two groups, MRS or non-MRS. Patients in the MRS group were seen by student pharmacists while the non-MRS group followed usual care. As part of the services provided by the student pharmacists, medication reconciliation was provided under the supervision of a clinical pharmacist. At the conclusion of their ED visit, patients were asked to complete a survey addressing knowledge of medications, confidence in medication taking and patient satisfaction. To evaluate the impact of provision of MRS by student pharmacists on readmission rates in the ED, the electronic health records of the institution were queried for subsequent inpatient hospitalizations and ED visits.Results: Based on the study, patients in MRS group were more likely to be satisfied with the education provided to them in the ED (p=0.016 and had greater confidence in taking their medications (p=0.03. Sixty days post ED visit MRS group readmissions were significantly lower compared to non-MRS group (P= 0.047.Conclusions: Students’ participation in the provision of medication reconciliation led to reduction of readmission in the tertiary care ED, improved patient satisfaction and confidence in medication use.

  13. Ibuprofen with acetaminophen for postoperative pain control following tonsillectomy does not increase emergency department utilization.

    Science.gov (United States)

    Bedwell, Joshua R; Pierce, Matthew; Levy, Michelle; Shah, Rahul K

    2014-12-01

    To compare the performance of ibuprofen vs codeine for postoperative pain management after tonsillectomy as measured by need for emergency department (ED) treatment for pain and/or dehydration. Retrospective case series with chart review. Tertiary children's hospital. Consecutive series of patients who underwent tonsillectomy with or without adenoidectomy at a tertiary children's hospital. Patients were categorized based on the type of postoperative pain management (acetaminophen with codeine vs acetaminophen and ibuprofen). The main outcome measure was the proportion of patients requiring ED visits or inpatient admissions for inadequate pain control or dehydration. Secondary measures included antibiotic use, postoperative hemorrhage, need for return to the operating room, vomiting, and oral diet tolerance. Patients in the ibuprofen/acetaminophen group were younger than those in the codeine/acetaminophen group (6.2 vs 8.1 years, P ibuprofen, P = .12). Multivariable analysis controlling for age and antibiotic use showed no difference in ED visits or admission for dehydration (P = .09). There was no difference between the groups for any of the secondary measures. Ibuprofen with acetaminophen represents a safe and acceptable analgesic alternative to codeine and acetaminophen in patients undergoing pediatric tonsillectomy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  14. Does determining serum alcohol concentrations in emergency department patients influence physicians' civil suit liability?

    Science.gov (United States)

    Simel, D L; Feussner, J R

    1989-05-01

    Emergency physicians may incur liability when impaired patients who have been treated and released are subsequently involved in traffic crashes. We surveyed attorneys to assess their perception of how serum alcohol determinations might influence their liability in civil suits. Overall, 63.9% of the attorneys surveyed would advise patients that they received potentially negligent care if they were impaired following treatment in the emergency department and were involved in a traffic crashes. Perceived liability was altered by physician behavior as follows: 43.1% of attorneys would advise clients that they received potentially negligent care when impairment was documented by a test for serum alcohol concentration and no advice was given regarding drunk driving, and 17.3% of attorneys would give similar advice when impairment was not documented by a test for serum alcohol concentration and no advice was given regarding drunk driving. In contrast, only 3.5% of attorneys would suggest possible negligence when impairment was documented by a test for serum alcohol concentration and with advice subsequently given not to drive. The coupling of diagnosing impairment by the serum alcohol concentration and driving advice is medically sensible and might result in minimal civil liability.

  15. Utilization of Emergency Department Services by the Bedouin Population in Southern Israel

    Directory of Open Access Journals (Sweden)

    Arnon Dov Cohen

    2007-01-01

    Full Text Available Excessive use of the emergency department (ED is associated with increased costs and workload in the ED, patients' inconvenience and disruption of the continuity of care. The study's goal was to describe trends in ED utilization among Bedouins living in southern Israel. A retrospective cross-sectional study was conducted in primary care clinics in southern Israel. Patients included Bedouin and Jewish patients insured by Clalit Health Services. Data was retrieved from a central database. The number of visits to the ED and age-adjusted rates of ED visits during 2000-2003 were determined in the Bedouin vs. Jewish population. All visits that ended in hospitalization were excluded. Data was stratified according to patients' residence (semi-nomadic vs. urban Bedouins and referral origin. Age-adjusted rates of ED visits decreased from 42.9/1000 patients/month in 2000 to 38.3/1000 patients/month in 2003. There were more ED visits in the Bedouin as compared to Jewish population (38.3/1000 vs. 21.8/1000 patients/month. The decrease in ED utilization was more prominent among adult semi-nomadic Bedouins (from 60.8/1000 to 40.3/1000 patients/month. The proportion of referrals by the family physician to ED significantly decreased (among urban Bedouins: from 54.3% to 43.2%, p<0.001; among semi-nomadic Bedouins: from 53.9% to 39.9%, p<0.001, while the proportion of selfreferrals and referrals from physicians other than the family physician increased. A decrease in ED utilization by the Bedouin population during the last years was demonstrated. Utilization of ED services is still increased as compared to the non-Bedouin population. Interventions to control excessive use of ED services in the Bedouin population are currently underway.

  16. 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.

  17. 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.

  18. 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....

  19. Memorandum of Understanding Between U.S. Fish and Wildlife Service and Department of Energy : Chicago Field Office, Argonne Area Office

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Memorandum of Understanding (MOU) was entered into by and between the U.S. Fish and Wildlife service and the Department of Energy, Chicago Field Office, Argonne...

  20. Does organizational support promote citizenship in service settings? The moderating role of service climate.

    Science.gov (United States)

    Wang, Mei-Ling

    2009-12-01

    The present study integrates social exchange, role theory, and climate research to suggest that employees who have contact with customers ("contact employees") will reciprocate felt obligations of high-quality employment relationships (i.e., perceived organizational support [POS]). They do this by expanding their role in ways that are consistent with contextual behavioral expectations. A longitudinal survey of 1,387 contact employees and 666 supervisors in a large supermarket chain in Taiwan demonstrated that the positive relationship between POS and service-oriented organizational citizenship behavior (SOCB) role definitions was strengthened by service climate. In summary, organizational support resulted in expanded SOCB role definitions within a strong service climate, while this relationship was much weaker and not significant in weak service climate, I discuss theoretical and managerial implications through this empirical examination.

  1. Does numeracy correlate with measures of health literacy in the emergency department?

    Science.gov (United States)

    Griffey, Richard T; Melson, Andrew T; Lin, Margaret J; Carpenter, Christopher R; Goodman, Melody S; Kaphingst, Kimberly A

    2014-02-01

    The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. This was a prospective cross-sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S-TOFHLA], Rapid Estimate of Adult Literacy in Medicine-Revised [REALM-R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) versus adequate health literacy, and the proportion of patients answering all numeracy questions correctly was calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. A total of 446 patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (interquartile range [IQR] = 1 to 2). Among patients with limited health literacy (LHL) by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% versus >50% of numeracy questions correctly, there was a significant difference between those with LHL and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S-TOFHLA rs  = 0.428 (p

  2. 42 CFR 137.255 - What does reassumption mean?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What does reassumption mean? 137.255 Section 137.255 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Reassumption § 137.255 What does reassumption...

  3. Traumatic Spinal Cord Injury Emergency Service Triage Patterns and the Associated Emergency Department Outcomes.

    Science.gov (United States)

    Selvarajah, Shalini; Haider, Adil H; Schneider, Eric B; Sadowsky, Cristina L; Becker, Daniel; Hammond, Edward R

    2015-12-15

    Paralysis is an indication for trauma patients to be preferentially triaged by emergency services to designated level I or II trauma centers (TC). We sought to describe triage practices for patients with acute traumatic spinal cord injury (TSCI) and its associated emergency department (ED) outcomes. Adults ages ≥ 18 years with a diagnosis of acute TSCI (International Classification of Diseases-9: 806 and 952) in the 2006-2011 United States Nationwide Emergency Department Sample were included in these analyses. Outcomes assessed include triage to non-trauma centers (NTC), which is referred to as "under-triage," and ED mortality. Of 117,444 adults with TSCI, 33.4% were under-triaged to NTC. Under-triage was more prevalent with increasing age. Among patients under-triaged to NTC, 37.4% had new injury severity score (NISS) >15, representing severe injuries or polytrauma. Among patients with NISS >15, the odds of ED mortality in NTC were four-fold greater compared to level I trauma centers (TC-I) (adjusted odds ratio [AOR] = 4.06; 95% confidence interval = 1.87-8.79; p triage of adults with acute TSCI occurred in at least one-third of the cases. Patients triaged to NTC rather than TC-I experienced higher likelihood of death in the ED even after controlling for personal and injury characteristics. Further research is necessary to elucidate detailed clinical and logistical factors that may be associated with under-triage of acute TSCI, to facilitate interventions aimed at improving patient experience and outcomes.

  4. Exploring patterns of health service use in older emergency department patients.

    Science.gov (United States)

    Hastings, S Nicole; Horney, Carolyn; Landerman, Lawrence R; Sanders, Linda L; Hocker, Michael B; Schmader, Kenneth E

    2010-10-01

    Study objectives were to identify groups of older patients with similar patterns of health care use in the 12 months preceding an index outpatient emergency department (ED) visit and to identify patient-level predictors of group membership.   Subjects were adults ≥ 65 years of age treated and released from an academic medical center ED. Latent cluster analysis (LCA) models were estimated to identify groups with similar numbers of primary care (PC), specialist, and outpatient ED visits and hospital days within 12 months preceding the index ED visit.   In this sample (n = 308), five groups with distinct patterns of health service use emerged. Low Users (35%) had fewer visits of all types and fewer hospital days compared to sample means. Low Users were more likely to be female and had fewer chronic health conditions relative to the overall sample (p < 0.05). The ED to Supplement Primary Care Provider (PCP) (23%) group had more PCP visits, but also significantly more ED visits. Specialist Heavy (22%) group members had twice as many specialist visits, but no difference in PCP visits. Members of this class were more likely to be white and male (p < 0.05). High Users (15%) received more care in all categories and had more chronic baseline health conditions (p < 0.05) but no differences in demographic characteristics relative to the whole sample. The ED and Hospital as Substitution Care (6%) group had fewer PC and specialist visits, but more ED visits and hospital days.   In this sample of older ED patients, five groups with distinct patterns of health service use were identified. Further study is needed to determine whether identification of these patient groups can add important information to existing risk-assessment methods. © 2010 by the Society for Academic Emergency Medicine.

  5. 25 CFR 1200.30 - How does a tribe notify the Department if it wishes to return withdrawn funds to Federal trust...

    Science.gov (United States)

    2010-04-01

    ... return withdrawn funds to Federal trust status? 1200.30 Section 1200.30 Indians OFFICE OF THE SPECIAL TRUSTEE FOR AMERICAN INDIANS, DEPARTMENT OF THE INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT Returning Tribal Funds to Trust § 1200.30 How does a tribe notify the Department if it wishes to return...

  6. How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

    OpenAIRE

    Parkman, Thomas; Neale, Joanne; Day, Ed; Drummond, Colin

    2017-01-01

    BACKGROUND: People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support.OBJECTIVES: This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services.METHODS: We conducted semi-structured interviews with 30 ...

  7. 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.

  8. 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.

  9. 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...

  10. 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...

  11. Defense Department Cyber Efforts: More Detailed Guidance Needed to Ensure Military Services Develop Appropriate Cyberspace Capabilities

    Science.gov (United States)

    2011-05-01

    Military Services Develop Appropriate Cyberspace Capabilities GAO-11-421 United States Government Accountability Office GAO Report...Ensure Military Services Develop Appropriate Cyberspace Capabilities 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S... Military Services Develop Appropriate Cyberspace Capabilities Why GAO Did This Study The U.S. military depends heavily on computer networks, and

  12. Realizing Shared Services--A Punctuated Process Analysis of a Public IT Department

    Science.gov (United States)

    Olsen, Timothy John

    2012-01-01

    IT services are increasingly being offered via a shared service model. This model promises the benefits of centralization and consolidation, as well as an increased customer satisfaction. Adopting shared services is not easy as it necessitates a major organizational change, with few documented exemplars to guide managers. This research explores a…

  13. One size does not fit all: a diagnostic post-occupancy evaluation model for an emergency department.

    Science.gov (United States)

    Guinther, Lindsey; Carll-White, Allison; Real, Kevin

    2014-01-01

    This study presents a detailed account of processes and multiple methodologies used in conducting a diagnostic post-occupancy evaluation (POE) in an urban hospital emergency department. Healthcare design POE research findings can lead to improved work environments for healthcare providers and higher levels of staff, patient, and visitor satisfaction. This evaluation was conducted in two separate phases over 12 months, with data analysis occurring after each phase. Phase 1 involved 200 hours of observation, physical measurements, and occupancy counts. Phase 2 included surveys (n = 315) of staff, visitors, and patients. In addition, eight distinct staff focus groups (e.g., Nursing, Housekeeping, Physician, etc.) were conducted. To illustrate the process, one healthcare design-related issue, privacy and confidentiality, was assessed in light of the linear design model with a central core. Phase 1 observation results indicated that most confidential conversations were contained within the linear core. However, Phase 2 focus groups revealed that many staff members had concerns regarding the level of privacy and confidentiality due to the core's open design. The use of multiple methods provided greater information and a more comprehensive picture of the emergency department environment and design. This study presents a comprehensive framework for diagnostic post-occupancy evaluation in healthcare design. The findings indicate that a systematic, multi-methodological approach developed around a conceptual framework can lead to higher quality evaluations. Diagnostic POEs should be grounded in extant literature and customized based on the setting, the client's guiding principles, and the design team's objectives. In diagnostic POEs, one size does not fit all. Case study, design process, interdisciplinary, post-occupancy, privacy and confidentiality.

  14. 75 FR 44808 - Notice of Intent To Repatriate Cultural Items: U.S. Department of Agriculture, Forest Service...

    Science.gov (United States)

    2010-07-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR... is published as part of the National Park Service's administrative responsibilities under NAGPRA, 25.... Based on material culture, architecture and site organization, the small cliff dwelling at Hidden House...

  15. A National Informatics Agenda for Nursing Education and Practice. Report to the Secretary of the Department of Health & Human Services.

    Science.gov (United States)

    National Advisory Council on Nurse Education and Practice, Rockville, MD.

    Nursing informatics is a specialty whose activities center around information management and processing for the nursing profession. The Division of Nursing of the U.S. Department of Health and Human Services and the National Advisory Council on Nurse Education and Practice (NACNEP) recognized a need to identify initiatives that would more…

  16. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

    Science.gov (United States)

    Rosen, Joshua B.; Olson, Mark H.; Kelly, Marianne

    2012-01-01

    Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving…

  17. 78 FR 69864 - Privacy Act of 1974; Department of Homeland Security U.S. Citizenship and Immigration Services, U...

    Science.gov (United States)

    2013-11-21

    ...; Education history; Employment history; Criminal history; Professional accreditation information; Medical... crime). BB. Consistent with the requirements of the INA, to the Department of Health and Human Services... children to HHS to facilitate the custodial transfer of such children from DHS to HHS. KK. To federal...

  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

    ... of costs. Consular Service Activities Working with its consultants, the Department reviewed all of... much time passport specialists working at a passport agency devote to particular tasks--for example... requests from American citizens abroad, notarizing documents for American citizens abroad, issuing consular...

  19. 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…

  20. Principal Investigator and Department Administrator Perceptions of Services Provided by Offices of Research Administration at Research Universities

    Science.gov (United States)

    Cole, Kimberley W.

    2010-01-01

    The purpose of this research study was to determine what service attributes were perceived as important factors for a successful Office of Research Administration (ORA) to provide to principal investigators and department administrators. Initially established more than 50 years ago, The Office of Research Administration (ORA) has evolved into an…

  1. Disparities in the Quality of HIV Care When Using US Department of Health and Human Services Indicators

    Science.gov (United States)

    Althoff, Keri N.; Rebeiro, Peter; Brooks, John T.; Buchacz, Kate; Gebo, Kelly; Martin, Jeffrey; Hogg, Robert; Thorne, Jennifer E.; Klein, Marina; Gill, M. John; Sterling, Timothy R.; Yehia, Baligh; Silverberg, Michael J.; Crane, Heidi; Justice, Amy C.; Gange, Stephen J.; Moore, Richard; Kitahata, Mari M.; Horberg, Michael A.; Kirk, Gregory D.; Benson, Constance A.; Bosch, Ronald J.; Collier, Ann C.; Boswell, Stephen; Grasso, Chris; Mayer, Kenneth H.; Hogg, Robert S.; Richard Harrigan, P.; Montaner, Julio SG; Cescon, Angela; Samji, Hasina; Brooks, John T.; Buchacz, Kate; Gebo, Kelly A.; Moore, Richard D.; Moore, Richard D.; Carey, John T.; Horberg, Michael A.; Silverberg, Michael J.; Thorne, Jennifer E.; Goedert, James J.; Jacobson, Lisa P.; Klein, Marina B.; Rourke, Sean B.; Burchell, Ann N.; Rachlis, Anita R.; Hunter-Mellado, Robert F.; Mayor, Angel M.; Gill, M.John; Deeks, Steven G.; Martin, Jeffrey N.; Saag, Michael S.; Mugavero, Michael J.; Willig, James; Eron, Joseph J.; Napravnik, Sonia; Kitahata, Mari M.; Crane, Heidi M.; Justice, Amy C.; Dubrow, Robert; Fiellin, David; Sterling, Timothy R.; Haas, David; Bebawy, Sally; Turner, Megan; Gange, Stephen J.; Anastos, Kathryn; Moore, Richard D.; Saag, Michael S.; Gange, Stephen J.; Kitahata, Mari M.; Althoff, Keri N.; McKaig, Rosemary G.; Justice, Amy C.; Freeman, Aimee M.; Moore, Richard D.; Freeman, Aimee M.; Lent, Carol; Kitahata, Mari M.; Van Rompaey, Stephen E.; Crane, Heidi M.; Morton, Liz; McReynolds, Justin; Lober, William B.; Gange, Stephen J.; Althoff, Keri N.; Abraham, Alison G.; Lau, Bryan; Zhang, Jinbing; Jing, Jerry; Golub, Elizabeth; Modur, Shari; Hanna, David B.; Rebeiro, Peter; Wong, Cherise; Mendes, Adell

    2014-01-01

    We estimated US Department of Health and Human Services (DHHS)–approved human immunodeficiency virus (HIV) indicators. Among patients, 71% were retained in care, 82% were prescribed treatment, and 78% had HIV RNA ≤200 copies/mL; younger adults, women, blacks, and injection drug users had poorer outcomes. Interventions are needed to reduce retention- and treatment-related disparities. PMID:24463281

  2. 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.

  3. [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.

  4. 34 CFR 692.30 - How does a State administer its community service-learning job program?

    Science.gov (United States)

    2010-07-01

    ... Administer Its Community Service-Learning Job Program? § 692.30 How does a State administer its community... community service-learning job program that satisfies the conditions set forth in paragraph (b) of this... not a grant. (b)(1) The community service-learning job program must be administered by institutions in...

  5. How does a traditional state highway department become a true department of transportation : a case study in state DOT organizational change.

    Science.gov (United States)

    2003-10-01

    A transformed New Mexico Department of Transportation (NMDOT) can better organize work around results that customers consider valuable and concentrate resources on ensuring high-quality results. With the freedom to create new partnerships, NMDOT can ...

  6. Technical Support Services to the Office of Major Project Management. Final report. [DOE demonstration plants

    Energy Technology Data Exchange (ETDEWEB)

    This document represents the final report on Contract No. DE-AC01-76ET13053, Technical Support Services to the Office of Major Project Management. The report provides brief technical summaries of contract activities. The purpose was for Radian Corporation to provide the Energy Research and Development Administration (ERDA) with environmental technical support for the development of fossil fuel demonstration plants. Since that time, Radian has provided environmental technical support services to ERDA, and now to DOE, in a variety of areas supporting the fossil fuel demonstration programs. Also Radian provided DOE with quick reviews of environmental documents, technology transfer requests, and/or quick studies to provide timely technical input to a DOE decision-making process. Because some task orders were expressly designed to provide quick-response, as-needed assistance, they did not generate any major reports. Task orders are listed and brief descriptions of work done are given; seventeen report titles in response to these task orders are listed.

  7. 75 FR 45606 - Department of Commerce Measuring and Enhancing Services Trade Data Conference

    Science.gov (United States)

    2010-08-03

    ... has invited well-known policy leaders from the White House, the Department, and private sector... to transformational technologies and analytics that enable better business and public policy decision...

  8. The Role of Social Work in Providing Mental Health Services and Care Coordination in an Urban Trauma Center Emergency Department.

    Science.gov (United States)

    Moore, Megan; Whiteside, Lauren K; Dotolo, Danae; Wang, Jin; Ho, Leyna; Conley, Bonnie; Forrester, Mollie; Fouts, Susan O; Vavilala, Monica S; Zatzick, Douglas F

    2016-12-01

    This study examined the role of emergency department (ED) social workers and identified predictors of receipt of social work services and length of ED stay. Comprehensive reviews were conducted of medical records of all patients (N=49,354) treated in a level 1 trauma center ED from January 1, 2012, to March 31, 2013. Content analysis of chart notes was used to categorize the types of social work services provided. Poisson regression was used to assess associations between demographic and clinical characteristics, receipt of social work services, and length of ED stay. Social work services were provided to 18,532 (38%) patients. Most were mental health services (54%), followed by care coordination (31%) and material support or other referrals (15%). Patients seen by social workers had complex presentations, involving mental disorder diagnoses (18%), substance use disorder diagnoses (29%), comorbid diagnoses (32%), and injuries (51%); a quarter of patients had multiple ED visits (26%). In adjusted regression analysis, females (relative risk [RR]=1.15), patients not discharged home (RR=1.44), and those with two or more comorbid diagnoses (RR=1.80), injuries due to assault (RR=1.37), and traumatic brain injury (RR=1.20) were more likely to receive social work services. Such services were associated with an increased length of ED stay (RR=1.34). Social workers provided services to patients with multifaceted needs resulting from complex presentations. Provision of social work services modestly increased length of ED stay. Triage algorithms are needed to target efficiencies, systematize provision of ED social work services, and improve access to services for all patients.

  9. 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...of their client’s networks. These specialized XaaS models are constantly emerging and therefore do not have standardized definitions as do IaaS , PaaS

  10. 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...

  11. 20 CFR 1002.101 - Does the five-year service limit include periods of service that the employee performed when he...

    Science.gov (United States)

    2010-04-01

    ... each employer for whom he or she works. When the employee takes a position with a new employer, the... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Does the five-year service limit include periods of service that the employee performed when he or she worked for a previous employer? 1002.101...

  12. 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

  13. Developing World-Class Customer Service at Navy Field Contracting Activities: An Assessment of the FISC San Diego Regional Contracts Department.

    Science.gov (United States)

    1997-06-01

    This thesis assesses the customer service ability of the FISC San Diego Regional Contracts Department Utilizing both archival research and interviews...perspective on service, how service is delivered, how to effectively communicate with the customer and how organizations can implement change to enhance their service quality.

  14. 76 FR 9361 - Public Availability of Department of Justice FY 2010 Service Contract Inventory

    Science.gov (United States)

    2011-02-17

    ... in the Justice Management Division, Management and Planning Staff, Procurement Policy and Review Group at (202) 616-3754 or [email protected] . Michael H. Allen, Deputy Assistant Attorney General, Policy Management and Planning, U.S. Department of Justice, Justice Management Division. BILLING CODE...

  15. 77 FR 6584 - Public Availability of Department of Justice FY 2011 Service Contract Inventory

    Science.gov (United States)

    2012-02-08

    ... in the Justice Management Division, Management and Planning Staff, Procurement Policy and Review Group at (202) 616-3754 or [email protected] . Michael H. Allen, Deputy Assistant Attorney General, Policy Management and Planning, US Department of Justice, Justice Management Division. BILLING CODE P ...

  16. Department of Defense Report and Plan on Services to Military Dependent Children with Autism

    Science.gov (United States)

    Exceptional Parent, 2007

    2007-01-01

    Military families who have a member with autism would like to have expanded options for providing care, easing financial burden, and increasing the prospect for greater results for their family member. The Department of Defense (DoD) issued a report in July, covering its belief in the efficacy of applied behavior analysis (ABA) as a form of…

  17. Reference as an Access Service: Collaboration between Reference and Interlibrary Loan Departments

    Science.gov (United States)

    Kern, M. Kathleen; Weible, Cherie L.

    2005-01-01

    Academic libraries increasingly rely on Interlibrary Loan (ILL) departments to obtain research materials. This adds to the workload of ILL at a time when many libraries are experiencing budget cuts and dwindling staff. Collaboration between ILL and Reference can assist ILL by providing searching expertise. Collaboration is facilitated by the…

  18. 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).

  19. Are the public health workforce competencies predictive of essential service performance? A test at a large metropolitan local health department.

    Science.gov (United States)

    Mayer, Jeffrey P

    2003-01-01

    Since many training initiatives employ the core public health workforce competencies as objectives, it is important to demonstrate an association between competency and essential service job performance. A cross-sectional survey of 420 employees of a local health department was conducted in 1999, with a response rate of 76 percent. Each of ten essential service performance measures was regressed on four core competency measures, controlling for employee experience and education. The competencies explained 2 percent to 20 percent of the variance in essential service performance. While offering support for the core competencies as a foundation for training program content, the results also make clear the large role that other individual, organizational, and community influences may have. Explaining additional variance in performance will require incorporating these variables into future studies.

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

    Science.gov (United States)

    2006-12-30

    personnel can be diminished or lost if human capital is not carefully managed. According to Nonaka and Takeuchi (1995), frequent dialogue and...R.S. (1990). Service operations management. Needham Heights, MA: Allyn and Bacon. Nonaka , I., & Takeuchi , H. (1995). The knowledge-creating company

  2. 75 FR 67696 - Meeting of the Defense Department Advisory Committee on Women in the Services (DACOWITS)

    Science.gov (United States)

    2010-11-03

    ... receive a briefing from the Defense Task Force on Sexual Assault in the Military. The meeting is open to... --Service briefs on DACOWITS 2009 Report --Briefings from DoD Task Force on Sexual Assault in the Military... recommendations on assignments and well-being --Executive session with Military Reps to discuss, craft, and vote...

  3. Evaluation of the University of Minnesota Libraries Reference Department Telephone Information Service. Pilot Study.

    Science.gov (United States)

    King, Geraldine B.; Berry, Rachel

    This pilot study was conducted to evaluate the telephone reference service of a university library. Questions were called in by volunteers to several different divisions of the library to try to determine: (a) factual accuracy of responses, (b) level of interviewing by the staff person, and (c) attitude of the staff person. Results of the study…

  4. 42 CFR 137.133 - What does a final offer contain?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What does a final offer contain? 137.133 Section 137.133 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer § 137.133 What does a...

  5. 42 CFR 137.236 - When does a withdrawal become effective?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false When does a withdrawal become effective? 137.236 Section 137.236 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Withdrawal § 137.236 When does a...

  6. 42 CFR 137.134 - When does the 45 day review period begin?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false When does the 45 day review period begin? 137.134 Section 137.134 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer § 137.134 When does...

  7. Does How Students Serve Matter? What Characteristics of Service Programs Predict Students' Social Justice Attitudes?

    Science.gov (United States)

    Littenberg-Tobias, Joshua

    2014-01-01

    Volunteering is often touted as a method to educate college students about social justice by providing students with an opportunity to apply classroom knowledge in a real-world setting. However, many critics have noted that service does not necessarily lead to social justice outcomes and that some forms of service may reinforce students'…

  8. 34 CFR 611.42 - How does the Secretary calculate the period of the scholarship recipient's service obligation?

    Science.gov (United States)

    2010-07-01

    ... scholarship recipient's service obligation? 611.42 Section 611.42 Education Regulations of the Offices of the... QUALITY ENHANCEMENT GRANTS PROGRAM Scholarships § 611.42 How does the Secretary calculate the period of the scholarship recipient's service obligation? (a) Calculation of period of scholarship assistance...

  9. Migrating Department of Defense (DoD) Web Service Based Applications to Mobile Computing Platforms

    Science.gov (United States)

    2012-03-01

    Natick Soldier Systems Center NFC Near Field Communications NOGAPS Navy Operational Global Atmospheric Prediction System NPS Naval Postgraduate School...component layer. The Component Layer is a set of pre-compiled libraries that expose device specific capability. The Component Layer is swapped out based on...and Near Field Communications ( NFC ). 2.3 Enterprise Data for Mobile The last 5 years of DoD software development has seen a dramatic push for Service

  10. How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

    Science.gov (United States)

    Parkman, Thomas; Neale, Joanne; Day, Ed; Drummond, Colin

    2017-09-19

    People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' socio-demographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

  11. Rapid intervention and treatment zone: redesigning nursing services to meet increasing emergency department demand.

    Science.gov (United States)

    Considine, Julie; Lucas, Elspeth; Martin, Roslyn; Stergiou, Helen E; Kropman, Matthew; Chiu, Herman

    2012-02-01

    The impact of emergency nursing roles in demand management systems is poorly understood. The aim of this study was to evaluate emergency nurses' role in a specific emergency department (ED) demand management system: rapid intervention and treatment zone (RITZ). A descriptive exploratory approach was used. Data were collected from audit of 193 randomly selected patient records and 12 h of clinical practice observation. The median age of participants was 31 years, 51.8% were males and 99.5% were discharged home. Nurse qualifications or seniority had no significant effect on waiting time or length of stay (LOS). There were disparities between documented and observed nursing practice. The designation and qualifications of RITZ nurses made little difference to waiting times and ED LOS. Specific documentation and communication systems for areas of the ED that manage large numbers of low complexity patients warrant further research. © 2012 Blackwell Publishing Asia Pty Ltd.

  12. [ANALYSIS OF A NEW ORGANIZATIONAL MODEL APPLIED TO THE PHYSIOTERAPY SERVICE C/O SURGERY DEPARTMENTS].

    Science.gov (United States)

    Rancati, Jacopo Matteo; Incarbone, Fina Maria Teresa; Pinna, Selene; Panella, Lorenzo

    2015-01-01

    The lowering number of physiotherapists c/o surgery departments of Orthopaedic Institute Gaetano Pini of Milan, required the application of a new organizational model based on the centralization of government activities, in order to optimize employment of staff. A programming and reporting tool was developed throught a database. The collected data (from January to December 2013) related to the reported physiotherapists activities were analysed and matched to operating theater's activities in order to find the correlation value. The results are lined up the hypothesis stated in the planning phase of the organizational model's project (in absence of hystorical referral). Correlation between Physiotherapists and Operation Theather's activities was good (r=0.59), giving us a reliable predictional model. This study has some limitations mostly related to the resistence expressed by employees in the change management.

  13. 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.

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

    CERN Multimedia

    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...

  15. Standards, Best Practices and Codes of Ethics Impact on IT Service Quality – The Case of Slovenian IT Departments

    Directory of Open Access Journals (Sweden)

    Dzangir Kolar

    2017-03-01

    Full Text Available The purpose of this paper is to explore the critical success factor for implementing standards, best practices and codes of ethics, what their benefits are when implemented and how they impact the quality of information technology (IT services. Through extensive literature review and interview with experts in the field we identified instrumental determinants. The structural equation model (SEM has been used on the case of IT departments in large Slovenian companies to test the hypotheses presented. The study is based on 102 responses from IT managers in large Slovenian companies. Research findings confirmed a positive correlation between used factors.

  16. 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.

  17. Pollution prevention opportunity assessment for Sandia National Laboratories/New Mexico's fleet services department.

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, Anastasia Dawn

    2003-06-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the Sandia National Laboratories/New Mexico's (SNL/NM) Fleet Services Department between December 2001 and August 2002. This is the third PPOA conducted at Fleet in the last decade. The primary purpose of this PPOA was to review progress of past initiatives and to provide recommendations for future waste reduction measures of hazardous and solid waste streams and increasing the purchase of environmentally friendly products. This report contains a summary of the information collected and analyses performed with recommended options for implementation. The Sandia National Laboratories/New Mexico Pollution Prevention Group will work with SNL/NM's Fleet Services to implement these options.

  18. 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.

  19. 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'.

  20. 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)

  1. Migration by Veterans Who Received Homeless Services From the Department of Veterans Affairs.

    Science.gov (United States)

    Metraux, Stephen; Treglia, Dan; O'Toole, Thomas P

    2016-10-01

    We examined migration patterns among 113,400 homeless veterans, focusing on the prevalence and the basic geographic patterns of this migration. Data were for all veterans who initiated use of Veterans Affairs homeless services in 2011 or 2012; and we followed them using Veterans Affairs administrative records for up to 2 years following this initial contact. Results showed that 15.3% of the veterans migrated across regions while homeless. Those who were homeless for longer periods were more likely to migrate, and migration, were it to occur, was most likely earlier on in veterans' homelessness episodes. There were no clear geographic correlates that explained the dynamics of this migration as, overall, in-migration tended to roughly balance out-migration in a region. These findings suggest that concerns about the extent of migration and its impact on localities are exaggerated, but also sets forth an agenda for more in-depth study of these data to gain a deeper and more expansive understanding of this phenomenon. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  2. United States Department of Agriculture-Agricultural Research Service research on natural products for pest management.

    Science.gov (United States)

    Duke, Stephen O; Baerson, Scott R; Dayan, Franck E; Rimando, Agnes M; Scheffler, Brian E; Tellez, Mario R; Wedge, David E; Schrader, Kevin K; Akey, David H; Arthur, Frank H; De Lucca, Anthony J; Gibson, Donna M; Harrison, Howard F; Peterson, Joseph K; Gealy, David R; Tworkoski, Thomas; Wilson, Charles L; Morris, J Brad

    2003-01-01

    Recent research of the Agricultural Research Service of USDA on the use of natural products to manage pests is summarized. Studies of the use of both phytochemicals and diatomaceous earth to manage insect pests are discussed. Chemically characterized compounds, such as a saponin from pepper (Capsicum frutescens L), benzaldehyde, chitosan and 2-deoxy-D-glucose are being studied as natural fungicides. Resin glycosides for pathogen resistance in sweet potato and residues of semi-tropical leguminous plants for nematode control are also under investigation. Bioassay-guided isolation of compounds with potential use as herbicides or herbicide leads is underway at several locations. New natural phytotoxin molecular target sites (asparagine synthetase and fructose-1,6-bisphosphate aldolase) have been discovered. Weed control in sweet potato and rice by allelopathy is under investigation. Molecular approaches to enhance allelopathy in sorghum are also being undertaken. The genes for polyketide synthases involved in production of pesticidal polyketide compounds in fungi are found to provide clues for pesticide discovery. Gene expression profiles in response to fungicides and herbicides are being generated as tools to understand more fully the mode of action and to rapidly determine the molecular target site of new, natural fungicides and herbicides.

  3. Mental health services use and management of eating disorders in an Italian Department of Mental Health.

    Science.gov (United States)

    Calugi, Simona; Avaldi, Vera Maria; Dalle Grave, Riccardo; Rucci, Paola; Fantini, Maria Pia

    2014-06-01

    To investigate the clinical characteristics of patients with eating disorders referred to Community Mental Health Centers (CMHCs) in the Department of Mental Health of Bologna, Italy, and to evaluate the number and type of interventions delivered. Adult patients with eating disorders who had a first contact with CMHCs between January 1, 2007 and December 31, 2012 were extracted from Bologna Local Health Authority database. Moreover, the hospital discharge records of patients were linked to the mental health information system of Bologna. Among the 276 patients with eating disorders identified, 59 (21.4%) were diagnosed as anorexia nervosa, 77 (27.9%) as bulimia nervosa and 140 (50.7%) as eating disorders not otherwise specified. The mean age of the sample was 37.3 (SD = 13.4), with no significant differences among the three diagnostic groups. The number of CMHCs outpatients increased each year from 2007 to 2011 and decreased in 2012. The proportion of new patients by year comprised about 50% of the total of patients. Psychotherapy accounted for about 10% of the interventions. Day-hospital and hospital admissions concerned 6.1 and 11.6% of the sample. CMHCs are part of the system of care outlined by the Regional policies for eating disorders and are responsible for providing the first level of outpatient care to adults. To date, there is the need to extend our monitoring across the whole system of care, to assess the implementation of specific and effective strategies to decrease the age of access of patients and to improve the quality of care delivered with the inclusion of evidence-based treatments in the process of care.

  4. A Six Sigma Approach to Analyze Time-to-Assembly Variance of Surgical Trays in a Sterile Services Department.

    Science.gov (United States)

    Fogliatto, Flavio S; Anzanello, Michel J; Tortorella, Guilherme L; Schneider, Daniela S S; Pereira, Cintia G R; Schaan, Beatriz D

    2017-03-24

    We analyze the assembly of surgical trays in a hospital's sterile services department. The department assembles 520 different tray setups. However, tray assembly times are unknown, imposing a challenge to production planners. To respond to demand, workers from other departments are often called, leading to higher operational costs and more frequent quality problems due to workers' poor training and inconsistency. Conducting traditional time-motion studies is infeasible in such a high variety production setting. Thus, we used design of experiments to optimize the data acquisition. Assembly times of 36 trays were sampled using a 2-factor nested factorial design. Through regression analysis, we built a model to estimate completion times of trays not sampled in the experiment. A prediction model with 90.8% accuracy was obtained from the experimental data. The model was validated with assembly times from several trays not included in the experiment. Predicted assembly times had an absolute error of 7.83% on average compared with observed assembly times. Design of experiments and regression analysis combined were able to optimize time data acquisition using a small sample of trays, resulting in a model that predicted assembly times within an acceptable margin of error.

  5. Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department.

    Science.gov (United States)

    Wand, Timothy; D'Abrew, Natalie; Barnett, Catherine; Acret, Louise; White, Kathryn

    2015-02-01

    To evaluate a nurse practitioner (NP)-led extended hours mental health liaison nurse (MHLN) service based in the emergency department (ED) of an inner city teaching hospital in Sydney and to explicate a model of care that is transferable across a broad range of ED settings, both in metropolitan and rural contexts. This mixed-methods evaluation encompassed descriptive data on ED mental health presentations, quantifying waiting times for MHLN involvement and interviews with MHLN team members at the commencement of the evaluation and 12 months later. Interviews were also conducted with a snapshot of ED patients, and a sample of ED and psychiatry staff. The expanded MHLN service was rapidly incorporated into the ED structure, enthusiastically endorsed by ED patients and highly valued by staff and the organisation. The MHLN team saw 55% of referred patients within the first hour of arrival (frequently before medical assessment), thereby initiating and expediting co-ordination of care at an early stage of the ED process. An NP-led extended hours MHLN team based in the ED provides prompt and effective access to specialised mental health care for people with 'undifferentiated health problems', and removes a significant workload from nursing and medical staff. Embedding the NP-led MHLN service within the ED structure was pivotal to the success and sustainability of this model of care.

  6. Support and services provided by public health regional surveillance teams to Local Health Departments in North Carolina.

    Science.gov (United States)

    Horney, Jennifer A; Markiewicz, Milissa; Meyer, Anne Marie; Macdonald, Pia D M

    2011-01-01

    Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.

  7. 20 CFR 667.170 - What responsibility review does the Department conduct for awards made under WIA title I...

    Science.gov (United States)

    2010-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS UNDER TITLE I OF THE... management system as required by Federal regulations; (4) Willful obstruction of the audit process; (5... subrecipient complies with its OMB Circular A-133 audit requirements specified at § 667.200(b); (12) Failure to...

  8. 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

  9. 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

  10. 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.

  11. Department of the Interior U.S. Fish and Wildlife Service : Final Environmental Assessment for Recreational Fishing Plan : Cypress Creek National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The primary purpose of the proposed action is to consider recreational fishing opportunities on Cypress Creek NWR. This EA analyzes four different fishing...

  12. 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 which departments are the most important ones to customer attitudes, and how these attitudes are influenced by department specific factors, have been scarce, however. Unlike most other departments of a self-service chain store, the fruit and vegetable department gives ample opportunity......As a result of the increased competition between self-service chains, retail managers try to strengthen store identity and customer loyalty to an increasing degree. In this respect a number of measures, as for example service management and direct marketing programmes, have been instigated. Most...... 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...

  13. Report to the Department of Energy on the DOE/EPSCoR planning activities for the state of South Dakota

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    An extensive review of the current status of energy-related research and educational activities within the state of South Dakota was carried out. Information exchange meetings were conducted at the major research institutions as well as with many representatives of state government. Visits were also made to professional educators who are deeply involved with the state`s principal minority group, the American Indian. Several activities in the human resource development area that will be carried out in the five-year implementation project were identified. Many of these will be closely coordinated with other efforts currently in progress under the auspices of the NSF SSI (Statewide Systemic Initiatives in Science, Mathematics, and Engineering Education) office. The authors will also work closely with AWU and other regional consortia to foster a higher level of participation in existing DOE programs and to develop adaptations and {open_quotes}follow-ons{close_quotes} that are tailored to the specific needs of South Dakota. Many of these programs will involve extensive interaction with DOE laboratories. Special programs will be carried out that are designed to keep a larger number of the Native American population in the science and engineering pipeline. An assessment of the research strengths of this state was made. With the assistance of external consultants, the authors identified two principal areas in which they have the potential to develop nationally competitive research programs that fall within DOE objectives. One is a comprehensive biomass systems study, and the other a water quality study as it relates to energy production.

  14. Adding physical therapy services in the emergency department to prevent immobilization syndrome - a feasibility study in a university hospital.

    Science.gov (United States)

    Tousignant-Laflamme, Yannick; Beaudoin, Ann-Marie; Renaud, Anne-Marie; Lauzon, Stephanie; Charest-Bossé, Marie-Catherine; Leblanc, Louise; Grégoire, Maryse

    2015-12-03

    The association between the functional decline occurring with bedrest and hospitalization in older persons is well-known. A long wait in the emergency department (ED), where patients can be bedridden, is a risk factor for the development of an immobilization syndrome (IS). IS is one of the unwanted consequences of inactivity, which causes pathological changes in most organs and systems. Early mobility interventions, such as physical therapy (PT) delivered in the ED, may prevent its development. To our knowledge, no prior studies have reported on this topic. The goal of this study was to (i) assess the feasibility and (ii) explore the potential clinical value of adding PT services to the ED, in collaboration with nursing staff, to prevent IS. For 12 weeks, PT services were delivered in the ED to older persons (>65 years old) presenting with ≥1 clinical signs associated with the development of IS. Patients were screened by ED nurses and then seen by the physiotherapist. In order to assess feasibility, access to patients, percentage of patients who met eligibility criteria, acceptability of the intervention, and barriers/facilitators to the implementation were measured. To describe the clinical benefits of early PT services, we counted the number of new IS cases among patients after their admission to the ward. After 12 weeks, the ED nurses screened 187 potential patients and 20 received PT services in the ED (before their admission to the ward). Accessibility was not an issue and we observed good acceptability from the milieu. We did not find majors problems or insurmountable obstacles to implementation of the intervention. Clinical outcomes showed that nine patients received PT treatments in the ED and on the ward (after their admission). For the 11 other patients, no PT interventions were done in the ED following the assessment. Follow-up of these 11 patients showed that two of them developed IS during their hospital stay. As for the nine patients who began

  15. Education and the energy crisis: policies and actions for the Department of Energy. [Options and alternatives, DOE Education Programs Div

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-01-22

    This report is the result of a study carried out to determine options and alternatives for the Education Programs Division (EPD) of the Department of Energy. In the conduct of this study, numerous individuals from various concerned institutions were interviewed. While the project scope clearly precluded contact with every involved or potentially involved party, a concerted effort was made to obtain a representative sampling of the opinions and views of relevant government, academic and private sector agencies and organizations. A listing of those contacted, excluding the Department of Energy, is provided. In addition to interviews, an extensive range of literature was drawn upon including memoranda, brochures, program statements, school-enrollment data, speeches and the like. It was determined during this study that a wide range of public and private institutions are actively involved in the energy-education field. Oil companies, utilities, public interest groups, schools, agencies at every level of government, and others are formulating and delivering education which is enormously varied. It was concluded, however, that the public is not being reached, partially because current efforts are unfocused and partially because the public has become inured to problems and resistant to many of the traditional means of education. The study found that within this crowded and varied energy education field the Department of Energy is well placed to begin to provide direction and focus to the widespread activity now occurring.

  16. Fever Phobia as a Reason for Pediatric Emergency Department Visits: Does the Primary Care Physician Make a Difference?

    Directory of Open Access Journals (Sweden)

    Erella Elkon-Tamir

    2017-01-01

    Full Text Available Background Fever is a source of considerable parental anxiety. Numerous studies have also confirmed similar anxiety among health care workers. This study analyzed caregiver knowledge of fever, and beliefs concerning children with a febrile illness, with an emphasis on the referring physician. Methods This was a cross-sectional study of 100 caregivers of children 3 months to 12 years old, treated at an urban tertiary care pediatric emergency department for fever. Caregiver knowledge was assessed with a questionnaire. Results Most caregivers correctly defined the threshold for fever as >38.0–38.3°C. Caregivers commonly believed that fever can cause brain damage and epilepsy; the frequency of this belief was not affected by whether they were referred to the emergency department by their pediatrician/family physician or by another physician or arrived without a referral. For a comfortable-appearing child with a temperature not above 38.0°C, both groups reported that they would give antipyretics in similar proportions (mean 31%. The majority of parents in both groups believed that teething could cause fever (mean 74%. Conclusion Caregivers in this study had limited knowledge of fever and its management in children, even if referred by their primary care physician. We suggest that there is a need for aggressive educational interventions to reduce parents’ fever phobia, in clinics as well as in pediatric emergency departments, and that this need may extend to the education of medical personnel as well.

  17. 5 CFR 847.902 - How does an election to credit NAFI service for immediate CSRS or FERS retirement under subpart H...

    Science.gov (United States)

    2010-01-01

    ... Who Elect To Use NAFI Service To Qualify for an Immediate CSRS or FERS Retirement § 847.902 How does... elects to use NAFI service to qualify for an immediate CSRS or FERS retirement benefit will be reduced to...

  18. 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.

  19. Lab-Corps: Creating Market Pathways for Laboratory Research; U.S. Department of Energy (DOE), Energy Efficiency & Renewable Energy (EERE)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-08-01

    The Lab-Corps program is a specialized training curriculum aimed at accelerating the transfer of clean energy technologies from national laboratories into the commercial marketplace. Administered by the U.S. Department of Energy’s (DOE's) Office of Energy Efficiency and Renewable Energy, Lab-Corps is a new model of engagement as a part of the Lab Impact Initiative. In addition to Lab-Corps, the Lab Impact Initiative utilizes the Small Business Voucher and Technologist-in-Residence programs to increase and enhance laboratory-private sector relationships, streamline access to national laboratory capabilities, and demonstrate the value of laboratory-developed science and technology.

  20. 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

    in the CPOMR. The study is base on participant observation and interviews. Before and during the test period the author attended project planning meetings, a training workshop in the use of the CPOMR for nurses and physicians and local coordination meetings. After the test, 1 focus-group discussion...... with physicians and nurses (6 participants; duration 1½ hours) was conducted as well as 13 open-ended interviews (5 nurses, 2 social- and health assistants, 4 physicians, 2 IT-people; duration: 16-42 minutes; average of 29 minutes). The interviewees formed the core group using the CPOMRResults: Use of the CPOMR...... 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...

  1. 76 FR 40749 - Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department...

    Science.gov (United States)

    2011-07-11

    ... BUDGET DEPARTMENT OF VETERANS AFFAIRS Cost-Based and Inter-Agency Billing Rates for Medical Care or... updates the Cost-Based and Inter-Agency billing rates for medical care or services provided by the... care or services provided by VA is set forth in 38 CFR 17.102(h). These rates apply to medical care or...

  2. Patterns of dental service utilization following nontraumatic dental condition visits to the emergency department in Wisconsin Medicaid.

    Science.gov (United States)

    Pajewski, Nicholas M; Okunseri, Christopher

    2014-01-01

    To examine patterns of dental service utilization for adult Medicaid enrollees in Wisconsin following nontraumatic dental condition (NTDC) visits to the emergency department (ED). This is a retrospective, observational study of claims for NTDC visits to the ED and dental service encounters from the Wisconsin Medicaid Evaluation and Decision Support database (2001-2009). We used competing risk models to predict probabilities of returning to the ED versus obtaining follow-up care from a dentist. We observed a 43 percent increase in the rate of NTDC visits to the ED, with most of this increase occurring from 2001 to 2005. Within 30 days of an NTDC visit to the ED, ∼29.6 percent of enrollees will first visit a dentist office, while ∼9.9 percent will return to the ED. Young to middle-aged adults (18 to dental providers were more likely to return to the ED following a NTDC visit. Among the enrollees that first visited a dental office following an ED visit, 37.6 percent had an extraction performed at this visit. Almost one in five adult Medicaid enrollees will subsequently return to the ED following a previous NTDC visit. The provision of definitive care for these individuals appears to primarily consist of extractions. © 2012 American Association of Public Health Dentistry.

  3. 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

    2016-09-01

    To assess patients' judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. 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). The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. 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. The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT.

  4. 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

  5. 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

  6. 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.

  7. Defining "high-frequency" emergency department use: Does one size fit all for urban and rural areas?

    Science.gov (United States)

    Matsumoto, Cai Lei; O'Driscoll, Teresa; Madden, Sharen; Blakelock, Brittany; Lawrance, Jennifer; Kelly, Len

    2017-09-01

    To suggest a functional definition for identification of "high-frequency" emergency department (ED) users in rural areas. Retrospective analysis of secondary data. Sioux Lookout Meno Ya Win Health Centre in northwestern Ontario. All ED visitors (N = 7121) in 2014 (N = 17 911 visits) in one rural hospital. The number of patients and visits identified using different definitions of high-frequency use. RESULTS: By using the most common definition of high-frequency use (≥ 4 annual visits) for our hospital data, we identified 16.7% of ED patients. Using 6 or more annual visits as the definition, we identified 7.9% of ED patients; these patients accounted for 31.3% of the ED visit workload. Using the definition of 6 or more identifies less than 10% of the patients, which is a similar result to using the lower visit standard (≥ 4) in urban centres. We suggest that the definition for high-frequency visitors to a rural ED should be 6 or more annual visits. Other useful subsets might include very high-frequency users (12 to 19 annual visits) and super users (≥ 20 annual visits). Copyright© the College of Family Physicians of Canada.

  8. 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

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

    Science.gov (United States)

    Stoneking, L R; Waterbrook, A L; Garst Orozco, J; Johnston, D; Bellafiore, A; Davies, C; Nuño, T; Fatás-Cabeza, J; Beita, O; Ng, V; Grall, K H; Adamas-Rappaport, W

    2016-01-01

    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. 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. 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. Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study. Complete outcome data were available for 55 patients. Overall, resident physicians spoke Spanish 58% of the time. SC resident physicians spoke Spanish with 66% of the patients versus 45% for UC resident physicians. Patients rated resident physician Spanish ability as very good in 13% of encounters - 17% for SC versus 5% for UC. Patient satisfaction with their ED visit was rated as very good in 35% of encounters - 40% for SC resident physicians versus 25% for UC resident physicians. Of the 13 patients for whom Spanish was the language used during the medical encounter who followed medical recommendations, ten (77%) of these encounters were with SC resident physicians and three (23%) encounters were with UC

  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.

    Science.gov (United States)

    Bellis, Mark A; Leckenby, Nicola; Hughes, Karen; Luke, Chris; Wyke, Sacha; Quigg, Zara

    2012-09-06

    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. 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. Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P football matches are associated with nearly a three times increase in midweek assault presentation. Other football and rugby events examined show no impact. The 2008 Olympics saw assaults fall. The overall calendar model strongly predicts observed presentations (R2 = 0.918; P violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.

  12. 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.

  13. Health-hazard-evaluation report HETA 87-042-1869, Florida Department of Health and Rehabilitative Services, Jacksonville, Florida

    Energy Technology Data Exchange (ETDEWEB)

    Ornella, G.A.; Mathias, C.G.T.

    1988-02-01

    In response to a request from the State of Florida Department of Health and Rehabilitative Services, Jacksonville, Florida, an evaluation was made of working conditions at public health laboratories to investigate outbreaks of red rashes, dryness, and chapping of skin among employees. Exposure to the oxidase reagents used in the preliminary identification of Neisseria-gonorrhoeae cultures was reported by 54 of 99 workers completing a questionnaire. In skin-patch tests using oxidase reagents, seven of 27 individuals tested positive for allergic contact dermatitis to oxidase reagents. A relationship was also noted between those who were nonsensitized victims of dermatitis and the degree of exposure they had to the oxidase reagents. There is a health hazard from exposure to oxidase compounds at these public health laboratories. The authors recommend that more extensive patch testing be carried out and those workers testing positive be transferred to other areas of the facility. Those workers who are not sensitive should wear disposable vinyl gloves when working with oxidase reagents. Work practices should be changed to minimize accidental spillage.

  14. 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.

  15. What Does It Mean to Be a Service-Learning Teacher?--An Autoethnography

    Science.gov (United States)

    Verdi, Kristy C.

    2017-01-01

    This autoethnography of my lived experiences as a middle-school service-learning course teacher has helped me solve a personal mystery and present an important perspective for the K-12 service-learning field. With an eye on revealing a unique service-learning classroom concept to educational leaders, enhancing middle level teacher education, and…

  16. Mandatory use of technology-based self-service: does expertise help or hurt?

    NARCIS (Netherlands)

    Reinders, M.J.; Frambach, R.T.; Kleijnen, M.H.P.

    2015-01-01

    Purpose – This study aims to investigate the effects of two types of expertise (self-service technology and service type) on the disconfirmation of customers’ expectations and the use-related outcomes of technology-based self-service (TBSS). Design/methodology/approach – This empirical study

  17. Mandatory use of technology-based self-service: does expertise help or hurt?

    NARCIS (Netherlands)

    Reinders, Machiel J.; Frambach, Ruud; Kleijnen, Mirella

    2015-01-01

    Purpose – This study aims to investigate the effects of two types of expertise (self-service technology and service type) on the disconfirmation of customers’ expectations and the use-related outcomes of technology-based self-service (TBSS).
    Design/methodology/approach – This empirical study

  18. 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 service

  19. What Does Success Look Like in the Forensic Mental Health System? Perspectives of Service Users and Service Providers.

    Science.gov (United States)

    Livingston, James D

    2018-01-01

    Outcomes research in forensic mental health (FMH) has concentrated on reoffending as the principal indicator of success. Defining success in one-dimensional, negative terms can create a distorted view of the diverse objectives of the FMH system. This qualitative study examined the complexity of success from the perspectives of people in the FMH system. Interviews were conducted with 18 forensic service users and 10 forensic service providers. Data were analyzed inductively using thematic analysis to identify predominant themes. The participants conceptualized success as a dynamic process materializing across six different domains in the context of the FMH system: (a) normal life, (b) independent life, (c) compliant life, (d) healthy life, (e) meaningful life, and (f) progressing life. The results indicate that people who provide or use FMH services emphasize a broad range of processes and outcomes, apart from public safety, when they think about success.

  20. 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...

  1. 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 and Mineral Industries (DOGAMI) contracted with Watershed Sciences, Inc. to collect high resolution topographic LiDAR data for...

  2. 42 CFR 137.246 - How does a Self-Governance Tribe retrocede a PSFA?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How does a Self-Governance Tribe retrocede a PSFA? 137.246 Section 137.246 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Retrocession § 137...

  3. 42 CFR 137.132 - How does the Indian Tribe submit a final offer?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How does the Indian Tribe submit a final offer? 137.132 Section 137.132 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer § 137...

  4. 42 CFR 137.226 - How does a Self-Governance Tribe request a waiver?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How does a Self-Governance Tribe request a waiver? 137.226 Section 137.226 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Regulation Waiver...

  5. 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... Act, on a Statewide basis through: (i) Self-service; (ii) Facilitated self-help service; and (iii...

  6. 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

  7. 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

  8. World Trade Center-related physical and mental health burden among New York City Fire Department emergency medical service workers.

    Science.gov (United States)

    Yip, Jennifer; Zeig-Owens, Rachel; Webber, Mayris P; Kablanian, Andrea; Hall, Charles B; Vossbrinck, Madeline; Liu, Xiaoxue; Weakley, Jessica; Schwartz, Theresa; Kelly, Kerry J; Prezant, David J

    2016-01-01

    To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. 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.

  10. Does Exporting is Less Common Among Small Services Firms? Evidence From Turkey

    OpenAIRE

    ONDAY, Özgür

    2016-01-01

    Two of the most salient, interesting trends in the post-1950 U.S. economy have been the upcoming importance of the service sector and the growth in the skill premium in wages despite a large expansion in the relative supply of high-skilled workers. The growth of the service sector and the relative demand for high-skilled workers have been well understood in independent literatures. Key theoretical idea linking these two concepts based on structural characteristics differences between service...

  11. High-acuity GIS mapping of private practice dental services in New Zealand: does service match need?

    Science.gov (United States)

    Kruger, Estie; Whyman, Robin; Tennant, Marc

    2012-04-01

    New Zealand is a country with a relatively small population (4 million people) distributed unevenly over a relatively large land area. Adult oral health services in New Zealand are almost all delivered through a market-driven, private practice model and are funded directly by patient payments. Little attention has been given to the distribution of these services. This study reports the findings of a high-acuity examination of the distribution of private dental practices in New Zealand, using modern geographic information system (GIS) tools. A total of 1,045 private dental practices in New Zealand were geocoded. These dental practices overlaid 1,909 area units. The highest practice: adult population ratios found in this study reflected the areas with the highest population densities of Maori and Pacific Islander people. Oral health has a substantial impact on health-related quality of life and the utilisation of dental care services can contribute to its improvement. As such, it is expected that access to care should be focused on the population groups with the highest degree of need. However, in a market-driven, mostly private practice model, such as that in New Zealand, available care is concentrated largely in areas of high socioeconomic status and in populations with lower levels of oral disease. © 2012 FDI World Dental Federation.

  12. A Commentary on: "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008".

    Science.gov (United States)

    Brooks, Antone L

    2015-04-01

    This commentary provides a very brief overview of the book "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008" ( http://lowdose.energy.gov ). The book summarizes and evaluates the research progress, publications and impact of the U.S. Department of Energy Low Dose Radiation Research Program over its first 10 years. The purpose of this book was to summarize the impact of the program's research on the current thinking and low-dose paradigms associated with the radiation biology field and to help stimulate research on the potential adverse and/or protective health effects of low doses of ionizing radiation. In addition, this book provides a summary of the data generated in the low dose program and a scientific background for anyone interested in conducting future research on the effects of low-dose or low-dose-rate radiation exposure. This book's exhaustive list of publications coupled with discussions of major observations should provide a significant resource for future research in the low-dose and dose-rate region. However, because of space limitations, only a limited number of critical references are mentioned. Finally, this history book provides a list of major advancements that were accomplished by the program in the field of radiation biology, and these bulleted highlights can be found in last part of chapters 4-10.

  13. 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...

  14. Does Student Teaching Matter? Investigating Pre-Service Teachers' Sense of Efficacy and Preparedness

    Science.gov (United States)

    Brown, Amber L.; Lee, Joohi; Collins, Denise

    2015-01-01

    The purpose of this study was to investigate how student teaching experiences impact the sense of teaching efficacy and feelings of preparedness of pre-service teachers in a nearly and elementary teacher education program (EC-6). The study used an action research, mixed-methods design. Seventy-one pre-service teachers at a large public university…

  15. How Does Community Service Promote Prosocial Behavior? Examining the Role of Agency and Ideology Experience

    Science.gov (United States)

    Christoph, Gabriela; Gniewosz, Burkhard; Reinders, Heinz

    2014-01-01

    This study examines community service effects on adolescents' prosocial behaviors as mediated through experiences made during service. Based on theoretical assumptions by Youniss and Yates, we suggest that personal agency experiences and being confronted with situations that can challenge the own world views (ideology experiences) serve as…

  16. 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;

  17. 76 FR 70730 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-11-15

    ... Immigration Services--014 Electronic Immigration System-1 Temporary Accounts and Draft Benefit Requests System... and Immigration Services--014 Electronic Immigration System-1 Temporary Accounts and Draft Benefit.... Citizenship and Immigration Services to collect and maintain records on an individual as he or she creates a...

  18. 76 FR 60063 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-09-28

    ... Immigration Services-014 Electronic Immigration System- 1 Temporary Accounts and Draft Benefit Requests System....S. Citizenship and Immigration Services-014 Electronic Immigration System-1 Temporary Accounts and... Security/U.S. Citizenship and Immigration Services to collect and maintain records on an individual as he...

  19. All That Money and for What Purpose? Examining Selected State Departments' of Education Accountability for Implementation, Monitoring, and Evaluation of Supplemental Education Services

    Science.gov (United States)

    Giles, Bethany A.

    2013-01-01

    This study examined the accountability of selected state departments of education on how they implemented, monitored, and evaluated Supplemental Education Services (SES). No Child Left Behind (NCLB) requires low-performing Title I schools to use federal funds to extend the school day for at-risk children by providing SES afterschool programs. This…

  20. 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 ...

  1. 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.

  2. 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

    ... Silverman, Director, Office of Sustainability Support, Office of Health, Safety, and Security, at josh.silverman@hq.doe.gov or 202-586-6535. SUPPLEMENTARY INFORMATION: This MOU is pursuant to the Migratory Bird...

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

    National Research Council Canada - National Science Library

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

    2015-01-01

    ... 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...

  4. 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.

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

    DEFF Research Database (Denmark)

    Berger, Jesper B.; Hertzum, Morten; Schreiber, Trine Louise

    2016-01-01

    . 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.......Digital communication between government and citizens is pivotal to e-government. The Danish e-government initiative Digital Post aims to digitize all communication between government and citizens. We surveyed local government staff about how Digital Post affects the service delivered to citizens...

  6. Gains from trade due to within-firm productivity: Does services exporting matter?

    OpenAIRE

    Dincer, N. Nergiz; Tekin-Koru, Ayca

    2017-01-01

    This paper focuses on gains from trade due to rising within-firm productivity in presence of services exporting. The complementarity between exporting and investing in productivity enhancements is investigated by using descriptive regressions using rich, firm-level data for the period 2003-2011 for Turkey. The authors use three productivity measures for robustness purposes. The results show that firms that export both goods and services throughout the sample have higher productivity compared ...

  7. 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.

  8. Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services.

    Directory of Open Access Journals (Sweden)

    Peter F Rebeiro

    Full Text Available We sought to quantify agreement between Institute of Medicine (IOM and Department of Health and Human Services (DHHS retention indicators, which have not been compared in the same population, and assess clinical retention within the largest HIV cohort collaboration in the U.S.Observational study from 2008-2010, using clinical cohort data in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD.Retention definitions used HIV primary care visits. The IOM retention indicator was: ≥2 visits, ≥90 days apart, each calendar year. This was extended to a 2-year period; retention required meeting the definition in both years. The DHHS retention indicator was: ≥1 visit each semester over 2 years, each ≥60 days apart. Kappa statistics detected agreement between indicators and C statistics (areas under Receiver-Operating Characteristic curves from logistic regression analyses summarized discrimination of the IOM indicator by the DHHS indicator.Among 36,769 patients in 2008-2009 and 34,017 in 2009-2010, there were higher percentages of participants retained in care under the IOM indicator than the DHHS indicator (80% vs. 75% in 2008-2009; 78% vs. 72% in 2009-2010, respectively (p<0.01, persisting across all demographic and clinical characteristics (p<0.01. There was high agreement between indicators overall (κ = 0.83 in 2008-2009; κ = 0.79 in 2009-2010, p<0.001, and C statistics revealed a very strong ability to predict retention according to the IOM indicator based on DHHS indicator status, even within characteristic strata.Although the IOM indicator consistently reported higher retention in care compared with the DHHS indicator, there was strong agreement between IOM and DHHS retention indicators in a cohort demographically similar to persons living with HIV/AIDS in the U.S. Persons with poorer retention represent subgroups of interest for retention improvement programs nationally, particularly in light of the

  9. 10 CFR 820.5 - Service.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Service. 820.5 Section 820.5 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES General § 820.5 Service. (a) General rule. Any document filed... filed until service is complete and unless accompanied by proof of service; provided that the filing...

  10. 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

  11. 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

    In the Danish language "haven" means "the garden": A tranquil place with beautiful colours and vegetables where one can relax and prepare for the more stressful activities of modern life. Similarly, the chain store´s fruit and vegetable department can be the haven of the stressed self...... trend is that retail chain managers concentrate the effort on the key-departments of the chain store. So far, however, the academic research attempts to measure which departments are most significant for chain-equity have been scarce. This paper discusses the concept of chain-equity and gives a number...

  12. Condensed Task Report on Study of Ohio Public School Library Services, Operations, and Facilities to Ohio Department of Education.

    Science.gov (United States)

    Allen, Joyce M.

    An attempt was made to assess Ohio public school libraries in terms of their facilities, equipment, materials, services, operations, and leadership. A review of the literature relevant to school library services was made. In addition, interviews were conducted with people knowledgeable in the library field. The questionnaires were sent to…

  13. Medicaid: Determining Cost-Effectiveness of Home and Community-Based Services. Report to the Administrator, Health Care Financing Administration, Department of Health and Human Services.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    To examine alternatives to nursing home care, states have been testing home and community-based services under the Medicaid program. Information on the operations of the state projects will be vital to designing cost-effective alternative services in the future. The General Accounting Office (GAO) reviewed state reports to see if accurate,…

  14. An Appraisal of the Special Summer Food Service Program for Children. Food and Nutrition Service. Department of Agriculture. Report to Congress.

    Science.gov (United States)

    Comptroller General of the U.S., Washington, DC.

    The Special Summer Food Service Program for Children is one of several programs for the feeding of children administered by the Food and Nutrition Service (FNS). The program is designed to feed during summer vacation, children from areas having poor economic conditions or high concentrations of working mothers. It is authorized through fiscal year…

  15. 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...

  16. 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...

  17. 2011 U.S. Department of Agriculture- Natural Resources Conservation Service (USDA-NRCS) Topographic Lidar: Northwest 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...

  18. 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.

  19. 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.

  20. Mapping clinical journeys of Asian patients presenting to the Emergency Department with syncope: Strict adoption of international guidelines does not reduce hospitalisations.

    Science.gov (United States)

    Kojodjojo, Pipin; Boey, Elaine; Elangovan, Anita; Chen, Xianyi; Tan, Yuquan; Singh, Devinder; Yeo, Wee Tiong; Lim, Toon Wei; Seow, Swee Chong; Sim, Tiong Beng

    2016-09-01

    Limited data exists about management of syncope in Asia. The American College of Emergency Physicians (ACEP) and European Society of Cardiology (ESC) guidelines have defined the high-risk syncope patient. This study aims to determine the effectiveness of managing syncope in an Asian healthcare system and whether strict adherence of international guidelines would reduce hospitalizations. Patients attending the Emergency Department of a Singaporean tertiary hospital with syncope were identified. Clinical journeys of all patients were meticulously mapped by interrogation of a comprehensive electronic medical record system and linkages with national datasets. Primary endpoint was hospitalization. Secondary endpoints were recurrent syncope within 1year and all-cause mortality. Expected admission rates based on application of ACEP/ESC guidelines were calculated. 638 patients (43.8±22.4years, 49.0% male) presented with syncope. 48.9% were hospitalized for 2.9±3.2days. Yields of common investigations ranged from 0 to 11.5% and no diagnosis was reached in 51.5% of patients. Diuretics use (HR 5.1, p=0.01) and prior hospitalization for syncope (HR 6.9, padoption of ACEP or ESC guidelines does not reduce admissions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. 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)…

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

    OpenAIRE

    Hill,Barry

    2017-01-01

    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.

  3. 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.

  4. How Does Public Service Motivation Among Teachers Affect Student Performance in Schools?

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Heinesen, Eskil; Holm Pedersen, Lene

    2014-01-01

    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...

  5. 76 FR 70735 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-11-15

    ... a first-time Applicant does not begin drafting a benefit request within 30 days of opening the... in a locked drawer behind a locked door. The records are stored on magnetic disc, tape, digital media... System; JUSTICE/FBI-002--FBI Central Records System; and JUSTICE/FBI-009--Fingerprint Identification...

  6. 76 FR 60059 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2011-09-28

    ... a first-time Applicant does not formally submit a benefit request within 30 days of opening the... secure facilities in a locked drawer behind a locked door. The records are stored on magnetic disc, tape... System; JUSTICE/FBI-002--FBI Central Records System; and JUSTICE/FBI-009--Fingerprint Identification...

  7. 20 CFR 10.902 - Does every employee's death due to injuries incurred in connection with his or her service with...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Does every employee's death due to injuries incurred in connection with his or her service with an Armed Force in a contingency operation qualify for... connection with his or her service with an Armed Force in a contingency operation qualify for the death...

  8. The Pay, Promotion, and Retention of High-Quality Civil Service Workers in the Department of Defense

    National Research Council Canada - National Science Library

    Asch, Beth

    2001-01-01

    White-collar General Schedule (GS) workers in federal civil service jobs are covered by a commonly structured pay table that varies somewhat to account for differences in federal and nonfederal pay across geographic areas...

  9. 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...

  10. 78 FR 20673 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2013-04-05

    ..., genocide, killing, injuring, forced sexual contact, limiting or denying others religious beliefs, service... records); SSN, if applicable; Supporting documentation as necessary (e.g., birth, marriage, and/or divorce...

  11. Differences in cause of death of Washington State veterans who did and did not use Department of Veterans Affairs healthcare services.

    Science.gov (United States)

    Maynard, Charles; Boyko, Edward J

    2006-01-01

    Relatively little is known about the cause of death in the veteran population, although more is known about the cause of death in Vietnam veterans or veterans receiving mental health services. This article compares characteristics and causes of death in Washington State veterans who did and did not use Department of Veterans Affairs (VA) healthcare services in the 5 years prior to death. This study included 62,080 veterans who died between 1998 and 2002, of whom 21% were users of VA healthcare services. The veterans who used VA healthcare services were younger, more often men, less educated, more often divorced, and more often smokers than the veterans who did not use VA healthcare services. Both female and male veterans who used VA healthcare services were more likely to die from drug- and/or alcohol-related causes. These findings suggest that the VA patient population is socially disadvantaged and more severely affected by substance-use disorders compared with veterans who do not use VA healthcare services.

  12. 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.

  13. 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...... 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...... 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....

  14. Does cadastral division of area-based ecosystem services obstruct comprehensive management?

    DEFF Research Database (Denmark)

    Vejre, Henrik; Vesterager, Jens Peter; Andersen, Peter S.

    2015-01-01

    potential ES are to be unfolded in spatial explicit contexts; all landowners must be aligned in terms of new regulation if the particular service is to be released simultaneously and uniformly in a spatial defined area. It is concluded that sound ecosystem and landscape management that follows boundaries......Management of ecological entities in agricultural landscapes is often challenged by a complex ownership structure governed by a cadastral system dictated by agricultural interests and historical land use practices. The cadastral division is suspected to obstruct the deliverance of ecosystem...... services (ES) from the landscape. The objective of this analysis is to quantify the cadastral fragmentation of selected landscape-scale ES. Contiguous ecological units and landscape entities as designated in Danish municipal planning were analyzed. The designations comprised the existing ES represented...

  15. 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.

  16. 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.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Chunzhu Wei

    2016-10-01

    Full Text Available 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.

  19. 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

  20. 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.

  1. Onsite provision of specialized contraceptive services: does Title X funding enhance access?

    Science.gov (United States)

    Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D

    2014-05-01

    This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all pTitle X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.

  2. 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.

  3. Report on the status of implementing site-specific environmental data collection project planning at the Department of Energy`s (DOE) Office of Environmental and Waste Management (EM)

    Energy Technology Data Exchange (ETDEWEB)

    Carter, M.; Bottrell, D.

    1994-12-31

    The Department of Energy (DOE) is faced with a huge, highly publicized, and costly environmental challenge. In any decision making process that establishes when, where, and how to cleanup or manage wastes, environmental data are essential. Equally important is the definition and determination of project completion which also relies on environmental data. Recognizing that environmental data are both essential and costly, various planning processes have been developed, enhanced, and implemented by DOE and other agencies. This presentation briefly describes these programs and the status of activities to improve planning and efficiency of environmental restoration, waste management, and technology development activities across DOE.

  4. [Scientific and technologic aspects of equipping the preventive services department during general mass screening of the population].

    Science.gov (United States)

    Ananin, V F; Timonin, V M

    1989-01-01

    The analysis of the screening stage of follow-up medical technology practice has been carried out. The study tackles the problems of selection of medical programmes of mass periodic medical check-ups, definition of diagnostic informative indices and their biometrology, programme algorithmic control with its preliminary diagnostic decisions, wide use of an individual principle of health status assessment and further organization of check-up flows, building up of technical equipment patterns for prophylactic departments. A two-stage system of technical equipment patterns of prophylactic departments in a city polyclinic is discussed. At the first stage the department should be equipped with compact, cheap, easily transported, safe and simple in operation, high-quality autonomous specialized automated diagnostic complexes. The second stage consists in the development of the data bank formation system proceeding from the examination results within the region assigned to the polyclinic.

  5. Skills development for non-core financial managers in the North West Provincial Departments - a financial management perspective and an imperative for service delivery improvement / Peter Thelele

    OpenAIRE

    Thelele, Peter

    2013-01-01

    The primary research problem revolves around lack of basic financial management skills (e.g. financial management, project management, strategic management, computer literacy, supply chain management, risk management, compliance with legislation and various regulations) among the non-core financial managers in the North West Provincial departments. These managers have been entrusted with the responsibility to manage public funds, and subsequently deliver services in terms of ...

  6. 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...

  7. Can Local Police and Sheriff’s Departments Provide a Higher Degree of Homeland Security Coordination and Collaboration Through Consolidation of Police Services

    Science.gov (United States)

    2010-09-01

    44 Figure 2. Intelligence Cycle from (From Fuentes , 2006)................................................60 Figure 3. Rand MGT104-S-1...their cities. For example, the San Carlos Police Department 2 just took bids to outsource police services because of the severe financial burden a...because of the information sharing that is a natural byproduct of consolidation. According to Colonel Joseph R. Fuentes , Superintendant of the New Jersey

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Suhonen Aki

    2009-09-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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.

  10. 77 FR 57012 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2012-09-17

    ... Department analyzed these 18 comments and reproduces that analysis in the Analysis of Comments section below... consulates in China and Brazil was unfair because very few H-2 workers come from either of these countries... requires a review of extensive documentation and a more in-depth interview of the applicant than for other...

  11. 76 FR 77012 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Organ...

    Science.gov (United States)

    2011-12-09

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF THE INTERIOR... remains have been determined to be Native American dating to A.D. 1150-1450, commonly known to the...'odham. A Hia C-ed O'odham association with lands lying directly to the west of the Ajo Mountains...

  12. 78 FR 38343 - Notice of a Department of Health and Human Services Public Meeting and Request for Comments on...

    Science.gov (United States)

    2013-06-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... view the public meeting via live streaming technology. Information on that option is provided in... visitors must be escorted while in the building. D. Live Streaming Information For participants who cannot...

  13. 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…

  14. 75 FR 28188 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2010-05-20

    ... entertainers); Q (international cultural exchange visitors); and R (aliens in religious occupations). Each of... Immigration Lawyers Association, and one from the Air Transport Association of America, Inc., requested that... Immigration Lawyers Association argued that the Department did not provide evidence to support what it termed...

  15. 78 FR 48927 - Hours of Service of Drivers: U.S. Department of Defense (DOD); Application for Exemption

    Science.gov (United States)

    2013-08-12

    ... from the U.S. Department of Defense (DOD) Military Surface Deployment and Distribution Command (SDDC... carriers and their employee-drivers engaged in the transportation of weapons, munitions, and sensitive... effect on July 1, 2013. The Military Surface Deployment and Distribution Command (SDDC) manages the motor...

  16. 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.

  17. Alcohol use and adherence to prescribed therapy among under-served Latino and African-American patients using emergency department services.

    Science.gov (United States)

    Bazargan-Hejazi, Shahrzad; Bazargan, Mohsen; Hardin, Eugene; Bing, Eric G

    2005-01-01

    Non-adherence to prescribed therapy is a factor that results in many patients attending emergency departments. However, increasingly, we recognize that patients who seek health care from inner-city emergency departments are among those experiencing health disparities. For these marginalized patients, emergency departments can play an important role in complementing the process of individualized care to achieve successful health outcomes. Research that examines socio-psychological characteristics and correlates of healthcare utilization of emergency department service users among under-served minority patients is needed for redirecting appropriate care among this segment of our population. This study examines the prevalence and correlates of adherence to prescribed therapy among patients presenting to an inner-city emergency department for a medical emergency or trauma injury. Specific attention is paid to the role of alcohol. A cross-sectional face-to-face survey was conducted among a consecutive sample of 412 Hispanic and African Americans aged 18 years and older who sought care at an inner-city emergency department facility. Among patients who use medication (N=145), 32% reported low adherence. More than 24% scored positive for alcohol problems based on the Alcohol Use Disorders Identification Test (AUDIT). Results of multivariate regression analysis showed that those emergency department patients who: 1) identified themselves as Hispanic, 2) reported excessive use of alcohol, 3) reported a higher number of depressive symptoms, and 4) reported a higher number of alcohol related consequences were less likely to adhere to prescribed therapy. Future investigation regarding factors related to adherence to prescribed medication among emergency department patients should take into consideration the role of alcohol and depression in this process. Further research is also needed to factor in patient's ethnicity in the context of treatment adherence.

  18. Estimating prevalence of drug and alcohol presentations to hospital emergency departments in NSW, Australia: impact of hospital consultation liaison services.

    Science.gov (United States)

    Butler, Kerryn; Reeve, Rebecca; Viney, Rosalie; Burns, Lucinda

    2016-09-30

    The impact of drug and alcohol misuse has been the subject of widespread media discussion in the past year, particularly in the context of restricted alcohol trading hours in an effort to reduce alcohol-fuelled violence. A recent study evaluating NSW Health's drug and alcohol consultation liaison (CL) services1 demonstrates how pervasive drug and alcohol problems are, and the impact they have on the health system. This paper highlights how expanding CL services to fill current unmet need could deliver a range of benefits to patients and hospitals.

  19. Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

    Directory of Open Access Journals (Sweden)

    Minna Sadeniemi

    2014-08-01

    Full Text Available Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration.

  20. Does attending general practice prior to the emergency department change patient outcomes? A descriptive, observational study of one central London general practice.

    Science.gov (United States)

    Morton, S; Hames, R; Kelso, I; Newth, A; Gnani, S

    2017-05-01

    The challenge of keeping Emergency Department (ED) attendances down continues and timely access to general practice (GP) is often portrayed as a potential solution. One London general practice (registered population = 4900). Does seeing a GP before attending the ED affect the outcome of a patient's ED care? Routine clinical data were extracted using SystmOne primary care computer system for all registered patients with an ED attendance between 1 October 2014 and 31 September 2015. The scanned discharge summaries from the ED and GP notes were reviewed and outcome measures extracted. 227 patients (121 female; 104 male) attended the ED. The most common presentation was abdominal pain (n = 11). 25% of patients had seen (n = 50), or contacted by phone (n = 6), a GP about the same presenting complaint before attending the ED. Of those, 73% (n = 41/56) were referred to the ED and 49% (n = 20/41) were admitted versus 33% (n = 60/184) who self-presented (statistically significant, p = 0.05). An additional 32% of those who saw the GP first (n = 13/41) received specialist ED treatment. Only 25% of patients see their GP prior to attending the ED. The majority of patients who were referred by their GP required admission or specialised ED treatment. It remains unclear why the majority of patients did not choose to contact their GP prior to attending the ED, despite urgent appointments being offered; research into patients' health beliefs in this group is required for greater understanding.

  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. Audit of the Transfer of DoD Service Treatment Records to the Department of Veterans Affairs

    Science.gov (United States)

    2014-07-31

    2010, an STR is a record of all essential medical, mental health, and dental care received by service members during their military career . The STR is...care repository that contains results of annual health care assessments and information from private physicians and dentists . Although the Army

  3. 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

    for layoffs ” (Chi, Arnold, & Perkins, 2003). Although the best practices in contracting among private and government services acquisition are not... ethics . Retrieved April 23, 2010, from Berkshire Hathaway Corporate Web site: http://www.berkshirehathaway.com/govern/ethics.pdf Camm, F. (2006

  4. 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…

  5. 75 FR 28035 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2010-05-19

    ... information cannot be matched because the employee is asserting that there is a mistake in the document, the..., managers, and administrators; and Individuals who may have been victims of identity theft and have chosen...). System Manager and address: Chief, Verification Division, U.S. Citizenship and Immigration Services...

  6. 78 FR 21405 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grand...

    Science.gov (United States)

    2013-04-10

    ... ceramic canteen. Site architecture and associated funerary objects indicate that the site was occupied by... County, AZ, during legally authorized excavations by the School of American Research under the direction... School of American Research, transferred to the National Park Service's Western Archeological and...

  7. 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

    ... the statement of work written so that it supports the need for a specific service? (2) Is the statement of work written so that it permits adequate evaluation of contractor versus in-house cost and performance? (3) Are the choices of contract type, quality assurance plan, competition strategy, or other...

  8. 78 FR 20680 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

    Science.gov (United States)

    2013-04-05

    ... Identification Number; Travel History; Professional Accreditation Information; Tax Records; Marriage Certificates..., injuring, forced sexual contact, limiting or denying others religious beliefs; service in military or other... documentation as necessary (e.g., birth, marriage, and/or divorce certificates, appeals or motions to reopen or...

  9. 76 FR 76032 - Schedule of Fees for Consular Services, Department of State and Overseas Embassies and Consulates

    Science.gov (United States)

    2011-12-06

    ... States currently pay the Department of State a $330 application processing fee as well as a $74 immigrant....C. 1101 note, 1153 note, 1183a note, 1351, 1351 note, 1713, 1714, 1714 note; 10 U.S.C. 2602(c); 11 U.S.C. 1157 note; 22 U.S.C. 214, 214 note, 1475e, 2504(a), 4201, 4206, 4215, 4219, 6551; 31 U.S.C...

  10. How does searching for health information on the Internet affect individuals' demand for health care services?

    Science.gov (United States)

    Suziedelyte, Agne

    2012-11-01

    The emergence of the Internet made health information, which previously was almost exclusively available to health professionals, accessible to the general public. Access to health information on the Internet is likely to affect individuals' health care related decisions. The aim of this analysis is to determine how health information that people obtain from the Internet affects their demand for health care. I use a novel data set, the U.S. Health Information National Trends Survey (2003-07), to answer this question. The causal variable of interest is a binary variable that indicates whether or not an individual has recently searched for health information on the Internet. Health care utilization is measured by an individual's number of visits to a health professional in the past 12 months. An individual's decision to use the Internet to search for health information is likely to be correlated to other variables that can also affect his/her demand for health care. To separate the effect of Internet health information from other confounding variables, I control for a number of individual characteristics and use the instrumental variable estimation method. As an instrument for Internet health information, I use U.S. state telecommunication regulations that are shown to affect the supply of Internet services. I find that searching for health information on the Internet has a positive, relatively large, and statistically significant effect on an individual's demand for health care. This effect is larger for the individuals who search for health information online more frequently and people who have health care coverage. Among cancer patients, the effect of Internet health information seeking on health professional visits varies by how long ago they were diagnosed with cancer. Thus, the Internet is found to be a complement to formal health care rather than a substitute for health professional services. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Make or Buy: A Systematic Approach to Department of Defense Sourcing Decisions for Services (An Interim Report)

    Science.gov (United States)

    2013-04-01

    Economist’s Perspective Firms are sized and organized to maximize the value of output less both the costs of production and the costs of the transactions... kinds of goods and services that firms often choose to purchase rather than produce internally. The transactions costs associated with using outside...may not lend themselves to a physical examination.11 Sourcing Decisions From a Business Management Perspective The business management literature on

  12. Oversight of Aegis’s Performance on Security Services Contracts in Iraq with the Department of Defense

    Science.gov (United States)

    2009-01-14

    Medical/ dental checks: Aegis requires all personnel to confirm that they are fit both medically and dentally prior to deployment. All individuals...are processed through the London office, where they undergo full medical/ dental checks. In addition, Aegis requires annual medical/ dental checks...To estimate the cost of government provided shelter services, we obtained a daily/per person rate charged to the government by Fluor Corporation the

  13. The United States Army Medical Department Journal. The United States Army Dental Corps: A Century of Commitment, Service, and Care

    Science.gov (United States)

    2011-03-01

    Washington, DC. 1 November 1993 – The US Army Dental Command (DENCOM) was provisionally activated in San Antonio, Texas, as a major subordinate element...first commander. (On 2 October 1994, provisional status was removed.) This action established Army dental service delivery under a dental command with...period includes prophies ( dental cleanings ) comprising 14% of the nonexamination dental procedures. TF MED policy was that all dental providers spend

  14. 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.

  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. 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.

  17. Does Increasing Home Care Nursing Reduce Emergency Department Visits at the End of Life? A Population-Based Cohort Study of Cancer Decedents.

    Science.gov (United States)

    Seow, Hsien; Barbera, Lisa; Pataky, Reka; Lawson, Beverley; O'Leary, Erin; Fassbender, Konrad; McGrail, Kim; Burge, Fred; Brouwers, Melissa; Sutradhar, Rinku

    2016-02-01

    Despite being commonplace in health care systems, little research has described home care nursing's effectiveness to reduce acute care use at the end of life. To examine the temporal association between home care nursing rate on emergency department (ED) visit rate in the subsequent week during the last six months of life. We conducted a retrospective cohort study of end-of-life cancer decedents in Ontario, Canada, from 2004 to 2009 by linking administrative databases. We examined the association between home care nursing rate of one week with the ED rate in the subsequent week closer to death, controlling for covariates and repeated measures among decedents. Nursing was dichotomized into standard and end-of-life care intent. Our cohort included 54,576 decedents who used home care nursing services in the last six months before death, where 85% had an ED visit and 68% received end-of-life home care nursing. Patients receiving end-of-life nursing at any week had a significantly reduced ED rate in the subsequent week of 31% (relative rate [RR] 0.69; 95% confidence interval [CI] 0.68, 0.71) compared with standard nursing. In the last month of life, receiving end-of-life nursing and standard nursing rate of more than five hours/week was associated with a decreased ED rate of 41% (RR 0.59, 95% CI 0.58, 0.61) and 32% (RR 0.68, 95% CI 0.66, 0.70), respectively, compared with standard nursing of one hour/week. Our study showed a temporal association between receiving end-of-life nursing in a given week during the last six months of life, and of more standard nursing in the last month of life, with a reduced ED rate in the subsequent week. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  18. The Comparison of Self-Efficacy Belief Levels on Anatomy Education between the Undergraduate Students from Physical Therapy and Rehabilitation Department and the Associate Students from Vocational School of Health Services in Western Black Sea Region

    Science.gov (United States)

    Acar, Derya; Colak, Tuncay; Colak, Serap; Gungor, Tugba; Yener, Deniz M.; Aksu, Elif; Guzelordu, Dilsat; Sivri, Ismail; Colak, Enis; Ors, Abdullah

    2017-01-01

    Physical Therapy and Rehabilitation (PTR) undergraduate degree departments and Vocational School of Health Services (VSHS) associate degree departments train healthcare professionals, which is important for both continuance of human health and treatment of various illnesses. Anatomic structures underlie the illnesses that these departments treat…

  19. 10 CFR 501.6 - Service.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Service. 501.6 Section 501.6 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS ADMINISTRATIVE PROCEDURES AND SANCTIONS General Provisions § 501.6 Service. (a..., personally or by mail, unless otherwise provided in these regulations. (b) DOE will consider service upon a...

  20. [Changing health, activity and mood Department of day care clients comprehensive social service center: training program, methods, results].

    Science.gov (United States)

    Dolgova, V I

    2016-01-01

    The comparative analysis of changes in the self-assessment of health, activity and mood of older clients (men and women) separating the daycare center of the complex of social services. Used psychodiagnostic method of self-assessment of the functional state of the differential «Test SAN» (V.A.Doskin, N.A. Lavrentiev, V.B.Sphere, M.P.Miroshnikov). The study of these states conducted before and after the implementation of targeted training programs, simulation and which goal setting made from the standpoint of the system and subject-activity approach.

  1. 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.

  2. 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

  3. The effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study.

    Science.gov (United States)

    Mustonen, Katri; Kantonen, Jarmo; Kauppila, Timo

    2017-11-28

    It has not been studied what happens to patient flow to EDs and other parts of local health care system if distances to ED services are manipulated as a part of health policy in urban areas. The present work was an observational and quasi-experimental study with a control and it was based on before-after comparisons. The impact of terminating a geographically distant suburban primary care ED on patient flow to doctors in local public primary care EDs, office-hour primary care, secondary care EDs and in private primary care was studied. The effect of this intervention was compared with a primary care system where no similar intervention was performed. The number of monthly visits to doctors in different departments of health care was scored as the main measure of the study in each department studied (e.g. in primary care EDs, secondary care ED, office-hour public primary care and private primary care). Monthly mortality rates were also recorded. Increasing the distance to ED services by terminating a peripheral ED did not cause an increase in the use of local office-hour services in those areas whose local ED was terminated, although use of ED services decreased by 25% in these areas (P primary care doctor services rather decreased - if anything - after this intervention while use of doctor services in secondary care ED remained unaffected. Doctor visits to the complementary private primary care increased but this was probably not associated with the intervention because a simultaneous increase in this parameter was observed in the control. There was no increased mortality in any age groups. Manipulating distances to ED services can be used to direct patient flows to different parts of the health care system. The correlation between distance to ED and the tendency to use ED by inhabitants is negative. If secondary care ED was available there were no life-threatening side-effects at the level of general public health when a minor ED was closed in a primary care ED

  4. Biological control of weeds: research by the United States Department of Agriculture-Agricultural Research Service: selected case studies.

    Science.gov (United States)

    Quimby, Paul C; DeLoach, C Jack; Wineriter, Susan A; Goolsby, John A; Sobhian, Rouhollah; Boyette, C Douglas; Abbas, Hamed K

    2003-01-01

    Research by the USDA-Agricultural Research Service (ARS) on biological control of weeds has been practiced for many years because of its inherent ecological and economic advantages. Today, it is further driven by ARS adherence to Presidential Executive Order 13112 (3 February 1999) on invasive species and to USDA-ARS policy toward developing technology in support of sustainable agriculture with reduced dependence on non-renewable petrochemical resources. This paper reports examples or case studies selected to demonstrate the traditional or classical approach for biological control programs using Old World arthropods against Tamarix spp, Melaleuca quinquenervia (Cav) ST Blake and Galium spurium L/G aparine L, and the augmentative approach with a native plant pathogen against Pueraria lobata Ohwi = P montana. The examples illustrated various conflicts of interest with endangered species and ecological complexities of arthropods with associated microbes such as nematodes.

  5. 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

  6. 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.

  7. Memorandum from the HR Department and the Legal Service concerning income tax declarations for 2006 in SWITZERLAND

    CERN Multimedia

    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...

  8. 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,…

  9. Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services.

    Science.gov (United States)

    2012-11-09

    This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services (DHHS) for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services. Implementing integrated services for prevention of HIV infection, viral hepatitis, STDs, and TB is intended to provide persons who use drugs illicitly with increased access to services, to improve timeliness of service delivery, and to increase effectiveness of efforts to prevent infectious diseases that share common risk factors, behaviors, and social determinants. This guidance is intended for use by decision makers (e.g., local and federal agencies and leaders and managers of prevention and treatment services), health-care providers, social service providers, and prevention and treatment support groups. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and substance use and mental disorders, use resources efficiently, and improve health-care services and outcomes in persons who use drugs illicitly. An integrated approach to service delivery for persons who use drugs incorporates recommended science-based public health strategies, including 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for infectious diseases; 5) screening, diagnosis, and counseling for infectious diseases; 6) vaccination; 7) prevention of mother-to-child transmission of infectious diseases; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical

  10. 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...

  11. United States Department of Agriculture-Agricultural Research Service stored-grain areawide integrated pest management program.

    Science.gov (United States)

    Flinn, Paul W; Hagstrum, David W; Reed, Carl; Phillips, Tom W

    2003-01-01

    The USDA Agricultural Research Service (ARS) funded a demonstration project (1998-2002) for areawide IPM for stored wheat in Kansas and Oklahoma. This project was a collaboration of researchers at the ARS Grain Marketing and Production Research Center in Manhattan, Kansas, Kansas State University, and Oklahoma State University. The project utilized two elevator networks, one in each state, for a total of 28 grain elevators. These elevators stored approximately 31 million bushels of wheat, which is approximately 1.2% of the annual national production. Stored wheat was followed as it moved from farm to the country elevator and finally to the terminal elevator. During this study, thousands of grain samples were taken in concrete elevator silos. Wheat stored at elevators was frequently infested by several insect species, which sometimes reached high numbers and damaged the grain. Fumigation using aluminum phosphide pellets was the main method for managing these insect pests in elevators in the USA. Fumigation decisions tended to be based on past experience with controlling stored-grain insects, or were calendar based. Integrated pest management (IPM) requires sampling and risk benefit analysis. We found that the best sampling method for estimating insect density, without turning the grain from one bin to another, was the vacuum probe sampler. Decision support software, Stored Grain Advisor Pro (SGA Pro) was developed that interprets insect sampling data, and provides grain managers with a risk analysis report detailing which bins are at low, moderate or high risk for insect-caused economic losses. Insect density was predicted up to three months in the future based on current insect density, grain temperature and moisture. Because sampling costs money, there is a trade-off between frequency of sampling and the cost of fumigation. The insect growth model in SGA Pro reduces the need to sample as often, thereby making the program more cost-effective. SGA Pro was validated

  12. 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

    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...... 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...... 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...

  13. 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...

  14. 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.

  15. 41 CFR 102-118.45 - How does a transportation service provider (TSP) bill my agency for transportation and...

    Science.gov (United States)

    2010-07-01

    ... transportation service provider (TSP) bill my agency for transportation and transportation services? 102-118.45... provider (TSP) bill my agency for transportation and transportation services? The manner in which your agency orders transportation and transportation services determines the manner in which a TSP bills for...

  16. 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...

  17. 20 CFR 655.1200 - What enforcement authority does the Department have with respect to a facility's H-1C Attestations?

    Science.gov (United States)

    2010-04-01

    ... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE... performing an investigation, inspection, or law enforcement function under 8 U.S.C. 1182(m) or subparts L or... of this part or any other DOL regulation promulgated under 8 U.S.C. 1182(m). (5) In the event of such...

  18. Accounting and comparing of expenditure on the medical services given at neuro-surgery department of Imam Khomeyni Hospital in the year of 1994 (1373

    Directory of Open Access Journals (Sweden)

    Abasi Moghadam M

    1998-09-01

    Full Text Available This study was focused on analysis of expenditure on all the medical services given at Neuro-Surgery Department of Imam-Khomeini Hospital in the year of 1994 (1373. In this study, all the information on descriptive method and the techniques of cost analysis and cost per unit of service provided accountancy, were analysed. 573 patients were considered in this study. 522 of them underwent 13 different types of neuro-surgery operations. 92.6% of them total departmental costs were related to current expenditures and 7.4% of that was related to the capial expenditures. The personnel costs with 49% was the highest portion of the total costs. Percentage wise, the costs were as follows: Medicine, materials and equipment 22%, food 17.6%, depreciation 7.4%, fuel, water, electricity and telephone 3.5%. The mean duration of stay was 16.3 days for every in-patient. The percentage of occupied bed was 58% if the percentage of desired bed occupancy was supposed 80%, therefore, 22% of the bed, plus 3512 bed-day were gone wasted. The real cost of med-care policy need to be more rational for the operation and hospitalization. It should be mentioned that the wasted time was 886 hours and wasted cost was 71, 708, 410 Rials in operation room.

  19. 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.

  20. Using the past to predict the future: latent class analysis of patterns of health service use of older adults in the emergency department.

    Science.gov (United States)

    Hastings, S Nicole; Whitson, Heather E; Sloane, Richard; Landerman, Lawrence R; Horney, Carolyn; Johnson, Kimberly S

    2014-04-01

    To classify older adults in the emergency department (ED) according to healthcare use and to examine associations between group membership and future ED visits and hospital admissions. Secondary analysis. Medicare Current Beneficiary Survey. Adults aged 65 and older with at least one treat-and-release ED visit between January 1, 2000, and September 30, 2007 (N = 4,964). Measures of health service use included primary care visits, treat-and-release ED visits, and hospital days in the 12 months preceding the index ED visit. Five groups of individuals in the ED with distinct patterns of health service use were identified. "Primary Carederly" (39%) had low rates of ED and hospital use and a high mean number of primary care visits. "Wellderly" (34%) had fewer visits of all types than other groups. "Chronically Illderly" (14%) had the highest mean number of primary care visits and hospital days. "Acute Carederly" (9.8%) had lowest mean number of primary care visits but higher ED visits and hospital days than all other groups except the "Sickest Elderly." Sickest Elderly (3.2%) had the highest number of ED visits; mean number of hospital days was more than four times that of any other group. Primary Carederly and Wellderly had a lower risk of hospital admission within 30 days of the index ED visit than the other groups. In older adults released from an ED, group membership was associated with future health services use. Classification of individuals using readily available previous visit data may improve targeting of interventions to improve outcomes. Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

  1. Using the Past to Predict the Future: Latent Class Analysis of Patterns of Health Service Use Among Older Emergency Department Patients

    Science.gov (United States)

    Hastings, S. Nicole; Whitson, Heather E.; Sloane, Richard; Landerman, Lawrence R.; Horney, Carolyn; Johnson, Kimberly S.

    2014-01-01

    Objectives To classify older emergency department (ED) patients by health care use and to examine associations between group membership and future ED visits and hospital admissions. Design Secondary analysis Setting Medicare Current Beneficiary Survey Participants Adults aged > = 65 years with at least one treat-and-release ED visit between 1/1/00 and 9/30/07 (N = 4,964). Measurements Measures of health service use included (1) primary care visits, (2) treat-and-release ED visits, and (3) hospital days in the 12 months preceding the index ED visit. Results Five groups of ED patients with distinct patterns of health service use were identified. "Primary Carederly" (39%) had low rates of ED and hospital use and a high mean number of primary care (PC) visits. “Wellderly" (34%) had fewer visits of all types compared to other groups. “Chronically Illderly” (14%) patients had the highest mean number of PC visits and hospital days. “Acute Carederly” (9.8%) had lowest mean number of PC visits but higher ED visits and hospital days than all other groups except the Sickest Elderly. Patients in the “Sickest Elderly” group (3.2%) had the highest number of ED visits; mean number of hospital days was more than four times that of any other group. “Primary Carederly” and “Wellderly” had a lower risk of hospital admission within 30 days of the index ED visit, while all other groups had a higher risk. Conclusion Among older patients released from an ED, group membership was associated with future health services use. Classification of patients using readily available previous visit data may improve targeting of interventions to improve patient outcomes. PMID:24635112

  2. Medicare, Medicaid, and Maternal and Child Health Services Block Grant programs; civil money penalties and assessments for false or improper claims--Department of Health and Human Services. Notice of proposed rulemaking.

    Science.gov (United States)

    1982-12-30

    These proposed regulations are intended to strengthen the Department's ability to protect the health care financing programs against persons and organizations who defraud and abuse those programs. The regulations would specify procedures for implementing the authority provided to the Department by section 2105 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35), as amended by section 137(b)(26) of the Tax Equity and Fiscal Responsibility Act of 1982 (Pub. L. 97-248), to impose civil money penalties and assessments administratively for the filing of false or certain other improper claims in the Medicare, Medicaid, or Maternal and Child Health Services Block Grant programs. The statute also permits an individual upon whom the Department imposes a civil money penalty or assessment to be suspended from participation in the Medicare and Medicaid programs. Until enactment of the civil money penalties legislation, the federal government had to rely upon litigation under the False Claims Act or criminal proceedings in order to compel restitution of funds falsely or improperly claimed under HHS health care financing programs.

  3. 42 CFR 62.8 - What does an individual have to do in return for the scholarship program award?

    Science.gov (United States)

    2010-10-01

    ... the scholarship program award? 62.8 Section 62.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.8 What does an...

  4. 49 CFR 40.373 - Before starting a PIE proceeding, does the initiating official give the service agent an...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Before starting a PIE proceeding, does the... TESTING PROGRAMS Public Interest Exclusions § 40.373 Before starting a PIE proceeding, does the initiating... initiating official must send you a correction notice before starting a PIE proceeding. (b) The correction...

  5. 20 CFR 1002.210 - What seniority rights does an employee have when reemployed following a period of uniformed service?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What seniority rights does an employee have... and Benefits Seniority Rights and Benefits § 1002.210 What seniority rights does an employee have when... and seniority-based rights and benefits that the employee would have attained if he or she had...

  6. 25 CFR 39.117 - How does a school provide gifted and talented services for a student?

    Science.gov (United States)

    2010-04-01

    ... services are provided through or under the supervision of highly qualified professional teachers. To... which the student is receiving services and the student's performance level; (4) Measurable goals and...

  7. Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?

    NARCIS (Netherlands)

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

    Objective: To investigate whether (1) education predicts the use of care services for mental health problems, independently of mental disorder and functional impairment and (2) education modifies the association between mental disorder and service use. Method: Predictors of service use were recorded

  8. 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...

  9. 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.

  10. 42 CFR 137.274 - Does this subpart cover construction programs?

    Science.gov (United States)

    2010-10-01

    ... Program; (b) Construction program functions; and, (c) Planning services and construction management... 42 Public Health 1 2010-10-01 2010-10-01 false Does this subpart cover construction programs? 137... INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction...

  11. Does it require to exclude cardiobiliary reflex in every acute coronary syndrome follow up patient with bedside ultrasound on emergency department

    Directory of Open Access Journals (Sweden)

    Mustafa Bolatkale

    2017-06-01

    Full Text Available In emergency department, physicians can diagnose pulseless electrical activity, asystole, pericardial effusions, ischemic heart disease, wall motion abnormalities, valvular cardiac disease volume status or global cardiac function evaluating with electrocardiographic findings or using bedside cardiac ultrasonography. But these two methods are not always sufficient to explain the underlying another pathologies such as pancreatitis and acute cholecystitis which can mimick acute cardiac events. Patients who are followed up with a preliminary diagnosis of acute coronary syndrome in the emergency department, might have underlying biliary or pancreatic pathologies, or even more, these might be the sole reason of the clinical picture. So bedside abdomen ultrasonography and liver enzymes may be requested in all patients with suspected cardiac pathology with a normal cardiac ultrasonography when a patient presented with acute chest or abdominal pain. Physicians must be aware for coexisting pathophysiologies and take into account the differential diagnosis of all life-threatening causes such as cardiac ischemia or acute abdominal situations. So the diagnostic tests for gallbladder pathology could be added to cardiac ultrasonography

  12. DOE occupational radiation exposure 1998 report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1998-12-31

    The U.S. Department of Energy (DOE) Office of Environment, Safety and Health with support from Environment Safety and Health Technical Information Services publishes the DOE Occupational Radiation Exposure Report. This report is intended to be a valuable tool for DOE/DOE contractor managers in managing radiological safety programs and to assist them in prioritizing resources. We appreciate the efforts and contributions from the various stakeholders within and outside DOE and hope we have succeeded in making the report more useful. This report includes occupational radiation exposure information for all monitored DOE employees, contractors, subcontractors, and visitors. The exposure information is analyzed in terms of aggregate data, dose to individuals, and dose by site. For the purposes of examining trends, data for the past 5 years are included in the analysis.

  13. "They Shouldn't Be Coming to the ED, Should They?": A Descriptive Service Evaluation of Why Patients With Palliative Care Needs Present to the Emergency Department.

    Science.gov (United States)

    Green, Emilie; Ward, Sarah; Brierley, Will; Riley, Ben; Sattar, Henna; Harris, Tim

    2017-12-01

    Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records. A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted. Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient's presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.

  14. Understanding preventive health screening services use in persons with serious mental illness: how does integrated behavioral health primary care compare?

    Science.gov (United States)

    Xiong, Glen L; Iosif, Ana-Maria; Suo, Shannon; Mccarron, Robert M; Koike, Alan; Onate, John; Carter, Cameron S

    2015-01-01

    People with serious mental illness have reduced life expectancy, in large part due to reduced access to medical services and underutilization of preventive health services. This is a cross-sectional study that compared preventive services use in an integrated behavioral health primary care clinic (IBHPC) with two existing community mental health programs. Participants completed questionnaires about preventive health services use that contained 33 questions about demographic clinical information, and use of preventive health services, from October 2010 to December 2012. Services examined included mammogram, Papanicolaou Test, prostate specific antigen, digital rectal exam, fecal occult blood test, and flexible sigmoidoscopy or colonoscopy; blood pressure, height and weight, cholesterol, and blood sugar for diabetes; and influenza immunization, Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) antibodies. A health service utilization score was developed and used as primary outcome for data analyses. In the multivariate analyses female gender (p compared to White), program type (p compared to one community mental health program (p compared another (p = 0.34). There was high variability in use of individual services among the clinical programs. More studies are needed to examine the effectiveness of integrated care in improving use of health screening services. Characteristics of the clinic in relation to use of preventive services deserve further study. © 2015, The Author(s).

  15. Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?

    Science.gov (United States)

    Gillet, Aline; Ghuysen, Alexandre; Bonhomme, Suzanne; D'Orio, Vincent; Nyssen, Anne Sophie

    2015-06-01

    To improve the communication during shift handover in an emergency department. We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care.

  16. Does High Speed Rail services influence tourists' choice? Some concerns from Paris and Roma and other linked cities

    OpenAIRE

    Marie Delaplace; FRANCESCA PAGLIARA; Julie Perrin

    2013-01-01

    Improvement of transportation has contributed to tourism expansion. Indeed tourism implies mobility and mobility needs transportation. Furthermore, transportation links the various destinations and people, goods, and services. The link between HSR services and tourism has been investigated only recently in the literature, analysing potential effects of HSR on tourism (depending on the type of tourism), and local expectation of stakeholders. This paper analyses HSR services as a potential fact...

  17. 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.

  18. 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.

  19. 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.

  20. [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.

  1. Does access to a demand-led evidence briefing service improve uptake and use of research evidence by health service commissioners? A controlled before and after study.

    Science.gov (United States)

    Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S

    2017-02-14

    The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on

  2. Does caregiver participation in decision making within child welfare agencies influence children's primary and mental health care service use?

    Science.gov (United States)

    Jolles, M P; Wells, R

    2017-03-01

    Many children in contact with child welfare agencies do not receive needed health services. These agencies have used participatory decision making (PDM) practices as a way to increase families' use of recommended services. However, we lack evidence of whether caregiver participation in PDM increases children's use of health services. This study uses a national sample of children involved with child welfare to compare their health service use between those children serve through a PDM practice and those who did not experience it. Cross-sectional analyses using the 2009-2010 National Survey of Child and Adolescent Well-Being. Propensity score analysis accounted for observed selection bias. PDM practice was measured as whether the caregiver was included in decision-making during service planning meetings. Health service use was measured as child's receipt of any primary or mental health care services in the past year. Primary health care need was measured using standardized measures and caseworker report. The sample was comprised of children ages 2-17 with primary or mental health needs in contact with a child welfare agency. In the unmatched sample of 1,358 children, 14% were served through a PDM service practice, and 12% had a primary health care and 37% a mental health need. Families served through PDM were also reported by caseworkers as more cooperative during the child welfare investigation, and with fewer reports of domestic violence and agency re-referrals (P child use of primary health services. Inclusion of caregivers in decision making may not be sufficient to overcome barriers to children's mental health service use. © 2016 John Wiley & Sons Ltd.

  3. Does Medicaid improve utilization of medical and dental services and health outcomes for Medicaid-eligible children in the United States?

    Science.gov (United States)

    Fisher, Monica A; Mascarenhas, Ana K

    2007-08-01

    Data are lacking to support the contention that Medicaid services improve utilization of healthcare services and result in better health. To compare sociodemographic, utilization of healthcare services and health status characteristics among Medicaid-eligible children. The third National Health and Nutrition Examination Survey included 2821 children 2-16 years of age eligible for Medicaid. The main outcome measures are annual physician visit, annual dentist visit, general health status, oral health status, asthma (second most common childhood disease), dental caries (most common childhood disease), asthma treatment needs, and dental treatment needs. We quantified the association of these outcome measures with Medicaid insurance status and sociodemographic status using multiple logistic regression modeling, taking into account the complex survey design and sample weights. Among Medicaid-eligible children, 27% were uninsured. Among uninsured Medicaid-eligible children, 62% had an annual physician visit, 32% had an annual dentist visit, 10% needed asthma treatment, and 57% needed dental treatment. Among insured Medicaid-eligible children, 81% had an annual physician visit, 39% had an annual dentist visit, 13% needed asthma treatment, and 42% needed dental treatment. After simultaneously taking into account other characteristics, uninsured Medicaid-eligible children were more likely to not have an annual physician visit (OR(NoMDvisit) = 2.21; 1.26-3.90), and to need dental treatment (OR(DentalNeed) = 1.57; 1.13-2.18). This USA population-based study found disparities exist within Medicaid's services between utilization of dental and medical services. Medicaid insurance improved utilization of medical services, but did not improve the utilization of dental services. This suggests that Medicaid insurance does not improve access to dental services for poor children.

  4. Does beverage type and drinking context matter in an alcohol-related injury? Evidence from emergency department patients in Latin America.

    Science.gov (United States)

    Andreuccetti, Gabriel; Carvalho, Heraclito B; Ye, Yu; Bond, Jason; Monteiro, Maristela; Borges, Guilherme; Cherpitel, Cheryl J

    2014-04-01

    Previous studies have already substantiated alcohol's causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study, a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and the drinking context is reported. Emergency department (ED) injured patients were interviewed in eight countries from the Latin American and Caribbean (LAC) region. Data on the type of alcoholic beverage, total alcohol volume, and the place where the injury occurred were obtained from patients who reported any alcohol consumption within 6h prior to being injured. Patients who did not drink prior to injury were also asked about their typical drinking pattern and the injury place. Differences within- and between-groups were evaluated regarding patients' typical drinking and drinking before injury. Beer was the most prevalent beverage type usually consumed among injured patients across countries, however, patients who drank before injury had a higher typical consumption of spirits than those not drinking prior to injury. The total alcohol volume typically consumed and drinking in public settings were also found to be positively associated with alcohol-related injury. A similar beverage-specific association with alcohol-related injury was found across LAC countries, mainly attributed to beer consumption, and spirits drinkers seem to have a greater chance of becoming involved in injury events. Future prevention strategies should inform the public about harms from drinking associated with the context in which drinking takes place. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Risk stratifying emergency department patients with acute pulmonary embolism: Does the simplified Pulmonary Embolism Severity Index perform as well as the original?

    Science.gov (United States)

    Vinson, David R; Ballard, Dustin W; Mark, Dustin G; Huang, Jie; Reed, Mary E; Rauchwerger, Adina S; Wang, David H; Lin, James S; Kene, Mamata V; Pleshakov, Tamara S; Sax, Dana K; Sax, Jordan M; McLachlan, D Ian; Yamin, Cyrus K; Swap, Clifford J; Iskin, Hilary R; Vemula, Ridhima; Fleming, Bethany S; Elms, Andrew R; Aujesky, Drahomir

    2016-12-01

    The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital setting in the U.S. and compare their performance in predicting 30-day all-cause mortality and classification of cases into low-risk and higher-risk categories. This retrospective cohort study included adults with acute objectively confirmed PE from 1/2013 to 4/2015 across 21 community EDs. We evaluated the misclassification rate of the sPESI compared with the PESI. We assessed accuracy of both indices with regard to 30-day mortality. Among 3006 cases of acute PE, the 30-day all-cause mortality rate was 4.4%. The sPESI performed as well as the PESI in identifying low-risk patients: both had similar sensitivities, negative predictive values, and negative likelihood ratios. The sPESI, however, classified a smaller proportion of patients as low risk than the PESI (27.5% vs. 41.0%), but with similar low-risk mortality rates (<1%). Compared with the PESI, the sPESI overclassified 443 low-risk patients (14.7%) as higher risk, yet their 30-day mortality was 0.7%. The sPESI underclassified 100 higher-risk patients (3.3%) as low risk who also had a low mortality rate (1.0%). Both indices identified patients with PE who were at low risk for 30-day mortality. The sPESI, however, misclassified a significant number of low-mortality patients as higher risk, which could lead to unnecessary hospitalizations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Does how much a resident teaches impact performance? A comparison of preclinical teaching hours to pathology residents’ in-service examination scores

    Directory of Open Access Journals (Sweden)

    Talmon GA

    2015-04-01

    Full Text Available Geoffrey A Talmon,1 Donna K Czarnecki,2 Harlan R Sayles3 1Department of Pathology and Microbiology, 2Educational Support Office, 3Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA Background: While others have studied the effects of resident teaching on medical student performance, few have examined the benefits to the resident educator. Our study compared the quantity of pathology residents’ didactic teaching with their performance on in-service examinations. Methods: The academic records of anatomic/clinical pathology residents over 10 years were reviewed. Scores on step I of the United States Medical Licensing Examination (USMLE®, the annual percentile on the in-service examination, and preclinical teaching hours for each resident were obtained. Results: Average annual teaching hours showed a weak positive correlation with mean in-service examination performance. Those below the 50th percentile had a lower number of teaching hours (average 7.8 than above the 50th percentile (mean 10.4, P=0.01. The incremental positive association between the two metrics increased by year in training and was strongest among senior residents, even controlling for USMLE performance (P<0.01. Conclusion: There is an association between the amount of pathology residents’ preclinical educational activity and their mean performance on in-service examinations. Keywords: residency, medical student, USMLE

  7. Selected DOE headquarters publications

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-07-01

    Selected DOE Headquarters Publications provides cumulative listings, from October 1, 1977 onward, of two groups of publications issued by headquarters organizations of the Department of Energy, and an index to their title keywords. The two groups consist of publications assigned a DOE/XXX-type report number code and headquarters contractor publications, prepared by contractors (and published by DOE) to describe research and development work they have performed for the Department. Publications such as pamphlets, fact sheets, bulletins, newsletters, and telephone directories, are omitted, as are publications issued under the DOE-tr, CONF, DOE/JPL, and DOE/NASA codes. (RWR)

  8. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: a cross-sectional comparison.

    Science.gov (United States)

    Chmiel, Corinne; Huber, Carola A; Rosemann, Thomas; Zoller, Marco; Eichler, Klaus; Sidler, Patrick; Senn, Oliver

    2011-05-09

    Emergency Departments (ED) in Switzerland are faced with increasing numbers of patients seeking non-urgent treatment. The high rate of walks-ins with conditions that may be treated in primary care has led to suggestions that those patients would best cared for in a community setting rather than in a hospital. Efficient reorganisation of emergency care tailored to patients needs requires information on the patient populations using the various emergency services currently available. The aim of this study is to evaluate the differences between the characteristics of walk-in patients seeking treatment at an ED and those of patients who use traditional out-of-hours GP (General Practitioner) services provided by a GP-Cooperative (GP-C). In 2007 and 2009 data was collected covering all consecutive patient-doctor encounters at the ED of a hospital and all those occurring as a result of contacting a GP-C over two evaluation periods of one month each. Comparison was made between a GP-C and the ED of the Waid City Hospital in Zurich. Patient characteristics, time and source of referral, diagnostic interventions and mode of discharge were evaluated. Medical problems were classified according to the International Classification of Primary Care (ICPC-2). Patient characteristics were compared using non-parametric tests and multiple logistic regression analysis was applied to investigate independent determinants for contacting a GP-C or an ED. Overall a total of 2974 patient encounters were recorded. 1901 encounters were walk-ins and underwent further analysis (ED 1133, GP-C 768). Patients consulting the GP-C were significantly older (58.9 vs. 43.8 years), more often female (63.5 vs. 46.9%) and presented with non-injury related medical problems (93 vs. 55.6%) in comparison with patients at the ED. Independent determining factors for ED consultation were injury, male gender and younger age. Walk-in distribution in both settings was equal over a period of 24 hours and most common

  9. Walk-ins seeking treatment at an emergency department or general practitioner out-of-hours service: a cross-sectional comparison

    Directory of Open Access Journals (Sweden)

    Eichler Klaus

    2011-05-01

    Full Text Available Abstract Background Emergency Departments (ED in Switzerland are faced with increasing numbers of patients seeking non-urgent treatment. The high rate of walks-ins with conditions that may be treated in primary care has led to suggestions that those patients would best cared for in a community setting rather than in a hospital. Efficient reorganisation of emergency care tailored to patients needs requires information on the patient populations using the various emergency services currently available. The aim of this study is to evaluate the differences between the characteristics of walk-in patients seeking treatment at an ED and those of patients who use traditional out-of-hours GP (General Practitioner services provided by a GP-Cooperative (GP-C. Methods In 2007 and 2009 data was collected covering all consecutive patient-doctor encounters at the ED of a hospital and all those occurring as a result of contacting a GP-C over two evaluation periods of one month each. Comparison was made between a GP-C and the ED of the Waid City Hospital in Zurich. Patient characteristics, time and source of referral, diagnostic interventions and mode of discharge were evaluated. Medical problems were classified according to the International Classification of Primary Care (ICPC-2. Patient characteristics were compared using non-parametric tests and multiple logistic regression analysis was applied to investigate independent determinants for contacting a GP-C or an ED. Results Overall a total of 2974 patient encounters were recorded. 1901 encounters were walk-ins and underwent further analysis (ED 1133, GP-C 768. Patients consulting the GP-C were significantly older (58.9 vs. 43.8 years, more often female (63.5 vs. 46.9% and presented with non-injury related medical problems (93 vs. 55.6% in comparison with patients at the ED. Independent determining factors for ED consultation were injury, male gender and younger age. Walk-in distribution in both settings was

  10. 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).

  11. Approach for conducting the longitudinal program evaluation of the US Department of Health and Human Services National Action Plan to prevent healthcare-associated infections: roadmap to elimination.

    Science.gov (United States)

    Kahn, Katherine L; Mendel, Peter; Weinberg, Daniel A; Leuschner, Kristin J; Gall, Elizabeth M; Siegel, Sari

    2014-02-01

    In response to mounting evidence about skyrocketing morbidity, mortality, and costs associated with healthcare-associated infections (HAIs), in 2009, the US Department of Health and Human Services (HHS) issued the HHS HAI Action Plan to enhance collaboration and coordination and to strengthen the impact of national efforts to address HAIs. To optimize timely understanding of the Action Plan's approach and outcomes, as well as improve the likely success of this effort, HHS requested an independent longitudinal and formative program evaluation. This article describes the evaluation approach to assessing HHS's progress and the challenges encountered as HHS attempted to transform the national strategy to HAI elimination. The Context-Input-Process-Product (CIPP) model, a structured-yet-flexible formative and summative evaluation tool, supported the assessment of: (1) the Context in which the Action Plan developed, (2) the Inputs and decisions made about selecting activities for implementation, (3) Processes or implementation of selected activities, and (4) Products and outcomes. A system framework consisting of 4 system functions and 5 system properties. The CIPP evaluation model provides a structure for tracking the components of the program, the relationship between components, and the way in which components change with time. The system framework allows the evaluation team to understand what the Action Plan is doing and how it aims to facilitate change in the healthcare system to address the problem of HAIs. With coordination and alignment becoming increasingly important among large programs within healthcare and other fields, program evaluations like this can inform the policy community about what works and why, and how future complex large-scale programs should be evaluated.

  12. Does the Use of Nursing-Care Services Reduce the Information about Dementia Patients Provided by Their Caregivers

    Directory of Open Access Journals (Sweden)

    Yu Nakamura

    2011-06-01

    Full Text Available Background: The rate of use of nursing-care services has been increasing dramatically in recent years with the upgrading of the public long-term care insurance system in Japan. We addressed how the increased use of the nursing-care services might affect the information on the patients provided by their caregivers. Methods: A questionnaire survey of 531 family caregivers caring for dementia patients at home was carried out to investigate how the use of these services might affect the information about the patients provided by the caregivers. The survey revealed that the use of the nursing-care services reduced the burden (quality, quantity, time of nursing care, and feeling on the caregivers. Results: According to the observation provided by the caregivers, the patients’ behaviors and activities at home tended to decrease. These results indicated that the use of the nursing-care services resulted in a reduction in the opportunity for and the time spent on observation of the patients by the caregivers, making it more difficult for the caregiver to provide an appropriate assessment of the patient’s condition. Conclusions: We discussed the impact of the use of the nursing-care services on the Clinician’s Interview-Based Impression of Change plus (CIBIC-plus rating. Due to the reduction in the time spent on nursing care and in the opportunity for observation of the patient’s activities of daily living by the caregiver resulting from the use of the nursing-care services, it is difficult to obtain an accurate picture of the patient’s clinical condition using the CIBIC-plus, probably leading to an inappropriate CIBIC-plus rating.

  13. How much does it cost to achieve coverage targets for primary healthcare services? A costing model from Aceh, Indonesia.

    Science.gov (United States)

    Abdullah, Asnawi; Hort, Krishna; Abidin, Azwar Zaenal; Amin, Fadilah M

    2012-01-01

    Despite significant investment in improving service infrastructure and training of staff, public primary healthcare services in low-income and middle-income countries tend to perform poorly in reaching coverage targets. One of the factors identified in Aceh, Indonesia was the lack of operational funds for service provision. The objective of this study was to develop a simple and transparent costing tool that enables health planners to calculate the unit costs of providing basic health services to estimate additional budgets required to deliver services in accordance with national targets. The tool was developed using a standard economic approach that linked the input activities to achieving six national priority programs at primary healthcare level: health promotion, sanitation and environment health, maternal and child health and family planning, nutrition, immunization and communicable diseases control, and treatment of common illness. Costing was focused on costs of delivery of the programs that need to be funded by local government budgets. The costing tool consisting of 16 linked Microsoft Excel worksheets was developed and tested in several districts enabled the calculation of the unit costs of delivering of the six national priority programs per coverage target of each program (such as unit costs of delivering of maternal and child health program per pregnant mother). This costing tool can be used by health planners to estimate additional money required to achieve a certain level of coverage of programs, and it can be adjusted for different costs and program delivery parameters in different settings. Copyright © 2012 John Wiley & Sons, Ltd.

  14. Response diversity to land use occurs but does not consistently stabilise ecosystem services provided by native pollinators.

    Science.gov (United States)

    Cariveau, Daniel P; Williams, Neal M; Benjamin, Faye E; Winfree, Rachael

    2013-07-01

    More diverse biological communities may provide ecosystem services that are less variable over space or time. However, the mechanisms underlying this relationship are rarely investigated empirically in real-world ecosystems. Here, we investigate how a potentially important stabilising mechanism, response diversity, the differential response to environmental change among species, stabilises pollination services against land-use change. We measured crop pollination services provided by native bees across land-use gradients in three crop systems. We found that bee species responded differentially to increasing agricultural land cover in all three systems, demonstrating that response diversity occurs. Similarly, we found response diversity in pollination services in two of the systems. However, there was no evidence that response diversity, in general, stabilised ecosystem services. Our results suggest that either response diversity is not the primary stabilising mechanism in our system, or that new measures of response diversity are needed that better capture the stabilising effects it provides. © 2013 John Wiley & Sons Ltd/CNRS.

  15. 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.

  16. Does respite care address the needs of palliative care service users and carers? Their perspectives and experiences.

    Science.gov (United States)

    Wolkowski, Anna; Carr, Susan M

    2017-04-02

    To establish whether respite care addresses the needs of palliative care service users and carers. Respite care is often described in UK policy and guidance as a key need to providing support for this group and yet little is known about it and there is a lack of research to support its efficacy. The approach was qualitative and the methodology was interpretive. The method used was constructivist grounded theory. Data collection was carried out by unstructured informal interview with three couples and two bereaved carers who had experienced hospice respite care. Findings showed that respite care is valued by palliative care service users and carers although there are some fundamental tensions in service models which limit its potential. A reframing of respite care as an empathic response within a new palliative care approach is proposed. Within this, the centrality of the relationship is reinforced.

  17. 21 CFR 822.4 - Does this part apply to me?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Does this part apply to me? 822.4 Section 822.4 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES POSTMARKET SURVEILLANCE General Provisions § 822.4 Does this part apply to me? If we have...

  18. 2 CFR 376.20 - Does this part apply to me?

    Science.gov (United States)

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Does this part apply to me? 376.20 Section 376.20 Grants and Agreements Federal Agency Regulations for Grants and Agreements DEPARTMENT OF HEALTH AND HUMAN SERVICES NONPROCUREMENT DEBARMENT AND SUSPENSION § 376.20 Does this part apply to me? This...

  19. 42 CFR 423.425 - Licensure does not substitute for or constitute certification.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Licensure does not substitute for or constitute certification. 423.425 Section 423.425 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Organization Compliance with State Law and Preemption by Federal Law § 423.425 Licensure does not substitute...

  20. 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...

  1. LED Provides Effective and Efficient Parking Area Lighting at the NAVFAC Engineering Service Center

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-08-12

    U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) emerging technology case study showcasing LED lighting to improve energy efficiency in parking areas at the NAVFAC Engineering Services Center.

  2. 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…

  3. A Macroecological Approach to Forecasting Fisheries Services: How much Energy Does it Take to Catch a Fish?

    Science.gov (United States)

    The U.S. Environmental Protection Agency is currently developing methods to quantify freshwater fisheries services (e.g., standing-stock abundance and/or biomass) at multiple spatial scales, and to forecast their future distributions. One approach uses linked, ecosystem process ...

  4. From quasi-market to market in the National Health Service in England: what does this mean for the purchasing of health services?

    Science.gov (United States)

    Lewis, Richard; Smith, Judith; Harrison, Anthony

    2009-01-01

    The purchasing function was first developed within the British National Health Service as part of a quasi-market introduced by a Conservative government in 1990 and retained by the Labour government on coming to power in 1997. Since 2002 further reforms in England have begun to transform the quasi-market into a 'real' market with greater diversity of supplier, including from the private sector, a payment regime designed to reward additional hospital activity and new rights for patients to choose their provider. Evidence from the quasi-market era suggests that the purchasing function made little significant impact on services for patients or shifts in the pattern of hospital provision. The new market reforms, in theory, provide an opportunity to overcome prior weaknesses in the purchasing function. As this market develops, we suggest that the purchasers should develop three new sets of skills and activities if they are to be effective: the identification of need and shaping of demand; shaping the structure of supply; and holding the market to account.

  5. 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

  6. Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

    Science.gov (United States)

    Petratos, Pythagoras

    2005-12-01

    The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System.

  7. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

    Science.gov (United States)

    Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

    2016-09-01

    This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

  8. 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.

  9. 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.

  10. 32 CFR Appendix C to Part 57 - Procedures for the Provision of Related Services by the Military Medical Departments to DoDDS...

    Science.gov (United States)

    2010-07-01

    ... PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS Pt. 57, App. C... education and related services, and oversees an EDIS evaluation used in determining a child's need for... of gross motor and fine motor adaptive skills, psychological status, and visual and audiological...

  11. 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

  12. Research on the value of medical library services: does it make an impact in the health care literature?*

    Science.gov (United States)

    Sherwill-Navarro, Pamela J.; Wallace, Addajane L.

    2004-01-01

    Objective: To evaluate the impact in the health care literature of research articles that provided evidence of the value of library services (including MEDLINE) as an element of quality health care. Data Sources/Selection: Four research articles on the relationship between use of library services and quality health care were selected as “primary articles” from a MEDLINE search using appropriate Medical Subject Heading. Primary articles met the following criteria: written in English, reported research, related to clinical care, and published before 1995. Data Extraction: The technique of citation analysis was used to measure the impact of the primary articles on the subsequent literature. The number, authorship, type, and publication venue of articles citing the primary articles were determined using ISI Web of Science, MEDLINE, other electronic resources, and the citing articles themselves. For the 146 English-language citing articles, the article type (i.e., advocacy, instructional, research) was noted; and, for those that reported research, the use to which the author put the cited material was determined. Results: The primary articles were cited more often than the average articles published that year in the same journals. At the time of the study each article had been cited almost every year since publication. Of the 146 citing articles written in English, 43% were written by librarians, 38% by physicians, 12% by librarians with physicians. The majority were published in medical journals, followed in order of decreasing frequency by the Bulletin of the Medical Library Association, information science journals, and health administration journals. Conclusions: The results of this study demonstrate that published research on the value of medical library services has an impact on the literature. These articles are read and cited and continue to be of value. PMID:14762461

  13. 31 CFR 103.41 - Registration of money services businesses.

    Science.gov (United States)

    2010-07-01

    ... registration number that may be assigned to the business at a location in the United States and for the period... (whether or not licensed as a money services business by any State) must register with the Department of.... 5330 and this section. This section does not apply to the United States Postal Service, to agencies of...

  14. Does involvement of local NGOs enhance public service delivery? Cautionary evidence from a malaria-prevention program in India.

    Science.gov (United States)

    Das, Ashis; Friedman, Jed; Kandpal, Eeshani

    2018-01-01

    Partnerships between government and non-state actors that aim to enhance the quality or efficiency of service delivery are increasingly common in today's development policy landscape. We investigate the impacts of such an approach using data from an experimental supportive intervention to India's malaria control program that leveraged local non-state capacity in order to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by 3 NGOs, contracted out by the Indian government, in 2 endemic districts in the state of Odisha. We find that program impact significantly varied by location. Examining 3 potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), we provide evidence that both population and NGO characteristics significantly affected the success of the program. Specifically, the results suggest that the quality and effort of the local implementer played a key role in the differential effectiveness. We discuss these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of health and other service delivery systems to benefit from limited non-state capacity in underresourced areas. Copyright © 2017 John Wiley & Sons, Ltd.

  15. [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.

  16. 31 CFR 370.0 - What does this part cover?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What does this part cover? 370.0 Section 370.0 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT ELECTRONIC TRANSACTIONS AND FUNDS TRANSFERS...

  17. 31 CFR 355.0 - What does this part cover?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What does this part cover? 355.0 Section 355.0 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING FISCAL AGENCY CHECKS...

  18. 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)

    2015-01-01

    82 8.6. Estimated Percentage of Reserve-Component Service Members Who Experienced a Sex -Based MEO Violation in the Past Year...fear that they would be perceived to be gay or bisexual. This suggests that men (as well as some women) might benefit from additional training to...would be wise to assess service members’ sexual orientation in future studies, as in some other contexts lesbian, gay , bisexual, and transgender

  19. The Analysis of Teacher Candidates’ Teaching Skill in Department of Biology Education, University of Borneo Tarakan, Through Pre-service Teaching Activities

    OpenAIRE

    Fitri Wijarini; Silfia Ilma

    2017-01-01

    This study aimed to know pre-service student teaching skill on Biology education by PPL activities semester 2016/ 2017. This was descriptive research in which the subject were 27 students year 2013 in Biology education program. The research assessment instrument used was the rubric fulfilled by Pre-service teachers based on observational activity during three months. The data analysis technique were data presentation and conclusion of the study. The teaching skill components observed consist ...

  20. Department of Public Administrat

    African Journals Online (AJOL)

    USER

    2014-11-08

    Nov 8, 2014 ... Department of Public Administration and Health Services Management, University of Ghana. Business School, P. O. Box LG 78, Legon, Accra. Abstract. In both development policy and practice climate change adaptation and adaptive capacity have become ..... environmental risks, and enhance adaptive.

  1. The Department of Architecture

    African Journals Online (AJOL)

    This shows a mixed development of shops, apartments and offices with parking and service access under. The second project is the work of Assefa. Bekele and is a project for a national Museum with departments for archeology, painting, sculpture, constumes etc. and an auditorium. I would like to have shown the projects of.

  2. 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

  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. 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.

  5. Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries.

    Science.gov (United States)

    Vogler, Sabine; Habimana, Katharina; Arts, Danielle

    2014-09-01

    To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. 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 STOCKS DOD Has Addressed Required Reporting Elements but Needs to Develop a Department-wide Policy...United States Government Accountability Office Highlights of GAO-16-418, a report to congressional committees April 2016 PREPOSITIONED STOCKS ...prepositions stocks --such as combat vehicles and repair parts--at locations around the world to prepare forces quickly for conflicts when needed

  7. 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

    Emergency Departments (ED) have a high flow of patients and time is often crucial. New technologies for laboratory analysis have been developed, including Point of Care Technologies (POCT), which can reduce the transport time and time of analysis significantly compared with central laboratory...

  8. 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.

  9. 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...

  10. 25 CFR 900.197 - Does FTCA cover employees of the contractor who are paid by the contractor from funds other than...

    Science.gov (United States)

    2010-04-01

    ... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND... those provided through the self-determination contract? Yes, as long as the services out of which the... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA cover employees of the contractor who are paid...

  11. 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

    the DRM capability to study federal employee retention by estimating the model on subsets of General Schedule (GS) DoD employees, focusing on the most...Areas for Future Research We simulated the responsiveness of DoD civil service employee retention to changes in com- pensation using a logically

  12. 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.

  13. Statement of the Special Libraries Association on the Department of Commerce Solicitation of Public Comment on the Study of Alternatives for Privatizing the National Technical Information Service.

    Science.gov (United States)

    Special Libraries Association, Washington, DC.

    In this response to the issues and alternatives for the proposed privatization of the National Technical Information Service (NTIS) as presented in the "Federal Register" of April 28, 1986, the Special Libraries Association (SLA) rejects outright the proposal to privatize all of its functions, and expresses its preference for keeping…

  14. Calgary Laboratory Services: A Unique Canadian Model for an Academic Department of Pathology and Laboratory Medicine Succeeding in the Face of Provincial Integration of Public, Private, and Academic Laboratories.

    Science.gov (United States)

    Wright, James R

    2015-01-01

    Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million) and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta's debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an "unhappy shotgun marriage" by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context.

  15. 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

    offenders Individual 57% 54% 63% Group 43% 46% 37% Gender of the offender( s ) Man or men only 75% 67% 87% Woman or women only 11% 16% 3% Mix of men and... Rights This document and trademark( s ) contained herein are protected by law. This representation of RAND intellectual property is provided for...to take effective actions. Sexual harassment and gender discrimination are forms of unlawful discrimi- nation that deprive service members of equal

  16. Software for pest-management science: computer models and databases from the United States Department of Agriculture-Agricultural Research Service.

    Science.gov (United States)

    Wauchope, R Don; Ahuja, Lajpat R; Arnold, Jeffrey G; Bingner, Ron; Lowrance, Richard; van Genuchten, Martinus T; Adams, Larry D

    2003-01-01

    We present an overview of USDA Agricultural Research Service (ARS) computer models and databases related to pest-management science, emphasizing current developments in environmental risk assessment and management simulation models. The ARS has a unique national interdisciplinary team of researchers in surface and sub-surface hydrology, soil and plant science, systems analysis and pesticide science, who have networked to develop empirical and mechanistic computer models describing the behavior of pests, pest responses to controls and the environmental impact of pest-control methods. Historically, much of this work has been in support of production agriculture and in support of the conservation programs of our 'action agency' sister, the Natural Resources Conservation Service (formerly the Soil Conservation Service). Because we are a public agency, our software/database products are generally offered without cost, unless they are developed in cooperation with a private-sector cooperator. Because ARS is a basic and applied research organization, with development of new science as our highest priority, these products tend to be offered on an 'as-is' basis with limited user support except for cooperating R&D relationship with other scientists. However, rapid changes in the technology for information analysis and communication continually challenge our way of doing business.

  17. 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)

  18. 34 CFR 611.43 - What are the consequences of a scholarship recipient's failure to meet the service obligation?

    Science.gov (United States)

    2010-07-01

    ... failure to meet the service obligation? 611.43 Section 611.43 Education Regulations of the Offices of the... recipient's failure to meet the service obligation? (a) Obligation to repay: General. (1) A scholarship recipient who does not fulfill his or her service obligation must— (i) Repay the Department the full amount...

  19. Assessment of hospital inpatient discharge summaries, written for general practitioners, from a department of medicine for the elderly service in a large teaching hospital.

    Science.gov (United States)

    Mc Larnon, E; Walsh, J B; Ni Shuilleabhain, A

    2016-02-01

    The discharge document summarising an acute inpatient stay in hospital is often the only means of communication between secondary and primary care. This is especially important in the elderly population who have multiple morbidities and are often on many medications. This study aimed to assess if information important to general practitioners is being included in inpatient hospital discharge summaries for patients of the medicine for the elderly service in a large teaching hospital. After a thorough literature review, a "gold standard" letter was defined as having included a discharge diagnosis, medications on discharge and follow-up plans. Forty computerised discharge summaries were retrospectively assessed for inclusion of these parameters. The study group consisted of the first eight sequentially discharged patients under the care of each of the five consultants during a 1-month period (1 September 2011-30 September 2011). A discharge diagnosis was included in 37 of the 40 summaries (92.5 %), medications on discharge were included in 39 summaries (97.5 %) and follow-up was recorded in 35 summaries (87.5 %). This study showed that the information assessed was available in the vast majority of discharge summaries for patients admitted acutely under the care of this medicine for the elderly service. Improvements can be made, including documentation of follow-up plans.

  20. 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.

  1. Financial analysis of revision knee surgery based on NHS tariffs and hospital costs: does it pay to provide a revision service?

    Science.gov (United States)

    Kallala, R F; Vanhegan, I S; Ibrahim, M S; Sarmah, S; Haddad, F S

    2015-02-01

    Revision total knee arthroplasty (TKA) is a complex procedure which carries both a greater risk for patients and greater cost for the treating hospital than does a primary TKA. As well as the increased cost of peri-operative investigations, blood transfusions, surgical instrumentation, implants and operating time, there is a well-documented increased length of stay which accounts for most of the actual costs associated with surgery. We compared revision surgery for infection with revision for other causes (pain, instability, aseptic loosening and fracture). Complete clinical, demographic and economic data were obtained for 168 consecutive revision TKAs performed at a tertiary referral centre between 2005 and 2012. Revision surgery for infection was associated with a mean length of stay more than double that of aseptic cases (21.5 vs 9.5 days, p service. Moreover, especially as greater costs are incurred for infected cases. These losses may adversely affect the provision of revision surgery in the NHS. ©2015 The British Editorial Society of Bone & Joint Surgery.

  2. 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.

  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. 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...

  5. 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,...

  6. Department of the Interior : Bison Conservation Initiative

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This framework for managing bison by the Department of the Interior (DOI) bureaus articulates a basis for improved management of the species and provides a...

  7. [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

    2016-06-23

    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

  8. 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...

  9. External Service Providers to the National Security Technology Incubator

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-02-28

    This report documents the identification and assessment of external service providers to the National Security Technology Incubator (NSTI) program for southern New Mexico. The NSTI is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant to Arrowhead Center, New Mexico State University. This report contains 1) a summary of the services to be provided by NSTI; 2) organizational descriptions of external service providers; and 3) a comparison of NSTI services and services offered by external providers.

  10. 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…

  11. The joint DoD/DOE Munitions Technology Development Program

    Energy Technology Data Exchange (ETDEWEB)

    Repa, J.V. Jr.

    1994-08-01

    The joint Department of Defense (DoD)/Department of Energy (DOE) Munitions Technology Development Program is a cooperative, jointly funded effort of research and development to improve nonnuclear munitions technology across all service mission areas. This program is enabled under a Memorandum of Understanding, approved in 1985 between the DoD and the DOE, that tasks the nuclear weapons laboratories of the DOE to solve problems in conventional defense. The selection of the technical areas to be investigated is based on their importance to the military services, the needs that are common to the conventional and nuclear weapons programs, the expertise of the performing organization, and the perceived benefit to the overall national defense efforts. The research benefits both DoD and DOE programs; therefore, funding, planning, and monitoring are joint activities. Technology Coordination Groups (TCGs), organized by topical areas, serve as technology liaisons between the DoD and DOE for the exchange of information. The members of the TCGs are technical experts who meet semiannually in an informal workshop format to coordinate multiagency requirements, establish project plans, monitor technical activity, and develop classification guidance. A technical advisory committee of senior DoD and DOE managers administers the program and provides guidance on policy and strategy. The abstracts in this volume were collected from the technical progress report for fiscal year 1993. The annual report is organized by major technology areas. Telephone and fax numbers for the principal contacts are provided with each abstract.

  12. restructuring the apartheid education departments

    African Journals Online (AJOL)

    Erna Kinsey

    1 This paper has drawn from a chapter prepared for a doctoral thesis submitted to the School of Education at the University of the Witwatersrand. 139. Changing the ... coexistence of the old and the new bureaucracy in the new Department of Education (DoE) and the impact this has had on the establishment of the new ...

  13. 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.

  14. 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.

  15. 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.

  16. IT Service

    Data.gov (United States)

    Department of Homeland Security — Means of delivering value to customers by facilitating outcomes customers want to achieve without the ownership of specific costs and risks. The term 'service' is...

  17. 31 CFR 370.36 - When does a transaction request become effective?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false When does a transaction request become effective? 370.36 Section 370.36 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT ELECTRONIC...

  18. 31 CFR 356.33 - Does the Treasury have any discretion in the auction process?

    Science.gov (United States)

    2010-07-01

    ... Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT SALE... CIRCULAR, PUBLIC DEBT SERIES NO. 1-93) Miscellaneous Provisions § 356.33 Does the Treasury have any... provide a public notice if we change any auction provision, term, or condition. (c) We reserve the right...

  19. 31 CFR 356.30 - When does the Treasury pay principal and interest on securities?

    Science.gov (United States)

    2010-07-01

    ... Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT SALE... CIRCULAR, PUBLIC DEBT SERIES NO. 1-93) Miscellaneous Provisions § 356.30 When does the Treasury pay... it under its terms, which include providing appropriate public notice. (b) Treasury inflation...

  20. 31 CFR 355.5 - What warranties does a presenting bank make?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false What warranties does a presenting bank make? 355.5 Section 355.5 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING FISCAL...