With diverse missions and multiple service provision strategies, nonprofit human services organizations have worked individually and collaboratively to create responses to social problems throughout the history of United States. This article highlights the important historic roots of the sector in understanding the scope and breadth of nonprofit human service organizations today. Challenges influencing this set of organizations, including the competing values of contracting out versus collaboration and the push-pull of grassroots or community-based versus professionalized orientations, are discussed. The article closes with important questions for nonprofit leaders and policymakers about the role of government in the human services arena.
Sarzyńska-Długosz, Iwona; Skowrońska, Marta; Członkowska, Anna
According to the recommendations of stroke organizations, every stroke patient should be treated in a specialized stroke unit (SU). We aimed to evaluate the development of the SU network in Poland during the past decade. In Poland, stroke is treated mainly by neurologists. A questionnaire evaluating structure and staff of neurological departments was sent to all neurological departments in 2003, 2005 and 2007. In 2010, we collected data based on information from the National Health Fund. We divided departments into categories: with a comprehensive SU, with a primary SU unit, and departments without an SU. Primary SUs were further divided into class A SUs (fulfilling criteria of the National Programme of Prevention and Treatment of Stroke Experts - eligible for thrombolysis), class B (conditionally fulfilling criteria), and class C (not fulfilling criteria). Final analyses included 87.4% of departments (194/222) in 2003, 85.5% of departments (188/220) in 2005, and 83.1% of departments (182/219) in 2007. According to the above-mentioned classification there were 20 class A SUs in 2003, 58 in 2005 and 5 comprehensive and 51 class A SUs in 2007. In 2012, based on information from the National Health Fund there were 150 SUs, all fulfilling criteria for thrombolysis, 9 of them comprehensive SUs. The SU network in Poland is developing dynamically but thrombolysis and endovascular procedures are done too rarely. Now it is necessary to improve quality of stroke services and to make organizational changes in the in-hospital stroke pathways as well as to organize continuous education of medical staff.
Agnew, Carson E.; Bhagat, Jai; Hopper, Edwin A.; Kiesling, John D.; Exner, Michael L.; Melillo, Lawrence; Noreen, Gary K.; Parrott, Billy J.
Mobile satellite service (MSS) has been under development in the United States for more than two decades. The service will soon be provided on a commercial basis by a consortium of eight U.S. companies called the American Mobile Satellite Consortium (AMSC). AMSC will build a three-satellite MSS system that will offer superior performance, reliability and cost effectiveness for organizations requiring mobile communications across the U.S. The development and operation of MSS in North America is being coordinated with Telesat Canada and Mexico. AMSC expects NASA to provide launch services in exchange for capacity on the first AMSC satellite for MSAT-X activities and for government demonstrations.
Graham, Laura A
In the past 20 years there have been many changes in the way that neurological rehabilitation is delivered worldwide. This is in part a reflection of improved acute medical therapies and intensive care and also related to the development of a more holistic approach to recovery, embracing the principles of the WHO International Classification of Functioning as a model for rehabilitation. Traditionally, rehabilitation services have tended to develop piecemeal according to local resources and need. By definition such services should be driven by a patient-centered approach and thus there is wide variety in service provision nationally and internationally. This chapter describes the background to current service set-ups and provision, exploring models of rehabilitation delivery and common presentations in neurological rehabilitation. Relevant legislation and guidance documents are reviewed. The text provides an overview of different aspects of rehabilitation services including acute and inpatient provision, outpatient services, community-based rehabilitation, residential facilities, and vocational services.
Full Text Available Background: Today’s healthcare organizations are challenged by pressures to meet growing population demands and enhance community health through improving service quality. Quality function deployment is one of the widely-used customerdriven approaches for health services development. In the current study, quality function deployment is used to improve the quality of chemotherapy unit services. Methods: First, we identified chemotherapy outpatient unit patients as chemotherapy unit customers. Then, the Delphi technique and component factor analysis with orthogonal rotation was employed to determine their expectations. Thereafter, data envelopment analysis was performed to specify user priorities. We determined the relationships between patients’ expectations and service elements through expert group consensus using the Delphi method and the relationships between service elements by Pearson correlation. Finally, simple and compound priorities of the service elements were derived by matrix calculation. Results: Chemotherapy unit patients had four main expectations: access, suitable hotel services, satisfactory and effective relationships, and clinical services. The chemotherapy unit has six key service elements of equipment, materials, human resources, physical space, basic facilities, and communication and training. There were four-level relationships between the patients’ expectations and service elements, with mostly significant correlations between service elements. According to the findings, the functional group of basic facilities was the most critical factor, followed by materials. Conclusion: The findings of the current study can be a general guideline as well as a scientific, structured framework for chemotherapy unit decision makers in order to improve chemotherapy unit services.
US Forest Service, Department of Agriculture — A map service on the www depicting National Grassland units designated by the Secretary of Agriculture and permanently held by the Department of Agriculture under...
@@ With strong customer demand in in ternational markets continuing, United announced today that it will deploy a larger aircraft on its Beijing-Chicago summer service; increase service on its existing route between Hong Kong and Chicago; and offer new service between Nagoya, Japan, and Taipei.
Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne
This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.
Akasaka, Fumiya; Ohno, Takehiko; Jensen, Mika Yasuoka
More and more companies are applying service design approaches to develop services and products. Not every project, however, has achieved its goals. In many cases, difficulties arise from organizational issues such as organization structure and evaluation system. In this research, we held workshops...... where success and failure factors of service design projects in organization are presented. By analysing the results, we construct a model that explains the “difficulties of deploying the service design approach in organization.” On the basis of the model, this paper discusses the challenges...... to the deployment of the service design approach in organizations....
... Research and data analytics Technology services Meeting planning Advertising Online store NEWS Media toolkit Subscribe to our ... only. Watch the the ceremony live on UNOS’ Facebook page . ‘Josh’s List’ Goes Viral Oct 25, 2016 | ...
Smith, Maureen A.; Seplaki, Christopher; Biagtan, Mark; DuPreez, Amanda; Cleary, James
Purpose: Although caregivers desire specific information about hospice programs, there is little descriptive information available. We characterized agencies that provide formal or informal hospice care in the United States according to four types of services considered important by caregivers: medications and treatments; rehabilitative care;…
US Forest Service, Department of Agriculture — A map service on the www depicting National Forest Service land units. An NFS Land Unit is nationally significant classification of Federally owned forest, range,...
...: Proposed rule. SUMMARY: NCUA proposes to amend its credit union service organization (CUSO) regulation to... complete and accurate financial information about CUSOs and the nature of their services to ensure... structure of CUSOs, the services they offer, and their financial condition. The reporting addressed in this...
Russia has all kinds of resources for the development of sports and recreation, medical, cultural, educational, business, ecological and rural tourism. One of the main problems of the organization of service in tourism is the quality of service, including the level of comfort of hotels, range of products and services, convenient location, animation programs.
Negaard, Chere; Van Fossen, Michael
Presents an annotated bibliography of 124 items published by the United Nations and 12 other international organizations in 1992-93. Themes addressed include agriculture, development, poverty eradication, trade, privatization, peace, conflict resolution, women's equality, and health issues. (LRW)
Organic waste products, potentially harmful to the human health and the environment, are primarily produced in the synthesis stage of manufacturing processes. Many such synthetic unit processes, such as halogenation, oxidation, alkylation, nitration, and sulfonation are common to...
... 7 Agriculture 10 2010-01-01 2010-01-01 false United States Customs Service. 1212.32 Section 1212... § 1212.32 United States Customs Service. “United States Customs Service” or “Customs” means the United States Customs and Border Protection, an agency of the Department of Homeland Security. Honey Packers...
Smith, S.W. [IBM T.J. Watson Research Center, Yorktown Heights, NY (United States); Pedersen, P.S. [Los Alamos National Lab., NM (United States)
With increasing numbers of commercial and government services being considered for electronic delivery, effective vulnerability analysis will become increasingly critical, Organizing sets of proposed electronic services into security taxonomies will be a key part of this work. However, brute force enumeration of services and risks is inefficient, and ad hoc methods require re-invention with each new set of services. Furthermore, both such approaches fail to communicate effectively the tradeoffs between vulnerabilities and features in a set of electronic services, and fail to scale to large sets of service. From our experience advising players considering electronic delivery, we have developed a general, systematic, and scalable methodology that addresses these concerns. In this paper, we present this methodology, and apply it to the example of electronic services offered via kiosks (since kiosk systems are representative of a wide range of security issues in electronic commerce).
Rosa E. Lillo
Full Text Available We examine the service mechanism of two queueing models with two units in tandem. In the first model, customers who complete service in Unit 1 must wait in an intermediate buffer until the ongoing service in Unit II ends. In the second model, jobs can be pre-positioned in an intermediate buffer to await service in Unit II. Under the assumption of phase-type service times, the steady-state regime of the service system is studied in detail.
Kessinger, Thomas A.
Are the following terms synonymous: service, volunteerism, community service, service-learning? This article offers a survey of service-related terms and definitions by various groups. It also shows a connection between service (and/or service- learning) and citizenship. Finally, it notes how some public and private institutions (organizations)…
Full Text Available The accelerated development of the world services trade fostered the concerns of marketing theorists and practitioners regarding the development of new strategies for adapting existing strategies in order to enhance the beneficial effects at the economic and social level of international transactions. Successful companies in the services sector have a precise, clear, competitive strategy. With a clearly outlined strategy, managers can more easily accept or reject certain initiatives and providers know how to serve customers better. Our study highlights the theories about the strategies in services. Some modalities for organizing IT and telecommunication service delivery are also exemplified.
Parsons, Mike; Scutt, Simon
Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.
The enormous variety of diagnoses and prescriptions for dealing with the health care crisis in the United States can be simplified and clarified by reference to four logically distinct models of methods for organizing the production of health services. The assumptions of the free market model, the bureaucratic planning model, the professional model and the cooperative equalitarian model are described, as are the characteristic pathologies connected with the form those models take in reality. The intrinsically expansionist character of the manufacturing, service and consumer segments of the U.S. health system is described and the suggestion made that legislative attempts to contain costs will lead to increased bureaucratization primarily at the expense of the consumer.
US Forest Service, Department of Agriculture — A map service on the www depicting units designated by the Secretary of Agriculture or previously approved by the National Forest Reservation Commission for purposes...
US Forest Service, Department of Agriculture — A map service on the www depicting geopolitical data for the entire area of the United States and territories. This includes States, Counties or Boroughs,...
... 49 Transportation 7 2010-10-01 2010-10-01 false Qualified human service organizations. 604.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.7 Qualified human service organizations. (a) A recipient may provide charter service to a qualified human service organization (QHSO)...
Schaffer, C L
Effective information management and other shared costs can reduce agencies' operating expenses as well as make new products available while providing opportunities to gain a competitive advantage. By taking a close look at ways of controlling documentation, such as the use of a management services organization for information system/computer-based management, agencies can prepare for the challenges of the next century.
Furman, C.; Roncoli, C.; Crane, T.A.; Hoogenboom, G.
Organic farmers are a prime clientele for climate services by virtue of their social profile and vulnerability of produce to climate extremes. The study draws on an online survey and in-depth interviews with organic farmers in Georgia (United States). It shows that organic farmers access and act on
US Forest Service, Department of Agriculture — Through application of a nearest-neighbor imputation approach, mapped estimates of forest carbon density were developed for the contiguous United States using the...
U.S. Geological Survey, Department of the Interior — This map service displays present and past oil and gas production in the United States, as well as the location and intensity of exploratory drilling outside...
U.S. Geological Survey, Department of the Interior — This map service displays present and past oil and gas production in the United States, as well as the location and intensity of exploratory drilling outside...
Nur Adiana Hiau Abdullah
Full Text Available This paper examines the variables that might explain the initial service charge (ISC imposed on unit-holders of Malaysian unit trust funds in the year 1999. By using 39 openend unit trust funds, customer service and board structure variables are found to have asignificant effect in explaining the variations of ISC. Financial performance variables do not seem to have any influence on the level of ISC charged to the unit-holders. Our results also showed that funds which charged higher ISC do not necessarily provide higher returns to investors. Furthermore, there are unit trust funds that are having an initial service charge beyond the maximum 10% level required by the Securities Commissions or did not fulfil the independent directors requirement.
ZONG Yi-xiang; ZHANG Hong-jie
Taking its development in Baoding City as an example, we introduced service fields of rural cooperative economic organized united association. It mainly includes setting up service platform and providing scientific and technological services; organizing economic and trade negotiation and exchange, and promoting farmer-supermarket partnership; providing financial services and solving fund-raising problems. In line with these fields, we analyzed existing problems: (i) regional development is unbalanced and organization lacks internal connection; (ii) the development in some counties (cities) is to be improved, and the promotion effect is not significant; (iii) there is shortage of talent and the innovation strength is not enough; and (iv) it lacks system and management lacks restriction mechanism. Finally, we put forward countermeasures and recommendations: strengthen propaganda and cultivate farmers’ cooperative awareness; incorporate rural cooperative economic organized united association into formal system arrangement, and absorb professional talents; innovate upon organization system of rural cooperative economic organized united association and improve service methods; improve internal operating mechanism and innovate upon working contents of rural cooperative economic organized united association at new development background.
This fact sheet describes how the National Renewable Energy Laboratory's Fleet Test and Evaluation team evaluated the 12-month, in-service performance of six Class 4 hybrid electric delivery vans - fueled by regular diesel - and six comparable conventional diesel vans operated by the United Parcel Service.
U.S. Environmental Protection Agency — This EnviroAtlas web service contains layers depicting hydrologic unit boundary layers and labels for the Subregion level (4-digit HUCs), Subbasin level (8-digit...
Witmer, J.; Gerschefske, K.
With the Joint Space Operations Center Mission Systems (JMS) focus to deploy a service-oriented architecture (SOA) environment, the Space Situational Awareness (SSA) community is moving rapidly toward a platform environment. Organizations will no longer rely entirely on systems within their boundaries. Instead, services and data are shared across organizational boundaries between diverse organizations. For SSA to succeed, JMS and similar efforts must employ and share resources across organizational boundaries (from AFSPC, to other US partners, to non-US partners and even universities). However, sharing services across organizational boundaries presents visibility and dependency issues. What information does an organization need to rely on these external services for mission critical needs? This paper presents an approach to dynamic service use agreement (SUA) negotiation that provides service platforms (and SOAs) the ability to dynamically negotiate the use of services across organizational boundaries. Using a small set of common service level agreement metadata (SLA metadata) parameters, service use can automatically be negotiated between SOAs. The Managing Aggregated Services (MASS) toolkit is designed to enable automated SUA across organizational boundaries by standardizing the service use parameters (the SLA metadata) as the foundation for SUA. The MASS toolkit demonstrates that this SUA can be done between systems as the SLA metadata provides the necessary visibility for the consuming organization into the provider organization services. The MASS toolkit also answers the question "who is using my service?" Service access can be limited to only SOAs which have negotiated an SUA, providing information security for service providers. In the highly dynamic SSA environment, where services will be provided by a variety of organizations, previous work has shown that SOA can shorten service integration from months to weeks. MASS demonstrates the potential to move this
Boyero Saavedra, Martín Ramiro
Full Text Available The service is the fundamental experience that takes place in the contact between the organization and the customer. From the adequately perform of this relationship depends retention or loss of a customer. Therefore, it is imperative that organizations visualize the service as the essential element in which lies the very meaning of their existence and relevance.The service in the organization essentially seeks to satisfy those needs that the client has, which is why we can say then that the lack of demand for services does not allow organizations to develop projects that revolve around it.Taking in count the service as an essential factor in the organization, various tools have been developed in order to have a continuous improvement in meeting the needs of customers, one of which is the CRM (Customer Relationship Management that in this article is presented as an important tool to make an impact on the services provided by the organization.
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C...—United States Customs Service 1. In general. This appendix applies to the United States Customs Service. 2. Public reading room. The public reading room for the United States Customs Service is...
Schwartz, Sara L; Austin, Michael J
Jewish Family and Children's Services of San Francisco, the Peninsula, Marin, and Sonoma Counties is a pioneering nonprofit human service organization that has delivered services for 157 years. Over the course of its history, the organization has transformed itself from an all-volunteer agency delivering aid to immigrant families during the Gold Rush era to a $30 million nonprofit human service organization offering a full-range of services to adults, children, and families. The history of Jewish Family and Children's Services sheds light on the importance of strong leadership, strategic planning, external relationships, and strong donor support.
... Employment and Training Administration International Business Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team, Payroll, Travel and Mobility... Business Machines Corporation, Global Technology Services Business Unit, Integrated Technology...
Bruynooghe, Kevin; Verhaeghe, Mieke; Bracke, Piet
Exchange theory and homophily theory give rise to counteracting expectations for the interaction between human service organizations. Based on arguments of exchange theory, more interaction is expected between dissimilar organizations having complementary resources. Based on arguments of homophily theory, organizations having similar characteristics are expected to interact more. Interorganizational relations between human service organizations in two regional networks in Flanders are examined in this study. Results indicate that human service organizations tend to cooperate more with similar organizations as several homophily effects but not one effect of dissimilarity were found to be significant. The results of this study contribute to the understanding of interorganizational networks of human service organizations and have implications for the development of integrated care.
8. 42Following the signing of the Treaty of Versailles in 1919, the Albanian State was created but with only one-half of the Albanian population...NORTH ATLANTIC TREATY ORGANIZATION, THE UNITED STATES, AND INTERNATIONAL LEGITIMACY A Monograph by MAJ Mark Van Gelder...North Atlantic Treaty Organization, The United States, and International Legitimacy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT
... Human Service Organizations and Duties for Recipients With Respect to Charter Registration Web site § 604.15 Registration of qualified human service organizations. (a) Qualified human service... human service organization resides; (3) Basic financial information regarding the qualified...
Pantouvakis, A.; Krystallis, Athanasios
Purpose: The present study attempts to bring together and combine the "Nordic" dimensions of service quality with the overall satisfaction received from the service. A relationship satisfaction measurement instrument is introduced to investigate and deploy the significant factors that contribute...... to customers' overall satisfaction. Methodology/ Approach: The results are based on a questionnaire survey in 9 major Greek Public hospitals answered by 1298 respondents. Dimensions of satisfaction are derived and confirmed with CFA whereas a multinomial logistic regression model provides evidence on its...... predictive ability to overall satisfaction. Finally, the relationship between the derived factors and socio-demographic characteristics is also examined. Findings: On the basis of the results presented qualitative and empirical evidence is provided that customer satisfaction and service quality are multi...
Frances X. Frei; Harker, Patrick T.; Larry W. Hunter
Financial services comprise over 4 percent of the gross domestic product of the United States and employ over 5.4 million people. By offering vehicles for investment of savings, extension of credit and risk management, they fuel the modern capitalistic society. While the essential functions performed by the organizations that make up the financial services industry have remained relatively constant over the past several decades, the structure of the industry has undergone dramatic change. Lib...
O'Hagan, Joshua; Persaud, David
Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.
Bliss, Norman B.; Waltman, Sharon W.; West, Larry T.; Neale, Anne; Mehaffey, Megan; Hartemink, Alfred E.; McSweeney, Kevin M.
The U.S. Soil Survey Geographic (SSURGO) database provides detailed soil mapping for most of the conterminous United States (CONUS). These data have been used to formulate estimates of soil carbon stocks, and have been useful for environmental models, including plant productivity models, hydrologic models, and ecological models for studies of greenhouse gas exchange. The data were compiled by the U.S. Department of Agriculture Natural Resources Conservation Service (NRCS) from 1:24,000-scale or 1:12,000-scale maps. It was found that the total soil organic carbon stock in CONUS to 1 m depth is 57 Pg C and for the total profile is 73 Pg C, as estimated from SSURGO with data gaps filled from the 1:250,000-scale Digital General Soil Map. We explore the non-linear distribution of soil carbon on the landscape and with depth in the soil, and the implications for sampling strategies that result from the observed soil carbon variability.
Fink, Barbara; Widom, Rebecca
The Project on Devolution and Urban Change conducted a study to learn how new welfare policies and funding mechanisms, especially devolution and Temporary Assistance for Needy Families block grants, affect human service agencies in neighborhoods with high concentrations of welfare recipients and people living in poverty. Key personnel at 106…
Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi
We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate...
In the Tibet Autonomous Region, 80 percent of residents are still living in rural pasturage areas. In addition to accomplishing the tasks assigned by upper level governments, village organizations can also offer flexible and effective public services.
In the Tibet Autonomous Region,80 percent of residents are still living in rural pasturage areas.In addition to accomplishing the tasks assigned by upper level governments, village organizations can also offer flexible and effective public services.
Statistics show about 80 percent of the people in the Tibet Autonomous Region live in the rural and pastoral areas. This points up the need for further improve-ment of village organizations and their public services.
Full Text Available The paper shows how the idea of "service orientation" may be used not as a technical principle only but also as a tool for analysis of the substance of the business - for building the process-managed organization. The principle of services as a common principle for developing the business, and organizing its IT support is used for mental overcoming of the illusory contradiction between both areas - business, and IT.
There have been five major types of correctional education organizations over the centuries: Sabbath school, traditional or decentralized, bureau, correctional school district (CSD), and integral education. The middle three are modern organizational patterns that can be implemented throughout a system: Decentralized, bureau, and CSD. The…
Organized Crime and Drug Enforcement Task Force. Hearing before the Committee on the Judiciary. United States Senate, Ninety-Eighth Congress, First Session on the Organized Crime and Drug Enforcement Task Force in the Mid-Atlantic Region Which Would Coordinate Government Agencies, Including U.S. Attorneys, the FBI, DEA, Customs Service, BATF, and the IRS. Dover, Delaware.
Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.
This document presents testimony and proceedings from the Congressional hearings on organized crime and drug enforcement in the Mid-Atlantic region, and government efforts to solve these problems. Opening statements are presented from Senators Strom Thurmond and Joseph Biden. Testimony is also presented from the United States attorneys for the…
J. Lokkerbol; R.J.M.M. Does; J. de Mast; M. Schoonhoven
Purpose - The purpose of this paper is to create actionable knowledge, thereby supporting and stimulating practitioners to improve processes in the financial services sector. Design/methodology/approach - This paper is based on a case base of improvement projects in financial service organizations.
Lokkerbol, J.; Does, R.J.M.M.; de Mast, J.; Schoonhoven, M.
Purpose - The purpose of this paper is to create actionable knowledge, thereby supporting and stimulating practitioners to improve processes in the financial services sector. Design/methodology/approach - This paper is based on a case base of improvement projects in financial service organizations.
Mirza, Mansha; Heinemann, Allen W
To examine the adequacy of existing service systems in addressing the needs of refugees with disabilities resettled in the U.S.A. A cross-disability group of eight Cambodian and seven Somali refugees were purposively selected to participate in a 2-year qualitative study in the Midwestern U.S.A. Ten disability/refugee service providers and key experts on refugee resettlement were also recruited to participate. Data sources included in-depth interviews, focus groups, participant observations and social network surveys with disabled refugees. Participant observations and semi-structured interviews were also conducted with service providers and key experts. Data were analyzed using coding procedures based on a grounded theory approach. Disabled refugee participants experienced several unmet disability-related needs and limited access to resettlement resources on account of their disability. These findings were associated with refugee service providers having limited awareness of disability rights and resources and a narrow biomedical perspective of disability. Additionally there was a disconnection between refugee and disability service systems resulting from resource limitations within agencies, mistrust between the different service entities, and a lack of cross-cultural nuance among disability service organizations. These findings contribute important insights to the literature on disability disparities. Disabled refugees resettled in the U.S.A. have many unmet needs associated with gaps in-service delivery stemming from disconnections between refugee and disability service systems.
Full Text Available Dental Service Organizations (DSOs are an up-and-coming platform for dental treatment, and are quickly becoming a lucrative business. In light of this, a closer look must be taken at the ethical foundation of these organizations to ensure that the pursuit of profit does not outweigh the best interests of the patient.
Zhang, Bo; Huang, Zhenhua; Zheng, Ziming
This paper proposes a self-organized service negotiation method for CDM in intelligent and automatic manners. It mainly includes three phases: semantic-based capacity evaluation for the CDM sponsor, trust computation of the CDM organization, and negotiation selection of the decision-making service provider (DMSP). In the first phase, the CDM sponsor produces the formal semantic description of the complex decision task for DMSP and computes the capacity evaluation values according to participator instructions from different DMSPs. In the second phase, a novel trust computation approach is presented to compute the subjective belief value, the objective reputation value, and the recommended trust value. And in the third phase, based on the capacity evaluation and trust computation, a negotiation mechanism is given to efficiently implement the service selection. The simulation experiment results show that our self-organized service negotiation method is feasible and effective for CDM.
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C... Customs Service 1. In general. This appendix applies to the United States Customs Service. It sets forth... records and accounting of disclosures. (a) For records which are maintained at the United States...
Kristensen, Niels Heine; Netterstrøm, Sune; He, Chen
Public food provision has received increased attention over the past decades from policymakers, consumers and citizens. As an example food at schools are increasingly coming into focus of change and innovation agendas. One of the most persistent agendas is the call for more organic foods...... and organic procurement schemes are developing as a strategic part of policymaker’s tools. However evidence has shown that the organic change agenda in public food service supply chains seems to be fragile. This is due to the fact that the organic agenda challenges the normal way that food service provision...... works and thus it seems not enough to implement organic food once and for all. The organic supply chain is dynamic being challenged by influences as price premiums, supply shortages and problems of convenience level. This paper investigates three Danish municipalities focusing on important elements...
Allard, Scott W; Smith, Steven Rathgeb
Medicaid reimbursements have become a key source of funding for nonprofit social service organizations operating outside the medical care sector, as well as an important tool for states seeking resources to fund social service programs within a devolving safety net. Drawing on unique survey data of more than one thousand nonprofit social service agencies in seven urban and rural communities, this article examines Medicaid funding of nonprofit social service organizations that target programs at working-age, nondisabled adults. We find that about one-quarter of nonprofit service organizations--mostly providers offering substance abuse and mental health treatment in conjunction with other services--report receiving Medicaid reimbursements, although very few are overly reliant on these funds. We also find Medicaid-funded social service nonprofits to be less accessible to residents of high-poverty neighborhoods or areas with concentrations of black or Hispanic residents than to residents of more affluent and white communities. We should expect that the role of Medicaid within the nonprofit social service sector will shift in the next few years, however, as states grapple with persistent budgetary pressures, rising Medicaid costs, and decisions to participate in the Medicaid expansion provisions contained within the 2010 Patient Protection and Affordable Care Act.
Ahmad, Ghazi; Iftikhar, Sadia
There is currently an organ shortage crisis in the United States. This paper analyzes the magnitude of the problem, the organ procurement programs in other developed countries as compared to the US, and discusses the changes that can be made to address this problem. With the opt-in or explicit-consent method currently practiced in the US, less that one third of the population consents to organ donation. In order to narrow the gap between the demand and supply of organs, steps need to be taken to improve the organ procurement infrastructure. The public needs to be educated about the dire need, the benefits and risks in organ donation, and living vs. deceased donation. [Full article available at http://rimed.org/rimedicaljournal-2016-05.asp, free with no login].
... Employment and Training Administration International Business Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team, Working From Various States..., applicable to workers of International Business Machines Corporation, Global Technology Services...
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Schaefer, Mark; Goldman, Erica; Bartuska, Ann M; Sutton-Grier, Ariana; Lubchenco, Jane
The concept of nature as capital is gaining visibility in policies and practices in both the public and private sectors. This change is due to an improved ability to assess and value ecosystem services, as well as to a growing recognition of the potential of an ecosystem services approach to make tradeoffs in decision making more transparent, inform efficient use of resources, enhance resilience and sustainability, and avoid unintended negative consequences of policy actions. Globally, governments, financial institutions, and corporations have begun to incorporate natural capital accounting in their policies and practices. In the United States, universities, nongovernmental organizations, and federal agencies are actively collaborating to develop and apply ecosystem services concepts to further national environmental and economic objectives. Numerous federal agencies have begun incorporating these concepts into land use planning, water resources management, and preparations for, and responses to, climate change. Going forward, well-defined policy direction will be necessary to institutionalize ecosystem services approaches in federal agencies, as well as to guide intersector and interdisciplinary collaborative research and development efforts. In addition, a new generation of decision support tools are needed to further the practical application of ecosystem services principles in policymaking and commercial activities. Improved performance metrics are needed, as are mechanisms to monitor the status of ecosystem services and assess the environmental and economic impacts of policies and programs. A greater national and international financial commitment to advancing ecosystem services and natural capital accounting would likely have broad, long-term economic and environmental benefits.
Full Text Available The literature on innovation suggests that projects are successful when rigorous project management is mixed judiciously with 'organic' development. This paper argues that organic growth can play a substantial role in the implementation of electronic services in healthcare settings. Evidence for organic growth is presented, based on a study of email use. Methods are presented for investigating email use in health service settings in the National Health Service (NHS in Bradford, England. Geographical information systems (GIS outputs and social network analyses are presented. The results demonstrate a fivefold increase in the use of email over a 13-month period, which is shown to be largely independent of the growth in the number of organisations using the network. They also demonstrate a marked increase in the complexity of the patterns of email use over the period.
Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli
It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.
Anglin, Richard L., Jr.
Numbers of systems exist or have been proposed to provide world-wide mobile satellite services (MSS). Developers of these systems have formulated institutional structures they consider most appropriate for profitable delivery of these services. MSS systems provide niche services and complement traditional telecommunications networks; they are not integrated into world-wide networks. To be successful, MSS system operators must be able to provide an integrated suite of services to support the increasing globalization, interconnectivity, and mobility of business. The critical issue to enabling 'universal roaming' is securing authority to provide MSS in all of the nations of the world. Such authority must be secured in the context of evolving trends in international telecommunications, and must specifically address issues of standardization, regulation and organization. Today, only one existing organization has such world-wide authority. The question is how proponents of new MSS systems and services can gain similar authority. Securing the appropriate authorizations requires that these new organizations reflect the objectives of the nations in which services are to be delivered.
... Fiscal Service Financial Management Service; Proposed Collection of Information: Claim Against the United States for the Proceeds of a Government Check AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of...
Randhawa, G; Neuberger, J
At a national policy level, the United Kingdom is at the forefront of recognizing the role of faith and its impact on organ donation. This is demonstrated by the recommendations of the Organ Donation Taskforce, National Institute for Clinical Excellence guidelines on organ donation, All-Party Parliamentary Kidney Group, and National Black, Asian and Minority Ethnic Taskforce Alliance. Evidence to date shows that further thought is required to ensure the active engagement of faith communities with organ donation in the UK. The "Taking Organ Transplantation to 2020" strategy was launched in July 2013 by National Health Service Blood and Transplant (NHSBT) in collaboration with the Department of Health and Welsh, Scottish, and Northern Irish governments and seeks to increase the number of people, from all sections of the UK's multiethnic and multifaith population, who consent to and authorize organ donation in their life. NHSBT seeks to work in partnership with faith leaders and this culminated in a Faith and Organ Donation Summit. Faith leaders highlight that there is a need for engagement at both national and local levels concerning organ donation as well as diagnosis and definition of death.
Full Text Available There is a growing interest among scholars, practitioners and organizations as to how design may benefit management, particularly when this happens in a service context. In this exploratory qualitative study, I investigate such a multi-disciplinary intersection with the aim of better understanding how service design may be of value for leaders in service organizations on a strategic level. The research draws on a service design approach called AT-ONE. Addressed are ways that the strategic use of service design may influence attitudes and transformation in service organizations. The study presents views from the designers, implementers and users of this approach, supported by participant observation and interviews. This was done through in-depth qualitative interviews with the AT-ONE project members and designer, with the service design professional company involved, and leaders from the businesses participating in the project and workshop sessions. These were observed by the researcher. Drawing on the findings of this exploratory study, some implications for the field of service design management at the corporate level are offered.
Holosko, M J; Leslie, D R; Cassano, D R
This article presents an empowerment model (EM) to be used by service users in human service organizations (HSOs). The EM is a structure for service user input to be integrated within the HSO at various administrative levels through a four-step sequential process. The article fills a distinct void in the literature as there are numerous accounts about the importance of empowerment, but few on processes that need to be defined to operationalize the concept. Implications are directed toward administrators as they need to take leadership in implementing the EM in order to deliver more efficient and relevant services to their clients.
... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Services rendered by Cuba to United... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 515.548 Services rendered by Cuba to United States aircraft. Specific licenses are issued for payment to Cuba of charges for services...
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri
Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri
Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…
Large-scale decentralized systems organized in overlay networks are complex to manage. Such systems integrate organizational complexity in the application-level resulting in low abstraction and modularity in their services. This thesis introduces a multi-level conceptual architecture for overlay
M.P.A. van Oosterhout (Marcel)
textabstractService organizations have to deal with highly uncertain events, both in the internal and external environment. In the academic literature and in practice there is not much knowledge about how to deal with this uncertainty. This PhD dissertation investigates the role and impact of inform
Large-scale decentralized systems organized in overlay networks are complex to manage. Such systems integrate organizational complexity in the application-level resulting in low abstraction and modularity in their services. This thesis introduces a multi-level conceptual architecture for overlay ser
Large-scale decentralized systems organized in overlay networks are complex to manage. Such systems integrate organizational complexity in the application-level resulting in low abstraction and modularity in their services. This thesis introduces a multi-level conceptual architecture for overlay ser
Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena
The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.
Alexander I. Travnikov
Full Text Available In the present article author reveals the order of creation, structure, aims and objectives of national and international intergovernmental aeronautical organizations, governing procedure for flight operations and providing direct air traffic control over sovereign territory and abroad. In this article, author notes that in the world there are three main organizational and legal forms of air traffic control systems to ensure coordination between civil and military air navigation services (agencies. In the Russian Federation, author notes that air navigation services on behalf of the State are made by the State Corporation for Air Traffic Management that has the legal status of the commercial organization - the Federal State Unitary Enterprise. Author analyzes the work of the Organization for the Civil Air Navigation Services (CANSO, the International Federation of Air Traffic Controllers (IFATCA. During the study author also concludes that in the past decade, there is the steady trend of transferring functions of air navigation from the State to commercial organizations (joint stock companies and limited liability companies, which are financed from the funds received as payment for air traffic services. The responsibility for the improper maintenance of international air navigation, of course, is borne by the State. Author notes that regional and international intergovernmental aeronautical organizations operate in respect of all aircraft (public, civil, experimental, i.e., perform general air navigation, unlike ICAO, which takes standards and recommended practices, rules and procedures for safety and air traffic services only to civil aircraft, that does not ensure the creation of a regulatory framework for the global unification of aeronautical processes.
Martos, Alexander J; Wilson, Patrick A; Meyer, Ilan H
LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.
Wilson, Patrick A.; Meyer, Ilan H.
Background LGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs. Methods This study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by “LGBT community health centers” today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September–December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop. Findings LGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services. Conclusions LGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people
Jones, Rachel K; Jerman, Jenna
Following a long-term decline, abortion incidence stabilized between 2005 and 2008. Given the proliferation of state-level abortion restrictions, it is critical to assess abortion incidence and access to services since that time. In 2012-2013, all facilities known or expected to have provided abortion services in 2010 and 2011 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. Incidence of abortions was assessed by provider type and caseload. Information on state abortion regulations implemented between 2008 and 2011 was collected, and possible relationships with abortion rates and provider numbers were considered. In 2011, an estimated 1.1 million abortions were performed in the United States; the abortion rate was 16.9 per 1,000 women aged 15-44, representing a drop of 13% since 2008. The number of abortion providers declined 4%; the number of clinics dropped 1%. In 2011, 89% of counties had no clinics, and 38% of women of reproductive age lived in those counties. Early medication abortions accounted for a greater proportion of nonhospital abortions in 2011 (23%) than in 2008 (17%). Of the 106 new abortion restrictions implemented during the study period, few or none appeared to be related to state-level patterns in abortion rates or number of providers. The national abortion rate has resumed its decline, and no evidence was found that the overall drop in abortion incidence was related to the decrease in providers or to restrictions implemented between 2008 and 2011. Copyright © 2014 by the Guttmacher Institute.
Danielle Faust Cruz
Full Text Available It is growing the importance of services sector in the global economy. Facing a global and dynamic market, characterized by fierce competition, Competitive Intelligence - CI can help services organizations in decision making process and in the conception of competitive advantages against competitors. This paper aims to outline the state of art concerning the use of competitive intelligence in the services sector organizations, through research and analysis of articles found in major databases. This is a theoretical study consisting of a systematic literature review including bibliometric and content analysis. Relevant publications were retrieved in the following data bases related to the subject: Web of Knowledge, Scopus, Ebsco, ScienceDirect, and Engineering Village. The results allow considering the importance of competitive intelligence for survival and competitiveness of services organizations. Finally, it was verified the existence of a gap related to prescriptive studies, focusing on investigations about the subject, being this type of study relevant to the area to reach maturity
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Penteado, Eliane Villas Bôas de Freitas; de França, Maria Goretti; Ramalhoto, Ana Maria de Brito; de Oliveira, Ana Maria; Machado, Bruno Rangel Cortoppassi; Genipapeiro, Joana Angélica Matos
This article discusses the implementation of ergonomics in a service unit of a major company in the energy sector. From the perspective of management, it analyses the process of implementation of ergonomics programmes in four operational areas. The objective was to diagnose the level of implementation of ergonomics. The study is descriptive, undertaken through the interaction with the technical staff of the operational areas involved, incorporating the perception of these role players concerning their work routines. The results indicated significant differences in the level of implementation of the programmes, especially those concerning structural conditions. Important conquests were registered, such as the investment in the training of specialists, the establishment of a facilitator network and the improvement of the standard for the directioning and alignment of the execution of initiatives. The linking in of the programmes with those of occupational health management emphasises its contribution to the safety and well-being of the workforce through interventions aimed mainly at eliminating and reducing ergonomic biomechanical risks. However, the need to broaden and deepen the ergonomic approach regarding organizational and cognitive aspects, as well as the insertion of ergonomics in project design of new work spaces and processes were also identified.
Full Text Available This paper reviews the progress in the line of research on Service Organizations at IDOCAL (Research Institute on Personnel Psychology, Organizational Development, and Quality of Working Life, University of Valencia, and its integration with international research efforts. The investigation we have carried out has as a common general objective the compatibility of the well-being and performance of workers (the latter in terms of service quality to users, in accordance with the strategy of the European Union to end the crisis. The main topics covered are service quality, service climate, well-being, and organizational justice. In general, our indings indicate the existence of positive synergies between well-being and performance in the service sector.
Yang, Jun; Guo, Aimin; Wang, Yadong; Zhao, Yali; Yang, Xinhua; Li, Hang; Duckitt, Roger; Liang, Wannian
We report a study on the developmental status of human resource staffing and service functions of community health services (CHS) in China and offer recommendations for improving the CHS in the future. A study questionnaire was completed by 712 CHS organizations distributed in 52 cities and districts in all areas of China using a multilevel stratified randomized sampling method. Data were collected on the backgrounds, human resources, and service functions of CHS organizations. We found that 68.2% of doctors and 86.5% of nurses employed in CHS centers have low-level medical training. The doctor-nurse ratio in CHS centers is 1.2 to 1 and in CHS stations is 1.3 to 1. More than 50% of CHS organizations have developed on-the-job training programs, causing cost trends for staff training to increase. Although the delivery of basic clinical services and public health services is steadily increasing, 58.6% of stations are open less than 12 hours per day. Health records are established in a high proportion of CHS organizations. Two kinds of health education--general public health education, and personal education for specific problems--have been adopted by more than 92% of CHS centers and 90% of CHS stations. Desired functions for CHS organizations have been partially achieved. Training for doctors and nurses engaged in CHS should be promoted and improved as quickly as possible. Training in basic clinical services and management of noncommunicable chronic diseases should be strongly promoted. Changes in government policies should be pursued to promote effective support for the development of CHS.
Kong, Guo-Qiang; Han, Zhi-Da; He, Yabing; Ou, Sha; Zhou, Wei; Yildirim, Taner; Krishna, Rajamani; Zou, Chao; Chen, Banglin; Wu, Chuan-De
Two new organic building units that contain dicarboxylate sites for their self-assembly with paddlewheel [Cu2(CO2)4] units have been successfully developed to construct two isoreticular porous metal-organic frameworks (MOFs), ZJU-35 and ZJU-36, which have the same tbo topologies (Reticular Chemistry Structure Resource (RCSR) symbol) as HKUST-1. Because the organic linkers in ZJU-35 and ZJU-36 are systematically enlarged, the pores in these two new porous MOFs vary from 10.8 Å in HKUST-1 to 14.4 Å in ZJU-35 and 16.5 Å in ZJU-36, thus leading to their higher porosities with Brunauer-Emmett-Teller (BET) surface areas of 2899 and 4014 m(2) g(-1) for ZJU-35 and ZJU-36, respectively. High-pressure gas-sorption isotherms indicate that both ZJU-35 and ZJU-36 can take up large amounts of CH4 and CO2, and are among the few porous MOFs with the highest volumetric storage of CH4 under 60 bar and CO2 under 30 bar at room temperature. Their potential for high-pressure swing adsorption (PSA) hydrogen purification was also preliminarily examined and compared with several reported MOFs, thus indicating the potential of ZJU-35 and ZJU-36 for this important application. Studies show that most of the highly porous MOFs that can volumetrically take up the greatest amount of CH4 under 60 bar and CO2 under 30 bar at room temperature are those self-assembled from organic tetra- and hexacarboxylates that contain m-benzenedicarboxylate units with the [Cu2(CO2)4] units, because this series of MOFs can have balanced porosities, suitable pores, and framework densities to optimize their volumetric gas storage. The realization of the two new organic building units for their construction of highly porous MOFs through their self-assembly with [Cu2(CO2)4] units has provided great promise for the exploration of a large number of new tetra- and hexacarboxylate organic linkers based on these new organic building units in which different aromatic backbones can be readily incorporated
Austin, Michael J
This analysis describes the nature of a learning organization, defines the boundaries of evidence-informed practice, identifies the elements of knowledge management, and specifies the elements of the transfer of learning. A set of principles are presented to guide managers in transforming human service organizations into learning organizations along with a set of implementation strategies that can inform participants of the values and benefits of knowledge management. This analysis features concepts and principles adapted and synthesized from research in diverse fields, such as evidence-based health care and the for-profit sector related to learning organizations, knowledge management, and the transfer of learning.
US Forest Service, Department of Agriculture — A map service on the www that depicts sixty-seven maps from Royce’s 1897 report that have been scanned, georeferenced in JPEG2000 format, and digitized to create...
M. D. Vadhvani
Full Text Available Role of service sector can be considered vital as these industries are accountable for accelerating the major functions of the secondary organizations. Hence it is a very important element of economy in enhancing competitive dimensions- quality, flexibility, cost and delivery. Improvement initiatives such as Total Quality Management, Lean Practices, and Leansigma focus on increasing the competitive dimensions. Among these Lean Practices are having the inherent principles of reducing the cost and increasing the quality by focusing the non value added activities from the value chain of the service or product. Lean Principles (LPs are being practiced since long by the organizations of secondary sectors and followed by that of the tertiary sectors. Albeit the reported improvement achieved are limited by the drawbacks such as lack of proper set of guidelines, partial features of measurable characteristics, lack of guideline for measurement. Present work proposes a measurement frame work with aids of flowchart and questionnaire for measuring the potential of LPs in service organization which help them to take accompanying initiatives to implement the LPs.
Full Text Available Efforts to enlist small faith-related organizations as partners in public service delivery raise many questions. Using community social service networks as the unit of analysis, this paper asks one with broader relevance to nonprofit sector managers: What factors support and constrain effective integration of these organizations into a local service delivery network? The evidence and illustrations come from longitudinal case studies of five faith-related organizations who received their first government contract as part of a California faith-based initiative. By comparing the organizational development and network partnership trajectories of these organizations over more than a decade, the analysis identifies four key variables influencing partnership dynamics and outcomes: organizational niche within the local network; leadership connections and network legitimacy; faith-inspired commitments and persistence; and core organizational competencies and capacities. The evidence supports shifting the focus of faith-based initiatives to emphasize local planning and network development, taking into account how these four variables apply to specific organizations and their community context.
Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R
Involvement by residents in professional medical organizations can enrich their training, but little data exist regarding the number and types of involvement opportunities available to otolaryngology residents. We sought to fill this gap in knowledge by quantifying the extent to which major otolaryngology-related organizations in the United States provide involvement opportunities to otolaryngology residents. Our analysis included 23 organizations and subspecialty societies. Results showed that many opportunities exist for residents to attend conferences and present research; however, fewer involvement and funding opportunities existed in any other leadership, health policy, or service-learning experiences. These findings were consistent across general and subspecialty societies. Given the many purported benefits of resident involvement in otolaryngology outside of the standard training environment, future efforts may be warranted to increase the number and type of involvement opportunities currently available in professional societies.
Mick, Stephen S; Mark, Barbara A
We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Coordination with United States Customs Service... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.8 Coordination with United States Customs Service. (a) Nothing in this part shall preclude examination of imported materials pursuant to the Customs laws...
This student guide is for Unit 5, Fuel and Carburetion Systems, in the Engine Tune-Up Service portion of the Automotive Mechanics Curriculum. It deals with inspecting and servicing the fuel and carburetion systems. A companion review exercise book and posttests are available separately as CE 031 218-219. An introduction tells how this unit fits…
Human Resources Research Organization, Fort Knox, KY. Div. 2.
A study was conducted to ascertain the job requirements and training needs of juvenile service unit workers. A training needs assessment inventory questionnaire was mailed to all juvenile service unit workers in the Kentucky Department of Child Welfare (DCW). Data from 146 questionnaires were analyzed to provide job descriptive information, which…
... 40 Protection of Environment 3 2010-07-01 2010-07-01 false United States Postal Service substitute Clean Fuel Fleet Program. 52.351 Section 52.351 Protection of Environment ENVIRONMENTAL PROTECTION... § 52.351 United States Postal Service substitute Clean Fuel Fleet Program. Revisions to the...
This exciting volume explores the role of technical services functions and organizational structure as forces in the library change process. It provides practical information to help administrators make decisions about how their libraries are organized and managed. As libraries change in many ways--organizational structure, design of jobs, managerial philosophy, responsibilities of professionals, and the impact of automation--librarians in technical services, administrators, and personnel officers--need guidance in meeting the new challenges in order to continue providing thorough efficient se
Full Text Available The advantages of usage of cloud technologies, particularly, of Gmail service Google Apps in work of organizational-educational units of higher educational institutions are analyzed in this work. The main accents are put concerning usage of corporate e-mail Gmail service Google Apps, with the help of which informational-analytical support of activity of organizational-educational units of the University is provided. The author of the publication underlines key advantages of Gmail and analyses its opportunities. Main characteristics of corporate e-mail Gmail service Google Apps are described. It is identified that implementation of corporate e-mail Gmail service Google Apps is a part of creation of certain information system, that will ensure united information space of a modern higher educational institution. Effective organization of educational process, that was used by methodist of organizational-educational units (Scientific-methodological centre of research, scientific projects and programs of Borys Grinchenko Kyiv University in the work of corporate mail Gmail service Google Aps is analyzed and presented. It is identified, that creation and improvement of mechanisms of building corporate content with the help of Gmail service Google Apps will allow the collaborators of organizational-educational units of the higher educational institution to plan and organize educational process. Such organization of educational process optimizes the activity of organizational-educational units of higher educational institutions.
Georgopoulos, B S
A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.
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Tanushree Biswas; Mike Walterman; Paul Maus; Kevin A. Megown; Sean P. Healey; Kenneth. Brewer
The Food and Agricultural Organization (FAO) of the United Nations conducted a global assessment for forest change in 2010 using satellite imagery from 1990, 2000, and 2005. The U.S. Forest Service was responsible for assessing forest change in the United States. A polygon-based, stratified sampling design developed by FAO was used to assess change in forest area...
Packard, Thomas; Patti, Rino; Daly, Donna; Tucker-Tatlow, Jennifer
This is a study of organizational change strategies employed in seven county human service agencies to improve the coordination of services through the structural integration of previously free standing organizations or the development of voluntary interagency collaborative service delivery systems. The central question involves the identification of organizational change tactics which contributed to the success of the organizational change initiatives. The literature on organizational change is reviewed, with particular attention to a framework developed by Fernandez and Rainey based on their extensive review and synthesis of the research on successful change strategies in the public and business sectors. Qualitative and quantitative data were gathered from over 250 individuals and from agency documents. Findings are compared with the success factors identified by Fernandez and Rainey, and refinements to their propositions are suggested. More precise methods for measuring successful and unsuccessful change initiatives are suggested. Implications for practice and research are presented.
Zhang, Yong; Parilla, P. A.; Ahrenkiel, S. P.; Mascarenhas, A.; Islam, Z.; Ren, Y.; Lee, P. L.; McNevin, M. J.; Naumov, I.; Fu, H. X.; Huang, X. Y.; Li, J.
Designing inorganic-organic hybrid materials in a nanoscopic scale allows taking the full advantage of the two worlds, which has recently been demonstrated in a new family of hybrid crystalline materials that are the fully ordered assemblies of sub-nanometer scale inorganic units (e.g., few monolayer-thick slab, single atomic chain) and organic molecules.They have been shown to exhibit a number of unique properties that are not readily available in either of the components or their nanostructures: for instance, strongly enhanced exciton-polariton absorption and exciton binding energy, a massive bandgap blue shift (˜ 2 eV) from that of the bulk inorganic semiconductor, and fine-tuning of thermal expansion and achieving zero-thermal expansio. They have great potential for applications in areas including transparent conducting materials, thermoelectric materials, UV optoelectronic devices, because of their unusual electronic, vibrational and optical properties and the flexibility in tailoring the material properties adapting to the specific application requirements. . X. H. Huang et al., JACS 125, 7049 (03).  Y. Zhang et al., PRL 96, 26405 (06).  B. Fluegel et al., PRB 70, 205308 (04).  Y. Zhang et al., PRL 99, 215901 (07).
There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
van der Ster, Daniel; Wiebalck, Arne
Emerging storage requirements, such as the need for block storage for both OpenStack VMs and file services like AFS and NFS, have motivated the development of a generic backend storage service for CERN IT. The goals for such a service include (a) vendor neutrality, (b) horizontal scalability with commodity hardware, (c) fault tolerance at the disk, host, and network levels, and (d) support for geo-replication. Ceph is an attractive option due to its native block device layer RBD which is built upon its scalable, reliable, and performant object storage system, RADOS. It can be considered an "organic" storage solution because of its ability to balance and heal itself while living on an ever-changing set of heterogeneous disk servers. This work will present the outcome of a petabyte-scale test deployment of Ceph by CERN IT. We will first present the architecture and configuration of our cluster, including a summary of best practices learned from the community and discovered internally. Next the results of various functionality and performance tests will be shown: the cluster has been used as a backend block storage system for AFS and NFS servers as well as a large OpenStack cluster at CERN. Finally, we will discuss the next steps and future possibilities for Ceph at CERN.
Sweeney, R E; Franklin, S P
This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.
Aida Azlina Ali
Full Text Available Objectives : To study the Drug Information Service (DIS awareness program organized by a DIS unit in Malaysian hospital through utilization of provided services by the healthcare professionals, allied healthcare providers, patients and the public, and to identify the characteristics of inquiries received. Materials and Methods : An awareness program to promote the services of the DIS unit was held throughout the month of March in 2010. Drug information queries forms that have been documented six months prior to (September 2009-February 2010 and six months after (April-September 2010 the awareness program were collected and assessed. Mean monthly inquiries volumes pre- and post-program were compared to evaluate the effectiveness of the program. Types of information requestors, inquiries, reference sources, and drug class information were identified and evaluated. Results: A total of 747 drug information queries forms were received during the study period. The mean total utilization of the DIS unit services after (63.67 ± 18.24 the DIS awareness program was increased but not significant (P < 0.05 when compared to records before (60.83 ± 21.49 the program. Majority of the DIS service users were the pharmacist (67.5%, followed by the doctors (24.9%. Most inquiries were regarding the dosage and route of administration of drugs (61.4%. The most frequently referred sources of information were the Micromedex and the Internet (37.3%. The most common inquiries were related to the anti-infective agents (37.8%. Conclusion: Provision of sufficient and accurate drug information to the healthcare professionals, patients, and the public is crucial to ensure optimization of therapy. The utilization of services provided by the DIS unit should be supported. Frequent DIS awareness program should be undertaken to promote and encourage the use of services.
Fung-Kee-Fung, M.; Kennedy, E.B.; Biagi, J.; Colgan, T.; D’Souza, D.; Elit, L.M.; Hunter, A.; Irish, J.; McLeod, R.; Rosen, B.
Background A system-level organizational guideline for gynecologic oncology was identified by a provincial cancer agency as a key priority based on input from stakeholders, data showing more limited availability of multidisciplinary or specialist care in lower-volume than in higher-volume hospitals in the relevant jurisdiction, and variable rates of staging for ovarian and endometrial cancer patients. Methods A systematic review assessed the relationship of the organization of gynecologic oncology services with patient survival and surgical outcomes. The electronic databases medline and embase (ovid: 1996 through 9 January 2015) were searched using terms related to gynecologic malignancies combined with organization of services, patterns of care, and various facility and physician characteristics. Outcomes of interest included overall or disease-specific survival, short-term survival, adequate staging, and degree of cytoreduction or optimal cytoreduction (or both) for ovarian cancer patients by hospital or physician type, and rate of discrepancy in initial diagnoses and intraoperative consultation between non-specialist pathologists and gyne-oncology–specialist pathologists. Results One systematic review and sixteen additional primary studies met the inclusion criteria. The evidence base as a whole was judged to be of lower quality; however, a trend toward improved outcomes with centralization of gynecologic oncology was found, particularly with respect to the gynecologic oncology care of patients with advanced-stage ovarian cancer. Conclusions Improvements in outcomes with centralization of gynecologic oncology services can be attributed to a number of factors, including access to specialist care and multidisciplinary team management. Findings of this systematic review should be used with caution because of the limitations of the evidence base; however, an expert consensus process made it possible to create recommendations for implementation. PMID:26300679
Full Text Available Abstract The purpose of this research to analyzing the process of the management of internal integration in an effort to improve public services in the secretariat of the city .In the research results seen that there are culture of bubuhan familial in the management of internal integration in the secretariat of the city of samarinda through a the creation of a language together and conceptual categories in b the distribution of power and status c establishment norms closeness of a working relationship peers and d the application of the award and punishment. In addition to want to answer a desire as well as the need for public service excellence service unit to improve integrated permit handling UPT integrated permit handling services agency one gate BPPTSP capital city of samarinda . In the management of internal integration process in cultural organization that takes the conceptculture of bubuhan must be planned carefully and without prejudice to the rules of law applicable because if not handled wisely can be counter-productive with the vision and mission of Samarinda Government because it can cause a client patron relations which can actually inhibit the organization in achieving its vision and mission.
Service orientation is a broadly discussed design paradigm for information systems engineering. Only recently there have been several contributions to individual dimensions of service orientation like service definition, service modeling, service management or service governance. However, a combination of useful solutions for partial problems might not constitute an effective overall approach to service orientation. We argue that the establishment of service orientation is a wicked [design] p...
Lindsay, Patrice; Furie, Karen L; Davis, Stephen M; Donnan, Geoffrey A; Norrving, Bo
, particularly in the realm of primary prevention. Despite differences in resource availability, the message we wish to convey is that stroke awareness, education, prevention, and treatment should always be feasible. Communities and institutions should set goals to continuously expand their stroke service capabilities. This document is intended to augment stroke advocacy efforts throughout the world, providing a strategic plan for optimizing stroke outcomes. © 2014 The Authors. International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization.
Castle, Mary Ann
Over the last 30 years, conservative power in the United States, financed and organized by Christian fundamentalist sects, the Catholic Church, and conservative corporate and political leadership, has become more threatening and potentially destabilizing of progressive democratic principles and practices. Powerful interlocking political, financial and social forces are arrayed against women in many Southern and Western states. They are having destructive effects on women's ability to control their fertility and maintain bodily integrity and health. Poor women and women of color are disproportionately affected by restrictions on abortion services. Strategically developed interventions must be initiated and managed at every level in these localities. It is urgent to coordinate and empower individuals, multiple organizations and communities to engender effective changes in attitudes, norms, behavior and policies that will enable women to obtain reproductive health services, including abortion care. This paper describes contextual factors that continue to decimate U.S. women's right to health and, then, describes a community organizing-social action project in a number of US' states aimed at reversing the erosion of women's right to have or not to have children.
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....
Parikh, Neehar D; Hutton, David; Marrero, Wesley; Sanghani, Kunal; Xu, Yongcai; Lavieri, Mariel
With the aging US population, demographic shifts, and obesity epidemic, there is potential for further exacerbation of the current liver donor shortage. We aimed to project the availability of liver grafts in the United States. We performed a secondary analysis of the Organ Procurement and Transplantation Network database of all adult donors from 2000 to 2012 and calculated the total number of donors available and transplanted donor livers stratified by age, race, and body mass index (BMI) group per year. We used National Health and Nutrition Examination Survey and Centers for Disease Control and Prevention historical data to stratify the general population by age, sex, race, and BMI. We then used US population age and race projections provided by the US Census Bureau and the Weldon Cooper Center for Public Service and made national and regional projections of available donors and donor liver utilization from 2014 to 2025. We performed sensitivity analyses and varied the rate of the rise in obesity, proportion of Hispanics, population growth, liver utilization rate, and donation after cardiac death (DCD) utilization. The projected adult population growth in the United States from 2014 to 2025 will be 7.1%. However, we project that there will be a 6.1% increase in the number of used liver grafts. There is marked regional heterogeneity in liver donor growth. Projections were significantly affected by changes in BMI, DCD utilization, and liver utilization rates but not by changes in the Hispanic proportion of the US population or changes in the overall population growth. Overall population growth will outpace the growth of available donor organs and thus potentially exacerbate the existing liver graft shortage. The projected growth in organs is highly heterogeneous across different United Network for Organ Sharing regions. Focused strategies to increase the liver donor pool are warranted.
U.S. Geological Survey, Department of the Interior — The USGS Governmental Unit Boundaries service from The National Map (TNM) represents major civil areas for the Nation, including States or Territories, counties (or...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Weather Service (NWS) Storm Prediction Center uses RSS feeds to disseminate all watches, warnings and advisories for the United States that are...
Professional service organizations are organizations predominantly employed with professionals; employees with specific and dedicated expertise in an area. IT support of the primary operations in this type of organizations is suboptimal. Methodological support of development and implementation of in
Professional service organizations are organizations predominantly employed with professionals; employees with specific and dedicated expertise in an area. IT support of the primary operations in this type of organizations is suboptimal. Methodological support of development and implementation of
Tye, C C; Ross, F.; Kerry, S. M.
OBJECTIVE: To establish the current and predicted distribution of formal emergency nurse practitioner services in major accident and emergency departments in the United Kingdom; to determine organisational variations in service provision, with specific reference to funding, role configuration, training, and scope of clinical activity. METHODS: Postal survey of senior nurses of all major accident and emergency departments in the United Kingdom (n = 293) in May/June 1996. RESULTS: There were 27...
No. DODIG-2015-043 D E C E M B E R 1 , 2 0 1 4 Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization... FINANCE AND ACCOUNTING SERVICE SUBJECT: Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization (Report No...organization, Defense Finance and Accounting Service Office of Internal Review (DFAS IR), in effect for the period ended June 30, 2014. The generally
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Braddock, David; Hemp, Richard
Current trends in mental retardation services in Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Massachusetts' movement toward reducing reliance on state institutions, reallocating funding, and developing community services and family support is…
... request. Such inspection shall be conducted during the regular business hours of the Secret Service Field Office or other facility where the disclosure is made. A person of his or her own choosing may accompany... delivered to the following location: General Counsel, United States Secret Service, Suite 8300, 950 H...
47 Figure 14. Training Received............................................................................................48 Figure 15. QAP ...Surveillance Plan QAP Quality Assurance Personnel PSC Product Service Code SOO Statement of Objectives USA United States Army USN United States...Assurance Personnel ( QAP ), and the multi-functional teams (USAF, 2005). This policy has established clear guidelines and responsibilities for the USAF in
Jelinek, Richard C.; And Others
To evaluate the effectiveness of Service Unit Management (SUM) in reducing costs, improving quality of care, saving professional nursing time, increasing personnel satisfaction, and setting a stage for further improvements, a national questionnaire survey identified the characteristics of SUM units, and compared the performance of a total of 55…
Toy libraries have become a favoured way of providing a service to families in which there is a mentally handicapped child. The purpose of this study was to gain information about how parents valued the service provided by the toy library at Honeylands Family Support Unit. Parents expressed a great deal of satisfaction with the service. Suggestions are made as to how it could be further improved and about the desirability of it being extended to school-aged children.
This document has two intended audiences. The first part, ``Geothermal Energy at a Glance,`` is intended for energy system decision makers and others who are interested in wide ranging aspects of geothermal energy resources and technology. The second part, ``Technology Specifics,`` is intended for engineers and scientists who work with such technology in more detailed ways. The glossary at the end of the document defines many of the specialized terms. A directory of US geothermal industry firms who provide goods and services for clients around the world is available on request.
probability of a value outside 2.0 standard deviations ranges from .0456 for A-3 -Al" 122 NILITRY HEALTH SERVICE SYSTEM AMULRTORY MORKe UurNT CANdU )(U) ARMY...00 2 w w >4 &4~ ~z til 0n0 rz~ co00 P - xU) I : 0 ) ) %z E-4 z U) HHw H~~ ~ ~ 0 olf4 E1E- 004 H U) UDm 0 4 E- H wE- ~ H E-4 H 04 H Z U H Q z HO H % x z
Full Text Available Objective. To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Methods. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Results. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard – the systematic reviews of The Cochrane Collaboration – were used less frequently (n=12; 57% than advertising materials from pharmaceutical companies (n=16; 76%. Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. Conclusion. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.
Angela P Vivanti
Full Text Available Aims Assessment and Planning Units have increased globally however, models of care literature is limited. With high malnutrition prevalence amongst ageing populations, this case report identifies demands for dietetic services. Methods Descriptive data compared and contrasted two service including medical models, eligibility criteria, malnutrition screening, dietetic services, clinical follow-up, and team composition. Results High malnutrition prevalence (17 per cent, 31 per cent was evident with different screening approaches successfully implemented. Both units favoured rapid assessment and intervention. Conclusion Dietetic expertise was required for malnutrition assessment, and ongoing management in acute or community setting as determined by differing health-care system arrangements
A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers.
Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.
Full Text Available AIM: This study is carried out descriptively with the aim of determining occupational risks the nurses working in dialysis units and nephrology services. METHOD: 47 nurses working in dialysis and nephrology units of the hospitals in Erzurum were included in the study content. In the collection of the data, questionnaire form prepared in the light of literature and including the preventions taken by nurses themselves or their organizations against the professional risks they faced, or personal problems the nurses experienced, professional risk or professional-personal features was used. RESULTS: In the result of the study, it was detected that 48.9% of the nurses was at 28-32 age group, and that 38.3% of the nurses graduated from nursing higher school, and that 72.3% of the nurses worked in dialysis unit. It was found out that while practicing their professions, the nurses expressed that infection risk (97.9%, stress (83%, verbal abuse (80.9%, psychiatric trauma (66%, allergic substance (63.8%, the noise (36.2%, and physical abuse (23.4% were the risk factors they raced in working medium .In the health problem seen in the nurses, in the first row is lumbago. CONCLUSION: In the result of the study, it was found out that while practicing their professions, the nurses expressed that infection risk was the highest rate among the risk factors they raced in working medium and, in the health problem seen in the nurses, in the first row is lumbago and that the nurses and organizations’ attempts which will reduce the risks were not sufficient. [TAF Prev Med Bull 2009; 8(4.000: 339-344
Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R
The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.
... 7 Agriculture 4 2010-01-01 2010-01-01 false Food service payments to sponsoring organizations for... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day care homes. (a) Payments shall be made only to sponsoring organizations operating under an agreement...
... of 1954) § 31.3306(c)(16)-1 Services in employ of international organization. (a) Subject to the provisions of section 1 of the International Organizations Immunities Act (22 U.S.C. 228), services performed in the employ of an international organization as defined in section 7701(a)(18) are excepted...
Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi
We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.
Walsh, Joe; Mushett, Mike
In the United States, Paralympic sport is governed by the United States Olympic Committee (USOC), as set forth in the Ted Stevens Olympic and Amateur Sports Act of 1998. The USOC formed a dedicated Paralympic Division in 2001 to manage this responsibility in close cooperation with other USOC divisions and many of the sport-specific national…
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Full Text Available Abstract Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1 environmental, (2 unit-level, and (3 unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care
Wells, Rebecca; Lemak, Christy Harris; D'Aunno, Thomas A
Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1) environmental, (2) unit-level, and (3) unit leadership. A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care contracts for prevention and outreach. The effects of
Schalock, Robert L; Lee, Tim; Verdugo, Miguel; Swart, Kees; Claes, Claudia; van Loon, Jos; Lee, Chun-Shin
The work described in this article focuses primarily on how human service organizations can use an evidence-based, self-assessment approach to organization evaluation to facilitate continuous quality improvement and organization change. Real-life examples are presented, strengths and challenges discussed, and future conceptual and measurement issues identified.
Full Text Available Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD. Methods: The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA. Results: In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE. Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita, compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion: The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of
... rounded to the nearest five-dollar increment. Thus, in order to recover the actual and reasonable costs of..., investment, productivity, innovation, or on the ability of United States-based enterprises to compete...
Alleman, Brandon W; Luger, Tana; Reisinger, Heather Schacht; Martin, Rene; Horowitz, Michael D; Cram, Peter
There are growing reports of United States (US) residents traveling overseas for medical care, but empirical data about medical tourism are limited. To characterize the businesses and business practices of entities promoting medical tourism and the types and costs of procedures being offered. DESIGN, PARTICIPANTS, AND OUTCOMES: Between June and August 2008, we conducted a telephone survey of all businesses engaged in facilitating overseas medical travel for US residents. We collected information from each company including: the number of employees; number of patients referred overseas; medical records security processes; destinations to which patients were referred; treatments offered; treatment costs; and whether patient outcomes were collected. We identified 63 medical tourism companies and 45 completed our survey (71%). Companies had a mean of 9.8 employees and had referred an average of 285 patients overseas (a total of approximately 13,500 patients). 35 (79%) companies reported requiring accreditation of foreign providers, 22 (50%) collected patient outcome data, but only 17 (39%) described formal medical records security policies. The most common destinations were India (23 companies, 55%), Costa Rica (14, 33%), and Thailand (12, 29%). The most common types of care included orthopedics (32 companies, 73%), cardiac care (23, 52%), and cosmetic surgery (29, 66%). 20 companies (44%) offered treatments not approved for use in the US--most commonly stem cell therapy. Average costs for common procedures, CABG ($18,600) and knee arthroplasty ($10,800), were similar to previous reports. The number of Americans traveling overseas for medical care with assistance from medical tourism companies is relatively small. Attention to medical records security and patient outcomes is variable and cost-savings are dependent on US prices. That said, overseas medical care can be a reasonable alternative for price sensitive patients in need of relatively common, elective medical
Kuru, W.C.; Panchal, C.B.
A new type of fouling unit is developed for high-temperature (500 C) and high-pressure (70 atmosphere) fouling experiments by modifying a commercial autoclave. Key modifications are the installation of a helical impeller in a flow tube and a fouling probe in the autoclave to simulate the fluid dynamics and heat transfer of typical heat-exchange equipment. A calibration technique is described, and fouling results are presented for experimental runs with indene and kerosene. The results are compared with those obtained using other types of fouling test units. Other potential applications of the fouling unit, such as corrosion and micro-scale reaction experiments, are discussed.
... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Official activities of the United States Government and international organizations. 538.531 Section 538.531 Money and Finance: Treasury....531 Official activities of the United States Government and international organizations. (a)...
Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise
In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources.
In the context of globalization and dynamic markets, collaboration among organizations is a condition sine qua non for organizations, especially small and medium enterprises, to remain competitive. Virtual organizations have been proposed as an organizational structure adapted to collaboration among organizations. The concept of Virtual Organization Breeding Environment (VOBE) has been proposed as a means to support the creation and operation of virtual organizations. With the rise of the service-oriented architecture (SOA), the concept of service-oriented VOBE (SOVOBE) has been proposed as a VOBE systematically organized around the concept of services. In the context of SOVOBEs, novel competence models supporting both service orientation and collaboration among organizations have to be developed to support efficiently partner selection, a key aspect of VO creation. In this paper, such a competence model is presented. Our competence model consists of a competence description model, a competence verification m...
Full Text Available Undocumented immigrants face significant challenges in accessing health care. Throughout the United States, these challenges may relate to the structure of the public health system in which the undocumented find themselves. In addition, local, regional, and national practices aimed at targeting immigrants for deportation or other non-health reasons may serve to punish them for seeking health services or care. Spain and the United Kingdom serve as useful case studies in comparing the ability of the undocumented to seek health services in Europe and the United States. Overall, promoting access to comprehensive health services for the undocumented should be a national priority, along with analysis of any immigration-related laws or policies for potential harmful impact on health care access.
Asakawa, Kyosuke; Toyoshima, Koh-ei; Ishibashi, Naoko; Tobe, Hirofumi; Iwadate, Ayako; Kanayama, Tatsuya; Hasegawa, Tomoko; Nakao, Kazuhisa; Toki, Hiroshi; Noguchi, Shotaro; Ogawa, Miho; Sato, Akio; Tsuji, Takashi
Organ regenerative therapy aims to reproduce fully functional organs to replace organs that have been lost or damaged as a result of disease, injury, or aging. For the fully functional regeneration of ectodermal organs, a concept has been proposed in which a bioengineered organ is developed by reproducing the embryonic processes of organogenesis. Here, we show that a bioengineered hair follicle germ, which was reconstituted with embryonic skin-derived epithelial and mesenchymal cells and ectopically transplanted, was able to develop histologically correct hair follicles. The bioengineered hair follicles properly connected to the host skin epithelium by intracutaneous transplantation and reproduced the stem cell niche and hair cycles. The bioengineered hair follicles also autonomously connected with nerves and the arrector pili muscle at the permanent region and exhibited piloerection ability. Our findings indicate that the bioengineered hair follicles could restore physiological hair functions and could be applicable to surgical treatments for alopecia. PMID:22645640
Spanish law establishes the standard concerning ionizing radiation in accordance to European Union directives. the Spanish NSC (CSN) is the regulatory body in matters of radiological safety which issues a perceptive report on work conditions in everything related to radiological protection of nuclear and radioactive installations. It also inspects and approves their action protocols and makes demands that certain entities employ additional support with respect to radiological protection which they can receive through calls for radiological protection services and technical units. This article takes a look at what these services and technical units are and how they act. (Author)
Halofsky, J.; Peterson, D. L.
Effective climate change engagement on public lands is characterized by (1) an enduring science-management partnership, (2) involvement of key stakeholders, (3) consideration of broad landscapes with multiple landowners, (4) science-based, peer-reviewed assessments of sensitivity of natural resources to climate change, (5) adaptation strategies and tactics developed by resource managers, (6) leadership and a workforce motivated to implement climate-smart practices in resource planning and project management. Using this approach, the U.S. Forest Service, in partnership with other organizations, has developed climate change vulnerability assessments and adaptation plans for diverse ecosystems and multiple resources in national forests and other lands in the western United States, although implementation (step 6) has been slow in some cases. Hundreds of meetings, strategies, plans, and panels have focused on climate change adaptation over the past decade, but only direct engagement between scientists and resource managers (less research, less planning, more action) has resulted in substantive outcomes and increased organizational capacity for climate-smart management.
Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore
In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of 1,009,095.35 euros. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.
... organization. (a) Subject to the provisions of section 1 of the International Organizations Immunities Act (22 U.S.C. 288), services performed in the employ of an international organization as defined in section... with the intent thereof— (18) International organization. The term “international organization” means...
Compared with the development of united communication around the globe, the progress of China is relatively slow. Four mains challenges are confronted by domestic operators to develop RCS in the future. Based on analysis on current research fruit academic circles, two contents were selected as the focuses. One is the service requirements and typical scenarios of personal future communication under the background of unite communication. Another is network routing planning solution driven by service requirements.%对比全球融合通信发展，我国发展步调相对较慢，国内运营商未来发展RCS面临4个方面的主要挑战。在深入剖析学术界现行研究成果的基础上，将2项内容作为研究切入点，一是融合通信背景下的个人未来通信业务需求及典型场景，二是业务需求驱动下的网络路由规划方案。
LAZARSFELD, PAUL F.; SIEBER, SAM D.
THE CHIEF TECHNICAL PROBLEM OF THIS STUDY WAS TO MEASURE THE NUMEROUS SOCIAL CONDITIONS WHICH MIGHT CONCEIVABLY IMPINGE ON THE PRODUCTION OF RESEARCH AND OF RESEARCHERS BY GRADUATE SCHOOLS OF EDUCATION. THE TECHNIQUES EMPLOYED INCLUDED (1) QUESTIONNAIRE SURVEYS OF EDUCATION DEANS, RESEARCH COORDINATORS, DIRECTORS OF RESEARCH UNITS, PROJECT…
Kemicer-Chmielewska, Ewa; Karakiewicz, Beata
The cause for this document is to present a deliberation on public health facility image development on the medical services market. Marketization of the health service, growing awareness of Polish citizens and their expectation of high service quality as well as increased competition in the healthcare system market is the reason why health unit managers need to put a lot of strength and effort in sustaining or improving the image of the facility they run. Such action gives a chance for obtaining a competitive advantage.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Services for American businessmen and organizations. 101.3 Section 101.3 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER FUNCTIONS ECONOMIC AND COMMERCIAL FUNCTIONS § 101.3 Services for American businessmen and organizations. Officers of...
Evans, Scot D.; Hanlin, Carrie E.; Prilleltensky, Isaac
This paper describes the challenges and benefits of an action-research project with a Nashville-based nonprofit human service organization. In our view, outmoded human service organizations are in serious need of innovation to promote psychological and physical wellness, prevention of social problems, empowerment, and social justice. This project…
González-Vázquez, Tonatiuh Tomás; Torres-Robles, Cristian Armando; Pelcastre-Villafuerte, Blanca Estela
Document the transnational utilization of health resources and services by Mexican immigrants in the United States. Between December 2009-February 2011, Interviews and focus groups were conducted in California and four states of México. Data were collected from 135 individuals, including return migrants, allopathic physicians and traditional healers. Faced with obstacles to accessing US health care and some health services within the Mexican system, many immigrants within the US make use of Mexican health resources and services, either from a distance or during visits to Mexico. These resources and services include allopathic medicine, traditional medicine, and home remedies and medicines. The legal status of immigrants and their access to health insurance in the US are related to whether their transnational use of Mexican health resources and services is formal or informal; immigrants who are undocumented and without health insurance are the most vulnerable.
Paagman, Arnaud; Tate, Mary; Furtmueller, Elfi; Bloom, de Jessica
This paper contributes to the understanding of the meaning of shared services and motives for introducing shared services in government organizations. We review and clarify definitions of shared services and derive a definition applicable for the government context. Based on an extensive literature
..., and homemaker services. (vi) Physical therapy, occupational therapy, and speech-language pathology... 42 Public Health 3 2010-10-01 2010-10-01 false Condition of Participation: Organization and administration of services. 418.100 Section 418.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...
Johnson, Lester W.
When teaching a services course (e.g., Services Marketing) it is essential that students understand that marketing/management, operations and human resource management within the service organization be fully coordinated. One useful acronym used to remind students of this need is "CHROME", standing for Communications, Human Resources,…
Soboleva Nina Pavlovna
Full Text Available The paper covers the implementation of phraseological units in the language of public service advertising, as well as theoretical and practical aspects of phraseological units and their contextual use. The research is aimed at the analysis, classification of the cases of implementation and identification of the main structural and semantic classes of phraseological units used in public service advertising slogans in the Russian, English and German languages. The choice of practical material is stipulated by a growing role of public service advertising and interest in this issue. As a result of our research we analysed three thousand slogans in three languages taken from posters and websites. The author dwells on occasional configuration of the first type, introduced by A.V. Kunin, and considers the following stylistic modifications: dual actualisation, substitution, ellipsis, extension, permutation and other. A relevant classification is introduced which covers the stylistic modifications implemented in public service advertising slogans in three languages. The most frequently used stylistic modifications are identified. The most commonly used structure types of phraseological units are revealed in the article. No matter what kind of modification is explored the reasons of transformation can be the following: the structure of PU, the inner form and pragmatics.
...--010 Asylum Information and Pre-Screening System of Records AGENCY: Privacy Office; DHS. ACTION: Notice... Security's inventory, entitled Unites States Citizenship and Immigration Services-010 Asylum Information... systems: The Refugees, Asylum, and Parole System and the Asylum Pre-Screening System. Refugees,...
... Federal Aviation Administration 14 CFR Part 71 RIN 2120-AA66 Proposed Amendment of Air Traffic Service Routes; Southwestern United States AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of... Administration, 800 Independence Avenue SW., Washington, DC 20591; telephone: (202) 267-8783....
@@ United Airlines, the leading carrier between the U.S. and China, announced today that its new Beijing to San Francisco non-stop flight took off from Beijing at 12:00 p.m. helping to open a new air service route between two of the world's greatest cities.
Williams, Donald B.
By analyzing the scope and structure of agricultural extension services in Australia, Great Britain, and the United States, this work attempts to set guidelines for measuring progress and guiding extension efforts. Extension training, agricultural policy, and activities of national, international, state, and provincial bodies are examined. The…
.... (DNC), Central Vermont Public Service Corporation (CVPS) and Massachusetts Municipal Wholesale Electric Company (MMWE) (collectively ``the licensees'' or ``DNC, Inc., et al.'') are the co-holders of the Renewed... Power Station, Unit 3 (MPS3). CVPS is a non-operating owner of a 1.7303% interest in MPS3. DNC is...
Carol Raish; Alice M. McSweeney
The U.S. Forest Service (FS) has a long, shared history with the Spanish and Mexican land grants of northern New Mexico. The Treaty of Guadalupe Hidalgo, which ended the war between the United States and Mexico, was supposed to recognize and respect the property rights of the resident Hispano population. In many cases the intent of the Treaty was not honored. During...
Scarborough, Anita A.; Hebbeler, Kathleen M.; Spiker, Donna
In the United States, legislation originally enacted in 1986 provided grants to states to build interagency service systems for children from birth to 3 years of age with developmental delays and disabilities. This legislation now renamed the Individuals with Disabilities Education Act (IDEA) was intended to facilitate the development of a…
Yang, Jun; Guo, Aimin; Wang, Yadong; Zhao, Yali; Yang, Xinhua; Li, Hang; Duckitt, Roger; Liang, Wannian
PURPOSE We report a study on the developmental status of human resource staffing and service functions of community health services (CHS) in China and offer recommendations for improving the CHS in the future.
US Fish and Wildlife Service, Department of the Interior — In February 2004, the United States National Park Service (USNPS) recognized the significance of the United States Fish and Wildlife Service's Great Dismal Swamp...
M. D. Vadhvani; M. G. Bhatt
.... Among these Lean Practices are having the inherent principles of reducing the cost and increasing the quality by focusing the non value added activities from the value chain of the service or product. Lean Principles (LPs...
Rewari, Anil; Adler, Mark; Anick, Peter; Billmers, Meyer; Carifio, Mike; Gunderson, Alan; Pundit, Neil; Swartwout, Mark W.
The Digital Services Research Group and its predecessor groups and offshoots in Digital Equipment Corporation have been mobilizing leading-edge AI research to bear on real-life problems that face the corporation and its customers. The general strategy of the group is to explore emerging techniques relevant to service and support needs through developing rapid prototypes, deploying these prototypes, and incorporating feedback from users. With over 32 major projects undertaken during the past d...
U.S. Environmental Protection Agency — This GIS dataset contains polygon features that represent communities with residential organics collection programs in the United States. EPA used US Census Bureau...
In order to be an efficient and relevant intergovernmental organization, United Nations Children s Fund (UNICEF) has since 2007 made the innovation turn and has become a leader in innovation activity in the UN body. The embracement and assimilation of technology and innovation are a marked shift in the way the organization works, compared to earlier times. The purpose of this study is two-sided: Firstly, to examine what innovation practices UNICEF s HQ Innovation Unit uses in their aid work...
Kristensen, Niels Heine; Netterstrøm, Sune; He, Chen
works and thus it seems not enough to implement organic food once and for all. The organic supply chain is dynamic being challenged by influences as price premiums, supply shortages and problems of convenience level. This paper investigates three Danish municipalities focusing on important elements...
Rousseau, Cécile; Nadeau, Lucie; Pontbriand, Annie; Johnson-Lafleur, Janique; Measham, Toby; Broadhurst, Joanna
The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Press correspondents employed by United States... GOVERNING DEPARTMENT OF STATE PRESS BUILDING PASSES § 9b.2 Press correspondents employed by United States media organizations. In order to obtain a Department of State press building pass, press...
Sa, Creso M.; Oleksiyenko, Anatoly
Organized research units--also known as centers, institutes, and laboratories--are increasingly prominent in the university. This paper examines how ORUs emerge to promote global agendas and international collaborations in an academic health center in North America. The roles these units play in helping researchers work across institutional and…
Gainforth, Heather L; Berry, Tanya; Faulkner, Guy; Rhodes, Ryan E; Spence, John C; Tremblay, Mark S; Latimer-Cheung, Amy E
New evidence-based physical activity and sedentary behavior guidelines for Canadians were launched in 2011. As a consequence, service organizations that promote physical activity directly to the public needed to change their promotion materials to reflect the new guidelines. Little is known about the rate at which service organizations adopt and integrate new evidence-based guidelines and determinants of guideline adoption. In this natural observational study, we evaluated the rate of online adoption of the new guidelines among key service organizations that promote physical activity and examined participation in a booster webinar as a supplemental dissemination strategy. One hundred fifty nine service organization websites were coded by one of six raters prior to the release of the new guidelines as well as at 3, 6, and 9 months after the release. Online adoption of the guidelines increased during the coding period with 51 % of organizations posting the guidelines or related information on their websites. Organizations' engagement in a webinar was associated with their adoption of the guidelines. The release of new Canadian Physical Activity and Sedentary Behaviour Guidelines led to increased guideline adoption on service organizations' websites. However, adoption was not universal. In order for the uptake of the new guidelines to be successful, further efforts need to be taken to ensure that service organizations present physical activity guidelines on their websites. Comprehensive, active dissemination strategies tailored to address organizational barriers are needed to ensure online guideline adoption.
McGinn, Therese; Casey, Sara E
Background Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors’ observations suggest that four reasons are typically given for this gap: ‘There’s no need’; ‘Abortion is too complicated to provide in crises’; ‘Donors don’t fund abortion services’; and ‘Abortion is illegal’. Discussion However, each of these reasons is based on false premises. Unsafe abortion is a...
Adrienne C. Shelton
Full Text Available Abstract Organic farmers require improved varieties that have been adapted to their unique soils, nutrient inputs, management practices, and pest pressures. One way to develop adapted varieties is to situate breeding programs in the environment of intended use, such as directly on organic farms, and in collaboration with organic farmers. This model is a form of participatory plant breeding, and was originally created in order to meet the needs of under-served, small-scale farmers in developing countries. A robust body of literature supports the quantitative genetic selection theory of participatory plant breeding, and helps to explain its increasing prevalence among organic breeding projects in the United States. The history of the organic farming movement in the United States highlights the cultural relevance of engaging organic farmers in the breeding process, complementing the biological rationale for participatory plant breeding. In addition, limited private investment in organic plant breeding encourages the involvement of plant breeders at public institutions. This paper synthesizes the biological, cultural, and economic justifications for utilizing participatory plant breeding as an appropriate methodology for organic cultivar development.
Pye, Havala O T; Luecken, Deborah J; Xu, Lu; Boyd, Christopher M; Ng, Nga L; Baker, Kirk R; Ayres, Benjamin R; Bash, Jesse O; Baumann, Karsten; Carter, William P L; Edgerton, Eric; Fry, Juliane L; Hutzell, William T; Schwede, Donna B; Shepson, Paul B
Organic nitrates are an important aerosol constituent in locations where biogenic hydrocarbon emissions mix with anthropogenic NOx sources. While regional and global chemical transport models may include a representation of organic aerosol from monoterpene reactions with nitrate radicals (the primary source of particle-phase organic nitrates in the Southeast United States), secondary organic aerosol (SOA) models can underestimate yields. Furthermore, SOA parametrizations do not explicitly take into account organic nitrate compounds produced in the gas phase. In this work, we developed a coupled gas and aerosol system to describe the formation and subsequent aerosol-phase partitioning of organic nitrates from isoprene and monoterpenes with a focus on the Southeast United States. The concentrations of organic aerosol and gas-phase organic nitrates were improved when particulate organic nitrates were assumed to undergo rapid (τ = 3 h) pseudohydrolysis resulting in nitric acid and nonvolatile secondary organic aerosol. In addition, up to 60% of less oxidized-oxygenated organic aerosol (LO-OOA) could be accounted for via organic nitrate mediated chemistry during the Southern Oxidants and Aerosol Study (SOAS). A 25% reduction in nitrogen oxide (NO + NO2) emissions was predicted to cause a 9% reduction in organic aerosol for June 2013 SOAS conditions at Centreville, Alabama.
... United Nations and the Organization of American States. 148.88 Section 148.88 Customs Duties U.S. CUSTOMS... members of the staff of the United Nations and the Organization of American States, and their personal... United Nations member nation as the principal resident representative to the United Nations of...
H. Ajith Hebbar
Full Text Available The effluents from food service facilities like restaurants, hostels and cafeteria typically contain floating cooked oil, ghee, and other fatty materials which are of organic in origin. Conventionally, before allowing this effluent to treatment plant or sewer, grease traps and skimming devices are used to separate these floating organic matters. If these are not effectively separated, these may clog sewers or interfere with biological treatment system. But these conventional methods need frequent maintenance and may not be cost effective. Alternatively, in this experimental work, an attempt was made to remove floating oil and grease using adsorption by passing the wastewater through a Laterite grain column. A real scale study unit was set up at the effluent point of a restaurant. The Various parameters like height of the column, grain size, and flow rate were monitored during the experiment. The results showed that the oil and grease could be removed up to an extent of 97.6% proving that Laterite has good adsorption potential.
Pointer, D D
One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.
Full Text Available Every product marketed under ’organic’ must comply with a set of UK, European Union and international rules. These rules (also known as standards assure the consumers that they bought original organic products able to be traced back all the way to the farm. Organic standards cover all of the aspects of organic food certification, including production and packaging, animal welfare, wildlife preservation and interdict all useless and dangerous food additives in processing organic foods. The British organic control bodies authorize individual organic operators. These are approved by DEFRA (The Department for Environment, Food and Rural Affairs. In order for a producer to have his merchandise marketed as organic, he must be affiliated to one of the control bodies and comply to its standards and requirements. The present article presents the certification control bodies in organic agriculture as well as the steps to be taken in the organic certification process within the United Kingdom.
Dicle, Ulku; And Others
This study examines human resource management practices in Japanese organizations in the United States, specifically those in the Fort Custer Industrial Park, Battle Creek, Michigan. It identifies characteristics of human resource management, compares them with those of their parent organizations, and looks at modifications needed because of a new…
... organizations engaged abroad in disseminating information which significantly promotes U.S. interests. The... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false United States nonprofit organizations engaged abroad in disseminating information which significantly promotes U.S. interests. 319.6 Section 319...
Joseph Joseph Sungau
Full Text Available Organizations in today’s business environment struggle on how to reduce operation cost in order to set prices that can be afforded by many customers while obtaining reasonable profit. In order to reduce Operational Cost, service organizations have been working hard to identify techniques that facilitate business processes improvement for reduced Operational Cost. In so doing, the global literature indicates that service organizations adopt Business Process Re-engineering technique as a panacea of reducing Operational Cost. Despite a documented potentiality of Business Process Re-engineering technique, there are mixed empirical results, findings and conclusions regarding the effect of Business Process Re-engineering on Operational Cost. Therefore, this paper aimed at assessing and explaining effects of BPR on Operational Cost. The study used cross-sectional survey design to investigate the effect of BPR on Operational Cost. Intensive literature review enabled the construction of structural measurement model, formulation of testable hypotheses and operationalization of constructs. In order to test the model and hypotheses, data were collected from ninety five (95 service organizations in Tanzania. Results of the study reveal that BPR and delivering speed have no direct effects on Operational Cost; they indirectly affect Operational Cost through the mediations of service quality. Therefore, BPR influences first both service quality and delivery speed in affecting Operational Cost of service organizations. It is now recommended that service organizations should use Business Process Re-engineering as panacea of reducing Operational Cost.
Full Text Available Immigrant Workers Centers (IWCs are community-based organizations that have been developed in the United States to promote and protect workers’ rights through support, services, advocacy, and organizing initiatives. The purpose of this research study was to examine how IWCs in the Eastern part of the state of Massachusetts are structured along twelve dimensions of organizational development and community organizing. Qualitative research methods were used to identify shared themes within the six IWCs and three immigrant support organizations, as well as their organizational responses to the current anti-immigrant environment. IWCs constituted a convenience sample which enabled the researchers to gather data utilizing a case study methodology. In-depth semi-structured interviews were conducted between the months of July and September of 2009 to answer the following research questions: 1What are the shared themes for the development of Immigrant Workers Centers?, and 2 How do Immigrant Workers Centers respond to current anti-immigrant sentiment, intolerant immigration policies, and increased exploitation in this troubled economy? Shared themes among the IWCs include prioritizing community organizing for workers’ rights and collective empowerment. Sub-modalities such as education, training and leadership development area common feature. While some individual support is provided, and in some cases, programming, it always is offered within a context that emphasizes the need for collective action to overcome injustice. Issues addressed include health/safety, sexual harassment, discrimination, and various problems associated with wages (underpayment, missed payments, collecting back wages, and lack of overtime pay. IWCs respond to antiimmigrant policies and practices by supporting larger efforts for immigration reformat the municipal, state, and federal levels. Coalitions of IWCS and their allies attempt to make state wide and federal policy changes
Andrews, Hannah; Singh, Yogen
Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.
Hoffman, August John
This mixed-methods qualitative study examined the relationship between perceptions of the importance of social media (i.e., Facebook, Twitter) with community service projects and volunteerism. Participants (n = 80) were interviewed and surveyed regarding their experiences in participating in a variety of community service work (CSW) projects…
Hoffman, August John
This mixed-methods qualitative study examined the relationship between perceptions of the importance of social media (i.e., Facebook, Twitter) with community service projects and volunteerism. Participants (n = 80) were interviewed and surveyed regarding their experiences in participating in a variety of community service work (CSW) projects…
The study investigates the inbound and outbound health tourism in the United Kingdom (UK) to determine if the UK can be considered as a net exporter of health services. Although there is an increasing number of studies analysing the phenomenon of health tourism, little empirical data are available. This paper contributes to reducing this gap by providing reliable data on health tourism flows for the British case. Using microdata drawn from the International Passenger Survey (IPS) for the peri...
The purpose of this monograph is to examine the role organizational culture plays in the leadership of United States Air Force (USAF) Services...squadrons. While some might argue that the study of organizational culture is a somewhat vague notion, there is significant theory and findings to show...determine the link between organizational culture and financial performance as indicated by Standard and Poor’s financial ratios. In summarizing his
Fetsch, Susan H; DeBasio, Nancy O
Two leading nursing organizations, the Greater Kansas City Area Collegiate Nurse Educators and the Kansas City Area Nurse Executives, represent the Kansas City metropolitan area nursing programs and area employers. These two organizations have been engaged in collaborative workforce planning and strategy development around key nursing issues for over 25 years. This model of collaboration is unique in that the partnership is between organizations representing 17 nursing programs and 28 hospitals. The collaborative partnership has enhanced organizational efficiency and efficacy between the groups, which has directly benefited the organizational members. Most importantly, it has had a transformative impact on both nursing education and professional practice in the Kansas City metropolitan area. This article describes the evolution of the partnership and the collaborative work that has led to the accomplishment of mutual goals.
... employees of the United States Customs Service return information (as defined by section 6103(b)) with.... Disclosure of return information by officers or employees of the Internal Revenue Service as provided by.... (f) Use by Customs Service. Return information disclosed under this section may be used by the...
Valdez, Carmen R.; Budge, Stephanie L.
This study evaluated an adolescent depression in-service training for school staff in the United States. A total of 252 school staff (e.g., teachers, principals, counselors) completed assessments prior to and following the in-service and a subsample of these staff participated in focus groups following the in-service and three months later.…
Christopher E. McCoy
Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.
Lima, Sheyla Maria Lemos; Portela, Margareth Crisóstomo; Ugá, Maria Alicia Domíngues; de Vasconcellos, Maurício Teixeira Leite
This paper characterizes regulatory procedures applied by private health plan operators on their outpatient radiotherapy and chemotherapy services, especially via contracts, and outlines the health care providers’ perception on regulation. The study relied on primary data, taking into consideration 638 hospitals and outpatient health care units with the services in question. A stratified random sample was selected, resulting in the inclusion of 54 units that are representative of the population, excluding hospitals that only provide radiotherapy. Private chemotherapy services are largely funded by health insurance plans (75.0%), while radiotherapy services are predominantly covered by the public health system (49.0%). Contracts are not applied by third part payers, in their potential, as regulatory and health care coordination instruments. The mechanisms of regulation applied by third part payers are centered on services use control and administrative aspects. It is recognized the need of adjustments for a health care quality focus, and contracts may contribute in this sense.
An Zhang; Haiyang Sun; Yanxia Zhang
The problem of cloud cooperation of military service providers (MSPs) is addressed for alocating limited resources to military service users (MSUs) that are geographicaly dis-tributed. The MSPs, also caled military organization clouds, are virtualized and encapsulated by the services they can offer and each of them contains different kinds of resources that MSU needs. The MSPs are also geographicaly dis-persed. They are required to alocate their resources to the MSU complying with the corresponding quality of service (QoS), so that each MSU gathers the services it needs to guarantee its task to be implemented. The outline of military organization cloud cooperation is discussed and the method of service optimal selection is proposed based on QoS evaluation. The QoS evaluation method based on exponential approximation is put forward to include the users’ will. Simulation results verify the effectiveness of the proposed algorithm.
During the 1992-1995 war in Bosnia and Herzegovina (BH), Croatian people in BH had 19,600 (2.6%) killed and 135,000 (17.6%) displaced persons, and 222,500 (28.9%) refugees. They lost around two thirds of both physicians and other health personnel, and were left with 8. 5% of prewar patient beds. Fortunately, the organized defence against Serbs was initiated in time and Croats defended the territories where they formed majority. The first defense unit established was the Medical Corps Headquarters (MCH), caring for soldiers and civilians alike. The MCH was soon incorporated in the Croatian Defense Council (CDC, armed forces of Croatian people in BH). The MCH had two chains of command. One went through the district commanders of medical services and their subordinated physicians to paramedics in military units, and the other directly to the commanders of 14 war hospitals. After its formation in 1993, the Ministry of Health took the jurisdiction over the civilian medical services and after the Washington Peace Agreement (April 1994) over the war hospitals, too, whereas the medical services within military units remained under control of the Ministry of Defense. Dayton Peace Agreement divided BH into the Federation of BH and Republic Srpska, each with their own army. The Federation of BH Army is composed of the CDC and Bosniac-controlled Army of BH, with overall numerical ratio 1:2.3 for Bosniacs, and organized in accordance with NATO standards. Military medical services are provided by the Logistics Sector of both Ministry of Defense and Military Corps Headquarters (Joint Command).
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's hea...
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's hea...
with difficult subordinates such as Patton, and allies such as Winston Churchill, Montgomery, and Charles de Gaulle . He had fundamental...military organization intact when Charles de Gaulle withdrew French forces from the military command structure in 1966. France’s withdrawal had the
Singh, Karun Krishna
This research investigated the question: What is the impact of strategic planning process variation on superior organizational performance in nonprofit human service organizations providing mental health services? The study employed a retrospective, cross-sectional, comparison group design using a combination of survey data, unobtrusive agency backup data, and follow-up in-person interview data. The sample was comprised of two main groups of organizations, those that were doing strategic planning and those that were not engaged in strategic planning. Responses were obtained from the chief executive officers of 306 of the 380 randomly selected organizations resulting in a response rate of 81%. Hypotheses were tested using multiple and logistic regression procedures. The major finding of this study was that complete strategic planning is highly correlated with superior organizational performance. The implications of the findings for administration, policy, research, and the social work profession are discussed.
Olsen, Even Meek; Sky, Astrid
Frontline employees, the employees with customer contact, are the face of service organizations and play a critical role in determining customer satisfaction. Service quality is greatly improved when these employees are customer oriented. Customer orientation refers to an individual’s commitment to delivering great customer service. While some research exists, the antecedents to customer orientation are insufficiently studied. Answering a call for new insights into this importa...
Watson, Paula D.; Landis, Martha
Data from 43 responses to a questionnaire distributed to the academic members of the RASD Discussion Group in Reference Services in Large Research Libraries are summarized in tables. The purpose of the survey was to reflect patterns of staff size, services, and organization in reference departments in large academic libraries. The tables present…
... COMMISSION 47 CFR Parts 0, 1, 73, and 74 Commission Organization; Practice and Procedure; Radio Broadcast Services; and Experimental Radio, Auxiliary, Special Broadcast and Other Program Distributional Services... obsolete. Section 1.805 of the Commission's rules requires common carriers engaged in public radio...
Poell, Rob F.; Van der Krogt, Ferd J.
This study investigates how social networks in service organizations contribute to employee learning. Two specific types of social network seem especially relevant to individual learning: first, the service network, where employees carry out and improve their work, which may lead to learning; and second, the learning network, where employees…
... anticipated needs of the organization. See, § 1.537-1(b). Whether there is an improper accumulation of funds... and operated by the United States, a State, the District of Columbia, or a possession of the...
Wasan A. A. Al-Taie
Full Text Available The objectives of this study were to determine the extent of organic food consumption in the United Arab Emirates (UAE, examine the consumers’ perceptions of the effects of organic foods on human health and the environment, and investigate the factors that limit the consumption of organic foods. Five hundred questionnaires were randomly distributed to communities in the UAE from October to December 2013, and 266 questionnaires were completed and returned giving us a response rate of 53%. Our findings indicated that organic food is more recognized among the youth. Furthermore, organic fish, fruits, and chocolates are consumed more than other types of organic foods. Health and environmental awareness are the main reasons that people consume organic foods. Moreover, the development of society, an individual’s social level and peers, and advertisements encourage people to buy organic foods by presenting the consumption of organic foods as a new trendy lifestyle that generates a type of prestige. Conversely, cost, availability, shelf life, taste, and a lack of knowledge are the main factors that limit the consumption of organic foods. We recommend that organic foods should be highlighted more through research, media, lectures, and health campaigns to enhance the public’s knowledge of organic foods. Moreover, we believe that the cost of organic foods could be reduced by increasing the number of standard local organic food farms throughout the UAE.
Ayres, B. R.; Allen, H. M.; Draper, D. C.; Brown, S. S.; Wild, R. J.; Jimenez, J. L.; Day, D. A.; Campuzano-Jost, P.; Hu, W.; de Gouw, J.; Koss, A.; Cohen, R. C.; Duffey, K. C.; Romer, P.; Baumann, K.; Edgerton, E.; Takahama, S.; Thornton, J. A.; Lee, B. H.; Lopez-Hilfiker, F. D.; Mohr, C.; Wennberg, P. O.; Nguyen, T. B.; Teng, A.; Goldstein, A. H.; Olson, K.; Fry, J. L.
Gas- and aerosol-phase measurements of oxidants, biogenic volatile organic compounds (BVOCs) and organic nitrates made during the Southern Oxidant and Aerosol Study (SOAS campaign, Summer 2013) in central Alabama show that a nitrate radical (NO3) reaction with monoterpenes leads to significant secondary aerosol formation. Cumulative losses of NO3 to terpenes are correlated with increase in gas- and aerosol-organic nitrate concentrations made during the campaign. Correlation of NO3 radical consumption to organic nitrate aerosol formation as measured by aerosol mass spectrometry and thermal dissociation laser-induced fluorescence suggests a molar yield of aerosol-phase monoterpene nitrates of 23-44 %. Compounds observed via chemical ionization mass spectrometry (CIMS) are correlated to predicted nitrate loss to BVOCs and show C10H17NO5, likely a hydroperoxy nitrate, is a major nitrate-oxidized terpene product being incorporated into aerosols. The comparable isoprene product C5H9NO5 was observed to contribute less than 1 % of the total organic nitrate in the aerosol phase and correlations show that it is principally a gas-phase product from nitrate oxidation of isoprene. Organic nitrates comprise between 30 and 45 % of the NOy budget during SOAS. Inorganic nitrates were also monitored and showed that during incidents of increased coarse-mode mineral dust, HNO3 uptake produced nitrate aerosol mass loading at a rate comparable to that of organic nitrate produced via NO3 + BVOCs.
Atlan- tic Treaty Organization (NATO) nations and of other officially rec- ognized foreign military personnel at military installations within the...representatives of religious groups, celebrities, and enter- tainers; representatives of the United Service Organization( USO ), other social agencies, and...from DOD, or from one of the military depart- ments, to visit military commands overseas. b. Dependents of USO oversea area executives, club directors
Rakich, J S; Darr, K; Longest, B B
The health services paradigm with respect to quality has shifted to that of conformance to requirements (the absence of defects) and fitness for use (meeting customer expectations and needs). This article presents an integrated model of continuous quality improvement (CQI) (often referred to as total quality management) and productivity improvement for health services organizations. It incorporates input-output theory and focuses on the CQI challenge--"How can we be certain that we do the right things right the first time, every time?" The twin pillars of CQI are presented. Achievement of both will result in productivity improvement and enhancement of the health services organization's competitive position.
Two USDA agencies, the Forest Service (USFS) and the Agricultural Research Service (USDA-ARS) are cooperating on the complementary conservation of crop wild relatives (CWR) native to the United States. The USFS manages 193 million acres of National Forest System lands in 43 states and provides suppo...
Lennox, Charlotte; Mason, Julie; McDonnell, Sharon; Shaw, Jenny; Senior, Jane
Offenders with mental health problems often have complex and interrelated needs which separately challenge the criminal justice system (CJS) and National Health Service (NHS) in the United Kingdom (U.K.). Consequently, interagency collaboration and timely information sharing are essential. This study focused on the sharing of information about people with mental health problems in contact with the CJS. Questionnaires were distributed to a range of health and criminal justice personnel. The results showed that there was a mismatch between what service user information criminal justice agencies felt they needed and what was routinely received. Prison Service staff received more information (between 15% and 37%) from health agencies than the police (between 6% and 22%). Health professionals received most of the information they needed from criminal justice agencies (between 55% and 85%). Sharing service user information was impeded by incompatible computer systems and restrictions due to data protection/confidentiality requirements. In the U.K., recent governmental publications have highlighted the importance of information sharing; however there remains a clear mismatch between what health related information about service users criminal justice agencies need, and what is actually received. Better guidance is required to encourage and empower people to share.
Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick
In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.
James J. Connolly; Erika S. Svendsen; Dana R. Fisher; Lindsay K. Campbell
How do stewardship groups contribute to the management of urban ecosystem services? In this paper, we integrate the research on environmental stewardship with the social-ecological systems literature to explain how stewardship groups serve as bridge organizations between public agencies and civic organizations, working across scales and sectors to build the flexible...
Thompson, Heather; Legorreta, Kimberly; Maher, Mary Ann; Lavin, Melanie M
Our health system recognized the need to update facility space and associated technology for the labor and birth unit within our large volume perinatal service to improve the patient experience, and enhance safety, quality of care, and staff satisfaction. When an organization decides to invest $30 million dollars in a construction project such as a new labor and birth unit, many factors and considerations are involved. Financial support, planning, design, and construction phases of building a new unit are complex and therefore require strong interdisciplinary collaboration, leadership, and project management. The new labor and birth unit required nearly 3 years of planning, designing, and construction. Patient and family preferences were elicited through consumer focus groups. Multiple meetings with the administrative and nursing leadership teams, staff nurses, nurse midwives, and physicians were held to generate ideas for improvement in the new space. Involving frontline clinicians and childbearing women in the process was critical to success. The labor and birth unit moved to a new patient tower in a space that was doubled in square footage and geographically now on three separate floors. In the 6 months prior to the move, many efforts were made in our community to share our new space. The marketing strategy was very detailed and creative with ongoing input from the nursing leadership team. The nursing staff was involved in every step along the way. It was critical to have champions as workflow teams emerged. We hosted simulation drills and tested scenarios with new workflows. Move day was rehearsed with representatives of all members of the perinatal team participating. These efforts ultimately resulted in a move time of ~5 hours. Birth volumes increased 7% within the first 6 months. After 3 years in our new space, our birth volumes have risen nearly 15% and are still growing. Key processes and roles responsible for a successful build, efficient and safe move
Pages, F; Girod, R
Vector-borne diseases constitutes a threat to the operational capability of armed forces personnel operating outside or stationed overseas. To take this risk into account, the French armed forces medical corps created a medical entomology unit in 2003. The primary function of this unit is to monitor the entomological status of French military bases in sub-Saharan Africa (identification of vectors, study of vector behavior, and measurement of resistance to insecticides) as a means of maintaining an effective vector-control strategy. The French medical entomology unit takes part in the Impact Vector project aimed at evaluating the vector-borne disease risks for troops in combat situations, contributes its expertise to the investigation of epidemic disease, and participates in the development of a global strategy for vector-control for the armed services. To improve understanding and control of vector-borne disease risks, the unit provides basic training in medical entomology to army physicians, veterinarians, and pharmacists as well as to others involved in control programs. The purpose of this article is to present the results of the unit's first activities: investigation of a malaria epidemic that occurred in Ivory Coast in 2003, measurement of malaria exposure over a 4-month period in a combat group on duty in rural Africa, and initial evaluation of control techniques (spraying around living quarters and use of insecticide-impregnated battle dress).
Reynolds, Lucy; Gerada, Clare; McKee, Martin
Reforms to the British National Health Service introduce major changes to how health care will be delivered. The core elements include the creation of new purchaser organizations, Clinical Commissioning Groups, which unlike their predecessors will be able to recruit and reject general practices and their patients without geographical restriction. The Clinical Commissioning Groups are to transition from statutory bodies to freestanding organizations, with most of their functions privatized and an increasingly privatized system of provision, In this paper, we explore the likely consequences of these proposals, drawing in particular on the experience of managed care organizations in the United States, whose approach has influenced the English proposals extensively. We argue that the wrong lessons are being learned and the English reforms are likely to fundamentally undermine the principles on which the British National Health Service was founded.
Haas, Curtis E; Eckel, Stephen; Arif, Sally; Beringer, Paul M; Blake, Elizabeth W; Lardieri, Allison B; Lobo, Bob L; Mercer, Jessica M; Moye, Pamela; Orlando, Patricia L; Wargo, Kurt
This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the "unit-based" and "service-based" orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient-centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high-quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit-based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task-oriented clinical services. By definition, the service-based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision-making process and the development of patient-centered care plans. The service-based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service-based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes.
Tranchemontagne, David J.; Mendoza-Cortés, José L.; O'Keeffe, Michael; Yaghi, Omar M.
This critical review presents a comprehensive study of transition-metal carboxylate clusters which may serve as secondary building units (SBUs) towards construction and synthesis of metal–organic frameworks (MOFs). We describe the geometries of 131 SBUs, their connectivity and composition. This contribution presents a comprehensive list of the wide variety of transition-metal carboxylate clusters which may serve as secondary building units (SBUs) in the construction and synthesis of metal–org...
In this paper we consider two social organizations -- service-oriented communities and fractal organizations -- and discuss how their main characteristics provide an answer to several shortcomings of traditional organizations. In particular, we highlight their ability to tap into the vast basins of "social energy" of our societies. This is done through the establishing of mutualistic relationships among the organizational components. The paper also introduces a mathematical model of said mutu...
Pardo-Hernández, A; Navarro-Royo, C; Arguedas-Sanz, R; Albeniz-Lizarraga, C; Morón-Merchante, J
To identify the barriers and challenges for the effective development of risk management units in hospitals of the Madrid Health Service. Descriptive cross-sectional study aimed at the management teams and members of the functional units of 31 hospitals in the Madrid Health Service. A self-administered questionnaire requesting answers in free text was used, identifying up to five barriers and challenges, and their prioritization by awarding from 1-5 points according to their importance. A discourse analysis was then conducted, grouping common themes and sorting them according to their score. The overall response rate was 94%. The most frequently identified barriers were lack of time (21%), inadequate safety culture (13%), lack of publication of their activities (10%), and lack of training (10%). The most important challenge was developing the training (18%), followed by improving the culture (17%), communication of safety activities (11%), and achieve leadership from the managers of the services (11%). According to the study conditions, the main identified barrier identified was the lack of available time, and the principal challenge found was promoting a proactive learning culture. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization.
Alexander L. Kanibolotsky
Full Text Available The aim of this review is to give an update on current progress in the synthesis, properties and applications of thiophene-based conjugated systems bearing tetrathiafulvalene (TTF units. We focus mostly on the synthesis of poly- and oligothiophenes with TTF moieties fused to the thiophene units of the conjugated backbone either directly or via a dithiin ring. The electrochemical behaviour of these materials and structure–property relationships are discussed. The study is directed towards the development of a new type of organic semiconductors based on these hybrid materials for application in organic field effect transistors and solar cells.
Gro Harlem Brundtland, who became Director General of the World Health Organization in July 1998, has created a small revolution at the WHO headquarters in Geneva. She is in the process of changing how WHO works, how it interacts with other parts of the United Nations system, and how it enlists ministries, whole governments, universities, and other private organizations to improve health in the world. Here, the Editor describes the reorganization, the new people and resources, and prospects for setting a precedent in United Nations reform.
Gro Harlem Brundtland, who became Director General of the World Health Organization in July 1998, has created a small revolution at the WHO headquarters in Geneva. She is in the process of changing how WHO works, how it interacts with other parts of the United Nations system, and how it enlists ministries, whole governments, universities, and other private organizations to improve health in the world. Here, the Editor describes the reorganization, the new people and resources, and prospects for setting a precedent in United Nations reform. Imagesp30-ap31-ap39-a PMID:9925169
... by United States organizations engaged in disseminating information. 319.4 Section 319.4 Aliens and... States organizations engaged in disseminating information. To be eligible for naturalization under... United States, and favorably disposed toward the good order and happiness of the United States; and (h...
Tanenbaum, Sandra J
This research compares two types of consumer organizations in one state in order to explore the significance of organizational independence for internal structure/operations and external relationships. The first type, consumeroperated service organizations (COSOs), are independent and fully self-governing; the second are peer-support service organizations (PSSOs), which are part of larger non-consumer entities. Mail surveys were completed by COSO and PSSO directors of a geographically representative sample of organizations; telephone interviews were conducted with a sub-sample. Owing to small sample size, matched COSO-PSSO pairs were analyzed using non-parametric statistics. COSOs and PSSOs are similar in some ways, e.g., types of services provided, but significantly different on internal variables, such as budget size, and external variables, such as number of relationships with community groups. Organizational independence appears to be a significant characteristic for consumer service organizations and should be encouraged by funders and among participants. Funders might establish administrative and/or programmatic measures to support consumer organizations that are independent or moving toward independence; their participants would also benefit from the provision, by authorities or advocates, of materials to guide organizations toward, for example, 501(c)3 status.
Cohen-Mansfield, Jiska; Frank, Julia K
The objective of this study was to describe the development, utilization and utility of an ongoing evaluation of a system of coordinated services to persons living in two naturally occurring retirement communities (NORCs). The evaluation system includes service provision, service utilization and client satisfaction. It identifies trends in provided services and determines how services are utilized. A continuous monitoring system for reporting and quality improvement was developed with the four service agencies associated with the service provision system. The monthly data from each agency are compiled and distributed in the form of a report. The evaluation project was successful in tailoring the reporting system to each agency. Multiple issues arose with staff compliance in utilization of the system, but, overall, the system evaluation presents detailed feedback on the services provided and helps with continuing development, testing of new delivery models, planning, maximizing resource utilization, customer service, and attaining and sustaining funding. A system evaluation of an organization that provides services to a community is vital to optimizing frequency and quality of services. There are many ways to implement system evaluations. However, the use of electronic-based records increases the likelihood of maintaining and utilizing the system.
Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence
Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
Full Text Available Abstract Background The VELO study is a comparative study of two Community Mental Health Centres (CMHC in Northern Norway. The CMHCs are organized differently: one has no local inpatient unit, the other has three. Both CMHCs use the Central Mental Hospital situated rather far away for compulsory and other admissions, but one uses mainly local beds while the other uses only central hospital beds. In this part of the study the ward staffs level of competence and treatment philosophy in the CMHCs bed units are compared to Central Mental Hospital units. Differences may influence health service given, resulting in different treatment for similar patients from the two CMHCs. Methods 167 ward staff at Vesterålen CMHCs bed units and the Nordland Central Mental Hospital bed units answered two questionnaires on clinical practice: one with questions about education, work experience and clinical orientation; the other with questions about the philosophy and practice at the unit. An extended version of Community Program Philosophy Scale (CPPS was used. Data were analyzed with descriptive statistics, non-parametric test and logistic regression. Results We found significant differences in several aspects of competence and treatment philosophy between local bed units and central bed units. CMHC staff are younger, have shorter work experience and a more generalised postgraduate education. CMHC emphasises family therapy and cooperation with GP, while Hospital staff emphasise diagnostic assessment, medication, long term treatment and handling aggression. Conclusion The implications of the differences found, and the possibility that these differences influence the treatment mode for patients with similar psychiatric problems from the two catchment areas, are discussed.
Manski, Richard J.; Hyde, Jody Schimmel; Chen, Haiyan; Moeller, John F.
Objective The purpose of this article is to explore differences in the socioeconomic, demographic characteristics of older adults in the United States with respect to their use of different types of dental care services. Methods The 2008 Health and Retirement Study (HRS) collected information about patterns of dental care use and oral health from individuals in the U.S. aged 55 years and older. We analyze these data and explore patterns of service use by key characteristics before modeling the relationship between service use type and those characteristics. Results The most commonly used service category was fillings, inlays or bonding, reported by 43.6 percent of those with any utilization. Just over one-third of those with any utilization reported a visit for a crown, implant or prosthesis, and one-quarter reported a gum treatment or tooth extraction. The strongest consistent predictors of use type are denture, dentate, and oral health status along with dental insurance coverage and wealth. Conclusions Our results provide insight into the need for public policies to address inequalities in access to dental services among an older US population. Our findings that showed lower income, less wealthy elderly with poor oral health are more likely to not use any dental services rather than using only preventive dental care, and that cost prevents most non-users who say they need dental care from going to the dentist, suggest a serious access problem and one that ultimately produces even worse oral health and expensive major procedures for this population in the future. PMID:27284127
Goldberg, D; Kallan, M J; Fu, L; Ciccarone, M; Ramirez, J; Rosenberg, P; Arnold, J; Segal, G; Moritsugu, K P; Nathan, H; Hasz, R; Abt, P L
The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009-2012, 96,028 (3.3%) were a "possible deceased-organ donor." The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0-57.0%); and (2) organs transplanted per possible donor (range: 0.52-1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.
Seijas, A.; Ledezma, M. [INTEVEP S.A., Los Teques (Venezuela)
An automatic ultrasonic inspection of a horizontal separator revealed cracking in various structural welds of the shell wall. The pressure vessel has been working in a gas compressing unit for several years. A review of the operation history (including fluids, pressure and temperature) indicated the cracking was probably associated with hydrogen induced cracking (HIC). To assure mechanical integrity a Fitness for Service Assessment was conducted based on fracture mechanics procedures. Using the fitness-for-service document and the computer software of the Materials Properties Council (MPC), limiting flaw size curves were obtained. The cracks were evaluated to determine their effect in the structural integrity of the pressure vessel, and to define the inspection program for the future.
Soil organic carbon (SOC) is the most important parameter influencing soil health, global climate change, crop productivity, and various ecosystem services. Therefore, estimating SOC at larger scales is important. The present study was conducted to estimate the SOC pool at regional scale using the historical database gathered by the National Soil Survey Staff. Specific objectives of the study were to upscale the SOC density (kg C m(-2)) and total SOC pool (PgC) across the Midwestern United States using the geographically weighted regression kriging (GWRK), and compare the results with those obtained from the geographically weighted regression (GWR) using the data for 3485 georeferenced profiles. Results from this study support the conclusion that the GWRK produced satisfactory predictions with lower root mean square error (5.60 kg m(-2)), mean estimation error (0.01 kg m(-2)) and mean absolute estimation error (4.30 kg m(-2)), and higher R(2) (0.58) and goodness-of-prediction statistic (G=0.59) values. The superiority of this approach is evident through a substantial increase in R(2) (0.45) compared to that for the global regression (R(2)=0.28). Croplands of the region store 16.8 Pg SOC followed by shrubs (5.85 Pg) and forests (4.45 Pg). Total SOC pool for the Midwestern region ranges from 31.5 to 31.6 Pg. This study illustrates that the GWRK approach explicitly addresses the spatial dependency and spatial non-stationarity issues for interpolating SOC density across the regional scale.
The author presents the history of the places where patients with epidemic pathologies were isolated. Since the study of medicine began, such places have been known as asclepiei, xenodochi, hospices, lazarettos, sanitary cordons, and quarantine stations and they contributed to controlling epidemics in Europe. Important not only in the context in which they were created, these structures expressed the medical culture and point of view of that age. Although very far from discovering the cause of the pathology due to their lack of scientific knowledge, the medical class sometimes knew how to effectively organize the isolation of patients. The history of such structures interweaves with the long history of Christianity and with the emerging nations of Europe and the city-states of the Italian Renaissance. Previously, in classical Greece and Imperial Rome there had also been "homes for the sick" to isolate patients. Today the world is periodically hit by epidemics. In such moments the medical profession uses its research ability and organizational capabilities but also historical memory to reduce epidemic contagion.
Nicholson, Tricia; Roderick, Paul
In England and Wales, the quantity and quality of renal services have improved significantly in the last decade. While acceptance rates for renal replacement therapy appear low by international standards, they are now commensurate with many other northern European countries. The major growth in renal services has been in hemodialysis, especially at satellite units. Health care is predominantly publicly funded through a tax-based National Health Service, and such funding has increased in the last 10 years. Improvements in health outcomes in England and Wales are expected to continue due to the recent implementation of standards, initiatives, and monitoring mechanisms for renal transplantation, vascular access, and patient transport.
Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric
Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.
Hausknecht, John P; Trevor, Charlie O; Howard, Michael J
Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.
Seoyoung Lee; Eun-Kyung Kim
The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea...
Puchalski, Krzysztof; Korzeniowska, Elżbieta
In 2014 the health promotion program aimed at managing personnel smoking was implemented in the Polish prison service (PS) in cooperation with the Nofer Institute of Occupational Medicine (NIOM). It combined education of managers, encouraging them to implement good practices, with employees' education. This paper describes the process of implementation and its effects in 159 units of PS, against the data on the management of smoking in medium and large companies in Poland gathered in 2010. Situations concerning smoking management in PS units before and after a half-year program implementation were compared. Data were gathered using self-diagnosis questionnaires (initial and final assessments) collectively filled in by representatives of management and employees. Due to the program implementation there was an increase in the percentage of PS units with known number of smoking employees (19% vs. 61%), consultions on formal smoking regulations with personnel (14% vs. 57%), minimal antismoking medical interventions (46% vs. 59%), and assessments of effects of antismoking activities (14% vs. 55%). There was also increase in the number of PS units with personnel totally obeying smoking regulations (28% vs. 41%) and decrease in those where such rules are not completely met (9% vs. 7%). In 3/4 PS units there was an increase in employees' interest in quitting smoking and in 40% of them employees smoke less at work. Almost every second unit has set up a health promotion team. In many aspects the program has brought along satisfying effects and allowed for depicting areas of improvement. Its scheme and tools can be used, after adaptation, in interventions concerning other health problems in workplaces. Med Pr 2016;67(5):605-621.
Nik Mustaffa, Nik Azah Karimah
This paper is prepared to understand an organization moves towards establishing financial shared service as a strategic finance function. The research is conducted by selected few multinational organizations from oil and gas industry to analyze the purpose of the move, how organizations are restructure and values generated from the financial shared services. The research also will extend towards identifying various challenges faced by the organizations during the restructuring process. The is...
Busch, Phyllis S.
Suggests simple ways to introduce students to the concept that the cell is the basic unit of structure of most organisms. Mentions materials for microscope study that are readily available and easy to handle, e.g., membranes from between the scales of the onion bulb, thin-leaved plants, pond water, and pollen. (JHZ)
Dr. Mike Miller reads an abridged version of the article, Encephalitis Caused by Pathogens Transmitted through Organ Transplants, United States, 2002â2013. Created: 10/21/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 10/23/2014.
Markham, W.T.; Koppen, van C.S.A.
This article investigates the messages about climate change that ten nature protection organizations in Germany, the Netherlands, and the United States communicate to their members and the public through their Internet sites, member magazines, and annual reports. Based on analysis of this content, w
Haglind, Fredrik; Montagud, Maria E. Mondejar; Andreasen, Jesper Graa
The project PilotORC was aimed at evaluating the technical and economic feasibility of the use of organic Rankine cycle (ORC) units to recover low-temperature waste heat sources (i.e. exhaust gases, scavenge air, engine cooling system, and lubricant oil system) on container vessels. The project...
Full Text Available Awareness about negative externalities generated by conventional farming is gaining momentum with consumers around the world, opting for alternatively, namely organically, produced food products. Information about consumers’ awareness is an essential element for farmers and marketing agencies to successfully plan production that can capture a greater market share. This study discusses effective factors influencing consumers’ awareness about the benefits of organic food in the United Arab Emirates. Sample data and ordinary least square (OLS regression techniques are applied to delineate factors influencing consumers’ awareness about organic food. The results from this regression analysis highlight the importance of specific socioeconomic determinants that change awareness about organic food products in United Arab Emirates (UAE households. This study finds that awareness about organic food is influenced more effective factors such as gender, nationality, and education as well as income, occupation and age. These research findings apply to other economies and societies that have an increasing per capita spending on organic food, but also where people are highly sensitive to information provided about organic food. Therefore, these results are important to these research beneficiaries including food marketing planners, researchers, and agricultural and food policy makers.
Aarons Gregory A
Full Text Available Abstract Background Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States. Methods In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS at the individual clinician level as a function of the Organizational Social Context (OSC measure at the organizational level, controlling for other organization and clinician characteristics. Results We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice. Conclusions The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes.
Domingo, Christian; Rubio, Vicente Ortún
Health care demands have increased dramatically in recent decades. With the introduction of major changes in the management of health problems, health care costs have spiralled. Today, in the interests of cost control, medicine is geared towards outpatient care whenever possible.In this process, the medical community has been obliged to adapt its traditional criteria to the dictates of national economies. Today the criteria for the organization and evaluation of the health services are based on the concepts of efficacy, effectiveness and efficiency. This has led to the emergence of a new discipline for the design and evaluation of medical service production, known as servuction, an amalgam of "service" and "production". The organigram of a new health product should include the problems the program faces and the steps proposed to overcome these problems. The concept of evaluation can be divided into two categories: administrative evaluation, and evaluative research. Avedis Donabedian was one of the founders of evaluative research, based on an easy-to-remember triad: structure-process-results. In the final evaluation of a new health care model, the innovations it provides must be considered.In this article we describe the stages involved in the design of a new health product and correlate them with the types of evaluation that should be applied at each point in the process. Our discussion addresses general aspects of servuction, but also focuses on the design of a particular service, created to care for patients with severe COPD.
Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Appointment based on service in United States positions of the Panama Canal Commission. 315.609 Section 315.609 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or Career-Conditional Appointment Under...
Gong, Xin; Wang, Pengcheng
This study provides a comparative analysis of the pre-service education system for preschool educators in China and the United States. Based on collected data and materials (literature, policy documents, and statistical data), we compare two areas of pre-service training: (1) the formal system; (2) the informal system. In the formal system, most…
Winqvist, Camilla; Ahnström, Johan; Bengtsson, Jan
The recent intensification of the arable landscape by modern agriculture has had negative effects on biodiversity. Organic farming has been introduced to mitigate negative effects, but is organic farming beneficial to biodiversity? In this review, we summarize recent research on the effects of organic farming on arable biodiversity of plants, arthropods, soil biota, birds, and mammals. The ecosystem services of pollination, biological control, seed predation, and decomposition are also included in this review. So far, organic farming seems to enhance the species richness and abundance of many common taxa, but its effects are often species specific and trait or context dependant. The landscape surrounding the focal field or farm also seems to be important. Landscape either enhances or reduces the positive effects of organic farming or acts via interactions where the surrounding landscape affects biodiversity or ecosystem services differently on organic and conventional farms. Finally, we discuss some of the potential mechanisms behind these results and how organic farming may develop in the future to increase its potential for sustaining biodiversity and associated ecosystem services.
Asmolov, V. G.; Povarov, V. P.; Vitkovskii, S. L.; Berkovich, V. Ya.; Chetverikov, A. E.; Mozul', I. A.; Semchenkov, Yu. M.; Suslov, A. I.
Basic statements of the Concept of Extending the Service Life of the VVER-440-Based Power Units at the Novovoronezh NPP beyond 45 years are considered. This topic is raised in connection with the fact that that in December 2016 and in December 2017 the extended service lives of Units 3 and 4 at this NPP will expire. The adopted concept of repeatedly extending the service life of the Novovoronezh NPP Unit 4 implies fitting the power unit with additional reactor core cooling systems with a view to extend the (ultimate) design-basis accidents (which have hitherto been adopted to be a loss of coolant accident involving a leak of reactor coolant through a break with a nominal diameter of 100 mm) to a reactor coolant leak equivalent to rupture of the main reactor coolant pipeline. The modified Unit 4 will also use the safety systems of Unit 3 that is going to be decommissioned. Preliminary calculated assessments of the new design-basis accident scenario involving rupture of the reactor coolant pipeline in Unit 4 fitted with a new configuration of safety systems confirmed the correctness of the adopted concept of repeatedly extending the service life of Unit 4.
Harvey, R Reid; Zakhour, Christine M; Gould, L Hannah
Consumer demand for organically produced foods is increasing in the United States as well as globally. Consumer perception often credits organic foods as being safer than conventionally produced foods, although organic standards do not directly address safety issues such as microbial or chemical hazards. We reviewed outbreaks reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System where the implicated food was reported to be organic. Information collected for each outbreak included the year, state, number of illnesses, pathogen, and implicated food. We identified 18 outbreaks caused by organic foods from 1992 to 2014, resulting in 779 illnesses, 258 hospitalizations, and 3 deaths; 56% of outbreaks occurred from 2010 to 2014. Nine outbreaks occurred in a single state, and nine outbreaks were multistate. Salmonella sp. (44% of outbreaks) and Escherichia coli O157:H7 (33%) were the most commonly occurring pathogens. Eight of the outbreaks were attributed to produce items, four to unpasteurized dairy products, two to eggs, two to nut and seed products, and two to multi-ingredient foods. Fifteen (83%) outbreaks were associated with foods that were definitely or likely U.S. Department of Agriculture certified. More foodborne outbreaks associated with organic foods in the United States have been reported in recent years, in parallel with increases in organic food production and consumption. We are unable to assess risk of outbreaks due to organic foods compared with conventional foods because foodborne outbreak surveillance does not systematically collect food production method. Food safety requires focused attention by consumers, regardless of whether foods are produced organically or conventionally. Consumers should be aware of the risk of milk and produce consumed raw, including organic.
Dahlén, Gunnar; Alenäs-Jarl, Elna; Hjort, Gunilla
Presence of bacteria in high levels in the water lines of dental units is well known. The extent of this problem is however less well studied.This study was conducted to evaluate the water quality of all dental units within the Public Dental Health Service (Folktandvården, FTV) of the city of Göteborg, Sweden. 405 dental units in 35 clinics were tested.The evaluation included both "fast growing" (2 days incubation) and "slow growing" (7 days incubation) bacteria in 50 ml water sample from the units. The presence of potential pathogens, e.g., coliforms, Pseudomonas spp and Legionella pneumophila were also examined. Of the 405 dental units, 303 (75%) did not have acceptable (desinfection of all units of the Public Dental Health Service is needed.
Full Text Available The analysis of stages of formation of the modern legislation, established kinds of medical aid and sources of their financing depending on levels of the power, structure of a network of organization of public health services concerning protection of constitutional laws of citizens on reception of timely, qualitative, highly technological and accessible medical aid is presented in the article. Aspects of formation of standard-legal base of service of the first aid, including specialized aid are considered in detail. The classification signs defining technologies of rendering of medical aid and the form of its organization are considered
Brix, Jacob; Krogstrup, Hanne Kathrine; Mortensen, Nanna Møller
A change from New Public Management to New Public Governance (NPG) does not occur overnight. This forces public service organizations to develop new hybrid organizational forms as strategic response to the current situation. In NPG the basic assumption is that coproduction will result in increased...... efficiency and effectiveness for public service organizations as a new organizational recipe. However, a recent review determines that only few empirical studies document these claimed effects. To enable the creation of more empirical evidence that establish the effects of co-production, the purpose of our...
Tobagi, Fouad A.; Dalgic, Ismail; Pang, Joseph
The design and implementation of interface units for high speed Fiber Optic Local Area Networks and Broadband Integrated Services Digital Networks are discussed. During the last years, a number of network adapters that are designed to support high speed communications have emerged. This approach to the design of a high speed network interface unit was to implement package processing functions in hardware, using VLSI technology. The VLSI hardware implementation of a buffer management unit, which is required in such architectures, is described.
... government or international organization. 31.3401(a)(5)-1 Section 31.3401(a)(5)-1 Internal Revenue INTERNAL....3401(a)(5)-1 Remuneration for services for foreign government or international organization. (a... are immaterial for purposes of the exception. (b) Services for international organization. (1)...
Beck, Charlotte; Wernham, Connie
Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the 'place then train' philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual
Lawler, Joshua J; Lewis, David J; Nelson, Erik; Plantinga, Andrew J; Polasky, Stephen; Withey, John C; Helmers, David P; Martinuzzi, Sebastián; Pennington, Derric; Radeloff, Volker C
Providing food, timber, energy, housing, and other goods and services, while maintaining ecosystem functions and biodiversity that underpin their sustainable supply, is one of the great challenges of our time. Understanding the drivers of land-use change and how policies can alter land-use change will be critical to meeting this challenge. Here we project land-use change in the contiguous United States to 2051 under two plausible baseline trajectories of economic conditions to illustrate how differences in underlying market forces can have large impacts on land-use with cascading effects on ecosystem services and wildlife habitat. We project a large increase in croplands (28.2 million ha) under a scenario with high crop demand mirroring conditions starting in 2007, compared with a loss of cropland (11.2 million ha) mirroring conditions in the 1990s. Projected land-use changes result in increases in carbon storage, timber production, food production from increased yields, and >10% decreases in habitat for 25% of modeled species. We also analyze policy alternatives designed to encourage forest cover and natural landscapes and reduce urban expansion. Although these policy scenarios modify baseline land-use patterns, they do not reverse powerful underlying trends. Policy interventions need to be aggressive to significantly alter underlying land-use change trends and shift the trajectory of ecosystem service provision.
Noyce, Matthew; Szabo, Aniko; Pajewski, Nicholas M; Jackson, Scott; Bradley, T Gerard; Okunseri, Christopher
Language barriers have been well documented as a contributing factor to disparities in the receipt of medical services, especially for Hispanic children. However, there is a paucity of information on the effect of language barriers on children's dental service utilization. We examined the association of primary language spoken at home with the receipt of preventive and routine dental care for children in the United States. We analyzed data from the Medical Expenditure Panel Survey (2002-2004), which contains data on 21,049 children weighted to represent 75.8 million children nationally. Among children aged 1-18 years, 13 percent spoke a language other than English at home. Whites, females, children between the ages of 7 and 12 years, and those whose parents spoke English at home had the highest marginal rates of preventive and routine dental visits. However, the large marginal effect of language, even among Hispanics, was not significant after adjusting for other covariates. Parental education and having a primary provider were the strongest predictors of preventive and routine dental visits. Children that did not speak English at home were less likely to receive preventive or routine dental care. However, after adjusting for other socio-economic factors, our study suggests that language barriers may not play as pronounced a role in the receipt of dental care as that documented for medical services.
Much talk about service design has focused on how to bring design practices, design thinking and design methods into an organization in order to transform or change the way it is going about business. There is only one thing that researchers and practitioners have overlooked: Design principles......, methods and practices are already deeply embedded in organizations. That is, in fact, the real problem: Organizations are full of design legacies, however flawed and poorly suited. If service designers want to effect real change in real organizations, they have to be able to articulate...... these organizational design practices. This paper explains the concept of design legacies and describes three elements of organizational design legacies: organizational purpose, organizational design approaches and organizational design practices. Using a matrix developed around designing for, with and by, the paper...
Chatterjee, Paula; Venkataramani, Atheendar S; Vijayan, Anitha; Wellen, Jason R; Martin, Erika G
Shortages in transplantable solid organs remain a critical public health challenge in the United States. During the past 2 decades, all states have implemented policies to increase organ supply, although their effectiveness is unknown. To determine the effects on organ donation and transplantation rates of state policies to provide incentives for volunteer donation. Using a quasi-experimental design and difference-in-differences regression analyses, we estimated the effect of policies in all 50 states and the District of Columbia on organ donors per capita and the number of transplantations from January 1, 1988, to December 31, 2010. Analyses were also stratified by type of donor (living vs deceased). Data were derived from the United Network for Organ Sharing. All data collection occurred between July 7 and September 27, 2013. Policies of interest were the presence of first-person consent laws, donor registries, dedicated revenue streams for donor recruitment activities, population education programs, paid leave for donation, and tax incentives. Information on states' passage of various policies was obtained from primary legislative and legal sources. The number of organ donors and transplantations per state, per year, during the study period. From 1988 to 2010, the number of states passing at least 1 donation-related policy increased from 7 (14%) to 50 (100%). First-person consent laws, donor registries, public education, paid leave, and tax incentives had no robust, significant association with either donation rates or number of transplants. The establishment of revenue policies, in which individuals contribute to a protected state fund for donation promotion activities, was associated with a 5.3% increase in the absolute number of transplants (95% CI, 0.57%-10.1%; P = .03). These associations were driven by a 4.9% increase in organ donations (95% CI, 0.97%-8.7%; P = .01) and an 8.0% increase in transplants (95% CI, 3.1%-12.9%; P = .001) from
Jenny Marcela Cardona Bedoya
Full Text Available This article presents the results of processes thesis of "Master in Management and Marketing Management and Global New Markets" for the University Camilo José Cela. The data collection is done through an exploratory research and the study of business unit Unit Providing Services of Virtual Training Unipanamericana - Compensate. Considering secondary sources we identified: 1 The most important in the world and in Colombia at the level of new technologies, 2 The development trends of the array Mic Mac establishes the relationship between trends and portfolio of the business unit. And 3 Identify the growth of applications and the impact of E-learning. The collection and analysis of information on the qualitative method developed through interviews, aiming to identify trends that impact the marketing plan. In the analysis were found four trends that impact the line of business: The joint educational levels, The new educational experiences, Changes in learning models and Strengthening education systems. These trends were explored in an evaluative context, to identify new technologies that are necessary for professional development.
Jane M. Watson
Full Text Available This paper addresses issues associated with the development of a unit preparing pre-service teachers to be quantitatively literate in three respects. These issues surround (i the need to be aware of numeracy demands across the curriculum, (ii the need to model numerate behavior in all interactions of teachers, and (iii the need to be able to interpret and use system data provided from local and national testing programs. The context for the unit described is Australia, where a national testing program for literacy and numeracy requires teachers to analyze extensive data on their students, a national curriculum requires teachers of all subjects and levels to encompass literacy and numeracy in their teaching, and national standards for the teaching profession are being progressively introduced to set and assess teachers’ proficiency across their careers. The unit consists of 12 topics covered in lectures and tutorial material, which was offered to over 800 students in External and On-campus modes in 2010.
Full Text Available The contribution of marine organic emissions to the air quality in coastal areas of the western United States is studied using the latest version of the US Environmental Protection Agency (EPA regional-scale Community Multiscale Air Quality (CMAQv4.7 modeling system. Emissions of marine isoprene, monoterpenes, and primary organic matter (POM from the ocean are implemented into the model to provide a comprehensive view of the connection between ocean biology and atmospheric chemistry and air pollution. Model simulations show that marine organics can increase the concentration of PM2.5 by 0.1–0.3 μg m−3 (up to 5% in some coastal cities such as San Francisco, CA. This increase in the PM2.5 concentration is primarily attributed to the POM emissions, with small contributions from the marine isoprene and monoterpenes. When marine organic emissions are included, organic carbon (OC concentrations over the remote ocean are increased by up to 50% (25% in coastal areas, values consistent with recent observational findings. This study is the first to quantify the air quality impacts from marine POM and monoterpenes for the United States, and it highlights the need for inclusion of marine organic emissions in air quality models.
Mikkelsen, Bent Egberg; He, Chen
The discussion about nutritional advantages of organic consumption has traditionally focused on the properties of the food it self. Studies have shown however that change of consumption patterns towards organic food seems to induce changed dietary patterns. The current research was a part of the i...... to be driven by different agendas but that awareness raising on nutrition and sustainability issues seems to be an important feature of many change processes. Findings also suggest that the two agendas although separated in the scientific literature is more integrated in the everyday life perspective of school...
Jasper, Justin T.; Nguyen, Mi T.; Jones, Zackary L.; Ismail, Niveen S.; Sedlak, David L.; Sharp, Jonathan O.; Luthy, Richard G.; Horne, Alex J.; Nelson, Kara L.
Abstract Treatment wetlands have become an attractive option for the removal of nutrients from municipal wastewater effluents due to their low energy requirements and operational costs, as well as the ancillary benefits they provide, including creating aesthetically appealing spaces and wildlife habitats. Treatment wetlands also hold promise as a means of removing other wastewater-derived contaminants, such as trace organic contaminants and pathogens. However, concerns about variations in treatment efficacy of these pollutants, coupled with an incomplete mechanistic understanding of their removal in wetlands, hinder the widespread adoption of constructed wetlands for these two classes of contaminants. A better understanding is needed so that wetlands as a unit process can be designed for their removal, with individual wetland cells optimized for the removal of specific contaminants, and connected in series or integrated with other engineered or natural treatment processes. In this article, removal mechanisms of trace organic contaminants and pathogens are reviewed, including sorption and sedimentation, biotransformation and predation, photolysis and photoinactivation, and remaining knowledge gaps are identified. In addition, suggestions are provided for how these treatment mechanisms can be enhanced in commonly employed unit process wetland cells or how they might be harnessed in novel unit process cells. It is hoped that application of the unit process concept to a wider range of contaminants will lead to more widespread application of wetland treatment trains as components of urban water infrastructure in the United States and around the globe. PMID:23983451
Kênia Barreiro de Souza
Full Text Available The service sector expansion has shown to be a multiple trend process, producing distinct sectorial compositions. The present paper aims to make a comparison between two large economies in different stages of development with an extensive service sector (Brazil and United States, by focusing on final and intermediary demand changes and sectorial productivity as well. Input–output matrices for Brazil and United States were used and two applications were carried out: structural decomposition analysis and total factor productivity. Main results are as follows. Firstly, the growth in services was fostered by several factors, among which household consumption assumes an important role for both countries. Second, inter-industrial linkages play a major role only for United States. Thirdly, there is now evidence of cost disease for Brazil. Finally, productivity is lower in Brazil, nonetheless labor productivity increased above the average in some service sectors.
Glazier, A K; Danovitch, G M; Delmonico, F L
A policy proposal relating to transplantation of deceased donor organs into nonresidents of the United States was jointly sponsored by the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) International Relations and Ethics Committees and approved by the OPTN/UNOS Board in June 2012. The proposal followed prior acceptance by the Board of the definitions of "travel for transplantation" and "transplant tourism" and the introduction in March 2012 of revised data collection categories for transplant candidates who are neither citizens nor residents. The most important aspect of the new policy concerns replacement of the previous so-called "5% rule" with the review of all residency and citizenship data and the preparation of a public annual report. The new policy does not prohibit organ transplantation in nonresidents. However, the policy and public data report will ensure transparency and support transplant center responsibility to account for their practices. Since the adoption of the policy, the first 19 months of data show that less than 1% of new deceased donor waitlist additions and less than 1% of transplantation recipients were non-US citizen/nonresidents candidates who traveled to the United States for purposes of transplantation. By adopting this policy, the US transplant community promotes public trust and serves as an example to the international transplant community.
Manski, Richard J; Macek, Mark D; Brown, Erwin; Carper, Kelly V; Cohen, Leonard A; Vargas, Clemencia
In the United States, health-care costs are increasing while state and federal budgets contract. In order to establish a baseline and provide data for alternative oral health workforce models, this report describes the types of dental procedures received by US working-age adults in 2009 and looks at trends since 1999. Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Surveys. The primary outcome variable represented the types of dental procedures undergone during a dental visit in the preceding year. Descriptive variables included dental insurance coverage and income. Analysis was restricted to adults aged 21-64 years. In 2009, diagnostic and preventive procedures accounted for >75 percent of all dental services received by working-age adults. Those with public insurance and those who were uninsured, as well as those with lower income, were less likely to receive these services than their peers. Between 1999 and 2009, small but statistically significant increases in the proportion of preventive and diagnostic procedures received occurred in the nation. The likelihood that a preventive service would be received during a visit also increased during this period, while the probability that a restorative procedure would be undergone went down. Preventive-type procedures represented the vast majority of dental services received by working-age adults in 2009. Between 1999 and 2009, receipt of preventive-type procedures generally increased while receipt of surgical-type procedures decreased. These findings emphasize the health-promoting role of the dental team and provide a baseline for the measurement of future trends. Published 2013. This article has been contributed to by U.S. Government employees and their work is in the public domain in the US.
Mancini, Michael A; Salas-Wright, Christopher P; Vaughn, Michael G
To examine illicit drug use and service utilization patterns of US-born and foreign-born Hispanics in the United States. Hispanic respondents 18 years and older in the NESARC were categorized as being of Mexican (n = 3,556), Puerto Rican (n = 785), Cuban (n = 346), Central American (n = 513), or South American (n = 381) origin. We examined lifetime prevalence of drug use and substance abuse treatment utilization patterns for US-born and Hispanic immigrants across subgroups. Lifetime prevalence of drug use was greater among US-born Hispanics than Hispanic immigrants after controlling for age, gender, income, education, urbanicity, parental history of drug use problems and lifetime DSM-IV mood/anxiety disorders. Both US-born and immigrant Hispanic drug users were less likely than non-Hispanic white drug users to have utilized any form of substance abuse treatment (US-born AOR = 0.89, immigrant AOR = 0.64) and more likely to have utilized family or social services (US-born AOR = 1.17, immigrant AOR = 1.19). Compared to US-born Hispanic drug users, Hispanic immigrant drug users were less likely to have used any form of substance abuse treatment (AOR = 0.81) and were more likely to have utilized family or social services (AOR = 1.22). Strategies to increase engagement and retention of Hispanic drug users in substance abuse treatment include increasing access to linguistically and culturally competent programs that address unmet family and social needs. Further studies examining differences in drug use and service utilization patterns within Hispanic subgroups are needed.
National Park Service, Department of the Interior — This data set was developed in conjunction with the U.S. Department of Agriculture, Natural Resources Conservation Service, and meets the standards and...
Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P
Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in
Benato, A.; Kærn, Martin Ryhl; Pierobon, Leonardo
This paper is devoted to the investigation of critical dynamic events causing thermochemical decompositionof the working fluid in organic Rankine cycle power systems. The case study is the plant of an oiland gas platform where one of the three gas turbines is combined with an organic Rankine cycle...... unit toincrease the overall energy conversion efficiency.The dynamic model of the plant is coupled with a one-dimensional model of the once-through boilerfed by the exhaust thermal power of the gas turbine. The heat exchanger model uses a distributedcross-flow physical topology and local correlations...... and fluid decomposition. It is demonstrated thatthe use of a spray attemperator can mitigate the problems of local overheating of the organic compound.As a practical consequence, this paper provides guidelines for safe and reliable operation of organicRankine cycle power modules on offshore installations....
Domingo, Christian; Rubio, Vicente Ortún
Health care demands have increased dramatically in recent decades. With the introduction of major changes in the management of health problems, health care costs have spiralled. Today, in the interests of cost control, medicine is geared towards outpatient care whenever possible. In this process, the medical community has been obliged to adapt its traditional criteria to the dictates of national economies. Today the criteria for the organization and evaluation of the health services are based on the concepts of efficacy, effectiveness and efficiency. This has led to the emergence of a new discipline for the design and evaluation of medical service production, known as servuction, an amalgam of “service” and “production”. The organigram of a new health product should include the problems the program faces and the steps proposed to overcome these problems. The concept of evaluation can be divided into two categories: administrative evaluation, and evaluative research. Avedis Donabedian was one of the founders of evaluative research, based on an easy-to-remember triad: structure-process-results. In the final evaluation of a new health care model, the innovations it provides must be considered. In this article we describe the stages involved in the design of a new health product and correlate them with the types of evaluation that should be applied at each point in the process. Our discussion addresses general aspects of servuction, but also focuses on the design of a particular service, created to care for patients with severe COPD. PMID:19340319
... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Regulation and examination of service organizations. 611.1136 Section 611.1136 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM... associations, it is subject to applicable Farm Credit Administration (we, our) regulations. (b) Who examines...
Svensson, Per G.; Huml, Matthew R.; Hancock, Meg G.
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…
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Suppliers of services-privately owned commercial suppliers and nonprofit organizations. 228.53 Section 228.53 Foreign Relations AGENCY FOR... Waivers § 228.53 Suppliers of services—privately owned commercial suppliers and nonprofit...
Fardani Haryadi, Adiska; Janssen, Marijn; Hulstijn, Joris; van der Voort, Haiko; Wahyudi, Agung
Big data has been acknowledged for its enormous potential. In contrast to the potential, in a recent survey more than half of financial service organizations reported that big data has not delivered the expected value. One of the main reasons for this is related to data quality. The objective of
Studies on the need for counseling services were conducted at three separate corporate settings in Malaysia. The three organizations were the National Institute of Public Administration Malaysia; Syarikat Telekom Malaysia Berhad; and the Johor Port Authority. Subjects included 129 supervisory officers and 135 supervisees at the National Institute…
Cronley, Courtney; Patterson, David A.
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)…
... AFFAIRS Proposed Information Collection (Appointment of Veterans Service Organization/or Individuals as... of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal... information, including each proposed extension of currently approved collection, and allow 60 days for public...
... AFFAIRS Agency Information Collection (Appointment of Veterans Service Organization/or Individuals as... of Veterans Affairs, will submit the collection of information abstracted below to the Office of... information collection and its expected cost and burden; it includes the actual data collection instrument...
Cronley, Courtney; Patterson, David A.
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)…
Tanenbaum, Sandra J
Consumer-operated service organizations (COSOs) are independent organizations whose administrative and financial control resides with consumers. Based on a 2008 mail survey and followup interviews conducted in 2009, this study depicts the internal characteristics and external relationships, as well as some relationships between the two, of COSOs in one state. Profiles include on the one hand, governance structures, services provided, sources and levels of funding, etc. and on the other, relationships between COSOs and other actors in the mental health system and the local community. COSOs emerge as more self-governing and community-based than required by certification requirements and as developing internally and externally in tandem. COSOs are not only adjunct or alternative service providers, but also civic associations and loci for the expression of citizenship by mentally ill people.
Bean, Corliss N; Fortier, Michelle; Post, Courtney; Chima, Karam
Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little to date has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of papers on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. Ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health.
Song Dangyu; Yang Cunbei; Zhang Xiaokui; Su Xianbo; Zhang Xiaodong
X-ray diffraction (XRD) was used to study the structure of the organic crystallite unit (La,Lc,d002) in coals collected from Henan and Shanxi Provinces,XRD patterns of coal were collected in a step-scan mode (0.1 °/step) over an angular range of 2-90° (2θ),allowing 8 s at each step.The structure of the crystallite unit was determined from the Scherrer equation and peak parameters deduced from whole pattern fitting.The results show that the structure of the crystallite unit in coal is mainly controlled by the coal rank.As the coal rank increases the average diameter of a coal crystallite unit (La) increases,the interlayer spacing (d002) decreases slightly,and the average height of a coal crystallite unit (Lc) increases at first but then decreases.A new diffraction peak from the crystallite unit in coal was found at a low scattering angle in the XRD pattern (2-10°).This suggests a structure with an inter-layer spacing from 1.9 to 2.8 nm exists in coal crystallites.
Mads V. Markussen
Full Text Available Resource use and environmental impacts of a small-scale low-input organic vegetable supply system in the United Kingdom were assessed by emergy accounting and Life Cycle Assessment (LCA. The system consisted of a farm with high crop diversity and a related box-scheme distribution system. We compared empirical data from this case system with two modeled organic food supply systems representing high- and low-yielding practices for organic vegetable production. Further, these systems were embedded in a supermarket distribution system and they provided the same amount of comparable vegetables at the consumers’ door as the case system. The on-farm resource use measured in solar equivalent Joules (seJ was similar for the case system and the high-yielding model system and higher for the low-yielding model system. The distribution phase of the case system was at least three times as resource efficient as the models and had substantially less environmental impacts when assessed using LCA. The three systems ranked differently for emissions with the high-yielding model system being the worst for terrestrial ecotoxicity and the case system the worst for global warming potential. As a consequence of being embedded in an industrial economy, about 90% of resources (seJ were used for supporting labor and service.
Stitt, Caroline R. [Mills College, Oakland, CA (United States)
Forest soils represent a large portion of global terrestrial carbon; however, which soil carbon sources are used by soil microbes and respired as carbon dioxide (CO2) is not well known. This study will focus on characterizing microbial carbon sources from organic and mineral soils from four eastern United States deciduous forests using a unique radiocarbon (14C) tracer. Results from the dark incubation of organic and mineral soils are heavily influenced by site characteristics when incubated at optimal microbial activity temperature. Sites with considerable differences in temperature, texture, and location differ in carbon source attribution, indicating that site characteristics play a role in soil respiration.
Petzold, Donald; Heppen, John
Many student geography organizations or clubs associated with colleges and universities undertake community service projects each year to meet local needs and to gain recognition within the community. A uniquely geographical project of playground map painting provides a great community service and goes one step further by incorporating elements of…
Paul V. Ellefson; Michael A. Kilgore; Kenneth E. Skog; Christopher D. Risbrudt
Located in 23 countries, 40 forest-products research and development organizations outside the United States were reviewed in 2004 and 2005. The intent was to obtain a better understanding of how such organizations are structured and administered and their performance judged. Investing over $600 million annually, the 40 organizations employed 7,000 to 7,500 scientists...
James, Natalie J; Hussain, Rumana; Moonie, Alasdair; Richardson, Donald; Waring, W Stephen
An Acute Medical Unit has recently been established at York Hospital. The present study sought to characterise the case mix of acutely unwell medical patients to allow identification of priorities for ongoing service development and to assess educational opportunities for trainees in the region. Data were collected for 16001 admission episodes between January 2010 and April 2011 inclusive. These allowed characterisation of the case mix, and identified key priorities where clinical pathway do not yet exist, namely heart failure, urinary tract infection, and acute diarrhoea. Good educational opportunities exist for most aspects of the Acute Medicine curriculum; several weaknesses were identified, and trainees might address these by undertaking a specific period of specialty training in endocrinology and neurology.
Alviani, F. [Law and Economics Consulting Group, London (United Kingdom)
This article investigates BG Storage monopoly position in the supply of gas storage services. The company is currently thought by the regulator to be exploiting its monopoly power to price in discriminatory way. The analysis, however, shows that unsold storage capacity depend on the current over capacity in the United Kingdom gas market, more than on the abuse od market power. [Italian] Questo articolo analizza la posizione di monopolio di BG Storage nell'offerta di servizi di stoccaggio del gas. Dall'analisi emerge che la capacita' di stoccaggio invenduta potrebbe dipendere piu' dalla situazione di sovracapacita' del mercato del gas inglese che dall'abuso di posizione dominante, di cui la compagnia e' accusata.
Loewenson, Rene; Simpson, Sarah
Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health-oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles. It presents ways in which early first contact and continuity of PC, PC coordination of referral, multidisciplinary team approaches, investment in PC competencies, and specific payment and incentive models have all supported comprehensive approaches. These experiences locate PC as a site of innovation, where information technology and peer-to-peer learning networks support learning from practice.
... 39 Postal Service 1 2010-07-01 2010-07-01 false Headquarters organization. 221.5 Section 221.5 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.5 Headquarters organization. (a) Postmaster General—(1) Appointment. The postmaster general (PMG), the...
Eileen Van Aken
Full Text Available Previous research has shown that military units operating in the context of risky missions display the characteristics of a Learning Organization. The present work provides preliminary exploratory evidence about the association between Learning Organization characteristics and leadership styles used by military leaders in the field. Based on the literature, we hypothesized that higher Learning Organization characteristics would be associated with a more transformational style of leadership that inspires followers. With this purpose, the five characteristics of a Learning Organization as defined by Peter Senge (Systems Thinking, Team Learning, Shared Vision, Mental Models, and Personal Mastery and leadership styles as defined by the multifactor leadership model of Bass and Avolio (Transformational, Transactional, and Passive-Avoidant, were measured among commanding officers who had recently served in a mission abroad. Associations with organizational outcomes (Extra-Effort, Effectiveness, and Satisfaction were also investigated for both Learning Organization characteristics and leadership styles. The correlations showed that Learning Organization characteristics were highly related to Transformational leadership dimensions, and also with Transactional leadership based on Contingent Rewards; meanwhile no association was found with a Passive-Avoidant leadership. Organizational outcomes were also related to Transformational leadership, Contingent Rewards and to various characteristics of a Learning Organization. Implications of these results, as well as avenues for future research, are also discussed.
Tsymbal, V. P.; Kozhemyachenko, V. I.; Rybenko, I. A.; Mochalov, S. P.; Padalko, A. G.; Kalashnikov, S. N.; Krasnoperov, S. Yu; Ermakova, L. A.; Olennikov, A. A.
The basic principles laid in the creation of a new jet-emulsion process and metallurgical unit were considered. Development of self-organizing oscillator reactor, bottom feed of the prepared in it combustible mixture to the column reactor and a large deviation from the thermodynamic equilibrium allow dissipative structure to be created, and thus control the ratio of reducing and oxidizing processes, the carbon content in the metal.
Brozek, Carl Kavanaugh; Dinca, Mircea
Cation exchange is an emerging synthetic route for modifying the secondary building units (SBUs) of metal–organic frameworks (MOFs). This technique has been used extensively to enhance the properties of nanocrystals and molecules, but the extent of its applications for MOFs is still expanding. To harness cation exchange as a rational tool, we need to elucidate its governing factors. Not nearly enough experimental observations exist for drawing these conclusions, so we provide a conceptual fra...
Nielsen, Mette Strange
Employee engagement has long been capturing the attention of researchers and practitioners, (e.g. Bakker, Albrecht, & Leiter, 2011; Buckingham & Coffman, 1999) due to its positive impact on various measures of organizational performance (Gruman & Saks, 2011; Harter, Schmidt, & Hayes, 2002; Mone...... & London, 2010). To date, however, employee engagement has primarily been studied in private manufacturing firms leaving out a gap of research in a public service organization, such as eldercare organizations, although engagement according to Boselie (2010) is highly relevant in the specific context....... The purpose of the PhD project is to build a model explaining employee engagement in a public service organization. Research on work design theory (e.g. Hackman & Oldham, 1976) will be used, since it has often been applied to identify antecedents associated with engagement (Bakker & Demerouti, 2007; Kahn...
Andreea Jenica PETCU (DRAGHICI
Full Text Available As service organizations become increasingly aware that knowledge is among their most valuable strategic assets, they will try to develop and maintain the knowledge transfer through the organization and to make the employees understand the importance of knowledge and communication.The paper highlights that advanced information and communication technologies, a dedicated knowledge sharing culture and a strong leadership based on continuous improvement and excellence models such is Lean Six Sigma are essential factors in facilitating knowledge transfer. The Lean Six Sigma approach is necessary because service organizations and their employees need a methodology and a leadership approach for improving and resolving problems, which arise from organizational culture and knowledge transfer.
Providence, C; Gommans, J; Burns, A
To determine the current provision of acute medical services, including the development of medical assessment and planning units (MAPUs), by district health boards (DHBs) throughout New Zealand (NZ). A questionnaire-based survey about organisation of acute medical services and establishment of MAPUs was sent to all 21 DHBs in NZ. All 21 DHBs responded. Seven DHBs serving 42% of the population have established MAPUs since 2003 and a further six have plans to do so over the next 3 years, potentially expanding service to 73% of the NZ population. All seven current MAPUs are in close proximity to and accept patients directly from emergency departments. Each MAPU has a documented target length of stay, four units have referral protocols, five provide guidelines for management of common medical emergencies and five routinely audit unit performance. Five MAPUs have cardiac monitored beds and isolation rooms. Rapid access is available to computed tomography scanning (six units), ultrasound (five) and echocardiography (four). Two units have no nominated physician leadership and two lack dedicated therapy resources. General physicians are involved in provision of acute medical services in 20 of 21 DHBs. Medical assessment and planning units have become an important component of acute medical service provision in NZ. The established units largely comply with Australasian recommendations, although important deficiencies exist. Training of physicians must combine the needs of acute medical patients and clinical roles of physicians within MAPUs with local DHB requirements for services to be most effective. © 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.
Full Text Available BACKGROUND: School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. METHODS: Analyses are based on weighted data (N = 6483 from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13-18 years. Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. RESULTS: School mental health service use predicted subsequent out-of-school service utilization for mental disorders i in the medical specialty sector, in adolescents with affective (hazard ratio (HR = 3.01, confidence interval (CI = 1.77-5.12, anxiety (HR = 3.87, CI = 1.97-7.64, behavior (HR = 2.49, CI = 1.62-3.82, substance use (HR = 4.12, CI = 1.87-9.04, and eating (HR = 10.72, CI = 2.31-49.70 disorders, and any mental disorder (HR = 2.97, CI = 1.94-4.54, and ii in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17-4.56, behavior (HR = 1.99, CI = 1.29-3.06, and substance use (HR = 2.48, CI = 1.57-3.94 disorders, and any mental disorder (HR = 2.33, CI = 1.54-3.53, but iii not in the mental health specialty sector. CONCLUSIONS: Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby
Lee, Seoyoung; Kim, Eun-Kyung
The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals. Copyright © 2017. Published by Elsevier B.V.
Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel
To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P hospital mortality rates were higher at larger hospitals, but no significant differences were found when mortality was risk adjusted. There was an association between nurse workload with mortality rate for selected conditions (r: 0.25; P = 0.009). Safety committee and multidisciplinary ward rounds were also associated with outcomes. We have not found any association between complexity and intra-hospital mortality. There is an association between some management indicators with intra-hospital mortality and the length of stay. Better disease-specific outcomes adjustments and a larger number of IMUs in the sample may provide more insights about the association between management of IMUs with healthcare outcomes.
Okumura, Lucas Miyake; da Silva, Daniella Matsubara; Comarella, Larissa
Abstract Objective: Clinical Pharmacy Services (CPS) are considered standard of care and is endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU). Methods: This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention. Results: Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs. Conclusions: Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications. PMID:27578187
Walker, Mary Ellen; Anonson, June; Szafron, Michael
The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: email@example.com.
Feichtl, Maria Maniscalco; Clauson, Kevin A; Alkhateeb, Fadi M; Jamass, Daniel S; Polen, Hyla H
To examine community pharmacists' use of language-access services (LASs) in the United States. Cross-sectional study. United States from January to February 2009. 1,000 pharmacists (500 community chain and 500 community independent pharmacists). Mailed survey. Use, availability, and characterization of written translation and verbal interpretation LASs, along with perceived barriers for LASs. 296 surveys were completed, yielding an adjusted response rate of 30.0%. Computer software was used more often for translation LASs (57.4%) compared with pharmacists using on-site personnel (38.4%). Almost one-half of all pharmacies (49.8%) that possessed LAS capacity failed to notify patients of their availability. Many respondents indicated that they never used translation (40.9%) or interpretation (39.8%) in their pharmacies. The most commonly cited barrier for use of LASs by community pharmacists was potential inaccuracies in translation/interpretation (52.1%). Lack of time (25.1%) was frequently cited for failing to use LASs. Community pharmacists are not consistently or optimally using LASs in daily practice. Failure to use LASs can result in poorer outcomes for patients with limited English proficiency. Developing means to navigate work station-related barriers to LASs may yield improved patient care. Incorporation of professional continuing educational programs, automated LAS kiosks, natural language processing, and social media solutions merit exploration in addressing these challenges.
Zelnick, Jennifer; Campbell, Richard; Levenstein, Charles; Balbach, Edith
As efforts to make U.S. worksites smoke-free took shape in the 1980s, the tobacco industry sought to defeat them by forming alliances with organized labor. The alliance between the tobacco industry and organized labor was based on framing the regulation of environmental tobacco smoke (ETS) as a threat to jobs, an example of management unilateralism, and an issue that divided smoking and nonsmoking union members. The dynamics of organized labor and tobacco control began to change in the late 1980s with attempts to ban smoking on airlines and in the hospitality industry. Flight attendants, bar and restaurant workers, and casino dealers-all subject to ETS in their work environments-confronted ETS as an occupational health issue. Against the backdrop of increasing awareness of the hazards of ETS, and the acceptance of tobacco control policy, this framing changed the basis of organized labor's role in tobacco control. Because service workers share the workplace with the general public, their occupational health issues are also public health issues. This fact presents new opportunities for coalition building to protect the health of service workers and the public alike.
Full Text Available In the shadow of World War II’s end, unprecedented discourse regarding international human rights was birthed from knowledge regarding the gross abuses that took place and subsequent shock that the civilized world had no international legislation in place to counter similar, future atrocities. In 1948, the International Labour Organization (ILO adopted the Freedom of Association and Protection of the Right to Organise Convention while, in the same year, the United Nations (UN adopted the Universal Declaration of Human Rights [Swepston 1998, p.169]. The comparatively younger World Trade Organization (WTO has been both condemned and heralded for its handling, and lack thereof, of human rights violations. In the formidable wake of globalisation, all three organizations have had to bind their human rights policies to economics, thereby enhancing the interconnectivity of the entities and, by extension, international policy. The following, critical comment explores the history and current state of UN, ILO, and WTO human rights’ approaches to market policy, affording particular attention to recommendations for amending the policies in order to foster greater cohesion and address one of the most pressing human rights issues of the twenty-first century.
Edson V. Guilherme
Full Text Available The enzyme-linked immunosorbent assay (ELISA is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0% has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167 tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7, increased serum IgE levels (6/7 and a positive allergy test for mites (5/7. The presence of pets (dogs or cats at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.
Guilherme, Edson V; Marchioro, Ariella A; Araujo, Silvana M; Falavigna, Dina Lúcia Morais; Adami, Carolina; Falavigna-Guilherme, Gustavo; Rubinsky-Elefant, Guita; Falavigna-Guilherme, Ana Lucia
The enzyme-linked immunosorbent assay (ELISA) is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0%) has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP) from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167) tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7), increased serum IgE levels (6/7) and a positive allergy test for mites (5/7). The presence of pets (dogs or cats) at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.
In support of national and subnational decision makers, the 21st Century Power Partnership regularly works with country partners to organize peer-to-peer consultations on critical issues. In March 2014, 21CPP collaborated with the Regulatory Assistance Project - India to host two peer-to-peer exchanges among experts from India, South Africa, Europe, and the United States to discuss the provision of ancillary services, particularly in the context of added variability and uncertainty from renewable energy. This factsheet provides a high level summary of the peer-to-peer consultation.
Oshima, Masamitsu; Mizuno, Mitsumasa; Imamura, Aya; Ogawa, Miho; Yasukawa, Masato; Yamazaki, Hiromichi; Morita, Ritsuko; Ikeda, Etsuko; Nakao, Kazuhisa; Takano-Yamamoto, Teruko; Kasugai, Shohei; Saito, Masahiro; Tsuji, Takashi
Donor organ transplantation is currently an essential therapeutic approach to the replacement of a dysfunctional organ as a result of disease, injury or aging in vivo. Recent progress in the area of regenerative therapy has the potential to lead to bioengineered mature organ replacement in the future. In this proof of concept study, we here report a further development in this regard in which a bioengineered tooth unit comprising mature tooth, periodontal ligament and alveolar bone, was successfully transplanted into a properly-sized bony hole in the alveolar bone through bone integration by recipient bone remodeling in a murine transplantation model system. The bioengineered tooth unit restored enough the alveolar bone in a vertical direction into an extensive bone defect of murine lower jaw. Engrafted bioengineered tooth displayed physiological tooth functions such as mastication, periodontal ligament function for bone remodeling and responsiveness to noxious stimulations. This study thus represents a substantial advance and demonstrates the real potential for bioengineered mature organ replacement as a next generation regenerative therapy.
Wong, Michael Paul A.; Buckner, Joshua
This article provides insight into the recent appearance of multiracial student services in U.S. higher education by presenting a review of current practice within student affairs administration. The authors begin by discussing the historical and social context for multiracial student services within prevailing approaches to multicultural identity…
Wittman, Michael; Allroggen, Florian; Malina, Robert
Public service obligations (PSOs) are used by governments in many countries, including the United States and 11 countries in Europe, to mandate a minimum level of commercial air transportation service, especially for small or rural communities. This paper analyzes PSOs in these 12 countries for the year 2010 using the recently proposed Global Connectivity Index to measure direct and indirect market access and a novel subsidy database covering 90% of PSO movements in these countries to assess ...
Jerman, Jenna; Jones, Rachel K.
Background Aspects of U.S. clinical abortion service provision such as gestational age limits, charges for abortion services, and anti-abortion harassment can impact the accessibility of abortion; this study documents changes in these measures between 2008 and 2012. Methods In 2012 and 2013, we surveyed all known abortion-providing facilities in the United States (n = 1,720). This study summarizes information obtained about gestational age limits, charges, and exposure to anti-abortion harass...
... 32 National Defense 1 2010-07-01 2010-07-01 false DD Form 2581-1, Public and Community Service Organization Validation C Appendix C to Part 77 National Defense Department of Defense OFFICE OF THE SECRETARY..., App. C Appendix C to Part 77—DD Form 2581-1, Public and Community Service Organization...
... or division of a railway labor organization. 204.7 Section 204.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT EMPLOYMENT RELATION § 204.7 Employment relation—service to a local lodge or division of a railway labor organization. Service by an individual to...
Kamali, Amanda; Jamieson, Denise J; Kpaduwa, Julius; Schrier, Sarah; Kim, Moon; Green, Nicole M; Ströher, Ute; Muehlenbachs, Atis; Bell, Michael; Rollin, Pierre E; Mascola, Laurene
Many of the survivors of the 2014-2015 epidemic of Ebola virus disease (EVD) in western Africa were women of childbearing age. Limited clinical and laboratory data exist that describe these women's pregnancies and outcomes. We report the case of an EVD survivor who became pregnant and delivered her child in the United States, and we discuss implications of this case for infection control practices in obstetric services. Hospitals in the United States must be prepared to care for EVD survivors.
Full Text Available Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge.
Castelli, Mauro; Manzoni, Luca; Popovič, Aleš
Quality of service, that is, the waiting time that customers must endure in order to receive a service, is a critical performance aspect in private and public service organizations. Providing good service quality is particularly important in highly competitive sectors where similar services exist. In this paper, focusing on banking sector, we propose an artificial intelligence system for building a model for the prediction of service quality. While the traditional approach used for building analytical models relies on theories and assumptions about the problem at hand, we propose a novel approach for learning models from actual data. Thus, the proposed approach is not biased by the knowledge that experts may have about the problem, but it is completely based on the available data. The system is based on a recently defined variant of genetic programming that allows practitioners to include the concept of semantics in the search process. This will have beneficial effects on the search process and will produce analytical models that are based only on the data and not on domain-dependent knowledge.
Full Text Available Varun Vaidya, Gautam Partha, Jennifer HowePharmacy Health Care Administration, Department of Pharmacy Practice, University of Toledo College of Pharmacy, Toledo, OH, USAObjective: To describe and analyze utilization of preventive care services and their effect on cardiovascular outcomes in the United States.Methods: Data from the 2007 Medical Expenditure Panel Survey (MEPS were used to analyze utilization of preventive care services and their effect on cardiovascular outcomes. Recommendations by the Seventh Report of the Joint Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and the National Cholesterol Education Program were used to determine appropriate levels of preventive care utilization. Utilization of blood pressure screening and cholesterol checkup services were used as the dependent variable, while age, gender, race, ethnicity, insurance status, and perceived health status were used as independent variables. Since guidelines differ for people with elevated blood pressure, respondents with elevated blood pressure were identified in the MEPS database by self-reported diagnosis. Descriptive statistics were used to describe the population, while a multivariate logistic regression model was built to predict odds of utilizing appropriate levels of preventive services.Results: Total number of adult respondents for which data were available for blood pressure checkup and cholesterol checkup was 20,523 and 15,784, respectively. Overall, MEPS respondents were found to adhere to guideline recommendations for preventive care utilization. Multivariate logistic regression showed that odds of utilization of preventive care services were higher for elderly patients (age >65 years for blood pressure (odds ratio [OR] = 2.39, 95% confidence interval [CI]: 1.92–2.97 and cholesterol (OR = 3.05, 95% CI: 2.18–4.27 preventive services compared with younger population (age 18–54 years. Males had much lower odds of
Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki
Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the
Samant, Deepti; Soffer, Michal; Hernandez, Brigida; Adya, Meera; Akinpelu, Omolara; Levy, Joel M; Repoli, Elizabeth; Kramer, Michael; Blanck, Peter
Corporate culture reflects an organization's value system and impacts the recruitment, retention, and promotion of employees. Individuals with disabilities are positively impacted by a corporate culture that espouses and establishes a diverse workforce as a priority. This article provides an overview of corporate culture and the employment of individuals with disabilities, and presents a case example of the corporate culture of a large not-for-profit disability service organization. With an in-depth understanding of corporate culture and disability issues, social workers can be particularly helpful to applicants and employees with disabilities as well as employers.
The article introduces a service-oriented architecture (SOA) governance framework for successful implementation in a healthcare organization. The proposed framework, based on a rigorous literature review, proposes nine governance elements that should be considered during the SOA implementation...... process. This proposal aims to pinpoint attributes and guidelines for each element required to successfully govern SOA and tackle longstanding healthcare information systems (HIS) implementation challenges. The framework was tested in a healthcare organization and valuable insights are presented herein....... The intended use of this framework is as a decision-supporting tool for SOA governance in a healthcare setting....
The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.
Mason, Jennifer; Medley, Amy; Yeiser, Sarah; Nightingale, Vienna R; Mani, Nithya; Sripipatana, Tabitha; Abutu, Andrew; Johnston, Beverly; Watts, D Heather
People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The United States (US) President's Emergency Plan for AIDS Relief (PEPFAR) is committed to meeting the reproductive health needs of PLHIV by improving their access to voluntary FP counselling and services, including prevention of unintended pregnancy and counselling for safer conception. Inclusion of preconception care and counselling (PCC) as part of routine HIV services is critical to preventing unintended pregnancies and perinatal infections among PLHIV. PLHIV not desiring a current pregnancy should be provided with information and counselling on all available FP methods and then either given the method onsite or through a facilitated referral process. PLHIV, who desire children should be offered risk reduction counselling, support for HIV status disclosure and partner testing, information on safer conception options to reduce the risk of HIV transmission to the partner and the importance of adhering to antiretroviral treatment during pregnancy and breastfeeding to reduce the risk of vertical transmission to the infant. Integration of PCC, HIV and FP services at the same location is recommended to improve access to these services for PLHIV. Other considerations to be addressed include the social and structural context, the health system capacity to offer these services, and stigma and discrimination of providers. Evaluation of innovative service delivery models for delivering PCC services is needed, including provision in community-based settings. The US Government will continue to partner with local organizations, Ministries of Health, the private sector, civil society, multilateral and bilateral donors, and other key stakeholders to strengthen both the policy and
Makabira D.K.; Ester Waiganjo
Procurement is an important and expensive business activity for organizations. This is because organizations usually spend a large portion (even up to 70%) of their revenue and operational budget on purchasing goods and services. Procurement is generally the process of acquiring goods and services as well as hiring contractors and consultants to carry out works and services (Hornby, 2005). The main objective of this study was to establish the role of procurement practices on performance of Ke...
Wasim Abbas Awan
Full Text Available This study aims to investigate the impact of determinants of shift work on job satisfaction in service sector organizations of Pakistan. History reveals that the invention of Thomas Edison brought the change in working environment and industrial revolution results in the birth of shift works. A great number of theories in Management are there to define Job satisfaction. All of them show the relationship between ability to perform and the productivity. In order to investigate their impact descriptive study is taken in to account in which survey research method is used to collect data. On the basis of quantitative analysis this study reveals that determinants of shift work has positive impact on job satisfaction. Finally recommendations are made to increase shift work in service sector organizations of Pakistan so that people may upraise their standards of living.
In this report the organization and performance of the IMSS-Solidaridad Program of Mexico is described. This program is managed by the Mexican Institute for Social Security, which services 10.5 million inhabitants of the rural underserved areas, with federal government resources in 18 states. This study compares the structure and functioning of the IMSS-Solidaridad Program with Local Health Systems, as they have been proposed by the Panamerican Health Organization for country members and by the Ministry of Health of Mexico, particularly in relation to the decision-making process at local level. Some assets and limitations of the IMSS-Solidaridad Program are analyzed and, finally, concrete procedures to improve coordination between the IMSS-Solidaridad Program and other health services for similar populations (populations without social security protection) in Mexico are suggested, with the purpose of using resources more adequately and succeed in the national goal to achieve equity in health.
Joe, Ellen; Schwartz, Sara L; Austin, Michael J
The Bayview Hunters Point Foundation for Community Improvement is a nonprofit organization established in 1971 to defend the legal rights of African-Americans living in its community. Over the years, the agency diversified its services to include mental health and substance abuse treatment, violence prevention, youth programming, and HIV services. The organization has overcome multiple challenges during its 37-year history in relation to social, political, and economic changes that have influenced the way the organization has financed and delivered its services. The history of the organization presents a collaborative approach to community problem-solving and exemplifies the important role that external relationships play in relationship to nonprofit growth and survival.
Montes de Oca, Lis Klovning Hansen
This paper seeks to explore social work as it can be observed in the welfare service organizations of Danish municipalities, specifically within the context of social work concerned with the protection of the child at risk. The paper uses the systems theory of Niklas Luh-mann to elaborate...... and explore how social work within the specific frame of child protection care becomes an actual hybrid (Philippopoulos-Mihalopoulos, 2012). The paper recognizes social work as a social system, the system for help in society (Baecker, 1994) (Nissen, 2010). The paper sets out to explore how structural coupling...... within the welfare system of child protection can be said to emerge into a different form than (maybe) other welfare services. The explorative curiosity rises from recognition of the economic systems expansion and dominant semantics within social services, specifically child protection and how social...
Lucas Miyake Okumura
Full Text Available Abstract Objective: Clinical Pharmacy Services (CPS are considered standard of care and is endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU. Methods: This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention. Results: Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs which were solved within clinicians (89% acceptance of all interventions. The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21% and a composite of inadequate doses (17% due to low, high and non-optimized doses. Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs. Conclusions: Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.
Sullivan, Michael [Nexant Inc., Burlington, MA (United States); Schellenberg, Josh [Nexant Inc., Burlington, MA (United States); Blundell, Marshall [Nexant Inc., Burlington, MA (United States)
This report updates the 2009 meta-analysis that provides estimates of the value of service reliability for electricity customers in the United States (U.S.). The meta-dataset now includes 34 different datasets from surveys fielded by 10 different utility companies between 1989 and 2012. Because these studies used nearly identical interruption cost estimation or willingness-to-pay/accept methods, it was possible to integrate their results into a single meta-dataset describing the value of electric service reliability observed in all of them. Once the datasets from the various studies were combined, a two-part regression model was used to estimate customer damage functions that can be generally applied to calculate customer interruption costs per event by season, time of day, day of week, and geographical regions within the U.S. for industrial, commercial, and residential customers. This report focuses on the backwards stepwise selection process that was used to develop the final revised model for all customer classes. Across customer classes, the revised customer interruption cost model has improved significantly because it incorporates more data and does not include the many extraneous variables that were in the original specification from the 2009 meta-analysis. The backwards stepwise selection process led to a more parsimonious model that only included key variables, while still achieving comparable out-of-sample predictive performance. In turn, users of interruption cost estimation tools such as the Interruption Cost Estimate (ICE) Calculator will have less customer characteristics information to provide and the associated inputs page will be far less cumbersome. The upcoming new version of the ICE Calculator is anticipated to be released in 2015.
Clydette L Powell
Full Text Available For many years, and before the term “FBO” was used for faith-based organizations, the United States Agency for International Development (USAID has supported the work of FBOs in global health and development. The Agency has long recognized the impact of FBOs within that development space, because these organizations are often well positioned to reach the hard-to-reach and to go the last mile because of their strong ties to the community. Moreover, FBOs deliver a substantial percentage of the health services in some developing countries. Faith partners, whether Catholic, Protestant, Buddhist, Hindu, Muslim, or other, have an important role to play as implementers in global health and to support global efforts towards achieving the Millennium Development Goals (MDGs in health. In addition, partnerships at national and international levels are key to the success of US Presidential Initiatives in the developing world, such as President’s Emergency Plan for AIDS Relief (PEPFAR and President’s Malaria Initiative (PMI. FBOs also have an important voice in policy and strategy formulation. Among other international donors, USAID support has been of great importance to the work of FBOs, thereby helping host nations to achieve goals in ending preventable child and maternal deaths, improving communicable disease control and prevention, and by supporting the construction and renovation of hospitals and health facilities where service delivery is most needed. The development literature is replete with examples of the work of FBOs made possible through access to resources. This paper focuses on some of the work supported by USAID in global health initiatives in order to reach complementary goals and achieve significant public health advances. Given the vastness of the topic, not all the global health initiatives involving FBOs supported by USAID are included here; the reader is encouraged to access the USAID website and USAID implementing partners for
Moughrabieh, Anas; Weinert, Craig
The conflict in Syria has created the largest humanitarian emergency of the twenty-first century. The 4-year Syrian conflict has destroyed hospitals and severely reduced the capacity of intensive care units (ICUs) and on-site intensivists. The crisis has triggered attempts from abroad to support the medical care of severely injured and acutely ill civilians inside Syria, including application of telemedicine. Within the United States, tele-ICU programs have been operating for more than a decade, albeit with high start-up costs and generally long development times. With the benefit of lessons drawn from those domestic models, the Syria Tele-ICU program was launched in December 2012 to manage the care of ICU patients in parts of Syria by using inexpensive, off-the-shelf video cameras, free social media applications, and a volunteer network of Arabic-speaking intensivists in North America and Europe. Within 1 year, 90 patients per month in three ICUs were receiving tele-ICU services. At the end of 2015, a network of approximately 20 participating intensivists was providing clinical decision support 24 hours per day to five civilian ICUs in Syria. The volunteer clinicians manage patients at a distance of more than 6,000 miles, separated by seven or eight time zones between North America and Syria. The program is implementing a cloud-based electronic medical record for physician documentation and a medication administration record for nurses. There are virtual chat rooms for patient rounds, radiology review, and trainee teaching. The early success of the program shows how a small number of committed physicians can use inexpensive equipment spawned by the Internet revolution to support from afar civilian health care delivery in a high-conflict country.
Farmanova, Elina; Bonneville, Luc; Bouchard, Louise
The availability of health services in French is not only weak but also inexistent in some regions in Canada. As a result, estimated 78% of more than a million of Francophones living in a minority situation in Canada experience difficulties accessing health care in French. To promote the delivery of health services in French, publicly funded organizations are encouraged to take measures to ensure that French-language services are clearly visible, available, easily accessible, and equivalent to the quality of services offered in English. This study examines the reorganization and management strategies taken by health care organizations in Ontario that provide health services in French. Review and analysis of designation plans of a sample of health care organizations. Few health care organizations providing services in French have concrete strategies to guarantee availability, visibility, and accessibility of French-language services. Implementation of the active offer of French-language services is likely to be difficult and slow. The Ontario government must strengthen collaboration with health care organizations, Francophone communities, and other key actors participating in the designation process to help health care organizations build capacities for the effective offer of French-language services. Copyright © 2017 John Wiley & Sons, Ltd.
Schwingenschlogl, Udo; Peskov, Maxim V.; Masghouni, Nejib
We employ the TOPOS package to study 697 coordination polymers containing paddlewheel-type secondary building units. The underlying nets are analyzed and 3 novel nets are chosen as potential topologies for paddlewheel-type metal organic frameworks (MOFs). Dicarboxylate linkers are used to build basic structures for novel isoreticular MOF series, aiming at relatively compact structures with a low number of atoms per unit cell. The structures are optimized using density functional theory. Afterwards the Grand Canonical Monte Carlo approach is employed to generate adsorption isotherms for CO2, CO, and CH4 molecules. We utilize the universal forcefield for simulating the interaction between the molecules and hosting MOF. The diffusion behavior of the molecules inside the MOFs is analyzed by molecular dynamics simulations.
Eddens, Katherine S.; Kreuter, Matthew W.
Cancer disproportionately affects the underserved. United Way 2-1-1 is an information and referral system that links underserved populations to community services. This study explores the feasibility of integrating proactive screening and referral to health services into 2-1-1. A cancer risk assessment was administered to callers (n=297), measuring their need for six cancer control services. A subset of respondents was randomized to receive generic or tailored referrals to needed services. Nearly all participants (85%) needed at least one of the services. Those who received tailored referrals were more likely to make appointments. Future research will explore approaches to address and eliminate health disparities through 2-1-1. PMID:21566702
Vega-Carrillo, H R; Navarro Becerra, J A; Pérez Arrieta, M L; Pérez-Landeros, L H
Using thermoluminiscent dosimeters the absorbed dose in the bladder, rectum and thyroid have been evaluated when 200 cGy was applied to the prostate. The treatment was applied with a (60)Co unit. A water phantom was built and thermoluminiscent dosimeters were located in the position where the prostate, bladder, rectum and thyroid are located. The therapeutic beam was applied in 4 irradiations at 0, 90, 180 and 270° with the prostate at the isocenter. The TLDs readouts were used to evaluate the absorbed dose in each organ. The absorbed doses were used to estimate the effective doses and the probability of developing secondary malignacies in thyroid, rectum and bladder.
Burmester, Nicolas; Jankowski, Michael
In the field of international relations, regional organizations (ROs) are not only assumed to play an important role in the regional context, but also on the international level. A growing number of studies analyze ROs’ voting behavior in the United Nations General Assembly (UNGA) in a similar way...... to the analyses of parties in national parliaments. In this paper, we reflect on the question whether ROs can be treated as ‘political party’-like entities. First, based on literature on political parties and legislative voting, we develop two criteria to evaluate ROs in the UNGA. Second, we analyze UNGA voting...
Vergara-Fernández, A.; Rebolledo-Castro, J.; Morales Rodriguez, Ricardo
Currently, biofiltration has become a viable and potential alternative for the treatment of airstreams with low concentrations of hydrophobic volatile organic compounds (VOCs), which can employ to this end, diverse microorganisms (such as, bacteria, fungal or microbial consortia, etc.) growing...... a biofilm. Usually, the design, analysis and scale-up of this kind of units have been mainly done via experimental approach, which can be costly in terms of time and resources. Therefore, the objective of this work is to introduce mathematical model for the prediction and simulation of a fungal biofilter...
..., Washington Coyote Valley Band of Pomo Indians of California Crow Tribe of Montana Crow Creek Sioux Tribe of... Bureau of Indian Affairs Indian Entities Recognized and Eligible To Receive Services From the United States Bureau of Indian Affairs AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice. SUMMARY: This...
... Coushatta Tribe of Louisiana Cow Creek Band of Umpqua Tribe of Indians (previously listed as the Cow Creek... Bureau of Indian Affairs Indian Entities Recognized and Eligible To Receive Services From the United States Bureau of Indian Affairs AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice. SUMMARY: This...
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Alien who departed the United States to avoid service in the armed forces. 40.82 Section 40.82 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Ineligible for Citizenship. § 40.82...
Owino, Elizabeth Akinyi
This paper assesses the type of services delivered by the existing Guidance and Counselling units in secondary schools in Kenya based on a survey conducted in Eldoret Municipality in Uasin Gishu County, Kenya. The study adopted an ex-post facto research design the target population being all secondary schools in the Municipality where a sample was…
Rout, S; Renehan, A G; Parkinson, M F; Saunders, M P; Fulford, P E; Wilson, M S; O'Dwyer, S T
Treatment of peritoneal surface malignancies with combined cytoreductive surgery and heated intraperitoneal chemotherapy may improve oncologic outcome. To better define treatment pathways, five-year results in patients referred to one of two centralized national treatment centers in the United Kingdom were analyzed. A prospective database of patients referred to the Manchester Peritoneal Tumor Service, established in 2002, was analyzed. Outcomes were evaluated using Kaplan-Meier life tables and Cox models. Two hundred seventy-eight patients (median age, 56.9 (range, 16-86) years) were considered by a dedicated multidisciplinary team and tracked on seven clinical pathways. Among the 118 surgically treated, the most common diagnosis was pseudomyxoma peritonei (101 patients, 86%). Major complications occurred in 11 patients (9%); there was no 30-day mortality. Where complete cytoreduction was achieved, three-year and five-year tumor-related survival rates were 94% and 86%, respectively. In the Cox model, incompleteness of cytoreduction (P = 0.001) and high-grade tumor (P < 0.0001) were independent prognosticators of poor outcome. The establishment of a national treatment center has allowed refinement of techniques to achieve internationally recognized results. Having achieved low levels of morbidity and mortality in the treatment of mainly pseudomyxoma peritonei of appendiceal origin, the technique of cytoreductive surgery and heated intraperitoneal chemotherapy may be considered for peritoneal carcinomatosis of colorectal origin.
Full Text Available QGIS releases equal to or newer than 0.7 can easily connected to GRASS GIS by means of a toolbox that provides a wide range of standard GRASS modules you can launch – albeit only on data coming from GRASS. This QGIS plugin is expandable through XML configurations describing the assignment of options and inputs for a certain module. But how about embedding a precise workflow where the several processes don’t consist of a single GRASS module by force? Especially for a sequence of dependent tasks it makes sense to merge relevant GRASS functionality into an own and encapsulated QGIS extension. Its architecture and development is tested and combined with the Web Processing Service (WPS for remote execution using the concept of hydrological response units (HRUs as an example. The results of this assay may be suitable for discussing and planning other wizard-like geoprocessing plugins in QGIS that also should make use of an additional GRASS server.
Tu, Binbin; Pang, Qingqing; Ning, Erlong; Yan, Wenqing; Qi, Yi; Wu, Doufeng; Li, Qiaowei
Materials built from multiple constituents have revealed emerging properties that are beyond linear integration of those from single components. We report a mesoporous metal-organic framework made from three geometrically distinct metal-containing secondary building units (SBUs) as a result of topological induction. The combinations of the Cu-based triangular, Zn-based octahedral, and Zn-based square pyramidal SBUs have created four types of cages in the network, despite that only one organic linker pyrazolecarboxylate was used. The longest distance for molecules maneuvering inside the largest cage is 5.2 nm. Furthermore, the complex and diversified pore environments allow the installation of various new functionalities in the framework as well as the expedited Ag nanoparticle formation in the pores. As presented in the molecule movement diagram, the crystal has provided specific arrangements of cages and apertures with distinct chemical features for guests transporting between the pores.
Barbazza, Luca; Pierobon, Leonardo; Mirandola, Alberto
Organic Rankine cycle turbogenerators are a promising technology to transform the solar radiation harvested by solar collectors into electric power. The present work aims at sizing a small-scale organic Rankine cycle unit by tailoring its design for domestic solar applications. Stringent design...... criteria, i.e., compactness, high performance and safe operation, are targeted by adopting a multi-objective optimization approach modeled with the genetic algorithm. Design-point thermodynamic variables, e.g., evaporating pressure, the working fluid, minimum allowable temperature differences....... Findings also suggest that the evaporator and condenser minimum allowable temperature differences have the largest impact on the system volume and on the cycle performances. Among the fluids considered, the results indicate that R1234yf and R1234ze are the best working fluid candidates. Using flat plate...
Garrett, Giorgia L; Blanc, Paul D; Boscardin, John; Lloyd, Amanda Abramson; Ahmed, Rehana L; Anthony, Tiffany; Bibee, Kristin; Breithaupt, Andrew; Cannon, Jennifer; Chen, Amy; Cheng, Joyce Y; Chiesa-Fuxench, Zelma; Colegio, Oscar R; Curiel-Lewandrowski, Clara; Del Guzzo, Christina A; Disse, Max; Dowd, Margaret; Eilers, Robert; Ortiz, Arisa Elena; Morris, Caroline; Golden, Spring K; Graves, Michael S; Griffin, John R; Hopkins, R Samuel; Huang, Conway C; Bae, Gordon Hyeonjin; Jambusaria, Anokhi; Jennings, Thomas A; Jiang, Shang I Brian; Karia, Pritesh S; Khetarpal, Shilpi; Kim, Changhyun; Klintmalm, Goran; Konicke, Kathryn; Koyfman, Shlomo A; Lam, Charlene; Lee, Peter; Leitenberger, Justin J; Loh, Tiffany; Lowenstein, Stefan; Madankumar, Reshmi; Moreau, Jacqueline F; Nijhawan, Rajiv I; Ochoa, Shari; Olasz, Edit B; Otchere, Elaine; Otley, Clark; Oulton, Jeremy; Patel, Parth H; Patel, Vishal Anil; Prabhu, Arpan V; Pugliano-Mauro, Melissa; Schmults, Chrysalyne D; Schram, Sarah; Shih, Allen F; Shin, Thuzar; Soon, Seaver; Soriano, Teresa; Srivastava, Divya; Stein, Jennifer A; Sternhell-Blackwell, Kara; Taylor, Stan; Vidimos, Allison; Wu, Peggy; Zajdel, Nicholas; Zelac, Daniel; Arron, Sarah T
Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years. Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR). Overall, 10 649 organ transplant recipients (mean [SD] age, 51  years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2
Bigeriego, Elena; Cabezas, José; Labrador, Juana; María Moreno, Marta
This work aims to develop an alternative methodology that enables monitoring the environmental differential that agroecological management involves in order to consolidate feasible payments for environmental services generated by organic agriculture. For this purpose, LANDSAT images have been used, and the Normalized Difference Vegetation Index (NDVI) of organic fruit farms, all of them with the same species and the similar edaphic and climatic characteristics, has been compared with the NDVI obtained at other nearby fruit farms under conventional management, all of them in Extremadura (Spain). As a result, we obtained a series of statistical data that allows us to clearly differentiate between these two types of management. Among these data, remarkable differences have been detected regarding the minimum values of NDVI in the non-productive periods of the fruit, which is higher in the organic farms due to the permanent vegetation soil cover, with the subsequent effects on soil protection and carbon sequestration. The conclusions of the paper show that it is possible to distinguish different models of crop management by using satellite images obtained in a quick and inexpensive way. Keywords: LANDSAT images; NDVI; environmental services; agroecology; organic agriculture.
郭美茹; 朱启的; 孙志强; 周天; 周孑民
To improve energy conversion efficiency, optimization of the working fluids in organic Rankine cycles (ORCs) was explored in the range of low-temperature heat sources. The concept of unit-heat-exchange-area (UHEA) net power, embodying the cost/performance ratio of an ORC system, was proposed as a new indicator to judge the suitability of ORC working fluids on a given condition. The heat exchange area was computed by an improved evaporator model without fixing the minimum temperature difference between working fluid and hot fluid, and the flow pattern transition during heat exchange was also taken into account. The maximum UHEA net powers obtained show that dry organic fluids are more suitable for ORCs than wet organic fluids to recover low-temperature heat. The organic fluid 1-butene is recommended if the inlet temperature of hot fluid is 353.15−363.15 K or 443.15−453.15 K, heptane is more suitable at 373.15−423.15 K, and R245ca is a good option at 483.15−503.15 K.
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A; Friedmann, Peter D; Lee, I-Heng
Standardized patient placement criteria such as those developed by the American Society of Addiction Medicine are increasingly common in substance abuse treatment, but it is unclear what factors are associated with their use or with treatment units' provision of related services. This study examined these issues in the context of a national survey of outpatient substance abuse treatment units. Regressions using 2005 data revealed that both public and private managed care were associated with a greater likelihood of using American Society of Addiction Medicine criteria to develop client treatment plans. However, only public managed care was associated with a greater likelihood of offering more resource-intensive services. Associations between client population severity and resource-intensive service provision were sparse but positive.
LAURA MAGDALENA TROCAN
Full Text Available In accordance with the Resolution of the UN General Assembly A/RES/61/261 in 30 April 2007 within the United Nations was established a new system in order to settle the internal disputes and disciplinary matters between Organization and its employees designed to meet the current needs of the Organization and which became operational on 1 July 2009. The establishment of this system was based on the conclusions of several reports of the UN Secretary - General, of the Panel on the Redesign of the UN system of administration of justice, of the Advisory Committee on Administrative and Budgetary Questions what pointed out that the old system of administration of justice at UN became a slow, heavy, ineffective and lacking professionalism and that the system of administrative review has no longer corresponded to current needs of this important international Organization. Given these considerations and based on the premise that a transparent, impartial, independent and efficient system of administration of justice is essential for each of the employees of the Organization to be guaranteed a fair and equitable treatment in the performance of professional duties and taking into account the need to reform the management of human resources at the UN, the Organization has decided to establish a new, independent, transparent, professionalized, adequately resourced and decentralized system of administration of justice who comply the rules of International Law and the right to a fair trial and to ensure the implementation of rights and obligations of the employees but also to establish the liability for their actions. Taking into account those mentioned above this study goals are to present the organization and functioning of this new system for settlement disputes between UN staff and administration and to make a brief comparative analysis with the old system.
Louis A. Martinette
Full Text Available This study examines the influence of learning orientation on business performance (the achievement of sales and profit objectives in the context of pure service. The conceptual framework used in this research has been drawn from marketing, finance, and organizational behavior theory. Specifically, relationships related to learning orientation, sources of competitive advantage, and business performance have been identified. This research develops and tests a framework about learning orientation and its consequences in an organization. Specifically, this study focused on several research questions, including: 1“Is there a relationship between learning orientation and business performance in terms of the achievement of sales and profit objectives in pure service and service-reliant organizations?”, 2 “Is there a relationship between learning orientation and competitive advantage in pure service and service-reliant organizations?”, and 3 “Does competitive advantage moderate the relationship between learning orientation and business performance in pure service and service-reliant organizations?” A survey-based research methodology is used to explore these research questions and pertinent findings reported in the light of previous studies (Martinette, 2006, Martinette and Obenchain-Leeson, 2010. The findings of this study suggested that competitive advantage moderates the relationship between learning orientation and business performance in pure service and service-reliant organizations.
... foreign organization engages in the United States are incidental to its international or foreign business... representative office. (2) The following activities are incidental to international or foreign business: (i... INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY INTERNATIONAL BANKING §...
Full Text Available The aim of the article. The aim of the article is the analysis of main marketing components formation for non-governmental organizations and researching the advantages of using modern Internet marketing tools for NGOs in terms of the current economic. The results of the analysis. The analysis of main marketing components for non-governmental organizations and systematization of the known Internet marketing tools were made. The article examines the concept of non-governmental organization and defines the problems of NGOs functioning, which can be solved with the help of a competent marketing plan. Traditional marketing is the process of planning and executing the conception, pricing and promotion and distribution of ideas, goods and services to create exchanges that satisfy the individual and organizational objectives. The concept of social/public marketing aims to raise awareness about important issues our society. Authors research such traditional marketing components for NGOs, as the product, stuff, price, advertising (promotion and place of service. The «product» of NGOs can be considered as «changed human life» like the help for sick people, improving the ecological environment, solving problems for particular social groups and more. Most of non-governmental organizations have stuff, whose work is paid and volunteer, whom working on a voluntary basis. As donors pay all related costs of their implementation, most NGOs provide their services free of charge, but also writing the project for implementing NGOs products/services required the budgeting on the basis of prices for NGOs services. Place of service for non-governmental organizations are limited to three scenarios: own premises, premises partners or the location of the target groups (customers. The most common promoting instruments for NGO are personal customer advice and recommendations of partner organizations or public bodies. Successful functioning of non
Bond, C A; Raehl, Cynthia L
Adverse drug reactions (ADRs) were examined in 1,960,059 hospitalized Medicare patients in 584 United States hospitals in 1998. A database was constructed from the MedPAR database and the National Clinical Pharmacy Services survey. The 584 hospitals were selected because they provided specific information on 14 clinical pharmacy services and on pharmacy staffing; they also had functional ADR reporting systems. The study population consisted of 35,193 Medicare patients who experienced an ADR (rate of 1.8%). Of the 14 clinical pharmacy services, 12 were associated with reduced ADR rates. The most significant reductions occurred in hospitals offering pharmacist-provided admission drug histories (odds ratio [OR] 1.864, 95% confidence interval [CI] 1.765-1.968), drug protocol management (OR 1.365, 95% CI 1.335-1.395), and ADR management (OR 1.360, 95% CI 1.328-1.392). Multivariate analysis, performed to further evaluate these findings, showed that nine variables were associated with ADR rate: pharmacist-provided in-service education (slope -0.469, p=0.018), drug information (slope -0.488, p=0.005), ADR management (slope -0.424, p=0.021), drug protocol management (slope -0.732, p=0.002), participation on the total parenteral nutrition team (slope 0.384, p=0.04), participation on the cardiopulmonary resuscitation team (slope -0.506, p=0.008), medical round participation (slope -0.422, p=0.037), admission drug histories (slope -0.712, p=0.008), and increased clinical pharmacist staffing (slope -4.345, p=0.009). As clinical pharmacist staffing increased from the 20th to the 100th percentile (from 0.93+/-0.77/100 to 5.16+/-4.11/100 occupied beds), ADRs decreased by 47.88%. In hospitals without pharmacist-provided ADR management, the following increases were noted: mean number of ADRs/100 admissions by 34.90% (OR 1.360, 95% CI 1.328-1.392), length of stay 13.64% (Mann-Whitney U test [U]=11047367, p=0.017), death rate 53.64% (OR 1.574, 95% CI 1.423-1.731), total Medicare
Wang, J; Long, M C; Zhang, Z J; Chi, L N; Qiao, X L; Zhu, H X; Zhang, Z F
Wastewater in Shaoxing wastewater treatment plant (SWWTP) is composed of more than 90% dyeing and printing wastewater with high pH and sulfate. Through a combination process of anaerobic acidogenic [hydraulic retention time (HRT) of 15h], aerobic (HRT of 20h) and flocculation-precipitation, the total COD removal efficiency was up to 91%. But COD removal efficiency in anaerobic acidogenic unit was only 4%. As a comparison, the COD removal efficiency was up to 35% in the pilot-scale upflow anaerobic sludge bed (UASB) reactor (HRT of 15h). GC-MS analysis showed that the response abundance of these wastewater samples decreased with their removal of COD. A main component of the raw influent was long-chain n-alkanes. The final effluent of SWWTP had only four types of alkanes. After anaerobic unit at SWWTP, the mass percentage of total alkanes to total organic compounds was slightly decreased while its categories increased. But in the UASB, alkanes categories could be removed by 75%. Caffeine as a chemical marker could be detected only in the effluent of the aerobic process. Quantitative analysis was given. These results demonstrated that GC-MS analysis could provide an insight to the measurement of organic compounds removal.
Lutsiya Sayetovna Gatina
Full Text Available Objective to define the group of factors influencing on the quality of services rendered by a housing and communal services organization. Methods methods of systemic analysis and synthesis economicstatistical analysis. Results using the statistical methods of analysis a group of factors is defined which should be taken into account when developing the strategy of services market in housing and communal sphere. The objective of the strategy is to increase the level of quality services to the population of Russia in the housing and communal industry. Scientific novelty the indicators are revealed of the quality of communal services formed under socialeconomic factors. When analyzing the data of the matrix of interfactoral influence those were extinguished which show the largest influence on the level of services market development in housing and communal sphere. Practical value is the ability to use the assessment results to develop measures to improve the quality of housing and communal services organizations. nbsp
Quinn, Amity E; Stewart, Maureen T; Brolin, Mary; Horgan, Constance M; Lane, Nancy E
The Affordable Care Act (ACA) expanded insurance benefits and coverage for substance use disorder (SUD) treatment and encouraged delivery and payment reforms. Massachusetts passed a similar reform in 2006. This study aims to assess Massachusetts SUD treatment organizations' responses to the ACA. Organizational interviews addressing challenges of and responses to the ACA were conducted in person June-December 2014 with 31 leaders at 12 treatment organizations across Massachusetts. Many organizations were affiliated with medical or social services and offered a range of SUD services. Sampling was based on services offered (detoxification only, detoxification and outpatient, outpatient only). Framework analysis was used. Challenges identified were considered similar to ongoing challenges, not unique to the ACA. Organizations experienced insurance expansions in 2006 and faced new challenges, including insurance coverage, payment arrangements, expansion of services, and system design. System design efforts included care coordination/integration, workforce development, and health information technology. Differences in responses related to connections with medical and social service organizations. Many organizations engaged in efforts to respond to changing policies by expanding capacity and services. Offering a range of SUD treatment (e.g., detoxification and outpatient) and affiliating with a medical organization could enable organizations to respond to new insurance, delivery, and payment reforms.
Nicole, Madelyn; Fairbrother, Michele; Nagarajan, Srivalli Vilapakkam; Blackford, Julia; Sheepway, Lyndal; Penman, Merrolee; McAllister, Lindy
Through a collaborative university-hospital partnership, a student-led service model (SLS-model) was implemented to increase student placement capacity within a physiotherapy department of a 150 bed Sydney hospital. This study investigates the perceived barriers and enablers to increasing student placement capacity through student-led services…
Fraisse, Alain; Le Bel, Stéphane; Mas, Bertrand; Macrae, Duncan
Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill, neonatal, paediatric and adult patients with congenital and acquired heart disease. The majority of high-volume centres (dealing with over 300 surgical cases per year) have dedicated paediatric cardiac intensive care units, with the smallest programmes more likely to care for paediatric cardiac patients in mixed paediatric or adult intensive care units. Specialized nursing staff are also a crucial presence at the patient's bedside for quality of care. A paediatric cardiac intensive care programme should have patients (preoperative and postoperative) grouped together geographically, and should provide proximity to the operating theatre, catheterization laboratory and radiology department, as well as to the regular ward. Age-appropriate medical equipment must be provided. An optimal strategy for running a paediatric cardiac intensive care programme should include: multidisciplinary collaboration and involvement with paediatric cardiology, anaesthesia, cardiac surgery and many other subspecialties; a risk-stratification strategy for quantifying perioperative risk; a personalized patient approach; and anticipatory care. Finally, progressive withdrawal from heavy paediatric cardiac intensive care management should be institutionalized. Although the countries of the European Union do not share any common legislation on the structure and organization of paediatric intensive care or paediatric cardiac intensive care, any paediatric cardiac surgery programme in France that is agreed by the French Health Ministry must perform at least '150 major procedures per year in children' and must provide a 'specialized paediatric intensive care unit'.
FAO, the Food and Agriculture Organization of the United Nations, is the largest autonomous agency within the United Nations system dealing with agriculture, fisheries, forestry, and related disciplines. FAO provides a neutral forum for policy dialogue, a source of information and knowledge, technical assistance, and advice to 180 member countries. Technical...
... variable life insurance policies. Form N-6 shall be used as the registration statement to be filed pursuant... statement of separate accounts organized as unit investment trusts that offer variable life insurance... insurance policies to register as unit investment trusts. This form shall also be used for...
Finn, Natalie K; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C; Aarons, Gregory A
The Implementation Leadership Scale (ILS) is a brief, pragmatic, and efficient measure that can be used for research or organizational development to assess leader behaviors and actions that actively support effective implementation of evidence-based practices (EBPs). The ILS was originally validated with mental health clinicians. This study validates the ILS factor structure with providers in community-based organizations (CBOs) providing child welfare services. Participants were 214 service providers working in 12 CBOs that provide child welfare services. All participants completed the ILS, reporting on their immediate supervisor. Confirmatory factor analyses were conducted to examine the factor structure of the ILS. Internal consistency reliability and measurement invariance were also examined. Confirmatory factor analyses showed acceptable fit to the hypothesized first- and second-order factor structure. Internal consistency reliability was strong and there was partial measurement invariance for the first-order factor structure when comparing child welfare and mental health samples. The results support the use of the ILS to assess leadership for implementation of EBPs in child welfare organizations.
US Forest Service, Department of Agriculture — A map service on the www that includes polygons with a minimum of 40 acres of woodlands per square mile as depicted in William H. Brewer’s 1873 map of woodland...
In order to respond to the multiple paradoxes of current medical and healthcare services, some health professionals have chosen to operate as collective entities by creating multidisciplinary health houses. This trend is the practical outcome of an initiative that began in the early 2000s and that resulted in the creation of the Federation of health and healthcare houses (Fédération des maisons de soin et de santé), now known as the French federation of health houses and medical hubs (Fédération française des maisons et pôles de santé). Health houses offer a rich and varied range of prospects for improving the provision of healthcare services for local populations. Because of their multidisciplinary focus, health houses provide a comprehensive service for patients (i.e. treatment projects) with the possibility of articulating public healthcare policies around the coordination of prevention, education, screening and healthcare services (i.e. healthcare projects). They restore patients to a central position within the healthcare system and promote the provision of healthcare services aimed at ?fragile' populations. Socio-medical coordination also optimizes the use of hospitalization and the quality of home healthcare. To ensure the provision of such services, these new modes of organization require other means in addition to consultation fees. The "structure fee" (or forfait structure) is one such key element. The French federation of health houses and medical hubs is thus conceived in partnership with administrative and policy-making bodies on questions concerning access to healthcare, medical demography and the development of health houses and medical hubs.
Tania Ivón Sosa Ibarra
Full Text Available Achieving quality of service is a necessity in this highly competitive and turbulent world, one of the elements that influence it is training. This research was designed and implemented a training procedure to improve the quality of services in a cafeteria of Development, were detected with the training needs of their staff to plan and implement actions that will raise the skills of workers. Surveys were conducted to determine the state of opinion of internal and external clients implemented before and after the procedure and to evaluate the quality of service received from the selected attributes to the application of Delphi method experts. The unit has made progress recognized and improved economic indicators becoming a reference center in the municipality, which shows that is possible to provide quality services from training workers.
4 Juarez Cartel ................................................................................................................ 5 La Familia ...CIA Central Intelligence Agency CRS Congressional Research Service DTO Drug Trafficking Organization GDP Gross Domestic Product LFM La Familia ...are vacant leaving the organization highly susceptible to take over by one of the other TCOs. La Familia Michoacana La Familia Michoacana (LFM
D Evan Mercer; David Cooley; Katherine Hamilton
Forests provide a variety of critical services to human societies, including carbon sequestration, water purification, and habitat for millions of species. Because landowners have traditionally not been paid for the services their land provides to society, financial incentives are usually too low to sustain production of services at optimal levels. To remedy this, a...
Schmidt, Matthew; Fulton, Lori
The need to prepare students with twenty-first-century skills through STEM-related teaching is strong, especially at the elementary level. However, most teacher education preparation programs do not focus on STEM education. In an attempt to provide an exemplary model of a STEM unit, we used a rapid prototyping approach to transform an inquiry-based unit on moon phases into one that integrated technology in a meaningful manner to develop technological literacy and scientific concepts for pre-service teachers (PSTs). Using qualitative case study methodology, we describe lessons learned related to the development and implementation of a STEM unit in an undergraduate elementary methods course, focusing on the impact the inquiry model had on PSTs' perceptions of inquiry-based science instruction and how the integration of technology impacted their learning experience. Using field notes and survey data, we uncovered three overarching themes. First, we found that PSTs held absolutist beliefs and had a need for instruction on inquiry-based learning and teaching. Second, we determined that explicit examples of effective and ineffective technology use are needed to help PSTs develop an understanding of meaningful technology integration. Finally, the rapid prototyping approach resulted in a successful modification of the unit, but caused the usability of our digital instructional materials to suffer. Our findings suggest that while inquiry-based STEM units can be implemented in existing programs, creating and testing these prototypes requires significant effort to meet PSTs' learning needs, and that iterating designs is essential to successful implementation.
Widarti, Hayuni Retno; Retnosari, Rini; Marfu'ah, Siti
A descriptive quantitative research has been done to identify the level of understanding and misconceptions of the pre-service chemistry teachers related to the concept of resonance in the organic chemistry course. The subjects of the research were 51 students of State University of Malang, majoring Chemistry Education, currently in their fourth semester, 2015-2016 academic year who have taken the course of Organic Chemistry I. The instruments used in this research is a combination of 8 numbers of multiple choice tests with open answer questions and certainty of response index (CRI). The research findings revealed that there are still misconceptions found in the organic chemistry course, especially about the concept of resonance. There were several misconceptions of the pre-service chemistry teachers, such as resonance structures are in equilibrium with each other; resonance structures are two or more Lewis structures with different in arrangement of both atom and electron; resonance structures are only structures containing charged atoms; formal charge and resonance structures are not related; and the stability of resonance structures are only determined by location of charges in atoms found in such structures. There is also a lack of understanding of curved arrows notation to show electron pair movement.
Schwartz, Vardit; Kravitz, Martine Szyper
According to the "To Err is Human" report, medication-related errors are common in medicine and may have several and different effects. Clinical Pharmacy is a leading worldwide established pharmacy service which has been improving the quality of care for the last 30 years. The accumulated experience shows improved quality of care, improved patient safety and economic benefit. These understandings led to the definition and expansion of the Clinical Pharmacist Intervention Program and a joint project with the Risk Management Unit was created. A characterization process was conducted, parameters were defined for monitoring and surveillance and interventions were devised. The relevant data requiring pharmacist intervention was defined (e.g., dose adjustments, contraindications, side-effects); a report was devised, based on the patient's electronic medical record; daily follow-up included analysis, stratification, quantification and understanding of the different types of pharmacist interventions. The pharmacist interventions were summed up and assessed for performance and quality control. Between March 2013 and February 2014 the medical records of 14,499 patients were examined in our hospital Only in 16% of the records an active pharmacist intervention was performed, according to the parameters defined. Interventions for potentially high risk events such as therapeutic duplication, drug administration in spite of contraindication and in spite of documented allergy were very rare, less than 2% of all the pharmacist interventions. This joint venture, which is based on an existing platform, reflects an up-to-date view of an important facet of the clinical work performed at the hospital, helps identify trends, potential failures and vulnerabilities with regard to medication treatment and allows the formulation of intervention programs to improve the quality and safety of drug therapy.
Jenine K. Harris
Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.
Gowdy, E A; Rapp, C A; Poertner, J
The political nature of human services is a given. The multiple constituency dilemma coupled with the retrenchment of the 1970s and 1980s has led to a great gulf separating managers from clients, and managers from front-line personnel. These political factors have been reinforced by management theory and the blind adoption of "state-of-the-art" management technologies developed in business and the military, and the separation has gained legitimacy. The result is less than optimal service, a dissatisfied workforce, and continued attacks for being inefficient, self-serving, and ineffective. The purpose of this article is to portray an alternative form of human service management. Its vision places clients center stage in our organizations and places the manager as the director and producer. It accepts the premises that "management is the principle engine of progress" (Levitt, 1976) and that management is performance. It then lays a foundation for client-centered management by presenting four principles for social service administrators who desire to adopt this perspective in their daily practice. An elaboration of the skills and methods of client-centered management can be found in a recently published text (Rapp & Poertner, 1991).
Chendev, Yu. G.; Sauer, T. J.; Gennadiev, A. N.; Novykh, L. L.; Petin, A. N.; Petina, V. I.; Zazdravnykh, E. A.; Burras, C. L.
Shelterbelts that were created in place of meadow and meadow-steppe landscapes of the forest-steppe zone of northern continents serve as areas of carbon accumulation and participate in the formation of soil organic matter. In the Great Plains of the United States (in North Dakota, South Dakota, and Nebraska) and on the Central Russian Upland (Belgorod, Voronezh, and Kursk oblasts), a general tendency toward an increase in the Corg pool in the topsoil (0-30 cm) from the marginal parts of the shelterbelts toward their central parts by about 3.5-10.0 t per each 10 m has been identified. In 55 years of the existence of shelterbelts on chernozems in the European part of Russia, the mean annual rate of the organic carbon accumulation in the upper meter has been varying within 0.7-1.5 t/ha. In 19 years of the existence of a shelterbelt in the area of Huron (South Dakota), the mean annual rate of the organic carbon accumulation in the 1-m-thick layer of the Bonilla soil series (Haplustolls) has reached 1.9 t/ha.
Full Text Available Satisfaction is satisfying the needs and desires of the consumer (Besterfield, 1994. In case of public health service organizations, patient satisfaction is vital. Research attempts to determine factors affecting patient satisfaction in PHSOs; know the reliability and validity of items & factors of patient satisfaction and create a mathematical equation model for factors of patient satisfaction. Researcher selected 100 employees from only 3 government hospitals in Addalaichenai Divisional Secretariat of Ampara District. Data have been collected during the period of first quarter of 2013. Collected questionnaires have been analysed by a factor analysis and regression analysis. Core services, human element, non- human element and servicescape factors have been factors have been identified as determinants of patient satisfaction in public health service organizations. Cronbach alpha for core service, human element of the service, nonhuman element of the service and servicescapes are 0.819, 0.626, 0.965 and 0.783 respectively. Most of the items in factors have higher validity. Values of KMO for items of core service, human element of the service, non- human element of the service and servicescapes are 0.500, 0.554, 0.697 and 0.610 respectively. These values indicate that content and convergent validity are higher. Discriminant validity are lower statistically. In this study, Log log model is the best fitted model than linear models since core services, human element of the service and non- human of the service factors in the model explain 94% of total variation for patient satisfaction.
Jahnke, Sara A; Haddock, Christopher K; Carlos Poston, Walker S; Jitnarin, Nattinee
Military and Veterans Service Organizations (MVSOs) have a unique opportunity to influence legislation and advocate for the interests of their members. However, little is known about what legislative priorities MVSOs see as important. Understanding the legislative priorities of MVSOs can inform efforts by health scientists to promote policy and laws designed to improve the health of our nation's veterans. Using a mixed methods approach, we conducted a thematic analysis of legislative priorities MVSOs promote with their legislative agendas. Most commonly, MVSOs addressed issues related to disability evaluations and ratings with the Veterans Administration and access to Veterans Administration services. Other common themes identified as priorities include benefits such as retirement, education, housing assistance for veterans, and TRICARE benefits. Findings highlight the broad range of topics MVSOs identify as legislative priorities as well as some health issues that receive relatively limited attention. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Ansmann, L; Kuhr, K; Kowalski, C
Multilevel Analysis (MLA) are still rarely used in Health Services Research in Germany, though hierarchical data, e. g. from patients clustered in hospitals, is often present. MLA provide the valuable opportunity to study the health care context in health care organizations and the associations between context and health care outcomes. This article's aims are to introduce this particular method of data analysis, to discuss its' benefits and its' applicability particularly for Health Services Research focusing on organizational characteristics and to provide a concise guideline for performing the analysis. First, the benefits and the necessity for MLA compared to ordinary correlation analyses in the case of hierarchical data are discussed. Furthermore, the statistical requirements and key decisions for the performance of MLA are illustrated. © Georg Thieme Verlag KG Stuttgart · New York.
Beavers, R. L.
83 National Park Service (NPS) units contain nearly 12,000 miles of coastal, estuarine and Great Lakes shoreline and their associated resources. Iconic natural features exist along active shorelines in NPS units, including, e.g., Cape Cod, Padre Island, Hawaii Volcanoes, and the Everglades. Iconic cultural resources managed by NPS include the Cape Hatteras Lighthouse, Fort Sumter, the Golden Gate, and heiaus and fish traps along the coast of Hawaii. Impacts anticipated from sea level rise include inundation and flooding of beaches and low lying marshes, shoreline erosion of coastal areas, and saltwater intrusion into the water table. These impacts and other coastal hazards will threaten park beaches, marshes, and other resources and values; alter the viability of coastal roads; and require the NPS to re-evaluate the financial, safety, and environmental implications of maintaining current projects and implementing future projects in ocean and coastal parks in the context of sea level rise. Coastal erosion will increase as sea levels rise. Barrier islands along the coast of Louisiana and North Carolina may have already passed the threshold for maintaining island integrity in any scenario of sea level rise (U.S. Climate Change Science Program Synthesis and Assessment Program Report 4.1). Consequently, sea level rise is expected to hasten the disappearance of historic coastal villages, coastal wetlands, forests, and beaches, and threaten coastal roads, homes, and businesses. While sea level is rising in most coastal parks, some parks are experiencing lower water levels due to isostatic rebound and lower lake levels. NPS funded a Coastal Vulnerability Project to evaluate the physical and geologic factors affecting 25 coastal parks. The USGS Open File Reports for each park are available at http://woodshole.er.usgs.gov/project-pages/. These reports were designed to inform park planning efforts. NPS conducted a Storm Vulnerability Project to provide ocean and coastal
Larson, Eric Christopher
Large, multi-business unit firms are decentralizing their overall corporate structures. At the same time, the structures of their IT organizations are becoming more centralized. This is contrary to current wisdom that the IT organization structure will mimic the structure of the corporation, all else being equal. Because the general business…
James T. Hathaway
Full Text Available A close look at Pittsburgh’s environmental service firms in recent decades provides insight into the locational dynamics and trends of the United States environmental industry and insight into forces underlying this broad ranging sector of the economy. For my purposes, I place environmental services into two categories of producer services: professional services (e.g., environmental consulting or engineering and environmental contractors (e.g., remediation, emergency response while the third category lies in the realm of consumer services: operation and maintenance services (e.g., waste collection, treatment and disposal. I will provide portraits of these businesses by describing their revenues, employment, labor characteristics, clientele, and overall nature. My sources of information include trade publications and business databases, census data, content from firm websites, and personal interviews. I use a political economy perspective 1 to illuminate the forces affecting the locational dynamics and evolution of environmental service firms at metropolitan, national, and global scales and 2 to see what an analysis of environmental firms can contribute to debates on such processes as agglomeration and dispersal, outsourcing, the changing regulatory environment, and the “greening” of industry. Large manufacturing job declines have stimulated a move in the Pittsburgh area toward the environmental sector, but some environmental service industries have had turbulent trajectories. Pittsburgh’s environmental service firms have benefited from the region’s long history of struggling with environmental issues and by national trends including the public sector’s retreat from the provision of services and the “greening” of industry.
Wilson, Fernando A; Rampa, Sankeerth; Trout, Kate E; Stimpson, Jim P
This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data. Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data-provided by the Health Care Cost Institute-included claims from Aetna, Humana, and UnitedHealth for more than 50 million individuals per year. In 2009-2013, there were 13,480 MH/SA telehealth provider claims out of 3,986,159 claims, with the majority of telehealth claims submitted by psychiatrists. For telehealth services, there was a decreasing trend for average reimbursements ($54.61 in 2009 to $43.28 in 2013). Average reimbursements for telehealth claims were half those for nontelehealth claims. Reimbursements for nine of the top 10 telehealth services were lower in 2015 dollars than for the same services provided during face-to-face treatment. Widespread adoption and use of costly telehealth technologies for mental health services may be limited by low reimbursements for telehealth services.
that interbreeds when mature. Excluded is any species of the Class Insecta determined to constitute a pest whose protection would present ?n overwhelming...species are important sources of medicinal drugs. At least a quarter of all prescription drugs in the United States come from wild plants.3 1 3. Human... Medicinal Uses of Plants: Protection under the Endangered Species Act, 103d Congress, 1st Session, Nov. 9, 1992; James B. Hudson, Antiviral Compounds from
Eaton, Kenneth A; Pitts, Nigel B
Over the years, several members of the staff of the Dental Health Services Research Unit (DHSRU) at Dundee have published papers in Primary Dental Care. Furthermore, its Director, Professor Nigel Pitts, together with Drs Jan Clarkson and Gail Topping have co-edited a number of the Faculty of General Dental Practice (UK)'s standards manuals and contributed to others. It had been suggested to the Unit by several parties that, having been in funded existence for some 30 years, it would be appropriate to mark this anniversary with a conference to explore 'Dental Health Services Research: After 30 years, what was the impact, what have we learned and where are we going?' So, following a range of consultations, the conference was convened at the West Park Conference Centre in Dundee with a mixed audience representing both dental research and dental practice.
Thorne, K.; Hutchings, H.A.; Elwyn, G.
BACKGROUND: The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. METHODS: This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely
Perdue, Michael L; Bright, Rick A
Since 2005, the Government of the United States of America has provided more than US$ 50 million to advance influenza vaccine development in low-resourced countries. This programme has provided a unique opportunity for the US Government to develop a comprehensive view of, and to understand better the challenges and future needs for influenza vaccines in the developing world. The funding for this programme has been primarily through a cooperative agreement with the World Health Organization (WHO) to support directly its capacity-building grants to government-owned or -supported vaccine manufacturers in developing countries. A second cooperative agreement with the Program for Appropriate Technologies in Health (PATH) was initiated to accelerate the completion of a current Good Manufacturing Practice cGMP production facility, along with supporting facilities to obtain a reliable source of eggs, and to conduct clinical trials of influenza vaccine manufactured in Vietnam. This mechanism of utilizing cooperative agreements to support capacity-building for vaccine development in low-resourced settings has been novel and unique and has yielded fruitful returns on minimal investment. The information derived from this programme helps to clarify not only the development challenges for influenza vaccines and how the United States may assist in meeting those challenges, but also other vaccine development issues common to manufacturers in developing countries. While building the initial capacity to produce influenza vaccines can be a straightforward exercise, the sustainability of the enterprise and expansion of subsequent markets will be the key to future usefulness. There is hope for expansion of the global influenza vaccine market. Ongoing burden of disease studies are elucidating the impact of influenza infections, particularly in children, and more countries will take note and respond accordingly, since respiratory diseases are now the number one killer of children under
Myloslava M. Chernii
Full Text Available Today especially urgent problem is communication and the development of communication skills of future teachers as well as communicative culture is the main structural component of his professionalism. Schools and classes, both conventional and virtual, must have teachers, armed with technology resources and skills, and able to effectively teach the subject using information and communication technologies. It all comes down to the fact that the modern teacher has to be aware of the latest technologies that can help him to organize trainings and communication. Therefore, a special role is given to the training of future teachers and vector of application of social services in the organization of communication in the learning process.
Jaklič Tatjana Kitić
Full Text Available Background and Purpose: The modern environment requires that organizations (profit and non-profit continually harmonize their organizational models with changes in their respective environments and with their own visions and strategies for further development. The organizational structure of Emergency Medical Services (hereinafter EMS is currently a very topical issue in Slovenia, given that a project to establish a new organization of EMS is currently underway at the national level. By examining the case of one region in Slovenia, this article presents an analysis of factors that impact on the number and types of EMS activities and depicts a forecast of future trends for the requirement of EMS. The analysis presents the initial phase of a strategic planning process for the mentioned activity and consequently, a starting point for the formation of an organizational EMS model.
Orozco, Gabriel; Schwartz, Sara L; Austin, Michael J
The Spanish Speaking Unity Council (Unity Council) is a community development nonprofit organization that was established in 1964, during the civil rights movement, by a group of community members who wanted to ensure the political representation of the Latino community. Over its 45-year history, the Unity Council has grown into a $12 million community development organization that delivers a range of programming, including social services and employment training as well as facilitating the development and support of local businesses, low-income housing, and neighborhood improvement activities. The history of the agency presents the multiple challenges and rewards associated with development in an underserved community and an example of the important role that leadership plays in the growth of a nonprofit.
Semmens, Darius; Kepner, William; Goodrich, David
A consortium of federal, academic, and nongovernment organization (NGO) partners have established a collaborative research enterprise in the San Pedro River Basin to develop methods, standards, and tools to assess and value ecosystem goods and services. The central premise of ecosystem services research is that human condition is intrinsically linked to the environment. Human health and well-being (including economic prosperity) depend on important supporting, regulating, provisioning, and cultural services that we derive from our surrounding ecosystems. The AGAVES project is intended as a demonstration study for incorporating ecosystem services information into resource management policy and decisionmaking. Accordingly, a nested, multiscale project design has been adopted to address a range of stakeholder information requirements. This design will further facilitate an evaluation of how well methods developed in this project can be transferred to other areas.
Full Text Available A new homochiral multifunctional metal-organic framework, [Zn2(CTBA2·H2O] (JUC-112, was synthesized under solvothermal conditions, through the design of chiral ligand 4-(3-carboxy-2,2,3-trimethylcyclopentanecarboxamido benzoic acid (H2CTBA based on camphoric acid as building block. The crystal structure of the new material is a 2-dimensional (2D chiral layer packed with infinite rod-shaped secondary building units (SBUs. The homochiral framework was identified by circular dichroism (CD spectrum. Thermogravimetric measurement indicates its high thermal stability up to 450 °C. In addition, JUC-112 exhibits the capability of separating water from alcohols, second-order nonlinear optical effect, and photoluminescence.
Cai, Kun; Zhao, Nian; Zhang, Ning; Sun, Fu-Xing; Zhao, Qing; Zhu, Guang-Shan
A new homochiral multifunctional metal-organic framework, [Zn2(CTBA)2·H2O] (JUC-112), was synthesized under solvothermal conditions, through the design of chiral ligand 4-(3-carboxy-2,2,3-trimethylcyclopentanecarboxamido) benzoic acid (H2CTBA) based on camphoric acid as building block. The crystal structure of the new material is a 2-dimensional (2D) chiral layer packed with infinite rod-shaped secondary building units (SBUs). The homochiral framework was identified by circular dichroism (CD) spectrum. Thermogravimetric measurement indicates its high thermal stability up to 450 °C. In addition, JUC-112 exhibits the capability of separating water from alcohols, second-order nonlinear optical effect, and photoluminescence. PMID:28430135
In an in-depth field study of the work practices among the teams engaged in the delivery of outsourced IT services in a large IT services company in India, I discovered the organizational form that I call "Polymorphous Organization". It is the phenomenon where each team was embedded in a unique work context constituted by both the parent…
Ebaugh, Helen Rose Fuchs; Saltzman, Janet; Pipes, Paula F.
Organizational religiosity is analyzed with data from a national survey of faith-based social service coalitions (N = 656). Twenty-one items related to religious practices within these organizations result in three distinct factors: service religiosity, staff religiosity and organizational religiosity scales. Self-defined faith-based coalitions…
Ratniyom, Jadsada; Boonphadung, Suttipong; Unnanantn, Thassanant
This study examined the effects of the introductory organic chemistry online homework on first year pre-service science teachers' learning achievements. The online homework was created using a web-based Google form in order to enhance the pre-service science teachers' learning achievements. The steps for constructing online homework were…
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Direct payments to Indian Tribal Organizations (title IV-B, subpart 1, child welfare services). 1357.40 Section 1357.40 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND...
Nanes, Jessica A; Xia, Yulin; Dassanayake, R M A Priyanthi S; Jones, Rachael M; Li, An; Stodgell, Christopher J; Walker, Cheryl; Szabo, Sara; Leuthner, Steve; Durkin, Maureen S; Moye, Jack; Miller, Richard K
Emerging and legacy environmental pollutants such as polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and organochlorine pesticide metabolite DDE are found in human placenta, indicating prenatal exposure, but data from the United States are sparse. We sought to determine concentrations of these compounds in human placentae as part of a formative research project conducted by the National Children's Study Placenta Consortium. A total of 169 tissue specimens were collected at different time points post delivery from 43 human placentae at three U.S. locations, and analyzed by gas chromatography coupled with mass spectrometry following extraction using matrix solid phase dispersion. PBDEs, PCBs, and DDE were detected in all specimens. The concentrations of 10 PBDEs (Σ10PBDEs), 32 PCBs (Σ32PCBs) and p,p'-DDE were 43-1723, 76-856 and 10-1968pgg(-1) wet weight, respectively, in specimens collected shortly after delivery. Significant geographic differences in PBDEs were observed, with higher concentrations in placentae collected in Davis, CA than in those from Rochester, NY or Milwaukee, WI. We combined these with other published data and noted first-order declining trends for placental PCB and DDE concentrations over the past decades, with half-lives of about 5 and 8years, respectively. The effect of time to tissue collection from refrigerated placentae on measured concentrations of these three classes of persistent organic pollutants was additionally examined, with no significant effect observed up to 120h. The results of this work indicate that widespread prenatal exposure to persistent organic pollutants in the United States continues. Copyright © 2014 Elsevier Ltd. All rights reserved.
Bernot, Melody J; Becker, Jesse C; Doll, Jason; Lauer, Thomas E
We collaborated with 26 groups from universities across the United States to sample 42 sites for 33 trace organic compounds (TOCs) in water and sediments of lotic ecosystems. Our goals were 1) to further develop a national database of TOC abundance in United States lotic ecosystems that can be a foundation for future research and management, and 2) to identify factors related to compound abundance. Trace organic compounds were found in 93% of water samples and 56% of sediment samples. Dissolved concentrations were 10-1000× higher relative to sediment concentrations. The ten most common compounds in water samples with detection frequency and maximum concentration were sucralose (87.5%, 12,000ng/L), caffeine (77.5%, 420ng/L), sulfamethoxazole (70%, 340ng/L), cotinine (65%, 130ng/L), venlafaxine (65%, 1800ng/L), carbamazepine (62.5%, 320ng/L), triclosan (55%, 6800ng/L), azithromycin (15%, 970ng/L), diphenylhydramine (40%, 350ng/L), and desvenlafaxine (35%, 4600ng/L). In sediment, the most common compounds were venlafaxine (32.5%, 19ng/g), diphenhydramine (25%, 41ng/g), azithromycin (15%, 11ng/g), fluoxetine (12.5%, 29ng/g) and sucralose (12.5%, 16ng/g). Refractory compounds such as sucralose may be good indicators of TOC contamination in lotic ecosystems, as there was a correlation between dissolved sucralose concentrations and with the total number of compounds detected in water. Discharge and human demographic (population size) characteristics were not good predictors of compound abundance in water samples. This study further confirms the ubiquity of TOCs in lotic ecosystems. Although concentrations measured rarely approached acute aquatic-life criteria, the chronic effects, bioaccumulative potential, or potential mixture effects of multiple compounds are relatively unknown.
Sato, T.; Nishiyama, A. [Fuji Denki Reiki Co. Ltd., Tokyo (Japan)
The market of automatic tea service machines demands sanitation, reduction in time required for pouring tea, feeding the material, cleaning the inside of the machine, the maintenance and service of the machine, and excellent design. To meet these demands, Fuji Electric has changed the former configuration and components for functions and has developed a new series of instantaneous automatic tea service machines based on a new concept. This paper outlines the advantages of the instantaneous cooling tank and improvements in handling. (author)
Tanenbaum, Sandra J
Consumer-operated services organizations (COSOs) are independent, non-profit organizations that provide peer support and other non-clinical services to seriously mentally ill people. Mental health consumers provide many of these services and make up at least a majority of the organization's leadership. Although the dominant conception of the COSO is as an adjunct to clinical care in the public mental health system, this paper reconcieves the organization as a civic association and thereby a locus of citizenship. Drawing on empirical research on COSOs in one state and the citizenship and civic democracy literatures, COSOs are analyzed here as membership organizations with democratic norms and strong ties to local communities. The suggestion is made that by embracing and enhancing their status as civic associations, COSOs may advance the goals of the social movement that spawned them and avoid predictable obstacles to further growth and development.
Dumont, Olivier; Carmo, Carolina; Randaxhe, François
modes that need to be chosen optimally depending on the weather conditions, the heat demand and the temperature level of the storage. The ORC mode is activated, as long as the heat demand of the house is covered by the storage to produce electricity based upon the heat generated by the solar roof...... regarding control strategies and enhancement of the global system are drawn. A control strategy with a low storage temperature set-point (50˚C) allows reducing electrical consumption from 11% up to 24% when compared to higher set-point (60˚C). The system performance to produce power could also be optimized......This paper presents a dynamic model of a passive house located in Denmark with a large solar absorber, a horizontal ground heat exchanger coupled with a HP/ORC unit. The HP/ORC reversible unit is a module able to work as an Organic Rankine Cycle (ORC) or as a heat pump (HP). There are 3 possible...
This List is composed solely of US companies with major offices within the United States. All of the companies listed are involved in selling geothermally related goods and services internationally, or have the proven capability to do so. Each specific listing includes the company name, the name or title of the key contact person, address, telephone and if available a facsimile machine or telex number.
... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Remuneration for services performed in... TAX AT SOURCE Collection of Income Tax at Source § 31.3401(a)(8)(B)-1 Remuneration for services...) Remuneration paid for services for an employer (other than the United States or any agency thereof)...
... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Remuneration for services performed in Puerto... Source § 31.3401(a)(8)(C)-1 Remuneration for services performed in Puerto Rico by citizen of the United States. (a) Remuneration paid for services performed within Puerto Rico for an employer (other than...
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.
Sriram, V; Gururaj, G; Razzak, J A; Naseer, R; Hyder, A A
Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Söderfeldt, M; Söderfeldt, B; Warg, L E; Ohlson, C G
The Maslach Burnout Inventory, MBI, is a well established measure of burnout. Its validity outside the USA is, however, uncertain. The aim of the present study was therefore to apply the MBI on personnel in two Swedish human service organizations, comparing factor solutions and scoring norms to the original results. The population consisted of 5730 employees in the Social Insurance Organization (SIO) and the Individual and Family Care section (IFC) of the social welfare agencies. Principal components analysis, principal axes and alpha factor analyses were performed, all with varimax rotation. The suggested three factor solution showed to be remarkably stable irrespective of type of analysis. Score levels were somewhat lower on two subscales in the Swedish population. The conclusion is that the psychometric properties of the MBI seem to be very satisfactory and stable, at least in comparison between Sweden and USA. It is suggested that the dimensionality of MBI is rather invariant, but that the score levels covary with national, cultural, or professional contexts within the human services.
Korhonen, Lauren C; DeGroote, Nicholas P; Shouse, R Luke; Valleroy, Linda A; Prejean, Joseph; Bradley, Heather
The prevalence of diagnosed human immunodeficiency virus (HIV) infection in Hispanics/Latinos in the United States is more than twice as high as the prevalence among non-Hispanic whites (1). Services that support retention in HIV medical care and assist with day-to-day living, referred to here as ancillary services, help persons living with HIV access HIV medical care, adhere to HIV treatment, and attain HIV viral suppression. The needs for these ancillary services among Hispanics/Latinos are not well described (2). To obtain nationally representative estimates of and reasons for unmet needs for such services among Hispanic/Latino adults receiving outpatient HIV medical care during 2013-2014, CDC analyzed data from the Medical Monitoring Project (MMP). The analysis found that Hispanics/Latinos in all age and sexual orientation/behavior subgroups reported substantial unmet needs, including 24% needing dental care, 21% needing eye or vision care, 15% needing food and nutrition services, and 9% needing transportation assistance. Addressing unmet needs for ancillary services among Hispanics/Latinos living with HIV might help increase access to HIV care, improve health outcomes, and reduce health disparities.
Arroyo, Juan; Pastor-Goyzueta, Ada
Based on the results achieved to date by the Metropolitan System of Solidarity (SISOL) in Peru, this study undertook to analyze the extent to which SISOL has contributed to innovation in the organization of health services delivery. SISOL performance indicators were analyzed and compared with those of other health services delivery models in Peru, drawing on data from a survey of 4 570 SISOL users conducted in the last quarter of 2011, National Household Surveys from 2003 through 2011, and statistical data from the Peruvian Ministry of Health and Social Security. SISOL rated high in terms of growth of the demand served in Lima, productivity of human resources in office visits, and levels of user satisfaction. These results are attributed to: (a) the presence of specialists at the first level of care; (b) an innovative public-private structure, as opposed to outsourcing; and (c) a system of incentives based on shared risk management. The findings support the need for primary health care renewal, especially in urban areas to reduce the proliferation of unnecessary levels and sublevels of care. They also point to the possibility of developing synergistic public-private partnerships in which both sectors share risks and act in collaboration within a single service system. And finally, they indicate that primary care needs to be articulated into the segmented models.
Full Text Available The purpose of this study was to evaluate the services of municipal authorities of Komotini Greece, as they are recorded through the opinions of citizen’s of the municipality. In order to examine the services, a questionnaire was used that included questions about the participation in the programs, the reasons / factors for participation in exercise, the content of the programs and the personal characteristics of the citizens (exercising and no exercising people at municipal organization. Subjects in this study were 303 people all citizens of municipality of Komotini. Factor analysis detected five factors in the questionnaire: 1 quality of instructors, 2 functionality, 3 availability and program provision, 4 other services and 5 location. Also, were applied two-way factor analysis between the factors "age" and "education", "weekly frequency of exercise" and "monthly duration of exercise", "age" and "income" to find which of the criteria affect the participation. From the analysis appeared important effect of criteria of "weekly frequency of exercise" and was realised difference between the rungs.
Duval, J E; Bareille, N; Fourichon, C
are – from private veterinary practitioners’ point of views- i) to describe the roles of veterinarians today in organic dairy farmers’ animal health promotion strategies, ii) to identify factors related to organic farming which determine their role on organic dairy farms, and, iii) to identify opportunities...... for improvement of veterinarians’ advisory services for organic dairy herds. Fourteen veterinarians, providing herd health advisory services to dairy farmers, were interviewed using qualitative semi-structured research interviews. A modified approach to Grounded Theory was used for data collection and analysis...... not always able to establish themselves an advisory role supporting farmers in improving this. Indeed, organic production principles, regulations and farmers’ health approaches challenged veterinarians’ values on animal health and welfare and their perceptions of ‘good veterinary practices’. Also, some...
A N Katkina
Full Text Available Social networks such as Facebook and Twitter have recently become very popular and turned to be an effective instrument for achieving political goals. However, the social networks’ impact is rather ambivalent: on the one hand, social media form specific political actors and support self-organization and civil movements; on the other hand, social media reinforce destructive and aggressive manifestations with the pronounced criminal purposes, e.g. social media ability to disseminate information among large groups is used to organize mass riots. The article analyzes one of the recent and significant events largely provoked by the social networks - mass riots in the United Kingdom in August 2011 that were originally a reaction to the murder of M. Diggan by a police officer who tried to arrest him as a suspect in drug trafficking and possession of weapons. The way events developed into mass riots was the result of discussions in social media and use of social networks to coordinate joint actions of mass riots participants. The article provides a detailed description of the events and authorities’ actions to overcome the crisis and prevent such riots in the future, thus making some conclusions about the nature of social media impact on the politics.
Covalent organic frameworks (COFs) having periodicity in pores of nanoscale dimensions can be suitably designed for the organic building units bearing reactive functional groups at their surfaces. Thus, they are an attractive option as an anticancer agent to overcome the limitations of chemotherapy. Herein, we first report a new porous biodegradable nitrogen containing COF material, EDTFP-1 (ethylenedianiline-triformyl phloroglucinol), synthesized using 4,4\\'-ethylenedianiline and 2,4,6-triformylphloroglucinol via Schiff base condensation reaction. EDTFP-1 exhibited 3D-hexagonal porous structure with average pores of ca. 1.5 nm dimension. Here, we have explored the anti-cancer potentiality of EDTFP-1. Result demonstrated an enhanced cytotoxicity was observed against four cancer cells HCT 116, HepG2, A549, and MIA-Paca2 with significant lower IC50 on HCT116 cells. Additionally, EDTFP-1-induced cell death was associated with the characteristic apoptotic changes like cell membrane blebbing, nuclear DNA fragmentation, externalization of phosphatidylserine from the cell membrane followed by a loss of mitochondrial membrane potential as well as modulation of pro and anti-apoptotic proteins. Further, the result depicted a direct correlation between the generations of ROS with mitochondrial-dependant apoptosis through the involvement of p53 phosphorylation upon EDTFP-1 induction, suggesting this COF material is a novel chemotherapeutic agent for cancer treatment.
Plischke, M; Wagner, M; Haarbrandt, B; Rochon, M; Schwartze, J; Tute, E; Bartkiewicz, T; Kleinschmidt, T; Seidel, C; Schüttig, H; Haux, R
This article is part of a Focus Theme of METHODS of Information in Medicine on Health Record Banking. Poor communication of health care information between health care providers (HCP) is still a major problem. One recent approach is the concept of Health Record Banking. With this report we want to introduce the Lower Saxony Bank of Health (LSBH) to the international community. The main objective of this paper is to report and explain: 1) why this organization has been founded, 2) which basic principles have been set, 3) which services will be provided, 4) which type of organization has been chosen, and 5) which architectural framework has been selected. To report and discuss how we plan to achieve the intended objectives. The LSBH was founded as an entrepreneurial company, regarding itself as a neutral third-party information broker. The bank does not store medical documents on its central servers but offers a document registry with links to documents stored at participating health care providers. Subject to valid patient consent, the LSBH grants access to these documents to authorized health care providers. To implement our services, we chose the established technical frameworks of the Integrating the Healthcare Enterprise (IHE) initiative using cross-enterprise document sharing (XDS). Different approaches to establish health information exchange (HIE) are in early stages and some have failed in the past. Health Record Banking can address major challenges described in the literature about HIE. The future will show if our provider-sponsored business model is sustainable. After reaching a stable network, we intend to add additional HCPs, e.g., care homes or ambulance services, to the network.
Zandbergen, Jelmer; Koorneef, Guusje; Veen, Cees; Schrama, Jan; van der Putten, Wim
Worldwide soil fertility decreases and it is generally believed that organic matter (OM) addition to agricultural soils can improve soil properties leading to beneficial ecosystem services. However, it remains unknown under which conditions and how fast biotic, physical and chemical soil properties respond to varying quality and quantity of OM inputs. Therefore, the aims of this research project are (1) to unravel biotic, physical and chemical responses of soils to varying quantity and quality of OM addition; and (2) to understand how we can accelerate the response of soils in order to improve beneficial soil ecosystem services faster. The first step in our research project is to determine how small-scale spatio-temporal patterns in soil biotic, physical and chemical properties relate to crop production and quality. To do this we combine field measurements on soil properties with remote and proximate sensing measures on crop development and yield in a long-term farming systems experiment in the Netherlands (Vredepeel). We hypothesize that spatio-temporal variation in crop development and yield are strongly related to spatio-temporal variation in soil parameters. In the second step of our project we will use this information to identify biological interactions underlying improving soil functions in response to OM addition over time. We will specifically focus on the role of soil communities in driving nutrient cycling, disease suppression and the formation of soil structure, all crucial elements of key soil services in agricultural soils. The knowledge that will be generated in our project can be used to detect specific organic matter qualities that support the underlying ecological processes to accelerate the transition towards improved soil functioning thereby governing enhanced crop yields.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE.../Iridium Service is a dual mode GSM/GPRS and Iridium platform to ensure that connections are highly... customer service purposes, that the vessel owner keep for his or her records (and that Stratos Global or...
Planned Parenthood--World Population, Austin, TX. Southwest Region.
The directory is intended to serve those working at providing migrant workers with family planning services. Covering 46 states, it lists agencies and their addresses, schedules, appropriate contacts, and birth control methods available and fees charged (if any). The directory should be of particular help in providing a continuity of service to…
Parish, Susan L.; Braddock, David; Hemp, Richard; Rizzolo, Mary C.
Analysis of data on family support services and spending for individuals with developmental disabilities presents information on cash subsidy payments, respite care, and other family support. A graph shows U.S. spending for family support, 1986-1998. Additional tables break down subsidy spending for family support services by state in 1998 and…
Young, Diane S.
Examines mental health service provision by social workers in a county jail through a retrospective review of 359 mentally ill jail inmates' health and mental health records. Of the non-psychiatric, mental health services provided beyond initial assessment, housing placement evaluations and follow-up sessions were the most frequent. Suggestions…
Daynes, Gary; Longo, Nicholas V.
This article uses primary and secondary research on educational, social, and political theory in the late 19th and early 20th centuries to argue that the history of service-learning must be revised to include Jane Addams' pioneering work. A full consideration of Addams significantly revises understanding the origins of service-learning, suggesting…
Park, Yong Joon; Yang, Youjin
Many teacher educators believe that pre-service teachers should be aware of their future classroom environment including students who have linguistically and culturally diverse backgrounds. This paper is a description of how two teacher educators helped pre-service teachers develop their multicultural awareness in preparation for careers in Early…
Parkum, K H
Surveys a stratified sample of patients in six different hospitals and compares their perceptions of hospital chaplaincy and other pastoral care efforts with related hospital services. Reports the presence of a strong impact of pastoral care services and discusses these findings from the perspective of a theory of expressive and instrumental social orientations as explicated by the sociologist Talcott Parsons.
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Surviving spouses of United States citizens... Surviving spouses of United States citizens who died during a period of honorable service in an active duty... section 319(d) of the Act, the surviving spouse of a United States citizen must: (1) Establish that his...
Rowe, Rachel E; Townend, John; Brocklehurst, Peter; Knight, Marian; Macfarlane, Alison; McCourt, Christine; Newburn, Mary; Redshaw, Maggie; Sandall, Jane; Silverton, Louise; Hollowell, Jennifer
To explore whether service configuration and obstetric unit (OU) characteristics explain variation in OU intervention rates in 'low-risk' women. Ecological study using funnel plots to explore unit-level variations in adjusted intervention rates and simple linear regression, stratified by parity, to investigate possible associations between unit characteristics/configuration and adjusted intervention rates in planned OU births. Characteristics considered: OU size, presence of an alongside midwifery unit (AMU), proportion of births in the National Health Service (NHS) trust planned in midwifery units or at home and midwifery 'under' staffing. 36 OUs in England. 'Low-risk' women with a 'term' pregnancy planning vaginal birth in a stratified, random sample of 36 OUs. Adjusted rates of intrapartum caesarean section, instrumental delivery and two composite measures capturing birth without intervention ('straightforward' and 'normal' birth). Funnel plots showed unexplained variation in adjusted intervention rates. In NHS trusts where proportionately more non-OU births were planned, adjusted intrapartum caesarean section rates in the planned OU births were significantly higher (nulliparous: R(2)=31.8%, coefficient=0.31, p=0.02; multiparous: R(2)=43.2%, coefficient=0.23, p=0.01), and for multiparous women, rates of 'straightforward' (R(2)=26.3%, coefficient=-0.22, p=0.01) and 'normal' birth (R(2)=17.5%, coefficient=0.24, p=0.01) were lower. The size of the OU (number of births), midwifery 'under' staffing levels (the proportion of shifts where there were more women than midwives) and the presence of an AMU were associated with significant variation in some interventions. Trusts with greater provision of non-OU intrapartum care may have higher intervention rates in planned 'low-risk' OU births, but at a trust level this is likely to be more than offset by lower intervention rates in planned non-OU births. Further research using high quality data on unit characteristics and
Dubois, Carl-Ardy; D'amour, Danielle; Tchouaket, Eric; Clarke, Sean; Rivard, Michèle; Blais, Régis
To examine the associations of four distinct nursing care organizational models with patient safety outcomes. Cross-sectional correlational study. Using a standardized protocol, patients' records were screened retrospectively to detect occurrences of patient safety-related events. Binary logistic regression was used to assess the associations of those events with four nursing care organizational models. Twenty-two medical units in 11 hospitals in Quebec, Canada, were clustered into 4 nursing care organizational models: 2 professional models and 2 functional models. Two thousand six hundred and ninety-nine were patients hospitalized for at least 48 h on the selected units. Composite of six safety-related events widely-considered sensitive to nursing care: medication administration errors, falls, pneumonia, urinary tract infection, unjustified restraints and pressure ulcers. Events were ultimately sorted into two categories: events 'without major' consequences for patients and events 'with' consequences. After controlling for patient characteristics, patient risk of experiencing one or more events (of any severity) and of experiencing an event with consequences was significantly lower, by factors of 25-52%, in both professional models than in the functional models. Event rates for both functional models were statistically indistinguishable from each other. Data suggest that nursing care organizational models characterized by contrasting staffing, work environment and innovation characteristics may be associated with differential risk for hospitalized patients. The two professional models, which draw mainly on registered nurses (RNs) to deliver nursing services and reflect stronger support for nurses' professional practice, were associated with lower risks than are the two functional models.
Duval, J E; Bareille, N; Fourichon, C; Madouasse, A; Vaarst, M
Veterinarians could be the expected sparring partners of organic dairy farmers in promoting animal health which is one of the main organic principles. However, in the past organic dairy farmers did not always consider veterinarians to be pertinent advisors for them. The objectives of this study are - from private veterinary practitioners' point of views- i) to describe the roles of veterinarians today in organic dairy farmers' animal health promotion strategies, ii) to identify factors related to organic farming which determine their role on organic dairy farms, and, iii) to identify opportunities for improvement of veterinarians' advisory services for organic dairy herds. Fourteen veterinarians, providing herd health advisory services to dairy farmers, were interviewed using qualitative semi-structured research interviews. A modified approach to Grounded Theory was used for data collection and analysis. Most often veterinarians had only contact with the organic dairy farmers in cases of individual ill animals or acute herd health problems. Even though certain veterinarians experienced situations and approaches of animal health and welfare on organic dairy farms not meeting their standards, they were not always able to establish themselves an advisory role supporting farmers in improving this. Indeed, organic production principles, regulations and farmers' health approaches challenged veterinarians' values on animal health and welfare and their perceptions of 'good veterinary practices'. Also, some veterinarians considered that there was no direct economic interest for them in the organic dairy sector and that could diminish their willingness to invest in this sector. Possible opportunities for improvement were identified; for example proposing more proactively advice via existing organisations, by making adaptations to advisory services for the organic sector and/or by dissociating veterinarians' curative role from their advisory role in disease prevention.
... Service, Organ Pipe Cactus National Monument, Ajo, AZ and Arizona State Museum, Tucson, AZ AGENCY... Drive, Ajo, AZ 85321, telephone (520) 387-6849 ext. 7500. SUPPLEMENTARY INFORMATION: Notice is here... of Organ Pipe Cactus National Monument, Ajo, AZ and in the physical custody of the Arizona...
In 2003, Oklahoma State University and USDA, Agricultural Research Service, South Central Agricultural Research Laboratory received organic certification for 8 acres at the Lane Agricultural Center, Lane, OK. The certified organic land was used to develop a cooperative project with a diversity of a...
Full Text Available Although developing strategic and operational plans is a difficult and complicated process, their successful implementation is much more difficult. Many organizations fail in the full implementation of their strategies. This is not due to the partial definition of strategies and organization‘s operational plan, but this is likely due to the lack of strong framework for creating alignment between employees and operational process and the organizational goals. To implement strategies effectively and to develop a comprehensive management system and to improve the performance, Robert Kaplan and David Norton introduced a modern management system which is Balanced ScoreCard. Likewise they introduced five main criteria: leadership, translation, alignment, every day process and ongoing process for a strategy oriented organization. This paper is intended to offer a systematic approach for measuring the effectiveness and efficiency of the strategic plan performance. For this study the questionnaire was distributed in a project- orientated service organization and after collection, by the use of statistical. Analysis especially factor analysis the grouping of sub-criteria under the five main criteria was confirmed. The statistical analysis showed that, two criteria of alignment and every day work had the lowest scores in terms of both implementation and effectiveness in the organization‘s senior and executive manager‘s point of view. With deep interview, studying of scorecards and meeting of the strategic committee of the studied organization, the two dimension of alignment and every day work were further examined and after identifying upgradeable areas, some suggestions for improving the effectiveness and efficiency of the studied organization were presented.
Chandra, Anjani; Copen, Casey E; Stephen, Elizabeth Hervey
This report presents nationally representative estimates and trends for infertility service use among women aged 15-44 and 25-44 in the United States in 1982-2010. While greater detail on types of infertility service is shown for women, basic data on types of infertility service use, as reported by men aged 25-44, are also presented. Data for this report come primarily from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The response rate for females in the 2006-2010 NSFG was 78%, and for males was 75%. Selected trends are shown based on prior NSFG cycles. Twelve percent of women aged 15-44 in 2006-2010 (7.3 million women), or their husbands or partners, had ever used infertility services. Among women aged 25-44, 17% (6.9 million) had ever used any infertility service, a significant decrease from 20% in 1995. Thirty-eight percent of nulliparous women with current fertility problems in 2006-2010 had ever used infertility services, significantly less than 56% of such women in 1982. In all survey years, ever-use of medical help to get pregnant was highest among older and nulliparous women, non-Hispanic white women, women with current fertility problems, and women with higher levels of education and household income. The most commonly used infertility services among women aged 25-44 in 2006-2010 were advice, testing, medical help to prevent miscarriage, and ovulation drugs. Ever-use of infertility services was reported by 9.4% of men aged 25-44 in 2006-2010, similar to levels seen in 2002. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Kay, B J; Whitted, N A; Hardin, S S
Compared with other medical services, elective abortion is a special case where economic factors affecting delivery remain essentially constant. The consumer purchases it infrequently and the provider provides relatively frequently; the patient is not seeking information or interpretation of symptoms, only therapeutic service for which the technique is almost universal. In this area of medicine the consumer assesses the symptoms and decides on treatment before selecting a provider. U.S. women are not using abortion as a means of contraception in general and if they do, it is only once or twice. Prices charged for 1st trimester abortions are relatively stable ($171 in 1978, $174 in 1980). Since the liberalization of abortion legislation in 1973 there has been a yearly increase in elective 1st trimester abortions (85%), but a decreasing rate for each subsequent year (21% for 1973-74, 4% for 1977-78). Unmet need decreased from 58% in 1973 to 26% in 1978, concentrated in rural areas. The supply of abortions is subjected to constraints such as the aura of illegality, negative professional peer pressure, and distribution of providers. In 1977 13% of all providers performed 71% of all abortions, freestanding clinics had an average case load of more than 1600 year, hospitals provided 3% of abortions and office-based physicians performed 4%. In contrast to other medical services, abortion is a cash-on-delivery transaction with only 10% of patients submitting insurance forms. Information is provided to consumers regarding cost and quality of services through advertising and professional referral and is relatively widely available due to efforts of women's organizations, evaluative information is also disseminated. In Atlanta, 7 clinics performed 20,337 procedures in 1977, an increase of 1859 from 1976, prices ranging from $125-$165 in 1978 with a coefficient of variation of 0.09, the same since 1972-73. In a survey of 75 university students who had had abortions (16.8% of
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challange has been to integrate ecology with economics to better understand the effects of human policies and acti...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This EnviroAtlas dataset...
US Forest Service, Department of Agriculture — The data are designed for strategic analyses at a national or regional scale which require spatially explicit information regarding the extent, distribution, and...
Department of Agriculture — A map service on the www that depicts sixty-seven maps from Royceâ€™s 1897 report that have been scanned, georeferenced in JPEG2000 format, and digitized to create...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The EnviroAtlas Potentially...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This EnviroAtlas dataset shows...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The EnviroAtlas Potential...
A focus for resource management, conservation planning, and environmental decision analysis has been mapping and quantifying biodiversity and ecosystem services. The challange has been to integrate ecology with economics to better understand the effects of human policies and acti...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This EnviroAtlas dataset...
Full Text Available The practice of corruption always exist in public goods and service procurement in Indonesia. The Government efforts in reducing this case are doing new breakthrough like creating new system of service and goods procurement in an electronic way, usually called E-Procurement. After being instructed by Presidential Regulation number 54, year of 2010, the Local Government must use the E-Procurement System in the process of goods and service procurement, including Kepulauan Riau Province. This Research aims to analyzed the implementation of e-procurement system that had been adopted by Kepulauan Riau Province at year 2008. This research is not just for viewing the implementation of e-procurement system technically, but also to see how the influence of political process to the implementation of e-procurement. The Methodology used in this research is mix-method. This research are conducted in LPSE Kepulauan Riau Province, Procurement Service Unit (ULP and also the vendors that supplies service and goods, that had been using the system. The results of this research are clearly stated that even the system of e-procurement of Kepulauan Riau Province are effective, and the political process is a factor which influencing the implementation of e-procurement.Keywords : E-Procurement, E-Procurement Implementation, Political Process, Principal Influence, Agent Influence.
Danielson, L.; Righter, K.; McCubbin, F.
Large sample volume 5000 ton multi-anvil presses have contributed to the exploration of deep Earth and planetary interiors, synthesis of ultra-hard and other novel materials, and serve as a sample complement to pressure and temperature regimes already attainable by diamond anvil cell experiments. However, no such facility exists on the North American continent. We propose the establishment of an open user facility for COMPRES members and the entire research community, with the unique capability of a 5000 ton (or more) press, supported by a host of extant co-located experimental and analytical laboratories and research staff. We offer wide range of complementary and/or preparatory experimental options. Any required synthesis of materials or follow up experiments can be carried out controlled atmosphere furnaces, piston cylinders, multi-anvil, or experimental impact apparatus. Additionally, our division houses two machine shops that would facilitate any modification or custom work necessary for development of CETUS, one for general fabrication and one located specifically within our experimental facilities. We also have a general sample preparation laboratory, specifically for experimental samples, that allows users to quickly and easily prepare samples for ebeam analyses and more. A service we can offer to COMPRES community members in general, and CETUS visiting users specifically, is a multitude of analytical instrumentation literally steps away from the experimental laboratories. This year we will be pursuing site funding of our laboratories through NASA's Planetary Science Directorate, which should result in substantial cost savings to all visiting users, and supports our mission of interagency cooperation for the enhancement of science for all (see companion PSAMS abstract). The PI is in a unique position as an employee of Jacobs Technology to draw funding from multiple sources, including those from industry and commerce. We submitted a Planetary Major Equipment
Dsikowitzky, L; Botalova, O; al Sandouk-Lincke, N A; Schwarzbauer, J
Due to the very limited number of studies dealing with the chemical composition of industrial wastewaters, many industrial organic contaminants still escape our view and consequently also our control. We present here the chemical characterization of wastewaters from different units of a chemical complex, thereby contributing to the characterization of industrial pollution sources. The chemicals produced in the investigated complex are widely and intensively used and the synthesis processes are common and applied worldwide. The chemical composition of untreated and treated wastewaters from the chemical complex was investigated by applying a non-target screening which allowed for the identification of 39 organic contaminants. According to their application most of them belonged to four groups: (i) unspecific educts or intermediates of industrial syntheses, (ii) chemicals for the manufacturing of pharmaceuticals, (iii) educts for the synthesis of polymers and resins, and (iv) compounds known as typical constituents of municipal sewage. A number of halogenated compounds with unknown toxicity and with very high molecular diversity belonged to the second group. Although these compounds were completely removed or degraded during wastewater treatment, they could be useful as "alarm indicators" for industrial accidents in pharmaceutical manufacturing units or for malfunctions of wastewater treatment plants. Three potential branch-specific indicators for polymer manufacturing were found in the outflow of the complex. Among all compounds, bisphenol A, which was present in the leachate water of the on-site waste deposit, occurred in the highest concentrations of up to 20 000 μg L(-1). The comparison of contaminant loads in the inflow and outflow of the on-site wastewater treatment facility showed that most contaminants were completely or at least significantly removed or degraded during the treatment, except two alkylthiols, which were enriched during the treatment process
Jin Young Choi
Full Text Available Organics is the one of the fastest growing segments in food sales. Though the amount of certified organic land is increasing, the supply of organic foods lags behind demand in the United States. The reasons for this gap include a lack of government support for organics, and the peculiarities of organics as an innovation. In an attempt to close this gap, and increase the environmental sustainability of U.S. agriculture, this paper has two objectives. The first is to document the structural and institutional constraints to organic adoption. This is accomplished through a review of organic programs and policies in the U.S., in particular the National Organic Program. The second objective is to investigate the predictors of interest and the perceived barriers to organic adoption among pragmatic conventional producers in Texas, compared to organic and conventional producers. This is accomplished through a survey of a representative sample of producers in Texas. The results indicate that more than forty percent of producers who currently have conventional operations have at least some interest in organic production (pragmatic conventional producers. There are significant differences among the three groups in their structural and attitudinal characteristics related to organic adoption. For the pragmatic conventional producers, an increase in revenue would be a major facilitator of organic adoption. Their high levels of uncertainty regarding organic production and marketing, and especially organic certification constrain organic adoption. The results also reveal that the institutional setting in the U.S. hindered adoption. The paper concludes that increased institutional support would facilitate organic adoption.
Full Text Available In our country there have been many efforts in recent years to introduce laws that lead to the introduction of the concept of quality in the field of public hospitals. The implementation of health quality systems contributes to health care improvement, while the assessment of quality services is a basic tool in quality management. Purpose: The purpose of the study was to describe the benefits that can be gained by a public institute of health when a quality model is applied. Material and methods: This paper focus on the application of the ISO 9001:2008 standard in the Intensive Care Unit of the General Hospital of Larissa during the years 2010-2012. The results and benefits of its implementation, recorded by measuring satisfaction of the relatives of the patients. The questionnaire Family Satisfaction with Care in the Intensive Care Unit (FS-ICU 24 and quality indicators were applied. The study sample was all the relatives of the patients hospitalized in ICU during 2010-2012. Descriptive statistics was performed. Results: Quality indicators were considerably improved after ISO implementation with SMR falling to 35% in 2012 (from 58% in 2007, thus being one of the lowest in Greece and below European ICU’s SMR mean value. Over 80% of patients’ relatives answered that Nursing and Medical care was “excellent” and over 10% characterized it as “very good”. Family members’ total satisfaction surpassed 90%. Medical and Nursing care were highly appreciated by family members (very positive attitude expressed by over 90% of participants and satisfaction from nursing services approaches 100%. Conclusion: The implementation of quality systems in healthcare organizations is not easy and has many dimensions. However, it offers competitive advantage, improves the efficiency and effectiveness of the health care service providers and substantially contributes to the improvement of the delivered heath care.
Samer Hamidi School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates Introduction: A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Duba...
Full Text Available Organic Rankine cycle turbogenerators are a promising technology to transform the solar radiation harvested by solar collectors into electric power. The present work aims at sizing a small-scale organic Rankine cycle unit by tailoring its design for domestic solar applications. Stringent design criteria, i. e., compactness, high performance and safe operation, are targeted by adopting a multi-objective optimization approach modeled with the genetic algorithm. Design-point thermodynamic variables, e. g., evaporating pressure, the working fluid, minimum allowable temperature differences, and the equipment geometry, are the decision variables. Flat plate heat exchangers with herringbone corrugations are selected as heat transfer equipment for the preheater, the evaporator and the condenser. The results unveil the hyperbolic trend binding the net power output to the heat exchanger compactness. Findings also suggest that the evaporator and condenser minimum allowable temperature differences have the largest impact on the system volume and on the cycle performances. Among the fluids considered, the results indicate that R1234yf and R1234ze are the best working fluid candidates. Using flat plate solar collectors (hot water temperature equal to 75 °C, R1234yf is the optimal solution. The heat exchanger volume ranges between 6.0 and 23.0 dm3, whereas the thermal efficiency is around 4.5%. R1234ze is the best working fluid employing parabolic solar collectors (hot water temperature equal to 120 °C. In such case the thermal efficiency is around 6.9%, and the heat exchanger volume varies from 6.0 to 18.0 dm3.
Inclusivity and dementia: health services planning with individuals with dementia: effective inclusion requires action at multiple levels by individuals with dementia, care partners, service providers and funding organizations.
Whitfield, Kyle; Wismer, Susan
Historically, Alzheimer societies have identified the care partners of persons with dementia as their central clients. This focus is broadening to include the person with the disease, as well. This paper presents the results of a Canadian research study addressing organizational considerations related to effective inclusion of persons with dementia in planning and decision-making about health services and programs. Our findings suggest that effective inclusion requires action at multiple levels by individuals with dementia, care partners and friends; service organizations and providers; and funding organizations. Additional research is needed to explore the applicability of these findings to other organizations in different localities and to examine emergent themes further. Of these, one that has received little attention to date concerns the potential risks associated with effective inclusion.
Angeli, Federica; Maarse, Hans
Recent policy developments in Western European health care - for example in the Netherlands - aim to enhance efficiency and curb public expenditures by strengthening the role of private sector. Mergers and acquisitions (M&As) play an important role in this respect. This article presents an analysis of 1606 acquisition deals targeting health care provider organizations in Western Europe between 1990 and 2009. We particularly investigate the role of financial services organisations as acquirers. Our analysis highlights (a) a rise of M&As in Western Europe since 2000, (b) an increase of M&As with financial service organisations acting as acquirer in absolute terms, and (c) a dominant role of the latter type of M&As in cross-border deals. To explain these developments, we make a distinction between an integration and a diversification rationale for M&As and we argue that the deals with financial services organisations in the role of acquirer are driven by a diversification rationale. We then provide arguments why health care, from the acquirer's perspective, can be considered as an interesting target in a diversification strategy and we advance reasons why health care providers may welcome this development. Although caution in drawing conclusions is needed, our findings suggest a penetration of private capital into health care provision that may be interpreted as a specific form of privatisation. Furthermore, they point to a rising internationalisation of health care. Both findings may entail far-reaching implications for health care, as they may induce both cultural privatisation and cultural internationalisation.
Barbu Andreea Mihaela
Full Text Available Romanian education, which is an important pillar for human resource forming process and the basis for economic development, suffered a lot of changes in the last decades. The main factors that have influenced the undergraduate and university training programs are the political and social-cultural ones. Educational services organizations are facing various challenges as: creating and maintaining a good institutional image, managing all types of resources efficiently, motivating the academic personnel, satisfying the community needs and supporting the public policy. The marketing tools and activities help these entities to improve the educational programs and adapt them to the individual needs of the clients, to keep under control the production costs, which are limited by the small public budget and to perform and promote these services efficiently, leading to an increased organizational performance. The paper begins by presenting the current situation of higher education in Romania, underlining the fierce competition among the universities, the increased market potential and the financing sources. It continues by mentioning the advantages of strategic marketing planning for universities, as superior results and effectiveness, improved decision making and multiple benefits for the people involved. The paper reveals also the characteristics of segmenting and positioning on higher education market and the specific of marketing mix. Thereby, educational product is more easily adapted to customer needs when it is designed in collaboration with existing and future students, their parents, with other universities in the field or even with graduates. Students themselves can contribute to the increase the quality of their education. Price may be a factor of choice when future student chooses to pursue a university course, especially in those situations where the price does not include only the payment of annual fees for education. Distribution takes into
Fleisher, M; Schwartz, M K
Critical-care medicine requires rapidity of treatment decisions and clinical management. To meet the objectives of critical-care medicine, the critical-care laboratory must consider four major aspects of laboratory organization in addition to analytical responsibilities: specimen collection and delivery, training of technologists, selection of reliable instrumentation, and efficient data dissemination. One must also consider the advantages and disadvantages of centralization vs decentralization, the influence of such a laboratory on patient care and personnel needs, and the space required for optimal operation. Centralization may lead to workflow interruption and increased turnaround time (TAT); decentralization requires redundancy of instrumentation and staff but may shorten TAT. Minimal TAT is the hallmark of efficient laboratory service. We surveyed 55 laboratories in 33 hospitals and found that virtually all hospitals with 200 or more beds had a critical-care laboratory operating as a satellite of the main laboratory. We present data on actual TAT, although these were available in only eight of the 15 routine laboratories that provided emergency service and in eight of the 40 critical-care laboratories. In meeting the challenges of an increasing workload, a reduced clinical laboratory work force, and the need to reduce TAT, changes in traditional laboratory practice are mandatory. An increased reliance on whole-blood analysis, for example, should eliminate delays associated with sample preparation, reduce the potential hazards associated with centrifugation, and eliminate excess specimen handling.
Swaine, Jamie G; Parish, Susan L; Igdalsky, Leah; Powell, Robyn M
Consumer direction is a service delivery model that shifts decision-making from agencies to the individuals they serve. Using government funding, consumers hire, supervise, and schedule their own staff and maintain control over the delivery of their services. This study sought to understand the process of consumer direction as well as the experiences and perspectives of both the consumers and employees. The study also sought to better understand if and how consumer direction allows the consumer to direct his or her life, the impact consumer direction may have on the individual's health and health care, and how employment in consumer directed programs impacts the workers providing direct care services. This qualitative study included interviews with consumers (N = 20) and workers (N = 15) in Virginia, a southern state in the US. Semi-structured phone interviews were conducted by one member of the research team and transcribed and coded for themes by the research team using grounded theory methodology. Consumers reported greater control over their services and increased access to health care, compared to what they previously received with traditional services. Conversely, consumers reported challenges in managing their staff and fulfilling the role of an employer. Employees reported a lack of training prior to starting their jobs, as well as an inability to live off on low hourly wages. Still, the majority of employees reported job satisfaction and fulfillment. Policymakers should expand and strengthen the consumer directed program. Copyright © 2016 Elsevier Inc. All rights reserved.
李怀明; 王慧佳; 符林
For the problem of current access control strategies difficultly guaranteeing the flexibility of authorization of complex E-government system for Web service,this paper proposes an organization-based access control model for Web services on the basis of the research of the organization-based 4 level access control model. The model takes organization as the core and studies the issue of access control and authorization management from the perspective of management. Through importing the position agent and authorization unit in the model,the authorization can be adjusted according to the change of the environment context information to implement the dynamic authorization,while taking advantage of the state migration of authorization units,provides support for workflow patterns. Furthermore,the model divides permissions into service permissions and service attribute permissions, and achieves fine-grained resource protection. Application examples show that the model can commendably fit the complex organization structure in E-government system. Moreover,it can make authorization more efficient and flexible meanwhile protecting the Web service resources.%针对现有访问控制策略难以保障面向Web服务的复杂电子政务系统授权的灵活性问题，在研究基于组织的四层访问控制模型(OB4LAC)的基础上，提出一种基于组织的Web服务访问控制模型。以组织为核心，从管理的视角研究访问控制与授权管理问题。通过引入岗位代理和授权单元，使授权随着环境上下文信息的变化而调整，从而实现动态授权，同时利用授权单元的状态迁移，对工作流模式提供支持。并且模型将权限分为服务权限和服务属性权限2级，实现细粒度的资源保护。应用实例结果表明，该模型能够契合电子政务系统中的复杂组织结构，在保护Web服务资源的同时，使得授权更加高效和灵活。
Terence P. McGonigle
Full Text Available Primarily using cropped systems, previous studies have reported a positive linear relationship between microbial biomass carbon (MBC and soil organic carbon (SOC. We conducted a meta-analysis to explore this relationship separately for grasslands and croplands using available literature. Studies were limited to those using fumigation–extraction for MBC for field samples. Trials were noted separately where records were distinct in space or time. Grasslands were naturally occurring, restored, or seeded. Cropping systems were typical of the temperate zone. MBC had a positive linear response to increasing SOC that was significant in both grasslands (p < 0.001; r2 = 0.76 and croplands (p < 0.001; r2 = 0.48. However, MBC increased 2.5-fold more steeply per unit of increasing SOC for grassland soils, as compared to the corresponding response in cropland soils. Expressing MBC as a proportion of SOC across the regression overall, slopes corresponded to 2.7% for grasslands and 1.1% for croplands. The slope of the linear relationship for grasslands was significantly (p = 0.0013 steeper than for croplands. The difference between the two systems is possibly caused by a greater proportion of SOC in grasslands being active rather than passive, relative to that in croplands, with that active fraction promoting the formation of MBC.
Piccoli, Giorgina Barbara; Consiglio, Valentina; Deagostini, Maria Chiara; Manente, Elisa; Scarpa, Roberto Mario
The growing interest in patient empowerment in chronic diseases underlines the importance of assessing patients' opinions in planning healthcare strategies. Focus groups are flexible tools for investigating innovative aspects of care. The aim of the study was to use a focus group to define the main requirements for a chronic kidney disease (CKD) outpatient care unit. The focus group met during the opening of a new CKD outpatient facility. It consisted of 12 patients with long-term experience of CKD, dialysis and transplantation; they had been followed previously by the senior physician, who moderated the discussion. The discussion was tape-recorded and the results were summarized and approved by all participants. The group made 10 major suggestions: 1. Therapeutic continuity in all disease phases, from pre-dialysis to transplantation; 2. Possibility to choose the reference physician; 3. Strict integration with the nursing activities; 4. Organizational flexibility, to adapt to the needs of daily life; 5. To be "fully" taken care of, with organizational support for blood tests, imaging and consultations; 6. Need for time with the reference physician in critical phases of the disease; 7. Identification of a network of consultants, in keeping with the need for continuity of care; 8. Educational sessions; 9. Meetings for critical discussion of organizational performances; 10. As a setting: a home for the disease and not a disease to take home. Continuity of care and flexibility of organization, allowing time for education and discussion, are the quality requirements of our CKD patients.
Brenke, Christopher; Lassel, Elke A; Terris, Darcey; Kurt, Aysel; Schmieder, Kirsten; Schoenberg, Stefan O; Weisser, Gerald
A significant proportion of acute care neurosurgical patients present to hospital outside regular working hours. The objective of our study was to evaluate the structure of neurosurgical on-call services in Germany, the use of modern communication devices and teleradiology services, and the personal acceptance of modern technologies by neurosurgeons. A nationwide survey of all 141 neurosurgical departments in Germany was performed. The questionnaire consisted of two parts: one for neurosurgical departments and one for individual neurosurgeons. The questionnaire, available online and mailed in paper form, included 21 questions about on-call service structure; the availability and use of communication devices, teleradiology services, and other information services; and neurosurgeons' personal acceptance of modern technologies. The questionnaire return rate from departments was 63.1% (89/141), whereas 187 individual neurosurgeons responded. For 57.3% of departments, teleradiology services were available and were frequently used by 62.2% of neurosurgeons. A further 23.6% of departments described using smartphone screenshots of computed tomography (CT) images transmitted by multimedia messaging service (MMS), and 8.6% of images were described as sent by unencrypted email. Although 47.0% of neurosurgeons reported owning a smartphone, only 1.1% used their phone for on-call image communication. Teleradiology services were observed to be widely used by on-call neurosurgeons in Germany. Nevertheless, a significant number of departments appear to use outdated techniques or techniques that leave patient data unprotected. On-call neurosurgeons in Germany report a willingness to adopt more modern approaches, utilizing readily available smartphones or tablet technology. Georg Thieme Verlag KG Stuttgart · New York.
Directory of Book Trade and Related Organizations. Books Trade Associations, United States and Canada; International and Foreign Book Trade Associations; National Information Standards Organization (NISO) Standards; Calendar, 2003-2012; Acronyms; Index of Organizations; Subject Index.
Bowker Annual Library and Book Trade Almanac, 2003
Includes two lists: one of book trade associations in the United States and Canada, and one of international and foreign book trade associations. Concludes with National Information Standards Organization (NISO) standards; calendar, 2003-2012; acronyms; index of organizations; and subject index. (LRW)
Manski, Richard J; Cohen, Leonard A; Brown, Erwin; Carper, Kelly V; Vargas, Clemencia; Macek, Mark D
The oral health of older Americans will assume increasing importance because of their increasing numbers and the evolving connections between oral health and general health. To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65 years and older in 2009 and looks at trends since 1999. Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Survey. The primary outcome variable represented the types of dental procedures that were received during a dental visit in the preceding year. Descriptive variables included dental insurance and poverty status. Analysis was restricted to adults aged 65 and over. In 2009, diagnostic and preventive procedures accounted for almost three-quarters of all services. Compared with services received by those with private insurance, there were significantly fewer diagnostic and endodontic procedures among those with public coverage. Between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased. Also, the likelihood of receiving preventive procedures increased, whereas the probability of receiving restorative or endodontic services decreased. Findings point to a shift in the mix of dental services received by older adults during the two periods. The predominance of diagnostic and preventive procedures has important access and workforce implications. An expanded role for dental hygienists in helping to meet the oral health needs of older adults is possible given a hygienist's current scope of practice. Published 2014. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
Kalina, C M; Fitko, J
1. The occupational health nurse is often mandated by management to validate health services offered and programs developed for employees as valuable to the business and company mission. 2. The business plan of the occupational health service is a working document, changing as needs of the client/customer and internal and external business and socio-economic environment evolve. 3. Alignment with and support of the company mission, goals, and objectives is another method of proving good occupational health is good business. 4. Business planning is a basic business tool the wise and prudent occupational health nurse can use in proving good occupational health is vital to the success of a company.
Yan Carlos Ureña
Full Text Available This aims to analyze the intellectual capital as a strategic model for quality of service in smart organizations Municipality Maracaibo, Zulia State, Venezuela, is based on the principles of Boscan and Sandrea (2015, Zapata (2009, Bernardez (2008, Edvinsson and Malone (2003, among others. Methodologically it is based on a scientific-positivist paradigm, analytic, descriptive with a non-experimental, cross-sectional design field, with a non-experimental, cross-sectional design field. The population consisted of (36 people and features the following criteria: (6 managers, (15 employees and (15 customers in a smart organization of the Municipality Maracaibo, Zulia State, Venezuela. Among the results it is concluded that sometimes develop the human, structural and patronage equity thus increasing the intangible assets that each employee has (values, attitudes, skills and knowledge also sometimes show their best attitudes and dispositions to respond to the concerns in addition to responding to requests for users using tangibility, trust, responsibility, security and empathy.
Klein, A S; Messersmith, E E; Ratner, L E; Kochik, R; Baliga, P K; Ojo, A O
Despite the Organ Donation Breakthrough Collaborative's work to engage the transplant community and the suggested positive impact from these efforts, availability of transplanted organs over the past...
Glyanenko, A. S.; Lupar, E. E.; Trofimov, Yu A.; Faradzhaev, R. M.; Yurov, V. N.
Problems of onboard space scientific devices control, collecting auxiliary service information about working capacity, conditions of experiment carrying out and preliminary data processing for real time calibration and stabilizing of operational parameters are actual for any space devices. In this paper we describe and discuss service data acquisition and onboard control for “GRIS-BD” unit in “GRIS” space experiment onboard ISS. This system provides temperature measurements in different equipment parts (in power supplies, on scintillation crystals for energy ranges correction, etc.), precision thresholds measurements in discrimination circuits, status different switching on/off (in real time), precision control detector parameters by high-voltage regulation, fine thresholds changing (analog regulation), different switching on/off (in real time), statistical analysis of data flows and change of operation modes of the device.
Mendel-Reyes, Meta; Weinstein, Jeremy
Describes development of the first community service-learning program for democratic education in South Africa, based on the Swarthmore College (Pennsylvania) Democracy Education Project at a black high school near Capetown (South Africa). Notes that successful transposition of the model requires recognition of complex historical and cultural…
... ``Vomitoxin Qualitative'' and ``Vomitoxin Quantitative'' fees with one fee, ``All other Mycotoxins,'' in order... replace the ``Vomitoxin Qualitative'' and ``Vomitoxin Quantitative'' fees with one fee, ``All other... Services, including a comparison of the costs and revenues associated with official inspection and weighing...
Full Text Available Section 404 of the U.S. Clean Water Act includes most wetlands in its jurisdiction and requires wetland mitigation to compensate for permitted wetland losses. These mitigation wetlands can provide ecosystem services similar to original wetlands if properly constructed. Improvement of wetland monitoring requirements coupled with economic assessment is critical for effective implementation of the mitigation policy. The economic assessment when left out of evaluation of mitigation policy could result in mitigation wetlands being given too little weight in policy decisions. Under the assumption that mitigation requirements reported in the Army Corps permit files represent actual wetland creation, ecosystem services value is estimated using a wetland benefit‑function transfer approach. Wetland mitigation requirements during 2010–2012 recorded in the Army Corps permit files is used for the analysis. The results indicate that cumulative ecosystem services value per acre per year is in the range of $5000 to $70,000, which translates to a nationwide annual aggregate benefit of $2.7 billion. Given the history of the ecosystem services not fully captured nor adequately quantified, the current analysis is an initial step in understanding the value of wetland mitigation.
Sullivan, M.J.; Mercurio, Matthew; Schellenberg, Josh
Information on the value of reliable electricity service can be used to assess the economic efficiency of investments in generation, transmission and distribution systems, to strategically target investments to customer segments that receive the most benefit from system improvements, and to numerically quantify the risk associated with different operating, planning and investment strategies. This paper summarizes research designed to provide estimates of the value of service reliability for electricity customers in the US. These estimates were obtained by analyzing the results from 28 customer value of service reliability studies conducted by 10 major US electric utilities over the 16 year period from 1989 to 2005. Because these studies used nearly identical interruption cost estimation or willingness-to-pay/accept methods it was possible to integrate their results into a single meta-database describing the value of electric service reliability observed in all of them. Once the datasets from the various studies were combined, a two-part regression model was used to estimate customer damage functions that can be generally applied to calculate customer interruption costs per event by season, time of day, day of week, and geographical regions within the US for industrial, commercial, and residential customers. Estimated interruption costs for different types of customers and of different duration are provided. Finally, additional research and development designed to expand the usefulness of this powerful database and analysis are suggested.
due to the different historical experiences and traumas that each has endured. Institutional Identity---The Mask of War Each Service Wears Builder...216 Some of these priorities were: the F-22 Raptor , the F-35Joint Strike Fighter Lightning II, the next
Cabello-Argandona, Roberto; Haro, Roberto Peter
This study focuses on factors contributing to the low level of effectiveness of library and information services to the Spanish speaking community as reported in the literature. It analyzes, using an open system approach, models developed by public and academic libraries to serve the Spanish speaking population. Problems contributing to the…
20 Softwre ............................................... 62 Officem Auomaiontins the.Busiess.Worl...but professional and managerial staff as well1 ... (9:2) The General Services Administration was even more specific when * it defined office automation...Conquests for the Computer," Nation’s Business, Vol. 70, No. 6 (June 1982): pp. 67-76. Spindle, Les. "Computerizing Your Office," Radio -Electronics, Vol
Ferlie, Ewan; McGivern, Gerry; Fitzgerald, Louise
We explore the argument that a new mode of health care organizing is emerging which moves beyond the established professional dominance versus New Public Management (NPM) debate. We review Foucault's work on 'governmentality', as applied to health care organizations. We specify two specific Foucauldian themes (the power/knowledge nexus in Evidence Based Medicine (EBM); and the technologies of the clinical managerial self) to analyse organizing in the English cancer services field. We introduce two qualitative case studies of Managed Cancer Networks. We suggest their governance can be fruitfully seen through a 'governmentality' lens. We consider implications for developing Foucauldian analysis of health care organizations.
Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul
With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.
McLean, Scott; Gasperini, Lavinia; Rudgard, Stephen
The distance learning experiences of the United Nations Food and Agriculture Organization led to the following suggestions for applying distance learning strategies to the challenges of food security and rural development: use distance learning for the right reasons, be sensitive to context, use existing infrastructure, engage stakeholders, and…
Huffman, Raegan L.
Previous investigations indicate that concentrations of chlorinated volatile organic compounds (CVOCs) are substantial in groundwater beneath the 9-acre former landfill at Operable Unit 1, Naval Undersea Warfare Center, Division Keyport, Washington. The U.S. Geological Survey has continued to monitor groundwater geochemistry to ensure that conditions remain favorable for contaminant biodegradation as specified in the Record of Decision for the site.
de Rosa, Cecilia; Nadeau, Andrew; Hernandez, Emilio; Kafeero, Fred; Zahiga, Jacques
The Food and Agriculture Organization of the United Nations (FAO) utilizes training as a major component of the support it provides to its member countries in Africa. In the past, stand-alone training events targeting individual actors were the norm. However, an external evaluation indicated that this type of training scores low in terms of…
Azami-Aghdash, Saber; Ghojazadeh, Morteza; Naghavi-Behzad, Mohammad; Imani, Shahin; Aghaei, Mir Hossein
The present study was conducted aiming to determine the points of view of cardiac care units' nursing staff about designing and providing Hospice services in Iran for cardiovascular patients in the final stages of life...
Neumann, Cedric; Ramotowski, Robert; Genessay, Thibault
Forensic examinations of ink have been performed since the beginning of the 20th century. Since the 1960s, the International Ink Library, maintained by the United States Secret Service, has supported those analyses. Until 2009, the search and identification of inks were essentially performed manually. This paper describes the results of a project designed to improve ink samples' analytical and search processes. The project focused on the development of improved standardization procedures to ensure the best possible reproducibility between analyses run on different HPTLC plates. The successful implementation of this new calibration method enabled the development of mathematical algorithms and of a software package to complement the existing ink library.
Okafor, Maria C
The diversification and aging of the US population has been at the root of many political and policy debates in recent years. Of particular interest has been the place of immigrants in an aging society, and what rights these immigrants are entitled to. The objective of this article is to describe the current avenues and barriers to access of services for immigrant elders and examine potential solutions for reform. The article begins with a historical overview of the policy issue, followed by the current status of the issue in the United States and suggestions for reform.
Full Text Available Background: In 2014 the health promotion program aimed at managing personnel smoking was implemented in the Polish prison service (PS in cooperation with the Nofer Institute of Occupational Medicine (NIOM. It combined education of managers, encouraging them to implement good practices, with employees’ education. This paper describes the process of implementation and its effects in 159 units of PS, against the data on the management of smoking in medium and large companies in Poland gathered in 2010. Material and Methods: Situations concerning smoking management in PS units before and after a half-year program implementation were compared. Data were gathered using self-diagnosis questionnaires (initial and final assessments collectively filled in by representatives of management and employees. Results: Due to the program implementation there was an increase in the percentage of PS units with known number of smoking employees (19% vs. 61%, consultions on formal smoking regulations with personnel (14% vs. 57%, minimal antismoking medical interventions (46% vs. 59%, and assessments of effects of antismoking activities (14% vs. 55%. There was also increase in the number of PS units with personnel totally obeying smoking regulations (28% vs. 41% and decrease in those where such rules are not completely met (9% vs. 7%. In 3/4 PS units there was an increase in employees’ interest in quitting smoking and in 40% of them employees smoke less at work. Almost every second unit has set up a health promotion team. Conclusions: In many aspects the program has brought along satisfying effects and allowed for depicting areas of improvement. Its scheme and tools can be used, after adaptation, in interventions concerning other health problems in workplaces. Med Pr 2016;67(5:605–621
We analyzed the potential physical and economic impacts of climate change on freshwater fisheries and coral reefs in the United States, examining a reference scenario and two policy scenarios that limit global greenhouse gas (GHG) emissions. We modeled shifts in suitable habitat ...
Brian H. Hill; Randall K. Kolka; Frank H. McCormick; Matthew A. Starry
Ecosystem production functions for water supply, climate regulation, and water purification were estimated for 568 headwater streams and their catchments. Results are reported for nine USA ecoregions. Headwater streams represented 74-80% of total catchment stream length. Water supply per unit catchment area was highest in the Northern Appalachian Mountains ecoregion...
Iapichino, G; Radrizzani, D; Rossi, C; Pezzi, A; Anghileri, A; Boffelli, S; Giardino, M; Mistraletti, G; Bertolini, G
The aim of this study was to verify the capability of the Italian Group for the Evaluation of Intervention in Intensive Care Medicine (Gruppo Italiano Valutazione Interventi in Terapia Intensiva, GiViTI) Intensive Care Units (ICUs) in providing high level care (HLC) and to develop a flexible organiziational model, allowing for different levels of care in each ICU. Once the number of active beds, personnel and technology of each ICU were determined, we computed whether the available bed number and all available resources could provide HLC according to international standards. For ICUs lacking staff or equipment for safe HLC in all declared beds, we calculated the best combination between HLC and observation/monitoring beds with less need for nurses and technology (low level of care, LLC) in order to optimise the utilization of each bed. We also investigated the work organisation of physicians and nurses in these units. There are 2 070 available beds in the 293 GiViTI ICUs. To provide HLC according to international criteria, the beds would decrease to 80.9%, because 144 ICUs do not have nurses or equipment to provide HLC in each bed. In order to maximize the suitable use of available resources, these ICUs would have to reduce the HLC bed number using the regained nurse workload for LLC. Because of this, the total number of HLC beds would further decrease to 65.9% of all declared beds. During Sundays and holidays, the bed/doctor and the bed/nurse ratios increase in most ICUs. To maximize the staff and equipment resources available, the bed numbers of a general ICU providing HLC must vary, even daily, according to the level of care provided. This level is not always high for all patients present. Applying this organizing model to each ICU, we could have enough flexibility to face the different demands for assistance if the ICU is built as a large open space to achieve the best clinical model and use of resources.