WorldWideScience

Sample records for veterans custom designed

  1. 77 FR 3843 - Agency Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing...

    Science.gov (United States)

    2012-01-25

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0548] Agency Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing Survey) Under OMB Review AGENCY: Board of Veterans.... Title: Board of Veterans' Appeals Customer Satisfaction with Hearing Survey, VA Form 0745. OMB Control...

  2. 76 FR 70827 - Proposed Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing...

    Science.gov (United States)

    2011-11-15

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0548] Proposed Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing Survey Card) Activity; Comment Request AGENCY... information technology. Title: Board of Veterans' Appeals Customer Satisfaction with Hearing Survey Card, VA...

  3. Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

    Science.gov (United States)

    Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

    2015-09-01

    The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Veterans Administration Databases

    Science.gov (United States)

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  5. Accessibility and acceptability of the Department of Veteran Affairs health care: diverse veterans' perspectives.

    Science.gov (United States)

    Damron-Rodriguez, JoAnn; White-Kazemipour, Whitney; Washington, Donna; Villa, Valentine M; Dhanani, Shawkat; Harada, Nancy D

    2004-03-01

    Diverse veteran's perspectives on the accessibility and acceptability of the Department of Veteran Affairs (VA) health services are presented. The qualitative methodology uses 16 focus groups (N = 178) stratified by war cohort (World War II and Korean Conflict versus Vietnam War and Persian Gulf War) and four ethnic/racial categories (African American, Asian American, European American, Hispanic American). Five themes emerged regarding veterans' health care expectations: (1) better information regarding available services, (2) sense of deserved benefits, (3) concern about welfare stigma, (4) importance of physician attentiveness, and (5) staff respect for patients as veterans. Although veterans' ethnic/racial backgrounds differentiated their military experiences, it was the informants' veteran identity that framed what they expected of VA health services. Accessibility and acceptability of VA health care is related to veterans' perspectives of the nature of their entitlement to service. Provider education and customer service strategies should consider the identified factors to increase access to VA as well as improve veterans' acceptance of the care.

  6. 75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2010-03-01

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...

  7. Involving Customer Relations in Contextual Design

    DEFF Research Database (Denmark)

    Simonsen, Jesper

    1996-01-01

    This paper presents a case study in the form of a contextual design project, the aim of which was to design a system for a particular organization. The starting point in the case was a need in the organization for a specific system. The case involved an analysis of the organizations customer...... point of the design project, how the project was conducted, and which results it ended up with. This is followed by a discussion of the effects of, and lessons learned by, involving customer relations in contextual design....

  8. The interplay between customer participation and difficulty of design examples in the online designing process and its effect on customer satisfaction: mediational analyses.

    Science.gov (United States)

    Chang, Chia-Chi; Chen, Hui-Yun; Huang, I-Chiang

    2009-04-01

    In the current consumer-centric economy, consumers increasingly desire the opportunity to design their own products in order to express more effectively their self-image. Mass customization, based on efficient and flexible modulization designs, has provided individualized products to satisfy this desire. This work presents an experiment employed to demonstrate that customer participation leads to higher satisfaction. Specifically, the increment in customer satisfaction due to participation is greater when an easy example is provided than when either no example or a difficult one is provided. Additionally, self-congruity plays a mediating role on the customer participation-satisfaction relationship, and this mediating effect varies across different levels of the design example provided in the design process. When an easy design example is present, customer participation has a direct effect on satisfaction, in addition to the indirect effect of self-congruity. When a difficult example is provided, customer participation does not have incremental effects on either self-congruity or customer satisfaction. Finally, when no design example is shown to customers, contrary to our expectation, participation still enhances customer satisfaction due to an increased sense of self-congruity.

  9. 77 FR 2349 - Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2012-01-17

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... techniques or the use of other forms of information technology. Title: Nation-wide Customer Satisfaction...

  10. Transforming Multidisciplinary Customer Requirements to Product Design Specifications

    Science.gov (United States)

    Ma, Xiao-Jie; Ding, Guo-Fu; Qin, Sheng-Feng; Li, Rong; Yan, Kai-Yin; Xiao, Shou-Ne; Yang, Guang-Wu

    2017-09-01

    With the increasing of complexity of complex mechatronic products, it is necessary to involve multidisciplinary design teams, thus, the traditional customer requirements modeling for a single discipline team becomes difficult to be applied in a multidisciplinary team and project since team members with various disciplinary backgrounds may have different interpretations of the customers' requirements. A new synthesized multidisciplinary customer requirements modeling method is provided for obtaining and describing the common understanding of customer requirements (CRs) and more importantly transferring them into a detailed and accurate product design specifications (PDS) to interact with different team members effectively. A case study of designing a high speed train verifies the rationality and feasibility of the proposed multidisciplinary requirement modeling method for complex mechatronic product development. This proposed research offersthe instruction to realize the customer-driven personalized customization of complex mechatronic product.

  11. ASD Customer Satisfaction Survey

    Data.gov (United States)

    Department of Veterans Affairs — ASD implemented a customer satisfaction survey for our products and services. This feedback will provide a better understanding of how ASD products and services can...

  12. 77 FR 64382 - Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2012-10-19

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  13. 75 FR 25320 - Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2010-05-07

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  14. Advanced customization in architectural design and construction

    CERN Document Server

    Naboni, Roberto

    2015-01-01

    This book presents the state of the art in advanced customization within the sector of architectural design and construction, explaining important new technologies that are boosting design, product and process innovation and identifying the challenges to be confronted as we move toward a mass customization construction industry. Advanced machinery and software integration are discussed, as well as an overview of the manufacturing techniques offered through digital methods that are acquiring particular significance within the field of digital architecture. CNC machining, Robotic Fabrication, and Additive Manufacturing processes are all clearly explained, highlighting their ability to produce personalized architectural forms and unique construction components. Cutting-edge case studies in digitally fabricated architectural realizations are described and, looking towards the future, a new model of 100% customized architecture for design and construction is presented. The book is an excellent guide to the profoun...

  15. Group decision support system for customer-driven product design

    Science.gov (United States)

    Lin, Zhihang; Chen, Hang; Chen, Kuen; Che, Ada

    2000-10-01

    This paper describes the work on the development of a group decision support system for customer driven product design. The customer driven is to develop products, which meet all customer requirements in whole life cycle of products. A process model of decision during product primary design is proposed to formulate the structured, semi-structured and unstructured decision problems. The framework for the decision support system is presented that integrated both advances in the group decision making and distributed artificial intelligent. The system consists of the product primary design tool kit and the collaborative platform with multi-agent structure. The collaborative platform of the system and the product primary design tool kit, including the VOC (Voice of Customer) tool, QFD (Quality Function Deployment) tool, the Conceptual design tool, Reliability analysis tool and the cost and profit forecasting tool, are indicated.

  16. Customizing CAD system and its application for engineering design

    International Nuclear Information System (INIS)

    Shin, Jeong Ho; Kwak, Byung Man

    2003-01-01

    The computer is an important tool to design an engineering system and CAD systems are widely used for various design practice. To meet the market requirements, the old mass production system is being changed into the mass customization system. As for CAD systems, it is increasingly required to extend, automate, and customize a wide range of functionality. This article describes the state-of-the-art of the principal technologies for customizing CAD systems. And we have implemented an application that enables the parametric design by directly inputting numerical values of parameters for a CAD model. Based on this application, we have developed another system that makes it possible sharing of part family data between SolidEdge and Pro/Engineer. Through customization of CAD systems, it is possible to improve the product quality using external knowledge-based systems or to integrate with external system such as CAE tools. This paper can be a guide for engineering designers who want to customize CAD systems

  17. Cables - a question of custom-design

    International Nuclear Information System (INIS)

    Doig, Tom

    1994-01-01

    Electrical equipment such as cabling can often be the limiting factor as far as machine operations in radioactive environments are concerned. Electronic and electrical equipment will degrade if exposed to ionising radiation, affecting equipment reliability, or causing complete failure. However, several companies provide custom-designed products directed specifically at the nuclear industry. One such company is Habia Cable which has built up its business in submarine cables, internal engine cables, and cables for high fire risk situations. It began supplying custom-designed cables to the nuclear industry in 1986, and has since then supplied cables throughout Europe from its plant in Sweden. (Author)

  18. Designing Customer Relationship Management Model in Hospital

    OpenAIRE

    Mohammad Abbaszadeh; Roohollah Askari; Morad Alizadeh; Mohammad Amin Bahrami

    2017-01-01

    Background: Customer relationship management is a modern marketing concept which is also considered as a successful business strategy. The present study aimed to design a customer relationship management model in the hospital. Methods: The study is an applied research performed in 2 phases of 1) texts investigation and 2) the experts' opinions to achieve consensus. Data were analyzed using SPSS 18 software along with descriptive statistics. Results: The designed model included areas of ...

  19. A Research Review on the Key Technologies of Intelligent Design for Customized Products

    Directory of Open Access Journals (Sweden)

    Shuyou Zhang

    2017-10-01

    Full Text Available The development of technologies such as big data and cyber-physical systems (CPSs has increased the demand for product design. Product digital design involves completing the product design process using advanced digital technologies such as geometry modeling, kinematic and dynamic simulation, multi-disciplinary coupling, virtual assembly, virtual reality (VR, multi-objective optimization (MOO, and human-computer interaction. The key technologies of intelligent design for customized products include: a description and analysis of customer requirements (CRs, product family design (PFD for the customer base, configuration and modular design for customized products, variant design for customized products, and a knowledge push for product intelligent design. The development trends in intelligent design for customized products include big-data-driven intelligent design technology for customized products and customized design tools and applications. The proposed method is verified by the design of precision computer numerical control (CNC machine tools.

  20. Custom Formula-Based Visualizations for Savvy Designers"

    DEFF Research Database (Denmark)

    Kuhail, Mohammad Amin

    and expressive. For instance, chart tools are easy to use, but support only predefined visualizations, while visualization tools support custom visualizations, but require program-like specifications. This thesis presents Uvis, a visualization system that targets savvy designers. With Uvis, designers drag......Despite their usefulness in many domains (e.g. healthcare, finance, etc.), custom visualizations remain tedious and hard to implement. It would be advantageous if savvy designers (designers with end-user development skills and much domain knowledge) could refine visualizations to their needs....... For instance, it would save time and money if a clinician familiar with spreadsheet formulas could refine a visualization (e.g. the lifelines) rather than hiring a programmer. Existing approaches to visualization are one of the two: accessible to savvy designers but limited in customizability, or inaccessible...

  1. Design to learn: customizing services when the future matters

    Directory of Open Access Journals (Sweden)

    Dan Ariely

    2013-04-01

    Full Text Available Internet-based customization tools can be used to design service encounters that maximize customers' utility in the present or explore their tastes to provide more value in the future, where these two goals conflict with each other. Maximizing expected customer satisfaction in the present leads to slow rates of learning that may limit the ability to provide quality in the future. An emphasis on learning can lead to unsatisfied customers that will not only forego purchasing in the current period, but, more seriously, never return if they lose trust in the service provider's ability to meet their needs. This paper describes service design policies that balance the objectives of learning and selling by characterizing customer lifetime value as a function of knowledge. The analysis of the customization problem as a dynamic program yields three results. The first result is the characterization of customization policies that quantify the value of knowledge so as to adequately balance the expected revenue of present and future interactions. The second result is an analysis of the impact of operational decisions on loyalty, learning, and profitability over time. Finally, the quantification of the value of knowing the customer provides a connection between customer acquisition and retention policies, thus enhancing the current understanding of the mechanisms connecting service customization, value creation, and customer lifetime value.

  2. Innovative product design based on comprehensive customer requirements of different cognitive levels.

    Science.gov (United States)

    Li, Xiaolong; Zhao, Wu; Zheng, Yake; Wang, Rui; Wang, Chen

    2014-01-01

    To improve customer satisfaction in innovative product design, a topology structure of customer requirements is established and an innovative product approach is proposed. The topology structure provides designers with reasonable guidance to capture the customer requirements comprehensively. With the aid of analytic hierarchy process (AHP), the importance of the customer requirements is evaluated. Quality function deployment (QFD) is used to translate customer requirements into product and process design demands and pick out the technical requirements which need urgent improvement. In this way, the product is developed in a more targeted way to satisfy the customers. the theory of innovative problems solving (TRIZ) is used to help designers to produce innovative solutions. Finally, a case study of automobile steering system is used to illustrate the application of the proposed approach.

  3. Innovative Product Design Based on Comprehensive Customer Requirements of Different Cognitive Levels

    Directory of Open Access Journals (Sweden)

    Xiaolong Li

    2014-01-01

    Full Text Available To improve customer satisfaction in innovative product design, a topology structure of customer requirements is established and an innovative product approach is proposed. The topology structure provides designers with reasonable guidance to capture the customer requirements comprehensively. With the aid of analytic hierarchy process (AHP, the importance of the customer requirements is evaluated. Quality function deployment (QFD is used to translate customer requirements into product and process design demands and pick out the technical requirements which need urgent improvement. In this way, the product is developed in a more targeted way to satisfy the customers. the theory of innovative problems solving (TRIZ is used to help designers to produce innovative solutions. Finally, a case study of automobile steering system is used to illustrate the application of the proposed approach.

  4. The Role of Custom Design in ASIC Chips

    National Research Council Canada - National Science Library

    Dally, William

    1998-01-01

    The performance of an ASIC can be greatly improved without increasing design time by judiciously employing a number of custom design techniques, including floorplanning, prerouting critical signals...

  5. The real business of web design

    CERN Document Server

    Waters, John

    2004-01-01

    Written by a veteran Web designer, The Real Business of Web Design goes beyond the usual philosophy of simply creating a better customer experience online. Instead, it provides an array of visual design practices and tested business principles for clarifying and simplifying the Web development process and making a Website more customer friendly. Filled with anecdotes from the author's own experiences in the web design trenches, this guide shows readers how to use the Web in crucial ways to streamline communications, speed up transactions, boost profits, and much more. Anyone who wants to use t

  6. The Customer Flow Toolkit: A Framework for Designing High Quality Customer Services.

    Science.gov (United States)

    New York Association of Training and Employment Professionals, Albany.

    This document presents a toolkit to assist staff involved in the design and development of New York's one-stop system. Section 1 describes the preplanning issues to be addressed and the intended outcomes that serve as the framework for creation of the customer flow toolkit. Section 2 outlines the following strategies to assist in designing local…

  7. Evaluation and decision of products conceptual design schemes based on customer requirements

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Hong Zhong; Li, Yan Feng; Liu, Yu; Wang, Zhonglai [University of Electronic Science and Technology of China, Sichuan (China); Liu, Wenhai [2China Science Patent Trademark Agents Ltd., Beijing (China)

    2011-09-15

    Within the competitive market environment, understanding customer requirements is crucial for all corporations to obtain market share and survive competition. Only the products exactly meeting customer requirements can win in the market place. Therefore, customer requirements play a very important role in the evaluation and decision process of conceptual design schemes of products. In this paper, an evaluation and decision method based on customer requirements is presented. It utilizes the importance of customer requirements, the satisfaction degree of each evaluation metric to the specification, and an evaluation metric which models customer requirements to evaluate the satisfaction degree of each design scheme to specific customer requirements via the proposed BP neural networks. In the evaluation and decision process, fuzzy sets are used to describe the importance of customer requirements, the relationship between customer requirements and evaluation metrics, the satisfaction degree of each scheme to customer requirements, and the crisp set is used to describe the satisfaction degree of each metric to specifications. The effectiveness of the proposed method is demonstrated by an example of front suspension fork design of mountain bikes.

  8. Evaluation and decision of products conceptual design schemes based on customer requirements

    International Nuclear Information System (INIS)

    Huang, Hong Zhong; Li, Yan Feng; Liu, Yu; Wang, Zhonglai; Liu, Wenhai

    2011-01-01

    Within the competitive market environment, understanding customer requirements is crucial for all corporations to obtain market share and survive competition. Only the products exactly meeting customer requirements can win in the market place. Therefore, customer requirements play a very important role in the evaluation and decision process of conceptual design schemes of products. In this paper, an evaluation and decision method based on customer requirements is presented. It utilizes the importance of customer requirements, the satisfaction degree of each evaluation metric to the specification, and an evaluation metric which models customer requirements to evaluate the satisfaction degree of each design scheme to specific customer requirements via the proposed BP neural networks. In the evaluation and decision process, fuzzy sets are used to describe the importance of customer requirements, the relationship between customer requirements and evaluation metrics, the satisfaction degree of each scheme to customer requirements, and the crisp set is used to describe the satisfaction degree of each metric to specifications. The effectiveness of the proposed method is demonstrated by an example of front suspension fork design of mountain bikes

  9. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences

    Science.gov (United States)

    2010-01-01

    Background Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. Objective This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. Methods The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Results Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. Conclusion VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use. PMID:20190065

  10. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences.

    Science.gov (United States)

    Nazi, Kim M

    2010-01-01

    Consumer research reveals considerable interest in the use of Personal Health Records (PHRs), yet adoption remains relatively low. Both adopters and nonadopters represent important perspectives from which to understand this paradox. This study focuses on direct feedback from adopters obtained using the American Customer Satisfaction Index (ACSI) survey on the My HealtheVet PHR portal (http://www.myhealth.va.gov) of the Veterans Health Administration (VHA). The results represent a source of direct feedback with which to better understand veterans' needs and preferences. The ACSI Survey was implemented in October 2007 to measure satisfaction and elicit information about characteristics and preferences of My HealtheVet PHR adopters. The data represent a continuous random sample of site visitors who have navigated at least four pages on the site. A total of 100 617 surveys were completed (17.2%). Satisfaction with My HealtheVet is high (8.3/10.0), and users are highly likely to return to the site (8.6/10.0) and recommend the site to other veterans (9.1/10.0). The majority of system adopters are male (91%), between the ages of 51 and 70 (68%), and served in the Vietnam War (60%). Most veterans currently visit the site to utilize pharmacy-related features. VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use.

  11. Customer Relationship within the Furniture Design Market : A qualitative study of how companies within the furniture design market relate to the challenges connected to customer loyalty

    OpenAIRE

    Wahlström, Marie-Louise; Bergström, Jenny

    2010-01-01

    Background: The customer relationship is becoming more important for companies within the Swedish furniture design industry due to competition for market shares. The market is getting more crammed while the interest for furniture design amongst people is increasing, therefore furniture design companies need to find effective ways to attract loyal customers. Research has been made to show the importance of collaboration between companies and this is something that can increase the market share...

  12. Investigating the effect of m-commerce design usability on customers' trust

    Science.gov (United States)

    Hussain, Azham Bin; Mahmood, Alaa Thamer; Naser, Raed Kamil

    2017-10-01

    User experience may vary from one user to another based on the design characteristics for processing a certain task. Our review of the literature revealed that there is a noticeable lack of studies on the effect of mobile or m-commerce design usability on customers' trust to perform certain activities. We investigated the effect of m-commerce design usability in terms of navigability, supportability, readability, creditability, and content relevant. A close-ended questionnaire was distributed to 20 customers who were asked to perform some tasks. The result showed that majority of the participants found m-commerce design usability to influence their trust of the app. The mentioned usability elements were found to positively influence customers' trust except for supportability. Our findings provide some insights to the m-commerce designers and developers and extend the current understanding about the potential of design usability in explaining users' usage behavior.

  13. USER REQUIREMENTS CUSTOMIZATION AND ATTRACTIVE QUALITY CREATION FOR DESIGN IMPROVEMENT ATTRIBUTES

    Directory of Open Access Journals (Sweden)

    Ismail Wilson Taifa

    2017-03-01

    Full Text Available The aim of this paper was to customize user requirements and quality creation for design improvement of furniture. The major purpose has been achieved with the use of Quality Function Deployment technique and Kano Model. The study involved 564 students from 3 engineering colleges. Extensive user requirements were identified with the help of Questionnaires. The use of House of Quality, Kano Model and Pareto Diagram helped in prioritizing all important features which are needed in customizing user requirements. The prioritized requirements include ergonomic design, desk adjustability, comfortability, product corners (sharp corners and latest material. All these factors both got high relative and absolute weight. Therefore, more engineering efforts need to be directed towards these requirements for achieving user customization for design improvement. The developed House of Quality with the help of Kano Model results has proved to be a good tool in customizing user requirements.

  14. Effects of Platform Design on the Customer Experience in an Online Solar PV Marketplace

    Energy Technology Data Exchange (ETDEWEB)

    OShaughnessy, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Margolis, Robert M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Leibowicz, Benjamin [The University of Texas at Austin; Punjabi, Kunal [The University of Texas at Austin

    2018-05-09

    We analyze a unique dataset of residential solar PV quotes offered in an online marketplace to understand how platform design changes affect customer outcomes. Three of the four design changes are associated with statistically significant and robust reductions in offer prices, though none of the policies were designed explicitly to reduce prices. The results suggest that even small changes in how prospective solar PV customers interact with installers can affect customer outcomes such as prices. Specifically, the four changes we evaluate are: 1) a customer map that shows potential new EnergySage registrants the locations of nearby customers; 2) a quote cap that precludes more than seven installers from bidding on any one customer; 3) a price guidance feature that informs installers about competitive prices in the customer's market before they submit quotes; and 4) no pre-quote messaging to prohibit installers from contacting customers prior to offering quotes. We calculate descriptive statistics to investigate whether each design change accomplished its specific objectives. Then, we econometrically evaluate the impacts of the design changes on PV quote prices and purchase prices using a regression discontinuity approach.

  15. Customized Body Mapping to Facilitate the Ergonomic Design of Sportswear.

    Science.gov (United States)

    Cao, Mingliang; Li, Yi; Guo, Yueping; Yao, Lei; Pan, Zhigeng

    2016-01-01

    A successful high-performance sportswear design that considers human factors should result in a significant increase in thermal comfort and reduce energy loss. The authors describe a body-mapping approach that facilitates the effective ergonomic design of sportswear. Their general framework can be customized based on the functional requirements of various sports and sportswear, the desired combination and selection of mapping areas for the human body, and customized quantitative data distribution of target physiological indicators.

  16. US veterans and their unique issues: enhancing health care professional awareness

    Directory of Open Access Journals (Sweden)

    Olenick M

    2015-12-01

    Full Text Available Maria Olenick,1 Monica Flowers,1 Valerie J Diaz1,21Nicole Wertheim College of Nursing and Health Science, Florida International University, Miami, FL, USA; 2Operational Health Support Unit Jacksonville, United States Navy Nurse Corps, Jacksonville, FL, USAAbstract: United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18–44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies

  17. Applying CBR to machine tool product configuration design oriented to customer requirements

    Science.gov (United States)

    Wang, Pengjia; Gong, Yadong; Xie, Hualong; Liu, Yongxian; Nee, Andrew Yehching

    2017-01-01

    Product customization is a trend in the current market-oriented manufacturing environment. However, deduction from customer requirements to design results and evaluation of design alternatives are still heavily reliant on the designer's experience and knowledge. To solve the problem of fuzziness and uncertainty of customer requirements in product configuration, an analysis method based on the grey rough model is presented. The customer requirements can be converted into technical characteristics effectively. In addition, an optimization decision model for product planning is established to help the enterprises select the key technical characteristics under the constraints of cost and time to serve the customer to maximal satisfaction. A new case retrieval approach that combines the self-organizing map and fuzzy similarity priority ratio method is proposed in case-based design. The self-organizing map can reduce the retrieval range and increase the retrieval efficiency, and the fuzzy similarity priority ratio method can evaluate the similarity of cases comprehensively. To ensure that the final case has the best overall performance, an evaluation method of similar cases based on grey correlation analysis is proposed to evaluate similar cases to select the most suitable case. Furthermore, a computer-aided system is developed using MATLAB GUI to assist the product configuration design. The actual example and result on an ETC series machine tool product show that the proposed method is effective, rapid and accurate in the process of product configuration. The proposed methodology provides a detailed instruction for the product configuration design oriented to customer requirements.

  18. Application of computer graphics in the design of custom orthopedic implants.

    Science.gov (United States)

    Bechtold, J E

    1986-10-01

    Implementation of newly developed computer modelling techniques and computer graphics displays and software have greatly aided the orthopedic design engineer and physician in creating a custom implant with good anatomic conformity in a short turnaround time. Further advances in computerized design and manufacturing will continue to simplify the development of custom prostheses and enlarge their niche in the joint replacement market.

  19. Design of a semi-custom integrated circuit for the SLAC SLC timing control system

    International Nuclear Information System (INIS)

    Linstadt, E.

    1984-10-01

    A semi-custom (gate array) integrated circuit has been designed for use in the SLAC Linear Collider timing and control system. The design process and SLAC's experiences during the phases of the design cycle are described. Issues concerning the partitioning of the design into semi-custom and standard components are discussed. Functional descriptions of the semi-custom integrated circuit and the timing module in which it is used are given

  20. Case Study: South Texas Veterans Health Care System’s Communication Center

    Science.gov (United States)

    2008-07-14

    appropriate access to health care; technical quality is providing world-class care to our veterans; customer satisfaction is ensuring the STVHCS patients and...were not called. These results not only improved access to health care, but also positively affected customer service. 111 Case Study: South Texas...increased waiting times for the patient . With current regulatory requirements calling for improved access to health care services, many hospital and

  1. Pedagogical design for knowledge creating inquiry in customer projects

    Directory of Open Access Journals (Sweden)

    Hanni Muukkonen

    2013-09-01

    Full Text Available Two higher education courses involving students, teachers, and customers in multifaceted experiences of knowledge creation are described. The Trialogical Learning Approach (TLA provides a theoretical framework to address learning and teaching organized around authentic problems and the development of shared knowledge objects, such as reports, products, and new practices. The approach directs attention to those aspects of social interaction and artifact-mediated activities, which focus on the development of shared objects and the pursuit of novel knowledge and understanding. The roles of technology-mediation, customer involvement, and guidance in developing effective pedagogical practices for knowledge creation were addressed. It appears necessary to design sufficient open-endedness and complexity for students’ teamwork to generate unpredictable, practical, and epistemologically challenging situations. Pedagogical design for such a process has different foci in the four central phases: planning, project initiation, project execution, and presentation and evaluation. Planning and initiation are central to establishing relevance and project awareness for the collaboration of student teams with a customer. Guidance and expert modeling during project initiation and execution is needed to overcome feelings of uncertainty during a challenging and complex assignment. Mediation provided by collaboration tools facilitates reflection on collective practices, iterative development of knowledge objects, and documentation of the learning outcomes of customer projects.

  2. Association Between Chronic Conditions and Physical Function Among Veteran and Non-Veteran Women With Diabetes

    Science.gov (United States)

    Gray, Kristen E.; Katon, Jodie G.; Rillamas-Sun, Eileen; Bastian, Lori A.; Nelson, Karin M.; LaCroix, Andrea Z.; Reiber, Gayle E.

    2016-01-01

    Abstract Purpose of the Study: To compare the number of chronic conditions among a list of 12 and their association with physical function among postmenopausal non-Veteran and Veteran women with diabetes. Design and Methods: Among women with diabetes from the Women’s Health Initiative, we compared the average number of chronic conditions between non-Veterans and Veterans and the association between total number of chronic conditions on subsequent RAND-36 physical function. To examine associations between each condition and subsequent physical function, we compared women with diabetes plus one chronic condition to women with diabetes alone using linear regression in separate models for each condition and for non-Veterans and Veterans. Results: Both non-Veterans ( N = 23,542) and Veterans ( N = 618) with diabetes had a median of 3 chronic conditions. Decreases in physical function for each additional condition were larger among Veterans than non-Veterans (−6.3 vs. −4.1 points). Decreases in physical function among women with diabetes plus one chronic condition were greater than that reported for diabetes alone for all combinations and were more pronounced among Veterans (non-Veterans: −11.1 to −24.2, Veterans: −16.6 to −40.4 points). Hip fracture, peripheral artery disease, cerebrovascular disease, and coronary disease in combination with diabetes were associated with the greatest decreases in physical function. Implications: Chronic conditions were common among postmenopausal women with diabetes and were associated with large declines in physical function, particularly among Veterans. Interventions to prevent and reduce the impact of these conditions and facilitate coordination of care among women with diabetes may help them maintain physical function. PMID:26768385

  3. The Impact of a Customer Service Intervention and Facility Design on Firm Performance

    OpenAIRE

    Joanne M. Sulek; Mary R. Lind; Ann S. Marucheck

    1995-01-01

    The purpose of this research was to investigate the impact of a customer service intervention and store design on store performance within a regional food retailing chain. A longitudinal study examines the organization's implementation of a customer service intervention which utilized new service standards and customer feedback mechanisms. Moreover, the chain provided a natural experiment, since the forty-six stores in this chain represented three levels of facility design ranging from the tr...

  4. Creating a roadmap for delivering gender-sensitive comprehensive care for women Veterans: results of a national expert panel.

    Science.gov (United States)

    deKleijn, Miriam; Lagro-Janssen, Antoine L M; Canelo, Ismelda; Yano, Elizabeth M

    2015-04-01

    Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs. We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care. Modified Delphi expert panel process. Eleven clinicians and social scientists with expertise in women's health, primary care, and mental health. Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine's definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale. Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women's preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations. We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA's national efforts at improving customer service for all Veterans.

  5. The design of a semi-custom intergrated circuit for the SLAC SLC timing control system

    International Nuclear Information System (INIS)

    Linstadt, E.

    1985-01-01

    A semi-custom (gate array) integrated circuit has been designed for use in the SLAC Linear Collider timing and control system. The design process and SLAC's experiences during the phases of the design cycle are described. Issues concerning the partitioning of the design into semi-custom and standard components are discussed. Functional descriptions of the semi-custom integrated circuit and the timing module in which it is used are given

  6. Design of customer knowledge management system for Aglaonema Nursery in South Tangerang, Indonesia

    Science.gov (United States)

    Sugiarto, D.; Mardianto, I.; Dewayana, TS; Khadafi, M.

    2017-12-01

    The purpose of this paper is to describe the design of customer knowledge management system to support customer relationship management activities for an aglaonema nursery in South Tangerang, Indonesia. System. The steps were knowledge identification (knowledge about customer, knowledge from customer, knowledge for customer), knowledge capture, codification, analysis of system requirement and create use case and activity diagram. The result showed that some key knowledge were about supporting customer in plant care (know how) and types of aglaonema including with the prices (know what). That knowledge for customer then codified and shared in knowledge portal website integrated with social media. Knowledge about customer were about customers and their behaviour in purchasing aglaonema. Knowledge from customer were about feedback, favorite and customer experience. Codified knowledge were placed and shared using content management system based on wordpress.

  7. Survey of customer expectation and satisfaction: preliminary research of a modular product design approach for sheep cage design

    Directory of Open Access Journals (Sweden)

    Rochman Yuli Agusti

    2018-01-01

    Full Text Available This study aims to produce a modular sheep cage design. Feeding, maintenance and integrated waste management are taking into account in the design. The modular and integrated product design provides advantages such as (1 easy way of making and modifying the product, (2 enabling the utilization of existing facilities such as shade, (3 giving the user a sense of convenience as the waste can be processed and not being a source of pollution. The Modular Quality Function Deployment (QFD method is applied to identify modules associated with the customer needs of the product. A survey about customer expectation and satisfaction was conducted in order to evaluate the gap of both. The highest value of gap between customer expectation and satisfaction of products indicates that the customer needs are the focus of the problems. The most important customer needs are considered in modification and improvement of design. These are (1 the cage is not easy to fall down, (2 the sheep cage can last for long time, (3 it uses a strong frame, (4 the roof section materials is not easy to leak, and (5 It can be used even if one part of the cage is damaged.

  8. Armed to farm: Veteran labeled marketing, education and research strategies to soldier success for military veteran farmers

    Science.gov (United States)

    Farming opportunities for veterans are a natural fit and capitalize on skills that made them successful in the military. The project is specifically designed to develop comprehensive training and technical assistance programs and enhance market profitability for military veteran farmers. The project...

  9. Utilizing Mass Customization Methods for Modular Manufacturing System Design

    DEFF Research Database (Denmark)

    Jørgensen, Steffen; Jacobsen, Alexia; Nielsen, Kjeld

    2011-01-01

    Markets today have become dynamic and demand rapid product changes, product variety, and customized products. In order to operate under and taking advantages of such conditions requires, amongst other aspects, manufacturing processes robust to product changes - a contradiction to traditional...... manufacturing systems developed as dedicated engineer-to-order solutions, tailored to production of a specific product or a limited product assortment. In response, modular manufacturing concepts are evolving, which are aimed at possessing the needed responsiveness and aimed at being the manufacturing paradigm...... of Mass Customization (MC). Research focus has been on the basic principles and enabling technologies, while modular architectures and system design have received less attention. A potential to fill these gaps by applying selected design theories and methods of MC have been seen. Based on a communality...

  10. DESIGNING A MODEL OF CUSTOMER RELATIONSHIP MANAGEMENT FOR A MOBILE PHONE COMPANY

    OpenAIRE

    BRUTU MĂDĂLINA; MIHAI DANIELA MELANIA

    2015-01-01

    Customer relationship management refers to establishing, maintaining, developing and optimizing the relations between an organization and its customers and focuses on understanding and meeting its customers’ wishes and demands, the core items of the business strategy of any performant company. This paper aims at designing and testing a model of customer relationship management applicable within a mobile phone company. Starting from this purpose, the main objectives of the research were: prese...

  11. DESIGNING A MODEL OF CUSTOMER RELATIONSHIP MANAGEMENT FOR A MOBILE PHONE COMPANY

    Directory of Open Access Journals (Sweden)

    BRUTU MĂDĂLINA

    2015-07-01

    Full Text Available Customer relationship management refers to establishing, maintaining, developing and optimizing the relations between an organization and its customers and focuses on understanding and meeting its customers’ wishes and demands, the core items of the business strategy of any performant company. This paper aims at designing and testing a model of customer relationship management applicable within a mobile phone company. Starting from this purpose, the main objectives of the research were: presenting the concept of customer relationship management; the importance of companies’ orientation to the market; identifying a model of customer relationship management and, not least, analyzing the efficiency of this model. The results lead to the conclusion that the model of customer relationship management is extremely effective in the mobile phone industry, bringing significant profits.

  12. The effect of emotional design and online customer review on customer repeat purchase intention in online stores

    Science.gov (United States)

    Dewi, D. S.; Sudiarno, A.; Saputra, H.; Dewi, R. S.

    2018-04-01

    The internet users in Indonesia has increased rapidly over the last decade. A survey conducted by Association of Internet Service Providers Indonesia shows that the internet users has reached 34.9% of total population in Indonesia. The increase of internet users has led to a shift in trading practice from conventional trade to online trade. It is predicted in the next years the number of online consumers in Indonesia will continue to increase, provide many opportunity for online business. The huge number of internet users is not necesarily followed by the high number of e-purchase. It is therefore become the interest of many researchers to investigate factors that influence the decision on online purchasing.This research proposes a model that assess the effect of emotional design and customer review to customer intention on e-repeat purchase. Online questionnaire is designed and is distributed randomly through google forms. There are 187 respondent filled the questionnaire from which only 162 respondents actually have experience in online purchase. These data are then processed by using statistical analysis. A model is developed by applying structural equation modeling (SEM) approach. This study revealed that customer reviews especially objective reviews has a significant effect toward repeat purchase. Whereas emotional design particularly visual attractiveness also shows a significant effect toward e-repeat purchase.

  13. 78 FR 59426 - Board of Veterans Appeals, Veterans Information Office, Voice of the Veteran Call Center Survey...

    Science.gov (United States)

    2013-09-26

    ... Information Office, Voice of the Veteran Call Center Survey; Correction AGENCY: Board of Veterans Appeals... comment on the proposed collection. The department name should read ``Board of Veterans' Appeals (BVA... ``Board of Veterans' Appeals, Veterans Information Office, Voice of the Veterans Call Center Survey''. We...

  14. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  15. Mindfulness as a Weight Loss Treatment for Veterans.

    Science.gov (United States)

    Stanton, Michael V; Matsuura, Justin; Fairchild, Jennifer Kaci; Lohnberg, Jessica A; Bayley, Peter J

    2016-01-01

    Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

  16. Custom high-reliability radiation-hard CMOS-LSI circuit design

    International Nuclear Information System (INIS)

    Barnard, W.J.

    1981-01-01

    Sandia has developed a custom CMOS-LSI design capability to provide high reliability radiation-hardened circuits. This capability relies on (1) proven design practices to enhance reliability, (2) use of well characterized cells and logic modules, (3) computer-aided design tools to reduce design time and errors and to standardize design definition, and (4) close working relationships with the system designer and technology fabrication personnel. Trade-offs are made during the design between circuit complexity/performance and technology/producibility for high reliability and radiation-hardened designs to result. Sandia has developed and is maintaining a radiation-hardened bulk CMOS technology fabrication line for production of prototype and small production volume parts

  17. Web Based Customized Design

    OpenAIRE

    Moi, Morten Benestad

    2013-01-01

    This thesis studies the methods needed to create a web based application to remotely customize a CAD model. This includes customizing a CAD model by using a graphical user interface to be able to remotely control the inputs to- and outputs from the model in NX, and to get the result sent back to the user. Using CAD systems such as NX requires intensive training, is often a slow process and gives a lot of room for errors. An intuitive, simple user interface will eliminate the need for CAD trai...

  18. Building Store Satisfaction Centred on Customer Retention in Clothing Retailing: Store Design and Ease of Shopping

    Directory of Open Access Journals (Sweden)

    Gulden Turhan

    2016-01-01

    Full Text Available The study’s research model suggests that store design and ease of shopping are associated with customer retention through a mediated pathway in which store design and ease of shopping influence perceived store satisfaction, which in turn, influences customer retention. This survey was administered to two separate clothing stores offered to either females or males (in total, 533 participants. Using structural equation modelling methodology, data was analysed to explain the interrelations among the variables in the model. The results of an empirical study of a sample of store shoppers revealed that store design and ease of shopping influence customer retention in an indirect way through customer perception of satisfaction with the store. In building store satisfaction that is centred on customer retention, store design and shopping ease differ in their relative influences. This difference is high for females, but for men as low as to be considered negligible in males. As a result, improving customers’ perceptions of store design and ease of shopping is a way to ensure store satisfaction support customer retention. The results of the study provide a new insight into the relationships by suggesting indirect effects of shopping ease and store design on consumer retention by their impacts on store satisfaction, rather than direct effects.

  19. Building Store Satisfaction Centred on Customer Retention in Clothing Retailing: Store Design and Ease of Shopping

    Directory of Open Access Journals (Sweden)

    Gulden Turhan

    2014-01-01

    Full Text Available The study’s research model suggests that store design and ease of shopping are associated with customer retention through a mediated pathway in which store design and ease of shopping influence perceived store satisfaction, which in turn, influences customer retention. This survey was administered to two separate clothing stores offered to either females or males (in total, 533 participants. Using structural equation modelling methodology, data was analysed to explain the interrelations among the variables in the model. The results of an empirical study of a sample of store shoppers revealed that store design and ease of shopping influence customer retention in an indirect way through customer perception of satisfaction with the store. In building store satisfaction that is centred on customer retention, store design and shopping ease differ in their relative influences. This difference is high for females, but for men as low as to be considered negligible in males. As a result, improving customers’ perceptions of store design and ease of shopping is a way to ensure store satisfaction support customer retention. The results of the study provide a new insight into the relationships by suggesting indirect effects of shopping ease and store design on consumer retention by their impacts on store satisfaction, rather than direct effects.

  20. Mindfulness as a Weight Loss Treatment for Veterans

    Directory of Open Access Journals (Sweden)

    Michael Vicente Stanton

    2016-08-01

    Full Text Available Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the United States and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments.

  1. Perspectives of family and veterans on family programs to support reintegration of returning veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B

    2015-08-01

    Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population. (c) 2015 APA, all rights reserved).

  2. [Custom-designed 3D tibial augmentation for knee replacement].

    Science.gov (United States)

    Jirman, R; Vavrík, P; Horák, Z

    2009-02-01

    Reconstruction with the use of custom-made implants aims at optimal replacement of lost or damaged bone structures and restoration of their funkction. In this study the development and construction of a custom-made implant and the operative technique used for the treatment of an extensive tibial defect are described. The patient was a 65-year-old man treated for over 20 years for psoriatic arthritis and severe instability of the right knee, particularly in the frontal plane, with a worsening varus deformity. The radiogram showed an extensive destruction of the medial tibial condyle that also deeply involved the lateral condyle. The extent of defect made it impossible to use any commercial tibial augmentation. The geometry of the custom-designed implant for the medial tibial condyle was constructed on the basis of a 3D defect model and the shape of the medial tibial condyle of the collateral knee seen on CT scans. After its correct shape was verified on a plastic model, its coordinates were set in the software of a machine tool, and a titanium augmentation otherwise compatible with a standard knee replacement was produced.The use of such a custom implant to complete standard total knee arthroplasty has so far been demanding in terms of organisation and manufacture. Its production in the future could be facilitated by substituting titanium for plastic material such as poly-ether-ether-ketone (PEEK). Key words: custom-made implant, tibial augmentation, knee prosthesis.

  3. Yoga for veterans with chronic low back pain: Design and methods of a randomized clinical trial.

    Science.gov (United States)

    Groessl, Erik J; Schmalzl, Laura; Maiya, Meghan; Liu, Lin; Goodman, Debora; Chang, Douglas G; Wetherell, Julie L; Bormann, Jill E; Atkinson, J Hamp; Baxi, Sunita

    2016-05-01

    Chronic low back pain (CLBP) afflicts millions of people worldwide, with particularly high prevalence in military veterans. Many treatment options exist for CLBP, but most have limited effectiveness and some have significant side effects. In general populations with CLBP, yoga has been shown to improve health outcomes with few side effects. However, yoga has not been adequately studied in military veteran populations. In the current paper we will describe the design and methods of a randomized clinical trial aimed at examining whether yoga can effectively reduce disability and pain in US military veterans with CLBP. A total of 144 US military veterans with CLBP will be randomized to either yoga or a delayed treatment comparison group. The yoga intervention will consist of 2× weekly yoga classes for 12weeks, complemented by regular home practice guided by a manual. The delayed treatment group will receive the same intervention after six months. The primary outcome is the change in back pain-related disability measured with the Roland-Morris Disability Questionnaire at baseline and 12-weeks. Secondary outcomes include pain intensity, pain interference, depression, anxiety, fatigue/energy, quality of life, self-efficacy, sleep quality, and medication usage. Additional process and/or mediational factors will be measured to examine dose response and effect mechanisms. Assessments will be conducted at baseline, 6-weeks, 12-weeks, and 6-months. All randomized participants will be included in intention-to-treat analyses. Study results will provide much needed evidence on the feasibility and effectiveness of yoga as a therapeutic modality for the treatment of CLBP in US military veterans. Published by Elsevier Inc.

  4. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

    Data.gov (United States)

    Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

  5. Impact of presumed service-connected diagnosis on the Department of Veterans Affairs healthcare utilization patterns of Vietnam-Theater Veterans

    Science.gov (United States)

    Fried, Dennis A.; Rajan, Mangala; Tseng, Chin-lin; Helmer, Drew

    2018-01-01

    Abstract During the Vietnam War, the US military sprayed almost 20 million gallons of Agent Orange (AO), an herbicide contaminated with dioxin, over Vietnam. Approximately, 2.7 million US military personnel may have been exposed to AO during their deployment. Ordinarily, veterans who can demonstrate a nexus between a diagnosed condition and military service are eligible for Department of Veterans Affairs (VA) service-connected disability compensation. Vietnam Veterans have had difficulty, however, establishing a nexus between AO exposure and certain medical conditions that developed many years after the war. In response, VA has designated certain conditions as “presumed service connected” for Vietnam Veterans who were present and possibly exposed. Veterans with any of these designated conditions do not have to document AO exposure, making it easier for them to access the VA disability system. The extent to which VA healthcare utilization patterns reflect easier access afforded those with diagnosed presumptive conditions remains unknown. In this cross-sectional study, we hypothesized that Vietnam Veterans with diagnosed presumptive conditions would be heavier users of the VA healthcare system than those without these conditions. In our analysis of 85,699 Vietnam Veterans, we used binary and cumulative logit multivariable regression to assess associations between diagnosed presumptive conditions and VA healthcare utilization in 2013. We found that diagnosed presumptive conditions were associated with higher odds of 5+ VHA primary care visits (OR = 2.01, 95% CI: 1.93–2.07), 5+ specialty care visits (OR = 2.11, 95% CI: 2.04–2.18), emergency department use (OR = 1.22, 95% CI: 1.11–1.34), and hospitalization (OR = 1.23, 95% CI: 1.17–1.29). Consistent with legislative intent, presumptive policies appear to facilitate greater VA system utilization for Vietnam Veterans who may have been exposed to AO. PMID:29742706

  6. Design of VA Cooperative Study #591: CERV-PTSD, comparative effectiveness research in veterans with PTSD.

    Science.gov (United States)

    Schnurr, Paula P; Chard, Kathleen M; Ruzek, Josef I; Chow, Bruce K; Shih, Mei-Chiung; Resick, Patricia A; Foa, Edna B; Marx, Brian P; Huang, Grant D; Lu, Ying

    2015-03-01

    CERV-PTSD is a randomized controlled trial of two of the most effective treatments for PTSD, Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). Despite solid evidence that both treatments are effective, there is limited evidence about their effectiveness relative to one another. The primary objective is to compare the effectiveness of PE and CPT for reducing PTSD symptom severity in a healthcare system that offers both treatments. The secondary objective is to compare the effectiveness of PE and CPT for reducing the severity of comorbid mental health problems and service utilization as well as improving functioning and quality of life. The tertiary objective is to examine whether discrepancy between patient preferences and treatment assignment reduces the effectiveness of each treatment. Exploratory analyses will examine whether demographic and clinical characteristics predict differential response to PE and CPT. The study is designed to randomize 900 male and female veterans with PTSD due to any traumatic military event to receive PE or CPT. The standard dose of treatment is 12 weekly sessions but veterans who improve more rapidly may finish in fewer sessions and veterans who improve more slowly may have additional sessions. The primary outcome is improvement in PTSD symptoms, measured during and after treatment and then 3 and 6 months later. As a large multi-site trial with men and women, CERV-PTSD is designed to advance the delivery of care for PTSD by providing conclusive information about whether one treatment is better than the other, overall, and for different types of patients. Published by Elsevier Inc.

  7. System design of blood supply chain management based on Supplier Customer Relationship Management (SCRM approach

    Directory of Open Access Journals (Sweden)

    Allamsyah Zuhdi

    2018-01-01

    Full Text Available Blood supply chain management is very complex system. By considering blood’s demand that characterized as stochastic, therefore information and communication among stakeholders are considered as important cycle in supply chain. This research is objected to design interactive communication model based on information technology with android as platform to create effective customer-supplier relationship to support Customer Relationship Management or better known as CRM. The methods that suggested in designing its information system are Quality Function Deployment (QFD approach, Kano Model and Morphological Chart. From mentioned methods, attributes of design and specification priorities of purposed android system technology design are established. Attributes of design will be adjusted with customers’ requirements derived from customer voice that will further be integrated with technical responds in QFD. Technical responds will provide priorities on each design’s attribute of android information system and will be forwarded to the specifications determination by using morphological chart. Later, work flow of design system will be generated by using Data Flow Diagram (DFD. The result of the research will demonstrate the design of information system technology based on android that already adjusted with the requirement of donors as means of communication between suppliers and customers in blood supply chain.

  8. Customer Attraction in a Design-Build-Finance-Maintain-Operate Contract

    NARCIS (Netherlands)

    Favie, R.; Nordennen, van A.; Kleine, A.J.; Maas, G.J.; Ceric, A.; Radujkovic, M.

    2009-01-01

    In the Netherlands, large public customers use integrated contracts more and more often for complicated civil engineering and architectural works. Projects with integrated contracts such as Design, Build, Finance, Maintenance and Operate require tenderers to behave differently than they are

  9. The Joint Effect of Competition and Complexity on Customer Accounting System Design

    DEFF Research Database (Denmark)

    Holm, Morten; Ax, Christian

    The importance of measuring customer profitability has recently been reiterated by the management accounting community. However, the stream of research on the factors influencing customer accounting (CA) design choices is still scarce and inconclusive. This paper addresses how the level...... in particular as well as the general research stream on environmental factors’ influence on the sophistication and use of management accounting systems across firms....

  10. Women Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report summarizes the history of women Veterans in the military and as Veterans. It profiles the characteristics of women Veterans in 2015, and illustrates how...

  11. From Camouflage to Classroom: Designing a Transition Curriculum for New Student Veterans

    Science.gov (United States)

    Osborne, Nicholas J.

    2016-01-01

    The landscape of higher education necessitates that strategies be in place to meet the needs of an ever changing student population. Since 2009, the Post-9/11 GI Bill has spurred an increased enrollment of student veterans that is forecasted to rise. Students who are veterans have unique experiences related to their service, age, and work-life…

  12. Female Veterans of Iraq and Afghanistan seeking care from VA specialized PTSD Programs: comparison with male veterans and female war zone veterans of previous eras.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert; Desai, Rani

    2010-04-01

    Differences in the characteristics and mental health needs of female veterans of the Iraq/Afghanistan war compared with those of veterans of other wars may have useful implications for VA program and treatment planning. Female veterans reporting service in the Iraq/Afghanistan war were compared with women reporting service in the Persian Gulf and Vietnam wars and to men reporting service in the Iraq/Afghanistan war. Subjects were drawn from VA administrative data on veterans who sought outpatient treatment from specialized posttraumatic stress disorder (PTSD) treatment programs. A series of analyses of covariance (ANCOVA) was used to control for program site and age. In general, Iraq/Afghanistan and Persian Gulf women had less severe psychopathology and more social supports than did Vietnam women. In turn, Iraq/Afghanistan women had less severe psychopathology than Persian Gulf women and were exposed to less sexual and noncombat nonsexual trauma than their Persian Gulf counterparts. Notable differences were also found between female and male veterans of the Iraq/Afghanistan war. Women had fewer interpersonal and economic supports, had greater exposure to different types of trauma, and had different levels of diverse types of pathology than their male counterparts. There appear to be sufficient differences within women reporting service in different war eras and between women and men receiving treatment in VA specialized treatment programs for PTSD that consideration should be given to program planning and design efforts that address these differences in every program treating female veterans reporting war zone service.

  13. Systematic review of women veterans' mental health.

    Science.gov (United States)

    Runnals, Jennifer J; Garovoy, Natara; McCutcheon, Susan J; Robbins, Allison T; Mann-Wrobel, Monica C; Elliott, Alyssa

    2014-01-01

    Given recent, rapid growth in the field of women veterans' mental health, the goal of this review was to update the status of women veterans' mental health research and to identify current themes in this literature. The scope of this review included women veterans' unique mental health needs, as well as gender differences in veterans' mental health needs. Database searches were conducted for relevant articles published between January 2008 and July 2011. Searches were supplemented with bibliographic reviews and consultation with subject matter experts. The database search yielded 375 titles; 32 met inclusion/exclusion criteria. The women veterans' mental health literature crosses over several domains, including prevalence, risk factors, health care utilization, treatment preferences, and access barriers. Studies were generally cross-sectional, descriptive, mixed-gender, and examined Department of Veterans Affairs (VA) health care users from all service eras. Results indicate higher rates of specific disorders (e.g., depression) and comorbidities, with differing risk factors and associated medical and functional impairment for female compared with male veterans. Although satisfaction with VA health care is generally high, unique barriers to care and indices of treatment satisfaction exist for women. There is a breadth of descriptive knowledge in many content areas of women veterans' mental health; however, the research base examining interventional and longitudinal designs is less developed. Understudied content areas and targets for future research and development include certain psychiatric disorders (e.g., schizophrenia), the effects of deployment on woman veterans' families, and strategies to address treatment access, attrition, and provision of gender-sensitive care. Published by Elsevier Inc.

  14. From customer needs to partners network specifications: (Design-Manufacturing-Supply) needs matrix

    OpenAIRE

    Zouggar , Salah; Zolghadri , Marc; Girard , P.

    2008-01-01

    New Product Design (NPD) projects consider sequentially various phases of new product design project: customer needs clarification, product specifications, design process, partners selection. Such sequencing ignores possible impacts of partners on the way that the product will be designed and realised. This paper explores early consideration of the partners network for building up relevant partnerships in NPD projects. We attempt to highlight the gain of visibility through suggested Design, M...

  15. The Analysis And Design Of Customer Relationship Management Model At STMIK STIKOM BALI

    Directory of Open Access Journals (Sweden)

    Ni Wayan Deriani

    2016-06-01

    Full Text Available The advantages of an organization can be seen from the organization's ability to compete in the business world today is increasingly more competition. The competition should be used as well as possible in order to retain customers by providing the best service. one way to provide the best service is the provision of means in the form of comprehensive information systems and integrated. CRM is an integrated system that is useful for both of the organization and of course for the customer. In this research, design analysis model of CRM approach from the perspective Planner and owner of Zachman framework. Design analysis using DFD, ERD and conceptual database. The expected outcome of this research is a form of planning the Customer Relationship Management system model as a reference for the managers in the development of an integrated system in the future.

  16. Social participation and self-rated health among older male veterans and non-veterans.

    Science.gov (United States)

    Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan

    2016-08-01

    To examine self-rated health (SRH) and its association with social participation, along with physical and mental health indicators, among USA male veterans and non-veterans aged ≥65 years. The two waves of the National Health and Aging Trend Study provided data (n = 2845 at wave 1; n = 2235 at wave 2). Multilevel mixed effects generalized linear models were fit to test the hypotheses. Despite their older age, veterans did not differ from non-veterans in their physical, mental and cognitive health, and they had better SRH. However, black and Hispanic veterans had lower SRH than non-Hispanic white veterans. Formal group activities and outings for enjoyment were positively associated with better SRH for veterans, non-veterans and all veteran cohorts. Aging veterans, especially black and Hispanic veterans, require programs and services that will help increase their social connectedness. Geriatr Gerontol Int 2016; 16: 920-927. © 2015 Japan Geriatrics Society.

  17. Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

    Science.gov (United States)

    Erickson, Megan; Braun, Katie; List, Riesa; Utech, Anne; Moore, Carolyn; White, Donna L; Garcia, Jose M

    2016-09-01

    Evaluate the effectiveness of nutrition education interventions for diabetes prevention. Retrospective cohort design. Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. Prediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). Visits with existing nutrition education classes were collected. diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. Cox proportional hazards method, χ(2) test, and logistic regression. In this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55-0.92; P Nutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

  18. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  19. Variation in Veteran Identity as a Factor in Veteran-Targeted Interventions.

    Science.gov (United States)

    Hack, Samantha M; DeForge, Bruce R; Lucksted, Alicia

    2017-07-01

    The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes. However, as discussed in this Open Forum, there is evidence that veteran identity is not monolithic but rather fluctuates on the basis of personal characteristics and individual military service experiences. Overall, the impact of veteran identity on veterans' health behaviors and use of health care is not known and has been understudied. A major limiting factor is the lack of a standardized measure of veteran identity that can assess variations in salience, prominence, and emotional valence.

  20. An Electronic Service Quality Reference Model for Designing E-Commerce Websites Which Maximizes Customer Satisfaction

    Science.gov (United States)

    Shaheen, Amer N.

    2011-01-01

    This research investigated Electronic Service Quality (E-SQ) features that contribute to customer satisfaction in an online environment. The aim was to develop an approach which improves E-CRM processes and enhances online customer satisfaction. The research design adopted mixed methods involving qualitative and quantitative methods to…

  1. Impact of presumed service-connected diagnosis on the Department of Veterans Affairs healthcare utilization patterns of Vietnam-Theater Veterans: A cross-sectional study.

    Science.gov (United States)

    Fried, Dennis A; Rajan, Mangala; Tseng, Chin-Lin; Helmer, Drew

    2018-05-01

    During the Vietnam War, the US military sprayed almost 20 million gallons of Agent Orange (AO), an herbicide contaminated with dioxin, over Vietnam. Approximately, 2.7 million US military personnel may have been exposed to AO during their deployment. Ordinarily, veterans who can demonstrate a nexus between a diagnosed condition and military service are eligible for Department of Veterans Affairs (VA) service-connected disability compensation. Vietnam Veterans have had difficulty, however, establishing a nexus between AO exposure and certain medical conditions that developed many years after the war. In response, VA has designated certain conditions as "presumed service connected" for Vietnam Veterans who were present and possibly exposed. Veterans with any of these designated conditions do not have to document AO exposure, making it easier for them to access the VA disability system. The extent to which VA healthcare utilization patterns reflect easier access afforded those with diagnosed presumptive conditions remains unknown. In this cross-sectional study, we hypothesized that Vietnam Veterans with diagnosed presumptive conditions would be heavier users of the VA healthcare system than those without these conditions. In our analysis of 85,699 Vietnam Veterans, we used binary and cumulative logit multivariable regression to assess associations between diagnosed presumptive conditions and VA healthcare utilization in 2013. We found that diagnosed presumptive conditions were associated with higher odds of 5+ VHA primary care visits (OR = 2.01, 95% CI: 1.93-2.07), 5+ specialty care visits (OR = 2.11, 95% CI: 2.04-2.18), emergency department use (OR = 1.22, 95% CI: 1.11-1.34), and hospitalization (OR = 1.23, 95% CI: 1.17-1.29). Consistent with legislative intent, presumptive policies appear to facilitate greater VA system utilization for Vietnam Veterans who may have been exposed to AO.

  2. Honoring our Nation's Veterans

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-11-01

    Full Text Available No abstract available. Article truncated at 150 words. Today is Armistice Day, renamed Veterans Day in 1954, to honor our Nation's Veterans. In Washington the rhetoric from both the political right and left supports our Veterans. My cynical side reminds me that this might have something to do with Veterans voting in a higher percentage than the population as a whole, but let me give the politicians this one. Serving our Country in the military is something that deserves to be honored. I was proud to serve our Veterans over 30 years at the four Department of Veterans Affairs (VA hospitals. However, the VA has had a very bad year. First, in Washington there were the resignations of the Secretary of Veterans Affairs, Eric Shinseki; the undersecretary for the Veterans Health Administration, Robert Petzel; and the undersecretary for the Veterans Benefits Administration, Allison Hickey. Locally, in the light of the VA wait scandal there were the firing of ...

  3. Customization Issues

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn; Brunø, Thomas Ditlev; Taps, Stig B.

    2014-01-01

    Implementation of mass customization and product configuration in companies requires fundamental considerations about how products can fulfil the demand from customers. In order to support such decision-making, a multi-level model for customization is developed. This model identifies four different...... levels of customization, ranging from the structure level at the bottom, through the performance level and the experience level, to the learning level at the top. The model also has a dual view with customers/demand at one side and product/supplier at the other side. It is a rather general model, which...... can be applied to many types of products, and typically, product designers must decide how far up in levels the customization should aim. In this paper, the four-level customization model is applied to wheel chairs....

  4. 19 CFR 101.7 - Customs seal.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Customs seal. 101.7 Section 101.7 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY GENERAL PROVISIONS § 101.7 Customs seal. (a) Design. According to the design furnished by the Department...

  5. Mortality in Postmenopausal Women by Sexual Orientation and Veteran Status

    Science.gov (United States)

    Lehavot, Keren; Rillamas-Sun, Eileen; Weitlauf, Julie; Kimerling, Rachel; Wallace, Robert B.; Sadler, Anne G.; Woods, Nancy Fugate; Shipherd, Jillian C.; Mattocks, Kristin; Cirillo, Dominic J.; Stefanick, Marcia L.; Simpson, Tracy L.

    2016-01-01

    Abstract Purpose of the Study: To examine differences in all-cause and cause-specific mortality by sexual orientation and Veteran status among older women. Design and Methods: Data were from the Women’s Health Initiative, with demographic characteristics, psychosocial factors, and health behaviors assessed at baseline (1993–1998) and mortality status from all available data sources through 2014. Women with baseline information on lifetime sexual behavior and Veteran status were included in the analyses ( N = 137,639; 1.4% sexual minority, 2.5% Veteran). The four comparison groups included sexual minority Veterans, sexual minority non-Veterans, heterosexual Veterans, and heterosexual non-Veterans. Cox proportional hazard models were used to estimate mortality risk adjusted for demographic, psychosocial, and health variables. Results: Sexual minority women had greater all-cause mortality risk than heterosexual women regardless of Veteran status (hazard ratio [HR] = 1.20, 95% confidence interval [CI]: 1.07–1.36) and women Veterans had greater all-cause mortality risk than non-Veterans regardless of sexual orientation (HR = 1.14, 95% CI: 1.06–1.22), but the interaction between sexual orientation and Veteran status was not significant. Sexual minority women were also at greater risk than heterosexual women for cancer-specific mortality, with effects stronger among Veterans compared to non-Veterans (sexual minority × Veteran HR = 1.70, 95% CI: 1.01–2.85). Implications: Postmenopausal sexual minority women in the United States, regardless of Veteran status, may be at higher risk for earlier death compared to heterosexuals. Sexual minority women Veterans may have higher risk of cancer-specific mortality compared to their heterosexual counterparts. Examining social determinants of longevity may be an important step to understanding and reducing these disparities. PMID:26768389

  6. Design and manufacture of customized dental implants by using reverse engineering and selective laser melting technology.

    Science.gov (United States)

    Chen, Jianyu; Zhang, Zhiguang; Chen, Xianshuai; Zhang, Chunyu; Zhang, Gong; Xu, Zhewu

    2014-11-01

    Recently a new therapeutic concept of patient-specific implant dentistry has been advanced based on computer-aided design/computer-aided manufacturing technology. However, a comprehensive study of the design and 3-dimensional (3D) printing of the customized implants, their mechanical properties, and their biomechanical behavior is lacking. The purpose of this study was to evaluate the mechanical and biomechanical performance of a novel custom-made dental implant fabricated by the selective laser melting technique with simulation and in vitro experimental studies. Two types of customized implants were designed by using reverse engineering: a root-analog implant and a root-analog threaded implant. The titanium implants were printed layer by layer with the selective laser melting technique. The relative density, surface roughness, tensile properties, bend strength, and dimensional accuracy of the specimens were evaluated. Nonlinear and linear finite element analysis and experimental studies were used to investigate the stress distribution, micromotion, and primary stability of the implants. Selective laser melting 3D printing technology was able to reproduce the customized implant designs and produce high density and strength and adequate dimensional accuracy. Better stress distribution and lower maximum micromotions were observed for the root-analog threaded implant model than for the root-analog implant model. In the experimental tests, the implant stability quotient and pull-out strength of the 2 types of implants indicated that better primary stability can be obtained with a root-analog threaded implant design. Selective laser melting proved to be an efficient means of printing fully dense customized implants with high strength and sufficient dimensional accuracy. Adding the threaded characteristic to the customized root-analog threaded implant design maintained the approximate geometry of the natural root and exhibited better stress distribution and

  7. Customer Relationship Management System in Occupational Safety & Health Companies: Research on Practice and Preliminary Design Solution

    Directory of Open Access Journals (Sweden)

    Robert Fabac

    2011-10-01

    Full Text Available One of the most prominent contemporary trends in formation of companies is the approach to development of a customer-oriented company. In this matter, various versions related to the intensity of this orientation are differentiated. Customer relationship management (CRM system is a well-known concept, and its practice is being studied and improved in connection to various sectors. Companies providing services of occupational safety and health (OHS mainly cooperate with a large number of customers and the quality of this cooperation largely affects the occupational safety and health of employees. Therefore, it is of both scientific and wider social interest to study and improve the relationship of these companies with their customers. This paper investigates the practice of applying CRM in Croatian OHS companies. It identifies the existing conditions and suggests possible improvements in the practice of CRM, based on experts’ assessments using analytic hierarchy process evaluation. Universal preliminary design was created as a framework concept for the formation of a typical customer-oriented OHS services company. Preliminary design includes a structural view, which provides more details through system diagrams, and an illustration of main cooperation processes of a company with its customer.

  8. Veteran Services - Welcome Employers

    Science.gov (United States)

    Assistance Crosswalk websites Transition GPS National Career Readiness Certificate Post Traumatic Stress Credits (PDF) Fidelity Bonding Program National Career Readiness (PDF) Veteran Recruitment State/Federal veteran recruitment process Military Veteran Employment Guide Veterans Hiring Toolkit Other Information

  9. Design and health care: a study of virtual design and direct metal lasersintering of titanium alloy for the production of customized facial implants

    Directory of Open Access Journals (Sweden)

    Wilson Kindlein Junior

    2009-11-01

    Full Text Available The increase in life expectancy and a great number ofaccidents lead to higher demand for medical products,including corrective implants. Patients with tumors or traumas need to replace injured areas in order to restore their aesthetic and structural function. Currently, the available craniofacial implants present a standard geometry and seldom generate satisfactory results. Customized implants, on theother hand, are designed to conform exactly to individual patient’s anatomy. This way, the use of customized implantscan show beneficial effects to the patient and the surgicalteam. In this study, the design and manufacturing of customized implant prior to surgery were described. Implant shape and functional requirements were established by digitaldata based on CT-scans and mirroring operations. The designprocess of customized mandible prosthesis is illustrated as well as its manufacturing process (direct metal laser sinteringand quality control. Laser sintering process and its constraints for the production of customized implants in titanium alloy(Ti-6Al-4V with complex geometry and internal structures are reported.

  10. Embitterment in War Veterans with Posttraumatic Stress Disorder.

    Science.gov (United States)

    Sabic, Dzevad; Sabic, Adela; Batic-Mujanovic, Olivera

    2018-04-01

    The aim of this study was to analyze frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD). It was analyzed 174 subjects (from Health Center Zivinice/ Mental Health Center) through a survey conducted in the period from March 2015 to June 2016, of witch 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the Clinician-Administered PTSD Scale - V (CAPS), the PTSD CheckList (PCL), the Combat Exposure Scale (CES), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A) and the World Health Organization Quality of Life Scale ( WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52·78 ± 5·99. In the control group average age was 51·42 ± 5·98. Statistical data were analyzed in SPSS statistical program. Comparing the results, t tests revealed significant difference between group veterans with PTSD and control group (t=-21·216, p<0·0001). War veterans group with PTSD (X= 51·41 SD= 8·91), war veterans without PTSD (X=14·39, SD=13·61). Embitterment is frequent in war veterans with PTSD.

  11. Race and vitamin D status and monitoring in male veterans.

    Science.gov (United States)

    Peiris, Alan N; Bailey, Beth A; Peiris, Prith; Copeland, Rebecca J; Manning, Todd

    2011-06-01

    African Americans have lower vitamin D levels and reduced health outcomes compared to white Americans. Vitamin D deficiency may contribute to adverse health outcomes in African Americans. We hypothesized that race would be associated with vitamin D status and testing in African Americans veterans, and that vitamin D status is a major contributor to health care costs in African American veterans compared to white veterans. A retrospective analysis of the medical data in the Veterans Integrated Service Network 9 (southeastern United States) was performed, and 14148 male veterans were identified. Race was designated by the patient and its relationship to vitamin D levels/status and costs was assessed. Vitamin D levels were significantly lower and the percent of patients with vitamin D deficiency was significantly higher in African American veterans. This difference was independent of latitude and seasonality. Vitamin D testing was done significantly more in white veterans compared to African American veterans (5.4% vs 3.8%). While follow-up testing was 42% more likely if a patient was found to be vitamin D deficient, white veterans were 34% more likely than African American veterans to have at least 1 follow-up 25-hydroxyvitamin D performed. African American veterans had significantly higher health care costs, which were linked to lower vitamin D levels; however, the cost differential persisted even after adjusting for vitamin D status. Vitamin D deficiency is highly prevalent in African American veterans and needs improved management within the Veteran Administration system. Vitamin D status appears not to be the sole contributor to increased health care costs in African American veterans.

  12. [Design and fabrication of the custom-made titanium condyle by selective laser melting technology].

    Science.gov (United States)

    Chen, Jianyu; Luo, Chongdai; Zhang, Chunyu; Zhang, Gong; Qiu, Weiqian; Zhang, Zhiguang

    2014-10-01

    To design and fabricate the custom-made titanium mandibular condyle by the reverse engineering technology combined with selective laser melting (SLM) technology and to explore the mechanical properties of the SLM-processed samples and the application of the custom-made condyle in the temporomandibular joint (TMJ) reconstruction. The three-dimensional model of the mandibular condyle was obtained from a series of CT databases. The custom-made condyle model was designed by the reverse engineering software. The mandibular condyle was made of titanium powder with a particle size of 20-65 µm as the basic material and the processing was carried out in an argon atmosphere by the SLM machine. The yield strength, ultimate strength, bending strength, hardness, surface morphology and roughness were tested and analyzed. The finite element analysis (FEA) was used to analyze the stress distribution. The complex geometry and the surface of the custom-made condyle can be reproduced precisely by the SLM. The mechanical results showed that the yield strength, ultimate strength, bending strength and hardness were (559±14) MPa, (659±32) MPa, (1 067±42) MPa, and (212±4)HV, respectively. The surface roughness was reduced by sandblast treatment. The custom-made titanium condyle can be fabricated by SLM technology which is time-saving and highly digitized. The mechanical properties of the SLM sample can meet the requirements of surgical implant material in the clinic. The possibility of fabricating custom-made titanium mandibular condyle combined with the FEA opens new interesting perspectives for TMJ reconstruction.

  13. Transfer of information from personal health records: a survey of veterans using My HealtheVet.

    Science.gov (United States)

    Turvey, Carolyn L; Zulman, Donna M; Nazi, Kim M; Wakefield, Bonnie J; Woods, Susan S; Hogan, Timothy P; Weaver, Frances M; McInnes, Keith

    2012-03-01

    Personal health records provide patients with ownership of their health information and allow them to share information with multiple healthcare providers. However, the usefulness of these records relies on patients understanding and using their records appropriately. My HealtheVet is a Web-based patient portal containing a personal health record administered by the Veterans Health Administration. The goal of this study was to explore veterans' interest and use of My HealtheVet to transfer and share information as well as to identify opportunities to increase veteran use of the My HealtheVet functions. Two waves of data were collected in 2010 through an American Customer Satisfaction Index Web-based survey. A random sample of veterans using My HealtheVet was invited to participate in the survey conducted on the My HealtheVet portal through a Web-based pop-up browser window. Wave One results (n=25,898) found that 41% of veterans reported printing information, 21% reported saving information electronically, and only 4% ever sent information from My HealtheVet to another person. In Wave Two (n=18,471), 30% reported self-entering medication information, with 18% sharing this information with their Veterans Affairs (VA) provider and 9.6% sharing with their non-VA provider. Although veterans are transferring important medical information from their personal health records, increased education and awareness are needed to increase use. Personal health records have the potential to improve continuity of care. However, more research is needed on both the barriers to adoption as well as the actual impact on patient health outcomes and well-being.

  14. The Entrepreneurship Bootcamp for Veterans' Families Program: Transformative Learning for Discontinuous Life Transition

    Science.gov (United States)

    Redmon, Stephen Thomas

    2013-01-01

    This multiple-case study explored the nature of the experiences of family members of service-disabled veterans who participated in the Entrepreneurship Bootcamp for Veterans Family Program (EBV-F), an entrepreneurial learning and coaching program designed to assist family members of service-disabled veterans to support the discontinuous life…

  15. Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder.

    Science.gov (United States)

    Verduin, Marcia L; LaRowe, Steven D; Myrick, Hugh; Cannon-Bowers, Jan; Bowers, Clint

    2013-03-01

    This study examined the impact of a computer simulation designed to provide the opportunity for individuals with alcohol use disorders (AUDs) to practice relapse prevention skills. Participants were 41 male veterans enrolled in an intensive outpatient substance abuse treatment program. Participants were randomly assigned to either view educational slides about treatment for AUD or play a simulation videogame for eight sessions within 12 weeks. Participants were assessed at a 4-week follow-up visit. Outcome measures included relapse rates as well as ratings on the Obsessive Compulsive Drinking Scale (OCDS) and a custom-designed relapse prevention self efficacy scale. While rates of relapse did not differ between groups, those who played the game showed overall reductions in ratings on the OCDS, as well as higher ratings of self-efficacy at week 8, suggesting that the videogame simulation may be a useful adjunct to AUD treatment. Published by Elsevier Inc.

  16. Designing Customer Education Activities to Change People’s Perception of Catfish

    Directory of Open Access Journals (Sweden)

    Stevanus Pratama Suwito

    2017-06-01

    Full Text Available Most people see catfish as an unhygienic fish, so less people want to consume it. In fact, catfish has better nutrition compared to Gourami. Therefore, catfish producers need to educate people. The purpose of this research is to design customer education activities to change people’s perception towards catfish using marketing communication mix. This research is a qualitative research and it uses in-depth interview method in gathering the required data. Based on the preliminary survey conducted to 50 people in Surabaya, it is known that Surabaya people are considered novice customers. As such, catfish producers can conduct customer education activities until people want to taste the catfish. The company can add picture, video, and oral information about the benefits in consuming catfish or the nutrition and the certificate of hygienic cultivation system. The producers can provide tester for the catfish and show the customers the comparison between good and bad quality catfish. The producers can also add two more marketing communication activities i.e. events and experiences as well as public relations and publicity. The producers need to use reliable sources in informing the catfish’s nutrition facts such as the certificate of catfish breeder, and certification from BPOM.

  17. Design and challenges for a randomized, multi-site clinical trial comparing the use of service dogs and emotional support dogs in Veterans with post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Saunders, Gabrielle H; Biswas, Kousick; Serpi, Tracey; McGovern, Stephanie; Groer, Shirley; Stock, Eileen M; Magruder, Kathryn M; Storzbach, Daniel; Skelton, Kelly; Abrams, Thad; McCranie, Mark; Richerson, Joan; Dorn, Patricia A; Huang, Grant D; Fallon, Michael T

    2017-11-01

    Posttraumatic stress disorder (PTSD) is a leading cause of impairments in quality of life and functioning among Veterans. Service dogs have been promoted as an effective adjunctive intervention for PTSD, however published research is limited and design and implementation flaws in published studies limit validated conclusions. This paper describes the rationale for the study design, a detailed methodological description, and implementation challenges of a multisite randomized clinical trial examining the impact of service dogs on the on the functioning and quality of life of Veterans with PTSD. Trial design considerations prioritized participant and intervention (dog) safety, selection of an intervention comparison group that would optimize enrollment in all treatment arms, pragmatic methods to ensure healthy well-trained dogs, and the selection of outcomes for achieving scientific and clinical validity in a Veteran PTSD population. Since there is no blueprint for conducting a randomized clinical trial examining the impact of dogs on PTSD of this size and scope, it is our primary intent that the successful completion of this trial will set a benchmark for future trial design and scientific rigor, as well as guiding researchers aiming to better understand the role that dogs can have in the management of Veterans experiencing mental health conditions such as PTSD. Published by Elsevier Inc.

  18. Treatment-seeking veterans of Iraq and Afghanistan: comparison with veterans of previous wars.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert

    2008-07-01

    Differences in the characteristics and mental health needs of veterans of the Iraq/Afghanistan war when compared with those of veterans who served in the Persian Gulf war and in the Vietnam war may have important implications for Veterans Affairs (VA) program and treatment planning. Subjects were drawn from administrative data bases of veterans who sought treatment from specialized VA programs for treatment of posttraumatic stress disorder (PTSD). Current Iraq/Afghanistan veterans were compared with 4 samples of outpatient and inpatient Persian Gulf and Vietnam veterans whose admission to treatment was either contemporaneous or noncontemporaneous with their admission. A series of analyses of covariance was used hierachically to control for program site and age. In analyses of contemporaneous veterans uncontrolled for age, Iraq/Afghanistan veterans differed most notably from Vietnam veterans by being younger, more likely to be female, less likely to be either married or separated/divorced, more often working, less likely to have ever been incarcerated, and less likely to report exposure to atrocities in the military. Regarding clinical status, Iraq/Afghanistan veterans were less often diagnosed with substance abuse disorders, manifested more violent behavior, and had lower rates of VA disability compensation because of PTSD. Differences are more muted in comparisons with Persian Gulf veterans, particularly in those involving noncontemporaneous samples, or those that controlled for age differences. Among recent war veterans with PTSD, social functioning has largely been left intact. There is a window of opportunity, therefore, for developing and focusing on treatment interventions that emphasize the preservation of these social assets.

  19. Heroes or Health Victims?: Exploring How the Elite Media Frames Veterans on Veterans Day.

    Science.gov (United States)

    Rhidenour, Kayla B; Barrett, Ashley K; Blackburn, Kate G

    2017-11-27

    We examine the frames the elite news media uses to portray veterans on and surrounding Veterans Day 2012, 2013, 2014, and 2015. We use mental health illness and media framing literature to explore how, why, and to what extent Veterans Day news coverage uses different media frames across the four consecutive years. We compiled a Media Coverage Corpora for each year, which contains the quotes and paraphrased remarks used in all veterans news stories for that year. In our primary study, we applied the meaning extraction method (MEM) to extract emergent media frames for Veterans Day 2014 and compiled a word frequency list, which captures the words most commonly used within the corpora. In post hoc analyses, we collected news stories and compiled word frequency lists for Veterans Day 2012, 2013, and 2015. Our findings reveal dissenting frames across 2012, 2013, and 2014 Veterans Day media coverage. Word frequency results suggest the 2012 and 2013 media frames largely celebrate Veterans as heroes, but the 2014 coverage depicts veterans as victimized by their wartime experiences. Furthermore, our results demonstrate how the prevailing 2015 media frames could be a reaction to 2014 frames that portrayed veterans as health victims. We consider the ramifications of this binary portrayal of veterans as either health victims or heroes and discuss the implications of these dueling frames for veterans' access to healthcare resources.

  20. Veterans' homecomings

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Refslund

    2015-01-01

    provided the soldier by rank, function, and mission vanishes and translates into an imperative ontological question about possible veteran subjectivity. In this article I argue that the veterans’ struggle to create postdeployment, postmilitary social identities entails profound secrecy work where past...... experiences, present conditions, and future ambitions are embedded in webs of concealment, disclosure, exposure, deception, lying, silence, and so forth, only partially controlled by the veterans themselves. The intricacies and anxieties associated with secrecy work are discussed in relation to three veteran...

  1. Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector.

    Science.gov (United States)

    Scotti, Dennis J; Harmon, Joel; Behson, Scott J

    2007-01-01

    Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.

  2. THE ROLE OF CUSTOMER SATISFACTION IN MEDIATING MARKETING COMMUNICATION EFFECT ON CUSTOMER LOYALTY

    OpenAIRE

    Mohamad Dimyati,

    2015-01-01

    This study aims to test the effect of a) marketing communication on customer satisfaction; b) marketing communication on customer loyalty; c) customer satisfaction on customer loyalty; and d) to identify the role of customer satisfaction in mediating marketing communication effect on customer loyalty of the IM3 user community in Jember regency, East Java province. The study was designed in a form confirmatory research, with the whole IM3 community members in the regency as the ...

  3. Structural and mechanical characterization of custom design cranial implant created using additive manufacturing

    OpenAIRE

    Khaja Moiduddin; Saied Darwish; Abdulrahman Al-Ahmari; Sherif ElWatidy; Ashfaq Mohammad; Wadea Ameen

    2017-01-01

    Background: Reconstruction of customized cranial implants with a mesh structure using computer-assisted design and additive manufacturing improves the implant design, surgical planning, defect evaluation, implant-tissue interaction and surgeon's accuracy. The objective of this study is to design, develop and fabricate cranial implant with mechanical properties closer to that of bone and drastically decreases the implant failure and to improve the esthetic outcome in cranial surgery with preci...

  4. 38 CFR 10.37 - Claim of widow not living with veteran at time of veteran's death.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Claim of widow not living with veteran at time of veteran's death. 10.37 Section 10.37 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUSTED COMPENSATION Adjusted Compensation; General § 10.37 Claim of widow not living with veteran at time of...

  5. 20 CFR 1001.123 - Performance standards governing the assignment and role of Local Veterans' Employment...

    Science.gov (United States)

    2010-04-01

    ... assignment and role of Local Veterans' Employment Representatives (LVERs). 1001.123 Section 1001.123... Veterans and Eligible Persons § 1001.123 Performance standards governing the assignment and role of Local... one member of each State agency staff, preferably an eligible veteran, shall be designated and...

  6. A modified dynamic evolving neural-fuzzy approach to modeling customer satisfaction for affective design.

    Science.gov (United States)

    Kwong, C K; Fung, K Y; Jiang, Huimin; Chan, K Y; Siu, Kin Wai Michael

    2013-01-01

    Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1) the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS) failed to run due to a large number of inputs; (2) the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort.

  7. A Modified Dynamic Evolving Neural-Fuzzy Approach to Modeling Customer Satisfaction for Affective Design

    Directory of Open Access Journals (Sweden)

    C. K. Kwong

    2013-01-01

    Full Text Available Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1 the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS failed to run due to a large number of inputs; (2 the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort.

  8. Gender, race & the veteran wage gap.

    Science.gov (United States)

    Vick, Brandon; Fontanella, Gabrielle

    2017-01-01

    This paper analyzes earnings outcomes of Iraq/Afghanistan-era veterans. We utilize the 2009-2013 American Community Survey and a worker-matching methodology to decompose wage differences between veteran and non-veteran workers. Among fully-employed, 25-40 year-olds, veteran workers make 3% less than non-veteran workers. While male veterans make 9% less than non-veterans, female and black veterans experience a wage premium (2% and 7% respectively). Decomposition of the earnings gap identifies some of its sources. Relatively higher rates of disability and lower rates of educational attainment serve to increase the overall wage penalty against veterans. However, veterans work less in low-paying occupations than non-veterans, serving to reduce the wage penalty. Finally, among male and white subgroups, non-veterans earn more in the top quintile due largely to having higher educational attainment and greater representation in higher-paying occupations, such as management. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans.

    Science.gov (United States)

    Duan-Porter, Wei; Van Houtven, Courtney H; Mahanna, Elizabeth P; Chapman, Jennifer G; Stechuchak, Karen M; Coffman, Cynthia J; Hastings, Susan Nicole

    2017-12-18

    Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in technology use. Thus, we sought to describe characteristics of Internet use and technology-related attitudes for two such groups: (1) Veterans with multi-morbidity and high acute care utilization and (2) informal caregivers of Veterans with substantial care needs at home. We used survey data from two ongoing trials, for 423 Veteran and 169 caregiver participants, respectively. Questions examined Internet use in the past year, willingness to communicate via videoconferencing, and comfort with new technology devices. Most participants used Internet in the past year (81% of Veterans, 82% of caregivers); the majority of users (83% of Veterans, 92% of caregivers) accessed Internet at least a few times a week, and used a private laptop or computer (81% of Veterans, 89% of caregivers). Most were willing to use videoconferencing via private devices (77-83%). A majority of participants were comfortable attempting to use new devices with in-person assistance (80% of Veterans, 85% of caregivers), whereas lower proportions were comfortable "on your own" (58-59% for Veterans and caregivers). Internet use was associated with comfort with new technology devices (odds ratio 2.76, 95% confidence interval 1.70-4.53). Findings suggest that technology-enhanced healthcare interventions are feasible and acceptable for Veterans with multi-morbidity and high healthcare utilization, and informal caregivers of Veterans. In-person assistance may be important for those with no recent Internet use.

  10. Veterans transitioning from isolation to integration: a look at veteran/service dog partnerships.

    Science.gov (United States)

    Crowe, Terry K; Sánchez, Victoria; Howard, Alyse; Western, Brenna; Barger, Stephanie

    2017-08-13

    This study explored the dynamics of veteran/service dog partnerships by gathering the perspectives of veterans with a history of post-traumatic stress disorder and/or traumatic brain injury. Exploratory qualitative methods (focus groups and individual interviews) were used to investigate veteran/service dog relationships related to community involvement, family and friend relationships, self-care, work, and leisure. Nine male veterans, Paws, and Stripes program graduates participated. Data were audio recorded and transcribed by two research team members who used qualitative analytic software to manage and code the data. The full research team discussed themes and reached consensus on the themes that emerged from analysis. Five themes emerged about the perceived benefit of veteran/service dog relationship: Secluded but Seeking Society (moving from isolation to reconnection); Opening Opportunities (navigating daily life); Bridging the Gap (facilitating social opportunities); and Reclaiming Life (transforming sense of worth and purpose). An overarching theme, Calming Catalyst, connected the other four themes. Veterans in this study reported that their goal was to reclaim and develop key aspects of their lives and they perceived service dogs as a support in their transition from isolation to reintegration. This study found that service dogs supported the veterans to meet their goal. Implications for rehabilitation There are a significant number of veterans with post-traumatic stress disorder and/or traumatic brain injury who are facing life challenges including self-care, securing work, participating in leisure activities, and integrating into the community. Service dogs are an emerging intervention used to assist veterans with reintegration into civilian life. There is a need for professionals to be aware of potential benefits of service dog/veteran partnerships. Based on our findings, veterans could benefit from being paired with a service dog to facilitate their

  11. Efek Customer Customer Interaction Terhadap Satisfaction Dan Word of Mouth Pada Hotel Mandarin Oriental

    OpenAIRE

    Hijir, Putri

    2016-01-01

    The background of this research was the effect of Customer to Customer Interaction affect satisfaction, word of mouth, in mandarin oriental hotel. The objective of this research is to examine the impact of Customer satisfaction, Service Atmosphere, Personal Interaction, Customer Customer Interaction, Word of Mouth. The design of this research applies primary data obtained by distributing questionnaires to 200 customer who are using Mandarin Oriental Hotel. Data analysis method used in this re...

  12. A comparative study on the customized design of mandibular reconstruction plates using finite element method

    Directory of Open Access Journals (Sweden)

    Abdulrahman Al-Ahmari

    2015-07-01

    Full Text Available Mandible defects and its deformities are serious complications and its precise reconstruction is one of the most challenging tasks in oral maxillofacial surgery. The commercially available standard mandible implants are manually bended before surgery to custom fit the patient’s jaw. A slight mismatch in the plate and bone alignment may result in the implant failure. However, with the integration of computer-aided design, rapid prototyping, and advanced imaging systems (computed tomography or magnetic resonance imaging, it is possible to produce a customized mandible implant that can precisely fit the patient’s jaw. The aim of this article is to compare a new design of customized mandible implant (sinewave plate and compare it with the commonly used straight implant design. The finite element–simulated results reveal that the commonly used straight reconstruction plates are more prone to loosening of the screws due to its higher strain concentration on the screw hole when compared to newly designed sinewave reconstruction plate. Moreover, the straight plate is more sensitive to the chewing load variations and develops almost 20% increase in the stresses when compared to sinewave plate. The study reveals that the sinewave reconstruction plate can significantly enhance the stability and safety of the mandible implant.

  13. Tuberculosis in Scottish military veterans: evidence from a retrospective cohort study of 57 000 veterans and 173 000 matched non-veterans.

    Science.gov (United States)

    Bergman, Beverly P; Mackay, D F; Pell, J P

    2017-02-01

    Tuberculosis was a major cause of morbidity and manpower loss in the Armed Forces during World War II. Military control programmes commenced in the 1950s but were initially limited in scope by the many recruits who were already tuberculin positive on enlistment. The aim of our study was to examine whether veterans have an increased risk of tuberculosis compared with non-veterans. Retrospective cohort study of 57 000 veterans born 1945-1985, and 173 000 people with no record of military service, resident in Scotland, matched for age, sex and area of residence, using Cox proportional hazard analysis to compare the risk of tuberculosis overall, by birth cohort, length of service and year of diagnosis and to examine comorbidities. Over mean 29 years follow-up, 69 (0.12%) veterans were recorded as having tuberculosis, compared with 267 (0.15%) non-veterans (unadjusted HR 0.90, 95% CIs 0.69 to 1.19, p=0.463). Only the 1945-1949 veterans' birth cohort was at higher risk, unadjusted HR 1.54, 95% CIs 0.98 to 2.45, p=0.061, although the difference in risk did not achieve significance. Veterans born from 1950 were at significantly reduced risk of tuberculosis compared with non-veterans after adjusting for deprivation, HR 0.67, 95% CI 0.47 to 0.95, p=0.026. The most common comorbidities were smoking-related and alcohol-related disease. The risk of comorbid hepatitis B or C was very low, in both veterans and non-veterans. No length of service was associated with an increased risk of tuberculosis in comparison with non-veterans. Scottish veterans born before 1950 are at moderately increased risk of tuberculosis compared with age, sex and geographically matched civilians with no record of service, although the difference is not statistically significant. Scottish veterans born from 1950 show a reduction in risk compared with civilians. Tuberculosis should be considered in the differential diagnosis of respiratory disease in the older veteran. Published by the BMJ Publishing

  14. Using alternative segmentation techniques to examine residential customer`s energy needs, wants, and preferences

    Energy Technology Data Exchange (ETDEWEB)

    Hollander, C.; Kidwell, S. [Union Electric Co., St. Louis, MO (United States); Banks, J.; Taylor, E. [Cambridge Reports/Research International, MA (United States)

    1994-11-01

    The primary objective of this study was to examine residential customers` attitudes toward energy usage, conservation, and efficiency, and to examine the implications of these attitudes for how the utility should design and communicate about programs and services in these areas. This study combined focus groups and customer surveys, and utilized several customer segmentation schemes -- grouping customers by geodemographics, as well as customers` energy and environmental values, beliefs, and opinions -- to distinguish different segments of customers.

  15. Customization and Customer-Product Learning

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn

    2011-01-01

    , through the performance level and the experience level to the learning level at the top. This model has a dual view with customers/demand at one side and product/supplier at the other side. It is developed so that it can be generally applied and, typically, product designers must decide how far up...... in levels the customisation should aim. This paper sets special focus on the upper levels of customisation, especially the learning level, and it is shown that products with a large range of user-oriented functionalities often require much training to use and that customers on the other hand are sometimes...

  16. Pathways into mental health care for UK veterans: a qualitative study.

    Science.gov (United States)

    Mellotte, Harriet; Murphy, Dominic; Rafferty, Laura; Greenberg, Neil

    2017-01-01

    Background : It is well established that veterans suffering from mental health difficulties under use mental health services. Objective : This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans' help-seeking and pathways to care. Method : The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results : Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans' help-seeking in future; these focussed on enhancing both veterans and health professionals' knowledge regarding mental health difficulties. Conclusions : This study identified a number of barriers and enablers that may impact a veteran's journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

  17. Bank Customers Management System

    Directory of Open Access Journals (Sweden)

    Ebubeogu Amarachukwu Felix

    2015-08-01

    Full Text Available ABSTRACT The purpose of this project is in partial fulfilment of the requirements of Bachelor of Science Hon in Information Technology. The Design and development of this Bank customers Management system provides a more secured approach in managing bank customers information which strengthens the relationships between banks and their customers by providing the right solutions that uses a multi-level security to improve customer satisfaction. The technology used in developing this project is ASP.NET and the programming language used to develop this project is C and the IDE used is Microsoft Visual Studio 2013 professional in designing the front end while the back end uses Microsoft SQL Server 2012.

  18. CUSTOMIZED PRODUCTS: THE INTEGRATING RELATIONSHIP MARKETING, AGILE MANUFACTURING AND SUPPLY CHAIN MANAGEMENT FOR MASS CUSTOMIZATION

    OpenAIRE

    Süleyman BARUTCU

    2007-01-01

    A customized product is a special product designed and manufactured for individual customers to meet their individual needs. Managers need to understand why customers demand and how companies supply customized products. The importance of this study is to highlight business, marketing and manufacturing strategies so as to supply customized products efficiently. It is expected from a manufacturer to successfully adopt relationship marketing, mass customization, agile manufacturing and supply ch...

  19. EFEK CUSTOMER CUSTOMER INTERACTION TERHADAP SATISFACTION DAN WORD OF MOUTH PADA HOTEL MANDARIN ORIENTAL

    Directory of Open Access Journals (Sweden)

    Putri Hijir

    2016-08-01

    Full Text Available The background of this research was the effect of Customer to Customer Interaction affect satisfaction, word of mouth, in mandarin oriental hotel. The objective of this research is to examine the impact of Customer satisfaction, Service Atmosphere, Personal Interaction, Customer Customer Interaction, Word of Mouth. The design of this research applies primary data obtained by distributing questionnaires to 200 customer who are using Mandarin Oriental Hotel. Data analysis method used in this research is Structural Equation Model (SEM. The result of this research there is positive impact Personal Interaction Quality toward customer Satisfaction, there is positive impact Service Atmosphere toward Customer Satisfaction, there is positive impact Service atmosphere toward Customer Customer Interaction, there is positive impact Customer Customer Interaction toward Customer Satisfaction, there is positive impact Customer Customer Interaction toward Word of Mouth, there is positive impact Customer Satisfaction toward Word of Mouth.

  20. Minority Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  1. Structural relationships between work environment and service quality perceptions as a function of customer contact intensity: implications for human service strategy.

    Science.gov (United States)

    Scotti, Dennis J; Harmon, Joel; Behson, Scott J

    2009-01-01

    This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.

  2. An Empirical Analysis to Design Enhanced Customer Lifetime Value Based on Customer Loyalty: Evidences from Iranian Banking Sector

    Directory of Open Access Journals (Sweden)

    Mohammad Safari Kahreh

    2012-07-01

    Full Text Available The more a marketing paradigm evolves, the more long-term relationship with customers gains its importance. Also, the move towards a customer-centred approach to marketing, coupled with the increasing availability of customer transaction data, has led to an interest in understanding and estimating customer lifetime value (CLV. There are several researches about the CLV formulas and calculating relations. But the effect of the CLV on the other departments of the organization and especially the effect of the CLV on the key parameters for organization’s profitability such as customer loyalty and satisfaction had little attention. This research is about these shortcomings and covers another essential element for organizational sustainable profitability, customer loyalty. The main purpose of this research is to demonstrate the effect of customer loyalty on the customer lifetime value. For this purpose one of the biggest parts of service sector in Iran is selected and the data from this sector are gathered and analyzed. Banking sector is the biggest body of Iranian service sector of economy. By means of a valid questionnaire, data were gathered from banking sector and after analyzing the hypotheses, results show that the high customer loyalty strongly affects on the enhanced customer lifetime value. In the final section of this paper, both applied and theoretical recommendations will be provided.

  3. 77 FR 27252 - Veterans' Employment and Training; Veterans Workforce Investment Program

    Science.gov (United States)

    2012-05-09

    ... service delivery systems that will address the complex employability problems facing eligible veterans; and (c) to increase the skills and competency level of veteran participants through longer-term...

  4. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  5. 2007 Veterans Employability Research Survey

    Data.gov (United States)

    Department of Veterans Affairs — The 2007 Veterans Employability Research Survey (VERS) was conducted to determine the factors that impact veterans' employability resulting from participation in the...

  6. Veterans Affairs Intensive Case Management for older veterans.

    Science.gov (United States)

    Mohamed, Somaia; Neale, Michael S; Rosenheck, Robert

    2009-08-01

    There is a growing need for information on evidence-based practices that may potentially address needs of elderly people with severe mental illness (SMI), and more specifically on community-based services such as assertive community treatment (ACT). This study examines national evaluation data from fiscal year 2001-2005 from Veterans Affairs Mental Health Intensive Case Management (MHICM) program (N = 5,222), an ACT-based service model, to characterize the age distribution of participants and the distinctive needs, patterns of service delivery, and treatment outcomes for elderly veterans. Altogether, 24.8% of participants were 55-64 years; 7.4% 65-74 years; and 2.8% were older than 75. Veterans over 75 formed a distinct subgroup that had a later age of onset of primarily nonpsychotic illnesses without comorbid substance abuse and had experienced more limited lifetime hospital treatment than younger participants. Older veterans were less symptomatic and more satisfied with their social relationships than younger clients. They mostly live independently or in minimally restrictive housing, but they received less recovery-focused services and more crisis intervention and medical services. They thus do not appear to be young patients with SMI who have aged but rather constitute a distinct group with serious late-onset problems. It is possible that MHICM services keep them in the community and avoid costly nursing home placement while providing a respite service that reduces family burden. These data highlight the unique characteristics of older veterans receiving ACT-like services and the need to focus greater attention on recovery-oriented services as well as community support for this subgroup.

  7. Mass Customization: more technology, less publicity and customer satisfaction

    Directory of Open Access Journals (Sweden)

    Mônica Heloísa Braga Vasques

    2007-11-01

    Full Text Available This article refers to mass customization as an individual marketing strategy, centered on costumer's order, by means of technology, emphasizing the sensibility, the flexibility and the elasticity. Such an approach is based on the mass customization advantages and its principles of flexibility: the postponement, the resenquencing and the process standardization. Moreover, the article refers to the Hewlett-Packard, (PCs success, due to its power of integrating the designs of products, processes and supply network. We can, thus, think about the end of the advertisement. So, the old message: “Buy it now!” is not worthwhile anymore. The intelligence, nowadays, by means of technology, creates a "fatal", customized relationship with each customer. And it sells much more.

  8. Using customer-focused research and design to build a self-service online store: a case study

    Directory of Open Access Journals (Sweden)

    Ahmadi MB

    2013-02-01

    Full Text Available Michael B Ahmadi,1 William Trefzger,2 Rich Morey,1 Ileana Quintas31Substance Abuse and Mental Health Services Administration, Rockville, 2Centers for Medicare and Medicaid Services, Baltimore, 3IQ Solutions, Inc, Rockville, MD, USAAbstract: American government information centers need to be responsive to an increasingly customer driven information environment while ensuring the sustainability of operations. Enhanced self-service options offer one avenue for addressing both of these needs. This article presents a case study of how the US Substance Abuse and Mental Health Services Administration used extensive stakeholder research and a customer-centric design to reframe its service model by building a self-service online store that integrates access to more than 1300 behavioral health publications previously housed in two separate clearinghouses. The redesigned Substance Abuse and Mental Health Services Administration Store offers users a modern e-commerce website that not only helps customers find, order, download, and share products, but also encourages serendipitous content exploration, which has led to increased orders containing both substance abuse and mental health publications.Keywords: customer research, taxonomy, usability testing, web analytics, web design

  9. 75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

    Science.gov (United States)

    2010-04-27

    ... Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into Employment... addresses complex problems facing Homeless Female Veterans and/or Veterans with Families eligible to... (including job readiness, literacy training, and skills training) to expedite the reintegration of homeless...

  10. Mass Customization Measurements Metrics

    DEFF Research Database (Denmark)

    Nielsen, Kjeld; Brunø, Thomas Ditlev; Jørgensen, Kaj Asbjørn

    2014-01-01

    A recent survey has indicated that 17 % of companies have ceased mass customizing less than 1 year after initiating the effort. This paper presents measurement for a company’s mass customization performance, utilizing metrics within the three fundamental capabilities: robust process design, choice...... navigation, and solution space development. A mass customizer when assessing performance with these metrics can identify within which areas improvement would increase competitiveness the most and enable more efficient transition to mass customization....

  11. National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses

    Data.gov (United States)

    Department of Veterans Affairs — The 2010 National Survey of Veterans (NSV) is the sixth in a series of comprehensive nationwide surveys designed to help the Department of Veterans Affairs (VA) plan...

  12. Korean War Veterans by State

    Data.gov (United States)

    Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...

  13. Modeling the customer in electronic commerce.

    Science.gov (United States)

    Helander, M G; Khalid, H M

    2000-12-01

    This paper reviews interface design of web pages for e-commerce. Different tasks in e-commerce are contrasted. A systems model is used to illustrate the information flow between three subsystems in e-commerce: store environment, customer, and web technology. A customer makes several decisions: to enter the store, to navigate, to purchase, to pay, and to keep the merchandize. This artificial environment must be designed so that it can support customer decision-making. To retain customers it must be pleasing and fun, and create a task with natural flow. Customers have different needs, competence and motivation, which affect decision-making. It may therefore be important to customize the design of the e-store environment. Future ergonomics research will have to investigate perceptual aspects, such as presentation of merchandize, and cognitive issues, such as product search and navigation, as well as decision making while considering various economic parameters. Five theories on e-commerce research are presented.

  14. Military veterans and Social Security.

    Science.gov (United States)

    Olsen, Anya

    There are 9.4 million military veterans receiving Social Security benefits, which means that almost one out of every four adult Social Security beneficiaries has served in the United States military. In addition, veterans and their families make up almost 40 percent of the adult Social Security beneficiary population. Policymakers are particularly interested in military veterans and their families and have provided them with benefits through several government programs, including Social Security credits, home loan guarantees, and compensation and pension payments through the Department of Veterans Affairs. It is therefore important to understand the economic and demographic characteristics of this population. Information in this article is based on data from the March 2004 Current Population Survey, a large, nationally representative survey of U.S. households. Veterans are overwhelmingly male compared with all adult Social Security beneficiaries who are more evenly split between males and females. Military veterans receiving Social Security are more likely to be married and to have finished high school compared with all adult Social Security beneficiaries, and they are less likely to be poor or near poor than the overall beneficiary population. Fourteen percent of veterans receiving Social Security benefits have income below 150 percent of poverty, while 25 percent of all adult Social Security beneficiaries are below this level. The higher economic status among veterans is also reflected in the relatively high Social Security benefits they receive. The number of military veterans receiving Social Security benefits will remain high over the next few decades, while their make-up and characteristics will change. In particular, the number of Vietnam War veterans who receive Social Security will increase in the coming decades, while the number of veterans from World War II and the Korean War will decline.

  15. Competitive Effects of Mass Customization

    OpenAIRE

    Oksana Loginova

    2010-01-01

    Earlier theoretical literature on mass customization maintains that customization reduces product differentiation and intensifies price competition. In contrast, operations management studies argue that customization serves primarily to differentiate a company from its competitors. Interactive involvement of the customer in product design creates an affective relationship with the firm, relaxing price competition. This paper provides a model that incorporates consumer involvement to explain t...

  16. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  17. Veterans' Employment and Training Service

    Science.gov (United States)

    ... Find a Job Veterans.Gov Apprenticeship Occupations and Careers Women Who Served Programs & Services Transition GPS Frequently Asked Questions Hire a Veteran Find qualified Veterans Policy & Compliance Employer Toolkit Apprenticeships HIRE Vets Medallion Program Service Providers Grants & ...

  18. Custom chipset and compact module design for a 75–110 GHz laboratory signal source

    International Nuclear Information System (INIS)

    Morgan, Matthew A; Boyd, Tod A; Castro, Jason J

    2016-01-01

    We report on the development and characterization of a compact, full-waveguide bandwidth (WR-10) signal source for general-purpose testing of mm-wave components. The monolithic microwave integrated circuit (MMIC) based multichip module is designed for compactness and ease-of-use, especially in size-constrained test sets such as a wafer probe station. It takes as input a cm-wave continuous-wave (CW) reference and provides a factor of three frequency multiplication as well as amplification, output power adjustment, and in situ output power monitoring. It utilizes a number of custom MMIC chips such as a Schottky-diode limiter and a broadband mm-wave detector, both designed explicitly for this module, as well as custom millimeter-wave multipliers and amplifiers reported in previous papers. (paper)

  19. World war II veterans, social support, and veterans' associations.

    Science.gov (United States)

    Hunt, N; Robbins, I

    2001-05-01

    People use many different coping strategies to deal with their traumatic recollections. Twenty-five British World War II veterans were interviewed regarding the ways they used social support both during the war and in the years afterwards. The findings demonstrate that social support is used in fundamentally different ways. During the war comradeship was particularly important and even fifty years after the war comrades are still a valuable resource for discussing war experiences, and dealing with the emotional content of traumatic recollections. Veterans rely on wives and families to help deal with the more physical and practical elements of coping, but tend not to discuss their traumatic memories with them. The findings show that social support is an important lifelong coping strategy for World War II veterans.

  20. Mail-order pharmacy experience of veterans living with AIDS/HIV.

    Science.gov (United States)

    Desai, Karishma Rohanraj; Chewning, Betty; Wilcox, Andrew; Safdar, Nasia

    2018-02-01

    The VA system is the largest single provider of healthcare in the United States and to individuals infected with HIV specifically. High quality medication management is particularly important since HIV is a chronic infectious condition which requires taking multiple medications with strict requirements for adherence to medication regimens. Veterans Administration (VA) patients are required to obtain all chronic medications using the VA mail-order pharmacy system. Drawing on Donabedian's Quality Improvement framework, this study sought to examine experiences that Veterans with HIV have with the Veterans Administration medication mail-order system, and to explore opportunities for quality improvement. A sequential, explanatory mixed-methods design was used to interview Veterans receiving care at a Midwestern Veterans Administration Hospital using a mail-order experience survey followed by in-depth interviews. All 57 Veterans, out of 72, who were successfully contacted consented to participate. Overall, Veterans evaluated the mail-order service positively and valued the accuracy (correct medication delivery). However, a notable problem emerged with respect to assuring access to HIV medications with about half (47%) indicating running out of HIV medication. Respondents identified structural issues with respect to days covered by mailed medications (90 versus current 30 days) and process issues with scheduling new refills. Veterans also indicated the information sheets were too long, complex and not helpful for their queries. Patients were open to pharmacists playing an active role during clinic visits and felt this would help manage their conditions better. Veterans generally reported that the VA Mail-order service was of high quality. However, some findings indicate there are opportunities to improve this service to be more patient-centered particularly for vulnerable HIV patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Linkages between organization climate and work outcomes: perceptual differences among health service professionals as a function of customer contact intensity.

    Science.gov (United States)

    Scotti, Dennis J; Harmon, Joel

    2014-01-01

    The delivery of high-quality service, rendered by health service professionals who interact with customers (patients), increases the likelihood that customers will form positive evaluations of the quality of their service encounters as well as high levels of customer satisfaction. Using linkage theory to develop our conceptual framework, we identify four clusters of variables which contribute to a chain of sequential events that connect organization climate to personal and operational work outcomes. We then examine the perceptual differences of service professionals, grouped by intensity of customer contact, with respect to these variables. National data for this project were obtained from multiple sources made available by the Veterans Healthcare Administration (VHA). Cross-group differences were tested using a series of variance analyses. The results indicate that level of customer-contact intensity plays a significant role in explaining variation in perceptions of support staff, clinical practitioners, and nurses at the multivariate and univariate levels of analysis. Contact intensity appears to be a core determinant of the nature of work performed by health service professionals as well as their psychological responses to organizational and customer-related dynamics. Health service professionals are important resources because of their specialized knowledge, labor expense, and scarcity. Based on findings from our research, managers are advised to survey employees' perceptions of their organizational environment and design practices that respond to the unique viewpoints of each of the professional groups identified in this study. Such tailoring should help executives maximize the value of investments in human resources by underwriting patient satisfaction and financial sustainability.

  2. Veterans Crisis Line: 1-800-273-8255

    Science.gov (United States)

    Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... Line FAQs Veteran Suicide Welcome to the Veterans Crisis Line Website The Veterans Crisis Line connects Veterans ...

  3. Customer Integration during Innovation Development

    DEFF Research Database (Denmark)

    Pedrosa, Alex

    2012-01-01

    of companies’ growing interest in effectively collaborating with customers, research has investigated the importance of firm–customer interaction during innovation development. However, despite valuable insights into the performance-enhancing effects of customer integration, research has thus far overlooked......To stay viable, companies need to increase their innovation development investments over time. However, successful innovation development also cannot happen without customers, and thus companies seek opportunities to enhance their knowledge of current and future customer needs. As a result...... the activities companies should engage in when integrating customers during innovation development. Thus, this study investigates how and when customer-oriented companies engage in customer interaction during innovation development. Using a multiple case study design, this study examines four substantive cases...

  4. Variation-Aware Design of Custom Integrated Circuits A Hands-on Field Guide A Hands-on Field Guide

    CERN Document Server

    McConaghy, Trent; Dyck, Jeffrey; Gupta, Amit

    2013-01-01

    This book targets custom IC designers who are encountering variation issues in their designs, especially for modern process nodes at 45nm and below, such as statistical process variations, environmental variations, and layout effects.  The authors have created a field guide to show how to handle variation proactively, and to understand the benefits of doing so. Readers facing variation challenges in their memory, standard cell, analog/RF, and custom digital designs will find easy-to-read, pragmatic solutions.   Reviews the most important concepts in variation-aware design, including types of variables and variation, useful variation-aware design terminology, and an overview and comparison of high-level design flows. Describes and compares a suite of approaches and flows for PVT corner-driven design and verification. Presents Fast PVT, a novel, confidence-driven global optimization technique for PVT corner extraction and verification that is both rapid and reliable. Presents a visually-oriented overview of ...

  5. Military sexual trauma among homeless veterans.

    Science.gov (United States)

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  6. THE IMPACTS OF PHILANTHROPY RESPONSIBILITY AND ETHICAL RESPONSIBILITY TOWARD CUSTOMER PURCHASE BEHAVIOR AND CUSTOMER LOYALTY

    OpenAIRE

    Kurniawati Chrisjatmiko; Danthy Margareth

    2018-01-01

    The purpose of this research is to analyze the impact of philanthropy responsibility and ethical responsibility towards customer purchase behavior and customer loyalty on fast food restaurants. The research was conducted by using quantitative research design and hypothetical testing to explore philanthropic responsibility, ethical responsibility, customer purchase behavior, and customer loyalty variables. Samples were taken from 186 respondents of employee population in Jakarta. Structural eq...

  7. 38 CFR 3.454 - Veterans disability pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Veterans disability pension. 3.454 Section 3.454 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Apportionments § 3.454 Veterans...

  8. Comprehensive Support for Family Caregivers of Post-9/11 Veterans Increases Veteran Utilization of Long-term Services and Supports: A Propensity Score Analysis

    Science.gov (United States)

    Shepherd-Banigan, Megan; Smith, Valerie A.; Stechuchak, Karen M.; Miller, Katherine E. M.; Hastings, Susan Nicole; Wieland, Gilbert Darryl; Olsen, Maren K.; Kabat, Margaret; Henius, Jennifer; Campbell-Kotler, Margaret; Van Houtven, Courtney Harold

    2018-01-01

    Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P.L. 111-163 for family caregivers of seriously injured post-9/11 Veterans) on Veteran use of LTSS. A two-cohort pre-post design with a nonequivalent comparison group (treated n = 15 650; comparison n = 8339) was used to (1) examine the association between caregiver enrollment in PCAFC and any VA-purchased or VA-provided LTSS use among Veterans and (2) describe program-related trends in HCBS and institutional LTSS use. The comparison group was an inverse-propensity-score weighted sample of Veterans whose caregivers applied for, but were not accepted into, the program. From baseline through 24 months post application, use of any LTSS ranged from 13.1% to 17.8% for Veterans whose caregivers were enrolled in PCAFC versus from 3.8% to 5.3% for Veterans in the comparison group. Participation in PCAFC was associated with a statistically significant increased use of any LTSS from 1 to 24 months post application (over time odds ratios ranged from 2.71 [95% confidence interval: 2.31-3.17] to 4.86 [3.93-6.02]). Support for family caregivers may enhance utilization of LTSS for Veterans with physical, emotional, and/or cognitive conditions. PMID:29591540

  9. Customization and design of directed self-assembly using hybrid prepatterns

    Science.gov (United States)

    Cheng, Joy; Doerk, Gregory S.; Rettner, Charles T.; Singh, Gurpreet; Tjio, Melia; Truong, Hoa; Arellano, Noel; Balakrishnan, Srinivasan; Brink, Markus; Tsai, Hsinyu; Liu, Chi-Chun; Guillorn, Michael; Sanders, Daniel P.

    2015-03-01

    Diminishing error tolerance renders the customization of patterns created through directed self-assembly (DSA) extremely challenging at tighter pitch. A self-aligned customization scheme can be achieved using a hybrid prepattern comprising both organic and inorganic regions that serves as a guiding prepattern to direct the self-assembly of the block copolymers as well as a cut mask pattern for the DSA arrays aligned to it. In this paper, chemoepitaxy-based self-aligned customization is demonstrated using two types of organic-inorganic prepatterns. CHEETAH prepattern for "CHemoepitaxy Etch Trim using a self-Aligned Hardmask" of preferential hydrogen silsesquioxane (HSQ, inorganic resist), non-preferential organic underlayer is fabricated using electron beam lithography. Customized trench or hole arrays can be achieved through co-transfer of DSA-formed arrays and CHEETAH prepattern. Herein, we also introduce a tone-reversed version called reverse-CHEETAH (or rCHEETAH) in which customized line segments can be achieved through co-transfer of DSA-formed arrays formed on a prepattern wherein the inorganic HSQ regions are nonpreferential and the organic regions are PMMA preferential. Examples of two-dimensional self-aligned customization including 25nm pitch fin structures and an 8-bar "IBM" illustrate the versatility of this customization scheme using rCHEETAH.

  10. Alcohol and Drug Abuse Among U.S. Veterans: Comparing Associations with Intimate Partner Substance Abuse and Veteran Psychopathology

    Science.gov (United States)

    Miller, Mark W.; Reardon, Annemarie F.; Wolf, Erika J.; Prince, Lauren B.; Hein, Christina L.

    2013-01-01

    This study examined the relative influences of PTSD, other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. PMID:23325433

  11. Nature and determinants of suicidal ideation among U.S. veterans: Results from the national health and resilience in veterans study.

    Science.gov (United States)

    Smith, Noelle B; Mota, Natalie; Tsai, Jack; Monteith, Lindsey; Harpaz-Rotem, Ilan; Southwick, Steven M; Pietrzak, Robert H

    2016-06-01

    Suicidal thoughts and behaviors among U.S. military veterans are a major public health concern. To date, however, scarce data are available regarding the nature and correlates of suicidal ideation (SI) among U.S. veterans. This study evaluated the prevalence and correlates of suicidal ideation in a contemporary, nationally representative, 2-year prospective cohort study. Data were analysed from a total of 2157 U.S. veterans who participated in the National Health and Resilience Veterans Study (NHRVS; Wave 1 conducted in 2011; Wave 2 in 2013). Veterans completed measures assessing SI, sociodemographic characteristics, and potential risk and protective correlates. The majority of veterans (86.3%) denied SI at either time point, 5.0% had SI onset (no SI at Wave 1, SI at Wave 2), 4.9% chronic SI (SI at Waves 1 and 2), and 3.8% had remitted SI (SI at Wave 1, no SI Wave 2). Greater Wave 1 psychiatric distress was associated with increased likelihood of chronic SI (relative risk ratio [RRR]=3.72), remitted SI (RRR=3.38), SI onset (RRR=1.48); greater Wave 1 physical health difficulties were additionally associated with chronic SI (RRR=1.64) and SI onset (RRR=1.47); and Wave 1 substance abuse history was associated with chronic SI (RRR 1.57). Greater protective psychosocial characteristics (e.g., resilience, gratitude) at Wave 1 were negatively related to SI onset (RRR=0.57); and greater social connectedness at Wave 1, specifically perceived social support and secure attachment style, was negatively associated with SI onset (RRR=0.75) and remitted SI (RRR=0.44), respectively. Suicidal ideation was assessed using a past two-week timeframe, and the limited duration of follow-up precludes conclusions regarding more dynamic changes in SI over time. These results indicate that a significant minority (13.7%) of U.S. veterans has chronic, onset, or remitted SI. Prevention and treatment efforts designed to mitigate psychiatric and physical health difficulties, and bolster social

  12. Challenges and opportunities in multichannel customer management

    NARCIS (Netherlands)

    Neslin, Scott A.; Grewal, Dhruv; Leghorn, Robert; Shankar, Venkatesh; Teerling, Marije L.; Thomas, Jacquelyn S.; Verhoef, Peter C.

    Multichannel customer management is the design, deployment, coordination, and evaluation of channels through which firms and customers interact, with the goal of enhancing customer value through effective customer acquisition, retention, and development. The authors identify five major challenges

  13. Challenges and opportunities in multichannel customer management

    NARCIS (Netherlands)

    Neslin, Scott A.; Grewal, Dhruv; Leghorn, Robert; Shankar, Venkatesh; Teerling, Marije L.; Thomas, Jacquelyn S.; Verhoef, Peter C.

    2006-01-01

    Multichannel customer management is the design, deployment, coordination, and evaluation of channels through which firms and customers interact, with the goal of enhancing customer value through effective customer acquisition, retention, and development. The authors identify five major challenges

  14. E-CUSTOMS PROGRAMME - NEW QUALITY OF SERVICES PROVIDED BY CUSTOMS ADMINISTRATIONS TO EUROPEAN BUSINESS

    Directory of Open Access Journals (Sweden)

    Małgorzata Czermińska

    2016-09-01

    Full Text Available E-Customs initiative includes a number of IT projects, organizational and legal measures. They are designed to creation of a simple and paperless environment for trade and customs, to short the duration of customs clearance and to ensure an appropriate level of security of commercial transactions. Modern customs administration must operate on the basis of advanced infrastructure in the field of information and communication technologies. Only then will it be able to provide cheaper and more efficient customs services. Therefore, the greatest challenge and the main goal of the e-Customs programme is to harmonize customs procedures and systems in the 28 Member States. The article describes the assumptions and objectives of the e-Customs, presents its genesis and evolution. Particular attention was paid to the activities that are aimed at improving the quality of customs services provided to European companies.

  15. Minority Veteran Report 2014

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  16. Measuring Customer Profitability in Complex Environments

    DEFF Research Database (Denmark)

    Holm, Morten; Kumar, V.; Rohde, Carsten

    2012-01-01

    Customer profitability measurement is an important element in customer relationship management and a lever for enhanced marketing accountability. Two distinct measurement approaches have emerged in the marketing literature: Customer Lifetime Value (CLV) and Customer Profitability Analysis (CPA...... propositions. Additionally, the framework provides design and implementation guidance for managers seeking to implement customer profitability measurement models for resource allocation purposes....... that the degree of sophistication deployed when implementing customer profitability measurement models is determined by the type of complexity encountered in firms’ customer environments. This gives rise to a contingency framework for customer profitability measurement model selection and five research...

  17. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  18. Veterans Affairs Suicide Prevention Synthetic Dataset

    Data.gov (United States)

    Department of Veterans Affairs — The VA's Veteran Health Administration, in support of the Open Data Initiative, is providing the Veterans Affairs Suicide Prevention Synthetic Dataset (VASPSD). The...

  19. Assesment of customer relationship development

    Directory of Open Access Journals (Sweden)

    Dagmar Lesáková

    2011-01-01

    Full Text Available The focus of this paper is customer relationship marketing and its new trends. The particular goal of the presented research study was to identify and analyse the indicators of customer relationship development in human resources recruitment / leasing companies. Nine indicators have been explored: mission statement concerning customer commitment, customer attraction, customer commitment, development of customer value, understanding customer needs, goals for customer satisfaction, after sales services, measurement of customer satisfaction, complaint management. The indicators were made sequentially operational in order to translate customer relationship development into specific activities designed to increase business performance. Based on a set of customer indicators four scientific hypotheses were tested. We proved that strong customer orientation has a positive impact on business performance. Out of nine indicators, seven of them have a strong impact on business outcomes. The research confirms that business performance increases with firm size and market density, and that introduction of quality management systems improves company performance. Finally, the appropriateness of the customer relationship indicators applied in human resources recruitment companies is discussed.

  20. Longitudinal Cognitive Trajectories of Women Veterans from the Women’s Health Initiative Memory Study

    Science.gov (United States)

    Padula, Claudia B.; Weitlauf, Julie C.; Rosen, Allyson C.; Reiber, Gayle; Cochrane, Barbara B.; Naughton, Michelle J.; Li, Wenjun; Rissling, Michelle; Yaffe, Kristine; Hunt, Julie R.; Stefanick, Marcia L.; Goldstein, Mary K.; Espeland, Mark A.

    2016-01-01

    Purpose of the Study: A comparison of longitudinal global cognitive functioning in women Veteran and non-Veteran participants in the Women’s Health Initiative (WHI). Design and Methods: We studied 7,330 women aged 65–79 at baseline who participated in the WHI Hormone Therapy Trial and its ancillary Memory Study (WHIMS). Global cognitive functioning (Modified Mini-Mental State Examination [3MSE]) in Veterans (n = 279) and non-Veterans (n = 7,051) was compared at baseline and annually for 8 years using generalized linear modeling methods. Results: Compared with non-Veterans, Veteran women were older, more likely to be Caucasian, unmarried, and had higher rates of educational and occupational attainment. Results of unadjusted baseline analyses suggest 3MSE scores were similar between groups. Longitudinal analyses, adjusted for age, education, ethnicity, and WHI trial assignment revealed differences in the rate of cognitive decline between groups over time, such that scores decreased more in Veterans relative to non-Veterans. This relative difference was more pronounced among Veterans who were older, had higher educational/occupational attainment and greater baseline prevalence of cardiovascular risk factors (e.g., smoking) and cardiovascular disease (e.g., angina, stroke). Implications: Veteran status was associated with higher prevalence of protective factors that may have helped initially preserve cognitive functioning. However, findings ultimately revealed more pronounced cognitive decline among Veteran relative to non-Veteran participants, likely suggesting the presence of risks that may impact neuropathology and the effects of which were initially masked by Veterans’ greater cognitive reserve. PMID:26615021

  1. Customer Order Decoupling Point Selection Model in Mass Customization Based on MAS

    Institute of Scientific and Technical Information of China (English)

    XU Xuanguo; LI Xiangyang

    2006-01-01

    Mass customization relates to the ability of providing individually designed products or services to customer with high process flexibility or integration. Literatures on mass customization have been focused on mechanism of MC, but little on customer order decoupling point selection. The aim of this paper is to present a model for customer order decoupling point selection of domain knowledge interactions between enterprises and customers in mass customization. Based on the analysis of other researchers' achievements combining the demand problems of customer and enterprise, a model of group decision for customer order decoupling point selection is constructed based on quality function deployment and multi-agent system. Considering relatively the decision makers of independent functional departments as independent decision agents, a decision agent set is added as the third dimensionality to house of quality, the cubic quality function deployment is formed. The decision-making can be consisted of two procedures: the first one is to build each plane house of quality in various functional departments to express each opinions; the other is to evaluate and gather the foregoing sub-decisions by a new plane quality function deployment. Thus, department decision-making can well use its domain knowledge by ontology, and total decision-making can keep simple by avoiding too many customer requirements.

  2. Health Disparities in Veterans: A Map of the Evidence.

    Science.gov (United States)

    Kondo, Karli; Low, Allison; Everson, Teresa; Gordon, Christine D; Veazie, Stephanie; Lozier, Crystal C; Freeman, Michele; Motu'apuaka, Makalapua; Mendelson, Aaron; Friesen, Mark; Paynter, Robin; Friesen, Caroline; Anderson, Johanna; Boundy, Erin; Saha, Somnath; Quiñones, Ana; Kansagara, Devan

    2017-09-01

    Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health. We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence. We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome. Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

  3. Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.

    Science.gov (United States)

    Park, Linda G; Collins, Eileen G; Shim, Janet K; Whooley, Mary A

    2017-07-18

    Adherence to antiplatelet medications is critical to prevent life threatening complications (ie, stent thrombosis) after percutaneous coronary interventions (PCIs), yet rates of nonadherence range from 21-57% by 12 months. Mobile interventions delivered via text messaging or mobile apps represent a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The Mobile4Meds study seeks to determine whether text messaging or a mobile app, compared with an educational website control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome (ACS) or PCI. The three aims of the study are to: (1) determine preferences for content and frequency of text messaging to promote medication adherence through focus groups; (2) identify the most patient-centered app that promotes adherence, through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and (3) compare adherence to antiplatelet medications in Veterans after ACS/PCI via a randomized clinical trial (RCT). We will utilize a mixed-methods design that uses focus groups to achieve the first and second aims (N=32). Patients will be followed for 12 months after being randomly assigned to one of three arms: (1) customized text messaging, (2) mobile app, or (3) website-control groups (N=225). Medication adherence will be measured with electronic monitoring devices, pharmacy records, and self-reports. Enrollment for the focus groups is currently in progress. We expect to enroll patients for the RCT in the beginning of 2018. Determining the efficacy of mobile technology using a Veteran-designed protocol to promote medication adherence will have a significant impact on Veteran health and public health, particularly for individuals with chronic diseases that require strict medication adherence. ClinicalTrials.gov NCT03022669. ©Linda G Park, Eileen G Collins, Janet K

  4. D-Day for Veterans' Jobs

    Science.gov (United States)

    Nathan, Robert R.

    1977-01-01

    Focuses on the unemployment problem among Vietnam veterans and on the various Federal and private employment programs open to these veterans. Discussion also covers labor force statistics, readjustment to civilian life, changes in the American economy, and the role of the Department of Defense and civilian employers in helping veterans to find…

  5. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  6. Impact of Rate Design Alternatives on Residential Solar Customer Bills. Increased Fixed Charges, Minimum Bills and Demand-based Rates

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Davidson, Carolyn [National Renewable Energy Lab. (NREL), Golden, CO (United States); McLaren, Joyce [National Renewable Energy Lab. (NREL), Golden, CO (United States); Miller, John [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    With rapid growth in energy efficiency and distributed generation, electric utilities are anticipating stagnant or decreasing electricity sales, particularly in the residential sector. Utilities are increasingly considering alternative rates structures that are designed to recover fixed costs from residential solar photovoltaic (PV) customers with low net electricity consumption. Proposed structures have included fixed charge increases, minimum bills, and increasingly, demand rates - for net metered customers and all customers. This study examines the electricity bill implications of various residential rate alternatives for multiple locations within the United States. For the locations analyzed, the results suggest that residential PV customers offset, on average, between 60% and 99% of their annual load. However, roughly 65% of a typical customer's electricity demand is non-coincidental with PV generation, so the typical PV customer is generally highly reliant on the grid for pooling services.

  7. Veterans Like Me: Formative evaluation of a patient decision aid design.

    Science.gov (United States)

    Gibson, Bryan; Butler, Jorie; Doyon, Katherine; Ellington, Lee; Bray, Bruce E; Zeng, Qing

    2017-07-01

    Patient decision aids are tools intended to facilitate shared decision-making. Currently development of a patient decision aid is resource intensive: it requires a decision-specific review of the scientific literature by experts to ascertain the potential outcomes under different treatments. The goal of this project was to conduct a formative evaluation of a generalizable, scalable decision aid component we call Veterans Like Me (VLme). VLme mines EHR data to present the outcomes of individuals "like you" on different treatments to the user. These outcome are presented through a combination of an icon array and simulated narratives. Twenty-six patients participated in semi-structured interviews intended to elicit feedback on the tool's functional and interface design. The interview focused on the filters users desired with which to make cases similar to them, the kinds of outcomes they wanted presented, and their envisioned use of the tool. The interview also elicited participants information needs and salient factors related to the therapeutic decision. The interview transcripts were analyzed using an iteratively refined coding schema and content analysis. . Participants generally expressed enthusiasm for the tool's design and functionality. Our analysis identified desired filters for users to view patients like themselves, outcome types that should be included in future iterations of the tool (e.g. patient reported outcomes), and information needs that need to be addressed for patients to effectively participate in shared decision making. Implications for the integration of our findings into the design of patient decision aids are discussed. Published by Elsevier Inc.

  8. Profile of Vietnam War Veterans (2015).

    Data.gov (United States)

    Department of Veterans Affairs — The Profile of Vietnam War Veterans uses the 2015 ACS to provide a view into the demographic characteristics and socioeconomic conditions of the Vietnam War Veteran...

  9. Veterans’ Health Care: Limited Progress Made to Address Concerns That Led to High Risk Designation

    Science.gov (United States)

    2017-03-15

    Women Veterans. GAO-17-52. Washington , D.C.: December 2, 2016. Veterans Health Care: Improvements Needed in Operationalizing Strategic Goals and...Access to Primary Care. GAO-16-328. Washington , D.C.: March 18, 2016. DOD and VA Health Care: Actions Needed to Help Ensure Appropriate Medication...ET Wednesday, March 15, 2017 GAO-17-473T United States Government Accountability Office United States Government Accountability Office

  10. 38 CFR 3.401 - Veterans.

    Science.gov (United States)

    2010-07-01

    ... compensation payable by reason of need for aid and attendance or housebound status shall also be awarded for... claim additional disability compensation payable to a veteran by reason of the veteran's spouse's need....) (Authority: 38 U.S.C. 5110 (f), (n)) (c) Divorce of veteran and spouse. See § 3.501(d). (d) Institutional...

  11. VA Veterans Health Administration Access Data

    Data.gov (United States)

    Department of Veterans Affairs — At the Department of Veterans Affairs (VA), our most important mission is to provide the high quality health care and benefits Veterans have earned and deserve —...

  12. Alcohol and drug abuse among U.S. veterans: comparing associations with intimate partner substance abuse and veteran psychopathology.

    Science.gov (United States)

    Miller, Mark W; Reardon, Annemarie F; Wolf, Erika J; Prince, Lauren B; Hein, Christina L

    2013-02-01

    This study examined the relative influences of posttraumatic stress disorder (PTSD), other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. Published 2013. This article is a US Government work and is in the public domain in the USA.

  13. Determining customer satisfaction in anatomic pathology.

    Science.gov (United States)

    Zarbo, Richard J

    2006-05-01

    Measurement of physicians' and patients' satisfaction with laboratory services has become a standard practice in the United States, prompted by national accreditation requirements. Unlike other surveys of hospital-, outpatient care-, or physician-related activities, no ongoing, comprehensive customer satisfaction survey of anatomic pathology services is available for subscription that would allow continual benchmarking against peer laboratories. Pathologists, therefore, must often design their own local assessment tools to determine physician satisfaction in anatomic pathology. To describe satisfaction survey design that would elicit specific information from physician customers about key elements of anatomic pathology services. The author shares his experience in biannually assessing customer satisfaction in anatomic pathology with survey tools designed at the Henry Ford Hospital, Detroit, Mich. Benchmarks for physician satisfaction, opportunities for improvement, and characteristics that correlated with a high level of physician satisfaction were identified nationally from a standardized survey tool used by 94 laboratories in the 2001 College of American Pathologists Q-Probes quality improvement program. In general, physicians are most satisfied with professional diagnostic services and least satisfied with pathology services related to poor communication. A well-designed and conducted customer satisfaction survey is an opportunity for pathologists to periodically educate physician customers about services offered, manage unrealistic expectations, and understand the evolving needs of the physician customer. Armed with current information from physician customers, the pathologist is better able to strategically plan for resources that facilitate performance improvements in anatomic pathology laboratory services that align with evolving clinical needs in health care delivery.

  14. Department of Veterans Affairs, Gulf War Veterans’ Illnesses Task Force to the Secretary of Veterans Affairs

    Science.gov (United States)

    2010-09-29

    National Health and Nutrition Examination Survey (NHANES); and the National Health Interview Survey ( NHIS ). As of July 1, 2010, VA has submitted to...NHANES and NHIS staff specific questions that if answered positively, will identify Veteran study subjects beginning in 2011 in both these National...several discussions with investigators on the NHANES and NHIS . Staffs from both surveys are willing to include Veteran-specific questions and to plan

  15. Design and milling manufacture of polyurethane custom contoured cushions for wheelchair users

    Directory of Open Access Journals (Sweden)

    Wilson Kindlein Junior

    2011-09-01

    Full Text Available BackgroundThe design of custom contoured cushions manufactured inflexible polyurethane foams is an option to improvepositioning and comfort for people with disabilities thatspend most of the day seated in the same position. Thesesurfaces increase the contact area between the seat and theuser. This fact contributes to minimise the local pressuresthat can generate problems like decubitus ulcers. Thepresent research aims at establishing development routesfor custom cushion production to wheelchair users. Thisstudy also contributes to the investigation of ComputerNumerical Control (CNC machining of flexible polyurethanefoams.MethodThe proposed route to obtain the customised seat beganwith acquiring the user’s contour in adequate posturethrough plaster cast. To collect the surface geometry, thecast was three-dimensionally scanned and manipulated inCAD/CAM software. CNC milling parameters such as tools,spindle speeds and feed rates to machine flexiblepolyurethane foams were tested. These parameters wereanalysed regarding the surface quality. The best parameterswere then tested in a customised seat. The possibledimensional changes generated during foam cutting wereanalysed through 3D scanning. Also, the customised seatpressure and temperature distribution was tested.ResultsThe best parameters found for foams with a density of50kg/cm3 were high spindle speeds (24000 rpm and feedrates between 2400–4000mm/min. Those parameters didnot generate significant deformities in the machinedcushions. The custom contoured cushion satisfactorilyincreased the contact area between wheelchair and user, asit distributed pressure and heat evenly.ConclusionThrough this study it was possible to define routes for thedevelopment and manufacturing of customised seats usingdirect CNC milling in flexible polyurethane foams. It alsoshowed that custom contoured cushions efficientlydistribute pressure and temperature, which is believed tominimise tissue lesions such as pressure

  16. The effect of customer relationship management on customer loyalty: Evidence from banking industry

    Directory of Open Access Journals (Sweden)

    Hadi Hajiyan

    2015-11-01

    Full Text Available Measuring customer satisfaction in banking industry plays essential role for increasing market share and profitability. In this paper, we present an empirical investigation to measure the effect of customer relationship management (CRM on customer loyalty in Iranian banking industry. The study aims to understand whether implementation of a good CRM could increase the quality of services. The study designs a questionnaire in Likert scale and distributes it among 65 selected customers who do their banking activities with Bank Melli Iran in city of Semnan, Iran. Cronbach alpha has been calculated as 0.939, which is well above desirable level. Using t-student test, the study has determined that implementation of CRM could increase customer loyalty and quality of services.

  17. Paralyzed Veterans of America

    Science.gov (United States)

    ... Connected Twitter @PVA1946 Facebook @Paralyzed Veterans of America Instagram @PVA1946 National Veterans Wheelchair Games App Download Now ... 838-7782 CONNECT WITH US Facebook Twitter YouTube Instagram Flickr STAY INFORMED WITH NEWS & UPDATES Enter your ...

  18. Pengaruh Customer Service Quality, Customer Perceived Value, Customer Satisfaction, Customer Trust Dan Switching Barriers Terhadap Customer Retention.

    OpenAIRE

    Hardjanti, Adiati; Amalia, Dinna

    2014-01-01

    Penelitian ini bertujuan untuk mengetahui pengaruh customer service quality, customer perceived value, customer satisfaction, customer trust dan switching barriers terhadap customer retention. Rancangan penelitian yang digunakan dalam penelitian ini adalah pengujian hipotesis (testing hypotesis). Pengambilan sampel dalam penelitian ini menggunakan teknik purposive sampling dan keseluruhan hipotesis diuji dengan metode structural equation modeling yang menggunakan Amos 7.0. Data dalam peneliti...

  19. Are You Being Served? Designing the Customer Service Curriculum

    Science.gov (United States)

    Ippoliti, Cinthya

    2014-01-01

    Customer service is a core component of user experience and an important element in making patrons feel welcomed and valued within our libraries. At the University of Maryland Libraries, we took on the challenging task of creating a customer service training curriculum for all staff working at public service points and offering a digital badge for…

  20. Danish Gulf War Veterans Revisited

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Stoltenberg, Christian; Nielsen, Anni B Sternhagen

    2016-01-01

    OBJECTIVE: To examine the assumption that postdeployment incidence of sickness and other absence from work are higher among Gulf War Veterans compared with nonveterans. METHODS: A prospective registry study including a cohort of 721 Danish Gulf War Veterans and a control cohort of 3,629 nonveterans...... and nonveterans in the incidence rate of long-term sickness absence. After an initial short period (3 months) with elevated incidence rate of long-term absence from work among veterans, there was no difference between the cohorts. CONCLUSION: Among Danish Gulf War Veterans, no postdeployment increased risk...... outcomes and information on deployment history was studied using time-to-event analysis. The index date was the return date from the last deployment to the Gulf. The follow-up period was the time from index date until April 27, 2014. RESULTS: As the main finding, no difference was found between veterans...

  1. British Nuclear Test Veterans' Association. Radiation exposure and subsequent health history of veterans and their children

    International Nuclear Information System (INIS)

    Urquhart, J.

    1993-01-01

    The present study of veterans' health carried out in association with Tyne Tees Television presents new and disturbing evidence of significant health effects in both veterans and their children, based on the health records of 1,454 members of the British Nuclear Test Veterans' Association, of whom 1,147 were fathers. (orig./MG)

  2. Profit-Based Model Selection for Customer Retention Using Individual Customer Lifetime Values.

    Science.gov (United States)

    Óskarsdóttir, María; Baesens, Bart; Vanthienen, Jan

    2018-03-01

    The goal of customer retention campaigns, by design, is to add value and enhance the operational efficiency of businesses. For organizations that strive to retain their customers in saturated, and sometimes fast moving, markets such as the telecommunication and banking industries, implementing customer churn prediction models that perform well and in accordance with the business goals is vital. The expected maximum profit (EMP) measure is tailored toward this problem by taking into account the costs and benefits of a retention campaign and estimating its worth for the organization. Unfortunately, the measure assumes fixed and equal customer lifetime value (CLV) for all customers, which has been shown to not correspond well with reality. In this article, we extend the EMP measure to take into account the variability in the lifetime values of customers, thereby basing it on individual characteristics. We demonstrate how to incorporate the heterogeneity of CLVs when CLVs are known, when their prior distribution is known, and when neither is known. By taking into account individual CLVs, our proposed approach of measuring model performance gives novel insights when deciding on a customer retention campaign. The method is dependent on the characteristics of the customer base as is compliant with modern business analytics and accommodates the data-driven culture that has manifested itself within organizations.

  3. Are loyal customers profitable? : customer satisfaction, customer loyalty and customer profitability at the individual level

    OpenAIRE

    Helgesen, Øyvind

    2000-01-01

    Customer satisfaction is supposed to be positively related to profitability. This conception may be called “the paradigm of customer satisfaction”. Nevertheless, only a few studies have examined this fundamental relationship. Thus, evidence for this “much talked about relationship” is questioned. In this working paper the focus is on the individual customer with respect to the relationships between customer satisfaction, customer loyalty and customer profitability at the customer level. The f...

  4. A non-pharmacologic approach to address challenging behaviors of Veterans with dementia: description of the tailored activity program-VA randomized trial.

    Science.gov (United States)

    Gitlin, Laura N; Mann, William C; Vogel, W Bruce; Arthur, Paul B

    2013-09-23

    Behavioral symptoms accompanying dementia are associated with increased health care costs, reduced quality of life and daily functioning, heightened family caregiver burden, and nursing home placement. Standard care typically involves pharmacologic agents, but these are, at best, modestly effective, carry serious risks, including mortality, and do not address behavioral symptoms families consider most distressful and which may prompt nursing home placement. Given dementia's devastating effects and the absence of an imminent cure, the Veterans Administration has supported the development and testing of new approaches to manage challenging behaviors at home. The Tailored Activity Program - Veterans Administration is a Phase III efficacy trial designed to reduce behavioral symptoms in Veterans with dementia living with their caregivers in the community. The study uses a randomized two-group parallel design with 160 diverse Veterans and caregivers. The experimental group receives a transformative patient-centric intervention designed to reduce the burden of behavioral symptoms in Veterans with dementia. An occupational therapist conducts an assessment to identify a Veteran's preserved capabilities, deficit areas, previous roles, habits, and interests to develop activities tailored to the Veteran. Family caregivers are then trained to incorporate activities into daily care. The attention-control group receives bi-monthly telephone contact where education on topics relevant to dementia is provided to caregivers. Key outcomes include reduced frequency and severity of behavioral symptoms using the 12-item Neuropsychiatric Inventory (primary endpoint), reduced caregiver burden, enhanced skill acquisition, efficacy using activities, and time spent providing care at 4 months; and long-term effects (8 months) on the Veteran's quality of life and frequency and severity of behavioral symptoms, and caregiver use of activities. The programs' impact of Veterans Administration cost

  5. New layer-based imaging and rapid prototyping techniques for computer-aided design and manufacture of custom dental restoration.

    Science.gov (United States)

    Lee, M-Y; Chang, C-C; Ku, Y C

    2008-01-01

    Fixed dental restoration by conventional methods greatly relies on the skill and experience of the dental technician. The quality and accuracy of the final product depends mostly on the technician's subjective judgment. In addition, the traditional manual operation involves many complex procedures, and is a time-consuming and labour-intensive job. Most importantly, no quantitative design and manufacturing information is preserved for future retrieval. In this paper, a new device for scanning the dental profile and reconstructing 3D digital information of a dental model based on a layer-based imaging technique, called abrasive computer tomography (ACT) was designed in-house and proposed for the design of custom dental restoration. The fixed partial dental restoration was then produced by rapid prototyping (RP) and computer numerical control (CNC) machining methods based on the ACT scanned digital information. A force feedback sculptor (FreeForm system, Sensible Technologies, Inc., Cambridge MA, USA), which comprises 3D Touch technology, was applied to modify the morphology and design of the fixed dental restoration. In addition, a comparison of conventional manual operation and digital manufacture using both RP and CNC machining technologies for fixed dental restoration production is presented. Finally, a digital custom fixed restoration manufacturing protocol integrating proposed layer-based dental profile scanning, computer-aided design, 3D force feedback feature modification and advanced fixed restoration manufacturing techniques is illustrated. The proposed method provides solid evidence that computer-aided design and manufacturing technologies may become a new avenue for custom-made fixed restoration design, analysis, and production in the 21st century.

  6. the customer at the final frontier of mass customization

    DEFF Research Database (Denmark)

    Svensson, Carsten; Jensen, Thomas

    2002-01-01

    , some of the factors influencing the use of this business paradigm are discussed and it is argued that the customer is the major limiting factor at the final frontier of mass customisation. Until recently mass customisation have mainly been turned towards the structural design of products, whereas...... this paper argues that there might be a need for an increased focus on the fulfilment of customer needs. As a result of this manufactures will have to hone the balance of trade-offs, as the paradigm of mass customisation becomes a commodity....

  7. Do Veterans With Posttraumatic Stress Disorder Receive First-Line Pharmacotherapy? Results From the Longitudinal Veterans Health Survey

    Science.gov (United States)

    Greenbaum, Mark A.; Rosen, Craig S.

    2012-01-01

    Objective: Guidelines addressing the treatment of veterans with posttraumatic stress disorder (PTSD) strongly recommend a therapeutic trial of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). This study examined veteran characteristics associated with receiving such first-line pharmacotherapy, as well as how being a veteran of the recent conflicts in Afghanistan and Iraq impact receipt of pharmacotherapy for PTSD. Method: This was a national study of 482 Veterans Affairs (VA) outpatients between the ages of 18 and 69 years who had been newly diagnosed with PTSD (DSM-IV criteria: 309.81) during a VA outpatient visit between May 31, 2006, and December 7, 2007. Participants completed a mailed survey between August 11, 2006, and April 6, 2008. Veterans from the Afghanistan and Iraq conflicts and female veterans were intentionally oversampled. Logistic regression models were developed to predict 2 dependent variables: odds of initiating an SSRI/SNRI and, among veterans who initiated an SSRI/SNRI, odds of receiving an adequate therapeutic trial. Each dependent variable was regressed on a variety of sociodemographic and survey characteristics. Results: Of the 377 veterans prescribed a psychotropic medication, 73% (n = 276) received an SSRI/SNRI, of whom 61% (n = 168) received a therapeutic trial. Afghanistan and Iraq veterans were less likely to receive a therapeutic trial (odds ratio [OR] = 0.45; 95% CI, 0.27–0.75; P < .01), with presence of a comorbid depression diagnosis in the year after the index episode moderating this relationship, which further decreased the odds of completing a therapeutic trial (OR = 0.29; 95% CI, 0.09–0.95; P < .05). Conclusions: Reduced levels of receipt of first-line pharmacotherapy among recent veteran returnees parallel previous findings of less mental health treatment utilization in this population and warrant investigation. PMID:22943028

  8. Design and milling manufacture of polyurethane custom contoured cushions for wheelchair users.

    Science.gov (United States)

    da Silva, Fabio Pinto; Beretta, Elisa Marangon; Prestes, Rafael Cavalli; Kindlein Junior, Wilson

    2011-01-01

    The design of custom contoured cushions manufactured in flexible polyurethane foams is an option to improve positioning and comfort for people with disabilities that spend most of the day seated in the same position. These surfaces increase the contact area between the seat and the user. This fact contributes to minimise the local pressures that can generate problems like decubitus ulcers. The present research aims at establishing development routes for custom cushion production to wheelchair users. This study also contributes to the investigation of Computer Numerical Control (CNC) machining of flexible polyurethane foams. The proposed route to obtain the customised seat began with acquiring the user's contour in adequate posture through plaster cast. To collect the surface geometry, the cast was three-dimensionally scanned and manipulated in CAD/CAM software. CNC milling parameters such as tools, spindle speeds and feed rates to machine flexible polyurethane foams were tested. These parameters were analysed regarding the surface quality. The best parameters were then tested in a customised seat. The possible dimensional changes generated during foam cutting were analysed through 3D scanning. Also, the customised seat pressure and temperature distribution was tested. The best parameters found for foams with a density of 50kg/cm(3) were high spindle speeds (24000 rpm) and feed rates between 2400-4000mm/min. Those parameters did not generate significant deformities in the machined cushions. The custom contoured cushion satisfactorily increased the contact area between wheelchair and user, as it distributed pressure and heat evenly. Through this study it was possible to define routes for the development and manufacturing of customised seats using direct CNC milling in flexible polyurethane foams. It also showed that custom contoured cushions efficiently distribute pressure and temperature, which is believed to minimise tissue lesions such as pressure ulcers.

  9. Disabled Veterans on the Job Front.

    Science.gov (United States)

    Walker, Michael J.

    1978-01-01

    The Disabled Veterans Outreach Program (DVOP) administered by the Department of Labor's Employment and Training Administration arranges training and placement for disabled veterans in local job service offices. These employees then assist in placing other disabled veterans on jobs. Some typical DVOP success stories are described. (MF)

  10. DefenseLink Special: Veterans Day 2005

    Science.gov (United States)

    our country, and for making a proud history. God bless you all. And God bless our wonderful country a special Veterans Day observance. Story * Command Sgt. Major Praises Women's Service Woman Vet Veterans Affairs * Center of Military History * White House: Honoring Our Veterans * Library of Congress

  11. Nature-based therapy as a treatment for veterans with PTSD

    DEFF Research Database (Denmark)

    Poulsen, Dorthe Varning

    2017-01-01

    studies. The purpose of this was to give an overview of existing literature, and there can be studies, that are not found in this process. Including qualitative and quantitative methods are useful in a process of understanding the impact of NBT for veterans with PTSD. The quantitative studies, which......, has been comprehensively conducted. This work is the foundation for the recommendations to decision makers and politicians. Design/methodology/approach: This paper provides a conceptual analyses and a general review of the literature. Following steps have been conducted. Based on the research question....... Being in a group of other veterans facing the same problems was highlighted as well. Some studies measured the ability to return to workforce for the veterans and found NBT beneficial in that process. Research limitations/implications: The limitation of the research due to the methods of identifying...

  12. Perancangan Customer Knowledge Management pada PT Pandawa Maju Perkasa

    Directory of Open Access Journals (Sweden)

    Joni Suhartono

    2014-12-01

    Full Text Available In the era of global trade, more countries want a quality of product with optimal price. PT Pandawa Maju Perkasa engaged in export trade services requires an application that can bridge the communication between the customer and the company. It can also create appropriate knowledge to present the product to the customer. Knowledge of the product obtained will be shared to the customer as company's marketing activities. In addition, critics and suggestions are very necessary for the improvement of customer service of the company. Research in this study was done by analyzing business process, designing model of knowledge management system, and designing system model. The design of the system made consisted of making class diagrams, use case diagrams, sequence diagrams, and user interface. The design of the CKM system will help the company capture customer demand for the goods they want, the communication between the customer and the company can be well established, critics and suggestions facility made is used to improve services to customers

  13. Customer Journeys: A Systematic Literature Review

    OpenAIRE

    Følstad, Asbjørn; Kvale, Knut

    2018-01-01

    Purpose – Customer journeys has become an increasingly important topic in service management and design. The study reviews customer journey terminology and approaches within the research literature prior to 2013, mainly from the fields of design, management, and marketing. Design/methodology/approach - The study was conducted as a systematic literature review. Searches in Google Scholar, Scopus, Web of Knowledge, ACM Digital Library, and ScienceDirect identified 45 papers for analysis. The pa...

  14. Dysthymia and depression increase risk of dementia and mortality among older veterans

    OpenAIRE

    Byers, AL; Covinsky, KE; Barnes, DE; Yaffe, K

    2012-01-01

    OBJECTIVE: To determine whether less severe depression spectrum diagnoses such as dysthymia, as well as depression, are associated with risk of developing dementia and mortality in a "real-world" setting. DESIGN: Retrospective cohort study conducted using the Department of Veterans Affairs (VA) National Patient Care Database (1997-2007). SETTING: VA medical centers in the United States. PARTICIPANTS: A total of 281,540 veterans aged 55 years and older without dementia at study baseline (1997-...

  15. Examination of Veterans Affairs disability compensation as a disincentive for employment in a population-based sample of Veterans under age 65.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2013-12-01

    Concerns that disability benefits may create disincentives for employment may be especially relevant for young American military veterans, particularly veterans of the recent wars in Iraq and Afghanistan who are facing a current economic recession and turning in large numbers to the Department of Veterans Affairs (VA) for disability compensation. This study describes the rate of employment and VA disability compensation among a nationally representative sample of veterans under the age of 65 and examines the association between levels of VA disability compensation and employment, adjusting for sociodemographics and health status. Data on a total of 4,787 veterans from the 2010 National Survey of Veterans were analyzed using multinomial logistic regressions to compare employed veterans with two groups that were not employed. Two-thirds of veterans under the age of 65 were employed, although only 36 % of veterans with a VA service-connected disability rating of 50 % or higher were employed. Veterans who received no VA disability compensation or who were service-connected 50 % or more were more likely to be unemployed and not looking for employment than veterans who were not service-connected or were service-connected less than 50 %, suggesting high but not all levels of VA disability compensation create disincentives for employment. Results were similar when analyses were limited to veterans who served in Iraq and Afghanistan. Education and vocational rehabilitation interventions, as well as economic work incentives, may be needed to maximize employment among veterans with disabilities.

  16. Formal computer-aided product family architecture design for mass customization

    DEFF Research Database (Denmark)

    Bonev, Martin; Hvam, Lars; Clarkson, John

    2015-01-01

    With product customization companies aim at creating higher customer value and stronger economic benefits. The profitability of the offered variety relies on the quality of the developed product family architectures and their consistent implementation in configuration systems. Yet existing method...

  17. Will Veterans Answer Sexual Orientation and Gender Identity Questions?

    Science.gov (United States)

    Ruben, Mollie A; Blosnich, John R; Dichter, Melissa E; Luscri, Lorry; Shipherd, Jillian C

    2017-09-01

    The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of sexual or gender minority identities among active duty personnel, Veterans may be reluctant to respond to SOGI questions. This population-based study assesses item nonresponse to SOGI questions by Veteran status. This is a secondary analysis of data from a population-based sample of adults in 20 US states that elected to administer a SOGI module in the 2014 Behavioral Risk Factor Surveillance System survey. Prevalence of SOGI refusals and responses of "don't know" were compared for Veterans and non-Veterans. Veterans (n=22,587) and non-Veterans (n=146,475) were surveyed. Nearly all Veteran respondents (≥98%) completed the SOGI questions, with 95.4% identifying as heterosexual, 1.2% as gay or lesbian, 1.2% as bisexual, and 0.59% as transgender. A significantly lower proportion of Veterans than non-Veterans refuse to answer sexual orientation (1.5% vs. 1.9%). There was no difference between Veterans and non-Veterans in responses for gender identity. Veterans are just as likely as non-Veterans to complete SOGI items in survey research. Asking Veterans about SOGI is unlikely to yield significant nonresponse. These data suggest that future research should investigate Veterans' perspectives on being asked about SOGI in research settings and as part of routine clinical care.

  18. Design and Implementation of a Perioperative Surgical Home at a Veterans Affairs Hospital.

    Science.gov (United States)

    Walters, Tessa L; Howard, Steven K; Kou, Alex; Bertaccini, Edward J; Harrison, T Kyle; Kim, T Edward; Shafer, Audrey; Brun, Carlos; Funck, Natasha; Siegel, Lawrence C; Stary, Erica; Mariano, Edward R

    2016-06-01

    The innovative Perioperative Surgical Home model aims to optimize the outcomes of surgical patients by leveraging the expertise and leadership of physician anesthesiologists, but there is a paucity of practical examples to follow. Veterans Affairs health care, the largest integrated system in the United States, may be the ideal environment in which to explore this model. We present our experience implementing Perioperative Surgical Home at one tertiary care university-affiliated Veterans Affairs hospital. This process involved initiating consistent postoperative patient follow-up beyond the postanesthesia care unit, a focus on improving in-hospital acute pain management, creation of an accessible database to track outcomes, developing new clinical pathways, and recruiting additional staff. Today, our Perioperative Surgical Home facilitates communication between various services involved in the care of surgical patients, monitoring of patient outcomes, and continuous process improvement. © The Author(s) 2015.

  19. Salt Lake Community College Veterans Services: A Model of Serving Veterans in Higher Education

    Science.gov (United States)

    Ahern, Aaron; Foster, Michael; Head, Darlene

    2015-01-01

    This chapter outlines the birth and growth of a veterans' program in Salt Lake City, Utah, and discusses next steps in spurring additional innovations and advancements to improve service for student veterans in community colleges.

  20. Influences on call outcomes among Veteran callers to the National Veterans Crisis Line

    Science.gov (United States)

    Britton, Peter C.; Bossarte, Robert M.; Thompson, Caitlin; Kemp, Janet; Conner, Kenneth R.

    2016-01-01

    This evaluation examined the association of caller and call characteristics with proximal outcomes of Veterans Crisis Line calls. From October 1-7, 2010, 665 Veterans with recent suicidal ideation or a history of attempted suicide called the Veterans Crisis Line, 646 had complete data and were included in the analyses. A multivariable multinomial logistic regression was conducted to identify correlates of a favorable outcome, either a resolution or a referral, when compared to an unfavorable outcome, no resolution or referral. A multivariable logistic regression was used to identify correlates of responder-rated caller risk in a subset of calls. Approximately 84% of calls ended with a favorable outcome, 25% with a resolution and 59% with a referral to a local health care provider. Calls from high-risk callers had greater odds of ending with a referral than without a resolution or referral, as did weekday calls (6:00 am to 5:59 pm EST, Monday through Friday). Responders used caller intent to die and the absence of future plans to determine caller risk. Findings suggest that the Veterans Crisis Line is a useful mechanism for generating referrals for high-risk Veteran callers. Responders appeared to use known risk and protective factors to determine caller risk. PMID:23611446

  1. Rural Veterans by State (2015)

    Data.gov (United States)

    Department of Veterans Affairs — This spreadsheet contains data from the 2015 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  2. Rural Veterans by State (2014)

    Data.gov (United States)

    Department of Veterans Affairs — This speadsheet contains data from the 2014 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  3. Supporting the education goals of post-9/11 veterans with self-reported PTSD symptoms: a needs assessment.

    Science.gov (United States)

    Ellison, Marsha Langer; Mueller, Lisa; Smelson, David; Corrigan, Patrick W; Torres Stone, Rosalie A; Bokhour, Barbara G; Najavits, Lisa M; Vessella, Jennifer M; Drebing, Charles

    2012-01-01

    The influx of young adult veterans with mental health challenges from recent wars combined with newly expanded veteran education benefits has highlighted the need for a supported education service within the Veterans Administration. However, it is unknown how such a service should be designed to best respond to these needs. This study undertook a qualitative needs assessment for education supports among veterans with post-9/11 service with self-reported PTSD symptoms. Focus groups were held with 31 veterans, 54% of whom were under age 30. Transcripts were analyzed and interpreted using a thematic approach and a Participatory Action Research team. Findings indicate a need for age relevant services that assist with: education planning and access, counseling for the G.I. Bill, accommodations for PTSD symptoms, community and family re-integration, and outreach and support. The veterans recommended that supported education be integrated with the delivery of mental health services, that services have varied intensity, and there be linkages between colleges and the Veterans Health Administration.

  4. A Health Assessment Survey of Veteran Students: Utilizing a Community College-Veterans Affairs Medical Center Partnership.

    Science.gov (United States)

    Misra-Hebert, Anita D; Santurri, Laura; DeChant, Richard; Watts, Brook; Sehgal, Ashwini R; Aron, David C

    2015-10-01

    To assess health status among student veterans at a community college utilizing a partnership between a Veterans Affairs Medical Center and a community college. Student veterans at Cuyahoga Community College in Cleveland, Ohio, in January to April 2013. A health assessment survey was sent to 978 veteran students. Descriptive analyses to assess prevalence of clinical diagnoses and health behaviors were performed. Logistic regression analyses were performed to assess for independent predictors of functional limitations. 204 students participated in the survey (21% response rate). Self-reported depression and unhealthy behaviors were high. Physical and emotional limitations (45% and 35%, respectively), and pain interfering with work (42%) were reported. Logistic regression analyses confirmed the independent association of self-reported depression with functional limitation (odds ratio [OR] = 3.3, 95% confidence interval [CI] 1.4-7.8, p statistic 0.72) and of post-traumatic stress disorder with pain interfering with work (OR 3.9, CI 1.1-13.6, p statistic 0.75). A health assessment survey identified priority areas to inform targeted health promotion for student veterans at a community college. A partnership between a Veterans Affairs Medical Center and a community college can be utilized to help understand the health needs of veteran students. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  5. Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

    Science.gov (United States)

    Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

    2017-11-01

    A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  6. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from Veterans Health ... videos from Veterans Health Administration Talking About It Matters see more videos from Veterans Health Administration Stand ...

  7. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... About About the Veterans Crisis Line FAQs Veteran Suicide Spread the Word Videos Homeless Resources Additional Information ... About About the Veterans Crisis Line FAQs Veteran Suicide The Veterans Crisis Line text-messaging service does ...

  8. Perceived Stigma, Discrimination, and Disclosure of Sexual Orientation Among a Sample of Lesbian Veterans Receiving Care in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin M; Sullivan, J Cherry; Bertrand, Christina; Kinney, Rebecca L; Sherman, Michelle D; Gustason, Carolyn

    2015-06-01

    Many lesbian women experience stigma and discrimination from their healthcare providers as a result of their sexual orientation. Additionally, others avoid disclosure of their sexual orientation to their providers for fear of mistreatment. With the increasing number of lesbian, gay, bisexual, and transgender (LGBT) veterans seeking care from the Veterans Health Administration (VHA), it is important to understand lesbian veterans' experiences with stigma, discrimination, and disclosure of sexual orientation. This article examines lesbian veterans' experiences with perceived stigma and discrimination in VHA healthcare, their perspectives on disclosure of sexual orientation to VHA providers, and their recommendations for improvements in VHA healthcare to create a welcoming environment for lesbian veterans. This is a mixed methods study of twenty lesbian veterans at four VHA facilities. The women veterans participated in a one-hour interview and then completed an anonymous survey. Ten percent of lesbian veterans had experienced mistreatment from VHA staff or providers, but nearly 50% feared that their Veterans Affairs (VA) providers would mistreat them if they knew about their sexual orientation. A majority of lesbian veterans (70%) believed that VHA providers should never ask about sexual orientation or should only ask if the veteran wanted to discuss it. A majority (80%) believed the VHA had taken steps to create a welcoming environment for LBGT veterans. Though many lesbian veterans have fears of stigma and discrimination in the context of VHA care, few have experienced this. Most lesbian veterans believed the VHA was trying to create a welcoming environment for its LGBT veterans. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.

  9. Veteran Religious Affiliation by State

    Data.gov (United States)

    Department of Veterans Affairs — This dataset provide a count of Veteran by their religious affiliation and state of residence. The dataset set covers all 50 states, District of Columbia and other...

  10. The Department of Veterans Health Administration Office of Nursing Service, "transforming nursing in a national healthcare system: an example of transformation in action".

    Science.gov (United States)

    Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena

    2011-01-01

    The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.

  11. Customer Preference-Based Information Retrieval to Build Module Concepts

    Directory of Open Access Journals (Sweden)

    Dongxing Cao

    2013-01-01

    Full Text Available Preference is viewed as an outer feeling of a product, also as a reflection of human's inner thought. It dominates the designers' decisions and affects our purchase intention. In the paper, a model of preference elicitation from customers is proposed to build module concepts. Firstly, the attributes of customer preference are classified in a hierarchy and make the surveys to build customer preference concepts. Secondly, the documents or catalogs of design requirements, perhaps containing some textual description and geometric data, are normalized by using semantic expressions. Some semantic rules are developed to describe low-level features of customer preference to construct a knowledge base of customer preference. Thirdly, designers' needs are used to map customer preference for generating module concepts. Finally, an empirical study of the stapler is surveyed to illustrate the validity of module concept generation.

  12. Developing a Leadership Development Program for the Veterans Benefits Administration within the Department of Veterans Affairs

    Science.gov (United States)

    2014-06-13

    highest priorities: Veteran homelessness, “ VBA access ” to allow improved awareness of available VA services and benefits, and the backlog of benefits...Veterans by 2015. VBA access refers to improved Veteran awareness of the various VA benefits and services available, particularly through outreach and...claim completion time. While all three of these priorities impact VBA , the second two--increased access and decreased backlog--directly relate to

  13. Brief report: Comparison of methods to identify Iraq and Afghanistan war veterans using Department of Veterans Affairs administrative data.

    Science.gov (United States)

    Bangerter, Ann; Gravely, Amy; Cutting, Andrea; Clothier, Barb; Spoont, Michele; Sayer, Nina

    2010-01-01

    The Department of Veterans Affairs (VA) has made treatment and care of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans a priority. Researchers face challenges identifying the OIF/OEF population because until fiscal year 2008, no indicator of OIF/OEF service was present in the Veterans Health Administration (VHA) administrative databases typically used for research. In this article, we compare an algorithm we developed to identify OIF/OEF veterans using the Austin Information Technology Center administrative data with the VHA Support Service Center OIF/OEF Roster and veterans' self-report of military service. We drew data from two different institutional review board-approved funded studies. The positive predictive value of our algorithm compared with the VHA Support Service Center OIF/OEF Roster and self-report was 92% and 98%, respectively. However, this method of identifying OIF/OEF veterans failed to identify a large proportion of OIF/OEF veterans listed in the VHA Support Service Center OIF/OEF Roster. Demographic, diagnostic, and VA service use differences were found between veterans identified using our method and those we failed to identify but who were in the VHA Support Service Center OIF/OEF Roster. Therefore, depending on the research objective, this method may not be a viable alternative to the VHA Support Service Center OIF/OEF Roster for identifying OIF/OEF veterans.

  14. Customer Feedback: A Framework for Action.

    Science.gov (United States)

    Micceri, Ted; Takalkar, Pradnya; Waugh, Gordon

    This paper is designed to identify effective methods and to lay out steps that can be used in a customer feedback survey process. In order for the results of any customer survey to stimulate useful changes in an organization, it is essential that the support of key players be present from the beginning. Developing a customer feedback process is a…

  15. House Committee on Veterans' Affairs

    Science.gov (United States)

    ... the beaches of Normandy, from t... [...] Read Article House Doubles Down on Commitment to Veterans 08 Nov ... R-Tenn.) released the following statement after the House of Representatives passed nine veterans bills Tuesday and ...

  16. The Veteran Population Projection 2014

    Data.gov (United States)

    Department of Veterans Affairs — VetPop2014 is an actuarial projection model developed by the Office of the Actuary (OACT) for Veteran population projection from Fiscal Year FY2014 to FY2043. Using...

  17. Application analysis tools for ASIP design: application profiling and instruction-set customization

    National Research Council Canada - National Science Library

    Karuri, Kingshuk; Leupers, Ranier

    2011-01-01

    ... of the operating system they are targeting and execute them on the main application processor in the SmartPhone. However these are not the only applications that need to run on the SmartPhone. There are many underlying applications, or lets better call them algorithms, that have very demanding performance and power consumption targets, yet need to be flexible. Here is where the custom processor comes into play for the implementation of algorithms that will have certain variability but are covering a narrow enough design sp...

  18. Veteran status, disability rating, and public sector employment.

    Science.gov (United States)

    Winters, John V

    2018-06-01

    This paper used microdata from the 2013-2015 American Community Survey to examine differences in federal government, state and local government, private sector, and self-employment among employed veterans and nonveterans. The U.S. federal and state governments have hiring preferences to benefit veterans, especially disabled veterans. Other factors may also push veterans toward public sector employment. I found that veteran status substantially increased the likelihood of federal employment, with the largest magnitudes for severely disabled veterans. Differences in state and local government employment were modest and exhibited heterogeneity by disability severity. Copyright © 2018 John Wiley & Sons, Ltd.

  19. A review of the customer lifetime value as a customer profitability measure in the context of customer relationship management

    Directory of Open Access Journals (Sweden)

    Raphael Damm

    2011-11-01

    Full Text Available Purpose: A number of customer metrics allow estimating customer profitability with methods such as the Customer Lifetime Value (CLV. However, investments in customer relationships carry the potential risk to destroy value and reduce profitability when based on incorrect estimates of customer profitability. Therefore, estimating future customer value correctly is essential to allocate marketing expenditures in the most effective way. In this article recent literature about the CLV is reviewed in order to assess its ability as a customer profitability measure. Besides the financial perspective of the CLV, non-financial perspectives such as customer advocacy, (customer or open innovation and learning have been identified to have an impact on customer profitability. How to properly estimate a customer’s value taking all relevant value creating factors, financial as well as non-financial, into account is the underlying research question.Design/methodology/approach: This research is based on the review of a number of theoretical and empirical articles published between 1990 and 2010. The aggregation of measures, key-drivers and risks of each key-perspective of the customer relationship contributes to the development of a more systematic understanding of the value creation process and provides answers to the research question. Indirect effects of the CLV as a source of value have received increasing attention in previous research but are not sufficiently accounted for by mainstream methods for valuing customers (Ryals, 2008. Therefore, the attempt to structure available knowledge on indirect effects of the CLV in its contextual setting is made.Findings: This research is concluded providing evidence that one-dimensional calculations of the CLV deliver an incomplete picture of the customer relationship and estimate customer profitability incorrectly. This supports the idea of a multidimensional CLV approach that accounts for interrelated key

  20. Direct fabrication through electron beam melting technology of custom cranial implants designed in a PHANToM-based haptic environment

    International Nuclear Information System (INIS)

    Mazzoli, Alida; Germani, Michele; Raffaeli, Roberto

    2009-01-01

    Repairing critical human skull injuries requires the production and use of customized cranial implants and involves the integration of computer aided design and manufacturing (CAD and CAM). The main causes for large cranial defects are trauma, cranial tumors, infected craniotomy bone flaps and external neurosurgical decompression. The success of reconstructive cranial surgery depends upon: the preoperative evaluation of the defect, the design and manufacturing of the implant, and the skill of the operating surgeon. Cranial implant design is usually carried out manually using CAD although this process is very time-consuming and the quality of the end product depends wholly upon the skill of the operator. This paper presents an alternative automated method for the design of custom-made cranial plates in a PHANToM ® -based haptic environment, and their direct fabrication in biocompatible metal using electron beam melting (EBM) technology.

  1. Balancing Demand and Supply for Veterans' Health Care: A Summary of Three RAND Assessments Conducted Under the Veterans Choice Act.

    Science.gov (United States)

    Farmer, Carrie M; Hosek, Susan D; Adamson, David M

    2016-06-20

    In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act") in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector.

  2. Creation of stable molecular junctions with a custom-designed scanning tunneling microscope

    International Nuclear Information System (INIS)

    Lee, Woochul; Reddy, Pramod

    2011-01-01

    The scanning tunneling microscope break junction (STMBJ) technique is a powerful approach for creating single-molecule junctions and studying electrical transport in them. However, junctions created using the STMBJ technique are usually mechanically stable for relatively short times (<1 s), impeding detailed studies of their charge transport characteristics. Here, we report a custom-designed scanning tunneling microscope that enables the creation of metal–single molecule–metal junctions that are mechanically stable for more than 1 minute at room temperature. This stability is achieved by a design that minimizes thermal drift as well as the effect of environmental perturbations. The utility of this instrument is demonstrated by performing transition voltage spectroscopy—at the single-molecule level—on Au–hexanedithiol–Au, Au–octanedithiol–Au and Au–decanedithiol–Au junctions.

  3. Multi-Dimensional Customer Data Analysis in Online Auctions

    Institute of Scientific and Technical Information of China (English)

    LAO Guoling; XIONG Kuan; QIN Zheng

    2007-01-01

    In this paper, we designed a customer-centered data warehouse system with five subjects: listing, bidding, transaction,accounts, and customer contact based on the business process of online auction companies. For each subject, we analyzed its fact indexes and dimensions. Then take transaction subject as example,analyzed the data warehouse model in detail, and got the multi-dimensional analysis structure of transaction subject. At last, using data mining to do customer segmentation, we divided customers into four types: impulse customer, prudent customer, potential customer, and ordinary customer. By the result of multi-dimensional customer data analysis, online auction companies can do more target marketing and increase customer loyalty.

  4. Psychosocial function and health in veteran families

    DEFF Research Database (Denmark)

    Jensen, Mai Tødsø; Karmsteen, Kirstine; Jørgensen, Anne-Marie Klint

    to the veteran or the mental health of the partner while relatively few publications deal with the veteran family as a whole or its members social relations outside the primary family. Furthermore, there are relatively few publications focusing on relatives to veterans deployed other places than Iraq...... the research field of psychosocial functioning and health among relatives living with a veteran, including potential gaps within this research field. We have found 103 publications. Most of them are American, 7 are from Europe and none from Scandinavia. Most publications focus on the partner’s relationship...... and Afghanistan, publications focusing on relatives of veterans with physical injuries and few publications dealing with relatives to female veterans. The overall conclusion is that there is a potential need for addressing psychosocial functioning and health among these groups of relatives in research to provide...

  5. Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression.

    Science.gov (United States)

    Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A

    2014-05-01

    Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed. Published by Elsevier Inc.

  6. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2011-10-20

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of... Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans...

  7. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2013-05-14

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of... Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans...

  8. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2010-04-01

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of... Veterans Affairs (VA) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans...

  9. Customer Loyalty and Customer Relationship Management

    Science.gov (United States)

    Zhang, Pengwei; Li, Min; Jiao, Xiaojing; Zhou, Ruijin

    The contemporary company attaches great importance to marketing relationship and customer relations is the core of this relationship. Further, customer satisfaction and loyalty is the core of the customer relationship management. Sometimes, high customer satisfaction causes low profit because enterprises do not realize that strengthening the loyalty of the aimed customer is the key of customer relationship management.

  10. A Study of Interpersonal Intimacy and Meaning of Life Among Elderly Institutionalized Veterans.

    Science.gov (United States)

    Niu, Chen-Chun; Huang, Hui-Man; Hung, Yun-Ying; Lee, Hsiu-Li

    2016-12-01

    Most senior veterans who live in veterans' homes in Taiwan are single and have few intimate, interpersonal relationships. Aging is often accompanied by solitude and illness, which causes senior veterans to doubt the meaning of life and to lose confidence in the value of life. This study investigated the personal characteristics that influence interpersonal intimacy and the meaning of life as well as the relationship between interpersonal intimacy and the meaning of life among senior veterans living in veterans' homes. A cross-sectional design was used, and 120 senior male veterans were convenience sampled from three veterans' homes in southern Taiwan. Three structured questionnaires were used in this study: personal characteristics questionnaire, interpersonal intimacy scale, and purpose in life test. (a) Interpersonal intimacy was influenced by source of income or funds, type of residence institution, religious affiliation, and the quality of the participant's relationships with family, friends, and fellow residents. Educational level and self-perceived health status correlated positively with interpersonal intimacy, and period of residence correlated negatively with interpersonal intimacy. (b) Meaning of life was influenced by the quality of relationships with family and friends. Educational level and self-perceived health status correlated significantly and positively with meaning of life, and period of residence correlated negatively with meaning of life. (c) Significant, positive correlations were found among interpersonal intimacy, the four domains of interpersonal intimacy, and meaning of life. Health professionals involved in the care of senior veterans in institutions may use the results of this study to develop and implement interventions that promote a higher degree of interpersonal intimacy and a higher appreciation of the meaning of life, thus enabling senior veterans to confront old age in a more positive manner.

  11. Barriers to the use of Veterans Affairs health care services among female veterans who served in Iraq and Afghanistan.

    Science.gov (United States)

    Newins, Amie R; Wilson, Sarah M; Hopkins, Tiffany A; Straits-Troster, Kristy; Kudler, Harold; Calhoun, Patrick S

    2018-02-08

    The study investigated barriers to the utilization of Veterans Affairs (VA) health care services among female veterans who served in served in Iraq and Afghanistan, including reasons for not choosing VA health care, reasons for not seeking mental health treatment, and types of desired VA services. Female respondents to a survey assessing Operation Enduring Freedom/Operation Iraqi Freedom veterans' needs and health (N = 186) completed measures of military history, posttraumatic stress disorder, depression, barriers to VA health care, and preferences for services. Barriers to use of VA health care endorsed by female veterans included receiving care elsewhere and logistical issues. Barriers to utilization of mental health services among female veterans who screened positive for depression or posttraumatic stress disorder included negative treatment biases and concerns about stigma, privacy, and cost. Female veterans endorsed preferences for services related to eligibility education, nonprimary care physical health services, vocational assistance, and a few behavioral/mental health services. Findings highlight the need for ongoing outreach and education regarding eligibility and types of resources for physical and mental health problems experienced by female veterans who served in Iraq and Afghanistan, as well as inform types of VA programming and services desired by female veterans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. 75 FR 77956 - Agency Information Collection (Annual Certification of Veteran Status and Veteran-Relatives...

    Science.gov (United States)

    2010-12-14

    ... Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below... Review: Extension of a currently approved collection. Abstract: VBA employees, non-VBA employees in VBA space and Veteran Service Organization employees who have access to VA's benefit records complete VA...

  13. THE IMPACTS OF PHILANTHROPY RESPONSIBILITY AND ETHICAL RESPONSIBILITY TOWARD CUSTOMER PURCHASE BEHAVIOR AND CUSTOMER LOYALTY

    Directory of Open Access Journals (Sweden)

    Kurniawati Chrisjatmiko

    2018-02-01

    Full Text Available The purpose of this research is to analyze the impact of philanthropy responsibility and ethical responsibility towards customer purchase behavior and customer loyalty on fast food restaurants. The research was conducted by using quantitative research design and hypothetical testing to explore philanthropic responsibility, ethical responsibility, customer purchase behavior, and customer loyalty variables. Samples were taken from 186 respondents of employee population in Jakarta. Structural equation modeling was used in order to test the proposed hypotheses. Research result showed the positive and significant impact of philanthropic responsibility towards customer purchase behavior. On contrary, there was no positive ethical responsibility impact found towards customer purchase behavior. These findings are supported by the fact that the majority of consumers purchased fast food base on impulsive buying and not driven by the fast food restaurants ethically responsible behavior. However, the research does show a positive and significant impact of customer purchase behavior on customer loyalty. Further research recommendation should be taken from more respondents in a broader population area. Companies are suggested to approach a strategic and relevant caused-related marketing and caused promotions in relation to philanthropy responsibility to increase customer purchase behavior.

  14. Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.

    Science.gov (United States)

    Thomas, Kali S; Allen, Susan M

    2016-01-01

    Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.

  15. Gulf War veterans' health: medical evaluation of a U.S. cohort.

    Science.gov (United States)

    Eisen, Seth A; Kang, Han K; Murphy, Frances M; Blanchard, Melvin S; Reda, Domenic J; Henderson, William G; Toomey, Rosemary; Jackson, Leila W; Alpern, Renee; Parks, Becky J; Klimas, Nancy; Hall, Coleen; Pak, Hon S; Hunter, Joyce; Karlinsky, Joel; Battistone, Michael J; Lyons, Michael J

    2005-06-07

    United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial. To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations. A cross-sectional prevalence study performed 10 years after the 1991 Gulf War. Veterans were examined at 1 of 16 Veterans Affairs medical centers. Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War. Primary outcome measures included fibromyalgia, the chronic fatigue syndrome, dermatologic conditions, dyspepsia, physical health-related quality of life (Short Form-36 [SF-36]), hypertension, obstructive lung disease, arthralgias, and peripheral neuropathy. Of 12 conditions, only 4 conditions were more prevalent among deployed than nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 6.0%; odds ratio, 1.87 [CI, 1.16 to 2.99]). The mean physical component summary score of the SF-36 for deployed and nondeployed veterans was 49.3 and 50.8, respectively. Relatively low participation rates introduce potential participation bias, and deployment-related illnesses that resolved before the research examination could not, by design, be detected. Ten years after the Gulf War, the physical health of deployed and nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36

  16. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables

    OpenAIRE

    Averill, Lynnette A.; Fleming, CJ Eubanks; Holens, Pamela L.; Larsen, Sadie E.

    2015-01-01

    Background: A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination.Objective: Many OEF/OIF Veterans do not use available Veterans Affairs (VA) servic...

  17. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Science.gov (United States)

    2012-04-06

    .... Funding Opportunity Description: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the... DEPARTMENT OF LABOR Homeless Veterans' Reintegration Program AGENCY: Veterans' Employment and...

  18. INDONESIAN CUSTOMER SATISFACTION IN ONLINE SHOPPING TRADING

    Directory of Open Access Journals (Sweden)

    Hermawan F.

    2018-03-01

    Full Text Available This research aims to find out if the ease of shopping, site design, informative, comprehensive, and communication have a significant influence on the level of Indonesian customer satisfaction in online shopping transactions and how the impact to the word of mouth communication. Respondents of this study are the 250 students of Jakarta colleges. This study found that the variables of design, simplicity, and security have an influence on customer satisfaction in shopping online, while the informative variable and communication have no influence on the customer's satisfaction online shopping.

  19. Custom-Made Computer-Aided-Design/Computer-Aided-Manufacturing Biphasic Calcium-Phosphate Scaffold for Augmentation of an Atrophic Mandibular Anterior Ridge

    Directory of Open Access Journals (Sweden)

    Francesco Guido Mangano

    2015-01-01

    Full Text Available This report documents the clinical, radiographic, and histologic outcome of a custom-made computer-aided-design/computer-aided-manufactured (CAD/CAM scaffold used for the alveolar ridge augmentation of a severely atrophic anterior mandible. Computed tomographic (CT images of an atrophic anterior mandible were acquired and modified into a 3-dimensional (3D reconstruction model; this was transferred to a CAD program, where a custom-made scaffold was designed. CAM software generated a set of tool-paths for the manufacture of the scaffold on a computer-numerical-control milling machine into the exact shape of the 3D design. A custom-made scaffold was milled from a synthetic micromacroporous biphasic calcium phosphate (BCP block. The scaffold closely matched the shape of the defect: this helped to reduce the time for the surgery and contributed to good healing. One year later, newly formed and well-integrated bone was clinically available, and two implants (AnyRidge, MegaGen, Gyeongbuk, South Korea were placed. The histologic samples retrieved from the implant sites revealed compact mature bone undergoing remodelling, marrow spaces, and newly formed trabecular bone surrounded by residual BCP particles. This study demonstrates that custom-made scaffolds can be fabricated by combining CT scans and CAD/CAM techniques. Further studies on a larger sample of patients are needed to confirm these results.

  20. Ambivalence in rehabilitation: thematic analysis of the experiences of lower limb amputated veterans.

    Science.gov (United States)

    Christensen, Jan; Langberg, Henning; Doherty, Patrick; Egerod, Ingrid

    2017-06-20

    Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. We used a qualitative exploratory design, triangulating interviews and participant observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post-hospitalization rehabilitation and included field notes in the dataset. Two main themes emerged: "experiencing different identities" and "experiencing discontinuity in rehabilitation." The first theme illustrated how veterans actively shift between the identities of disabled person, wounded veteran and athlete according to the context. The second theme illustrated the frustration of negotiating military versus civilian mindsets during rehabilitation and lack of coordination between the public healthcare system, municipal services and the military. Veterans live with shifting identities after returning to civilian life, increasing their awareness of the transition from active service to a new life as a civilian. During rehabilitation, it is important to acknowledge the disparities between the military and civilian mindsets and to integrate the different sets of values, such as structure versus autonomy. IMPLICATIONS FOR REHABILITATION Recommendations for the improvement of rehabilitation of amputated veterans include: Rehabilitation professionals working with veterans should focus on abilities instead of

  1. Prescription headache medication in OEF/OIF veterans: results from the Women Veterans Cohort Study.

    Science.gov (United States)

    Seng, Elizabeth K; Driscoll, Mary A; Brandt, Cynthia A; Bathulapalli, Harini; Goulet, Joseph; Silliker, Norman; Kerns, Robert D; Haskell, Sally G

    2013-09-01

    To examine differences in male and female veterans of Operations Enduring Freedom/Iraqi Freedom (OEF/OIF) period of service in taking prescription headache medication, and associations between taking prescription headache medication and mental health status, psychiatric symptoms, and rates of traumatic events. Headaches are common among active service members and are associated with impairment in quality of life. Little is known about headaches in OEF/OIF veterans. Veterans participating in the Women Veterans Cohort Study responded to a cross-sectional survey to assess taking prescription headache medication, mental health status (Post Deployment Health Assessment), psychiatric symptoms (portions of the Brief Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist), and traumatic events (the Traumatic Life Events Questionnaire and queries regarding military trauma). Gender differences among taking prescription headache medication, health status, psychiatric symptoms, and traumatic events were examined. Regression analyses were used to examine the influence of gender on the associations between taking prescription headache medication and health status, psychiatric symptoms, and traumatic events. 139/551 (25.2%) participants reported taking prescription headache medication in the past year. A higher proportion of women veterans (29.1%) reported taking prescription medication for headache in the last year compared with men (19.7%). Taking prescription headache medication was associated with poorer perceived mental health status, higher anxiety and posttraumatic stress disorder symptoms, and higher rates of traumatic events. The association between prescription headache medication use and perceived mental health status, and with the association between prescription headache medication use and posttraumatic stress disorder symptoms, was stronger for men than for women. Among OEF/OIF veterans, the prevalence of clinically relevant headache is high

  2. Monitoring mental health treatment acceptance and initial treatment adherence in veterans: veterans of Operations Enduring Freedom and Iraqi Freedom versus other veterans of other eras.

    Science.gov (United States)

    Lindley, Steven; Cacciapaglia, Holly; Noronha, Delilah; Carlson, Eve; Schatzberg, Alan

    2010-10-01

    Identifying factors that influence mental health outcomes in veterans can aid in the redesign of programs to maximize the likelihood of early resolution of problems. To that end, we examined demographic and clinical process data from 2,684 veterans who scored positive on a mental health screen. We investigated this data set for patterns and possible predictors of mental health referral acceptance and attendance. The majority of patients had not received mental health treatment within the last two years (76%). Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) were more likely to accept a mental health referral for depression but were equally likely to attend a mental health visit as other era veterans. Decreased acceptance was associated with provider type and contact method, clinic location, depression only, and specific age ranges (65-74). Among those who accepted a referral, decreased attendance was associated with clinic location, depression only, and retirement. No variables predicted OEF/OIF acceptance/attendance. In conclusion, our findings illustrate the importance of close, continual monitoring of clinical process data to help reveal targets for improving mental health care for veterans. © 2010 Association for Research in Nervous and Mental Disease.

  3. A data-driven framework for investigating customer retention

    OpenAIRE

    Mgbemena, Chidozie Simon

    2016-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University London. This study presents a data-driven simulation framework in order to understand customer behaviour and therefore improve customer retention. The overarching system design methodology used for this study is aligned with the design science paradigm. The Social Media Domain Analysis (SoMeDoA) approach is adopted and evaluated to build a model on the determinants of customer satisfaction ...

  4. Creating a Roadmap for Delivering Gender-sensitive Comprehensive Care for Women Veterans: Results of a National Expert Panel

    NARCIS (Netherlands)

    Kleijn, M.J.J. de; Lagro-Janssen, A.L.M.; Canelo, I.; Yano, E.M.

    2015-01-01

    BACKGROUND: Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in

  5. 38 CFR 17.39 - Certain Filipino veterans.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Certain Filipino veterans... Enrollment Provisions and Medical Benefits Package § 17.39 Certain Filipino veterans. (a) Any Filipino... organized Filipino guerilla forces, or any new Philippine Scout is eligible for hospital care, nursing home...

  6. Posttraumatic stress disorder among black Vietnam veterans.

    Science.gov (United States)

    Allen, I M

    1986-01-01

    Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD.

  7. Self-report and longitudinal predictors of violence in Iraq and Afghanistan war era veterans.

    Science.gov (United States)

    Elbogen, Eric B; Johnson, Sally C; Newton, Virginia M; Fuller, Sara; Wagner, H Ryan; Beckham, Jean C

    2013-10-01

    This study, using a longitudinal design, attempted to identify whether self-reported problems with violence were empirically associated with future violent behavior among Iraq and Afghanistan war veterans and whether and how collateral informant interviews enhanced the risk assessment process. Data were gathered from N = 300 participants (n = 150 dyads of Iraq and Afghanistan war veterans and family/friends). The veterans completed baseline and follow-up interviews 3 years later on average, and family/friends provided collateral data on dependent measures at follow-up. Analyses showed that aggression toward others at follow-up was associated with younger age, posttraumatic stress disorder, combat exposure, and a history of having witnessed parental violence growing up. Self-reported problems controlling violence at baseline had robust statistical power in predicting aggression toward others at follow-up. Collateral report enhanced detection of dependent variables: 20% of cases positive for violence toward others would have been missed relying only on self-report. The results identify a subset of Iraq and Afghanistan war veterans at higher risk for problematic postdeployment adjustment and indicate that the veterans' self-report of violence was useful in predicting future aggression. Underreporting of violence was not evidenced by most veterans but could be improved upon by obtaining collateral information.

  8. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us ... Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us ...

  9. Hospital System Performance within Veterans Affairs

    Data.gov (United States)

    Department of Veterans Affairs — Strategic Analytics for Improvement and Learning Value Model or SAIL, is a system for summarizing hospital system performance within Veterans Health Administration...

  10. From Engineer-To-Order to Mass Customization

    DEFF Research Database (Denmark)

    Haug, Anders; Ladeby, Klaes Rohde; Edwards, Kasper

    2009-01-01

    customization. Second, the individual transitions from mass production and ETO to mass customization are analyzed by: relating the transition to classifications from relevant literature; describing the motivations and risks associated with the transition; and defining some of the most important transition......Purpose - Most mass customization literature focuses on the move from mass production to mass customization. However, in some literature engineer-to-order (ETO) companies are also claiming to have become mass customizers, although it can be questioned if these companies conform to popular...... definitions of mass customizers. The purpose of this paper is to ask the question: under which conditions is it reasonable to label ETO companies as mass customizers? Design/methodology/approach - First, definitions of mass customization are examined and related to ETO companies that move towards mass...

  11. CUSTOMS POLICY, CUSTOMS BUSINESS, CUSTOMS REGULATION: TO PROBLEM OF CONCEPTION CORRELATIONS

    OpenAIRE

    A. D. Molokovich; K. N. Shabeka

    2010-01-01

    Theoretical and methodological comprehension of customs regulation place and role in provision of trade and transport activity under conditions of world integration processes is considered in the paper.The essence of such economic categories as «customs policy», «customs regulation», «customs and tariff regulation», «customs business» is ascertained with the help of justified argumentation, clear conception approaches.

  12. Employment of Veterans in the Federal Executive Branch

    Data.gov (United States)

    Department of Veterans Affairs — These quick facts use data from the 2011 Employment of Veterans in the Federal Executive Branch to compare Veteran employment in the Federal Government by agency,...

  13. [Evaluation of production and clinical working time of computer-aided design/computer-aided manufacturing (CAD/CAM) custom trays for complete denture].

    Science.gov (United States)

    Wei, L; Chen, H; Zhou, Y S; Sun, Y C; Pan, S X

    2017-02-18

    To compare the technician fabrication time and clinical working time of custom trays fabricated using two different methods, the three-dimensional printing custom trays and the conventional custom trays, and to prove the feasibility of the computer-aided design/computer-aided manufacturing (CAD/CAM) custom trays in clinical use from the perspective of clinical time cost. Twenty edentulous patients were recruited into this study, which was prospective, single blind, randomized self-control clinical trials. Two custom trays were fabricated for each participant. One of the custom trays was fabricated using functional suitable denture (FSD) system through CAD/CAM process, and the other was manually fabricated using conventional methods. Then the final impressions were taken using both the custom trays, followed by utilizing the final impression to fabricate complete dentures respectively. The technician production time of the custom trays and the clinical working time of taking the final impression was recorded. The average time spent on fabricating the three-dimensional printing custom trays using FSD system and fabricating the conventional custom trays manually were (28.6±2.9) min and (31.1±5.7) min, respectively. The average time spent on making the final impression with the three-dimensional printing custom trays using FSD system and the conventional custom trays fabricated manually were (23.4±11.5) min and (25.4±13.0) min, respectively. There was significant difference in the technician fabrication time and the clinical working time between the three-dimensional printing custom trays using FSD system and the conventional custom trays fabricated manually (Pmanufacture custom trays by three-dimensional printing method, there is no need to pour preliminary cast after taking the primary impression, therefore, it can save the impression material and model material. As to completing denture restoration, manufacturing custom trays using FSD system is worth being

  14. Meta-analysis of self-reported health symptoms in 1990–1991 Gulf War and Gulf War-era veterans

    Science.gov (United States)

    Maule, Alexis L; Janulewicz, Patricia A; Sullivan, Kimberly A; Krengel, Maxine H; Yee, Megan K; McClean, Michael; White, Roberta F

    2018-01-01

    Objectives Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990–1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans. Design Meta-analysis. Methods Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans. Results GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls. Conclusions The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status. PMID:29440208

  15. Customer Clustering Based on Customer Purchasing Sequence Data

    OpenAIRE

    Yen-Chung Liu; Yen-Liang Chen

    2017-01-01

    Customer clustering has become a priority for enterprises because of the importance of customer relationship management. Customer clustering can improve understanding of the composition and characteristics of customers, thereby enabling the creation of appropriate marketing strategies for each customer group. Previously, different customer clustering approaches have been proposed according to data type, namely customer profile data, customer value data, customer transaction data, and customer...

  16. Use of Veterans Health Administration Mental Health and Substance Use Disorder Treatment After Exiting Prison: The Health Care for Reentry Veterans Program.

    Science.gov (United States)

    Finlay, Andrea K; Stimmel, Matthew; Blue-Howells, Jessica; Rosenthal, Joel; McGuire, Jim; Binswanger, Ingrid; Smelson, David; Harris, Alex H S; Frayne, Susan M; Bowe, Tom; Timko, Christine

    2017-03-01

    The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care. Prevalence of mental health disorders was 57 %; of whom 77 % entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49 %; of whom 37 % entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

  17. Need to improve routine HIV testing of U.S. Veterans in care: results of an Internet survey.

    Science.gov (United States)

    Valdiserri, Ronald O; Nazi, Kim; McInnes, D Keith; Ross, David; Kinsinger, Linda

    2010-06-01

    Late diagnosis of HIV infection contributes to poor medical outcomes and helps sustain continued transmission of virus. Published evidence suggests that despite current public health recommendations, patients receiving care in the Veterans Health Administration (VHA) system are not being routinely tested for HIV infection. Using a sample of computer-literate veterans, we conducted a survey of recent testing experiences. My HealtheVet (MHV) is a secure website allowing registered Veterans to access limited personal VHA health information. Using the American Customer Satisfaction Index (ACSI) Survey, an electronic questionnaire on "health screening" was conducted in late Fall/early winter 2008-2009. A random sample (4%) of MHV users were surveyed; approximately 17% completed the survey and responses ranged from 31,237 to 33,074. Only 9% of the respondents indicated that they had been offered a test for HIV in the last 12 months compared to 83% who had been offered cholesterol screening, 65% blood sugar screening and 19% who had been offered testing for Hepatitis C virus (HCV). Of those who had been offered HIV testing, 91% indicated that they'd had the test performed. Of note, the percentage of respondents who indicated that they would "very likely" accept a test, if offered, was similar for HIV (73%), HCV (79%), cholesterol (75%), and blood sugar (75%). Although these results cannot be generalized to all Veterans in care, they suggest that routine testing for HIV has not been taking place and support recent VHA policy changes to remove barriers to HIV testing.

  18. Veterans Affairs Central Cancer Registry (VACCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local...

  19. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  20. Career Development for Transitioning Veterans. Monograph Series

    Science.gov (United States)

    McCormick, Carmen Stein; Osborn, Debra S.; Hayden, Seth C. W.; Van Hoose, Dan

    2013-01-01

    The purpose of this book is to increase career practitioners' awareness of the transition issues and resources specific to veterans and to provide several examples of how a practitioner might walk a veteran through the career planning process. Case studies based on interviews with real veterans by the authors and military consultants (Thomas…

  1. Custom-Designed Molecular Scissors for Site-Specific Manipulation of the Plant and Mammalian Genomes

    Science.gov (United States)

    Kandavelou, Karthikeyan; Chandrasegaran, Srinivasan

    Zinc finger nucleases (ZFNs) are custom-designed molecular scissors, engineered to cut at specific DNA sequences. ZFNs combine the zinc finger proteins (ZFPs) with the nonspecific cleavage domain of the FokI restriction enzyme. The DNA-binding specificity of ZFNs can be easily altered experimentally. This easy manipulation of the ZFN recognition specificity enables one to deliver a targeted double-strand break (DSB) to a genome. The targeted DSB stimulates local gene targeting by several orders of magnitude at that specific cut site via homologous recombination (HR). Thus, ZFNs have become an important experimental tool to make site-specific and permanent alterations to genomes of not only plants and mammals but also of many other organisms. Engineering of custom ZFNs involves many steps. The first step is to identify a ZFN site at or near the chosen chromosomal target within the genome to which ZFNs will bind and cut. The second step is to design and/or select various ZFP combinations that will bind to the chosen target site with high specificity and affinity. The DNA coding sequence for the designed ZFPs are then assembled by polymerase chain reaction (PCR) using oligonucleotides. The third step is to fuse the ZFP constructs to the FokI cleavage domain. The ZFNs are then expressed as proteins by using the rabbit reticulocyte in vitro transcription/translation system and the protein products assayed for their DNA cleavage specificity.

  2. Customer/User Workshops in Product development

    DEFF Research Database (Denmark)

    Brandt, Eva; Binder, Thomas

    1997-01-01

    In a recent product development project, we have taken part in establishing and organising a series of workshops with a group of customers/users of a future product line through out the development project. The workshops is a kind of informal meetingplace for engineering, marketing, customers...... and discuss experiences with this kind of collaborative fora. We have tried to demonstrate that having an on-going dialogue with users/customers also during detailed design in not only a means to keep 'the voive of the customer alive'. We have found that the workshops have an important impact on securing...

  3. Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans.

    Science.gov (United States)

    Yang, Mai See; Burr, Jeffrey A

    2016-01-01

    This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.

  4. Customer Satisfaction in Internal Customer Service : Case: Abloy Oy Internal Customer Service

    OpenAIRE

    Turunen, Susanna

    2011-01-01

    ABSTRACT Turunen, Susanna Marita 2011. Customer Satisfaction in Internal Customer Service. Case: Abloy Oy Internal Customer Service. Master’s thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 73. Appendix 1. This thesis discusses and studies service quality and customer satisfaction in internal customer service. The main objective is to find out what the service quality level in the internal customer service at Abloy Oy is and whether there exists a diffe...

  5. Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

    Science.gov (United States)

    Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

  6. Companies and the customers who hate them.

    Science.gov (United States)

    McGovern, Gail; Moon, Youngme

    2007-06-01

    Why do companies bind customers with contracts, bleed them with fees, and baffle them with fine print? Because bewildered customers, who often make bad purchasing decisions, can be highly profitable. Most firms that profit from customers' confusion are on a slippery slope. Over time, their customer-centric strategies for delivering value have evolved into company-centric strategies for extracting it. Not surprisingly, when a rival comes along with a friendlier alternative, customers defect. Adversarial value-extracting strategies are common in such industries as cell phone service, retail banking, and health clubs. Overly complex product and pricing options, for example, may have been designed to serve various segments. But in fact they take advantage of how difficult it is for customers to predict their needs (such as how many cell phone minutes they'll use each month) and make it hard for them to choose the right product. Similarly, penalties and fees, which may have been instituted to offset the costs of undesirable customer behavior, like bouncing checks, turn out to be very profitable. As a result, companies have no incentive to help customers avoid them. Tactics like these generate bad publicity and fuel customer defections, creating opportunities for competitors. Virgin Mobile USA, for example, has lured millions of angry cell phone customers away from the incumbents by offering a straightforward plan with no hidden fees, no time-of-day restrictions, and no contracts. ING Direct, now the fourth-largest thrift bank in the United States, offers accounts with no fees, no tiered interest rates, and no minimums. In industries where squeezing value from customers is commonplace, companies that dismantle these harmful practices and design a transparent, value-creating offer can head off customer retaliation and spur rapid growth.

  7. Aggression, Anxiety, and Social Development in Adolescent Children of War Veterans with PTSD Versus those of Non-Veterans

    Directory of Open Access Journals (Sweden)

    Gh Ahmadzadeh

    2004-10-01

    Full Text Available Background: Evaluation of psychological problems in children of war veterans with PTSD can be the first step in improving the war – related trauma and interrupting the known phenomenon of transgeneration transmission of this trauma. Methods: Using three self – administered questionnaires, this study was carried out to compare aggression, anxiety, and social development (as some of the most expected mental health problems in this group according to literature in adolescent children of war veterans and those of non-veterans. The two groups were matched regarding sex, academic achievement, stage of education, and economic status of the family. Results: After controlling the level of parental education (as a confounding variable, a higher rate of aggression and anxiety was found in adolescent children of war veterans with PTSD but the two groups showed no significant difference in social development. Conclusion: The higher rate of anxiety and aggression among children of war veterans with PTSD along with many other factors such as low socioeconomic status in this group signifies the importance of mental health screening programs and appropriate interventions in this group. Keywords: Aggression, Social Development, Anxiety, War Veterans, PTSD, Adolescent.

  8. Optometry within hospitals at the Veterans Administration.

    Science.gov (United States)

    Soroka, Mort; Crump, Trafford; Bennett, Amy

    2005-11-01

    This study was designed to determine the use of optometrists with the Veterans Health Administration hospital system and to develop accurate statistics regarding the number and type of services these doctors provide. The findings help describe their responsibilities in the treatment and management of ocular diseases and their use of diagnostic and therapeutic drugs. The study also investigated what, if any, role optometrists play beyond care in the education and research practices of the hospital. A descriptive analysis was conducted through the use of surveys and interviews of department chiefs or medical directors. A survey was sent out to 149 Veterans Affairs (VA) Hospitals, located using the VA facility locator Web site. Data were tabulated, aggregated, and analyzed. A response rate of 81% was achieved (122 surveys returned), 98% of which (120 facilities) provide eye services to their patients in either an outpatient or inpatient capacity. One hundred seventeen (98%) of these had optometrists affiliated with their facility. These optometrists were responsible for providing a range of services, prescribing the use of diagnostic or therapeutic drugs, and participating in educational training of other health personnel. Optometry has developed a strong partnership with the Veterans Health Administration, and act as an integral part of its hospital services. The VA has developed a workforce mix that should serve as a model for managed care organizations.

  9. 76 FR 20823 - Agency Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2011-04-13

    ... AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In... to VA's OMB Desk Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room... benefit claim within 30 days prior to the fielding period. The sample will be stratified as follows: (1...

  10. Post-Traumatic Stress Disorder in Kosovo Veterans

    Directory of Open Access Journals (Sweden)

    Mimoza Shahini

    2016-03-01

    Full Text Available Objective: The objective of this study was to explore the prevalence of post-traumatic stress disorder (PTSD at veterans 8 years after war, to find out relation of PTSD with other demographic and health related variables and discover the impact of depression and trauma on PTSD on 687 veterans from six municipalities in Kosovo. Method: Participants were 687 war veterans selected from six regions of Kosovo during 2008. The Harvard Trauma Questionnaire (HTQ-40, was administered to measure PTSD and Hopkins Symptom Checklist (HSCL-25 for depression and anxiety. Pearson chi-square, analysis of variance (ANOVA, and multiple regressions were used to analyze the data. Results: Results indicated that 11.2 % of veterans even 8 years after the war ended were suffering from PTSD. Six percent of veterans with PTSD did not seek medical help. They reported to have had emotional problems and physical problems, but they did not seek medical help. The findings suggest that self-medication may be one way of veterans dealing with PTSD symptoms. Veterans with PTSD symptoms were more concerned with “family issues” than those without PTSD symptoms. Conclusions: The study found that 8 years after the war the veterans of the war in Kosovo suffer PTSD symptoms and that a good number of them do not seek help for this problem. The establishment of adequate services by the state would transform these veterans’ dealing with PTSD not into a moral challenge but into a fundamental right to equal and high-quality services.

  11. A Descriptive Study of Veteran Students Attending The University of South Carolina, Fall 1975. No. 30-76.

    Science.gov (United States)

    Thurber, Robert G.; And Others

    The Office of Veteran Student Affairs (OVSA) at the University of South Carolina serves a total population of 3,310 veteran students. This survey, conducted during the fall semester of 1975, was designed to obtain data about the personal background of the respondents, their attitudes toward the services provided by the several offices serving…

  12. Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

    Science.gov (United States)

    Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C.; Weiner, Bryan J.; Kinsinger, Linda

    2013-01-01

    Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer counselor training program for volunteer veterans, the “Buddies” program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Results Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. Conclusions MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion. PMID:24199738

  13. Effects of Cognitive Behavioral Therapy for Insomnia on Suicidal Ideation in Veterans

    Science.gov (United States)

    Trockel, Mickey; Karlin, Bradley E.; Taylor, C. Barr; Brown, Gregory K.; Manber, Rachel

    2015-01-01

    Objective: To examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on suicidal ideation among Veterans with insomnia. Design: Longitudinal data collected in the course of an uncontrolled evaluation of a large-scale CBT-I training program. Setting: Outpatient and residential treatment facilities. Participants: Four hundred five Veterans presenting for treatment of insomnia. Interventions: Cognitive behavioral therapy for insomnia. Measurement and Results: At baseline, 32% of patients, compared with 21% at final assessment, endorsed some level of suicidal ideation [χ2(df = 1) = 125; P suicidal ideation. The effect of change in insomnia severity on change in depression severity was also significant. After controlling for change in depression severity and other variables in the model, the effect of change in insomnia severity on change in suicidal ideation remained significant. Conclusion: This evaluation of the largest dissemination of cognitive behavioral therapy for insomnia (CBT-I) in the United States found a clinically meaningful reduction in suicidal ideation among Veterans receiving CBT-I. The mechanisms by which effective treatment of insomnia with CBT-I reduces suicide risk are unknown and warrant investigation. The current results may have significant public health implications for preventing suicide among Veterans. Citation: Trockel M, Karlin BE, Taylor CB, Brown GK, Manber R. Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans. SLEEP 2015;38(2):259–265. PMID:25515115

  14. Perceptions regarding cardiothoracic surgical training at Veterans Affairs hospitals.

    Science.gov (United States)

    Bakaeen, Faisal G; Stephens, Elizabeth H; Chu, Danny; Holman, William L; Vaporciyan, Ara A; Merrill, Walter H; Grover, Frederick L

    2011-05-01

    With cardiothoracic education going through a critical phase of reevaluation and adaptation, we investigated perceptions of Veterans Affairs hospitals in cardiothoracic training. A content-validated survey was distributed electronically to 676 cardiothoracic surgery residents, recent cardiothoracic graduates (on or after June 2006), cardiothoracic surgery chairpersons, program directors, associate program directors, and section heads. The Cardiothoracic Surgery Network was used to identify target recipients and their e-mail addresses. Forty-three percent of the target recipients (292/676) completed the survey. Of those who were residents, 59% (65/111) rotated at a Veterans Affairs hospital during their cardiothoracic training; this rotation accounted for 25% or more of the total training period for 19% of them (21/111). A Veterans Affairs appointment was held by 42% of program directors/chairpersons (20/48) and 24% of graduates, associate program directors, and section heads (31/129). An affiliation with a Veterans Affairs hospital was rated as somewhat to very beneficial by 93% of the responders (273/292), and the cardiothoracic training received at Veterans Affairs facilities was rated as good to excellent by 73% of the responders (213/292). Sixty-nine percent of respondents (201/292) reported the operating room environment at Veterans Affairs hospitals to be at least as conducive to learning as that at the affiliate teaching hospital, and 76% (223/292) indicated that residents get more autonomy and hands-on experience at Veterans Affairs institutions. In addition, 64% of responders (188/292) reported that they would seek or recommend a Veterans Affairs job. Responses were positive toward the Veterans Affairs system regardless of whether the responder had any Veterans Affairs affiliation (ie, appointment as staff or rotation as resident); however, a Veterans Affairs affiliation was associated with a higher rate of positive responses regarding Veterans Affairs

  15. Benefits for Military Veterans with ALS

    Science.gov (United States)

    ... Chapters Certified Centers and Clinics Support Groups About ALS About Us Our Research In Your Community Advocate ... Veterans Resources for Military Veterans, Families & Survivors The ALS Association is working everyday to support people with ...

  16. 31 CFR 406.4 - Duties of customs officers.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Duties of customs officers. 406.4... 1934 AND GOLD REGULATIONS § 406.4 Duties of customs officers. The appropriate officials of the Bureau of Customs are hereby authorized and designated as the officers who shall perform such administrative...

  17. 75 FR 24514 - Supportive Services for Veteran Families Program

    Science.gov (United States)

    2010-05-05

    ... authorizes certain services for minor dependents of women veterans, it does not generally authorize the...), ``permanent housing'' is defined as ``community-based housing without a designated length of stay.'' The term... includes, but is not limited to, a house or apartment with a month-to-month or annual lease term, or home...

  18. Anteseden Customer Loyalty Pada Low Cost Carrier Airline

    OpenAIRE

    Harlan, Marcella

    2015-01-01

    The background of this research was Customer loyalty as a competitive advantage in service industry.The design of this research applies a survey toward unit of analysis on Low Cost Carrier Airline to interview the passanger for testing hypothesis. Meanwhile the required data consist of five variables; Recovery Satisfaction, Corporate Social Responsibility, Customer Trust, Customer Loyalty. The aggregate numbers of customer being respondent of the study are 200. Data analysis us...

  19. A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis.

    Science.gov (United States)

    Liu, Yun-Feng; Fan, Ying-Ying; Jiang, Xian-Feng; Baur, Dale A

    2017-11-15

    The purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA). A three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as "V" pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the "V" plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed. The stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems. The

  20. Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

    Science.gov (United States)

    Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

    2007-03-01

    Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

  1. Chronic obstructive pulmonary disease in Scottish military veterans.

    Science.gov (United States)

    Bergman, Beverly P; Mackay, D F; Pell, J P

    2018-02-01

    Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). Serving military personnel have previously been shown to be more likely to smoke, and to smoke more heavily, than civilians, but there is no clear consensus as to whether in later life, as veterans, they experience a higher prevalence and mortality from COPD than do non-veterans. We examined the risk of COPD in Scottish veterans and assessed the impact of changes in military smoking. Retrospective 30-year cohort study of 56 205 veterans born 1945-1985, and 172 741 people with no record of military service, matched for age, sex and area of residence, using Cox proportional hazard models to examine the association between veteran status, birth cohort, length of service and risk of COPD resulting in hospitalisation or death. There were 1966 (3.52%) cases of COPD meeting the definition in veterans, compared with 5434 (3.19%) in non-veterans. The difference was statistically significant (p=0.001) in the unadjusted model although it became non-significant after adjusting for deprivation. The highest risk was seen in the oldest (1945-1949) birth cohort and in veterans with the shortest service (Early Service Leavers). The risk was significantly reduced in veterans born from 1960, and in those with over 12 years' service. Our findings are consistent with falling rates of military smoking since the 1960s, and with the reduction in smoking with longer service. The oldest veterans, and those with the shortest service, are least likely to have benefited from this, as reflected in their higher risk for COPD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. QTc Prolongation in Veterans With Heroin Dependence on Methadone Maintenance Treatment.

    Science.gov (United States)

    Hassamal, Sameer; Fernandez, Antony; Moradi Rekabdarkolaee, Hossein; Pandurangi, Ananda

    2015-06-01

    QTc prolongation and Torsade de Ppointes have been reported in patients on methadone maintenance. In this study, QTc was compared before and after the veteran (n = 49) was on a stable dosage of methadone for 8.72 ± 4.50 years to treat heroin dependence. Risk factors were correlated with the QTc once the veteran was on a stable dose of methadone. Differences in the clinical risk factors in subgroups of veterans with below and above mean QTc change was compared. ECG data was obtained from a 12-lead electrocardiogram (pre-methadone and on methadone) on 49 veterans. Data and risk factors were retrospectively collected from the medical records. The mean QTc at baseline (pre-methadone) was 426 ± 34 msec and after being on methadone for an average of 8.72 ± 4.50 years was significantly higher at 450 ± 35 msec. No significant relationships were found between QTc prolongation and risk factors except for calcium. The methadone dosage was significantly higher in veterans with a QTc change above the mean change of ≥ 24 msec (88.48 ± 27.20 mg v.s 68.96 ± 19.84 mg). None of the veterans experienced cardiac arrhythmias. The low complexity of medical co-morbidities may explain the lack of a significant correlation between any risk factor with the QTc except calcium and methadone dosage. The absence of TdP may be explained by the low prevalence of QTc values > 500 msec as well as the retrospective design of the study. During long-term methadone treatment, there was a slight increase in the QTc interval but we did not find evidence of increased cardiac toxicity as a reason for treatment termination.

  3. The influence of gender on suicidal ideation following military sexual trauma among Veterans in the Veterans Health Administration.

    Science.gov (United States)

    Monteith, Lindsey L; Bahraini, Nazanin H; Matarazzo, Bridget B; Gerber, Holly R; Soberay, Kelly A; Forster, Jeri E

    2016-10-30

    No studies have examined whether military sexual trauma, as measured and defined within the Veterans Health Administration (VHA), is associated with suicidal ideation among Veterans in VHA care, when taking prior suicide attempts into account. Research regarding the role of gender in this association is also limited. The present study examined: (1) whether military sexual trauma was associated with the presence of past-week suicidal ideation among 354 Veterans in VHA (310 men, 44 women); (2) whether gender moderated the association between military sexual trauma and suicidal ideation. Information regarding military sexual trauma, suicidal ideation, suicide attempt, and psychiatric diagnoses was obtained from self-report instruments and medical records. Adjusting for age, gender, combat, posttraumatic stress disorder, depressive disorders, negative affect, and lifetime suicide attempt, Veterans with military sexual trauma were significantly more likely to report suicidal ideation, compared to Veterans without military sexual trauma. Furthermore, the association between military sexual trauma and suicidal ideation was stronger for men compared to women. These results contribute to a growing literature identifying military sexual trauma as a risk factor for suicidal thoughts and behaviors among Veterans in VHA care and emphasize the importance of screening for suicidal ideation among survivors of military sexual trauma. Published by Elsevier Ireland Ltd.

  4. Sexual Function in Female Veterans: A Review.

    Science.gov (United States)

    Rosebrock, Laina; Carroll, Richard

    2017-04-03

    Women comprise a significant proportion of the veteran population. Much research has been devoted to physical and mental health outcomes in veterans, both of which show significant decreases in quality of life. However, little is known about the effects of female veterans' unique military experience on sexual function. In particular, military sexual trauma, general military stressors, mental health diagnoses, and other vulnerability factors contribute to sexual dysfunction, dissatisfaction, and decreases in mental health-related quality of life. We propose a model whereby all of these factors interact and contribute to sexual dysfunction in female veterans, and areas for growth in assessment and treatment are discussed.

  5. Impact of Customer Relationship Management on Customer Loyalty, Customer Retention and Customer Profitability for Hotelier Sector

    Directory of Open Access Journals (Sweden)

    Sandra-Dinora Orantes-Jiménez

    2017-08-01

    Full Text Available Since the entrance of strategies oriented to marketing relational in Hotelier Sector, the traditional way of travel agents and other representatives arranging hospitality services for hotel and travel reservations has changed. The strategies oriented to customer relationship management are a relatively new area of specialty loyalty marketing in the hotel and hotelier sector, with advancements being made constantly. The use of this type of strategy can allow hoteliers or companies to tailor special guest programs, services and promotions based on hotel guest preferences. The hotel can use the data collected in a program to identify the needs of particular customers across hotel chains to be able to use marketing that can be targeted at specific groups of people. It also gives hoteliers the opportunity to evaluate frequent guest programs, personalize their services and perform trend analysis. A program based in marketing relational is typically run by hotels and companies to collect guest information and transaction data for use and examining to allow hoteliers to see target groups that should be marketed too. Based on these transactions hotels are able to create and manage guest loyalty programs and reward schemes. This research approach is to appraise the impact of customer relationship management on customer profitability as mediated by customer loyalty and customer retention within the hotelier sector of Mexico, and specifically for those hoteliers classified like of three stars. A sample of 100 hotels three stars was interviewed as respondents in this study. The objective of the study was to find the impact relationship between effective customer relationship implementation, customer loyalty, and customer retention and customer profitability. The findings of the study add value to hotels three stars in Mexico, and provide some invaluable statistical results essential for hotel managers and owners to successfully enhance customer loyalty

  6. "It's Changed Everything": Voices of Veterans in the Veteran-Directed Home and Community Based Services Program.

    Science.gov (United States)

    Mahoney, Ellen K; Milliken, Aimee; Mahoney, Kevin J; Edwards-Orr, Merle; Willis, Danny G

    2018-04-05

    The purpose of this study was to understand the value and impact of the Veteran-Directed Home and Community Based Services program (VD-HCBS) on Veterans' lives in their own voices. Focus groups and individual interviews by telephone were conducted to elicit participant perspectives on what was most meaningful, and what difference VD-HCBS made in their lives. Transcripts were analyzed using content analysis. The sample included 21 Veterans, with a mean age of 66±14, enrolled in VD-HCBS an average of 20.8 months. All were at risk of institutional placement based on their level of disability. Five major categories captured the information provided by participants: What a Difference Choice Makes; I'm a Person!; It's a Home-Saver; Coming Back to Life; and Keeping Me Healthy & Safe. Participants described the program as life changing. This study is the first time that Veterans themselves have identified the ways in which VD-HCBS impacted their lives, uncovering the mechanisms underlying positive outcomes. These categories revealed new ways of understanding VD-HCBS as an innovative approach to meeting the person-centered needs of Veterans wishing to remain at home, while experiencing quality care and leading meaningful lives, areas identified as priorities for improving long term services and supports.

  7. Impact of the Northridge earthquake on the mental health of veterans: results from a panel study.

    Science.gov (United States)

    Dobalian, Aram; Stein, Judith A; Heslin, Kevin C; Riopelle, Deborah; Venkatesh, Brinda; Lanto, Andrew B; Simon, Barbara; Yano, Elizabeth M; Rubenstein, Lisa V

    2011-09-01

    The 1994 earthquake that struck Northridge, California, led to the closure of the Veterans Health Administration Medical Center at Sepulveda. This article examines the earthquake's impact on the mental health of an existing cohort of veterans who had previously used the Sepulveda Veterans Health Administration Medical Center. From 1 to 3 months after the disaster, trained interviewers made repeated attempts to contact participants by telephone to administer a repeated measures follow-up design survey based on a survey that had been done preearthquake. Postearthquake data were obtained on 1144 of 1800 (64%) male veterans for whom there were previous data. We tested a predictive latent variable path model of the relations between sociodemographic characteristics, predisaster physical and emotional health measures, and postdisaster emotional health and perceived earthquake impact. Perceived earthquake impact was predicted by predisaster emotional distress, functional limitations, and number of health conditions. Postdisaster emotional distress was predicted by preexisting emotional distress and earthquake impact. The regression coefficient from earthquake impact to postearthquake emotional distress was larger than that of the stability coefficient from preearthquake emotional distress. Postearthquake emotional distress also was affected indirectly by preearthquake emotional distress, health conditions, younger age, and lower socioeconomic status. The postdisaster emotional health of veterans who experienced greater earthquake impact would have likely benefited from postdisaster intervention, regardless of their predisaster emotional health. Younger veterans and veterans with generally poor physical and emotional health were more vulnerable to greater postearthquake emotional distress. Veterans of lower socioeconomic status were disproportionately likely to experience more effects of the disaster because they had more predisaster emotional distress, more functional

  8. Military Veterans' Midlife Career Transition and Life Satisfaction

    Science.gov (United States)

    Robertson, Heather C.; Brott, Pamelia E.

    2014-01-01

    Many military veterans face the challenging transition to civilian employment. Military veteran members of a national program, Troops to Teachers, were surveyed regarding life satisfaction and related internal/external career transition variables. Participants included military veterans who were currently or had previously transitioned to K-12…

  9. 75 FR 61860 - Advisory Committee on Women Veterans; Notice of Meeting

    Science.gov (United States)

    2010-10-06

    ... on mental health, prosthetic services for women Veterans, readjustment counseling, women Veterans' legislative issues, special health initiatives, women Veterans' research, rural health, and homeless... Veterans Affairs regarding the needs of women Veterans with respect to health care, rehabilitation...

  10. Practical Telemedicine for Veterans with Persistently Poor Diabetes Control: A Randomized Pilot Trial.

    Science.gov (United States)

    Crowley, Matthew J; Edelman, David; McAndrew, Ann T; Kistler, Susan; Danus, Susanne; Webb, Jason A; Zanga, Joseph; Sanders, Linda L; Coffman, Cynthia J; Jackson, George L; Bosworth, Hayden B

    2016-05-01

    Telemedicine-based diabetes management improves outcomes versus clinic care but is seldom implemented by healthcare systems. In order to advance telemedicine-based management as a practical option for veterans with persistent poorly controlled diabetes mellitus (PPDM) despite clinic-based care, we evaluated a comprehensive telemedicine intervention that we specifically designed for delivery using existing Veterans Health Administration (VHA) clinical staffing and equipment. We conducted a 6-month randomized trial among 50 veterans with PPDM; all maintained hemoglobin A1c (HbA1c) levels continuously >9.0% for >1 year despite clinic-based management. Participants received usual care or a telemedicine intervention combining telemonitoring, medication management, self-management support, and depression management; existing VHA clinical staff delivered the intervention. Using linear mixed models, we examined HbA1c, diabetes self-care (measured by the Self-Care Inventory-Revised questionnaire), depression, and blood pressure. At baseline, the model-estimated common HbA1c intercept was 10.5%. By 6 months, estimated HbA1c had improved by 1.3% for intervention participants and 0.3% for usual care (estimated difference, -1.0%, 95% confidence interval [CI], -2.0%, 0.0%; p = 0.050). Intervention participants' diabetes self-care (estimated difference, 7.0; 95% CI, 0.1, 14.0; p = 0.047), systolic blood pressure (-7.7 mm Hg; 95% CI, -14.8, -0.6; p = 0.035), and diastolic blood pressure (-5.6 mm Hg; 95% CI, -9.9, -1.2; p = 0.013) were improved versus usual care by 6 months. Depressive symptoms were similar between groups. A comprehensive telemedicine intervention improved outcomes among veterans with PPDM despite clinic-based care. Because we specifically designed this intervention with scalability in mind, it may represent a practical, real-world strategy to reduce the burden of poor diabetes control among veterans.

  11. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... from Veterans Health Administration The Power of 1 PSA see more videos from Veterans Health Administration Commitments PSA see more videos from Veterans Health Administration The ...

  12. All-Cause Mortality Among US Veterans of the Persian Gulf War

    Science.gov (United States)

    Kang, Han K.; Bullman, Tim

    2016-01-01

    Objective: We determined cause-specific mortality prevalence and risks of Gulf War deployed and nondeployed veterans to determine if deployed veterans were at greater risk than nondeployed veterans for death overall or because of certain diseases or conditions up to 13 years after conflict subsided. Methods: Follow-up began when the veteran left the Gulf War theater or May 1, 1991, and ended on the date of death or December 31, 2004. We studied 621   901 veterans who served in the 1990-1991 Persian Gulf War and 746   247 veterans who served but were not deployed during the Gulf War. We used Cox proportional hazard models to calculate rate ratios adjusted for age at entry to follow-up, length of follow-up, race, sex, branch of service, and military unit. We compared the mortality of (1) Gulf War veterans with non–Gulf War veterans and (2) Gulf War army veterans potentially exposed to nerve agents at Khamisiyah in March 1991 with those not exposed. We compared standardized mortality ratios of deployed and nondeployed Gulf War veterans with the US population. Results: Male Gulf War veterans had a lower risk of mortality than male non–Gulf War veterans (adjusted rate ratio [aRR] = 0.97; 95% confidence interval [CI], 0.95-0.99), and female Gulf War veterans had a higher risk of mortality than female non–Gulf War veterans (aRR = 1.15; 95% CI, 1.03-1.28). Khamisiyah-exposed Gulf War army veterans had >3 times the risk of mortality from cirrhosis of the liver than nonexposed army Gulf War veterans (aRR = 3.73; 95% CI, 1.64-8.48). Compared with the US population, female Gulf War veterans had a 60% higher risk of suicide and male Gulf War veterans had a lower risk of suicide (standardized mortality ratio = 0.84; 95% CI, 0.80-0.88). Conclusion: The vital status and mortality risk of Gulf War and non–Gulf War veterans should continue to be investigated. PMID:28123229

  13. THE IMPACT OF POSTRAUMATIC STRESS DISORDER ON PARTNER OF IRANIAN VETERANS

    Directory of Open Access Journals (Sweden)

    H. Zarrabi

    2008-05-01

    Full Text Available Veterans with Post Traumatic Stress Disorder (PTSD suffer from distressing and disabling symptoms. Many studies have shown that PTSD symptoms can negatively influence quality of life of their partners. This study was designed to assess general health, marital satisfaction and self-esteem levels of partners of Iranian veterans with PTSD. We performed a case-control study. Cases were comprised of 40 partners of veterans with PTSD. Controls were comprised of 40 married women referred to general health center in Rasht city. Three self report psychometric inventories including General Health Questionnaire (GHQ28, Evaluating and Nurturing Relationship Issues, Communication and Happiness questionnaire (ENRICH and Cooper-Smith inventory-adult form were applied assessing general health, marital satisfaction and self-esteem levels in our subjects. Mean score of GHQ28 questionnaire was 39.77 ± 20.96 in case group and 17.12 ± 9.08 in control group (P = 0.0001, t = 6.269. Average scores of ENRICH questionnaire in case and control groups were 133.7 ± 28.05 and 165.90 ± 31.10 respectively (P = 0.0001, t = 4.861. Mean score of Cooper-Smith test was 29.62 ± 7.89 in cases while it was 39.92 ± 6.36 between controls (P = 0.0001, t = 4.551. We concluded that partners of veterans with PTSD significantly showed lower levels of general health, marital satisfaction and self-esteem than other women. In general, our results demonstrated that partners of veterans with PTSD had lower levels of quality of life comparing other women.

  14. 77 FR 69551 - Advisory Committee on Women Veterans; Notice of Meeting

    Science.gov (United States)

    2012-11-19

    ... Administration; and briefings on health care for women Veterans, mental health, women Veterans' legislative... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans; Notice of Meeting The...

  15. Suicide in Scottish military veterans: a 30-year retrospective cohort study.

    Science.gov (United States)

    Bergman, B P; Mackay, D F; Smith, D J; Pell, J P

    2017-07-01

    Although reassuring data on suicide risk in UK veterans of the 1982 Falklands conflict and 1991 Gulf conflict have been published, there have been few studies on long-term overall suicide risk in UK veterans. To examine the risk of suicide in a broad population-based cohort of veterans in Scotland, irrespect ive of length of service or exposure to conflict, in comparison with people having no record of military service. A retrospective 30-year cohort study of 56205 veterans born 1945-85 and 172741 matched non-veterans, using Cox proportional hazard models to compare the risk of suicide and fatal self-harm overall, by sex, birth cohort, length of service and year of recruitment. There were 267 (0.48%) suicides in the veterans compared with 918 (0.53%) in non-veterans. The difference was not statistically significant overall [adjusted hazard ratio (HR) 0.99; 95% confidence interval (CI) 0.86-1.13]. The incidence was lower in younger veterans and higher in veterans aged over 40. Early service leavers were at non-significantly increased risk (adjusted HR 1.13; 95% CI 0.91-1.40) but only in the older age groups. Women veterans had a significantly higher risk of suicide than non-veteran women (adjusted HR 2.44; 95% CI 1.32-4.51, P suicide did not differ significantly between veterans and non-veterans, for either sex. The Scottish Veterans Health Study adds to the emerging body of evidence that there is no overall difference in long-term risk of suicide between veterans and non-veterans in the UK. However, female veterans merit further study. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  16. Use of Psychotherapy by Rural and Urban Veterans

    Science.gov (United States)

    Cully, Jeffrey A.; Jameson, John P.; Phillips, Laura L.; Kunik, Mark E.; Fortney, John C.

    2010-01-01

    Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted…

  17. Pengaruh Customer Relationship Management (Crm) Terhadap Customer Satisfaction Dan Customer Loyalty Pada Pelanggan Matahari Department Store

    OpenAIRE

    Ham, Meyske

    2016-01-01

    This study was conducted to determine the effect Benefits of Customer Relationship Management and Customer satisfation to Customer Loyalty in Customers Matahari Department Store. Customer relationship management (CRM) is part of a marketing strategy to get satisfaction and increase customer loyalty. CRM and customer satisfaction can encourage customer loyalty where customers do not easily switch to other companies. The population is all customers Matahari Department Store, and the sample are ...

  18. Self-reported infertility among male and female veterans serving during Operation Enduring Freedom/Operation Iraqi Freedom.

    Science.gov (United States)

    Katon, Jodie; Cypel, Yasmin; Raza, Mubashra; Zephyrin, Laurie; Reiber, Gayle; Yano, Elizabeth M; Barth, Shannon; Schneiderman, Aaron

    2014-02-01

    Infertility is associated with psychosocial distress and is a growing public health concern. Our objective was to report the prevalence of lifetime history of infertility among men and women Veterans. We used data from the U.S. Department of Veterans Affairs National Health Study for a New Generation of U.S. Veterans, a nationally representative survey of Veterans serving during Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF). The primary dependent variables were self-reported lifetime history of infertility among Veterans and their partners, defined as trying unsuccessfully to become pregnant for at least 12 months, and seeking medical help for infertility. Multiple logistic regression was used to determine whether gender was associated with lifetime history of infertility or seeking medical help for infertility, after adjusting for sociodemographic and military characteristics. All analyses were weighted to account for the complex survey design and nonresponse. Among the 20,370 Veterans (16,056 men; 4,314 women) in our final analytic sample, the prevalence of lifetime history of infertility was 15.8% for women and 13.8% for men. After adjusting for age, ever married, education, race/ethnicity, component, branch of service, and deployment to OEF/OIF, compared with men, women Veterans had similar odds of lifetime history of infertility (odds ratio [OR] 1.07; 95% confidence interval [CI] 0.94, 1.20), but increased odds of seeking medical help for infertility (OR 1.35; 95% CI 1.06, 1.72). Women Veterans are more likely than their male counterparts to seek care for infertility, and given their increasing numbers, the demand for infertility evaluation and care within Veterans' Affairs may increase.

  19. Helping Veterans and Their Families Fight On!

    Directory of Open Access Journals (Sweden)

    Megan Hazle

    2012-04-01

    Full Text Available This new generation of veterans is coming home to families, friends, employers, and communities that likely do not understand military culture, nor the effects that military service and reintegration have on a veteran’s life, leading to the next war – the Reintegration War. Military servicemembers, veterans, and their families face challenges within the Reintegration War that are different from their civilian counterparts and are complicated by military-specific circumstances. In order to more effectively and efficiently address the challenges servicemembers, veterans, and their families face, we need to work together in a comprehensive effort. Strategies are presented to help win the Reintegration War and ease the transition for servicemembers, veterans, and their families.

  20. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... more videos from Veterans Health Administration Lost: The Power of One Connection see more videos from Veterans Health Administration The Power of 1 PSA see more videos from Veterans ...

  1. Prevalence of Gulf war veterans who believe they have Gulf war syndrome: questionnaire study

    Science.gov (United States)

    Chalder, T; Hotopf, M; Unwin, C; Hull, L; Ismail, K; David, A; Wessely, S

    2001-01-01

    Objectives To determine how many veterans in a random sample of British veterans who served in the Gulf war believe they have “Gulf war syndrome,” to examine factors associated with the presence of this belief, and to compare the health status of those who believe they have Gulf war syndrome with those who do not. Design Questionnaire study asking British Gulf war veterans whether they believe they have Gulf war syndrome and about symptoms, fatigue, psychological distress, post-traumatic stress, physical functioning, and their perception of health. Participants 2961 respondents to questionnaires sent out to a random sample of 4250 Gulf war veterans (69.7%). Main outcome measure The proportion of veterans who believe they have Gulf war syndrome. Results Overall, 17.3% (95% confidence interval 15.9 to 18.7) of the respondents believed they had Gulf war syndrome. The belief was associated with the veteran having poor health, not serving in the army when responding to the questionnaire, and having received a high number of vaccinations before deployment to the Gulf. The strongest association was knowing another person who also thought they had Gulf war syndrome. Conclusions Substantial numbers of British Gulf war veterans believe they have Gulf war syndrome, which is associated with psychological distress, a high number of symptoms, and some reduction in activity levels. A combination of biological, psychological, and sociological factors are associated with the belief, and these factors should be addressed in clinical practice. What is already known on this topicThe term Gulf war syndrome has been used to describe illnesses and symptoms experienced by veterans of the 1991 Gulf warConcerns exist over the validity of Gulf war syndrome as a unique entityWhat this study adds17% of Gulf war veterans believe they have Gulf war syndromeHolding the belief is associated with worse health outcomesKnowing someone else who believes they have Gulf war syndrome and receiving

  2. Cancer morbidity in British military veterans included in chemical warfare agent experiments at Porton Down: cohort study

    Science.gov (United States)

    Linsell, L; Brooks, C; Keegan, T J; Langdon, T; Doyle, P; Maconochie, N E S; Fletcher, T; Nieuwenhuijsen, M J; Beral, V

    2009-01-01

    Objective To determine cancer morbidity in members of the armed forces who took part in tests of chemical warfare agents from 1941 to 1989. Design Historical cohort study, with cohort members followed up to December 2004. Data source Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants All veterans included in the cohort study of mortality, excluding those known to have died or been lost to follow-up before 1 January 1971 when the UK cancer registration system commenced: 17 013 male members of the UK armed forces who took part in tests (Porton Down veterans) and a similar group of 16 520 men who did not (non-Porton Down veterans). Main outcome measures Cancer morbidity in each group of veterans; rate ratios, with 95% confidence intervals, adjusted for age group and calendar period. Results 3457 cancers were reported in the Porton Down veterans compared with 3380 cancers in the non-Porton Down veterans. While overall cancer morbidity was the same in both groups (rate ratio 1.00, 95% confidence interval 0.95 to 1.05), Porton Down veterans had higher rates of ill defined malignant neoplasms (1.12, 1.02 to 1.22), in situ neoplasms (1.45, 1.06 to 2.00), and those of uncertain or unknown behaviour (1.32, 1.01 to 1.73). Conclusion Overall cancer morbidity in Porton Down veterans was no different from that in non-Porton Down veterans. PMID:19318700

  3. Night eating among veterans with obesity.

    Science.gov (United States)

    Dorflinger, Lindsey M; Ruser, Christopher B; Masheb, Robin M

    2017-10-01

    The obesity rate is higher among veterans than the general population, yet few studies have examined their eating behaviors, and none have examined the presence of night eating and related comorbidities. This study examines night eating syndrome (NES) among veterans seeking weight management treatment, and relationships between NES and weight, insomnia, disordered eating, and psychological variables. The sample consisted of 110 veterans referred to a weight management program at VA Connecticut Healthcare System. More than one out of ten veterans screened positive for NES, and one-third screened positive for insomnia. Most individuals screening positive for NES also screened positive for insomnia. Night eating was associated with higher BMI, and with higher scores on measures of binge eating, emotional overeating, and eating disorder symptomatology. Veterans screening positive for NES were also significantly more likely to screen positive for depression and PTSD. When controlling for insomnia, only the relationships between night eating and binge and emotional eating remained significant. Those screening positive for PTSD were more likely to endorse needing to eat to return to sleep. Findings suggest that both NES and insomnia are common among veterans seeking weight management services, and that NES is a marker for additional disordered eating behavior, specifically binge eating and overeating in response to emotions. Additional studies are needed to further delineate the relationships among NES, insomnia, and psychological variables, as well as to examine whether specifically addressing NES within behavioral weight management interventions can improve weight outcomes and problematic eating behaviors. Published by Elsevier Ltd.

  4. Shouldn’t customers control customized product development

    NARCIS (Netherlands)

    Smets, L.P.M.; Langerak, F.; Rijsdijk, S.A.

    2013-01-01

    Nowadays, customized product development (CPD) is increasingly prevalent in business-to-business settings, which has motivated manufacturers into development approaches wherein the customer plays an active role. When the customer is merely viewed as a passive receiver of the customized product, the

  5. Understanding Customer Experience Throughout the Customer Journey

    NARCIS (Netherlands)

    Lemon, Katherine N.; Verhoef, Peter C.

    2016-01-01

    Understanding customer experience and the customer journey over time is critical for firms. Customers now interact with firms through myriad touch points in multiple channels and media, and customer experiences are more social in nature. These changes require firms to integrate multiple business

  6. Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services.

    Science.gov (United States)

    Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B

    2018-02-27

    Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.

  7. Customer-to-customer roles and impacts in service encounters

    OpenAIRE

    Lee, Linda

    2016-01-01

    This thesis investigates customer-to-customer roles and impacts in the context of service encounters. This topic is studied from two angles: customer interactions during group service encounters and customer perceptions post service encounters. The first angle is a focus on group service encounters that addresses the lack of research on customer-to-customer interactions that occur in customer-to-customer interaction-intensive contexts. These are contexts where the interactions between custome...

  8. Membangun Customer Loyalty Nasabah Bank melalui Customer Satisfaction

    OpenAIRE

    Sumarto, Sumarto

    2007-01-01

    In the relation between bank and its customer, the bank should to capable to fulfill need and satisfy through services and create the value to the customer. So in the compete situation, to give customer satisfaction is main duty of bank in order that the customer loyal permanently. The customer satisfaction is primary cause for building customer loyalty. More and more loyal customer to the bank, that's indicate the service superiority of its bank. Base description above this research purpose...

  9. Three-dimensional body scanning system for apparel mass-customization

    Science.gov (United States)

    Xu, Bugao; Huang, Yaxiong; Yu, Weiping; Chen, Tong

    2002-07-01

    Mass customization is a new manufacturing trend in which mass-market products (e.g., apparel) are quickly modified one at a time based on customers' needs. It is an effective competing strategy for maximizing customers' satisfaction and minimizing inventory costs. An automatic body measurement system is essential for apparel mass customization. This paper introduces the development of a body scanning system, body size extraction methods, and body modeling algorithms. The scanning system utilizes the multiline triangulation technique to rapidly acquire surface data on a body, and provides accurate body measurements, many of which are not available with conventional methods. Cubic B-spline curves are used to connect and smooth body curves. From the scanned data, a body form can be constructed using linear Coons surfaces. The body form can be used as a digital model of the body for 3-D garment design and for virtual try-on of a designed garment. This scanning system and its application software enable apparel manufacturers to provide custom design services to consumers seeking personal-fit garments.

  10. Erectile Dysfunction Medication Use in Veterans Eligible for Medicare Part D.

    Science.gov (United States)

    Spencer, Samantha H; Suda, Katie J; Smith, Bridget M; Huo, Zhiping; Bailey, Lauren; Stroupe, Kevin T

    2016-07-01

    Development Service as grant IIR 07-165-2. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or Health Services Research and Development Service. Study concept and design were contributed by Smith and Stroupe, assisted by the other authors. Huo, Bailey, and Stroupe took the lead in data collection, assisted by the other authors. Data interpretation was performed by Spencer and Suda, along with Smith and Stroupe and assisted by Huo and Bailey. The manuscript was primarily written by Spencer and Suda, with assistance from the other authors, and revised by Spencer, along with the other authors.

  11. 77 FR 18307 - Gulf War Veterans' Illnesses Task Force Report

    Science.gov (United States)

    2012-03-27

    ... DEPARTMENT OF VETERANS AFFAIRS Gulf War Veterans' Illnesses Task Force Report AGENCY: Department...) established the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA policies and programs addressing 1990-1991 Gulf War Veterans' illnesses. The GWVI-TF...

  12. INDONESIAN CUSTOMER SATISFACTION IN ONLINE SHOPPING TRADING

    OpenAIRE

    Hermawan F.; Wijayanti S.H.

    2018-01-01

    This research aims to find out if the ease of shopping, site design, informative, comprehensive, and communication have a significant influence on the level of Indonesian customer satisfaction in online shopping transactions and how the impact to the word of mouth communication. Respondents of this study are the 250 students of Jakarta colleges. This study found that the variables of design, simplicity, and security have an influence on customer satisfaction in shopping online, while the info...

  13. Smart Product Design and Production Control for Effective Mass Customization in the Industry 4.0 Concept

    Directory of Open Access Journals (Sweden)

    Zawadzki Przemysław

    2016-09-01

    Full Text Available The paper presents a general concept of smart design and production control as key elements for efficient operation of a smart factory. The authors present various techniques that aid the design process of individualized products and organization of their production in the context of realization of the mass customization strategy, which allows a shortened time of development for a new product. Particular attention was paid to integration of additive manufacturing technologies and virtual reality techniques, which are a base of the so-called hybrid prototyping.

  14. Veterans' Transitions to Community College: A Case Study

    Science.gov (United States)

    Wheeler, Holly A.

    2012-01-01

    Veterans on college campuses are not new; however, the recent influx of veterans returning home from war-time service present challenges to the colleges they attend. The purpose of this qualitative case study was to examine the transition process experienced by veterans leaving military service and attending community college for the first time.…

  15. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    van Triest, S.; Bun, M.J.G.; van Raaij, E.M.; Vernooij, M.J.A.

    2009-01-01

    We study the effects of customer-specific marketing expenses on customer retention and customer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a hitherto unstudied type of expense targeted at individual customer

  16. Spiritual distress of military veterans at the end of life.

    Science.gov (United States)

    Chang, Bei-Hung; Stein, Nathan R; Skarf, Lara M

    2015-06-01

    Although combat experiences can have a profound impact on individuals' spirituality, there is a dearth of research in this area. Our recent study indicates that one unique spiritual need of veterans who are at the end of life is to resolve distress caused by combat-related events that conflict with their personal beliefs. This study sought to gain an understanding of chaplains' perspectives on this type of spiritual need, as well as the spiritual care that chaplains provide to help veterans ease this distress. We individually interviewed five chaplains who have provided spiritual care to veterans at the end of life in a Veterans Administration hospital. The interviews were recorded, transcribed, and analyzed based on "grounded theory." Chaplains reported that they frequently encounter veterans at the end of life who are still suffering from thoughts or images of events that occurred during their military career. Although some veterans are hesitant to discuss their experiences, chaplains reported that they have had some success with helping the veterans to open up. Additionally, chaplains reported using both religious (e.g., confessing sins) and nonreligious approaches (e.g., recording military experience) to help veterans to heal. Our pilot study provides some insight into the spiritual distress that many military veterans may be experiencing, as well as methods that a chaplain can employ to help these veterans. Further studies are needed to confirm our findings and to examine the value of integrating the chaplain service into mental health care for veterans.

  17. Rural Veterans' dental utilization, Behavioral Risk Factor Surveillance Survey, 2014.

    Science.gov (United States)

    Wiener, R Constance; Shen, Chan; Sambamoorthi, Usha; Findley, Patricia A

    2017-09-01

    Rural residents are overrepresented in the military; however, access to Veteran services is limited in rural areas. There is a need to identify rural Veteran healthcare utilization. This study addresses that need and has two purposes: a) to determine if there is an association between rural dwelling and Veteran utilization of dental services; and b) to determine if there is an association between rural dwelling and the oral health outcome of missing teeth. Data from the 2014 Behavioral Risk Factor Surveillance Survey were used in this study. Chi square and logistic regression analyses were conducted. Rural Veterans were less likely to have a dental visit during the previous year as compared with metropolitan Veterans in unadjusted analysis (Odds ratio = 0.71, 95% Confidence Interval, 0.64, 0.77) and in adjusted analysis [0.87 (95% Confidence Interval, 0.78, 0.96)]. In cases in which all teeth were missing, rural Veterans had an unadjusted odds ratio of 1.79 [95% Confidence Interval, 1.55, 2.08] and an adjusted odds ratio of 1.37 [95% Confidence Interval, 1.17, 1.62] as compared with metropolitan Veterans. The Veterans Health Administration develops policies for establishing centers for care for Veterans. The policy development should take into consideration that rural Veterans have not been as likely as urban Veterans to utilize dental services and have poorer oral health outcomes. © 2017 American Association of Public Health Dentistry.

  18. The health and wellbeing needs of veterans: a rapid review.

    Science.gov (United States)

    Oster, Candice; Morello, Andrea; Venning, Anthony; Redpath, Paula; Lawn, Sharon

    2017-12-29

    For the majority of serving members, life in the military has a positive effect on wellbeing. However, the type, intensity and duration of service, along with the transition from fulltime military to civilian life, may have a negative effect on veterans' wellbeing. Such negative consequences, alongside the growing veteran population, indicate the need for greater exploration of veterans' physical, mental and social wellbeing. The current paper reports on the findings of a rapid review of the literature on the health and wellbeing needs of veterans, commissioned by the Australian Department of Veterans' Affairs to inform future programs and services. The databases Embase, Medline, Cinahl, PubMed, Web of Science and Cochrane Database were searched for systematic reviews reporting on veterans' physical, mental and social wellbeing published in English in peer-reviewed journals. A total of 21 systematic reviews were included. The reviews reported on a range of mental, physical and social health problems affecting veterans. While there was limited information on prevalence rates of physical, mental and social health problems in veterans compared to civilian populations, the reviews demonstrated the interconnection between these domains and the effect of demographic and military service factors. A key finding of the review is the interconnection of the mental, physical, and social health of veterans, highlighting the importance that an integrated approach to veterans' wellbeing is adopted. It is suggested that understanding key factors, such as demographic factors and factors relating to military service, can support improved service provision for veterans.

  19. PENGEMBANGAN CUSTOMER RELATIONSHIP MANAGEMENT BERBASIS SISTEM E-COMMERCE

    Directory of Open Access Journals (Sweden)

    Sugiarto Montana

    2010-10-01

    Full Text Available PT Dwisanjaya Abadi Mukti is a company engaged in distributing Pertamina lubricating agent with products for industrial and automotive lubricants. Therefore, companies need a Customer Relationship Management E-commerce-based systems, to address the issues of purchasing and service to customers that are still conducted manually. Systems analysis is done through observation interviews, and literature; analysis of survey findings; and identification of information needs from survey. The system is designed to give advantage to the user as to obtain the desired information quickly, to acquire new customers, improve customer relationships, and retain customers; other than that for the company this system reduces operating costs, more efficient time, accessible anytime and anywhere, improving work productivity, increase sales, increase the number of customers, and improve customer satisfaction.Keywords: customer relationship management, e-commerce, front end, back end

  20. Suicide and substance use among female veterans: a need for research.

    Science.gov (United States)

    Chapman, Shawna L Carroll; Wu, Li-Tzy

    2014-03-01

    The number of female veterans is increasing. Veterans Administration (VA) enrollment increased over 40% from past eras. However, little research has focused on their mental health. We reviewed literature to examine associations of substance use with suicide in female veterans, identify research gaps, and inform future studies. Google Scholar, Pub Med, and PsychINFO were searched using: substance use, female veteran, and suicide. Exclusion criteria (e.g., not discussing U.S. veterans) left 17 articles. Nine studies examined completed suicide among veterans. In most recent years, rates of deaths were greater for veterans than nonveterans, including females. Completed suicide was associated with past trauma, young age, and a mental disorder. Studies have often not addressed substance use. Three studies examined completed suicide among VA treated veterans without examining substance use as an associated factor. Rates of completed suicides were also higher among veterans than nonveterans, including females. A large proportion of females also had a mental diagnosis. Five studies examined substance use and attempted or completed suicide among VA treated veterans. Veterans in poor mental health had increased odds of suicide mortality; women with a substance use disorder (SUD) had a higher hazard ratio for completed suicide than men with a SUD. Engagement in substance abuse treatment decreased odds of suicide attempt among veterans. Available data suggest that suicide rates are higher among female veterans than women in the general population. Substance use may increase the likelihood of suicidal behaviors among female veterans, particularly those with a mental diagnosis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... videos from Veterans Health Administration Talking About It Matters see more videos from Veterans Health Administration Stand ... Health Administration I am A Veteran Family/Friend Active Duty/Reserve and Guard Signs of Crisis Identifying ...

  2. Cancer incidence in Dutch Balkan veterans

    NARCIS (Netherlands)

    Bogers, R.P.; Leeuwen, F.E. van; Grievink, L.; Schouten, L.J.; Kiemeney, L.A.L.M.; Schram-Bijkerk, D.

    2013-01-01

    Suspicion has been raised about an increased cancer risk among Balkan veterans because of alleged exposure to depleted uranium. The authors conducted a historical cohort study to examine cancer incidence among Dutch Balkan veterans. Male military personnel (n=18,175, median follow-up 11 years) of

  3. For Homeless Veterans

    Science.gov (United States)

    ... Business with VA Acquisition, Logistics, & Construction Small & Veteran Business Programs VetBiz.gov Financial & Asset Enterprise Management Security Investigation Center/Background Clearances Freedom of Information ...

  4. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    van Triest, S.; van Raaij, E.M.; Bun, M.; Vernooij, M.

    2007-01-01

    We study the effects of customer-specific marketing expenses on customer retention and cus-tomer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a type of expenses targeted at individual customer relationships: the

  5. Analisis dan Perancangan Electronik Customer Relationship Management Pada Klinik XYZ

    Directory of Open Access Journals (Sweden)

    Joni Suhartono

    2010-12-01

    Full Text Available This research is to foster a good connection between company and customers. For customers, e-CRM will accommodate in interation and transaction with the company. This research is done because there are still weaknesses for customer’s service. The research method used is literature, analysis method, and also designing method in identifying system needs then design one supporting system for the company. The research result is a CRM website that gives up-to-date information and suitable for customer needs. Therefore, CRM is hoped to help company giving a better service to customers.

  6. Utilization of travel reimbursement in the Veterans Health Administration.

    Science.gov (United States)

    Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall

    2014-01-01

    To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.

  7. Veterans Crisis Line: Videos About Reaching out for Help

    Science.gov (United States)

    Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  8. Responsive and resilient supply chain network design under operational and disruption risks with delivery lead-time sensitive customers

    DEFF Research Database (Denmark)

    Fattahi, Mohammad; Govindan, Kannan; Keyvanshokooh, Esmaeil

    2017-01-01

    We address a multi-period supply chain (SC) network design where demands of customers depend on facilities serving them based on their delivery lead-times. Potential customer demands are stochastic, and facilities’ capacity varies randomly because of possible disruptions. Accordingly, we develop...... a multi-stage stochastic program, and model disruptions’ effect on facilities’ capacity. The SC responsiveness risk is limited and, to obtain a resilient network, both mitigation and contingency strategies are exploited. Computational results on a real-life case study and randomly generated problem...... instances demonstrate the model's applicability, risk-measurement policies’ performance, and the influence of mitigation and contingency strategies on SC's resiliency....

  9. 38 CFR 11.116 - Death of veteran before final settlement.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death of veteran before... Death of veteran before final settlement. If the veteran dies after making application under the... considered valid if found to bear the bona-fide signature of the applicant, discloses an intention to claim...

  10. Major traumatic limb loss among women veterans and servicemembers

    OpenAIRE

    Jodie G. Katon, PhD; Gayle E. Reiber, PhD

    2013-01-01

    The number of women veterans is rapidly growing, and little is known regarding the health and healthcare needs of women veterans with traumatic limb loss. The objective of this study was to summarize physical and mental health conditions and rates of prosthetic prescriptions among women servicemembers and veterans with major traumatic limb loss. Researchers and clinicians who administered the Survey for Prosthetic Use contacted and enrolled 283 servicemembers and veterans of Operation Iraqi F...

  11. When to "Fire" Customers: Customer Cost-Based Pricing

    OpenAIRE

    Jiwoong Shin; K. Sudhir; Dae-Hee Yoon

    2012-01-01

    The widespread adoption of activity-based costing enables firms to allocate common service costs to each customer, allowing for precise measurement of both the cost to serve a particular customer and the customer's profitability. In this paper, we investigate how pricing strategies based on customer cost information affects a firm's customer acquisition and retention dynamics, and ultimately its profit, using a two-period monopoly model with high- and low-cost customer segments. Although past...

  12. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... a Self-Check Quiz Resources Spread the Word Videos Homeless Resources Additional Information Make the Connection Get Help When To Call What To Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live ...

  14. Client-oriented Building Mass Customization (CoBMC)

    Science.gov (United States)

    Lee, Xia Sheng; Faris Khamidi, Mohd; Kuppusamy, Sivaraman; Tuck Heng, Chin

    2017-12-01

    Although much later compared to other industries including aerospace, automobile, oil and gas etc., digital technology development has been cresting towards an exponential curve in the construction industry. Technological diversity and abundance change the game from “what you can” to “what you want”. Society is changing at an unprecedented rate. Consequently adaptability will be crucial. This research paper explores the integration of digital adaptive technologies that transform the construction industry from the mass production to that of a possible client-oriented mass customization. The focus on the design, construction and performance stages of a building project, currently undergoing major overhaul faces a paradigm shift globally that will impact and compel attention for the next three decades with viable solutions such as Building Information Modelling (BIM) to manage massive data cum information. Customization maximizes clients’ participation during the design process thereby achieving greater effective value and higher satisfaction. A study between customized and standardized examples will investigate how adaptive customization will shift the design paradigm from cost to value centric. This action research will explore different aspects of emerging innovative systems already in place pushing the edge of frontiers, and transforming the building industry landscape whether micro or giga, to compliment new technologies to create an unprecedented exhilaration of freshness over the mundane, routine and mediocrity. Three identified fundamental aspects that are instrumental to Client-oriented Building Mass Customization (CoBMC) are design option visualization, parametric product information and n-dimensional modelling. The study concluded that a paradigm shift is therefore inevitable for every stakeholder including clients who will need to re-examine their roles, capabilities, and competencies in preparation towards challenging future.

  15. ANTESEDEN CUSTOMER SATISFACTION DAN DAMPAKNYA PADA PURCHASE INTENTION

    Directory of Open Access Journals (Sweden)

    Jonathan Banjarnahor

    2018-02-01

    Full Text Available This research analyzed the effects of service quality and customer experience to customer satisfaction and its impact on purchase intention of costumer internet services in West Jakarta. This research used hypothesis testing as a research design. The primary data were obtained through questionnaire distributed to 180 respondents who should be users of internet services from Telkomsel, Telkomsel Grapari West Jakarta. Data was anlyzed by Structural Equation Method (SEM. The results showed there were positives service qualities and customer experience effects to customer satisfaction. There were positive customer satisfaction effects to purchase intention. There were positive effects of service quality and customer experience to purchase intention. Implications for managers are to increase purchase intention through fulfilled customer satisfaction led from good service quality and customer experience. For reasearch, it can be done in other service providers and by adding extra variables, such as coporate image and brand trust.

  16. Design and methods for the Better Resiliency Among Veterans and non-Veterans with Omega-3's (BRAVO) study: A double blind, placebo-controlled trial of omega-3 fatty acid supplementation among adult individuals at risk of suicide.

    Science.gov (United States)

    Marriott, Bernadette P; Hibbeln, Joseph R; Killeen, Therese K; Magruder, Kathryn M; Holes-Lewis, Kelly; Tolliver, Bryan K; Turner, Travis H

    2016-03-01

    Suicide remains the 10th leading cause of death among adults in the United States (U.S.). Annually, approximately 30 per 100,000 U.S. military Veterans commit suicide, compared to 14 per 100,000 U.S. civilians. Symptoms associated with suicidality can be treatment resistant and proven-effective pharmaceuticals may have adverse side-effects. Thus, a critical need remains to identify effective approaches for building psychological resiliency in at-risk individuals. Omega-3 highly unsaturated fatty acids (n-3 HUFAs) are essential nutrients, which must be consumed in the diet. N-3 HUFAs have been demonstrated to reduce symptoms of depression, anxiety, and impulsivity - which are associated with suicide risk. Here we present the design and methods for the Better Resiliency Among Veterans and non-Veterans with Omega-3's (BRAVO) study, which is a double blind, randomized, controlled trial among individuals at risk of suicide of an n-3 HUFA versus placebo supplementation in the form of all natural fruit juice beverages. The BRAVO study seeks to determine if dietary supplementation with n-3 HUFAs reduces the risk for serious suicidal behaviors, suicidal thinking, negative emotions, and symptoms associated with suicide risk. Sub-analyses will evaluate efficacy in reducing depressive symptoms, alcohol, and nicotine use. A sub-study utilizes functional magnetic resonance imaging (fMRI) to evaluate the neuropsychological and neurophysiological effects of n-3 HUFAs. We also outline selection of appropriate proxy outcome measures for detecting response to treatment and collection of ancillary data, such as diet and substance use, that are critical for interpretation of results. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Psychotherapy Utilization Among Rural and Urban Veterans From 2007 to 2010.

    Science.gov (United States)

    Mott, Juliette M; Grubbs, Kathleen M; Sansgiry, Shubhada; Fortney, John C; Cully, Jeffrey A

    2015-01-01

    This study evaluated change in rural and urban veterans' psychotherapy use during a period of widespread effort within the Veterans Health Administration (VHA) to engage rural veterans in mental health care. National VHA administrative databases were queried for patients receiving a new diagnosis of depression, anxiety, or posttraumatic stress disorder in fiscal years (FY) 2007 and 2010. Using the US Department of Agriculture Rural-Urban Continuum Codes, we identified urban (FY 2007: n = 192,347; FY 2010: n = 231,471) and rural (FY 2007: n = 72,923; FY 2010: n = 81,905) veterans. Veterans' psychotherapy use during the 12 months following diagnosis was assessed. From FY 2007 to 2010, the proportion of veterans receiving any psychotherapy increased from 17% to 22% for rural veterans and 24% to 28% for urban veterans. Rural veterans were less likely to receive psychotherapy across both fiscal years; however, the magnitude of this disparity decreased significantly from 2007 (odds ratio [OR] = 1.51) to 2010 (OR = 1.41). Similarly, although urban veterans received more psychotherapy sessions, urban-rural disparities in the receipt of 8 or more psychotherapy sessions decreased over the study period (2007: OR = 2.32; 2010: OR = 1.69). Rural and urban veterans are increasingly making use of psychotherapy, and rural-urban gaps in psychotherapy use are shrinking. These improvements suggest that recent VHA efforts to engage rural veterans in care have been successful at reducing differences between rural and urban veterans with respect to access and engagement in psychotherapy. © 2014 National Rural Health Association.

  18. Advanced engineering tools for design and fabrication of a custom nasal prosthesis

    Science.gov (United States)

    Oliveira, Inês; Leal, Nuno; Silva, Pedro; da Costa Ferreira, A.; Neto, Rui J.; Lino, F. Jorge; Reis, Ana

    2012-09-01

    Unexpected external defects resulting from neoplasms, burns, congenital malformations, trauma or other diseases, particularly when involving partial or total loss of an external organ, can be emotionally devastating. These defects can be restored with prosthesis, obtained by different techniques, materials and methods. The increase of patient numbers and cost constraints lead to the need of exploring new techniques that can increase efficiency. The main goal of this project was to develop a full engineering-based manufacturing process to obtain soft-tissue prosthesis that could provide faster and less expensive options in the manufacturing of customized prosthesis, and at the same time being able to reproduce the highest degree of details, with the maximum comfort for the patient. Design/methodology/approach - This case report describes treatment using silicone prosthesis with an anatomic retention for an 80-years-old woman with a rhinectomy. The proposed methodology integrates non-contact structured light scanning, CT and reverse engineering with CAD/CAM and additive manufacturing technology. Findings - The proposed protocol showed encouraging results since reveals being a better solution for fabricating custom-made facial prostheses for asymmetrical organs than conventional approaches. The process allows the attainment of prosthesis with the minimum contact and discomfort for the patient, disclosing excellent results in terms of aesthetic, prosthesis retention and in terms of time and resources consumed.

  19. A Customized Intervention for Dementia Caregivers: A Quasi-Experimental Design.

    Science.gov (United States)

    Wawrziczny, Emilie; Larochette, Clotilde; Papo, David; Constant, Emilie; Ducharme, Francine; Kergoat, Marie-Jeanne; Pasquier, Florence; Antoine, Pascal

    2018-04-01

    The aim of this study is to test the effects of a customized intervention on distress among caregivers of persons with dementia (PWD) using a quasi-experimental design. Fifty-one spouse caregivers in the experimental group and 51 in the control group participated in the study. The effects of the intervention were examined by comparing caregivers' responses with questionnaires at pre-intervention baseline (T0) and immediately after intervention (T1). Differences were quantified using repeated-measures ANOVA. The analyses indicated a stabilizing effect of the intervention on caregivers' perceptions of PWD's daily functioning, self-esteem related to caregiving, quality of family support, and feeling of distress. Linear increases were observed regarding sense of preparedness and impact on daily routine, while no differences (interaction and linear effects) were observed for degree of self-efficacy, depression, impact on finances, or self-rated health. These findings show a preliminary efficacy of the intervention proposed in this study to prevent the exacerbation of caregivers' distress.

  20. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results From the National Health and Resilience in Veterans Study.

    Science.gov (United States)

    Weiner, Melissa R; Monin, Joan K; Mota, Natalie; Pietrzak, Robert H

    2016-04-01

    To examine the associations between multiple aspects of social support-perceived support, structural support, and community integration-and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Cross-sectional Web survey of younger and older male veterans recruited from a contemporary, nationally representative sample of veterans residing in the United States. Data were drawn from the National Health and Resilience in Veterans Study. Participants were 290 younger male veterans (mean age: 37.0 years, SD: 6.9, range: 21-46) and 326 older male veterans (mean age: 81.7 years, SD: 3.2, range: 78-96). Participants completed measures of sociodemographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may help promote mental health in older veterans, whereas promotion of functional social support may help promote mental health in younger veterans. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  1. King customer forever: Customer satisfaction and beyond

    Directory of Open Access Journals (Sweden)

    Myuers James

    2004-01-01

    Full Text Available "King Customer!" So proclaimed the front cover of Business Week in a 1989 issue. At about the same time, "Rediscovering the Customer" was the title of a series of company vignettes in Fortune magazine. And a Wall Street Journal article asked, "For Customers, More Than Lip Service?" Combined, these three prestigious business publications reflected a new era in business firms perceptions of their customers and the role they should play in the formulation of company strategies and priorities. Had the "Era of the Customer" finally arrived in American business? .

  2. DefenseLink Special: Veterans Day 2006

    Science.gov (United States)

    information so we can address your issue or question. U.S. Department of Defense Header Image (click to return especially important this year as America's military members put their lives in danger to protect the country Service. Story Cities Carry ASY Banner to Honor Past, Present Veterans WASHINGTON, Nov. 8, 2006 - Veterans

  3. Negative emotions in veterans relate to suicide risk through feelings of perceived burdensomeness and thwarted belongingness.

    Science.gov (United States)

    Rogers, Megan L; Kelliher-Rabon, Jessica; Hagan, Christopher R; Hirsch, Jameson K; Joiner, Thomas E

    2017-01-15

    Suicide rates among veterans are disproportionately high compared to rates among the general population. Veterans may experience a number of negative emotions (e.g., anger, self-directed hostility, shame, guilt) during periods of postwar adjustment and reintegration into civilian life that may uniquely confer risk for suicide. Mechanisms of these associations, however, are less well studied. The purpose of the present study was to examine the relationship between negative emotions and suicide risk in veterans through the theoretical framework of the interpersonal theory of suicide. A large sample of veterans (N = 541) completed measures assessing their negative emotions, perceived burdensomeness, thwarted belongingness, and suicide risk. Self-directed hostility and shame related indirectly to suicide risk through both perceived burdensomeness and thwarted belongingness. Thwarted belongingness accounted for the association between anger and suicide risk, whereas perceived burdensomeness accounted for the relationship between guilt and suicide risk. This study had a cross-sectional design and relied solely on self-report measures. These findings provide evidence for the role of negative emotions in conferring risk for suicide in veterans. Clinical implications, limitations, and future research directions are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD.

    Science.gov (United States)

    Hall, Katherine S; Morey, Miriam C; Beckham, Jean C; Bosworth, Hayden B; Pebole, Michelle M; Pieper, Carl F; Sloane, Richard

    2018-03-15

    Posttraumatic stress disorder (PTSD) affects up to 30% of military veterans. Older veterans, many of whom have lived with PTSD symptoms for several decades, report a number of negative health outcomes. Despite the demonstrated benefits of regular exercise on physical and psychological health, no studies have explored the impact of exercise in older veterans with PTSD. This paper describes the development, design, and implementation of the Warrior Wellness exercise pilot study for older veterans with PTSD. Veterans aged ≥60 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis of PTSD will be recruited and randomized to (a) Warrior Wellness, a 12-week supervised, facility-based exercise intervention, or (b) usual care for 12 weeks. Warrior Wellness is a theory- and evidence-based behavioral intervention that involves 3 sessions per week of multi-component exercise training that targets strength, endurance, balance, and flexibility. Warrior Wellness focuses on satisfaction with outcomes, self-efficacy, self-monitoring, and autonomy. Factors associated with program adherence, defined as the number of sessions attended during the 12 weeks, will be explored. Primary outcomes include PTSD symptoms and cardiovascular endurance, assessed at baseline and 12 weeks. Compared to those in usual care, it is hypothesized that those in the Warrior Wellness condition will improve on these efficacy outcomes. The Warrior Wellness study will provide evidence on whether a short-term exercise intervention is feasible, acceptable, and effective among older veterans with PTSD, and explore factors associated with program adherence. ClinicalTrials.gov Identifier : NCT02295995.

  5. Development of customized positioning guides using computer-aided design and manufacturing technology for orthognathic surgery.

    Science.gov (United States)

    Lin, Hsiu-Hsia; Chang, Hsin-Wen; Lo, Lun-Jou

    2015-12-01

    The purpose of this study was to devise a method for producing customized positioning guides for translating virtual plans to actual orthognathic surgery, and evaluation of the feasibility and validity of the devised method. Patients requiring two-jaw orthognathic surgery were enrolled and consented before operation. Two types of positioning guides were designed and fabricated using computer-aided design and manufacturing technology: One of the guides was used for the LeFort I osteotomy, and the other guide was used for positioning the maxillomandibular complex. The guides were fixed to the medial side of maxilla. For validation, the simulation images and postoperative cone beam computed tomography images were superimposed using surface registration to quantify the difference between the images. The data were presented in root-mean-square difference (RMSD) values. Both sets of guides were experienced to provide ideal fit and maximal contact to the maxillary surface to facilitate their accurate management in clinical applications. The validation results indicated that RMSD values between the images ranged from 0.18 to 0.33 mm in the maxilla and from 0.99 to 1.56 mm in the mandible. The patients were followed up for 6 months or more, and all of them were satisfied with the results. The proposed customized positioning guides are practical and reliable for translation of virtual plans to actual surgery. Furthermore, these guides improved the efficiency and outcome of surgery. This approach is uncomplicated in design, cost-effective in fabrication, and particularly convenient to use.

  6. Innovations in Mechatronic Products and Mass Customization

    DEFF Research Database (Denmark)

    Habib, Tufail; Jørgensen, Kaj Asbjørn; Nielsen, Kjeld

    2011-01-01

    as a product type and new inventions have resulted in drastic changes in design and development of mechatronic products. Conventional mechanical systems are enhanced by mechatronic systems. In this paper, the particular structure and properties of mechatronic products compared to conventional mechanical......Mass Customization (MC) has been recognized as a successful strategy in the design and development of products tailored to customer needs. Global competition demands new products with added functionalities, as in the case of mechatronic products. These products are becoming more and more important...

  7. Marketing assets: relating brand equity and customer equity

    OpenAIRE

    Romero, Jaime; Yagüe, María J.

    2016-01-01

    Purpose: Brand equity and customer equity are inextricably linked. Some authors propose that marketing activities build these intangible assets simultaneously. In contrast, others suggest that brand equity is an antecedent of customer equity. In this research, we aim to shed light about the relationship between brand equity and customer equity, by empirically testing these two alternative explanations. Design/methodology/approach: We propose four research models that reflect these two alte...

  8. How to strengthen customer loyalty, using customer segmentation?

    Directory of Open Access Journals (Sweden)

    MELNIC Elena Lidia

    2017-01-01

    Full Text Available Do you provide exceptional customer service?”, “Is the customer service in your company extraordinary?” “How to convert satis fied customers into loyal customers?” - are the most frequent questions of today’s managers and have driven the research on this article to getting the answer to a highly important marketing topic “How to strengthen customer loyalty using customer segmentation?”. Anyone who has bought a product or a service has probably suffered at least once from a company’s apparent indifference to what should be its first concern: the customer experiences. If this is the case, the company is in a wrong direction, since loyalty is the most powerful tool in today competitive market. To strengthen the bonds with these high-profit customers, innovative companies are deploying enterprise-wide strategies built on consumer segmentation.

  9. Lingual Orthodontics simplified : Incognito -customization perfected

    Directory of Open Access Journals (Sweden)

    Haroutioun Dedeyan

    2013-01-01

    Full Text Available Esthetic orthodontics is the need of the hour, fuelled by the increasing number of adult patients seeking orthodontic treatment. Alternatives to labial appliance include clear aligners and lingual appliance. Conventional lingual treatment is laborious in terms of laboratory setup and manual dexterity of the operator, coupled with less than optimum treatment results. Customization of the appliance to meet varied requirements of each patient due to highly variable lingual morphology within and amongst patients is the key to successful treatment in lingual orthodontics. Efforts at bracket base customization using intra-oral jigs and laboratory setups are fraught with unavoidable errors affecting treatment outcome. With the advent of computer-aided design and computer-aided manufacturing (CAD/CAM technology the Eldorado of true customization is now a reality. This paper introduces the Incognito Appliance System based on custom-made brackets and custom-made series of pre-bent wires using state of art CAD/CAM manufacturing procedures.

  10. 76 FR 6197 - Advisory Committee on Women Veterans; Notice of Meeting

    Science.gov (United States)

    2011-02-03

    ... Administration, the National Cemetery Administration, and the Women Veterans Health Strategic Health Care Group; and briefings on mental health, women Veterans' legislative issues, women Veterans' research, rural... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach...

  11. More Research on Veteran Employment Would Show What’s Good for Business and for Veterans

    Science.gov (United States)

    2016-01-01

    approaches to addressing sexual harassment , sexual assault, hazing, and other problematic behaviors in the armed forces. ...indicate that certain cohorts of veterans are excelling in the workplace . For example, post-9/11 veterans’ median earnings are 11 percent higher than those...and programs, the October workshop focused on studies and research needs regarding leveraging skills that veterans bring to the workplace , effective

  12. Comparison study of memory status in war-PTSD veterans with depression and non- veterans depressed patients

    Directory of Open Access Journals (Sweden)

    Radfar Shokofeh

    2012-03-01

    Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05. There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05. A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05. Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.

  13. Women veterans' preferences for intimate partner violence screening and response procedures within the Veterans Health Administration.

    Science.gov (United States)

    Iverson, Katherine M; Huang, Kristin; Wells, Stephanie Y; Wright, Jason D; Gerber, Megan R; Wiltsey-Stirman, Shannon

    2014-08-01

    Intimate partner violence (IPV) is a significant health issue faced by women veterans, but little is known about their preferences for IPV-related care. Five focus groups were conducted with 24 women Veterans Health Administration (VHA) patients with and without a lifetime history of IPV to understand their attitudes and preferences regarding IPV screening and responses within VHA. Women veterans wanted disclosure options, follow-up support, transparency in documentation, and VHA and community resources. They supported routine screening for IPV and articulated preferences for procedural aspects of screening. Women suggested that these procedures could be provided most effectively when delivered with sensitivity and connectedness. Findings can inform the development of IPV screening and response programs within VHA and other healthcare settings. © 2014 Wiley Periodicals, Inc.

  14. Assessment of validity with polytrauma Veteran populations.

    Science.gov (United States)

    Bush, Shane S; Bass, Carmela

    2015-01-01

    Veterans with polytrauma have suffered injuries to multiple body parts and organs systems, including the brain. The injuries can generate a triad of physical, neurologic/cognitive, and emotional symptoms. Accurate diagnosis is essential for the treatment of these conditions and for fair allocation of benefits. To accurately diagnose polytrauma disorders and their related problems, clinicians take into account the validity of reported history and symptoms, as well as clinical presentations. The purpose of this article is to describe the assessment of validity with polytrauma Veteran populations. Review of scholarly and other relevant literature and clinical experience are utilized. A multimethod approach to validity assessment that includes objective, standardized measures increases the confidence that can be placed in the accuracy of self-reported symptoms and physical, cognitive, and emotional test results. Due to the multivariate nature of polytrauma and the multiple disciplines that play a role in diagnosis and treatment, an ideal model of validity assessment with polytrauma Veteran populations utilizes neurocognitive, neurological, neuropsychiatric, and behavioral measures of validity. An overview of these validity assessment approaches as applied to polytrauma Veteran populations is presented. Veterans, the VA, and society are best served when accurate diagnoses are made.

  15. 78 FR 48789 - Veterans' Advisory Committee on Education, Notice of Meeting

    Science.gov (United States)

    2013-08-09

    ... DEPARTMENT OF VETERANS AFFAIRS Veterans' Advisory Committee on Education, Notice of Meeting The..., that the Veterans' Advisory Committee on Education will meet on August 13-14, 2013, in the First Floor... on the administration of education and training programs for Veterans, Servicepersons, Reservists...

  16. 76 FR 64184 - Advisory Committee on Women Veterans; Notice of Meeting

    Science.gov (United States)

    2011-10-17

    ... Administration, and the Women Veterans Health Strategic Health Care Group; and briefings on mental health, women Veterans' legislative issues, women Veterans' research, rural health, and homeless initiatives for women... the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach, and...

  17. 77 FR 7244 - Advisory Committee on Women Veterans, Notice of Meeting

    Science.gov (United States)

    2012-02-10

    ..., and the Women Veterans Health Strategic Health Care Group; and briefings on mental health, women... regarding the needs of women Veterans with respect to health care, rehabilitation, compensation, outreach... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Women Veterans, Notice of Meeting The...

  18. Colleges' Experiences: Integrating Support Services for Military Veterans

    Science.gov (United States)

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  19. The Impact of Customer Relationship Management to Customer Loyalty Through Customer Satisfaction in Cabal Dining Manado

    OpenAIRE

    Pandowo, Merinda; Pangemanan, Sifrid S.; Wattilete, Randy

    2013-01-01

    Customer relationship management is the one influencing customer loyalty, but to get customer loyalty we should know how to make customer satisfaction. This research is purposed to analyze the impact of customer relationship management to customer loyalty through customer satisfaction in Cabal Dining Manado. This research used the Path analysis as the method of this research. Population in this research is mainly in this research is people in Manado. The sample of this research is 100 respond...

  20. Location of cancer surgery for older veterans with cancer.

    Science.gov (United States)

    Kouri, Elena M; Landrum, Mary Beth; Lamont, Elizabeth B; Bozeman, Sam; McNeil, Barbara J; Keating, Nancy L

    2012-04-01

    Many veterans undergo cancer surgery outside of the Veterans Health Administration (VHA). We assessed to what extent these patients obtained care in the VHA before surgery. VHA-Medicare data, VHA administrative data, and Veterans Affairs Central Cancer Registry data. We identified patients aged ≥65 years in the VHA-Medicare cohort who underwent lung or colon cancer resection outside the VHA and assessed VHA visits in the year before surgery. Over 60% of patients in the VHA-Medicare cohort who received lung or colon cancer surgeries outside the VHA did not receive any care in VHA before surgery. Veterans' receipt of major cancer surgery outside the VHA probably reflects usual private sector care among veterans who are infrequent VHA users. © Health Research and Educational Trust.

  1. All new custom path photo book creation

    Science.gov (United States)

    Wang, Wiley; Muzzolini, Russ

    2012-03-01

    In this paper, we present an all new custom path to allow consumers to have full control to their photos and the format of their books, while providing them with guidance to make their creation fast and easy. The users can choose to fully automate the initial creation, and then customize every page. The system manage many design themes along with numerous design elements, such as layouts, backgrounds, embellishments and pattern bands. The users can also utilize photos from multiple sources including their computers, Shutterfly accounts, Shutterfly Share sites and Facebook. The users can also use a photo as background, add, move and resize photos and text - putting what they want where they want instead of being confined to templates. The new path allows users to add embellishments anywhere in the book, and the high-performance platform can support up to 1,000 photos per book and up to 25 pictures per page. The path offers either Smart Autofill or Storyboard features allowing customers to populate their books with photos so they can add captions and customize the pages.

  2. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Science.gov (United States)

    2013-05-13

    ... Verification Self-Assessment Tool that walks the veteran through the regulation and how it applies to the...) Verification Guidelines AGENCY: Department of Veterans Affairs. ACTION: Advanced notice of proposed rulemaking... regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification...

  3. Analysis of Customer Loyalty through Total Quality Service, Customer Relationship Management and Customer Satisfaction

    Science.gov (United States)

    Binsar Kristian P., Feliks Anggia; Panjaitan, Hotman

    2014-01-01

    This research talks about total quality service and customer relationship management effects toward customer satisfaction and its impact on customer loyalty. Fast food restaurant KFC, always strives to continue to make improvements in total quality service, so that customer satisfaction can be maintained, which in turn will have an impact on…

  4. Rancang Bangun Sistem Informasi Customer Loyalty untuk Keunggulan Kompetitif Organisasi

    Directory of Open Access Journals (Sweden)

    Sri Mulyani

    2014-02-01

    Full Text Available Utilization of information technology to achieve competitive advantage has become a necessity  for business people and managers of organizations  in the information age now. This research aim to create a customer loyalty that the information system is one part of theCustomer  Relationship  Management  to  collect  data  on  indicators  of  customer  loyalty.  Indicator  of  customer  loyalty  is  determined according  empirical  model  customer  loyalty  and  create  customer  loyalty  information  system  that  can  be  used  to  gain  competitive advantage organizations. Structural Equation Modeling is used to obtain indicators of customer loyalty. Customer loyalty info rmation system designed using prototype system development and modeling analysis using Data Flow Diagram, database design using  Entity Relationship  Diagram,  and  a  web-based  interface.  Web-based  information  systems  that  provide online  customer  survey  facilities  and analysis  results  in  the  form  of  customer  loyalty  index  values  shaped  by  the  dynamic  graphic  indicator  of  loyalty  according  to  the empirical study of customer loyalty that can be used to gain competitive advantage. The value of customer loyalty index cons ists of four main variables, namely: the ability to anticipate customer value, customer value anticipation peace, customer satisfaction, and loyalty.Keywords: Customer loyalty, Structural Equation Modeling, Index loyalty, Competitive advantage

  5. The influence of psychosocial factors in veteran adjustment to civilian life.

    Science.gov (United States)

    Bowes, Margaret A; Ferreira, Nuno; Henderson, Mike

    2018-03-25

    Although most veterans have a successful transition to civilian life when they leave the military, some struggle to cope and adjust to the demands and challenges of civilian life. This study explores how a variety of psychosocial factors influence veteran adjustment to civilian life in Scotland, UK, and which of these factors predict a poor adjustment. One hundred and fifty-four veterans across Scotland completed a set of questionnaires that measured veteran adjustment difficulty, quality of life, mental health, stigma, self-stigma, attitude towards help-seeking, likelihood of help-seeking, experiential avoidance, reappraisal and suppression. Veteran adjustment difficulty and quality of life were significantly correlated to a number of psychosocial factors. Mental health, experiential avoidance and cognitive reappraisal were found to be predictors of veteran adjustment difficulty, and experiential avoidance and cognitive reappraisal partially mediated the relationship between mental health and veteran adjustment, with experiential avoidance being the stronger mediator. Our findings suggest that early assessment of experiential avoidance and cognitive reappraisal and the provision of relevant emotion regulation skills training could potentially reduce the veteran's need for more complex (and costly) psychological interventions in the future. Implications for veterans, as well as the services and professionals involved with veteran transition and health care are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

  6. Rural Women Veterans' Use and Perception of Mental Health Services.

    Science.gov (United States)

    Ingelse, Kathy; Messecar, Deborah

    2016-04-01

    While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

  7. Absorptive capacity and mass customization capability

    OpenAIRE

    Zhang, Min; Zhao, Xiande; Lyles, Marjorie A.; Guo, Hangfei

    2015-01-01

    Purpose The purpose of this paper is to investigate the effects of a manufacturer’s absorptive capacity (AC) on its mass customization capability (MCC). Design/methodology/approach The authors conceptualize AC within the supply chain context as four processes: knowledge acquisition from customers, knowledge acquisition from suppliers, knowledge assimilation, and knowledge application. The authors then propose and empirically test a model on the relationships among AC processes and MCC using s...

  8. Implementing effective policy in a national mental health re-engagement program for Veterans

    Science.gov (United States)

    Smith, Shawna N.; Lai, Zongshan; Almirall, Daniel; Goodrich, David E.; Abraham, Kristen M.; Nord, Kristina M.; Kilbourne, Amy M.

    2016-01-01

    Policy is a powerful motivator of clinical change, but implementation success can depend on organizational characteristics. This paper used validated measures of organizational resources, culture and climate to predict uptake of a nationwide VA policy aimed at implementing Re-Engage, a brief care management program that re-establishes contact with Veterans with serious mental illness lost to care. Patient care databases were used to identify 2,738 Veterans lost to care. Local Recovery Coordinators (LRCs) were to update disposition for 2,738 Veterans at 158 VA facilities and, as appropriate, facilitate a return to care. Multivariable regression assessed organizational culture and climate as predictors of early policy compliance (via LRC presence) and uptake at six months. Higher composite climate and culture scores were associated with higher odds of having a designated LRC, but were not predictive of higher uptake. Sites with LRCs had significantly higher rates of updated documentation than sites without LRCs. PMID:27668352

  9. Standards and Customer Service: Employees Behavior towards Customers

    Directory of Open Access Journals (Sweden)

    Venelin Terziev

    2017-09-01

    Full Text Available Ensuring effective customer service requires targeted efforts in a number of areas, one of which is to develop service standards for each market segment. The development and implementation of standards requires the organization to accurately determine customer service types, the cost of providing alternative services, and measures for measuring and controlling the services provided. At the core of the developed and implemented standards is the development and establishment of the customer service policy, which should start with a consumer demand analysis. The definition of customer service level should allow for quantitative measurement because the vague and quantifiable policy does not provide opportunities for evaluation and control of the activities and expenses of customer service. When developing service standards, it is appropriate to apply an algorithm that focuses primarily on standards related to employee behavior towards customers. This paper explores the need and capability to develop customer service standards and provides an algorithm for developing standards for employee behavior toward customers.

  10. Severe hearing impairment among military veterans--United States, 2010.

    Science.gov (United States)

    2011-07-22

    A substantial proportion of hearing loss in the United States is attributable to employment-related exposure to noise. Among military veterans, the most common service-connected disabilities are hearing impairments, suggesting that occupational noise exposure during military service might cause more veterans to have hearing loss than nonveterans. However, a recent analysis of data from the 1993-1995 Epidemiology of Hearing Loss Study did not find significant differences between the two groups. To further investigate hearing loss among veterans, specifically the prevalence of severe hearing impairment (SHI), data from the 2010 Annual Social and Economic Supplement (ASEC) to the Current Population Survey (CPS) were analyzed. This report describes the results of those analyses, which indicated that the prevalence of SHI among veterans was significantly greater than among nonveterans. Veterans were 30% more likely to have SHI than nonveterans after adjusting for age and current occupation, and veterans who served in the United States or overseas during September 2001-March 2010, the era of overseas contingency operations (including Operations Enduring Freedom and Iraqi Freedom), were four times more likely than nonveterans to have SHI. These findings suggest a need for increased emphasis on improving military hearing conservation programs (HCPs) and on hearing loss surveillance in military and veterans' health systems.

  11. Major traumatic limb loss among women veterans and servicemembers.

    Science.gov (United States)

    Katon, Jodie G; Reiber, Gayle E

    2013-01-01

    The number of women veterans is rapidly growing, and little is known regarding the health and healthcare needs of women veterans with traumatic limb loss. The objective of this study was to summarize physical and mental health conditions and rates of prosthetic prescriptions among women service members and veterans with major traumatic limb loss. Researchers and clinicians who administered the Survey for Prosthetic Use contacted and enrolled 283 servicemembers and veterans of Operation Iraqi Freedom/Operation Enduring Freedom with major traumatic limb loss. Participants provided information on health status; comorbidities; other combat injuries; and prosthetic device use, rejection, and replacement. Of the 283 veterans, 9 (3%) were women. Compared with men, women reported more than a threefold higher prevalence of migraine (67% vs 20%, p = 0.001). Compared with men, women received 0.42 more prostheses per year, rejected 0.11 more prostheses per year, but replaced 0.18 fewer prostheses per year. With the exception of migraine headaches, men and women servicemembers and veterans with major traumatic limb loss report similarly high prevalence of physical and mental health conditions. Women report higher rates of prosthesis receipt and rejection and lower rates of prosthesis replacement than men. These findings highlight some potential issues specific to women veterans that may require additional clinical attention.

  12. Effects of Job Design and Sales Managers' Behavior on Intrinsic Motivation, Customer Orientation and Performance of Salespeople : - A quantitative study in the Swedish electricity market.

    OpenAIRE

    Hedelius, Elina; Nilsson, Sara

    2014-01-01

    The main purpose of this study is to examine the effects of job design and sales managers’ behavior on intrinsic motivation and customer orientation of salespeople. Furthermore, we aim to examine if any of the factors included in our model have an effect on performance of Company X’s salespeople. Thus, our research questions are:  What impacts do job design and sales managers’ behaviors have on intrinsic motivation and customer orientation of salespeople? What kind of differences exist betwee...

  13. Firearm ownership among American veterans: findings from the 2015 National Firearm Survey.

    Science.gov (United States)

    Cleveland, Emily C; Azrael, Deborah; Simonetti, Joseph A; Miller, Matthew

    2017-12-19

    While the majority of veteran suicides involve firearms, no contemporary data describing firearm ownership among US veterans are available. This study uses survey data to describe the prevalence of firearm ownership among a nationally representative sample of veterans, as well as veterans' reasons for firearm ownership. A cross-sectional, nationally representative web-based survey conducted in 2015. Nearly half of all veterans own one or more firearms (44.9%, 95% CI 41.3-48.6%), with male veterans more commonly owning firearms than do female veterans (47.2%, 95% CI 43.4-51.0% versus 24.4%, 95%CI 15.6-36.1%). Most veteran firearm owners own both handguns and long guns (56.5%, 95% CI 51.1-61.8%); a majority cite protection as a primary reason for firearm ownership (63.1%, 95% CI 58.2-67.8%). The current study is the first to provide detailed, nationally representative information about firearm ownership among U.S. veterans. Better understanding firearm ownership among veterans can usefully inform ongoing suicide prevention efforts aiming to facilitate lethal means safety among vulnerable veterans during at-risk periods.

  14. Barriers and Health Beliefs Related to Weight Management Among Veterans With Human Immunodeficiency Virus.

    Science.gov (United States)

    Munro, Shannon; Dinatale, Emily; Hartley, Sarah; St Jacques, Monica; Oursler, Kris Ann

    2017-01-01

    The success of antiretroviral therapy has led to dramatic changes in causes of morbidity and mortality among U.S. Veterans with human immunodeficiency virus (HIV). Among the 25,000 Veterans treated for HIV, 70% are over age 50 and the rate of obesity has doubled in this population. Veterans with HIV have a 50% increased risk of myocardial infarction yet have limited presence in prevention-related programs designed to lower cardiovascular disease risk. This mixed methods study (focus groups, Schwarzer and Renner physical activity, and nutrition self-efficacy questionnaires) was used to explore factors related to health behavior and identify barriers that overweight Veterans with HIV face in enrolling in the MOVE weight management program. Institutional review board approval was granted before the start of the study. All participants were recruited from the Infectious Disease clinic if they met national inclusion criteria for the MOVE weight management program and had not previously participated in the program. Transcribed audio recordings were independently analyzed and coded by four of the researchers using an exploratory process to obtain consensus regarding themes. An interrater reliability analysis for the Kappa statistic was performed to determine consistency among raters. The relationship between physical activity self-efficacy scores and nutrition self-efficacy scores was tested using Spearman's correlation coefficient. The median age of the sample was 56 with high rates of diabetes (36%), hypertension (73%), hyperlipidemia (36%), and tobacco use history (82%). External barriers to participation were discussed in addition to 8 other themes, which influence treatment engagement for Veterans with obesity and HIV including adaptation, stigma, self-management, and support. Veterans held strong beliefs about responsibility and commitment to their health and wanted to assume an active and informed role in their health care. Veterans with high levels of perceived

  15. Veterans Choice Program

    Data.gov (United States)

    Department of Veterans Affairs — If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your...

  16. Perancangan E-Customer Relationship Management Pada Pt Starsindo Logistics

    Directory of Open Access Journals (Sweden)

    Nelly Nelly

    2010-12-01

    Full Text Available Starsindo Logistics Inc. (SL is a company in freight forwarding service. The problem in this company is less information provided to customers, especially about customer order status information. It is started from the departure of the EMKL truck until the standard time of customer container entering freight process. Therefore, it is needed to use the customer service application electronic-Customer Relationship Management (e-CRM, because it will ease to manage and control information flow about the customer order status. The research method is following rules in object oriented analysis and design by Mathiassen. Through website, public is hoped to easily access the company information or ship schedule, order list, tracking order status, or transaction history. This web-based customer service application could help the company to build a good relationship with customers

  17. Student Veteran perceptions of facilitators and barriers to achieving academic goals.

    Science.gov (United States)

    Norman, Sonya B; Rosen, Jay; Himmerich, Sara; Myers, Ursula S; Davis, Brittany; Browne, Kendall C; Piland, Neill

    2015-01-01

    According to recent estimates, over 1 million Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans are utilizing the post-9/11 GI Bill to pursue higher education. Data collected by the Department of Defense suggests that greater than 17% of returning Veterans may suffer from mental and physical health disorders, which can negatively affect school performance. The current study explored student Veterans' perceived facilitators and barriers to achieving academic goals. Thirty-one student Veterans completed self-report measures and interviews. Results suggested that Veterans that were reporting problems or symptoms in one mental or physical health domain were likely to be reporting symptoms or problems in others as well. The interview data were coded, and three overarching themes related to barriers and facilitators emerged: person features (e.g., discipline and determination, symptoms and stressors), institutional structure (i.e., what schools and the Department of Veterans Affairs do that was perceived to help or hinder student Veteran success), and policy concerns (i.e., how the structure of the GI Bill affects student Veteran school experience). Results from this research indicate the need for larger studies and program development efforts aimed at enhancing academic outcomes for Veterans.

  18. Do You Get Better User Experiences when You Customize Your Smartphone?

    DEFF Research Database (Denmark)

    Wang, Ying; Tan, Chee-Wee; Clemmensen, Torkil

    2016-01-01

    A system can be customized by is owner. The fundamental premise behind designing for customization is that it improves the user experience (UX) of the system. In this study, we contend that the effects of customization on UX of a smartphone can be theoretically modelled as users’ beliefs about....... Each participant was asked to perform customization tasks on a smartphone, and then instructed to complete a comparison task aimed at contrasting customized user interface with a standard one. Our manipulation checks confirmed that the customization task, in particular, the customization of the layout...

  19. VA Is Here for the People Who Support Our Veterans

    Science.gov (United States)

    ... a Self-Check Quiz Resources Spread the Word Videos Homeless Resources Additional Information Make the Connection Get Help When To Call What To Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live ...

  20. Three Generations, Three Wars: African American Veterans.

    Science.gov (United States)

    Black, Helen K

    2016-02-01

    This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Suicide mortality among male veterans discharged from Veterans Health Administration acute psychiatric units from 2005 to 2010.

    Science.gov (United States)

    Britton, Peter C; Bohnert, Kipling M; Ilgen, Mark A; Kane, Cathleen; Stephens, Brady; Pigeon, Wilfred R

    2017-09-01

    The purpose of this study was to calculate suicide rates and identify correlates of risk in the year following discharge from acute Veterans Health Administration psychiatric inpatient units among male veterans discharged from 2005 to 2010 (fiscal years). Suicide rates and standardized mortality ratios were calculated. Descriptive analyses were used to describe suicides and non-suicides and provide base rates for interpretation, and unadjusted and adjusted proportional hazard models were used to identify correlates of suicide. From 2005 to 2010, 929 male veterans died by suicide in the year after discharge and the suicide rate was 297/100,000 person-years (py). The suicide rate significantly increased from 234/100,000 py (95% CI = 193-282) in 2005 to 340/100,000 py (95% CI = 292-393) in 2008, after which it plateaued. Living in a rural setting, HR (95% CI) = 1.20 (1.05, 1.36), and being diagnosed with a mood disorder such as major depression, HR (95% CI) = 1.60 (1.36, 1.87), or other anxiety disorder, HR (95% CI) = 1.52 (1.24, 1.87), were associated with increased risk for suicide. Among male veterans, the suicide rate in the year after discharge from acute psychiatric hospitalization increased from 2005 to 2008, after which it plateaued. Prevention efforts should target psychiatrically hospitalized veterans who live in rural settings and/or are diagnosed with mood or other anxiety disorders.

  2. Preventing customer defection and stimulating return of the lost customers

    Directory of Open Access Journals (Sweden)

    Senić Radoslav

    2013-01-01

    Full Text Available Customers represent company's most valuable asset. Company can assure its survival, further growth and development by retaining existing, attracting new and returning lost customers. Retaining existing, loyal customers is the most profitable business activity, attracting new ones is the most expensive, while returning lost and frequently forgotten customers is a type of business activity that still generates modest interest among researchers and practitioners. So far, marketing strategies have been mainly directed towards the first two categories of customers. The objective of this paper is dedicated to customer defection and returning lost customers. Paper discusses customer relationship life-cycle and the significance of managing customer return within it, types of customer defections, the process of managing return, as well as, the reasons that led to customer defection.

  3. Supported Employment for Veterans With Traumatic Brain Injury: Patient Perspectives.

    Science.gov (United States)

    Carlson, Kathleen F; Pogoda, Terri K; Gilbert, Tess A; Resnick, Sandra G; Twamley, Elizabeth W; O'Neil, Maya E; Sayer, Nina A

    2018-02-01

    To quantify the need for, and interest in, supported employment (SE) among recent military veterans with traumatic brain injury (TBI); and to examine characteristics associated with veterans' interest in SE. Stratified random sample of Iraq and Afghanistan War veterans confirmed to have TBI through the Veterans Health Administration (VHA) screening and evaluation system. Community-based via mailed survey. We recruited 1800 veterans with clinician-confirmed TBI (mild TBI: n=1080; moderate/severe TBI: n=720) through multiple mailings. Among 1451 surveys that were not returned undeliverable, N=616 (42%) responded. Not applicable. Veterans rated their interest in SE after reading a script describing the program. Additional measures assessed mental health and pain-related comorbidities, employment, financial/housing difficulties, demographics, and military service characteristics. Estimates were weighted to represent the population of veterans with VHA clinician-confirmed TBI. Unemployment was reported by 45% (95% confidence interval [CI], 43-47) of veterans with TBI. Although 42% (95% CI, 40-44) reported they would be interested in using SE if it were offered to them, only 12% had heard of SE (95% CI, 11-14) and interest in SE. However, those who were unemployed, looking for work, experiencing financial strain, or at risk for homelessness were more likely to be interested in SE. Our research highlights an important gap between veterans' vocational needs and interests and their use of SE. Systematically identifying and referring those with employment and financial/housing difficulties may help close this gap. Published by Elsevier Inc.

  4. Aligning for Heroes: Partnership for Veteran Care in New Hampshire.

    Science.gov (United States)

    Fasoli, DiJon R

    2015-01-01

    A growing number of veterans and service members ("veterans" refers to both veterans and eligible service members) are returning home and may be living with mental health conditions related to their military service. For a variety of reasons, the majority of US veterans receive their health care outside the Veterans Administration or the military health system. Nurse leaders and citizen-soldiers were among a number of concerned government officials, health care professionals, service providers, and military leaders in New Hampshire (NH) who joined forces to explore NH veterans' mental health needs and manage provider service capacity. This article describes the formation and efforts of a permanent legislative commission, the NH Commission on PTSD and TBI (COPT), composed of interdisciplinary, multiorganizational, and cross-governmental leaders aligned to address the issues of stigma, military cultural awareness, and integration of care. Commission participants were asked to share their perspectives on the gaps and challenges to veterans' care, opportunities for collaboration, and measurable outcomes. Key challenges included interagency communication and care integration issues, veteran and provider knowledge gaps about needs and system problems. Favorable timing, available funding, and the collaborative environment of the commission were identified as potential opportunities. While still a work in progress, the COPT has begun making an impact. We identify early outcomes and lessons learned. The COPT is a model for leveraging interdisciplinary professional collaboration to improve access to care for veterans.

  5. Veterans Health Administration

    Science.gov (United States)

    ... Accountability & Whistleblower Protection Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival ...

  6. Empirical research on Kano's model and customer satisfaction.

    Science.gov (United States)

    Lin, Feng-Han; Tsai, Sang-Bing; Lee, Yu-Cheng; Hsiao, Cheng-Fu; Zhou, Jie; Wang, Jiangtao; Shang, Zhiwen

    2017-01-01

    Products are now developed based on what customers desire, and thus attractive quality creation has become crucial. In studies on customer satisfaction, methods for analyzing quality attributes and enhancing customer satisfaction have been proposed to facilitate product development. Although substantial studies have performed to assess the impact of the attributes on customer satisfaction, little research has been conducted that quantitatively calculate the odds of customer satisfaction for the Kano classification, fitting a nonlinear relationship between attribute-level performance and customer satisfaction. In the present study, the odds of customer satisfaction were determined to identify the classification of quality attributes, and took customer psychology into account to suggest how decision-makers should prioritize the allocation of resources. A novel method for quantitatively assessing quality attributes was proposed to determine classification criteria and fit the nonlinear relationship between quality attributes and customer satisfaction. Subsequently, a case study was conducted on bicycle user satisfaction to verify the novel method. The concept of customer satisfaction odds was integrated with the value function from prospect theory to understand quality attributes. The results of this study can serve as a reference for product designers to create attractive quality attributes in their products and thus enhance customer satisfaction.

  7. An Exploration of Transition Experiences Shaping Student Veteran Life Flow

    Science.gov (United States)

    Gregg, Brian Tuan

    2016-01-01

    Educational institutions offer transformative opportunities for veterans transitioning from military service. Veteran-specific cultural supports in educational environments offer participation in occupations and development of skills needed to complete educational goals. However, veterans experience complex life circumstances atypical from…

  8. The impact of rate design and net metering on the bill savings from distributed PV for residential customers in California

    International Nuclear Information System (INIS)

    Darghouth, Naim R.; Barbose, Galen; Wiser, Ryan

    2011-01-01

    Net metering has become a widespread mechanism in the U.S. for supporting customer adoption of distributed photovoltaics (PV), but has faced challenges as PV installations grow to a larger share of generation in a number of states. This paper examines the value of the bill savings that customers receive under net metering, and the associated role of retail rate design, based on a sample of approximately two hundred residential customers of California's two largest electric utilities. We find that the bill savings per kWh of PV electricity generated varies by more than a factor of four across the customers in the sample, which is largely attributable to the inclining block structure of the utilities' residential retail rates. We also compare the bill savings under net metering to that received under three potential alternative compensation mechanisms, based on California's Market Price Referent (MPR). We find that net metering provides significantly greater bill savings than a full MPR-based feed-in tariff, but only modestly greater savings than alternative mechanisms under which hourly or monthly net excess generation is compensated at the MPR rate. - Highlights: → We examine the value of bill savings under net metering to PV owners in California. → Bill savings per kWh of PV generation varies by a factor of four with net metering. The variation is attributable to rate design, the unique inclining block structure. → The median value of bill savings is reduced by 40-67% with MPR feed-in tariff. → The median value of bill savings is reduced by 6-12% with hourly netting.

  9. Searching the Soul: Veterans and Their Arts and Crafts

    Science.gov (United States)

    Hasio, Cindy

    2011-01-01

    For military veterans suffering from the long-term trauma of warfare, arts and crafts become much more than the fabrication of relics; they can literally save the spirit. Dialogue and interaction between the veterans, volunteers, and staff are crucial to the success of veterans' arts and crafts program. The purpose of this research was threefold.…

  10. Male combat veterans' narratives of PTSD, masculinity, and health.

    Science.gov (United States)

    Caddick, Nick; Smith, Brett; Phoenix, Cassandra

    2015-01-01

    This article uniquely examines the ways a group of male combat veterans talk about masculinity and how, following post-traumatic stress disorder (PTSD), they performed masculinities in the context of a surfing group, and what effects this had upon their health and wellbeing. Participant observations and life history interviews were conducted with a group of combat veterans who belonged to a surfing charity for veterans experiencing PTSD. Data were rigorously explored via narrative analysis. Our findings revealed the ways in which veterans enacted masculinities in accordance with the values that were cultivated during military service. These masculine performances in the surfing group had important effects both on and for the veterans' wellbeing. Significantly, the study highlights how masculine performances can be seen alternately as a danger and as a resource for health and wellbeing in relation to PTSD. The article advances knowledge on combat veterans and mental health with critical implications for the promotion of male veterans' mental health. These include the original suggestion that health-promoting masculine performances might be recognised and supported in PTSD treatment settings. Rather than automatically viewing masculinity as problematic, this article moves the field forward by highlighting how hegemonic masculinities can be reconstructed in positive ways which might improve veterans' health and wellbeing. A video abstract of this article can be found at: https://www.youtube.com/watch?v=BaYzaOP1kAY. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  11. Transgender Veterans' Satisfaction With Care and Unmet Health Needs.

    Science.gov (United States)

    Lehavot, Keren; Katon, Jodie G; Simpson, Tracy L; Shipherd, Jillian C

    2017-09-01

    Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. We used data from transgender Veterans collected in 2014 through an online, national survey. In total, 298 transgender Veterans living in the United States. We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.

  12. Conflicting Interests in User Requirements for Customization and Personalization

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk

    2015-01-01

    The term 'user requirements' appears unproblematic until it is confronted with conflicting interests of who 'the user' is or should be. Customization and personalization can in this context be understood as designers' attempt to avoid or soften the conflict related to the shaping of user requirem......The term 'user requirements' appears unproblematic until it is confronted with conflicting interests of who 'the user' is or should be. Customization and personalization can in this context be understood as designers' attempt to avoid or soften the conflict related to the shaping of user...... requirements. In this chapter we argue, based in a case-study of the design-process of a customizable web-interface for a public service broadcaster, that the customization strategy does not solve the problem of the conflicting interests in defining the user....

  13. The impact of customer-specific marketing expenses on customer retention and customer profitability

    NARCIS (Netherlands)

    S. van Triest (Sander); M.J.G. Bun (Maurice); E.M. van Raaij (Erik); M.J.A. Vernooij (Maarten)

    2009-01-01

    textabstractWe study the effects of customer-specific marketing expenses on customer retention and customer profitability in a business-to-business setting. Using data from a company providing hygiene services, we look at the impact of a hitherto unstudied type of expense targeted at individual

  14. CUSTOMER RELATIONSHIP MANAGEMENT AND BUSINESS STRATEGIES

    Directory of Open Access Journals (Sweden)

    Rozitta Chittaie

    2012-06-01

    Full Text Available Changing in the current competitive environment, increasing simplicity of penetrating into the competitive market, and rapid growing of information technology are essential motives for performing activities in an environment. Nowadays, some companies step into rapid and instant development of their markets in order to improve customer relationship. These companies through adopting customer relationship management (CRM systems can earn and retain their customers' loyalty. As a result, designing customer relationship management strategies can lead to market protection, customer value increase, and greater customer satisfaction opportunities for continuous promotion of the enterprise. Regarding the complexity and the variety of strategies associated with managing a business, information-related capability seems to be an essential capability for earning profit from companies' activities and competition among peers. Hence, relation and information are employed for managing the firms are vital tools for seizing opportunities and tackling future issues. Giving the information only employed to support a company’s performance, making crucial decision about surrounding environment, increasing competitive ability of the enterprise will be difficult for company. Furthermore, since increase of competitive ability is accompanied by making greater profit on the deal, methods of raising competitive ability is an interesting and critical issue. Therefore, companies through information technology, cost reduction, and development of low-level relations with customers can achieve greater profitability. This paper probes into customer relationship management and business strategies. The implications of CRM strategies are discussed in detail.

  15. 38 CFR 12.3 - Deceased veteran's cases.

    Science.gov (United States)

    2010-07-01

    ... accomplishing such inventories, detailed description will be given of items of material value or importance, for... OF VETERAN'S PERSONAL FUNDS AND EFFECTS Disposition of Veteran's Personal Funds and Effects on...) will be made of all personal effects (including those in the custody of the hospital, jewelry being...

  16. Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

    Science.gov (United States)

    Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S

    2017-03-01

    Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

  17. Relationship intention amongst clothing retail customers: An exploratory study

    Directory of Open Access Journals (Sweden)

    Stefanie W. Kuhn

    2015-08-01

    Full Text Available Orientation: Increasing competition has resulted in clothing retailers placing more emphasis on expensive relationship marketing tactics to retain customers. The retailers often use customers’ loyalty programme membership and the duration of their support to identify and target them in relationship-building efforts. Research purpose: This study determines the viability of relationship intention by measuring and categorising clothing customers according to their relationship intentions. The study also explores the duration of customer support for a clothing retailer, membership of their loyalty programme and the relationship thereof with customers’ relationship intentions towards that retailer. Motivation for the study: Relationship building efforts would be better directed at customers with relationship intentions. Research design, approach and method: Quantitative in nature, this study followed a descriptive research design and used an interviewer-administered survey to collect data from 511 clothing retail customers residing in the greater Pretoria metropolitan area. Main findings: Clothing retailers can effectively determine and categorise customers according to their relationship intentions. The duration customers have supported a clothing retailer and its loyalty programme has no relationship with their relationship intentions. Practical/Managerial implications: Clothing retailers should focus their relationship building on customers with relationship intentions, as they are more likely to respond favourably. They are more likely to be retained by the clothing retailer and provide a return on investment. Contribution/value-add: This study gives clothing retailers a reliable and valid measuring instrument that can be used to identify customers with relationship intentions, rather than relying on the duration of the customers’ support and their loyalty programme membership.

  18. Homelessness and money mismanagement in Iraq and Afghanistan veterans.

    Science.gov (United States)

    Elbogen, Eric B; Sullivan, Connor P; Wolfe, James; Wagner, Henry Ryan; Beckham, Jean C

    2013-12-01

    We examined the empirical link between money mismanagement and subsequent homelessness among veterans. We used a random sample of Iraq and Afghanistan War era veterans from the National Post-Deployment Adjustment Survey in 2009-2011. Veterans were randomly selected from a roster of all US military service members in Operation Iraqi Freedom or Operation Enduring Freedom who were separated from active duty or in the Reserves/National Guard. Veterans (n = 1090) from 50 states and all military branches completed 2 waves of data collection 1 year apart (79% retention rate). Thirty percent reported money mismanagement (e.g., bouncing or forging a check, going over one's credit limit, falling victim to a money scam in the past year). Multivariate analysis revealed money mismanagement (odds ratio [OR] = 4.09, 95% CI = 1.87, 8.94) was associated with homelessness in the next year, as were arrest history (OR = 2.65, 95% CI = 1.33, 5.29), mental health diagnosis (OR = 2.59, 95% CI = 1.26, 5.33), and income (OR = 0.30, 95% CI = 0.13, 0.71). Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness.

  19. A comprehensive custom panel design for routine hereditary cancer testing: preserving control, improving diagnostics and revealing a complex variation landscape.

    Science.gov (United States)

    Castellanos, Elisabeth; Gel, Bernat; Rosas, Inma; Tornero, Eva; Santín, Sheila; Pluvinet, Raquel; Velasco, Juan; Sumoy, Lauro; Del Valle, Jesús; Perucho, Manuel; Blanco, Ignacio; Navarro, Matilde; Brunet, Joan; Pineda, Marta; Feliubadaló, Lidia; Capellá, Gabi; Lázaro, Conxi; Serra, Eduard

    2017-01-04

    We wanted to implement an NGS strategy to globally analyze hereditary cancer with diagnostic quality while retaining the same degree of understanding and control we had in pre-NGS strategies. To do this, we developed the I2HCP panel, a custom bait library covering 122 hereditary cancer genes. We improved bait design, tested different NGS platforms and created a clinically driven custom data analysis pipeline. The I2HCP panel was developed using a training set of hereditary colorectal cancer, hereditary breast and ovarian cancer and neurofibromatosis patients and reached an accuracy, analytical sensitivity and specificity greater than 99%, which was maintained in a validation set. I2HCP changed our diagnostic approach, involving clinicians and a genetic diagnostics team from panel design to reporting. The new strategy improved diagnostic sensitivity, solved uncertain clinical diagnoses and identified mutations in new genes. We assessed the genetic variation in the complete set of hereditary cancer genes, revealing a complex variation landscape that coexists with the disease-causing mutation. We developed, validated and implemented a custom NGS-based strategy for hereditary cancer diagnostics that improved our previous workflows. Additionally, the existence of a rich genetic variation in hereditary cancer genes favors the use of this panel to investigate their role in cancer risk.

  20. Developing food products in accordance with customer demands

    DEFF Research Database (Denmark)

    Juhl, Hans Jørn; Kristensen, Kai; Poulsen, Carsten Stig

    1994-01-01

    Development of food products is considered as a design problem. Through development of a theoretical model QFD is applied to integrate market information on customer satisfaction with information from a sensory analysis. The aim is to translate th information from these two datasets into design a...... quality and systematized in the most efficient manner. In the empirical part of the paper we analyze data on customer requirements in a LISRE setting in order to improve the understanding of the market....

  1. 38 CFR 3.23 - Improved pension rates-Veterans and surviving spouses.

    Science.gov (United States)

    2010-07-01

    ... and World War I veterans. The applicable maximum annual rate payable to a Mexican border period or World War I veteran under this section shall be increased by the amount specified in 38 U.S.C. 1521(g...(d)) (3) Veterans who are housebound. (Authority: 38 U.S.C. 1521(e)) (4) Two veterans married to one...

  2. Adaptation of Lean Six Sigma Methodologies for the Evaluation of Veterans Choice Program at 3 Urban Veterans Affairs Medical Centers.

    Science.gov (United States)

    Ball, Sherry L; Stevenson, Lauren D; Ladebue, Amy C; McCreight, Marina S; Lawrence, Emily C; Oestreich, Taryn; Lambert-Kerzner, Anne C

    2017-07-01

    The Veterans Health Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers. LSS techniques were used to assess data obtained through semistructured interviews with Veterans, staff, and providers to describe and evaluate the VCP process by identifying wastes and defects. The LSS methodology facilitated the process of targeting priorities for improvement and constructing suggestions to close identified gaps and inefficiencies. Identified key process wastes included inefficient exchange of clinical information between stakeholders in and outside of the VHA; poor dissemination of VCP programmatic information; shortages of VCP-participating providers; duplication of appointments; declines in care coordination; and lack of program adaptability to local processes. Recommendations for improvement were formulated using LSS. This evaluation illustrates how LSS can be utilized to assess a nationally mandated health care program. By focusing on stakeholder, staff, and Veteran perspectives, process defects in the VCP were identified and improvement recommendations were made. However, the current LSS language used is not intuitive in health care and similar applications of LSS may consider using new language and goals adapted specifically for health care.

  3. Travel time and attrition from VHA care among women veterans: how far is too far?

    Science.gov (United States)

    Friedman, Sarah A; Frayne, Susan M; Berg, Eric; Hamilton, Alison B; Washington, Donna L; Saechao, Fay; Maisel, Natalya C; Lin, Julia Y; Hoggatt, Katherine J; Phibbs, Ciaran S

    2015-04-01

    Travel time, an access barrier, may contribute to attrition of women veterans from Veterans Health Administration (VHA) care. We examined whether travel time influences attrition: (a) among women veterans overall, (b) among new versus established patients, and (c) among rural versus urban patients. This retrospective cohort study used logistic regression to estimate the association between drive time and attrition, overall and for new/established and rural/urban patients. In total, 266,301 women veteran VHA outpatients in the Fiscal year 2009. An "attriter" did not return for VHA care during the second through third years after her first 2009 visit (T0). Drive time (log minutes) was between the patient's residence and her regular source of VHA care. "New" patients had no VHA visits within 3 years before T0. Models included age, service-connected disability, health status, and utilization as covariates. Overall, longer drive times were associated with higher odds of attrition: drive time adjusted odds ratio=1.11 (99% confidence interval, 1.09-1.14). The relationship between drive time and attrition was stronger among new patients but was not modified by rurality. Attrition among women veterans is sensitive to longer drive time. Linking new patients to VHA services designed to reduce distance barriers (telemedicine, community-based clinics, mobile clinics) may reduce attrition among women new to VHA.

  4. Effect of the 5-HTTLPR polymorphism on posttraumatic stress disorder, depression, anxiety, and quality of life among Iraq and Afghanistan veterans.

    Science.gov (United States)

    Kimbrel, Nathan A; Morissette, Sandra B; Meyer, Eric C; Chrestman, Roberta; Jamroz, Robert; Silvia, Paul J; Beckham, Jean C; Young, Keith A

    2015-01-01

    Posttraumatic stress disorder (PTSD), depression, anxiety, and stress are significant problems among returning veterans and are associated with reduced quality of life. A correlational design was used to examine the impact of a polymorphism (5-HTTLPR) in the serotonin transporter promoter gene on post-deployment adjustment among returning veterans. A total of 186 returning Iraq and Afghanistan veterans were genotyped for the 5-HTTLPR polymorphism. Symptoms of PTSD, depression, general stress, and anxiety were assessed along with quality of life. After controlling for combat exposure, age, sex of the participant, and race, 5-HTTLPR had a significant multivariate effect on post-deployment adjustment, such that S' carriers reported more post-deployment adjustment problems and worse quality of life than veterans homozygous for the L' allele. This effect was larger when the analyses were restricted to veterans of European ancestry. Our findings suggest that veterans who carry the S' allele of the 5-HTTLPR polymorphism may be at increased risk for adjustment problems and reduced quality of life following deployments to war zones.

  5. Using facebook to recruit young adult veterans: online mental health research.

    Science.gov (United States)

    Pedersen, Eric R; Helmuth, Eric D; Marshall, Grant N; Schell, Terry L; PunKay, Marc; Kurz, Jeremy

    2015-06-01

    Veteran research has primarily been conducted with clinical samples and those already involved in health care systems, but much is to be learned about veterans in the community. Facebook is a novel yet largely unexplored avenue for recruiting veteran participants for epidemiological and clinical studies. In this study, we utilized Facebook to recruit a sample of young adult veterans for the first phase of an online alcohol intervention study. We describe the successful Facebook recruitment process, including data collection from over 1000 veteran participants in approximately 3 weeks, procedures to verify participation eligibility, and comparison of our sample with nationally available norms. Participants were young adult veterans aged 18-34 recruited through Facebook as part of a large study to document normative drinking behavior among a large community sample of veterans. Facebook ads were targeted toward young veterans to collect information on demographics and military characteristics, health behaviors, mental health, and health care utilization. We obtained a sample of 1023 verified veteran participants over a period of 24 days for the advertising price of approximately US $7.05 per verified veteran participant. Our recruitment strategy yielded a sample similar to the US population of young adult veterans in most demographic areas except for race/ethnicity and previous branch of service, which when we weighted the sample on race/ethnicity and branch a sample better matched with the population data was obtained. The Facebook sample recruited veterans who were engaged in a variety of risky health behaviors such as binge drinking and marijuana use. One fourth of veterans had never since discharge been to an appointment for physical health care and about half had attended an appointment for service compensation review. Only half had attended any appointment for a mental health concern at any clinic or hospital. Despite more than half screening positive for

  6. Pengaruh Customer Perceived Value Terhadap Customer Satisfaction PT. Xyz

    OpenAIRE

    Sucahyo, Martinus Wilman

    2017-01-01

    Penelitian ini membahas tentang Customer Perceived Value terhadap Customer Satisfaction PT. XYZ. Dalam penelitian ini, Customer Perceived Value diukur melalui dimensi Core Product Value, Service Value dan Relationship Value. Masing-masing dimensi ini akan diuji pengaruhnya terhadap Customer Satisfaction, baik secara simultan maupun secara parsial, serta dimensi mana yang paling berpengaruh terhadap Customer Satisfaction. Sampel penelitian berjumlah 100 pelanggan PT. XYZ. Data penelitian diola...

  7. Developing a communication model between banking services quality via mediating variables of quality of relationship with customers and satisfaction with customer loyalty: A case study of Tejarat Bank

    Directory of Open Access Journals (Sweden)

    Hossein Rahimi Koloor

    2015-03-01

    Full Text Available This study develops a communication model. The purpose of this research was designing a regression model and developing a structural equation modeling (SEM for earning loyalty of Tejarat Bank customers. Given this concept, a questionnaire was designed and distributed among branches of Tejarat Bank in Ardabil. The data analyzed using LISREL software within the framework of path analysis using SEM model. Research results suggested that the quality of banking services, customer satisfaction, and the quality of bank relationship with customers had the most effects on customer loyalty, respectively. The findings of the study are discussed in detail.

  8. America's Women Veterans: Military Service History and VA Benefit Utilization Statistics

    Data.gov (United States)

    Department of Veterans Affairs — This comprehensive report chronicles the history of women in the military and as Veterans, profiles the characteristics of women Veterans in 2009, illustrates how...

  9. How do challenges increase customer loyalty to online games?

    Science.gov (United States)

    Teng, Ching-I

    2013-12-01

    Despite the design of various challenge levels in online games, exactly how these challenges increase customer loyalty to online games has seldom been examined. This study investigates how such challenges increase customer loyalty to online games. The study sample comprises 2,861 online gamers. Structural equation modeling is performed. Analytical results indicate that the relationship between challenge and loyalty intensifies when customers perceive that overcoming challenges takes a long time. Results of this study contribute to efforts to determine how challenges and challenge-related perceptions impact customer loyalty to online games.

  10. Improving Customer Satisfaction in an R and D Environment

    Science.gov (United States)

    Alexander, Anita; Liou, Y. H. Andrew

    1998-01-01

    Satisfying customer needs is critical to the sustained competitive advantage of service suppliers. It is therefore important to understand the types of customer needs which, if fulfilled or exceeded, add value and contribute to overall customer satisfaction. This study identifies the needs of various research and development (R&D) customers who contract for engineering and design support services. The Quality Function Deployment (QFD) process was used to organize and translate each customer need into performance measures that, if implemented, can improve customer satisfaction. This study also provides specific performance measures that will more accurately guide the efforts of the engineering supplier. These organizations can either implement the QFD methodology presented herein or extract a few performance measures that are specific to the quality dimensions in need of improvement. Listening to 'what' customers talk about is a good first start.

  11. Customer requirement modeling and mapping of numerical control machine

    Directory of Open Access Journals (Sweden)

    Zhongqi Sheng

    2015-10-01

    Full Text Available In order to better obtain information about customer requirement and develop products meeting customer requirement, it is necessary to systematically analyze and handle the customer requirement. This article uses the product service system of numerical control machine as research objective and studies the customer requirement modeling and mapping oriented toward configuration design. It introduces the conception of requirement unit, expounds the customer requirement decomposition rules, and establishes customer requirement model; it builds the house of quality using quality function deployment and confirms the weight of technical feature of product and service; it explores the relevance rules between data using rough set theory, establishes rule database, and solves the target value of technical feature of product. Using economical turning center series numerical control machine as an example, it verifies the rationality of proposed customer requirement model.

  12. Recruitment and retention of young adult veteran drinkers using Facebook

    Science.gov (United States)

    Pedersen, Eric R.; Naranjo, Diana; Marshall, Grant N.

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook’s wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment. PMID:28249027

  13. Recruitment and retention of young adult veteran drinkers using Facebook.

    Science.gov (United States)

    Pedersen, Eric R; Naranjo, Diana; Marshall, Grant N

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.

  14. Recruitment and retention of young adult veteran drinkers using Facebook.

    Directory of Open Access Journals (Sweden)

    Eric R Pedersen

    Full Text Available The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.

  15. 77 FR 65056 - Advisory Committee on Minority Veterans, Notice of Meeting

    Science.gov (United States)

    2012-10-24

    ..., Office of Health Equity, and a special panel discussion with Center for Women Veterans, Center for Faith... (VBA), Center for Minority Veterans, Office of Public and Intergovernmental Affairs, Veterans Health...

  16. Customer complaints and recovery effectiveness : A customer base approach

    NARCIS (Netherlands)

    Knox, G.; van Oest, R.D.

    2014-01-01

    Although customer complaints are a well-studied aspect of business, no study has measured the impact of actual complaints and recoveries on subsequent customer purchasing. The authors develop a customer base model to investigate the effectiveness of recovery in preventing customer churn. They

  17. Accuracy of computer-assisted template-guided autotransplantation of teeth with custom three-dimensional designed/printed surgical tooling : A cadaveric study

    NARCIS (Netherlands)

    Anssari Moin, D.; Verweij, J.P.; Waars, H.; van Merkesteyn, R.; Wismeijer, D.

    2017-01-01

    Purpose: The aim of the present cadaveric study was to assess the accuracy of computer-assisted template-guided autotransplantation of teeth with custom 3-dimensional (3D) designed/printed surgical tooling. Materials and Methods: Ten partially edentulous human mandibular cadavers were scanned using

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

    Science.gov (United States)

    2015-06-12

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

  19. Center for Women Veterans

    Science.gov (United States)

    ... Business with VA Acquisition, Logistics, & Construction Small & Veteran Business Programs VetBiz.gov Financial & Asset Enterprise Management Security Investigation Center/Background Clearances Freedom of Information ...

  20. Project VALOR: Trajectories of Change in PTSD in Combat-Exposed Veterans

    Science.gov (United States)

    2015-10-01

    Post - traumatic stress disorder ( PTSD ), military sexual trauma (MST), suicide, combat-exposed veterans, PTSD ...develop the first longitudinal registry of combat-exposed men and women with post - traumatic stress disorder ( PTSD ), 1649 participants from across the...Keane, T. M. (2012). Project VALOR: Design and methods of a longitudinal registry of post - traumatic stress disorder ( PTSD ) in

  1. A Dyadic Analysis of PTSD and Psychological Partner Aggression Among U.S. Iraq and Afghanistan Veterans: The Impact of Gender and Dual-Veteran Couple Status.

    Science.gov (United States)

    Watkins, Laura E; Laws, Holly B

    2018-03-01

    Posttraumatic stress disorder (PTSD) symptoms have been repeatedly linked to intimate partner aggression (IPA), and previous research has suggested that this association may be stronger among veterans and men. However, few studies have examined veteran status and gender as moderators of the association between PTSD and psychological IPA, taking both partners' perspectives into account (i.e., within a dyadic framework). The current study aimed to address this limitation by using dyadic multilevel modeling to examine the association between PTSD symptoms and psychological IPA perpetration among a sample of 159 Operation Iraqi Freedom and Operation Enduring Freedom veterans and their partners ( N = 318 participants). Findings revealed that both one's own and one's partner's PTSD symptoms were positively associated with greater psychological IPA. In addition, the effects of partner PTSD symptoms on psychological IPA perpetration differed across gender and veteran status. Results suggested that the association of partner PTSD and IPA perpetration may be stronger for male veterans than for female veterans. Findings from the current study are consistent with previous research showing associations between PTSD and IPA, and have clinical implications for treatment of PTSD and IPA among Operation Iraqi Freedom and Operation Enduring Freedom veterans.

  2. Factors affecting customer satisfaction of online travel agencies in India

    OpenAIRE

    Dutta, Sabyasachi; Kumar Chauhan, Ram; Chauhan, Kavita

    2017-01-01

    Purpose – The purpose of this paper is to identify the factors affecting customer satisfaction for online travel agencies in India. It will help guide existing online travel agencies and future entrants to have an in-depth understanding of customer satisfaction and customer loyalty in their domain. It will also help to improve their business operations and investment focus, which in turn will lead to greater customer satisfaction and loyalty. Design – This paper defines the concept of cust...

  3. Perceived barriers to physical activity in older and younger veterans with serious mental illness.

    Science.gov (United States)

    Muralidharan, Anjana; Klingaman, Elizabeth A; Molinari, Victor; Goldberg, Richard W

    2018-03-01

    Individuals with serious mental illness endorse many more medical and psychosocial barriers to physical activity (PA) than the general population. However, it is unknown if older adults with serious mental illness are at greater risk of experiencing barriers to PA than their younger counterparts. The present study utilized a national VA dataset to compare veterans with serious mental illness ages 55 and older (n = 9,044) to veterans with serious mental illness ages 54 and younger (n = 8,782) on their responses to a questionnaire assessment of barriers to PA. Older veterans were more likely to endorse arthritis and cardiopulmonary disease, and less likely to endorse work schedule, as barriers to PA. Interventions designed to increase PA for young/middle-aged adults with serious mental illness may be broadly useful for older adults with serious mental illness, with some modification to address specific health concerns. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  4. Post-traumatic Stress Disorder by Gender and Veteran Status.

    Science.gov (United States)

    Lehavot, Keren; Katon, Jodie G; Chen, Jessica A; Fortney, John C; Simpson, Tracy L

    2018-01-01

    Population-based data on the prevalence, correlates, and treatment utilization of post-traumatic stress disorder by gender and veteran status are limited. With changes in post-traumatic stress disorder diagnostic criteria in 2013, current information from a uniform data source is needed. This was a secondary analysis of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which consisted of in-person interviews that were conducted with a representative sample of U.S. adults. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past-year and lifetime post-traumatic stress disorder among veterans (n=3,119) and civilians (n=32,982). Data were analyzed from January to March 2017. Adjusting for age and race/ethnicity, women veterans reported the highest rates of lifetime and past-year post-traumatic stress disorder (13.4%, 95% CI=8.8%, 17.9%, and 11.7%, 95% CI=7.1%, 16.4%) compared with women civilians (8.0%, 95% CI=7.4%, 8.6%, and 6.0%, 95% CI=5.5%, 6.6%); men veterans (7.7%, 95% CI=6.5%, 8.8%, and 6.7%, 95% CI=5.7%, 7.8%); and men civilians (3.4%, 95% CI=3.0%, 3.9%, and 2.6%, 95% CI=2.2%, 2.9%). Traumatic event exposure, correlates of lifetime post-traumatic stress disorder, and treatment seeking varied across subgroups. Men and women veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men veterans exhibiting the longest delay in seeking treatment. Post-traumatic stress disorder is a common mental health disorder that varies by gender and veteran status. Women veterans' high rates of post-traumatic stress disorder highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men veterans and civilians is necessary. Published by Elsevier Inc.

  5. 38 CFR 3.453 - Veterans compensation or service pension or retirement pay.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Veterans compensation or service pension or retirement pay. 3.453 Section 3.453 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  6. Gambling problems and the impact of family in UK armed forces veterans.

    Science.gov (United States)

    Dighton, Glen; Roberts, Elystan; Hoon, Alice E; Dymond, Simon

    2018-05-09

    Background and aims International evidence indicates elevated problem gambling rates in armed forces veterans compared with the general population. Gambling problems adversely impact one's family, and family-related variables may increase vulnerability to gambling-related harm. Little is known, however, about gambling problems in the United Kingdom (UK) veterans or to what extent family variables, such as parenting history and experience of domestic violence, influence veterans' gambling. Methods We compared veterans (n = 257) and sex- and age-matched controls (n = 514) drawn from the 2007 Adult Psychiatric Morbidity Survey on gambling, financial management, domestic violence, childhood parental presence, and experience of stressful life events. Veterans who left the military before or after 4 years of service were compared. Results Problem gambling was significantly more prevalent in veterans (1.4%) than non-veterans (0.2%), and the impact of gambling problems on the family was specific to male veterans, particularly those who had experienced a traumatic event after the age of 16, and those who were more likely to have been physically attacked by their partner. Overall, this study revealed that the UK armed forces veterans report a higher prevalence rate of problem gambling compared with non-veterans, with potential negative impact on family life.

  7. MEASURING THE MEDIATING ROLE OF CUSTOMER SATISFACTION BETWEEN SERVICE QUALITY AND CUSTOMER LOYALTY IN UAE HOTEL INDUSTRY

    OpenAIRE

    Hassan Abbas Dost Mohamad; Mohd Shukri Ab Yazid; Ali Khatibi; S. M. Ferdous Azam

    2017-01-01

    Tourism has become one of the most essential segments of economy for these Asian countries. Rapid economic growth, political stability, and aggressive tourism campaigns by the governments have strongly enhanced the growth of tourism in this region. This study is primarily designed to review the relationship of service quality and customer satisfaction that leads to customer loyalty in UAE hotels. The study focused on the country UAE and in particular UAE’s hotel sector. Thus, this study has a...

  8. Faith-Based Organizations and Veteran Reintegration: Enriching the Web of Support.

    Science.gov (United States)

    Werber, Laura; Derose, Kathryn Pitkin; Rudnick, Mollie; Harrell, Margaret C; Naranjo, Diana

    2015-11-30

    Faith-based organizations (FBOs) are an important community-based resource for veterans as they readjust to civilian life. Through interviews with both national-level and smaller, local FBOs, the authors sought to understand better the current and potential roles for FBOs in veteran reintegration. Interviewees suggested that veterans may look to FBOs for support because they offer privacy and confidentiality, two features that may be especially critical when a potential stigma is involved. Some FBOs have also developed a reputation as safe places for veterans, providing supportive, judgment-free environments. FBOs not only help veterans with spiritual matters but address diverse areas of veteran health and wellness, including vocation, education, financial and legal stability, shelter, access to goods and services, mental health, access to health care, physical health, family, and social networks. In some cases, the support is offered to veterans directly; in other instances, the support is indirect, via training individuals to help veterans or educating the public about them. In the process of providing support, FBOs interact with varied organizations, including government entities, private nonprofits, and one another, for training, outreach, referrals, information exchange, obtaining donations, and collaboration. Yet challenges exist, including insufficient connections with chaplains working in different settings and others in the web of support, resource and capacity constraints, lack of awareness of experience with veterans, issues related to religious philosophy or orientation, and characteristics of veterans themselves. To move forward, the authors offer recommendations for policymakers, organizations that interact with FBOs, and FBOs themselves to help FBOs engage fully in the web of reintegration support.

  9. Influence of Customer Focused Mission Statement on Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Chijioke Nwachukwu

    2017-01-01

    Full Text Available The purpose of this study is to examine the influence of customer‑focused mission statements on customer satisfaction in selected cell phone manufacturing companies in the United States. The study employed content analysis for the mission statement and data from America customer satisfaction index (ACSI. In analysing our data, Pearson correlation, and multiple regression techniques were used. The result showed that product and service, technology, philosophy, self‑concept, and public image mission statement components are strongly positively correlated with customer satisfaction. Customer, survival, growth and profitability and market mission statement components are insignificantly negatively correlated with customer satisfaction. The study, therefore, recommends that companies that want to remain competitive by enhancing customer satisfaction should formulate mission statements from a customer perspective so that they include product and service, technology, philosophy, self‑concept, and public image components. The main limitation of the study represents the sample size and structure. This study empirically investigated the correlation and association of nine mission statement components with customer satisfaction.

  10. Late-life functional capacity and health among Finnish war veterans:Veteran Project 1992 and 2004 surveys

    OpenAIRE

    Leskinen, R. (Riitta)

    2015-01-01

    Abstract Becoming involved in war is an experience that has the potential to shape later-life health. The aim of the present study was to explore Finnish Second World War veterans’ health status and the determinants of self-rated health (SRH) and functional capacity, especially the ability to walk, and to identify risk factors and their combinations that predict late-life mortality among veterans. The study population comprised Finnish Second World War veterans who participated in the ...

  11. Semi-customizing patient surveys

    DEFF Research Database (Denmark)

    Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr

    2011-01-01

    Objective. The study investigated the needs and consequences of semi-customizing patient satisfaction surveys to low organizational levels and explored whether patient satisfaction was correlated with local organizational conditions. Design. From 1999 to 2006, the County of Aarhus carried out 398....... Establishing a link between patient satisfaction and organizational variables broadens the quality development focus to include more than simply analysis of specific questions. Semi-customizing patient surveys are recommended....... surveys during four rounds in eight hospitals. To explain differences between the wards, data on the 40 wards with the best and the 40 wards with the worst evaluations (identified by patient surveys) were compared with the data from job satisfaction surveys and management information systems. Setting...

  12. Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

    Science.gov (United States)

    Niv, Noosha; Bennett, Lauren

    2017-06-01

    Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

  13. Gender-specific mental health care needs of women veterans treated for psychiatric disorders in a Veterans Administration Women's Health Clinic.

    Science.gov (United States)

    Miller, Laura J; Ghadiali, Nafisa Y

    2015-04-01

    This pilot study aims to ascertain the prevalence of self-reported premenstrual, perinatal, and perimenopausal influences on mental health, and of gynecologic conditions that could interact with psychiatric conditions, among women veterans receiving psychiatric care within a Veterans Administration (VA) Women's Health Clinic (WHC). Participants included all women veterans (N=68) who received psychiatric evaluations within a VA WHC over a 5-month period. This setting encompasses colocated and coordinated primary care, gynecologic and mental health services. Evaluations included a Women's Mental Health Questionnaire, a psychiatric interview, and medical record review. Deidentified data were extracted from a clinical data repository for this descriptive study. High proportions of study participants reported that their emotional problems intensified premenstrually (42.6%), during pregnancy (33.3%), in the postpartum period (33.3%), or during perimenopause (18.2%). Unintended pregnancy (70.0% of pregnancies) and pregnancy loss (63.5% of women who had been pregnant) were prominent sex-linked stressors. Dyspareunia (22.1% of participants) and pelvic pain (17.6% of participants) were frequent comorbidities. Among women veterans receiving psychiatric care within a VA WHC, there are high rates of self-reported premenstrual, perinatal, and perimenopausal influences on mental health. This population also has substantial comorbidity of psychiatric disorders with dyspareunia and pelvic pain. This underscores the importance of recognizing and addressing women veterans' sex-specific care needs, including interactions among reproductive cycle phases, gynecologic pain, and psychiatric symptoms. The findings support the need for greater awareness of the sex-specific mental health needs of women veterans, and for more definitive studies to further characterize these needs.

  14. Using Facebook to Recruit Young Adult Veterans: Online Mental Health Research

    Science.gov (United States)

    2015-01-01

    Background Veteran research has primarily been conducted with clinical samples and those already involved in health care systems, but much is to be learned about veterans in the community. Facebook is a novel yet largely unexplored avenue for recruiting veteran participants for epidemiological and clinical studies. Objective In this study, we utilized Facebook to recruit a sample of young adult veterans for the first phase of an online alcohol intervention study. We describe the successful Facebook recruitment process, including data collection from over 1000 veteran participants in approximately 3 weeks, procedures to verify participation eligibility, and comparison of our sample with nationally available norms. Methods Participants were young adult veterans aged 18-34 recruited through Facebook as part of a large study to document normative drinking behavior among a large community sample of veterans. Facebook ads were targeted toward young veterans to collect information on demographics and military characteristics, health behaviors, mental health, and health care utilization. Results We obtained a sample of 1023 verified veteran participants over a period of 24 days for the advertising price of approximately US $7.05 per verified veteran participant. Our recruitment strategy yielded a sample similar to the US population of young adult veterans in most demographic areas except for race/ethnicity and previous branch of service, which when we weighted the sample on race/ethnicity and branch a sample better matched with the population data was obtained. The Facebook sample recruited veterans who were engaged in a variety of risky health behaviors such as binge drinking and marijuana use. One fourth of veterans had never since discharge been to an appointment for physical health care and about half had attended an appointment for service compensation review. Only half had attended any appointment for a mental health concern at any clinic or hospital. Despite more

  15. [Correction of congenital malformations by custom-made silicone implants: Contribution of computer-aided design. Experience of 611 cases].

    Science.gov (United States)

    Chavoin, J P; Chaput, B; Garrido, I; Moreno, B; Dahan, M; Grolleau, J L

    2016-10-01

    Modern techniques of computer-aided design and tridimensional prototyping for manufacturing silicone elastomer custom implants are growing. They have widely modified the surgical indications in our unit. By presenting their experience of 611 cases managed between 1993 and 2016, the authors describe the method of conception from CT-scans, the virtual image of the body and the manufacture of the custom-made implant perfectly adapted to the anatomy of each one. The operative techniques are described for the three main indications: the funnel chest or pectus excavatum (474 cases) according to a modified CHIN classification is corrected simply and very satisfactorily. This approach may render thoracic surgery techniques obsolete. Indeed, these operations remain risky and of doubtful functional utility; Poland syndrome (116 cases), where the use of a custom-made implant for compensation of muscle volume is frequently used, but can be improved by a transfer of adipose tissue or a classic breast implant; the leg atrophies (21 cases) receive custom elastomer implants introduced in a sub-fascial plane. The results are excellent for pectus excavatum but more difficult to optimize for the other two indications, requiring sometimes complementary techniques. Complications are rare and often benign, implants endure for life. Quality of life, psychological comfort and self-esteem have been improved with low morbidity and without having undergone a painful surgical experience. Reconstructive procedures of congenital malformations by custom-made silicone implants open a new field of activity for our surgical specialty with vast opportunities. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. The Veterans Health Administration’s Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans

    Science.gov (United States)

    2012-02-01

    make it more difficult for veterans with PTSD to seek or maintain treatment. VHA provides treatment for PTSD at VHA hospitals , outpatient clinics ...measured in days of inpatient hospital care and outpatient clinic visits. A veteran may have had several outpatient visits on a sin- gle day, each...reproduce the same results precisely. The DSS system takes clinical and financial information from other VHA databases and uses algorithms that merge

  17. Customer Loyalty Research : Can customer loyalty programs really build loyalty?

    OpenAIRE

    Romppanen, Maiju; Kellgren, Cecilia; Moradi, Ladan

    2007-01-01

    Background: During the last decades the efforts to foster customer relationships have become important due to increased competition in the consumer markets. One of the most popular strategies have been to introduce customer loyalty programs which are believed to enhance the customer loyalty. The popularity of the customer loyalty programs is based on the beliefs that loyal customers are lucrative and these programs would bond the customers to the company. More recently however, the discussion...

  18. 77 FR 37839 - Veterans' Group Life Insurance (VGLI) No-Health Period Extension

    Science.gov (United States)

    2012-06-25

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 9 RIN 2900-AO24 Veterans' Group Life Insurance (VGLI) No-Health Period Extension AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY... Veterans' Group Life Insurance (VGLI) to extend to 240 days the current 120-day ``no-health'' period during...

  19. 38 CFR 21.272 - Veteran-student services.

    Science.gov (United States)

    2010-07-01

    ... eligible to receive a work-study allowance. (Authority: 38 U.S.C. 3104(a)(4), 3485) (b) Selection criteria... by the Chapter 30 rate; (2) Motivation of the veteran; and (3) Compatibility of the work assignment with the veteran's physical condition. (Authority: 38 U.S.C. 3104(a)(4), 3108(f), 3485) (c) Utilization...

  20. Customer Experience Management and Business Performance

    DEFF Research Database (Denmark)

    Grønholdt, Lars; Martensen, Anne Duhr; Jørgensen, Stig

    2015-01-01

    Purpose: – The purpose of this paper is to examine how essential dimensions of customer experience management (CEM) drive business performance in Danish companies. Design/methodology/approach: – An empirical study is conducted to investigate the relationships between seven CEM dimensions...... customer experience into their products and service enjoy measurable financial success. Research limitations/implications: – This study is limited to the seven identified CEM dimensions in Danish companies. Practical implications: – This study has clear implications in terms of identifying and measuring...

  1. Localisation challenges in usability and customer relationship management of e-commerce environments

    OpenAIRE

    Minocha, Shailey; Hall, Pat; Dawson, Liisa

    2004-01-01

    With growing competition in the global E-Market place, the focus of E-Businesses is moving from customer acquisition to customer retention. Towards this, E-Businesses, in addition to providing a usable site, are integrating Customer-relationship Management (CRM) strategies into the design and usability of E-Commerce environments. These CRM strategies include personalisation, providing consistent customer service across different communication channels of the E-Business, meeting customers' exp...

  2. Systematic review and meta-analyses of psychosocial interventions for veterans of the military

    Directory of Open Access Journals (Sweden)

    Neil J. Kitchiner

    2012-12-01

    Full Text Available Background: The efficacy of psychosocial therapies for common mental health disorders in veterans is unclear and requires further examination. Method: Systematic review and meta-analyses of randomised controlled trials (RCTs. Twenty databases were searched. Studies were included if they reported a psychosocial intervention designed to treat or reduce common mental health symptoms in veterans identified as being symptomatic at the time they entered the study. Studies of substance dependency disorders and psychosis were excluded. Eligible studies were assessed against methodological quality criteria and data were extracted and analysed. Results: Twenty-nine RCTs were identified. There was evidence for the use of trauma-focused therapies for post-traumatic stress disorder (PTSD and some evidence for psychological interventions in the treatment of borderline personality disorder, depression, insomnia, and panic disorder co-morbid to PTSD. However, methodological quality of many of the studies was less than optimal. Conclusions: Trauma-focused psychological therapies are likely to be effective for combat-related PTSD but there is a need for more research to determine the efficacy of psychological treatments for other mental health disorders in veterans.

  3. A combined group treatment for nightmares and insomnia in combat veterans: a pilot study.

    Science.gov (United States)

    Swanson, Leslie M; Favorite, Todd K; Horin, Elizabeth; Arnedt, J Todd

    2009-12-01

    Insomnia and nightmares are hallmarks of posttraumatic stress disorder (PTSD). Sleep disturbances in PTSD negatively impact clinical course and functioning. In this open clinical trial, the preliminary effects of a combined treatment for insomnia and nightmares in combat veterans with PTSD were assessed. Ten combat veterans participated in a 10-session group treatment combining cognitive-behavioral therapy for insomnia with exposure, rescripting, and relaxation therapy. Participants maintained daily sleep and dream diaries and completed self-report measures of sleep quality and PTSD symptoms pre- and posttreatment. Participants reported improvements in sleep and nightmares following treatment. Future research using controlled designs to evaluate this treatment is warranted.

  4. FY2001 Customer Satisfaction Survey Report

    National Research Council Canada - National Science Library

    2001-01-01

    ...? To ensure that we gain this requisite knowledge, the 2001 Customer Satisfaction Survey, Part 1 of the two part survey process, was specifically designed to meet the following knowledge objectives...

  5. Substance use comorbidity among veterans with posttraumatic stress disorder and other psychiatric illness.

    Science.gov (United States)

    Petrakis, Ismene L; Rosenheck, Robert; Desai, Rani

    2011-01-01

    There is considerable concern about the emergence of significant substance abuse among younger veterans of war in the Middle East, especially among those with Posttraumatic Stress Disorder (PTSD), but little information exists on the magnitude of this problem. Using national administrative data from the Department of Veterans Affairs (VA) (n = 1,001,996), we examined rates of diagnosed substance use disorders in Veterans who served in Iraq and Afghanistan diagnosed with PTSD compared to other psychiatric disorders; and compared rates among veterans of other service eras. Of VA patients with a selected mental disorder, 21.0% had a comorbid substance diagnosis. Veterans who served in the post-Vietnam era (VET) (1973-1991) had the highest rates of comorbidity. Logistic regression models indicated that veterans with each selected psychiatric diagnosis were significantly more likely to be dually diagnosed in comparison to veterans with PTSD; post-Vietnam veterans were significantly more likely to be dually diagnosed than veterans from other eras. Bipolar disorder and schizophrenia are most strongly associated with dual diagnosis in OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veterans. There are high rates of substance use disorders among veterans with mental illness. The highest rates of comorbidity occur among those with bipolar disorder and schizophrenia; and in post-VET veterans.  © American Academy of Addiction Psychiatry.

  6. Customer Relationship Management Influence on Customer Value, Product Quality and Service Quality in Improving Customer Satisfaction and Its Implication on the Customer Loyalty

    OpenAIRE

    Harryani, Sri

    2017-01-01

    The purpose of this research is to determine the influence of Customer Relationship Management (CRM) on the Customer Value (CV), Product Quality (PQ) and Service Quality (SQ) in improving Customer Satisfaction (CS) that will have implications on the Customer Loyalty (CL). The research focuses on corporate banking, where customers serve as the research sample. The data in this research using the primary data and secondary data. Source primary data used questionnaire and source the secondary da...

  7. Student veterans' construction and enactment of resilience: A constructivist grounded theory study.

    Science.gov (United States)

    Reyes, A T; Kearney, C A; Isla, K; Bryant, R

    2018-02-01

    WHAT IS KNOWN ON THE SUBJECT?: Resilience is an ability and a process that allows an individual to develop positive adaptation despite challenges and adversities. Many military veterans returning to college after their military service have difficulty transitioning to civilian life. Although some research exists that explores factors related to the resilience of college student veterans, limited theoretical descriptions exist that explain how student veterans construct resilience, and how resilience is enacted and enhanced in their academic and personal (non-academic) lives. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The resilience of student veterans involves a complex process of transitioning from military to civilian life and an iterative journey between positive adaptation and transient perturbations. Student veterans' resilience is a result of integrating and resolving various aspects of their academic and personal challenges. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses can apply this grounded theory as a practical framework for equipping student veterans with effective strategies to develop and enhance resilience. Nurses can employ a holistic approach of care in their interactions with military veterans and student veterans that includes fostering psychological resilience, helping to manage their multiple non-academic responsibilities and supporting their academic success. Introduction Adjusting to college life is one of the most difficult experiences in a military veteran's transition to civilian life. Many military veterans returning to college not only encounter academic challenges, but also deal with physical and psychiatric disabilities, loss of military camaraderie and social disconnect. These often negatively affect their personal and academic lives. Hence, it is important to explore resilience to best support student veterans as they transition from military to civilian life. Aim The aim of this study was to explore how student veterans

  8. Induced abortion among women veterans: data from the ECUUN study.

    Science.gov (United States)

    Schwarz, Eleanor Bimla; Sileanu, Florentina E; Zhao, Xinhua; Mor, Maria K; Callegari, Lisa S; Borrero, Sonya

    2018-01-01

    We compared rates of induced abortion among women veterans receiving Veterans Affairs (VA) healthcare to rates in the general US population, as current policy prohibits VA provision of abortion counseling or services even when pregnancy endangers a veteran's life. We analyzed data from 2298 women veterans younger than 45 years who completed a telephone-based, cross-sectional survey of randomly sampled English-speaking women from across the United States who had received VA healthcare. We compared lifetime, last-5-year and last-year rates of unintended pregnancy and abortion among participants to age-matched data from the National Survey of Family Growth. As few abortions were reported in the last year, we used multivariable logistic regression to examine associations between abortion in the last 5 years and age, race/ethnicity, income, education, religion, marital status, parity, geography, deployment history, housing instability, and past medical and mental health among VA patients. Women veterans were more likely than matched US women to report ever having an abortion [17.7%, 95% confidence interval (CI): 16.1%-19.3% vs. 15.2% of US women]. In the last 5 years, unintended pregnancy and abortion were reported by veterans at rates similar to US women. In multivariable models, VA patients were more likely to report abortion in the last 5 years if their annual income was less than $40,000 (adjusted odds ratio (OR) 2.95, 95% CI 1.30-6.70), they had experienced homelessness or housing instability (adjusted OR 1.91, 95% CI 1.01-3.62), they were single (adj. OR 2.46, 95% CI 1.23-4.91) and/or they had given birth (adjusted OR 2.29, 95% CI 1.19-4.40). Women veterans face unintended pregnancy and seek abortion as often as the larger US population. The Veterans Health Care Act, which prohibits provision of abortion services, increases vulnerable veterans' out-of-pocket healthcare costs and limits veterans' reproductive freedom. Copyright © 2017. Published by Elsevier Inc.

  9. The influence of customer relationship management information on customer loyalty

    OpenAIRE

    Ignatovič, Eva

    2009-01-01

    The purpose of this master thesis is to approve that customer relationship management (CRM) has influenced on customer loyalty. In order to achieve this purpose the work was divided into four main tasks: review of the relevant literature; analyze the influence of customer relationship management on customer loyalty and approve its importance for companies, research of the concrete business-to-business (B2B) Company CRM process and its customer loyalty, and the development of the customer rela...

  10. CUSTOMER INTERACTION ON DIGITAL ECONOMY: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Mateus Tavares da Silva Cozer

    2007-10-01

    Full Text Available On a digital economy context, customer interaction is fundamental to any company to provide competitive advantage. This research intends to give concrete answers for the sea of information complexity which is the Internet. The main case is to build a model of digital customer interaction. Customization extends beyond targeted media to include the design and delivery of the product itself. Venkatraman (1998 defines dynamic customization based on three principles: modularity, intelligence and organization. The research is based on Interaction Model and its variables are: Products, Modularity, Artificial Intelligence, Market driven organization, and virtual communities. Two organizations were studied, one with physical product and another with virtual product, and the results were shown from a qualitative research.

  11. Solar + Storage Synergies for Managing Commercial-Customer Demand Charges

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, P. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Govindarajan, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Barbose, G. L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, N. R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, A. D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-18

    Demand charges, which are based on a customer’s maximum demand in kilowatts (kW), are a common element of electricity rate structures for commercial customers. Customer-sited solar photovoltaic (PV) systems can potentially reduce demand charges, but the level of savings is difficult to predict, given variations in demand charge designs, customer loads, and PV generation profiles. Lawrence Berkeley National Laboratory (Berkeley Lab) and the National Renewable Energy Laboratory (NREL) are collaborating on a series of studies to understand how solar PV can impact demand charges. Prior studies in the series examined demand charge reductions from solar on a stand-alone basis for residential and commercial customers. Those earlier analyses found that solar, alone, has limited ability to reduce demand charges depending on the specific design of the demand charge and on the shape of the customer’s load profile. This latest analysis estimates demand charge savings from solar in commercial buildings when co-deployed with behind-the-meter storage, highlighting the complementary roles of the two technologies. The analysis is based on simulated loads, solar generation, and storage dispatch across a wide variety of building types, locations, system configurations, and demand charge designs.

  12. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  13. Intimate partner violence among women veterans by sexual orientation.

    Science.gov (United States)

    Dardis, Christina M; Shipherd, Jillian C; Iverson, Katherine M

    2017-08-01

    National estimates suggest intimate partner violence (IPV) rates are equal or higher among lesbian, bisexual, or questioning (LBQ)-identified women than heterosexual-identified women. Women veterans are a population at high risk for IPV, yet the occurrence of lifetime and past-year IPV experiences by sexual orientation have not been examined in this population. Lifetime and past-year IPV experiences and current IPV-related posttraumatic stress disorder (PTSD) symptoms were assessed with validated screening measures as part of a 2014 web-based national survey of women veterans. Among 403 respondents, 9.7% (n = 39) identified as LBQ, and 90.3% (n = 364) identified as heterosexual. When controlling for age, LBQ-identified women veterans were significantly more likely to report lifetime sexual and physical IPV and lifetime intimate partner stalking. In the past year, LBQ-identified veterans were twice as likely to endorse emotional mistreatment and physical IPV, and three times more likely to endorse sexual IPV, than were heterosexual-identified women veterans. However, sexual orientation was unrelated to IPV-related PTSD symptoms, when controlling for age, race, and number IPV forms experienced. IPV is prevalent among LBQ-identified women veterans, suggesting the need to understand the potentially unique contextual factors and health-care needs of this group.

  14. Homeless Aging Veterans in Transition: A Life-Span Perspective

    Directory of Open Access Journals (Sweden)

    Carla J. Thompson

    2013-01-01

    Full Text Available The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative and qualitative research questions framed the investigation. Study participants completed a quantitative survey reflecting their preferences and needs with a subset of the sample (N=12 also participating in individual qualitative interview sessions. Thirty-two service providers and stakeholders completed quantitative surveys. Empirical and qualitative data with appropriate triangulation procedures provided interpretive information relative to a life-span development perspective. Study findings provide evidence of the need for future research efforts to address strategies that focus on the health and economic challenges of veterans before they are threatened with the possibility of homelessness. Implications of the study findings provide important information associated with the premise that human development occurs throughout life with specific characteristics influencing the individual’s passage. Implications for aging/homelessness research are grounded in late-life transitioning and human development intervention considerations.

  15. [Preliminary construction of a questionnaire about knowledge of HIV/AIDS in Colombian veterans].

    Science.gov (United States)

    Segura-Cardona, Angela; Berbesí-Fernández, Dedsy; Cardona-Arango, Doris; Ordóñez-Molina, Jaime

    2011-01-01

    In order to identify the level of knowledge about HIV/AIDS in Colombia veterans of war in the year 2009, a questionnaire was designed, built and validated, using a mixed design, for which three stages were followed: 1) Bibliographic review and construction of items of the questionnaire using a focus group, 2) Evaluation of content validity by a pannel of experts, 3) APLICACION of the final questionnaire, we selected non-randomly 323 people who were part of group of veterans in Colombia, and 4) Validation of the questionnaire through the evaluation of internal consistency and principal component analysis. We found that the questionnaire explored three factors: forms of infection, inadequate beliefs, and HIV prevention, which accounted for 52% of the variance. The survey showed adequate internal consistency values (Cronbach's α = 0.77). These results suggest the use of the questionnaire to assess knowledge level related to the form of infection, inaccurate beliefs and prevention of HIV-AIDS in this population.

  16. Comparison of criminal activity between Israeli veterans with and without PTSD.

    Science.gov (United States)

    Sherman, Shany; Fostick, Leah; Zohar, Joseph

    2014-02-01

    The literature, based on US Vietnam veterans, suggests that posttraumatic stress disorder (PTSD) is associated with increased criminal activity, especially violence, alcohol, and drug abuse, although more recent studies, which tested data from the United States as well as the United Kingdom, suggest a more moderate effect for this relationship. The current study examines Israeli veterans, who differ socioeconomically and have lower rates of substance abuse than veterans in previous studies. In this study, the social security numbers of 2,235 male veterans with PTSD and 2,235 matched control male veterans without a PTSD diagnosis were checked for criminal records in the Israeli Police criminal records database. Severity measures were also obtained for 273 veterans who are currently treated for PTSD by the Ministry of Defense. PTSD diagnosed veterans, as compared to controls, were slightly more likely to have criminal records (43%, n = 957/2235 versus 36%, n = 803/2235, Chi- square = 22.23, P legal authority." No difference was found in drugs or any other categories. In addition, criminal activity was not related to symptoms severity. More veterans with PTSD had their first criminal record after the traumatic event. Contrary to previous findings, in this large national cohort, only slight association was found between PTSD and criminal activity. The unique sample of Israeli veterans might account for this difference and suggest that PTSD per se might not be linked to increased criminal activity, violence, or substance abuse. © 2013 Wiley Periodicals, Inc.

  17. Sexual self-esteem and psychosocial functioning in military veterans after cancer.

    Science.gov (United States)

    Syme, Maggie L; Delaney, Eileen; Wachen, Jennifer Schuster; Gosian, Jeffrey; Moye, Jennifer

    2013-01-01

    Little is known about the sexual well-being of male Veteran cancer survivors, or the relationship of sexual concerns to psychosocial adaptation postcancer. This study examined the association between sexual self-esteem and psychosocial concerns in male Veteran cancer survivors. Forty-one male survivors were recruited from a Veterans Affairs (VA) hospital to participate in a pilot study addressing cancer survivorship care for Veterans. Sixty- to 90-minute interviews were conducted, assessing sociodemographic, medical, stress/burden (cancer-related posttraumatic stress disorder [PTSD], depression), and resource (social support, post-traumatic growth) variables. Twenty-one (51.2%) Veteran cancer survivors reported lowered sexual self-esteem as a result of cancer, which corresponded to significantly higher levels of depression and cancer-related PTSD. The lowered sexual self-esteem group also indicated significantly lower social support. Veteran cancer survivors with lowered sexual self-esteem tend to have higher levels of stress and lower levels of resources, putting them at risk for lowered quality of life. This increased risk highlights the importance of addressing sexual well-being in the survivorship care of Veterans.

  18. Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD

    Directory of Open Access Journals (Sweden)

    Janet C'de Baca

    2014-03-01

    Full Text Available Personality Disorders (PDs impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD range from 45%–79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%, Hispanic (27%, and African American (9%, mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046 then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046, and a cluster C PD with sexual trauma (p = 0.004, demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.

  19. ZEMCH toward the delivery of zero energy mass custom homes

    CERN Document Server

    2016-01-01

    In this book, leading international experts explore the emerging concept of the zero energy mass custom home (ZEMCH) – designed to meet the need for social, economic, and environmental sustainability – and provide all of the knowledge required for the delivery of zero energy mass customized housing and community developments in developed and developing countries. The coverage is wide ranging, progressing from explanation of the meaning of sustainable development to discussion of challenges and trends in mass housing, the advantages and disadvantages of prefabricated methods of construction, and the concepts of mass customization, mass personalization, and inclusive design. A chapter on energy use will aid the reader in designing and retrofitting housing to reduce energy demand and/or improve energy end‐use efficiency. Passive design strategies and active technologies (especially solar) are thoroughly reviewed. Application of the ZEMCH construction criteria to new buildings and refurbishment of old house...

  20. Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

    Science.gov (United States)

    Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

    2016-03-01

    The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

  1. Assessing Suicide Risk in Veterans: The Role of the Nurse Practitioner

    OpenAIRE

    Kathy Puskar; Giuliana Mazza

    2012-01-01

    Background: Statistics have shown that veteran men and women are at greater risk for suicide than the general population. In order to decrease the incidence of suicide in veterans, nurse practitioners (NPs) and other health care professionals must not only become more aware of the risk factors for veteran suicides but also develop strong psychiatric interviewing skills. Purpose: To discuss the risk factors associated with veteran suicide, the assessment tools to ensure a comprehensive...

  2. A Study to Investigate the Effect of Customer Value on Customer Satisfaction, Brand Loyalty and Customer Relationship Management Performance

    OpenAIRE

    Berrin Onaran,; Zeki Atil Bulut,; Alparslan Ozmen

    2013-01-01

    Beyond satisfying needs, customer value is the key to establish and maintain long run relationships. Hence, providing excellent customer value as a driving force of customer relationships management performance plays a key role in gaining sustainable competitive advantage. The aim of this research is to investigate the relationships among dimensions of customer value, customer satisfaction, brand loyalty and customer relationship management performance. Data obtained from customers of thermal...

  3. ICPP custom dissolver explosion recovery

    International Nuclear Information System (INIS)

    Demmer, R.; Hawk, R.

    1992-01-01

    This paper discusses the recovery from the February 9, 1991, small scale explosion in a custom processing dissolver at the Idaho Chemical Processing Plant (ICPP) a Department of Energy facility at the Idaho National Engineering Laboratory. The custom processing facility is a limited production area designed to recover unirradiated uranium fuel. A small amount of the nuclear material received and stored at the ICPP is unique and incompatible with the major head end dissolution processes. Custom processing is a small scale dissolution facility for processing these materials in an economical fashion in the CPP-627 hot chemistry laboratory. Two glass dissolvers were contained in a large walk in hood area. Utilities for dissolution and connections to the major ICPP uranium separation facility were provided. The fuel processing operations during this campaign involved dissolving uranium metal, uranium oxides, and uranium/fissium alloy in nitric acid

  4. Empirical research on Kano’s model and customer satisfaction

    Science.gov (United States)

    Lin, Feng-Han; Tsai, Sang-Bing; Lee, Yu-Cheng; Hsiao, Cheng-Fu; Zhou, Jie; Wang, Jiangtao; Shang, Zhiwen

    2017-01-01

    Products are now developed based on what customers desire, and thus attractive quality creation has become crucial. In studies on customer satisfaction, methods for analyzing quality attributes and enhancing customer satisfaction have been proposed to facilitate product development. Although substantial studies have performed to assess the impact of the attributes on customer satisfaction, little research has been conducted that quantitatively calculate the odds of customer satisfaction for the Kano classification, fitting a nonlinear relationship between attribute-level performance and customer satisfaction. In the present study, the odds of customer satisfaction were determined to identify the classification of quality attributes, and took customer psychology into account to suggest how decision-makers should prioritize the allocation of resources. A novel method for quantitatively assessing quality attributes was proposed to determine classification criteria and fit the nonlinear relationship between quality attributes and customer satisfaction. Subsequently, a case study was conducted on bicycle user satisfaction to verify the novel method. The concept of customer satisfaction odds was integrated with the value function from prospect theory to understand quality attributes. The results of this study can serve as a reference for product designers to create attractive quality attributes in their products and thus enhance customer satisfaction. PMID:28873418

  5. Customized products and cloud service information system development research

    Directory of Open Access Journals (Sweden)

    Hung Chien-Wen

    2017-01-01

    Full Text Available This study presents a cloud service customized product information system to enable businesses to provide customized product marketing on the Internet to meet consumer demand for customized products. The cloud service of the information system development strategic framework proposed in this study contains three elements: (1 e-commerce services, (2 promotion type modules, and (3 cloud services customized promotional products. In this study, a mining cloud information system to detect customer behavior is proposed. The association rules from relational database design are utilized to mine consumer behavior to generate cross-selling proposals for customer products and marketing for a retailing mall in Taiwan. The study is composed of several parts, as follows. A market segment and application of association rules in data exploration techniques (Association Rule Mining and sequence-like exploration (Sequential Pattern Mining, efficient analysis of customers, consumer behavior, identification of candidates for promotional products, and using cloud service delivery and evaluation of targets to evaluate candidates for promotional products for production. However, in addition to cloud service customized promotional products, the quantity of promotional products sales varies for different customers. We strive to achieve increased customer loyalty and profits through the use of active cloud service customized promotional products.

  6. 38 CFR 51.42 - Drugs and medicines for certain veterans.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Per Diem Payments § 51.42... illness or injury for a veteran receiving care in a State home, if: (1) The veteran: (i) Has a singular or... of such drugs and medicines for a service-connected disability; and (ii) Is in need of nursing home...

  7. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables

    Directory of Open Access Journals (Sweden)

    Lynnette A. Averill

    2015-05-01

    Full Text Available Background: A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD screenings within the Operation Enduring Freedom (Afghanistan conflict/Operation Iraqi Freedom (Iraq conflict (OEF/OIF military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. Objective: Many OEF/OIF Veterans do not use available Veterans Affairs (VA services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether—and where—Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military “Don't Ask, Don't Tell” policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. Conclusions: Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual

  8. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables.

    Science.gov (United States)

    Averill, Lynnette A; Eubanks Fleming, C J; Holens, Pamela L; Larsen, Sadie E

    2015-01-01

    A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. Many OEF/OIF Veterans do not use available Veterans Affairs (VA) services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether-and where-Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military "Don't Ask, Don't Tell" policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual orientation will provide rich data that will enhance our ability

  9. VeteranOtherInformationService

    Data.gov (United States)

    Department of Veterans Affairs — This service is used to create, read, delete and update additional information captured during the EVSS Disability Compensation interview in an effort to align with...

  10. Integrated Management System as a base for customer satisfaction

    International Nuclear Information System (INIS)

    Grabelnikov, Konstantin V.

    2012-01-01

    In this article JSC NCCP integrated management system procedures is presented. Unique possibility to collect different Customers Voices, based on different organisation culture and approaches, to improve the technological process, design of nuclear fuel, quality control methods and instrumentation is presented. As a result of the mutual efforts we have stable and valuable decreasing of leaking FA at NPP of our Customers. And, with other hand, we have stable and valuable increasing of Customer Satisfaction Level

  11. Customers as Partners in Radical Service Innovation

    DEFF Research Database (Denmark)

    Scupola, Ada; Nicolajsen, Hanne Westh

    2009-01-01

      Purpose- The main purpose of this paper is to investigate customer involvement and related challenges in radical service innovations in engineering consulting services Design/methodology/approach - The paper uses a case study approach and so called rich descriptions to investigate customer...... involvement, roles and related challenges and conditions in radical service innovations.Findings- One main finding is that customers can engage in radical service innovations in engineering consultancy services and may play a decisive role. In doing this they most likely take on all the three user involvement...... roles defined in the literature of New Service and New Product Development. Also a number of conditions are found to be necessary in order for this collaboration to succeed. The conclusion is that another understanding and handling of the customer/supplier relation is needed along with a need...

  12. Mass Customization Services

    DEFF Research Database (Denmark)

    Friedrich, Gerhard

    Topics of the IMCM’08 & PETO’08 and this book are: Mass customization in service, mass customizing financial services, mass customization in supply networks, implementation issues in logistics, product life cycle and mass customization. The research field of mass customization is more than 15 years...

  13. An EM Simulation-Based Design Flow for Custom-Built MR Coils Incorporating Signal and Noise.

    Science.gov (United States)

    Horneff, Andreas; Eder, Michael; Hell, Erich; Ulrici, Johannes; Felder, Jorg; Rasche, Volker; Anders, Jens

    2018-02-01

    Developing custom-built MR coils is a cumbersome task, in which an a priori prediction of the coils' SNR performance, their sensitivity pattern, and their depth of penetration helps to greatly speed up the design process by reducing the required hardware manufacturing iterations. The simulation-based design flow presented in this paper takes the entire MR imaging process into account. That is, it includes all geometric and material properties of the coil and the phantom, the thermal noise as well as the target MR sequences. The proposed simulation-driven design flow is validated using a manufactured prototype coil, whose performance was optimized regarding its SNR performance, based on the presented design flow, by comparing the coil's measured performance against the simulated results. In these experiments, the mean and the standard deviation of the relative error between the simulated and measured coil sensitivity pattern were found to be and . Moreover, the peak deviation between the simulated and measured voxel SNR was found to be less than 4%, indicating that simulations are in good accordance with the measured results, validating the proposed software-based design approach.

  14. 76 FR 30244 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-05-24

    ... on health care issues affecting enrolled Veterans residing in rural areas. The Committee examines... Rural Health Strategic Plan discussion and work session and the other is the Committee's annual report... DEPARTMENT OF VETERANS AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The...

  15. The main new driver of customer experience in Grocery retail - the Fresh opportunity

    Directory of Open Access Journals (Sweden)

    ISMANĂ -ILISAN Camelia -Maria

    2018-01-01

    Full Text Available The main challenge of a modern retailer is how to delight customers in fresh products without risking profitability. To compete effectively, businesses must focus on the customer's shopping experience. To manage a customer's experience, retailers should understand what “customer experience” actually means. Customer experience includes every point of contact at which the customer interacts with the business, product, or service. Customer experience management represents a business strategy designed to manage the customer experience. This paper presents the results of a marketing research study conducted for reviewing perception versus reality of customer experience delivery in fresh products and product availability.

  16. Customer satisfaction with the quality of the logistic services

    Directory of Open Access Journals (Sweden)

    Małgorzata Lisińska-Kuśnierz

    2014-03-01

    Full Text Available Background: Logistics services are evaluated mainly by measuring customer satisfaction. Measurement of the customer satisfaction provides the information about how organizations operate as well as how to effectively satisfy customer needs. The aim of this paper is to propose an evaluation model of the customer satisfaction of the quality of the logistic services provided. The research in this paper was focused on the evaluation of the level of customer satisfaction in the context of logistics service as well as on the analysis of importance of ten logistic services attributes influencing customer satisfaction. Methods: The research was conducted on the basis of the questionnaire designed for purchasers of logistic services. The subjects of the research were companies which are using refrigerated transport. Results: To define relation between level of customer satisfaction in the context of logistic service and logistic service attributes impacting this satisfaction Pearson's correlation method was used. In turn the model to evaluate the customer satisfaction in the context of logistic services in scope of refrigerated transport was built using multiple regression and stepwise regression methods.

  17. Mass Customization of Teaching and Training in Organizations: Design Principles and Prototype Evaluation

    Science.gov (United States)

    Nistor, Nicolae; Dehne, Anina; Drews, Frank Thomas

    2010-01-01

    In search of methods that improve the efficiency of teaching and training in organizations, several authors point out that mass customization (MC) is a principle that covers individual needs of knowledge and skills and, at the same time limits the development costs of customized training to those of mass training. MC is proven and established in…

  18. Customer experience

    OpenAIRE

    Koperdáková, Zuzana

    2016-01-01

    Bachelor thesis deals with the theme of customer experience and terms related to this topic. The thesis consists of three parts. The first part explains the terms generally, as the experience or customer loyalty. The second part is dedicated to medotology used for Customer Experience Management. In the third part is described application of Customer Experience Management in practice, particularly in the context Touch Point Analyses in GE Money Bank.

  19. Physical Activity among Veterans and Nonveterans with Diabetes

    Directory of Open Access Journals (Sweden)

    Erin D. Bouldin

    2012-01-01

    Full Text Available Engaging in regular physical activity (PA, with or without a corresponding decrease in weight, is associated with improved health outcomes. The purpose of this study was to quantify the extent to which PA differed between veterans and nonveterans and to determine how diabetes and age influenced this association. Data from the 2009 Behavioral Risk Factor Surveillance System were used in this study. Respondents were classified as having diabetes if they reported ever being diagnosed with diabetes except during pregnancy. Respondents who reported ever serving on active military duty were classified as veterans. Based on self-report, we calculated the average minutes per week of moderate, vigorous, and total activity. After adjusting for sex, race and ethnicity, household income, education level, body mass index (BMI, and recent health checkup, veteran status was associated with a small but significantly larger amount of average weekly moderate PA (2.2 minutes, P=0.0058 but not average weekly vigorous PA (−0.02 minutes, P=0.98. Diabetes and prediabetes were associated with significantly lower mean levels of both moderate and vigorous intensity PA, as was increasing age. Consistent with prior research, veterans engaged in more PA than nonveterans. The association between diabetes, age, and physical activity did not differ by veteran status.

  20. One-year incidence and predictors of homelessness among 300,000 U.S. Veterans seen in specialty mental health care.

    Science.gov (United States)

    Tsai, Jack; Hoff, Rani A; Harpaz-Rotem, Ilan

    2017-05-01

    The Department of Veterans Affairs (VA) is committed to preventing and ending homelessness among U.S. veterans, but there have been few estimates of the incidence of veteran homelessness and prospective studies to identify predictors of homelessness. This study examines the 1-year incidence of homelessness among veterans seen in VA specialty mental health clinics and identified sociodemographic and clinical predictors of homelessness. Using a retrospective cohort study design, data were extracted from the VA medical records of 306,351 veterans referred to anxiety and posttraumatic stress disorder clinics across 130 VA facilities from 2008-2012 and followed for 1 year after referral. Homeless incidence was defined as new use of any VA homeless services or a documented International Classification of Diseases (9th rev.) V60.0 (lack of housing) code during the year. Of the total sample, 5.6% (7.8% for women and 5.4% for men) experienced homelessness within 1 year after referral to VA specialty mental health care. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless; those who were Black or had annual incomes less than $25,000 were more than one and a half times as likely to become homeless. Together, these findings suggest a notable and important percentage of veterans seen in VA specialty mental health clinics newly experience homelessness annually. Monitoring early signs of housing vulnerability and preventing homelessness in this vulnerable but treatment-engaged population may be important in the VA's efforts to end veteran homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Learning Racial Hierarchies: Communication Skills Training in Transnational Customer Service Work

    Science.gov (United States)

    Mirchandani, Kiran

    2012-01-01

    Purpose: This paper aims to focus on the communications skills training given to transnational call center workers in India whose jobs involve providing customer service to Western customers. Emotion work is a key component of customer service jobs, and this work is constructed as an important soft skill. Design/methodology/approach: Between 2002…

  2. The spiritual health of veterans with a history of suicide ideation

    Science.gov (United States)

    Kopacz, Marek S.

    2014-01-01

    Introduction: In recent years, considerable empirical attention has been devoted to examining the increased risk of suicide observed in some Veteran populations. This has led to a renewed focus on developing novel support options which can be used to respond to Veterans in distress, reducing their risk of suicide. Spirituality and religion, however, have been largely absent from any public discourse related to suicide prevention, not least of all in Veteran populations. Aim: The aim of this cross-sectional study is to compare the self-rated spiritual health of Veterans with and without suicide ideation. Identifying differences which may exist between these two groups could highlight the relevance of spiritual well-being to Veteran suicide prevention efforts. Materials and Methods: Data were collected using pencil-and-paper surveys, called Spiritual Assessments, distributed within the general population of in- and outpatients at a U.S. Department of Veterans Affairs Medical Center. Using Likert-type scales, this study examines the self-rated spiritual health, spiritual devotion, and significance ascribed to spirituality in a sample of 5378 Veterans. Statistical analysis took place using chi-squared to examine differences in the distribution of responses between ideators and non-ideators. Results: Ideators significantly more often rated their spiritual health as worse than that of non-ideators. Even with similar levels of spiritual devotion or significance ascribed to spiritual life, ideators continued to significantly more often rate their spiritual health as worse than that of non-ideators. Conclusion: The results show that Veterans with suicide ideation more often rate their spiritual health as worse than that of Veterans without suicide ideation. This suggests that spiritual well-being may indeed be relevant to suicide prevention efforts in Veteran populations. PMID:25750787

  3. Longitudinal Cognitive Trajectories of Women Veterans from the Women's Health Initiative Memory Study.

    Science.gov (United States)

    Padula, Claudia B; Weitlauf, Julie C; Rosen, Allyson C; Reiber, Gayle; Cochrane, Barbara B; Naughton, Michelle J; Li, Wenjun; Rissling, Michelle; Yaffe, Kristine; Hunt, Julie R; Stefanick, Marcia L; Goldstein, Mary K; Espeland, Mark A

    2016-02-01

    A comparison of longitudinal global cognitive functioning in women Veteran and non-Veteran participants in the Women's Health Initiative (WHI). We studied 7,330 women aged 65-79 at baseline who participated in the WHI Hormone Therapy Trial and its ancillary Memory Study (WHIMS). Global cognitive functioning (Modified Mini-Mental State Examination [3MSE]) in Veterans (n = 279) and non-Veterans (n = 7,051) was compared at baseline and annually for 8 years using generalized linear modeling methods. Compared with non-Veterans, Veteran women were older, more likely to be Caucasian, unmarried, and had higher rates of educational and occupational attainment. Results of unadjusted baseline analyses suggest 3MSE scores were similar between groups. Longitudinal analyses, adjusted for age, education, ethnicity, and WHI trial assignment revealed differences in the rate of cognitive decline between groups over time, such that scores decreased more in Veterans relative to non-Veterans. This relative difference was more pronounced among Veterans who were older, had higher educational/occupational attainment and greater baseline prevalence of cardiovascular risk factors (e.g., smoking) and cardiovascular disease (e.g., angina, stroke). Veteran status was associated with higher prevalence of protective factors that may have helped initially preserve cognitive functioning. However, findings ultimately revealed more pronounced cognitive decline among Veteran relative to non-Veteran participants, likely suggesting the presence of risks that may impact neuropathology and the effects of which were initially masked by Veterans' greater cognitive reserve. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Military veteran mortality following a survived suicide attempt

    Directory of Open Access Journals (Sweden)

    Conigliaro Joseph

    2011-05-01

    Full Text Available Abstract Background Suicide is a global public health problem. Recently in the U.S., much attention has been given to preventing suicide and other premature mortality in veterans returning from Iraq and Afghanistan. A strong predictor of suicide is a past suicide attempt, and suicide attempters have multiple physical and mental comorbidities that put them at risk for additional causes of death. We examined mortality among U.S. military veterans after hospitalization for attempted suicide. Methods A retrospective cohort study was conducted with all military veterans receiving inpatient treatment during 1993-1998 at United States Veterans Affairs (VA medical facilities following a suicide attempt. Deaths occurring during 1993-2002, the most recent available year at the time, were identified through VA Beneficiary and Records Locator System data and National Death Index data. Mortality data for the general U.S. adult population were also obtained from the National Center for Health Statistics. Comparisons within the veteran cohort, between genders, and against the U.S. population were conducted with descriptive statistics and standardized mortality ratios. The actuarial method was used estimate the proportion of veterans in the cohort we expect would have survived through 2002 had they experienced the same rate of death that occurred over the study period in the U.S. population having the age and sex characteristics. Results During 1993-1998, 10,163 veterans were treated and discharged at a VA medical center after a suicide attempt (mean age = 44 years; 91% male. There was a high prevalence of diagnosed alcohol disorder or abuse (31.8%, drug dependence or abuse (21.8%, psychoses (21.2%, depression (18.5%, and hypertension (14.2%. A total of 1,836 (18.1% veterans died during follow up (2,941.4/100,000 person years. The cumulative survival probability after 10 years was 78.0% (95% CI = 72.9, 83.1. Hence the 10-year cumulative mortality risk was 22

  5. Customer satisfaction and customer loyalty as predictors of future business potential

    DEFF Research Database (Denmark)

    Eskildsen, Jacob Kjær; Kristensen, Kai

    2008-01-01

    This paper analyses the relationship between customer satisfaction, customer loyalty and the future business potential of existing customers. The data for the analysis come from the Danish Customer Satisfaction Index 2006. Here a total of approximately 2000 private customers evaluated...

  6. Veterans Health Administration (VHA)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is for SSA to verify SSNs and other identifying information for the Department of Veterans Affairs, VHA. DVA will use the information...

  7. A custom-built PET phantom design for quantitative imaging of printed distributions

    International Nuclear Information System (INIS)

    Markiewicz, P J; Angelis, G I; Kotasidis, F; Green, M; Matthews, J C; Lionheart, W R; Reader, A J

    2011-01-01

    This note presents a practical approach to a custom-made design of PET phantoms enabling the use of digital radioactive distributions with high quantitative accuracy and spatial resolution. The phantom design allows planar sources of any radioactivity distribution to be imaged in transaxial and axial (sagittal or coronal) planes. Although the design presented here is specially adapted to the high-resolution research tomograph (HRRT), the presented methods can be adapted to almost any PET scanner. Although the presented phantom design has many advantages, a number of practical issues had to be overcome such as positioning of the printed source, calibration, uniformity and reproducibility of printing. A well counter (WC) was used in the calibration procedure to find the nonlinear relationship between digital voxel intensities and the actual measured radioactive concentrations. Repeated printing together with WC measurements and computed radiography (CR) using phosphor imaging plates (IP) were used to evaluate the reproducibility and uniformity of such printing. Results show satisfactory printing uniformity and reproducibility; however, calibration is dependent on the printing mode and the physical state of the cartridge. As a demonstration of the utility of using printed phantoms, the image resolution and quantitative accuracy of reconstructed HRRT images are assessed. There is very good quantitative agreement in the calibration procedure between HRRT, CR and WC measurements. However, the high resolution of CR and its quantitative accuracy supported by WC measurements made it possible to show the degraded resolution of HRRT brain images caused by the partial-volume effect and the limits of iterative image reconstruction. (note)

  8. Stigma associated with PTSD: perceptions of treatment seeking combat veterans.

    Science.gov (United States)

    Mittal, Dinesh; Drummond, Karen L; Blevins, Dean; Curran, Geoffrey; Corrigan, Patrick; Sullivan, Greer

    2013-06-01

    Although stigma associated with serious mental illness, substance abuse disorders, and depression has been studied very little is known about stigma associated with Posttraumatic Stress Disorder (PTSD). This study explored stigma related to PTSD among treatment-seeking Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans. Sixteen treatment-seeking OEF/OIF veterans with combat-related PTSD participated in focus groups. We used qualitative methods to explore PTSD-related stigma. Common perceived stereotypes of treatment-seeking veterans with PTSD included labels such as "dangerous/violent," or "crazy," and a belief that combat veterans are responsible for having PTSD. Most participants reported avoiding treatment early on to circumvent a label of mental illness. Participants initially reported experiencing some degree of self-stigma; however, following engagement in treatment they predominantly resisted these stereotypes. Although most participants considered combat-related PTSD as less stigmatizing than other mental illnesses, they reported difficulties with reintegration. Such challenges likely stem from both PTSD symptoms and veterans' perceptions of how the public views them. Most reported that fellow combat veterans best understood them. Awareness of public stereotypes impacts help seeking at least early in the course of illness. Peer-based outreach and therapy groups may help veterans engage in treatment early and resist stigma. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  9. Customer Relationship Management

    OpenAIRE

    Abdillah, Leon

    2018-01-01

    Contents: 1) Introduction, 2) Basic Concept of CRM, 3) The Customer Service/Sales Profile, 4) Customer Relationship, 5) Planning and implementing CRM projects, 6) Developing, managing and using customer-related databases, 7) Managing and Sharing Customer Data, 8) Tools for Capturing Customer Information, 9) E-Commerce: Customer Relationships on the Internet, 10) Information Technology for CRM, 11) Sales-force automation, 12) Marketing automation, 13) Service automation, 14) Presentations, 15)...

  10. Analisa Customer Value dan Customer Experience terhadap Customer Loyalty dengan Customer Satisfaction sebagai Variabel Intervening (Studi pada Waroeng Spesial Sambal Cabang Purwokerto)

    OpenAIRE

    Ariningsih, Kuswanti; Muji Rahayu, Tri Septin

    2015-01-01

    This research was based on the comptitive business condition in restaurant business that was getting more competitive, therefore the corporates had to make a new marketing strategy to stay and achieve he higher market. This research aimed to test the effect of customer value and customer experience toward customer loyalty with customer satisfaction as intervening variable. The data were gained by questionnaire method to the 110 respondent of waroeng spesial sambal cabang purwok...

  11. Utilization of Mental Health Services by Veterans Living in Rural Areas.

    Science.gov (United States)

    Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan

    2017-06-01

    There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.

  12. Accuracy of Computer-Assisted Template-Guided Autotransplantation of Teeth With Custom Three-Dimensional Designed/Printed Surgical Tooling: A Cadaveric Study.

    Science.gov (United States)

    Anssari Moin, David; Verweij, Jop Pieter; Waars, Hugo; van Merkesteyn, Richard; Wismeijer, Daniel

    2017-05-01

    The aim of the present cadaveric study was to assess the accuracy of computer-assisted template-guided autotransplantation of teeth with custom 3-dimensional (3D) designed/printed surgical tooling. Ten partially edentulous human mandibular cadavers were scanned using a cone-beam computed tomography (CBCT) system and an intraoral scanning system. The 3D data of these cadavers were imported to specialized software and used to analyze the region of the recipient sites, and the donor teeth were selected. Subsequently, congruent to the donor teeth, custom surgical tooling and surgical-guided templates were designed and 3D printed. The guided osteotomies were performed and the donor teeth transplanted. To evaluate the planned donor teeth positions compared with the transplanted donor teeth positions, the mandibles were scanned again using the CBCT system, and software matching was applied to measure the accuracy of the procedure. The mean angular deflection of the transplanted donor teeth with the planned donor teeth positions was 5.6 ± 5.4°. Comparing the 3D positions of the shoulders, a mean deviation of 3.15 ± 1.16 mm and a mean apical deviation of 2.61 ± 0.78 mm were found. The described method of computer-assisted template-guided autotransplantation of teeth with custom 3D designed/printed surgical tooling could potentially provide a relatively accurate alternative for the currently available treatment approaches. Further research should focus on improving the accuracy of this technique and evaluating the clinical success and advantages of this method. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Smoking cessation among African American and white smokers in the Veterans Affairs health care system.

    Science.gov (United States)

    Burgess, Diana J; van Ryn, Michelle; Noorbaloochi, Siamak; Clothier, Barbara; Taylor, Brent C; Sherman, Scott; Joseph, Anne M; Fu, Steven S

    2014-09-01

    We examined whether a proactive care smoking cessation intervention designed to overcome barriers to treatment would be especially effective at increasing cessation among African Americans receiving care in the Veterans Health Administration. We analyzed data from a randomized controlled trial, the Veterans Victory over Tobacco study, involving a population-based electronic registry of current smokers (702 African Americans, 1569 whites) and assessed 6-month prolonged smoking abstinence at 1 year via a follow-up survey of all current smokers. We also examined candidate risk adjustors for the race effect on smoking abstinence. The interaction between patient race and intervention condition (proactive care vs. usual care) was not significant. Overall, African Americans had higher quit rates than Whites (13% vs. 9%; P Whites. These findings may be a result of the large number of veterans receiving smoking cessation services and the lack of racial differences in receipt of these services as well as racial differences in smoking history, self-efficacy, and motivation to quit that favor African Americans.

  14. 76 FR 24087 - Advisory Committee on Homeless Veterans; Notice of Meeting

    Science.gov (United States)

    2011-04-29

    ... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Homeless Veterans; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act... Harbor View Room at the Best Western Bay Harbor Hotel, 7700 Courtney Campbell Causeway, Tampa, Florida...

  15. AN INVESTIGATION OF DECISION - MAKING STRATEGIES OF THE VETERAN SOCCER PLAYERS

    Directory of Open Access Journals (Sweden)

    Mustafa BAŞ

    2015-07-01

    Full Text Available The aim of this research is to determine the decision - making strategies of veteran footballers, attended veteran football tournament organised in Trabzon in 2014, in line with several variables. The universe of the study involves all the veteran footballers attended the tournament while the population includes 196 footballers, selected through random sampling, and participated the study voluntarily. The data regarding decis ion - making strategies were collected by means of the questionnaire of “Melbourne Decision Making Questionnaire” (developed by Mann and others, 1998, “Decision - Making Scale” consisting 28 items (translated into Turkish by Deniz, 2004 and personal informa tion form designed by the researcher to get demographic information of footballers. Frequency distribution was administered in determining the level of decision - making of veteran footballers, Independent Samples T - Test” was used to compare two variables, a nd ANOVA tests were utilised in comparing the means of variables more than two. The difference between the views of groups was analysed through considering α=0.05 significance level. In this manner, significant difference was detected between the variables of age and marital status according to the means of self - esteem scale. In addition, there was significant difference between the scores of decision - making style scale in line with the variables of education level and their position at the game. However, t here was no significant difference between the scales of self - esteem and decision - making styles according to occupation and monthly income variables. To sum up, in the light of the findings of this research, we recommend playing football to develop decisio n - making strategies for all age groups.

  16. Product Customization

    DEFF Research Database (Denmark)

    Hvam, Lars; Mortensen, Niels Henrik; Riis, Jesper

    For the majority of industrial companies, customizing products and services is among the most critical means to deliver true customer value and achieve superior competitive advantage. The challenge is not to customize products and services in itself – but to do it in a profitable way...... from more than 40 product configuration projects in companies providing customer tailored products and services........ The implementation of a product configuration system is among the most powerful ways of achieving this in practice, offering a reduction of the lead time for products and quotations, faster and more qualified responses to customer inquiries, fewer transfers of responsibility and fewer specification mistakes...

  17. Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

    Science.gov (United States)

    Herrmann, Nathan; Eryavec, Goran

    1994-01-01

    Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Multivariate analysis for customer segmentation based on RFM

    Directory of Open Access Journals (Sweden)

    Álvaro Julio Cuadros López

    2018-02-01

    Full Text Available Context: To build a successful relationship management (CRM, companies must start with the identification of the true value of customers, as this provides basic information to implement more targeted and customized marketing strategies. The RFM methodology, a classic analysis tool that uses three evaluation parameters, allows companies to understand customer behavior, and to establish customer segments. The addition of a new parameter in the traditional technique is an opportunity to refine the possible outcomes of a customer segmentation since it not only provides a new element of evaluation to identify the most valuable customers, but it also makes it possible to differentiate and get to know customers even better. Method: The article presents a methodology that allows to establish customer segments using an extended RFM method with new variables, selected through multivariate analysis..  Results: The proposed implementation was applied in a company in which variables such as profit, profit percentage, and billing due date were tested. Therefore, it was possible to establish a more detailed customer segmentation than with the classic RFM. Conclusions: the RFM analysis is a method widely used in the industry for its easy understanding and applicability. However, it can be improved with the use of statistical procedures and new variables, which will allow companies to have deeper information about the behavior of the clients, and will facilitate the design of specific marketing strategies.

  19. Childhood antecedents of incarceration and criminal justice involvement among homeless veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2013-10-01

    Although criminal justice involvement and incarceration are common problems for homeless veterans, few studies have examined childhood risk factors for criminal justice involvement among veterans. This study examined the association between three types of childhood problems, family instability, conduct disorder behaviors, and childhood abuse, and criminal justice involvement and incarceration in adulthood. Data from 1,161 homeless veterans across 19 sites participating in the Housing and Urban Development-Veterans Affairs Supportive Housing program were examined. After controlling for sociodemographics and mental health diagnoses, veterans who reported more conduct disorder behaviors during childhood tended to report more criminal charges of all types, more convictions, and longer periods of incarceration during adulthood. However, the variance explained in criminal behavior by childhood was not large, suggesting that there are other factors that affect the trajectory by which homeless veterans become involved in the criminal justice system. Further research is needed to intervene in the pathway to the criminal justice system and guide efforts to prevent incarceration among veterans. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  20. Design basis knowledge management for the newcomer countries. Relying on the owner/operator as a knowledgeable customer

    International Nuclear Information System (INIS)

    Lepouze, Benoît

    2013-01-01

    Becoming a knowledgeable customer is the first step to manage knowledge: • Vendors, consulting firms, TSOs can assist the future operator but it will remain the sole owner of the decisions; • Future owner operator has to become a knowledgeable customer: • Know what to ask for, • Know how to ask for it, • Know how to check if it got what it asked. • Where should knowledge management belong (management?, HRD?, procurement?) and is it important? What it means for DBKM ? (example): • The owner/operator (the licensee) is responsible in front of the safety agency: it should answer its questions at every stage of the program; • It will often turn back to its vendor/suppliers especially for detailed design questions; • But that means it has to know what to ask for and to check the result before talking to the regulator; • That also means it has to make sure knowledge is managed throughout the life of the program