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Sample records for improving service delivery

  1. 76 FR 24339 - Streamlining Service Delivery and Improving Customer Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... Delivery and Improving Customer Service By the authority vested in me as President by the Constitution and...). However, with advances in technology and service delivery systems in other sectors, the public's... Federal Government has a responsibility to streamline and make more efficient its service delivery...

  2. Models To Improve Service Delivery. Chapter 8.

    ERIC Educational Resources Information Center

    1996

    This collection of papers presented at a 1996 conference on children's mental health focuses on models to improve service delivery. Papers have the following titles and authors: (1) "Empirical Evaluation of an Alternative to Hospitalization for Youth Presenting Psychiatric Emergencies" (Scott W. Henggeler); (2) "An Experimental Study of the…

  3. From service delivery to solution delivery: commissioning for health improvement.

    PubMed

    Shircore, Richard; Ladbury, Patrick

    2009-11-01

    The further division of responsibilities between commissioners and providers in England will have far-reaching consequences and opportunities for developing and enhancing health improvement. Commissioners will have the opportunity to craft local solutions to local issues. To be effective, these local responses need to tackle the core determinants of health and to build the social capital that is at the heart of all communities that enjoy high standards of health. This paper argues that the new arrangements mark an evolution of the Beveridge model of healthcare (centralized, top down and professionally prescribed) to a post-Beveridge model characterized by it being decentralized, localized and utilizing professional skills in the pursuit of client and community satisfaction and engagement rather than a narrowly defined professional perspective. This paper indicates some of the key conceptual changes commissioners need to employ to take advantage of the emerging opportunities. It is argued that the new arrangements will only be fully effective if commissioners of health improvement programmes ensure they factor in health promotion and social marketing expertise, both in the strategic and operational phases of commissioning. Finally, predictions are made about changes in the values and characteristics of current health improvement organizations. PMID:19994646

  4. Improving the delivery of veterinary services in India.

    PubMed

    Rao, S V N; Rasheed Sulaiman, V; Natchimuthu, K; Ramkumar, S; Sasidhar, P V K

    2015-12-01

    In pursuit of effective veterinary service delivery, the objectives of this study were threefold: (i) reduce the shortage of technical personnel in veterinary universities (VUs) and animal husbandry departments (AHDs), (ii) identify collaborative areas between VUs and AHDs, and (iii) build the capacity of the veterinary and animal husbandry sector. Primary data were collected from all the 16 veterinary colleges and AHDs in five south Indian states on: (i) student intake and the out-turn of veterinary graduates, (ii) technical personnel--existing and required at various levels, (iii) specific areas of collaboration where VUs and AHDs need each other and can extend support to each other, and (iv) areas in which university faculty and field veterinarians would benefit from further training. Two focus group discussions were held with top administrators of VUs and AHDs to collect qualitative data. The results revealed that there are not enough veterinary graduates to meet the needs of the system and that there is a shortage of faculty, field veterinarians and para-veterinarians. Both focus groups identified areas for collaboration and capacity building to improve veterinary service delivery. The results conclusively demonstrated that India's veterinary service delivery is constrained, not due to a lack of organisations or programmes, but due to the inability of the organisations to collaborate with each other. To improve the effectiveness of veterinary service delivery it will be necessary to: admit more graduate students, support the establishment of new colleges; recruit faculty, field veterinarians and para-veterinarians; remandate the Directorates of Extension at VUs to develop linkages with AHDs; allocate funds ('special central grants') for infrastructure development to all AHDs and veterinary colleges; establish one model veterinary college that follows international standards on veterinary education and create four regional academic staff training colleges

  5. Program Integration: An Alternative for Improving County Rural Human Services Delivery. Technical Paper No. 13.

    ERIC Educational Resources Information Center

    Center for Rural Pennsylvania, Harrisburg.

    This report examines program integration as a way to improve the delivery of rural human services in Pennsylvania. A panel of policymakers, human services providers, and representatives of state agencies identified barriers to effective rural human services delivery and generated policy recommendations. Most county-based human services in…

  6. Strengthening national health systems for improving efficiency of health service delivery in Nepal.

    PubMed

    Shakya, H S; Adhikari, S; Gurung, G; Pant, S; Aryal, S; Singh, A B; Sherpa, M G

    2012-05-01

    The success of Nepal's community-based health programmes in promoting maternal and child health has been achieved due to an overall improvement in service delivery facilities and health support systems. This article assesses the progress made by the Government of Nepal in improving health service delivery by introducing three key components: an improved health logistics management, facility-based maternal and neonatal health services, and decentralized health facility management. PMID:23034370

  7. Post-Soviet transition: improving health services delivery and management.

    PubMed

    Antoun, Joseph; Phillips, Frank; Johnson, Tricia

    2011-01-01

    During the post-Soviet transition of the last 2 decades, ex-Communist countries of the Eastern Bloc, including eastern and central Europe, the Soviet Union, and its satellite and aligned states, have undergone major health system reforms. Many health systems of those countries--previously adopting a Soviet-type Semashko model--are currently called "in transition," as reform agendas, such as shifting to a Bismarck, Beveridge, or mixed financing scheme or adopting new health delivery management policies, are still in development. In this article, we first review common characteristics of Semashko health systems (the predominant health system of Communist countries during the Soviet era) and then discuss the "new public management" principles that ex-Communist countries have recently started to adopt with various degrees of success. We then illustrate experiences with these principles using 2 case studies, from Russia and Albania, and propose health policy options for both cases. Based on a review of the literature and on the our work experience in Russia and Albania, we found that the 2 ex-Semashko systems have not fully capitalized on expected positive outcomes of new public management principles due to low local healthcare financing levels, depreciated healthcare infrastructure and operational capacities, overlapping and contradicting ideology and policies of the former and newer health systems, and finally, lack of leadership that has successful experience with these principles. In the case of pharmaceutical pricing, reimbursement, and access in Russia, we show how a well-intentioned but suboptimally designed and managed pharmaceutical coverage scheme has suffered moral hazard and adverse selection and has adversely impacted the new public management promise of efficient medicine coverage. In the case of Albania, the delayed investment in human resource reform within a depreciated and underfinanced delivery system has adversely affected the implementation of new

  8. Improving Bilingual Service Delivery in Catholic Schools through Two-Way Immersion

    ERIC Educational Resources Information Center

    Scanlan, Martin; Zehrbach, Gareth

    2010-01-01

    Catholic elementary schools underserve Latino students, especially those who are bilingual. This paper presents a conceptual argument for Catholic elementary schools to improve this by pursuing the two-way immersion model of bilingual service delivery in Spanish and English. The argument is presented in three stages. First, we show that Catholic…

  9. Efficacy of a Process Improvement Intervention on Delivery of HIV Services to Offenders: A Multisite Trial

    PubMed Central

    Shafer, Michael S.; Dembo, Richard; del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L.; Belenko, Steven; Frisman, Linda K.; Visher, Christy A.; Pich, Michele; Patterson, Yvonne

    2014-01-01

    Objectives. We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. Methods. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. Results. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Conclusions. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments. PMID:25322311

  10. Improved Service Delivery and Cost Effective Framework for e-Governance in India

    NASA Astrophysics Data System (ADS)

    Kumar, Puneet; Kumar, Dharminder; Kumar, Narendra

    2013-07-01

    In current era, the involvement of technologies like virtualization, consolidation and cloud computing, and adoption of free and open source software in designing and deploying e-governance that can reduce the total cost associated with and hence the financial burden abide by the state and central governments. The success of any e-governance project depends upon its utilization by the intended group and so there accessibility needs to be enhanced drastically by reengineered framework. Here, we design an Improved Service Delivery and Cost Effective Framework for e-Governance that will be useful for success of e-governance projects and the delivery mechanism in India by using free and open access software for development and deployment of e-governance applications, virtualization and consolidation techniques for management of e-services and cloud computing for enhancing the accessibility of services.

  11. Constraints in animal health service delivery and sustainable improvement alternatives in North Gondar, Ethiopia.

    PubMed

    Kebede, Hassen; Melaku, Achenef; Kebede, Elias

    2014-01-01

    Poor livestock health services remain one of the main constraints to livestock production in many developing countries, including Ethiopia. A study was carried out in 11 districts of North Gondar, from December 2011 to September 2012, with the objective of identifying the existing status and constraints of animal health service delivery, and thus recommending possible alternatives for its sustainable improvement. Data were collected by using pre-tested questionnaires and focus group discussion. Findings revealed that 46.34% of the responding farmers had taken their animals to government veterinary clinics after initially trying treatments with local medication. More than 90.00% of the clinical cases were diagnosed solely on clinical signs or even history alone. The antibacterial drugs found in veterinary clinics were procaine penicillin (with or without streptomycin), oxytetracycline and sulphonamides, whilst albendazole, tetramisole and ivermectin were the only anthelmintics. A thermometer was the only clinical aid available in all clinics, whilst only nine (45.00%) clinics had a refrigerator. In the private sector, almost 95.00% were retail veterinary pharmacies and only 41.20% fulfilled the requirement criteria set. Professionals working in the government indicated the following problems: lack of incentives (70.00%), poor management and lack of awareness (60.00%) and inadequate budget (40.00%). For farmers, the most frequent problems were failure of private practitioners to adhere to ethical procedures (74.00%) and lack of knowledge of animal diseases and physical distance from the service centre (50.00%). Of all responding farmers, 58.54% preferred the government service, 21.14% liked both services equally and 20.33% preferred the private service. Farmers' indiscriminate use of drugs from the black market (23.00%) was also mentioned as a problem by private practitioners. Sustainable improvement of animal health service delivery needs increased awareness for all

  12. Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care*

    PubMed Central

    MacPherson, Peter; Munthali, Chigomezgo; Ferguson, Jane; Armstrong, Alice; Kranzer, Katharina; Ferrand, Rashida A; Ross, David A

    2015-01-01

    Objectives Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. Methods We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle–Ottawa Scale. Results Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent-friendliness of clinics. Most studies were of low to moderate methodological quality. Conclusions This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent-tailored services appear promising interventions and warrant further investigation. PMID:25877007

  13. Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.

    PubMed

    Wickizer, T M; Franklin, G; Plaeger-Brockway, R; Mootz, R D

    2001-01-01

    This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational

  14. Will more inputs improve the delivery of health services? Analysis of district vaccination coverage in Pakistan.

    PubMed

    Loevinsohn, Benjamin; Hong, Rathavuth; Gauri, Varun

    2006-01-01

    In order to determine whether physical resources or technical inputs can make a difference to the delivery of health services, we carried out a study that examined the large variation in district level vaccination coverage in Pakistan. Vaccination coverage was assessed by district-wise cluster surveys and the predictor variables were collected from census data and from a survey of 99 district health offices. Information was collected on basic supplies, physical infrastructure, management, training, socio-economic variables, and a variety of other indicators. Univariate and multivariate analyses were carried out. A model including female literacy rate, TV ownership, and provincial dummies explained 48% of the variation in DTP3 coverage. Very few of the other variables examined were significantly correlated to coverage. Possible explanatory variables like adequacy of syringe and vaccine supply, the number of vaccinators per capita, recent training of managers, frequency of supervision, availability of micro-plans, and turnover of managers were not correlated with coverage. While the Government of Pakistan has ensured that many physical resources and technical inputs have been provided to the district health offices, this does not appear able to explain the relatively low overall coverage or the variation between districts. Bolder initiatives and innovations are likely needed to improve delivery of basic health services. PMID:16604848

  15. 3 CFR 13571 - Executive Order 13571 of April 27, 2011. Streamlining Service Delivery and Improving Customer...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...-service options accessed by the Internet or mobile phone and improved processes that deliver services... service channels (such as online, phone, in-person, and mail services); (e) streamlining agency...

  16. Improving service delivery by evaluation of the referral pattern and capacity in a clinical genetics setting.

    PubMed

    McCann, Emma; Baines, Elizabeth A; Gray, Jonathon R; Procter, Annie M

    2009-08-15

    Quality improvement in specialist services such as clinical genetics is challenging largely due to the complexity of the service and the difficulty in obtaining accurate, reproducible, and measurable data. The objectives were to evaluate the pattern of referrals to the All Wales Medical Genetics Service (AWMGS) North Wales Genetics team based in three separate hospitals, define the capacity of the team and implement change to improve equity, timeliness and efficiency of care delivery to patients. The methodology required collating the monthly referral rates retrospectively for each center over a 2.5-year period and plotting on statistical process control charts. Process mapping of the referral process in each center was undertaken, differences documented and a common pathway implemented. "Did not attend" and "time to first appointment" rates were also measured in one center. PDSA methodology was used to implement "patient focused booking." The results show that the range for referral rates in any given month for each center was 3-33 referrals. The range for referral rate for the whole team was 18-64 per month. Since January 2004 the average number of monthly referrals to the North Wales service has increased by 50%. The potential range in monthly referrals varies between centers and the range of the variability has also increased also in two out of the three centers. Introduction of Patient Focused Booking reduced the "Failed to Attend" rate and 100% of patients were offered a choice of appointments. In addition 100% had a first face-to-face contact within 6 weeks if they chose. The measurement of improvement involved firstly introducing a series of continuous measures to provide a baseline for the process prior to the implementation of any changes and secondly to indicate the impact of the changes following implementation. The measures implemented included process (referrals numbers, percentage of patients offered a choice of appointments), outcome (percentage of

  17. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    PubMed

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach. PMID:18082996

  18. Improving Service Delivery: Investigating the Role of Information Sharing, Job Characteristics, and Employee Satisfaction

    ERIC Educational Resources Information Center

    Bontis, Nick; Richards, David; Serenko, Alexander

    2011-01-01

    Purpose: The purpose of this study is to propose and test a model designed to investigate the impact of job characteristics, employee satisfaction, and information sharing on two key indicators of quality service delivery, such as worker perceptions of their efficiency and customer focus. Design/methodology/approach: During the project, 9,060…

  19. 22 CFR 96.41 - Procedures for responding to complaints and improving service delivery.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... provides expedited review of such complaints that are time-sensitive or that involve allegations of fraud... it makes systematic efforts to improve its adoption services as needed. The agency or person...

  20. Improving service delivery of water, sanitation, and hygiene in primary schools: a cluster-randomized trial in western Kenya.

    PubMed

    Alexander, Kelly T; Dreibelbis, Robert; Freeman, Matthew C; Ojeny, Betty; Rheingans, Richard

    2013-09-01

    Water, sanitation, and hygiene (WASH) programs in schools have been shown to improve health and reduce absence. In resource-poor settings, barriers such as inadequate budgets, lack of oversight, and competing priorities limit effective and sustained WASH service delivery in schools. We employed a cluster-randomized trial to examine if schools could improve WASH conditions within existing administrative structures. Seventy schools were divided into a control group and three intervention groups. All intervention schools received a budget for purchasing WASH-related items. One group received no further intervention. A second group received additional funding for hiring a WASH attendant and making repairs to WASH infrastructure, and a third group was given guides for student and community monitoring of conditions. Intervention schools made significant improvements in provision of soap and handwashing water, treated drinking water, and clean latrines compared with controls. Teachers reported benefits of monitoring, repairs, and a WASH attendant, but quantitative data of WASH conditions did not determine whether expanded interventions out-performed our budget-only intervention. Providing schools with budgets for WASH operational costs improved access to necessary supplies, but did not ensure consistent service delivery to students. Further work is needed to clarify how schools can provide WASH services daily. PMID:23981878

  1. A Promising Step for Improving Career Service Delivery: Comment on Sampson et al. (2000).

    ERIC Educational Resources Information Center

    Jepsen, David A.

    2000-01-01

    Presents a positive response to Sampson et al.'s article (this issue [2000]) describing a cognitive-information processing (CIP) framework useful for improving career services. Asserts that the authors strike an appropriate tone of optimism and caution that matches the article author's own experience as a practitioner and a teacher of the CIP…

  2. Policy strategies to improve maternal health services delivery and outcomes in Anambra State, Nigeria.

    PubMed

    Ezeonwu, Mabel

    2014-01-01

    Pregnancy and childbirth present major health risks for Nigerian women. Key maternal mortality measures indicate that the risks are high. Despite improvement efforts, the country has made insufficient progress in reaching the United Nations' millennium development goal of decreasing maternal mortality by 75% by 2015. The author in this qualitative descriptive study explores the perspectives of experienced nurse leaders on policy strategies to improve maternal health in Nigeria. In this study, the author suggests that removal of financial barriers to access and utilization of health services, spousal and family inclusiveness in plan of care, and health systems-related physical and human infrastructural improvements constitute critical policy approaches. PMID:24911182

  3. Designing a theory-informed, contextually appropriate intervention strategy to improve delivery of paediatric services in Kenyan hospitals

    PubMed Central

    2013-01-01

    Background District hospital services in Kenya and many low-income countries should deliver proven, effective interventions that could substantially reduce child and newborn mortality. However such services are often of poor quality. Researchers have therefore been challenged to identify intervention strategies that go beyond addressing knowledge, skill, or resource inadequacies to support health systems to deliver better services at scale. An effort to develop a system-oriented intervention tailored to local needs and context and drawing on theory is described. Methods An intervention was designed to improve district hospital services for children based on four main strategies: a reflective process to distill root causes for the observed problems with service delivery; developing a set of possible intervention approaches to address these problems; a search of literature for theory that provided the most appropriate basis for intervention design; and repeatedly moving backwards and forwards between identified causes, proposed interventions, identified theory, and knowledge of the existing context to develop an overarching intervention that seemed feasible and likely to be acceptable and potentially sustainable. Results and discussion In addition to human and resource constraints key problems included failures of relevant professionals to take responsibility for or ownership of the challenge of pediatric service delivery; inadequately prepared, poorly supported leaders of service units (mid-level managers) who are often professionally and geographically isolated and an almost complete lack of useful information for routinely monitoring or understanding service delivery practice or outcomes. A system-oriented intervention recognizing the pivotal role of leaders of service units but addressing the outer and inner setting of hospitals was designed to help shape and support an appropriate role for these professionals. It aims to foster a sense of ownership while

  4. The Bankruptcy of Service Delivery.

    ERIC Educational Resources Information Center

    Seeley, David S.

    The dominant concept of public education at present can be described as a "service delivery" model. The public wants its children educated, delegates the job to a government agency (the schools), and holds that agency responsible for the delivery of educational services. The problems in public education, however, will not be solved by holding the…

  5. Chemical Abstracts' Document Delivery Service.

    ERIC Educational Resources Information Center

    Rollins, Stephen

    1984-01-01

    The Document Delivery Service offered by Chemical Abstracts is described in terms of the DIALORDER option on the Dialog information retrieval system, mail requests, and requests transmitted through OCLC's Interlibrary Loan system. Transmission costs, success rates, delivery rates, and other considerations in utilizing the service are included.…

  6. A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness

    PubMed Central

    2013-01-01

    Background The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health system. This paper aims to increase understanding of the challenges faced by chronically ill patients and family carers in relation to their experiences with the health care system and health service providers. Method We interviewed patients, carers and health care professionals (HCPs) about the challenges faced by people living with complicated diabetes, chronic heart failure or chronic obstructive pulmonary disease. Results Patients indicated that they had a range of concerns related to the quality of health care encounters with health care professionals (HCPs), with these concerns being expressed as needs or wants. These included: 1) the need for improved communication and information delivery on the part of HCPs; 2) well organised health services and reduced waiting times to see HCPs; 3) help with self care; 4) greater recognition among professionals of the need for holistic and continuing care; and 5) inclusion of patients and carers in the decision making processes. Conclusions In order to address the challenges faced by people with chronic illness, health policy must be more closely aligned with the identified needs and wants of people affected by chronic illness than is currently the case. PMID:23819721

  7. The research agenda for improving health policy, systems performance, and service delivery for tuberculosis control: a WHO perspective.

    PubMed Central

    Nunn, Paul; Harries, Anthony; Godfrey-Faussett, Peter; Gupta, Raj; Maher, Dermot; Raviglione, Mario

    2002-01-01

    The development of WHO's DOTS strategy for the control of tuberculosis (TB) in 1995 led to the expansion, adaptation and improvement of operational research in this area. From being a patchwork of small-scale studies concerned with aspects of service delivery, TB operational research shifted to larger-scale, often multicountry projects that were also concerned with health policy and the needs of health systems. The results are now being put into practice by national TB control programmes. In 1998 an ad hoc committee identified the chief factors inhibiting the expansion of DOTS: lack of political will and commitment, poor financial support for TB control, poor organization and management of health services, inadequate human resources, irregular drug supplies, the HIV epidemic, and the rise of multidrug resistance. An analysis of current operational research on TB is presented on the basis of these constraints, and examples of successful projects are outlined in the article. We discuss the prerequisites for success, the shortcomings of this WHO- supported programme, and future challenges and needs. PMID:12132005

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

    PubMed

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

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis. PMID:24888629

  9. Managing Quality by Action Research--Improving Quality Service Delivery in Higher Education as a Marketing Strategy.

    ERIC Educational Resources Information Center

    Corbitt, Brian

    1998-01-01

    Describes two action research projects undertaken at an Australian university to improve quality of services to foreign students and improve the institution's image through word of mouth, or informal marketing. Each project, although small, facilitated changes or improvements to a targeted service. The role of management in empowering employees…

  10. A GIS-based methodology for improving needle exchange service delivery

    PubMed Central

    Davidson, Peter J.; Scholar, Shoshanna; Howe, Mary

    2010-01-01

    Background A variety of legal, social and logistical factors can prevent individuals from accessing formal needle exchange programs. One common solution to this problem is satellite exchange, which involves collaborating with people who already use an exchange to deliver needles and other supplies to those unable to access the exchange. While this approach can be very successful, one potential problem is that those most willing to deliver needles to their peers are often members of social networks that are already well connected with the needle exchange, leading to duplication of effort. In this paper we describe a simple and novel method for identifying groups of people who are demonstrably in need of improved access to needles, and for re-targeting efforts to meet the needs of those people. The method described was piloted at the Homeless Youth Alliance, San Francisco, USA, and further refined at Clean Needles Now, Los Angeles, USA. Methods People accessing needle exchange sites were asked to participate in a survey with two questions: “where were you and what time was it last time someone borrowed a needle from you?” and “where were you and what time was it last time you had to borrow a needle from someone else?” Responses were geocoded, and maps produced showing ‘hotspots’ where people were frequently finding themselves without needles. Results Satellite needle exchange was refined from an ad-hoc activity into one which focused on delivering needles to those with empirically demonstrable need. Maps produced in the process also proved valuable in discussions with local officials and other agencies about funding, as well as needle provision policy and practices. Conclusion We describe a method for rapidly assessing, describing, and responding to unmet and under-met need among injecting drug users. The method is particularly well-suited to organizations with extremely limited resources. PMID:21112757

  11. A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention

    PubMed Central

    Ambia, Julie; Mandala, Justin

    2016-01-01

    Introduction The success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps. Methods Selected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis. Results Interventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I2=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I2=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I2=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I2=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings. Conclusions Our findings indicate that mobile phone

  12. New Reference: Diversifying Service Delivery.

    ERIC Educational Resources Information Center

    Garner, Imogen

    This paper describes the experiences of a recent change process that focused on the delivery of reference services at the University of Western Australia (UWA). UWA reference librarians felt that they could not fulfill all of their duties while working from the reference desk for a significant period of time each day; they wanted time away from…

  13. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    PubMed Central

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  14. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  15. 77 FR 44306 - Service Delivery Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-27

    ... ADMINISTRATION Service Delivery Plan AGENCY: Social Security Administration (SSA). ACTION: Notice; request for comments. SUMMARY: We are requesting public input as we develop our Service Delivery Plan (SDP). We...) Deliver quality disability decisions and services; (2) provide quality service to the public; (3)...

  16. 78 FR 15797 - Service Delivery Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-12

    ... provide the best possible service. (77 FR 44306 (2012)). We have incorporated those suggestions into this... ADMINISTRATION Service Delivery Plan AGENCY: Social Security Administration (SSA). ACTION: Notice; request for comments. SUMMARY: We are requesting public input as we finalize our Service Delivery Plan (SDP)....

  17. 42 CFR 460.98 - Service delivery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... medical, health, and social services that integrate acute and long-term care. (2) These services must...

  18. Using a registry to improve immunization delivery.

    PubMed

    Kairys, Steven W; Gubernick, Ruth S; Millican, Adrienne; Adams, William G

    2006-07-01

    The NJIPSP was successful in encouraging a group of small urban practices to adopt the use of immunization registry and to transform immunization delivery from a mechanistic well-child service to a visible, monitored process of care. The project represents a unique combination of technology, public-private collaboration, and well-established quality improvement techniques. The change process involved the whole office as a team in adopting new immunization delivery roles and services. The greatest barrier to acceptance of the registry was (and continues to be) the need for manual data entry as the primary source of data collection, rather than electronic data transfer from other systems. The manual entry of data was labor intensive for participating practices and affected data measurement. Despite this barrier, however, the majority of practices substantially improved the quality of their immunization delivery practices in multiple areas. The rapid movement of primary care practices toward some form of electronic record may reduce this barrier and increase the percentage of practices willing to use a community registry. Practices that engaged collectively in the change process gained momentum from the group effort. Equally important was the public health partnership that helped identify and reduce improvement obstacles. Sustainability of practice-based immunization changes will rely, in part, on the registry's ease of use and the continued visibility of public health at the practice level. Active practice level collaboration by public health adds great value to change efforts. We believe that the best possible immunization delivery relies on both technology (registries and the EMR) and effective office systems. Projects like the NJIPSP are models for systems that integrate technology, practice change, and quality improvement, and their success has the potential to foster the spread of this approach to other primary care practices (especially in New Jersey). The

  19. Health Service Delivery in Developing Countries

    ERIC Educational Resources Information Center

    Benyoussef, Amor

    1977-01-01

    Reviews recent work dealing with methodological and technical issues in health and development; presents examples of the application of social sciences, including health demography and economics, in questions of health services delivery; and analyzes delivery of health services to rural and nomadic populations in Africa, Asia, and Latin America.…

  20. Male engagement as a strategy to improve utilization and community-based delivery of maternal, newborn and child health services: evidence from an intervention in Odisha, India

    PubMed Central

    2015-01-01

    Background In response to persistently poor levels of maternal, newborn and child health (MNCH) in rural India, the National Rural Health Mission (NRHM) was launched to support the provision of accessible, affordable and quality health care in deprived and underserved communities. The Accredited Social Health Activists (ASHAs), local women, are trained as health promoters to generate demand for, and facilitate access to MNCH care in their communities. While they are also expected to provide husbands of expectant women with information on MNCH care and family planning, their reach to the husbands is limited. The aim of this study is to describe the influence of a male engagement project on the utilization and community-based delivery of MNCH care in a rural district of the country. Methods We used qualitative data from the evaluation of a project which recruited and trained male Community Health Workers (CHWs) known as Male Health Activists (MHAs) to complement the work of ASHAs and target outreach to men. This paper uses data from in-depth interviews (IDIs) with ASHAs (n=11), Anganwadi Workers (AWWs) (n=4) and Auxiliary Nurse Midwives (ANMs) (n=2); with women who had delivered at home, community health center or district hospital in the few months preceding the date of the interview (n=11); and with husbands of these women (n=7). Results Participants’ responses are broadly organized around the facilitation of ASHAs’ work by MHAs, and male engagement activities undertaken by MHAs. More specifically, the narratives reflected gender-based divisions of work and space in three core areas of delivery and use of MNCH services: escorting women to health centers for facility-based deliveries; mobilizing women and children to attend Village Health and Nutrition Days and Immunization Days; and raising awareness among men on MNCH and family planning. Conclusion This study sheds light on male engagement as a strategy to improve the delivery, access and uptake of maternal

  1. A case study using a patient satisfaction survey to improve the delivery and effectiveness of drug addiction treatment services: marketing implications and organizational impact.

    PubMed

    Hogan, Beth; Hershey, Lewis; Ritchey, Steven

    2007-01-01

    Drug abuse and addiction continues to negatively impact many lives in this country. The United States health care system has grappled with how to best serve this vulnerable population. Since the personal and societal costs of addiction are high, all recent iterations of the United States strategic health plans (such as Healthy People 2010) have prioritized this area for improvement. At the local level, health care providers who care for those with addictions are challenged with shrinking insurance coverage for services, a difficult patient population, lack of treatment options, growing ranks of indigent patients, as well as a plethora of additional management challenges. It is known that successful treatment is integrally linked with patient satisfaction with services. The most critical factors in successful addiction treatment (from a patient's perspective) are (1) their belief that the counselor cares about them and, (2) their belief that they can recover. This paper reports a case study in the use of a patient satisfaction survey as a quality management/service refinement tool within a methadone treatment setting. Results indicate that the use of the survey itself provides patients with a tangible cue supporting the presence of the critical success factors. Further, the use of a survey provides a baseline for future measurements and trending. The paper concludes with a discussion of the marketing and organizational implications of incorporating the patient satisfaction survey into the ongoing delivery program for addiction services. PMID:19042522

  2. Commercial Document Delivery Services "Challenged" as EBSCO Drops Service.

    ERIC Educational Resources Information Center

    Machovec, George S.

    1998-01-01

    Discusses the EBSCO decision to stop its traditional commercial document delivery business. High prices for copyright clearance, government subsidized services, electronic formats available on the Internet, Web-based services, and consortium-based licensing activities are discussed as influencing the market for document delivery. (LRW)

  3. The Possible Relationship of the California Master Plan for Special Education to the State Department of Education Bureau of Pupil Personnel Services Plan for Improvement of Guidance Services in California Relative to Delivery of Services to Handicapped Pupils: Who's On First?

    ERIC Educational Resources Information Center

    Mendocino County Office of Education, Ukiah, CA.

    Service delivery to handicapped pupils is discussed in regard to the relationship between the California Master Plan for Special Education (see EC 062 915) and the Bureau of Pupil Personnel's Plan for Improvement of Guidance Services. The goals, benefits and limitations of both plans are described; and each plan is examined and compared in terms…

  4. 42 CFR 460.98 - Service delivery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY...

  5. 42 CFR 460.98 - Service delivery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY...

  6. 42 CFR 460.98 - Service delivery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Service delivery. 460.98 Section 460.98 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY...

  7. Models for Improving the Delivery of Services to: Underachieving Gifted Students. Research & Demonstration Series in Gifted Education.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Div. of Special Education.

    This report describes three model demonstration projects in Ohio school districts which focused on identifying types of gifted underachievers and providing them with services through unique instructional models. Provided for each program is information on: identifying characteristics (district, location, school population, project director);…

  8. Toward an Improved Regional Delivery System for Special Education Support Services in Massachusetts: Resource Linking System. Concept Paper.

    ERIC Educational Resources Information Center

    Lavin, Richard J.; And Others

    Proposed is a regional (Northeast) model to stimulate and draw together local and state services in a Resource Linking System for special education. It is explained that the model would provide the following five functions: appraisal of teachers' training needs, management and development of materials, field-based inservice training for teachers…

  9. The leadership of communities in HIV service delivery.

    PubMed

    Barr, David; Odetoyinbo, Morolake; Mworeko, Lillian; Greenberg, Julia

    2015-07-01

    HIV treatment and prevention strategies are life-long endeavours, requiring not only comprehensive, high-quality, consistent and equitable medical services but also appropriate political and cultural milieus to be effective. Communities directly affected by HIV offer a unique expertise and understanding in developing services to meet the needs of people seeking out and utilizing HIV treatment, prevention and support services. Through their organizations and networks, and through partnerships with health systems, these communities provide leadership, services and advocacy to ensure the delivery of high-quality, comprehensive services to meet the needs of diverse populations affected by HIV. This article describes integrated approaches to service delivery in which affected communities play a key role in the development and implementation of HIV programmes. Further scale-up of these approaches to care can improve overall quality, reduce stigma and discrimination, increase demand for services and improve retention in care. PMID:26102622

  10. Using Quality Concepts to Improve Reference Services.

    ERIC Educational Resources Information Center

    Brown, Janet Dagenais

    1994-01-01

    Discusses how to improve library reference service, especially the effective delivery of accurate answers, based on a program at Wichita State University (Kansas) that used concepts of quality from business and organizational management. Topics addressed include customers and customer service, and methods of reference service evaluation. (Contains…

  11. 76 FR 77483 - Nationwide Change in Postal Delivery Service Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... Nationwide Change in Postal Delivery Service Standards AGENCY: Postal Regulatory Commission. ACTION: Notice... pair service standards would be modified to move overnight delivery to 2-day delivery, and to move a portion of 2-day delivery to 3-day delivery. Id. at 1. Although changes to service standards...

  12. Personalizing knowledge delivery services: a conceptual framework

    NASA Technical Reports Server (NTRS)

    Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

    2003-01-01

    Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

  13. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis

    PubMed Central

    Free, Caroline; Phillips, Gemma; Watson, Louise; Galli, Leandro; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy

    2013-01-01

    Background Mobile health interventions could have beneficial effects on health care delivery processes. We aimed to conduct a systematic review of controlled trials of mobile technology interventions to improve health care delivery processes. Methods and Findings We searched for all controlled trials of mobile technology based health interventions using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990–Sept 2010). Two authors independently extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and we used random effects meta-analysis to give pooled estimates. We identified 42 trials. None of the trials had low risk of bias. Seven trials of health care provider support reported 25 outcomes regarding appropriate disease management, of which 11 showed statistically significant benefits. One trial reported a statistically significant improvement in nurse/surgeon communication using mobile phones. Two trials reported statistically significant reductions in correct diagnoses using mobile technology photos compared to gold standard. The pooled effect on appointment attendance using text message (short message service or SMS) reminders versus no reminder was increased, with a relative risk (RR) of 1.06 (95% CI 1.05–1.07, I2 = 6%). The pooled effects on the number of cancelled appointments was not significantly increased RR 1.08 (95% CI 0.89–1.30). There was no difference in attendance using SMS reminders versus other reminders (RR 0.98, 95% CI 0.94–1.02, respectively). To address the limitation of the older search, we also reviewed more recent literature. Conclusions The results for health care provider support interventions on diagnosis and management outcomes are generally consistent with modest benefits. Trials using mobile technology-based photos reported reductions in correct diagnoses when compared to the gold

  14. 22 CFR 228.24 - Other delivery services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Other delivery services. 228.24 Section 228.24... for USAID Financing § 228.24 Other delivery services. No source or nationality rules apply to other delivery services, such as export packing, loading, commodity inspection services, and services of...

  15. Human Services Course Delivery Systems.

    ERIC Educational Resources Information Center

    Soong, Robert K.; And Others

    This paper deals with various teaching methods and techniques currently is use in junior colleges in the Chicago area including traditional as well as innovative methods. The basic assumption is that teaching and learning are both essential aspects of the same system. The human services field is defined as encompassing the basic area of social…

  16. 78 FR 16753 - Service Delivery Plan; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... ADMINISTRATION Service Delivery Plan; Correction AGENCY: Social Security Administration. ACTION: Notice; request... Federal Register of March 12, 2013, in FR Doc. 2013-05595, on page 15797, in the third column; in the SUMMARY caption insert the following hyper-links. In the first sentence after the words,...

  17. Document Delivery Services: Today's Electronic Scriptoria.

    ERIC Educational Resources Information Center

    Sabosik, Patricia E.

    1992-01-01

    Discusses document delivery services in the light of new technology. Topics addressed include the historical influences of the printing press; the influence of microcomputers on the publishing industry; copyright issues; the changing role of publishers, researchers, and academic librarians; information partnerships among publishers, librarians,…

  18. Rural Gifted Education: Enhancing Service Delivery.

    ERIC Educational Resources Information Center

    Lewis, Joan D.

    Devising appropriate service delivery for gifted individuals is never an easy task and is especially challenging in rural areas. Characteristics of rural schools may be both barriers and benefits to gifted education. Limited numbers may mean that programming options for gifted students are unfeasible, but small schools and classes make…

  19. Full Service Document Delivery: Our Likely Future.

    ERIC Educational Resources Information Center

    Saldinger, Jeffrey

    1984-01-01

    Focuses on five issues of central concern to full-service document suppliers (provide on-demand delivery of any material, without limitations of subject, document type, or publication date) and their clients: end user access, ownership versus access, cooperation of all document suppliers, technology, and speed of access. (EJS)

  20. A Comparison of Service Delivery Models for Special Education Middle School Students Receiving Moderate Intervention Services

    ERIC Educational Resources Information Center

    Jones-Mason, Keely S.

    2012-01-01

    In an effort to improve academic performance for students receiving special education services, a large urban school district in Tennessee has implemented Integrated Service Delivery Model. The purpose of this study was to compare the performance of students receiving instruction in self-contained classrooms to the performance of students…

  1. 22 CFR 201.32 - Suppliers of delivery services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Suppliers of delivery services. 201.32 Section... COMMODITY TRANSACTIONS FINANCED BY USAID Responsibilities of Suppliers § 201.32 Suppliers of delivery services. (a) Performance of the service contract. The supplier of delivery services financed by...

  2. 39 CFR 761.6 - Delivery of Postal Service securities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Delivery of Postal Service securities. 761.6 Section 761.6 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve...

  3. 39 CFR 761.6 - Delivery of Postal Service securities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Delivery of Postal Service securities. 761.6 Section 761.6 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve...

  4. 39 CFR 761.6 - Delivery of Postal Service securities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Delivery of Postal Service securities. 761.6 Section 761.6 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve...

  5. 39 CFR 761.6 - Delivery of Postal Service securities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Delivery of Postal Service securities. 761.6 Section 761.6 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve...

  6. 39 CFR 761.6 - Delivery of Postal Service securities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Delivery of Postal Service securities. 761.6 Section 761.6 Postal Service UNITED STATES POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.6 Delivery of Postal Service securities. A Reserve...

  7. Effectiveness of Ng'adakarin Bamocha model in improving access to ante-natal and delivery services among nomadic pastoralist communities of Turkana West and Turkana North Sub-Counties of Kenya

    PubMed Central

    Jillo, Jillo Ali; Ofware, Peter Obonyo; Njuguna, Susan; Mwaura-Tenambergen, Wanja

    2015-01-01

    Introduction Access to maternal and child health care services among the nomadic pastoralists community in Kenya and African continent in general is unacceptably low. In Turkana, only 18.1% of the women had seen a nurse or a midwife for antenatal care during pregnancy while only 1.3% of pregnant women reported delivery at health facilities in 2005. Ng'adakarin BAMOCHA model, based on migratory routes of the Turkana pastoralists and container clinics was adopted in 2007 to improve access to maternal and child health services by the nomads. Methods A cross-sectional study design was used to establish the effectiveness of Ng'adakarin BAMOCHA model on accessibility and uptake of ante-natal care and delivery services. A total of 360 households and 400 households were interviewed for pre-intervention and post-intervention respectively. The study compared the pre-intervention and post-intervention findings. Structured questionnaires and focus group discussion were used for data collection. Results There was no improvement in the fourth ante-natal care visits between pre-intervention and post-intervention groups at 119(51.5%) and 111(41.9%) respectively (p < 0.05). Knowledge of the community on the importance of ANC visits improved from 60%-72% with significance level of p < 0.05. There was a significant increase 6%-17% of deliveries under a skilled health worker (p < 0.05). TBA assisted deliveries increased from 7.5%- 20.2% with a p < 0.05. There was significant reduction in home deliveries from 89.5%-79.5% with a p < 0.05. Conclusion The Ng'adakarin Bamocha model had a positive effect on the improving maternal health care among the nomadic pastoralist community in Turkana. PMID:26301007

  8. Media delivery and media service overlays

    NASA Astrophysics Data System (ADS)

    Wee, Susie

    2005-03-01

    Multimedia communication and streaming media services will become mainstream network infrastructure applications in the coming decade. However, there are many challenges that must be overcome. These challenges include the Internet"s limited ability to handle real-time, low-latency media streams, the need for media security, and an uncertainty of the killer app. The nature of these challenges lends itself to enabling technology innovations in the media delivery and media processing space. Specifically, we envision an overlay infrastructure that supports networked media services that couple media delivery with in-network media processing. The media overlay should be programmable to allow rapid deployment of new applications and services and manageable so as to support the evolving requirements of the resulting usage models. Furthermore, the media overlay should allow for the delivery of protected media content for applications that have security requirements. A properly architected infrastructure can enable real-time multimedia communication and streaming media services in light of the inherent challenges.

  9. Telerehabilitation: An Adjunct Service Delivery Model For Early Intervention Services

    PubMed Central

    Cason, Jana

    2011-01-01

    Early Intervention (EI) services for children birth through two years of age are mandated by Part C of the Individuals with Disabilities Education Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telerehabilitation has the potential to build capacity among caregivers and local providers as well as promote family-centered services through remote consultation. This article provides an overview of research related to telerehabilitation and early intervention services; discusses the feasibility of telerehabilitation within traditional EI service delivery models; examines telecommunications technology associated with telerehabilitation; and provides hypothetical case examples designed to illustrate potential applications of telerehabilitation in early intervention. PMID:25945179

  10. Improving: Services for Children

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2008

    2008-01-01

    This guide to self-evaluation and improvement builds upon the advice given in the publication "A Guide to Evaluating Services for Children and Young People Using Quality Indicators" (HMIE, 2006) (A summary of the quality indicators is reproduced in Appendix I). Local authorities, agencies and professionals who have responsibilities for providing…

  11. 77 FR 10033 - Advisory Committee International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-21

    ... Committee International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  12. 77 FR 24758 - Advisory Committee International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-25

    ... Committee International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... postal and delivery services of interest to Advisory Committee members and the public. For...

  13. Planning and Implementing Augmentative Communication Service Delivery, 2: Proceedings of the National Planners Conference on Assistive Device Service Delivery.

    ERIC Educational Resources Information Center

    Coston, Caroline A., Ed.

    The document consists of 30 author contributed chapters concerned with augmentative communication service delivery. Chapter titles and authors are: "Communication Options for Persons Who Cannot Speak: Planning for Service Delivery" (David Beukelman); "Planning Service Delivery Systems" (Roland Hahn II); "Planning Ohio's Augmentative Communication…

  14. 78 FR 41305 - Collect on Delivery (COD)-Service Features

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-10

    ... INFORMATION: The Postal Service published a notice of proposed rulemaking on May 31, 2013 (78 FR 32612-32613... 111 Collect on Delivery (COD)--Service Features AGENCY: Postal Service TM . ACTION: Final rule... proposed rule were received, the Postal Service will adopt the proposed changes to Collect on Delivery...

  15. Making Decisions about Service Delivery in Early Childhood Programs

    ERIC Educational Resources Information Center

    Case-Smith, Jane; Holland, Terri

    2009-01-01

    Purpose: This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. Method: The literature on occupational therapy, physical therapy, and speech-language…

  16. 22 CFR 201.13 - Eligibility of delivery services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Approval Application, have neither been suspended nor debarred under USAID Regulation 8, 22 CFR part 208... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Eligibility of delivery services. 201.13... for USAID Financing § 201.13 Eligibility of delivery services. (a) General. Delivery of...

  17. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  18. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  19. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  20. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  1. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  2. Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

    ERIC Educational Resources Information Center

    Burlison, John G.

    2010-01-01

    This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

  3. Engaging children and parents in service design and delivery.

    PubMed

    Bedford Russell, A R; Passant, M; Kitt, H

    2014-12-01

    The involvement of all user groups, including children, young people (CYP) and their parents, encourages people to take responsibility for healthier lifestyle behaviours, improves treatment compliance and leads to more appropriate use of healthcare resources. Initiatives to engage CYP in the UK are gathering momentum, but significant improvements are still needed. There is a national drive from the department of health (DH) and NHS England, strategic clinical networks, operational delivery networks (including newborn networks), charities, parent groups and a number of other bodies to embed CYP involvement in service design and delivery. User engagement and patient choice, is underpinned by the NHS outcomes framework, and a myriad of other DH and NHS England policies and practice frameworks. It is now everybody's business. PMID:25053734

  4. Electrostatic Surface Modifications to Improve Gene Delivery

    PubMed Central

    Shmueli, Ron B.; Anderson, Daniel G.

    2010-01-01

    Importance of the field Gene therapy has the potential to treat a wide variety of diseases including genetic diseases and cancer. Areas covered in this review This review introduces biomaterials used for gene delivery and then focuses on the use of electrostatic surface modifications to improve gene delivery materials. These modifications have been used to stabilize therapeutics in vivo, add cell-specific targeting ligands, and promote controlled release. Coatings of nanoparticles and microparticles as well as non-particulate surface coatings are covered in this review. Electrostatic principles are crucial for the development of multilayer delivery structures fabricated by the layer-by-layer method. What the reader will gain The reader will gain knowledge about the composition of biomaterials used for surface modifications and how these coatings and multilayers can be utilized to improve spatial control and efficiency of delivery. Examples are shown for the delivery of nucleic acids, including DNA and siRNA, to in vitro and in vivo systems. Take home message The versatile and powerful approach of electrostatic coatings and multilayers will lead to the development of enhanced gene therapies. PMID:20201712

  5. Improving implementation of evidence-based practice in mental health service delivery: protocol for a cluster randomised quasi-experimental investigation of staff-focused values interventions

    PubMed Central

    2013-01-01

    Background There is growing acceptance that optimal service provision for individuals with severe and recurrent mental illness requires a complementary focus on medical recovery (i.e., symptom management and general functioning) and personal recovery (i.e., having a ‘life worth living’). Despite significant research attention and policy-level support, the translation of this vision of healthcare into changed workplace practice continues to elude. Over the past decade, evidence-based training interventions that seek to enhance the knowledge, attitudes, and skills of staff working in the mental health field have been implemented as a primary redress strategy. However, a large body of multi-disciplinary research indicates disappointing rates of training transfer. There is an absence of empirical research that investigates the importance of worker-motivation in the uptake of desired workplace change initiatives. ‘Autonomy’ is acknowledged as important to human effectiveness and as a correlate of workplace variables like productivity, and wellbeing. To our knowledge, there have been no studies that investigate purposeful and structured use of values-based interventions to facilitate increased autonomy as a means of promoting enhanced implementation of workplace change. Methods This study involves 200 mental health workers across 22 worksites within five community-managed organisations in three Australian states. It involves cluster-randomisation of participants within organisation, by work site, to the experimental (values) condition, or the control (implementation). Both conditions receive two days of training focusing on an evidence-based framework of mental health service delivery. The experimental group receives a third day of values-focused intervention and 12 months of values-focused coaching. Well-validated self-report measures are used to explore variables related to values concordance, autonomy, and self-reported implementation success. Audits of work

  6. Delivery of satellite based broadband services

    NASA Astrophysics Data System (ADS)

    Chandrasekhar, M. G.; Venugopal, D.

    2007-06-01

    Availability of speedy communication links to individuals and organizations is essential to keep pace with the business and social requirements of this modern age. While the PCs have been continuously growing in processing speed and memory capabilities, the availability of broadband communication links still has not been satisfactory in many parts of the world. Recognizing the need to give fillip to the growth of broadband services and improve the broadband penetration, the telecom policies of different counties have placed special emphasis on the same. While emphasis is on the use of fiber optic and copper in local loop, satellite communications systems will play an important role in quickly establishing these services in areas where fiber and other communication systems are not available and are not likely to be available for a long time to come. To make satellite communication systems attractive for the wide spread of these services in a cost effective way special emphasis has to be given on factors affecting the cost of the bandwidth and the equipment. As broadband services are bandwidth demanding, use of bandwidth efficient modulation technique and suitable system architecture are some of the important aspects that need to be examined. Further there is a need to re-look on how information services are provided keeping in view the user requirements and broadcast capability of satellite systems over wide areas. This paper addresses some of the aspects of delivering broadband services via satellite taking Indian requirement as an example.

  7. Integrated delivery systems focus on service delivery after capitation efforts stall.

    PubMed

    2005-03-01

    Integrated delivery systems focus on service delivery after capitation efforts stall. Integrated delivery systems are going through changes that are focusing the provider organizations more on delivering care than managing risk, says Dean C. Coddington, one of the leading researchers into capitated organizations and a senior consultant with McManis Consulting in Denver. PMID:15889632

  8. Development, Implementation, and Evaluation of the Apollo Model of Pediatric Rehabilitation Service Delivery

    ERIC Educational Resources Information Center

    Camden, Chantal; Swaine, Bonnie; Tetreault, Sylvie; Bergeron, Sophie; Lambert, Carole

    2013-01-01

    This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical…

  9. Rehabilitation Technology Service Delivery, 1: A Practical Guide.

    ERIC Educational Resources Information Center

    RESNA: Association for the Advancement of Rehabilitation Technology, Washington, DC.

    The guide consists of six author contributed chapters and is intended to aid in the development of new rehabilitation technology service delivery programs as well as increasing the effectiveness of existing programs. The first chapter, by Roger Smith, describes and evaluates seven models of service delivery in rehabilitation technology. Chapter 2,…

  10. Leadership Dynamics Promoting Systemic Reform for Inclusive Service Delivery

    ERIC Educational Resources Information Center

    Scanlan, Martin

    2009-01-01

    This article presents a multicase study of two systems of schools striving to reform service delivery systems for students with special needs. Considering these systems as institutional actors, the study examines what promotes the understanding and implementation of special education service delivery within a system of schools in a manner that…

  11. Improving governance to improve oral health: addressing care delivery systems.

    PubMed

    Batchelor, Paul

    2012-09-01

    The evolving role of the state in the provision of health care has seen the adoption of new management philosophies to ensure that goals set for the system are reached. In particular, the term New Public Management (NPM) has tended to dominate reforms to help address perceived shortcomings in public sector services. NPM is based on the use of freemarket type arrangements as a mechanism to solve problems, the control of which provides new challenges. One particular challenge that has arisen from the combination of NPM with the large number of agencies involved in care provision is that of addressing the issues arising from the improved understanding of the determinants of health. This has led to the evolution of differing care arrangements across differing sectors at all levels. If resources are to be used as intended, the control of delivery systems to oversee their use must exist. The overarching term for such activity is â governance. This paper provides an overview of the issues that arise for addressing governance of oral health care and the subsequent challenges that face those responsible for ensuring compliance. PMID:22976573

  12. Low-dose RUTF protocol and improved service delivery lead to good programme outcomes in the treatment of uncomplicated SAM: a programme report from Myanmar.

    PubMed

    James, Philip T; Van den Briel, Natalie; Rozet, Aurélie; Israël, Anne-Dominique; Fenn, Bridget; Navarro-Colorado, Carlos

    2015-10-01

    The treatment of uncomplicated severe acute malnutrition (SAM) requires substantial amounts of ready-to-use therapeutic food (RUTF). In 2009, Action Contre la Faim anticipated a shortfall of RUTF for their nutrition programme in Myanmar. A low-dose RUTF protocol to treat children with uncomplicated SAM was adopted. In this protocol, RUTF was dosed according to beneficiary's body weight, until the child reached a Weight-for-Height z-score of ≥-3 and mid-upper arm circumference ≥110 mm. From this point, the child received a fixed quantity of RUTF per day, independent of body weight until discharge. Specific measures were implemented as part of this low-dose RUTF protocol in order to improve service quality and beneficiary support. We analysed individual records of 3083 children treated from July 2009 to January 2010. Up to 90.2% of children recovered, 2.0% defaulted and 0.9% were classified as non-responders. No deaths were recorded. Among children who recovered, median [IQR] length of stay and weight gain were 42 days [28; 56] and 4.0 g kg(-1) day(-1) [3.0; 5.7], respectively. Multivariable logistic regression showed that children older than 48 months had higher odds of non-response to treatment than younger children (adjusted odds ratio: 3.51, 95% CI: 1.67-7.42). Our results indicate that a low-dose RUTF protocol, combined with specific measures to ensure good service quality and beneficiary support, was successful in treating uncomplicated SAM in this setting. This programmatic experience should be validated by randomised studies aiming to test, quantify and attribute the effect of the protocol adaptation and programme improvements presented here. PMID:25850698

  13. Low–dose RUTF protocol and improved service delivery lead to good programme outcomes in the treatment of uncomplicated SAM: a programme report from Myanmar

    PubMed Central

    James, Philip T; Van den Briel, Natalie; Rozet, Aurélie; Israël, Anne-Dominique; Fenn, Bridget; Navarro-Colorado, Carlos

    2015-01-01

    The treatment of uncomplicated severe acute malnutrition (SAM) requires substantial amounts of ready-to-use therapeutic food (RUTF). In 2009, Action Contre la Faim anticipated a shortfall of RUTF for their nutrition programme in Myanmar. A low-dose RUTF protocol to treat children with uncomplicated SAM was adopted. In this protocol, RUTF was dosed according to beneficiary's body weight, until the child reached a Weight-for-Height z-score of ≥−3 and mid-upper arm circumference ≥110 mm. From this point, the child received a fixed quantity of RUTF per day, independent of body weight until discharge. Specific measures were implemented as part of this low-dose RUTF protocol in order to improve service quality and beneficiary support. We analysed individual records of 3083 children treated from July 2009 to January 2010. Up to 90.2% of children recovered, 2.0% defaulted and 0.9% were classified as non-responders. No deaths were recorded. Among children who recovered, median [IQR] length of stay and weight gain were 42 days [28; 56] and 4.0 g kg–1 day–1 [3.0; 5.7], respectively. Multivariable logistic regression showed that children older than 48 months had higher odds of non-response to treatment than younger children (adjusted odds ratio: 3.51, 95% CI: 1.67–7.42). Our results indicate that a low-dose RUTF protocol, combined with specific measures to ensure good service quality and beneficiary support, was successful in treating uncomplicated SAM in this setting. This programmatic experience should be validated by randomised studies aiming to test, quantify and attribute the effect of the protocol adaptation and programme improvements presented here. PMID:25850698

  14. 78 FR 32612 - Collect on Delivery (COD)-Service Features

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... From the Federal Register Online via the Government Publishing Office POSTAL SERVICE 39 CFR Part 111 Collect on Delivery (COD)--Service Features AGENCY: Postal Service\\TM\\. ACTION: Proposed rule. SUMMARY: Effective July 28, 2013, the Postal Service TM proposes to revise Mailing Standards of the...

  15. Analyzing IT Service Delivery in an ISP from Nicaragua

    NASA Astrophysics Data System (ADS)

    Flores, Johnny; Rusu, Lazar; Johanneson, Paul

    This paper presents a method for analyzing IT service delivery and its application in an Internet Service Provider (ISP). The method proposed is based on ITIL-processes and case study technique; it includes questionnaires for gathering information, semi-structured interviews, focus groups and documents as sources of information for recognition of factual information. The method application allows to the ISP determines its practices and limitations of the IT Service Delivery.

  16. Making government work: Electronic delivery of Federal services

    NASA Astrophysics Data System (ADS)

    1993-09-01

    Federal, State, and local governments face the challenge of delivering better services faster and at less cost at a time when demand is growing and budgets are tighter. Computer and telecommunication technologies offer a number of near-term opportunities for delivering Federal services electronically in partnership with State/local agencies and the private sector. To assure that these technologies benefit all citizens - not just the affluent and highly educated - will require Congress to pay special attention to policy and oversight. It will also require agencies to be innovative and skillful in introducing new electronic delivery systems. The Office of Technology Assessment's (OTA's) assessment of electronic service delivery was requested by Senator John Glenn, Chairman, Senate Committee on Governmental Affairs. This report provides Congress with alternative strategies for improving the performance of government by using modern information technologies. The report offers new perspectives to Congress as it considers reauthorizing the Paperwork Reduction Act and responds to the Administration's 'National Performance Review' and 'National Information Infrastructure' initiatives. More broadly, the report will contribute to the public debate over the role of information technology in reinventing government.

  17. Spatial service delivery system for smart licensing & enforcement management

    NASA Astrophysics Data System (ADS)

    Wahap, N. A.; Ismail, N. M.; Nor, N. M.; Ahmad, N.; Omar, M. F.; Termizi, A. A. A.; Zainal, D.; Noordin, N. M.; Mansor, S.

    2016-06-01

    Spatial information has introduced a new sense of urgency for a better understanding of the public needs in term of what, when and where they need services and through which devices, platform or physical locations they need them. The objective of this project is to value- add existing license management process for business premises which comes under the responsibility of Local Authority (PBT). Manipulation of geospatial and tracing technology via mobile platform allows enforcement officers to work in real-time, use a standardized system, improve service delivery, and optimize operation management. This paper will augment the scope and capabilities of proposed concept namely, Smart Licensing/Enforcement Management (SLEm). It will review the current licensing and enforcement practice of selected PBT in comparison to the enhanced method. As a result, the new enhanced system is expected to offer a total solution for licensing/enforcement management whilst increasing efficiency and transparency for smart city management and governance.

  18. User engagement in the delivery and design of maternity services.

    PubMed

    Patel, Nashita; Rajasingam, Daghni

    2013-08-01

    User engagement is defined as a mutual exchange of information between the patient and the health professional, which has shown to improve patient experience as well as outcomes. Engaging the patient is vital for the healthcare system to remain sustainable. The National Health Service has attempted to incorporate and enhance patient engagement in the delivery of maternity services for the last decade. The financial crisis, changing socio-demographic status, increase in birth rate and public expectations-engaging the patient to take responsibility of their own health has not been achieved. Through in-depth examinations of these barriers we are able to draw conclusions as to why current policies have failed and recommend potential solutions. PMID:23768954

  19. PACS and diagnostic imaging service delivery--a UK perspective.

    PubMed

    Sutton, Laurence N

    2011-05-01

    This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care. PMID:21600402

  20. Process Improvement: Customer Service.

    PubMed

    Cull, Donald

    2015-01-01

    Utilizing the comment section of patient satisfaction surveys, Clark Memorial Hospital in Jeffersonville, IN went through a thoughtful process to arrive at an experience that patients said they wanted. Two Lean Six Sigma tools were used--the Voice of the Customer (VoC) and the Affinity Diagram. Even when using these tools, a facility will not be able to accomplish everything the patient may want. Guidelines were set and rules were established for the Process Improvement Team in order to lessen frustration, increase focus, and ultimately be successful. The project's success is driven by the team members carrying its message back to their areas. It's about ensuring that everyone is striving to improve the patients' experience by listening to what they say is being done right and what they say can be done better. And then acting on it. PMID:26571974

  1. A Universal Design Approach to Government Service Delivery: The Case of ChileAtiende.

    PubMed

    Sandoval, Leonardo

    2016-01-01

    A common challenge for government administrations that aim to improve the delivery of information and services to citizens is to go beyond a government-centred approach. By focusing on citizens and the needs of a wide range of citizens, Universal Design (UD) can help to increase the effectiveness, efficiency and satisfaction of government services. This paper examines the case of an internationally recognised Chilean government service delivery programme inspired by UD principles known as ChileAtiende ("ChileService"). A brief account of its creation and current status is provided. PMID:27534348

  2. Improvement of Job Placement Services.

    ERIC Educational Resources Information Center

    Mount San Antonio Community Coll. District, Walnut, CA.

    The Improvement of Job Placement Services Project was undertaken to examine and strengthen job placement services and programs in the California community colleges. Specific objectives of the project were to: (1) select and convene a 12-member representative advisory committee to oversee project operations working with the California Placement…

  3. The Role of Libraries in eHealth Service Delivery in Australia

    ERIC Educational Resources Information Center

    Rao, Sarada

    2009-01-01

    eHealth is an emerging service sector which has great potential to improve health care delivery to rural and remote communities, facilitate health surveillance, and promote health education and research. Despite the critical need for eHealth services in Australia based on the challenges of distance and human resources, its utility has yet to be…

  4. Improving and Extending Rural Library Services in Idaho.

    ERIC Educational Resources Information Center

    Weatherby, James B.; And Others

    This study of rural libraries in Idaho was designed to identify appropriate alternative local revenue sources to support library services as well as ways of improving the coordination and delivery of library services in the state and extending library access to unserved areas. Data were gathered from U.S. Bureau of the Census reports and special…

  5. University Educational Service Delivery Strategy in a Changing World: Implications for Ethical Values and Leadership Integrity in Nigeria

    ERIC Educational Resources Information Center

    Akintayo, D. I.

    2008-01-01

    This paper examined university educational service delivery strategy in a changing world as it affects ethical values and leadership integrity in Nigeria. This was for the purpose of determining appropriate strategies for improving the quality of service delivery system in Nigerian universities. The paper submits that the quality and quantity of…

  6. 42 CFR 460.98 - Service delivery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... services. (3) Restorative therapies, including physical therapy and occupational therapy. (4) Personal care and supportive services. (5) Nutritional counseling. (6) Recreational therapy. (7) Meals. (d) Pace..., national origin, religion, sex, age, sexual orientation, mental or physical disability, or source...

  7. 22 CFR 228.55 - Delivery services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... case of bulk cargoes and large cargoes carried by liners; (2) Eligible vessels provide liner service... countries to be authorized by the waiver provide liner service without transshipment; (3) Eligible vessels... port handling facilities; (5) Eligible vessels do not provide liner service from the port of...

  8. 22 CFR 228.55 - Delivery services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... case of bulk cargoes and large cargoes carried by liners; (2) Eligible vessels provide liner service... countries to be authorized by the waiver provide liner service without transshipment; (3) Eligible vessels... port handling facilities; (5) Eligible vessels do not provide liner service from the port of...

  9. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial Reporting Group, Hartford, CT; Notice of...

  10. Organizing Services in Rural Communities: Moving toward Service Integration and Flexible Specialization. Part I: Models for Organizing Service Delivery.

    ERIC Educational Resources Information Center

    O'Looney, John

    1993-01-01

    Explores options for human service delivery and related organizational change in rural areas. Addresses the unique context and distinctive features of rural service delivery, urban service professionalism and fragmentation, and potential advantages of traditional integrated rural systems. Discusses eight models derived from combinations of three…

  11. United Parcel Service Evaluates Hybrid Electric Delivery Vans (Fact Sheet)

    SciTech Connect

    Not Available

    2010-02-01

    This fact sheet describes how the National Renewable Energy Laboratory's Fleet Test and Evaluation team evaluated the 12-month, in-service performance of six Class 4 hybrid electric delivery vans - fueled by regular diesel - and six comparable conventional diesel vans operated by the United Parcel Service.

  12. Toward improving the oral health of Americans: an overview of oral health status, resources, and care delivery. Oral Health Coordinating Committee, Public Health Service.

    PubMed Central

    1993-01-01

    Dental and oral diseases may well be the most prevalent and preventable conditions affecting Americans. More than 50 percent of U.S. children, 96 percent of employed U.S. adults, and 99.5 percent of Americans 65 years and older have experienced dental caries (also called cavities). Millions of Americans suffer from periodontal diseases and other oral conditions, and more than 17 million Americans, including 10 million Americans 65 years or older, have lost all of their teeth. Preventive dental services are known to be effective in preventing and controlling dental diseases. Unfortunately, groups at highest risk for disease--the poor and minorities--have lower rates of using dental care than the U.S. average. Cost is the principal barrier to dental care for many Americans. Of the $38.7 billion spent for dental services in 1992, public programs, including Medicaid, paid for less than 4 percent of dental expenditures. More than 90 percent of care was paid for either out-of-pocket by dental consumers or through private dental insurance. Americans are at risk for other oral health problems as well. Oropharyngeal cancer strikes approximately 30,000 Americans each year and results in an estimated 8,000 deaths annually. Underlying medical or handicapping conditions, ranging from rare genetic diseases to more common chronic diseases, affect millions of Americans and can lead to oral health problems. Among persons with compromised immune systems, oral diseases and conditions can have a significant impact on health. Oral diseases and conditions, though nearly universal, can be prevented easily and controlled at reasonable cost.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8265750

  13. Using patients’ experiences of adverse events to improve health service delivery and practice: protocol of a data linkage study of Australian adults age 45 and above

    PubMed Central

    Walton, Merrilyn; Smith-Merry, Jennifer; Harrison, Reema; Manias, Elizabeth; Iedema, Rick; Kelly, Patrick

    2014-01-01

    Introduction Evidence of patients’ experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia. Methods and analysis The 45 and Up Study is a cohort of 265 000 adults aged 45 years and above in NSW. Patients who were hospitalised between 1 January and 30 June 2014 will be identified from this cohort using data linkage and a random sample of 20 000 invited to participate. A cross-sectional survey (including qualitative and quantitative components) will capture patients’ experiences in hospital and specifically of adverse events. Approximately 25% of respondents are likely to report experiencing an adverse event. Quantitative components will capture the nature and type of events as well as common features of patients’ experiences. Qualitative data provide contextual knowledge of their condition and care and the impact of the event on individuals. Respondents who do not report an adverse event will report their experience in hospital and be the control group. Statistical and thematic analysis will be used to present a patient perspective of their experiences in hospital; the characteristics of patients experiencing an adverse event; experiences of information sharing after an event (open disclosure) and the other avenues of redress pursued. Interviews with key policymakers and a document analysis will be used to create a map of the current practice. Ethics and dissemination Dissemination via a one-day workshop, peer-reviewed publications and conference presentations will enable effective clinical responses and service provision and policy responses to adverse events to be developed. PMID:25311039

  14. Collaborative Service Delivery: From Instruction to Implementation

    ERIC Educational Resources Information Center

    Lundblom, Erin Elizabeth Gill

    2012-01-01

    Legal mandates, educational reform, and professional policy changes, have emphasized the need to promote the integration of services for students with communication impairments within the general education curriculum. However, speech-language pathologists (SLPs) continue to report the provision of primarily pull-out services with intervention…

  15. The Public Health Service action plan to improve access to immunization services. The Interagency Committee to Improve Access to Immunization Services.

    PubMed Central

    1992-01-01

    The Public Health Service's Interagency Committee to Improve Access to Immunization Services (ICI) has responsibility for improving the immunization protection of the nation's children and other vulnerable populations. ICI's Action Plan to Improve Access to Immunization Services sets 14 goals with 120 action steps for improving immunization services nationwide by (a) increasing coordination among Federal health, income, housing, education, and nutrition programs; (b) reducing policy and management barriers that limit access to delivery systems, and (c) strengthening the delivery infrastructure. To accomplish the goals of the plan, there is a $72.0 million increase in funding appropriated in fiscal year 1992 specifically for this purpose. The President's Budget for fiscal year 1993 includes a $24.5 million increase for continued program implementation. The additional resources will be used to address delivery and access problems, which have been determined to be the primary factors limiting immunization for many children. PMID:1594732

  16. 77 FR 65581 - Verizon Business Networks Services, Inc., Senior Analyst, Service Program Delivery (SA-SPD...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... Employment and Training Administration Verizon Business Networks Services, Inc., Senior Analyst, Service Program Delivery (SA-SPD), Including Workers Whose Wages Were Paid Under MCI Communication Services, Inc..., 2012, applicable to workers and former workers of Verizon Business Network Services, Inc.,...

  17. Wheeled mobility (wheelchair) service delivery: scope of the evidence.

    PubMed

    Greer, Nancy; Brasure, Michelle; Wilt, Timothy J

    2012-01-17

    Identifying the appropriate wheelchair for a person who needs one has implications for both disabled persons and society. For someone with severe locomotive problems, the right wheelchair can affect mobility and quality of life. However, policymakers are concerned about the increasing demand for unnecessarily elaborate chairs. The Office of Inspector General, U.S. Department of Health and Human Services, issued 4 reports between 2009 and 2011 detailing fraud and misapplication of Medicare funds for powered wheelchairs, more than a decade after similar concerns were first raised by 4 contractors who process claims for durable medical equipment. Subsequent concerns have arisen about whether some impaired persons who need wheeled mobility devices may now be inappropriately denied coverage. A transparent, evidence-based approach to wheeled mobility service delivery (the matching of mobility-impaired persons to appropriate devices and supporting services) might lessen these concerns. This review describes the process of wheeled mobility service delivery for long-term wheelchair users with complex rehabilitation needs and presents findings from a survey of the literature (published and gray) and interviews with key informants. Recommended steps in the delivery process were identified in textbooks, guidelines, and published literature. Delivery processes shared many commonalities; however, no research supports the recommended approaches. A search of bibliographic databases through March 2011 identified 24 studies that evaluated aspects of wheeled mobility service delivery. Most were observational, exploratory studies designed to determine consumer use of and satisfaction with the process. The evidence base for the effectiveness of approaches to wheeled mobility service delivery is insufficient, and additional research is needed to develop standards and guidelines. PMID:22250145

  18. Challenging Heterosexism in College Health Service Delivery.

    ERIC Educational Resources Information Center

    McKee, Michael B.; And Others

    1994-01-01

    Explores how HIV/AIDS, substance abuse, violence and hate crimes, suicide, and heterosexism all adversely affect the physical and emotional health of nonheterosexual college students. College health services must assume a leadership role in combatting all forms of oppression by actively incorporating and addressing the unique needs of…

  19. Community-based approaches and partnerships: innovations in health-service delivery in Bangladesh.

    PubMed

    El Arifeen, Shams; Christou, Aliki; Reichenbach, Laura; Osman, Ferdous Arfina; Azad, Kishwar; Islam, Khaled Shamsul; Ahmed, Faruque; Perry, Henry B; Peters, David H

    2013-12-14

    In Bangladesh, rapid advancements in coverage of many health interventions have coincided with impressive reductions in fertility and rates of maternal, infant, and childhood mortality. These advances, which have taken place despite such challenges as widespread poverty, political instability, and frequent natural disasters, warrant careful analysis of Bangladesh's approach to health-service delivery in the past four decades. With reference to success stories, we explore strategies in health-service delivery that have maximised reach and improved health outcomes. We identify three distinctive features that have enabled Bangladesh to improve health-service coverage and health outcomes: (1) experimentation with, and widespread application of, large-scale community-based approaches, especially investment in community health workers using a doorstep delivery approach; (2) experimentation with informal and contractual partnership arrangements that capitalise on the ability of non-governmental organisations to generate community trust, reach the most deprived populations, and address service gaps; and (3) rapid adoption of context-specific innovative technologies and policies that identify country-specific systems and mechanisms. Continued development of innovative, community-based strategies of health-service delivery, and adaptation of new technologies, are needed to address neglected and emerging health challenges, such as increasing access to skilled birth attendance, improvement of coverage of antenatal care and of nutritional status, the effects of climate change, and chronic disease. Past experience should guide future efforts to address rising public health concerns for Bangladesh and other underdeveloped countries. PMID:24268607

  20. Comparison of Delivery Strategies for Pharmacogenetic Testing Services

    PubMed Central

    Moaddeb, Jivan

    2013-01-01

    The number and use of pharmacogenetic tests to assess a patient’s likelihood of response or risk of an adverse event is expanding across medical specialties and becoming more prevalent. During this period of development and translation, different approaches are being investigated to optimize delivery of pharmacogenetic services. In this paper, we review preemptive and point-of-care delivery approaches currently implemented or being investigated and discuss the advantages and disadvantages of each approach. The continued growth in knowledge about the genetic basis of drug response combined with development of new and cheaper testing technologies and electronic medical records will impact future delivery systems. Regardless of delivery approach, the currently limited knowledge of health professionals about genetics generally or PGx specifically will remain a major obstacle to utilization. PMID:24384556

  1. Nursing Services Delivery Theory: an open system approach

    PubMed Central

    Meyer, Raquel M; O’Brien-Pallas, Linda L

    2010-01-01

    meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573

  2. Health Care Delivery Performance: Service, Outcomes, and Resource Stewardship

    PubMed Central

    Cowing, Michelle; Davino-Ramaya, Carrie M; Ramaya, Krishnan; Szmerekovsky, Joseph

    2009-01-01

    As competition intensifies within the health care industry, patient satisfaction and service quality are providing the evidentiary basis for patient outcomes. We propose a conceptual model of three interrelated areas, service, health outcomes, and resource stewardship, all affected by the clinician-patient relationship. Our model considers the perspectives of the health care organization, the clinician, and the patient to define a more comprehensive measure of health care delivery performance. Research and managerial aspects, including implementation, are discussed. PMID:20740107

  3. The Future of Telecommunications Technologies for the Delivery of Human Services.

    ERIC Educational Resources Information Center

    Dordick, Herbert S.; Goldman, Ronald J.

    The use of telecommunications technologies has been encouraged to improve quality and reduce costs of human services delivery; however, the adoption rate has been disappointing. This paper reviews the model found most useful for the analysis of barriers to the adoption of telecommunications technologies. Characteristics which have been found to be…

  4. The Effect of Leadership on Service Delivery in Universities

    ERIC Educational Resources Information Center

    Zvavahera, Promise

    2013-01-01

    This study was aimed at assessing leadership effectiveness on service delivery at the University of Namibia and all its campuses throughout the country. The study was carried out during the month of February 2013. The methodology consisted of document analysis, interviews through face to face, video and tele-conferencing. Purposive sampling was…

  5. Lessons Learned from a Tiered Service Delivery Implementation Project

    ERIC Educational Resources Information Center

    Johnson, Evelyn S.; Pool, Juli L.; Carter, Deborah R.

    2012-01-01

    Tiered models of service delivery for both academics and behavior are being increasingly adopted across the nation, and discussions of how to implement these models effectively and simultaneously are growing. In this article, the authors share some lessons learned from a 2-year implementation project to implement a comprehensive (both academic and…

  6. Teaching for Competence in the Delivery of Direct Services.

    ERIC Educational Resources Information Center

    Council on Social Work Education, New York, NY.

    Enhancing practitioner competence in the delivery of direct services continues to be a prime concern of social work practitioners and educators alike. This document contains 11 articles that pertain to teaching direct intervention theories and skills. Joseph D. Anderson writes on games social work educators' play in teaching practice theories;…

  7. California Integrated Service Delivery Evaluation Report. Phase I

    ERIC Educational Resources Information Center

    Moore, Richard W.; Rossy, Gerard; Roberts, William; Chapman, Kenneth; Sanchez, Urte; Hanley, Chris

    2010-01-01

    This study is a formative evaluation of the OneStop Career Center Integrated Service Delivery (ISD) Model within the California Workforce System. The study was sponsored by the California Workforce Investment Board. The study completed four in-depth case studies of California OneStops to describe how they implemented the ISD model which brings…

  8. The Delivery of Alcoholism Services: Meeting Whose Needs?

    ERIC Educational Resources Information Center

    Christmas, June J.

    Of grave concern to all who are involved in the delivery of health and mental health services are two recently-observed trends in the drug and alcohol abusing population: the emergence of formerly hidden individuals in need of treatment (among them women, children and the elderly), and the increasing incidence and severity of emotional problems…

  9. Supervision in Bilingual Counseling: Service Delivery, Training, and Research Considerations

    ERIC Educational Resources Information Center

    Fuertes, Jairo N.

    2004-01-01

    This article reviews selected literature on the topics of bilingual and multicultural counseling and supervision and provides a framework for understanding salient issues in the delivery of bilingual services. It also presents practical interventions and ideas for future empirical work in this area.

  10. Service Delivery for Mexican-American Children. Coursebook.

    ERIC Educational Resources Information Center

    Tijerina, Andres A.

    A special curriculum to be used in training sessions on Mexican American culture was developed to assist Texas Department of Human Resources personnel with service delivery for Mexican American children. Designed to heighten awareness in caseworkers and other personnel on the cultural variables affecting their relationship with Mexican American…

  11. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES... USDA Federal assistance rules and requirements for competency, quality, and selection, as...

  12. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES... USDA Federal assistance rules and requirements for competency, quality, and selection, as...

  13. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES... USDA Federal assistance rules and requirements for competency, quality, and selection, as...

  14. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES... USDA Federal assistance rules and requirements for competency, quality, and selection, as...

  15. 7 CFR 652.6 - Department delivery of technical services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Department delivery of technical services. 652.6 Section 652.6 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES... requirements for competency, quality, and selection, as appropriate. Any contract, contribution...

  16. A Multi-organisational Approach to Service Delivery

    NASA Astrophysics Data System (ADS)

    Purchase, Valerie; Mills, John; Parry, Glenn

    Who is involved in delivering a service? There has been growing recognition in a wide variety of contexts that service is increasingly being delivered by multi-rather than single-organisational entities. Such recognition is evident not only in our experience but in a number of areas of literature including strategy development, core competence analysis, operations and supply chain management, and is reflected in and further facilitated by ICT developments. Customers have always been involved in some degree in the process of value delivery and such involvement is increasing to include complex co-creation of value. Such interactions are challenging when they involve individual customers, however, this becomes ever more challenging when the 'customer' is another organisation or when there are multiple 'customers'. Within this chapter we will consider some of the key drivers for a multi-organisational approach to service delivery; examine the ways in which the parties involved in service co-creation have expanded to include multiple service providers and customers; and finally, identify some of the challenges created by a multi-organisational approach to service delivery.

  17. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    .../ Information Delivery Services (IDS)/Corporate & Financial Reporting Group, Hartford, CT; Notice of Negative... was published in the Federal Register on January 4, 2013 (78 FR 773). The Hartford-IDS Group...

  18. Links among Social Status, Service Delivery Mode, and Service Delivery Preference in LD, Low-Achieving, and Normally Achieving Elementary-Aged Children.

    ERIC Educational Resources Information Center

    Le Mare, Lucy; de la Ronde, Marie

    2000-01-01

    Relations among social status, current service delivery, and service delivery preferences were examined in 42 students with learning disabilities (LD), 40 low-achieving, and 42 average/high-achieving students in grades 2-4 and 6-7. Most students preferred pullout service to in-class service. Only among LD students were self- and peer-rated social…

  19. Libraries and E-Commerce: Improving Information Services and Beyond.

    ERIC Educational Resources Information Center

    Harris, Lesley Ellen

    2000-01-01

    Explains e-commerce and discusses how it can be used by special libraries. Highlights include library goals; examples of successful uses of e-commerce; how e-commerce can improve information services, including access to information, new information resources, delivery of information, and broadening information markets; and developing an…

  20. 78 FR 57671 - Advisory Committee on International Postal and Delivery Services; Membership Renewals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-19

    ... experts on international postal and delivery services. Members are not compensated for their service... Committee on International Postal and Delivery Services; Membership Renewals AGENCY: Department of State... international postal and private-sector delivery services. The Advisory Committee on International Postal...

  1. A proposed Next Generation Service Delivery Platform (NG-SDP) for eHealth domain.

    PubMed

    Andriopoulou, Foteini Gr; Lazarou, Nicolaos G; Lymberopoulos, Dimitrios K

    2012-01-01

    Nowadays, providing healthcare personalized services in user's intelligent space is an important issue for improving personal health, supporting predictive care and saving medical costs. In this paper, we propose an architecture for the Next Generation Service Delivery Platform (NG-SDP), suitable for composing and delivering personalized healthcare services. The core component of NG-SDP is a Context Decision Making Enabler (CDME) that assesses user contextual and bio information to yield personalized services. A prototype implementation of the proposed NG-SDP is also demonstrated. Finally a real case study demonstrates the CDME performance. PMID:23367312

  2. Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria

    PubMed Central

    Dahiru, Tukur; Oche, Oche Mansur

    2015-01-01

    Introduction Utilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average. Methods We analysed the 2013 Nigeria DHS to determine factors associated with utilization of these health MCH indicators by employing both bivariate and multivariate logistic regressions. Results Overall, 54% of women had at least four ANC visits, 37% delivered in health facility and 29% of new born had postnatal care within two of births. Factors that consistently predict the utilization of the three MCH services are maternal and husband's level education, place of residence, wealth level and parity. Antenatal care strongly predicts both health facility delivery (OR = 2.16, 95%CI: 1.99-2.34) and postnatal care utilization (OR = 4.67, 95%CI: 3.95-5.54); while health facility delivery equally predicting postnatal care (OR = 2.84, 95%CI: 2.20-2.80). Conclusion Improving utilization of these three MCH indicators will require targeting women in the rural areas and those with low level of education as well as creating demand for health facility delivery. Improving ANC use by making it available and accessible will have a multiplier effect of improving facility delivery which will lead to improved postnatal care utilization. PMID:26587168

  3. Delivery of a Clinical Genomics Service

    PubMed Central

    Newman, William G.; Black, Graeme C.

    2014-01-01

    Over the past five years, next generation sequencing has revolutionised the discovery of genes responsible for rare inherited diseases previously resistant to traditional discovery techniques. This review considers how this new technology is being introduced into clinical practice to aid diagnosis and improve the clinical management of individuals and families affected by rare diseases where access to genetic testing was previously limited. We compare and contrast the different approaches that have been adopted including panel based tests, exome and genome sequencing. We provide insights from our own clinical practice demonstrating the challenges and benefits of this new technology. PMID:25383561

  4. Citizen participation in community mental health center service delivery.

    PubMed

    Riley, W

    1981-01-01

    Citizen involvement in CMHC service delivery has two bases: (a) volunteerism and (b) identification with clients and citizens who may need services. This identification is expressed two ways, as cultural similarity to clients or social activism in their behalf. Paraprofessionals have been portrayed as a major mechanism. Current practice shows some discrepancy from the theoretical program goals. While CMHCs include an appreciable number of volunteers and mental health workers with less than a BA degree, the extent to which they augment services with community or social activism values is doubtful. PMID:7226740

  5. Computerized satellite delivery service: redefines central service and promotes nursing satisfaction.

    PubMed

    Haney, W

    1989-01-01

    Since its implementation in 1986, the Computerized Satellite Delivery Service at Saint Anthony's has contributed to improved efficiency in both the nursing and supply staffs. The system is easily modified, and has influenced other departments such as dietary to develop mechanisms to provide greater support to nursing service. Since the floor technician's role crosses many departmental boundaries, and this job function necessitates communication and facilitates interaction, thereby encouraging a team approach to health care. The implementation of programs which allow nursing staff to devote more time to patient care should be the basis on which any hospital service department operates. By providing a more efficient handling of support services, a closer working relationship between nursing and ancillary departments can be developed. Given the restrictions and limitations that surround many aspects of providing health care in today's society, it is inevitable that a "high tech", "high touch" approach to our efforts will prove not only financially viable, but will also support the basics for networking job satisfaction into the hospital environment. PMID:10293356

  6. Improving Instructional Delivery: Reflections on Student Feedback

    ERIC Educational Resources Information Center

    Oliveira, Lisa C.

    2013-01-01

    Teachers work countless hours preparing instruction for their students with the best intentions in mind. Each day many students enter into these classrooms to experience the delivery of the prepared instruction, yet their perceptions do not always match those of their teachers. The purpose of this research study is to develop and pilot a student…

  7. Contracting for Management: Assessing Management Capacity under Alternative Service Delivery Arrangements

    ERIC Educational Resources Information Center

    Brown, Trevor; Potoski, Matt

    2006-01-01

    Contracting critics suggest that when governments outsource, they reduce their capacity to produce services and manage service delivery. In this paper, we decompose the service delivery decision into service production and service management components. When governments contract for service production, they may also choose to contract for a…

  8. Improving policies for caregiver respite services.

    PubMed

    Rose, Miriam S; Noelker, Linda S; Kagan, Jill

    2015-04-01

    This paper provides a template for the decade ahead regarding the delivery, supply, and funding of caregiver respite services. Policy changes are needed to address these issues as concerns about our country's ability to meet future caregiving needs are growing along with our aging population. Federal initiatives and state-level policies and programs affecting respite are reviewed and directions for policy advancement are highlighted. Much more work is needed to educate caregivers and the general public about the necessity for respite beginning early in the caregiving career to prevent burnout and other adverse effects. Because it is unlikely that there will be a sufficient number of direct-care workers to replace unpaid caregivers, improved policies are needed to ensure that their situation is sustainable through increased availability of high-quality respite and other services vital to caregiver health and well-being. Among the 2015 White House Conference on Aging's priorities in the next decade, policies on long-term services and supports will require focused attention on family caregivers and the direct-care workforce to strengthen their ability to give care now and support their own physical, emotional, and financial needs in the future. PMID:26035607

  9. Transforming health care service delivery and provider selection.

    PubMed

    Reiner, Bruce I

    2011-06-01

    Commoditization pressures in medicine have risked transforming service provider selection from "survival of the fittest" to "survival of the cheapest." Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented performance metrics which provide patients with objective data related to individual service provider quality, safety, cost-efficacy, efficiency, and customer service. These performance metrics could in turn be customized to the individual preferences and health care needs of each individual patient, thereby providing an objective methodology for service provider selection while empowering health care consumers. PMID:21468775

  10. Investigation of the mediating effects of IT governance-value delivery on service quality and ERP performance

    NASA Astrophysics Data System (ADS)

    Tsai, Wen-Hsien; Chou, Yu-Wei; Leu, Jun-Der; Chao Chen, Der; Tsaur, Tsen-Shu

    2015-02-01

    This study aimed to explore the mediating effects of IT governance (ITG)-value delivery in the relationships among the quality of vendor service, the quality of consultant services, ITG-value delivery and enterprise resource planning (ERP) performance. The sampling of this research was acquired from a questionnaire survey concerning ERP implementations in Taiwan. In this survey, 4366 questionnaires were sent to manufacturing and service companies listed in the TOP 5000: The Largest Corporations in Taiwan 2009. The results showed that an ERP system will exhibit a decreased error rate and improved performance if ERP system vendors and consultants provide good service quality. The results also demonstrated that significant relationships exist among the quality of vendor service, the quality of consultant services and value delivery. The contribution of this article is twofold. First, it found that value delivery provides an effective measure of ERP performance under an ITG framework. Second, it provides evidence of the partial mediating effects of value delivery between service quality and ERP performance. In other words, if enterprises want to improve ERP performance, they need to consider factors such as value delivery and the quality of a vendor/consultant's service.

  11. 76 FR 59768 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Advisory Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice... the meeting of the Advisory Committee on International Postal and Delivery Services scheduled...

  12. Service Provider Combinations and the Delivery of Early Intervention Services to Children and Families

    ERIC Educational Resources Information Center

    Raspa, Melissa; Hebbeler, Kathleen; Bailey, Donald B., Jr.; Scarborough, Anita A.

    2010-01-01

    Using data from the National Early Intervention Longitudinal Study, this study provides a framework for characterizing the delivery of early intervention services based on the combinations of service providers who work with infants and toddlers with disabilities and their families. Five groups of providers were identified. Results showed that the…

  13. Service Delivery Rules and the Distribution of Local Government Services: Three Detroit Bureaucracies

    ERIC Educational Resources Information Center

    Jones, Bryan D.; And Others

    1978-01-01

    Argues that the routinized procedures governing delivery of local public services influence distribution of services to citizens by three municipal agencies in Detroit. Agencies are the Department of Parks and Recreation, the Sanitation Division, and the Environmental Enforcement Division of the Environmental Protection and Maintenance Department.…

  14. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

    PubMed Central

    Mahiti, Gladys Reuben; Mkoka, Dickson Ally; Kiwara, Angwara Dennis; Mbekenga, Columba Kokusiima; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-01-01

    Background Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs) and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services provided. Improvements

  15. Institutional Change in Delivery of Dental Services: A Marketing Perspective

    PubMed Central

    Capon, Noel

    1982-01-01

    The recent appearance and growth of new delivery systems for dental services is examined from a marketing perspective. Analysis reveals that the growth of low priced, high throughput operations is consistent not only with marketing principles, but with the development of American retail institutions in general. Options for independent dentists in the face of this new competitive environment are discussed. (Am J Public Health 1982; 72:679-683.) PMID:7091457

  16. Student Delivery of Health Services to Students: A Longitudinal Analysis.

    ERIC Educational Resources Information Center

    Martin, Gary L.; And Others

    1981-01-01

    Student health aide programs for college students have been instrumental in nutrition improvement, medication compliance, general preventive medicine, and in aiding in the mental health delivery system. In this study, headaches and upper respiratory infections constituted a significant percentage of the total visits to the health aide. (JN)

  17. Improvement in the Geofencing Service Interface Using Indoor Positioning Systems and Mobile Sensors

    NASA Astrophysics Data System (ADS)

    Nakagawa, M.

    2013-11-01

    The current state of location-based services provides spatial information delivery for mobile users based on position data taken from GPS sensors. However, sometimes the spatial information delivery service includes unwanted information. In particular, push-based or passive information delivery has a high probability that users receive unwanted information. We propose a new spatial information delivery to improve the integrity of spatial information delivery. We conducted an experiment using an Indoor Messaging System and an accelerometer, and concluded that our methodology can detect user behavior without accessing personal information and reduce the amount of spam information.

  18. 75 FR 8425 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-24

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... international postal and delivery services of interest to Advisory Committee members and the public....

  19. 78 FR 8683 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... postal and delivery services of interest to Advisory Committee members and the public. For...

  20. 76 FR 15028 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  1. 75 FR 57102 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... related to international postal and delivery services of interest to Advisory Committee members and...

  2. 76 FR 54829 - Advisory Committee On International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Committee On International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice... International Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of... related to international postal and delivery services that are of interest to Advisory Committee...

  3. 78 FR 55773 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice; FACA... Postal and Delivery Services. This Committee has been formed in fulfillment of the provisions of the 2006... delivery services of interest to Advisory Committee members and the public. FOR FURTHER INFORMATION...

  4. 29 CFR 4000.26 - What if I use a commercial delivery service?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false What if I use a commercial delivery service? 4000.26... § 4000.26 What if I use a commercial delivery service? (a) In general. Your filing or issuance date is the date you deposit your submission or issuance with the commercial delivery service if you meet...

  5. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING... are the basic components of an NFJP service delivery strategy? The NFJP service delivery strategy...

  6. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING... are the basic components of an NFJP service delivery strategy? The NFJP service delivery strategy...

  7. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING... are the basic components of an NFJP service delivery strategy? The NFJP service delivery strategy...

  8. 20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING... the basic components of an NFJP service delivery strategy? The NFJP service delivery strategy...

  9. Comprehensive Service Delivery through Senior Centers and Other Community Focal Points: A Resource Manual.

    ERIC Educational Resources Information Center

    National Council on the Aging, Inc., Washington, DC.

    This manual provides information on factors particularly relevant to focal point service delivery such as cooperative planning, interagency linkages, shared service delivery, accountability, and community relationships. An introduction describes what community focal points for service delivery are and how they are intended to fit into community…

  10. Improving vaccine delivery using novel adjuvant systems.

    PubMed

    Pichichero, Michael E

    2008-01-01

    Adjuvants have been common additions to vaccines to help facilitate vaccine delivery. With advancements in vaccine technology, several adjuvants which activate immune specific responses have emerged. Available data show these adjuvants elicit important immune responses in both healthy and immunocompromised populations, as well as the elderly. Guidelines for the use and licensure of vaccine adjuvants remain under discussion. However, there is a greater understanding of the innate and adaptive immune response, and the realization of the need for immune specific adjuvants appears to be growing. This is a focused review of four adjuvants currently in clinical trial development: ASO4, ASO2A, CPG 7907, and GM-CSF. The vaccines including these adjuvants are highly relevant today, and are expected to reduce the disease burden of cervical cancer, hepatitis B and malaria. PMID:18398303

  11. Viability of healthcare service delivery alternatives for the Australian mining sector.

    PubMed

    Williams, Patricia A H; Giles, Margaret

    2012-01-01

    The changing and demanding nature of the mining workforce in rural and remote Australia brings unique challenges to the delivery of healthcare services. In an attempt to control costs whilst delivering cost effective and quality healthcare, new models of delivery must be considered. For a workforce that is fly-in/fly-out, the provision of healthcare is problematic given the lack of consistency in location. A cost-benefit framework is analysed comparing three models of service provision using travel to a major location, locum services and remote health monitoring. Ultimately, new models of care must be considered to address the issues of increasing workforce turnover, to cater for rising healthcare costs, and to improve the health of such communities. PMID:23138092

  12. Are clinical audits enough to bring about improvement in overall health care delivery?

    PubMed

    Rajani, Amin; Sohail, Syed M

    2014-01-01

    This study was conducted to explore the entire spectrum of initiatives that have evolved globally over time in health care delivery mechanisms. The quality improvement initiatives that have been reviewed were undertaken at the department of radiology at a tertiary care teaching hospital in the developing world. This article reveals that conducting only clinical audits is not enough to bring about improvements in the health care delivery processes. It also illustrates examples of other initiatives that combine to enable sustainable, safe and high quality health care services for the patients whom we serve. PMID:24938030

  13. Exploring barriers to the delivery of cervical cancer screening and early treatment services in Malawi: some views from service providers

    PubMed Central

    Munthali, Alister C; Ngwira, Bagrey M; Taulo, Frank

    2015-01-01

    Background Cervical cancer is the most common reproductive health cancer in Malawi. In most cases, women report to health facilities when the disease is in its advanced stage. In this study, we investigate service providers’ perceptions about barriers for women to access cervical cancer screening and early treatment services in Malawi. Methods We conducted in-depth interviews with 13 district coordinators and 40 service providers of cervical cancer screening and early treatment services in 13 districts in Malawi. The study was conducted in 2012. The district coordinators helped the research team identify the health facilities which were providing cervical cancer screening and early treatment services. Results Almost all informants reported that cervical cancer was a major public health problem in their districts and that prevention efforts for this disease were being implemented. They were aware of the test and treat approach using visual inspection with acetic acid (VIA). They, however, said that the delivery of cervical cancer screening and early treatment services was compromised because of factors such as gross shortage of staff, lack of equipment and supplies, the lack of supportive supervision, and the use of male service providers. Informants added that the lack of awareness about the disease among community members, long distances to health facilities, the lack of involvement of husbands, and prevailing misperceptions about the disease (eg, that it is caused by the exposure to the VIA process) affect the uptake of these services. Conclusion While progress has been made in the provision of cervical cancer screening and early treatment services in Malawi, a number of factors affect service delivery and uptake. There is a need to continue creating awareness among community members including husbands and also addressing identified barriers such as shortage of staff and supplies in order to improve uptake of services. PMID:25848229

  14. Pricing: A Normative Strategy in the Delivery of Human Services.

    ERIC Educational Resources Information Center

    Moore, Stephen T.

    1995-01-01

    Discusses a normative strategy toward pricing human services, which will allow providers to develop pricing strategies within the context of organizational missions, goals, and values. Pricing is an effective tool for distributing resources and improving efficiency, and can be used as a tool for encouraging desired patterns of service utilization.…

  15. Critical Issues in the Delivery of Local Government Services in Rural America.

    ERIC Educational Resources Information Center

    Doeksen, Gerald A.; Peterson, Janet

    Technological changes, an increase in demand for quality community services, and environmental controls have created conditions of continual change in the delivery of rural services. This report summarizes economic theory on community service delivery, reviews economic literature on specific community services, and identifies research gaps and…

  16. Pharmacological Drug Delivery Strategies for Improved Therapeutic Effects: Recent Advances.

    PubMed

    Savaliya, Reema; Singh, Poornima; Singh, Sanjay

    2016-01-01

    The latest pharmacologic research has resulted number of new molecules with the potential to modernize the prevention or treatment of different complex diseases, including cancer. The therapeutics generally include moieties such as proteins, drugs and genes, etc. Current activities in the pharmacological field include the development of novel drug-delivery systems to overcome pharmacokinetic glitches such as limited bioavailability, unwanted distribution, drug resistant, and stability, etc. Therefore, to address these issues various biotechnological and pharmacological techniques has been introduced. However, effective drug delivery with improved efficacy remains challenging. This review is focused towards different strategies such as physical and biological methods for efficacious delivery at desired tissues and even sub-cellular targeting. Emphasis is also given about nanotechnology based drug or gene delivery strategies and co-delivery of drug-drug; gene-gene or combinations of drug-gene, etc. are the current cuttingedge methods, which are under clinical or pre-clinical stage of research. Uses of biodegradable materials, such as liposomes and polymeric particles are another class of drug delivery vehicles, which have shown tremendous success, are also discussed. Towards the end, future directions of pharmacological drug delivery methods have also been summarized. PMID:26654439

  17. 77 FR 41877 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-16

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice, FACA... Postal and Delivery Services (the Advisory Committee). This Committee has been formed in fulfillment of... delivery matters. Public input: Any member of the public interested in providing public input to...

  18. Context Matters: Practitioner Perspectives on Immunization Delivery Quality Improvement Efforts.

    PubMed

    Gingold, Janet A; Briccetti, Christine; Zook, Kathleen; Gillespie, Catherine W; Gubernick, Ruth S; Moon, Rachel Y; Fu, Linda Y

    2016-08-01

    Uneven adherence to immunization guidelines might leave some communities vulnerable to outbreaks of vaccine-preventable diseases. To examine factors related to implementation of immunization delivery best practices, we analyzed responses to monthly surveys and debriefing interviews from 16 diverse pediatric practices engaged in a year-long virtual learning collaborative. The collaborative provided a toolkit, online learning sessions, performance feedback, and conference calls with a quality improvement coach. Participants used iterative plan-do-study-act cycles to implement self-selected changes in immunization practices. Descriptive statistics were applied to quantitative data; qualitative data were analyzed using a framework approach. Impediments to implementing guidelines included difficulties with electronic record systems, rigid management structures, competing priorities, and parental resistance. Facilitators included linkage with regional immunization registries, positive social interactions, and performance feedback. Findings suggest that improving immunization delivery requires not only awareness of recommendations and training in improvement methods but also efforts to ameliorate contextual factors that impede immunization delivery. PMID:26743455

  19. Rethinking Library Service: Improving the User Experience with Service Blueprinting

    ERIC Educational Resources Information Center

    Pretlow, Cassi; Sobel, Karen

    2015-01-01

    Service blueprinting is a process that businesses use for analyzing and improving service. Originally presented in the Harvard Business Review in 1984, it has retained a strong following ever since. At present, it is experiencing a revival at numerous academic institutions. The authors of this article present the process of service blueprinting.…

  20. Great Service Pays: A Model for Service Delivery in an Academic Music Library

    ERIC Educational Resources Information Center

    Wilson, Andrew M.

    2007-01-01

    Special-subject libraries can be particularly intimidating for casual and seasoned patrons alike. Music libraries, with their variety of materials, formats, and vocabularies, can present particular challenges for the user. With this proposal for a model of service delivery, as well as many tips gained through experience working the front-of-house…

  1. Customer's Perceptions and Intentions on Online Travel Service Delivery: An Empirical Study in China

    NASA Astrophysics Data System (ADS)

    Li, Hongxiu; Suomi, Reima

    With the wide adoption of e-commerce in travel and tourism industry, the Internet has become an important travel service delivery channel, and traditional travel agency has been under severe disintermediation threat. This paper reports on a survey conducted to explore the Chinese consumer's current usage of the Internet as the channel to search travel information and to book travel services. It also investigates customer's future intentions on using the Internet to book travel services. This paper aims to examine whether there are difference between different consumer segments in terms of gender and age, and to find the hypothesis of disintermediation or intermediation in travel industry. The results indicates that online travel service delivery has grown as a popular direct distribution channel in travel industry, but more of the customers still turn to the traditional travel agencies, which support both the disintermediation and intermediation in travel industry. The results also reveal that online travel services provided by travel service providers still need to be improved since the number of online bookers is declined. This paper concludes by discussing the limitation of this study and highlighting areas for the future research in online travel service field.

  2. Improving drug delivery to solid tumors: priming the tumor microenvironment.

    PubMed

    Khawar, Iftikhar Ali; Kim, Jung Ho; Kuh, Hyo-Jeong

    2015-03-10

    Malignant transformation and growth of the tumor mass tend to induce changes in the surrounding microenvironment. Abnormality of the tumor microenvironment provides a driving force leading not only to tumor progression, including invasion and metastasis, but also to acquisition of drug resistance, including pharmacokinetic (drug delivery-related) and pharmacodynamic (sensitivity-related) resistance. Drug delivery systems exploiting the enhanced permeability and retention (EPR) effect and active targeting moieties were expected to be able to cope with delivery-related drug resistance. However, recent evidence supports a considerable barrier role of tumors via various mechanisms, which results in imperfect or inefficient EPR and/or targeting effect. The components of the tumor microenvironment such as abnormal tumor vascular system, deregulated composition of the extracellular matrix, and interstitial hypertension (elevated interstitial fluid pressure) collectively or cooperatively hinder the drug distribution, which is prerequisite to the efficacy of nanoparticles and small-molecule drugs used in cancer medicine. Hence, the abnormal tumor microenvironment has recently been suggested to be a promising target for the improvement of drug delivery to improve therapeutic efficacy. Strategies to modulate the abnormal tumor microenvironment, referred to here as "solid tumor priming" (vascular normalization and/or solid stress alleviation leading to improvement in blood perfusion and convective molecular movement), have shown promising results in the enhancement of drug delivery and anticancer efficacy. These strategies may provide a novel avenue for the development of new chemotherapeutics and combination chemotherapeutic regimens as well as reassessment of previously ineffective agents. PMID:25526702

  3. Improving Child Protection Services to Children under Ten Who Display Sexually Reactive Behaviors.

    ERIC Educational Resources Information Center

    Verstraete, Patricia A.

    This practicum was designed to improve Child Protective Services in a western state to sexually reactive children under the age of 10 by targeting four areas of the service delivery system: screening, assessment, treatment, and foster care. A panel of agency staff from all service areas researched, designed, proposed, and implemented changes…

  4. Telerehabilitation for service delivery in speech-language pathology.

    PubMed

    Theodoros, Deborah G

    2008-01-01

    Communication disorders in adults and children can have a significant effect on their quality of life and on that of their families. Speech-language pathologists face several challenges in providing assessment and treatment services to such people. Challenges include facilitating equitable access to services and providing appropriate management within a changing social and economic context. Telerehabilitation has the potential to deliver services in the home or local community via videoconferencing and through interactive computer-based therapy activities. This form of service delivery has the capacity to optimize functional outcomes by facilitating generalization of treatment effects within the person's everyday environment, and enable monitoring of communication and swallowing behaviours on a long-term basis. A number of image-based telerehabilitation applications have been used in the management of adult neurogenic speech and language disorders, stuttering, voice disorders, speech and language disorders in children, laryngectomy and swallowing dysfunction. Further development of such applications and other computer-based therapies, cost-benefit and cost-effectiveness analyses, and professional education are needed if telerehabilitation is to become an integral part of speech-language pathology practice. PMID:18632993

  5. Nanoemulsion: for improved oral delivery of repaglinide.

    PubMed

    Akhtar, Juber; Siddiqui, Hefazat Hussain; Fareed, Sheeba; Badruddeen; Khalid, Mohammad; Aqil, Mohammed

    2016-07-01

    Repaglinide (RPG) is a fast-acting prandial glucose regulator. It acts by stimulating insulin release from pancreatic β-cells. Recurrent dosing of RPG before each meal is burdensome remedy. Hence the plan of the present study was to evaluate nanoemulsion as a hopeful carrier for RPG for persistent hypoglycemic effect. The drug was incorporated into oil phase of nanoemulsion to give improved biopharmaceutical properties as compared to the lipid-based systems. Pseudo ternary phase diagrams were prepared by aqueous titration method. Formulations were selected at a difference of 5% w/w of oil from the o/w nanoemulsion region of phase diagrams. The optimized nanoemulsion formulation constituted sefsol-218 (5% v/v) as an oil phase, 30% v/v of Tween-80 and transcutol as a surfactant and co-surfactant to restrain nanodroplet size and low viscosity and distilled water (65%). In vitro dissolution studies showed higher drug release (98.22%), finest droplet size (76.23 nm), slightest polydispersity value (0.183), least viscosity (21.45 cps) and immeasurable dilution capability from the nanoemulsion as compared with existing oral tablet formulation. The optimized RPG nanoemulsion formulation showed better hypoglycemic effect in comparison to tablet formulation in experimental diabetic rats. No significant variations were also observed in the optimized formulation when subjected to accelerated stability study at different temperature and relative humidity over a period of 3 months. PMID:27187792

  6. Continue Service Improvement at CERN Computing Centre

    NASA Astrophysics Data System (ADS)

    Barroso Lopez, M.; Everaerts, L.; Meinhard, H.; Baehler, P.; Haimyr, N.; Guijarro, J. M.

    2014-06-01

    Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.

  7. 77 FR 2340 - Advisory Committee on International Postal and Delivery Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... Committee on International Postal and Delivery Services AGENCY: Department of State. ACTION: Notice of... the renewal of the charter of the Advisory Committee on International Postal and Delivery Services in... oversight of foreign policy related to international postal services and other international...

  8. Legal and Jurisdictional Problems in the Delivery of SRS Child Welfare Services on Indian Reservations.

    ERIC Educational Resources Information Center

    Baumheier, Edward C.; And Others

    Due to various factors, legal and jurisdictional issues often hinder the administration and delivery of Social and Rehabilitation Service (SRS) services on reservations. Focusing on child welfare programs, legal and jurisdictional problems concerning the delivery of SRS services on reservations and the means of coping with them were explored…

  9. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  10. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  11. 45 CFR 50.5 - Waivers for the delivery of health care service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Waivers for the delivery of health care service. 50.5 Section 50.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION U.S... for the delivery of health care service. In determining whether to request a waiver for an...

  12. Interventions to improve delivery of isoniazid preventive therapy: an overview of systematic reviews

    PubMed Central

    2014-01-01

    Background Uptake of isoniazid preventive therapy (IPT) to prevent tuberculosis has been poor, particularly in the highest risk populations. Interventions to improve IPT delivery could promote implementation. The large number of existing systematic reviews on treatment adherence has made drawing conclusions a challenge. To provide decision makers with the evidence they need, we performed an overview of systematic reviews to compare different organizational interventions to improve IPT delivery as measured by treatment completion among those at highest risk for the development of TB disease, namely child contacts or HIV-infected individuals. Methods We searched the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects (DARE), and MEDLINE up to August 15, 2012. Two authors used a standardized data extraction form and the AMSTAR instrument to independently assess each review. Results Six reviews met inclusion criteria. Interventions included changes in the setting/site of IPT delivery, use of quality monitoring mechanisms (e.g., directly observed therapy), IPT delivery integration into other healthcare services, and use of lay health workers. Most reviews reported a combination of outcomes related to IPT adherence and treatment completion rate but without a baseline or comparison rate. Generally, we found limited evidence to demonstrate that the studied interventions improved treatment completion. Conclusions While most of the interventions were not shown to improve IPT completion, integration of tuberculosis and HIV services yielded high treatment completion rates in some settings. The lack of data from high burden TB settings limits applicability. Further research to assess different IPT delivery interventions, including those that address barriers to care in at-risk populations, is urgently needed to identify the most effective practices for IPT delivery and TB control in high TB burden settings. PMID:24886159

  13. Recommendations for Improving Intervener Services

    ERIC Educational Resources Information Center

    National Consortium on Deaf-Blindness, 2012

    2012-01-01

    The U.S. Department of Education's Office of Special Education Programs (OSEP) recognizes the current challenges faced by states and schools relative to the provision of high-quality intervener services for children who are deaf-blind. To respond to these challenges, OSEP asked the National Consortium on Deaf-Blindness (NCDB) to conduct an…

  14. Scheduled vs. on-demand service for a fast package delivery system

    NASA Astrophysics Data System (ADS)

    Martin, Jared; Palmer, Kurt; Chan, Martin; Karasi, Anand; Glas, Dylan

    1999-01-01

    Fast Package Delivery refers to the transportation of freight over transpacific distances in a period of hours, and provides opportunity for synergistic development with reusable launch vehicle and HSCT technologies. Previous analyses of this topic have not recognized the bifurcation in the market and system requirements of a Fast Package Delivery service. This market is dichotomized as scheduled service, for less urgent items, operating similar to existing delivery services, and on-demand service, a charter type system for extremely time-sensitive commodities such as assembly line parts. Each of these solutions to the Fast Package Delivery issue has different market and system characteristics.

  15. Alternate Service Delivery Models in Cancer Genetic Counseling: A Mini-Review.

    PubMed

    Buchanan, Adam Hudson; Rahm, Alanna Kulchak; Williams, Janet L

    2016-01-01

    Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care, and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models, such as telephone counseling, telegenetics, and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology. PMID:27242960

  16. Alternate Service Delivery Models in Cancer Genetic Counseling: A Mini-Review

    PubMed Central

    Buchanan, Adam Hudson; Rahm, Alanna Kulchak; Williams, Janet L.

    2016-01-01

    Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care, and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models, such as telephone counseling, telegenetics, and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology. PMID:27242960

  17. Mental Health and Service Delivery Systems for Black Women.

    ERIC Educational Resources Information Center

    Smith, Elsie H.

    1981-01-01

    Examines mental health issues, especially alcoholism, suicide, and social depression, related to the counseling of Black women. Recommends improved mental health services, counselor/clinical training programs, and additional research focusing on the causes of stress among Black women. (Author/MW)

  18. Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery.

    PubMed

    Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

    2015-12-01

    A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. PMID:26489924

  19. Improving delivery of primary care for vulnerable migrants

    PubMed Central

    Pottie, Kevin; Batista, Ricardo; Mayhew, Maureen; Mota, Lorena; Grant, Karen

    2014-01-01

    Abstract Objective To identify and prioritize innovative strategies to address the health concerns of vulnerable migrant populations. Design Modified Delphi consensus process. Setting Canada. Participants Forty-one primary care practitioners, including family physicians and nurse practitioners, who provided care for migrant populations. Methods We used a modified Delphi consensus process to identify and prioritize innovative strategies that could potentially improve the delivery of primary health care for vulnerable migrants. Forty-one primary care practitioners from various centres across Canada who cared for migrant populations proposed strategies and participated in the consensus process. Main findings The response rate was 93% for the first round. The 3 most highly ranked practice strategies to address delivery challenges for migrants were language interpretation, comprehensive interdisciplinary care, and evidence-based guidelines. Training and mentorship for practitioners, intersectoral collaboration, and immigrant community engagement ranked fourth, fifth, and sixth, respectively, as strategies to address delivery challenges. These strategies aligned with strategies coming out of the United States, Europe, and Australia, with the exception of the proposed evidence-based guidelines. Conclusion Primary health care practices across Canada now need to evolve to address the challenges inherent in caring for vulnerable migrants. The selected strategies provide guidance for practices and health systems interested in improving health care delivery for migrant populations. PMID:24452576

  20. Global Document Delivery, User Studies, and Service Evaluation: The Gateway Experience

    ERIC Educational Resources Information Center

    Miller, Rush; Xu, Hong; Zou, Xiuying

    2008-01-01

    This study examines user and service data from 2002-2006 at the East Asian Gateway Service for Chinese and Korean Academic Journal Publications (Gateway Service), the University of Pittsburgh. Descriptive statistical analysis reveals that the Gateway Service has been consistently playing the leading role in global document delivery service as well…

  1. Interagency Cooperation--An Investigation of Human Service Agencies Collaboration in the Delivery of Services and Amenities to Rural Citizens in Clinton County New York.

    ERIC Educational Resources Information Center

    Gore, Jane S.; Nelson, Helen Y.

    Assuming that one way to meet the needs and to improve the delivery of services and amenities to isolated rural citizens is through increased interagency collaboration, an obective of this research was to explore stimuli and deterrents to such cooperative efforts. Thirty organizations (23 public groups, 4 private non-profit, and 3 private) serving…

  2. Look Through Patients' Eyes to Improve the Delivery of Care.

    PubMed

    2016-07-01

    By developing and implementing a method for seeing the healthcare experience from the standpoint of patients and family members, the University of Pittsburgh Medical Center has improved care delivery, lowered costs, and improved patient satisfaction. Cross-functional, multidisciplinary teams use a six-step patient and family-centered care methodology to identify gaps and develop changes that will improve the patient experience and clinical outcomes. Committee members shadow patients and family members to get firsthand knowledge about what they are going through and what goes wrong and what goes right. The teams proposed minor and major changes, but none involve adding more staff and few involve more expenditures. PMID:27434940

  3. Closed-loop insulin delivery: towards improved diabetes care.

    PubMed

    Kumareswaran, Kavita; Evans, Mark L; Hovorka, Roman

    2012-02-01

    The prevalence of type 1 diabetes is escalating worldwide. Novel therapies and management strategies are needed to reduce associated morbidity. Aggressive blood glucose lowering using conventional insulin replacement regimens is limited by the risk of hypoglycemia. Even the most motivated patients may struggle to manage day-to-day variability in insulin requirements. The artificial pancreas or closed-loop insulin delivery may improve outcomes, building on recent technological progress and combining continuous glucose monitoring with insulin pump therapy. So far, closed-loop prototypes have been evaluated under controlled conditions suggesting improved glucose control and a reduced risk of hypoglycemia. Limitations include suboptimal accuracy and reliability of continuous glucose monitors and delays associated with subcutaneous insulin delivery. Outpatient evaluation is required as the next step, leading to deployment into clinical practice. PMID:22369975

  4. Systematic Collective Action To Improve Media Services in a High School Library.

    ERIC Educational Resources Information Center

    McLellan, Francis R.

    This practicum was designed to improve a high school education media center through systematic collective action. The goal was to improve delivery of education media services by: (1) improving material conditions; (2) developing collaboration between education media specialists and academic teachers; and (3) involvement of the entire learning…

  5. Improving Service Management in Campus IT Operations

    ERIC Educational Resources Information Center

    Wan, Stewart H. C.; Chan, Yuk-Hee

    2008-01-01

    Purpose: This paper aims at presenting the benefits from implementing IT service management (ITSM) in an organization for managing campus-wide IT operations. In order to improve the fault correlation from business perspectives, we proposed a framework to automate network and system alerts with respect to its business service impact for proactive…

  6. General service incandescent lamp with improved efficiency

    SciTech Connect

    Berlec, I.

    1985-06-18

    A high efficiency general service incandescent lamp is disclosed. The disclosed improved general service incandescent lamp has an outer and an inner envelope. The inner envelope has a relatively small housing containing a halogen gas and a relatively high pressure efficient fill-gas and in which a low voltage filament is spatially disposed therein.

  7. Overcoming cellular and tissue barriers to improve liposomal drug delivery

    NASA Astrophysics Data System (ADS)

    Kohli, Aditya G.

    Forty years of liposome research have demonstrated that the anti-tumor efficacy of liposomal therapies is, in part, driven by three parameters: 1) liposome formulation and lipid biophysics, 2) accumulation and distribution in the tumor, and 3) release of the payload at the site of interest. This thesis outlines three studies that improve on each of these delivery steps. In the first study, we engineer a novel class of zwitterlipids with an inverted headgroup architecture that have remarkable biophysical properties and may be useful for drug delivery applications. After intravenous administration, liposomes accumulate in the tumor by the enhanced permeability and retention effect. However, the tumor stroma often limits liposome efficacy by preventing distribution into the tumor. In the second study, we demonstrate that depletion of hyaluronan in the tumor stroma improves the distribution and efficacy of DoxilRTM in murine 4T1 tumors. Once a liposome has distributed to the therapeutic site, it must release its payload over the correct timescale. Few facile methods exist to quantify the release of liposome therapeutics in vivo. In the third study, we outline and validate a simple, robust, and quantitative method for tracking the rate and extent of release of liposome contents in vivo. This tool should facilitate a better understanding of the pharmacodynamics of liposome-encapsulated drugs in animals. This work highlights aspects of liposome behavior that have prevented successful clinical translation and proposes alternative approaches to improve liposome drug delivery.

  8. Expanding services in a shrinking economy: desktop document delivery in a dental school library

    PubMed Central

    Gushrowski, Barbara A

    2011-01-01

    Question: How can library staff develop and promote a document delivery service and then expand the service to a wide audience? Setting: The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. Method: A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. Main results: IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Conclusion: Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated. PMID:21753911

  9. Controlled Delivery of Zoledronate Improved Bone Formation Locally In Vivo

    PubMed Central

    Peng, Jiang; Lu, Qiang; Wang, Yu; Wang, Aiyuan; Guo, Quanyi; Gao, Xupeng; Xu, Wenjing; Lu, Shibi

    2014-01-01

    Bisphosphonates (BPs) have been widely used in clinical treatment of bone diseases with increased bone resorption because of their strong affinity for bone and their inhibition of bone resorption. Recently, there has been growing interest in their improvement of bone formation. However, the effect of local controlled delivery of BPs is unclear. We used polylactide acid-glycolic acid copolymer (PLGA) as a drug carrier to deliver various doses of the bisphosphonate zoledronate (Zol) into the distal femur of 8-week-old Sprague-Dawley rats. After 6 weeks, samples were harvested and analyzed by micro-CT and histology. The average bone mineral density and mineralized bone volume fraction were higher with medium- and high-dose PLGA-Zol (30 and 300 µg Zol, respectively) than control and low-dose Zol (3 µg PLGA-Zol; p<0.05). Local controlled delivery of Zol decreased the numbers of osteoclast and increased the numbers of osteoblast. Moreover, local controlled delivery of medium- and high-dose Zol accelerated the expression of bone-formation markers. PLGA used as a drug carrier for controlled delivery of Zol may promote local bone formation. PMID:24618585

  10. The Whole PIC Catalog: Organization, Planning and Service Delivery Options under JTPA.

    ERIC Educational Resources Information Center

    National Alliance of Business, Inc., Washington, DC.

    This handbook illustrates and discusses organizational options for the delivery of employment and training services within service delivery areas (SDAs) mandated by the Job Training Partnership Act (JTPA) of 1982. Addressed primarily to members of private industry councils (PICs), representatives of local governments, and employment and training…

  11. Opening the Black Box: Exploring the Effect of Transformation on Online Service Delivery in Local Governments

    NASA Astrophysics Data System (ADS)

    van Veenstra, Anne Fleur; Zuurmond, Arre

    To enhance the quality of their online service delivery, many government organizations seek to transform their organization beyond merely setting up a front office. This transformation includes elements such as the formation of service delivery chains, the adoption of a management strategy supporting process orientation and the implementation of enterprise architecture. This paper explores whether undertaking this transformation has a positive effect on the quality of online service delivery, using data gathered from seventy local governments. We found that having an externally oriented management strategy in place, adopting enterprise architecture, aligning information systems to business and sharing activities between processes and departments are positively related to the quality of online service delivery. We recommend that further research should be carried out to find out whether dimensions of organizational development too have an effect on online service delivery in the long term.

  12. The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review.

    PubMed

    Househ, Mowafa

    2016-06-01

    Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. PMID:25038203

  13. 76 FR 4726 - Avaya Global Services, AOS Service Delivery, Worldwide Services Group, Including Workers Whose...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    .... The notice was published in the Federal Register on November 8, 2010 (75 FR 68622). At the request of... workers are related to the supply of service desk/help desk services providing the first level...

  14. Using a Transdisciplinary Service Delivery Model to Increase Parental Involvement with Special Education Students

    ERIC Educational Resources Information Center

    Cross, Robert J.

    2007-01-01

    Too often special education services are provided in a piece-by-piece fashion with individual support staff members each scheduling service to the child once or twice a week. Travel time and case-load numbers prohibit getting significant service time and frequency to the student. The literature suggests that transdisciplinary service delivery is…

  15. Strengthening district health service management and delivery through internal contracting: lessons from pilot projects in Cambodia.

    PubMed

    Khim, Keovathanak; Annear, Peter Leslie

    2013-11-01

    Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of 'internal contracting' for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success. PMID:23489889

  16. Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

    PubMed Central

    D'Ambruoso, Lucia; Abbey, Mercy; Hussein, Julia

    2005-01-01

    Background This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. Methods Twenty-one individual in-depth interviews and two focus group discussions were conducted with women of reproductive age who had delivered in the past five years in the Greater Accra Region. The study investigated women's perceptions and experiences of care in terms of factors that influenced place of delivery, satisfaction with services, expectations of care and whether they would recommend services. Results One component of care which appeared to be of great importance to women was staff attitudes. This factor had considerable influence on acceptability and utilisation of services. Otherwise, a successful labour outcome and non-medical factors such as cost, perceived quality of care and proximity of services were important. Our findings indicate that women expect humane, professional and courteous treatment from health professionals and a reasonable standard of physical environment. Women will consciously change their place of delivery and recommendations to others if they experience degrading and unacceptable behaviour. Conclusion The findings suggest that inter-personal aspects of care are key to women's expectations, which in turn govern satisfaction. Service improvements which address this aspect of care are likely to have an impact on health seeking behaviour and utilisation. Our findings suggest that user-views are important and warrant further investigation. The views of providers should also be investigated to identify channels by which service improvements, taking into account women's views, could be operationalised. We also recommend that interventions to improve delivery care should not only be directed to the health professional, but also to general health system improvements. PMID:16372911

  17. The Leadership Role in Transitioning an Urban Secondary School from a Traditional Service Delivery Model to a Co-Teaching Service Delivery Model for Students with Disabilities: A Phenomenological Case Study

    ERIC Educational Resources Information Center

    McDonald, Ginni E.

    2013-01-01

    This research studies the leadership role in transitioning from a traditional service delivery model to a co-teaching service delivery model for students with disabilities. While there is an abundant amount of information on the service delivery model of co-teaching, sustaining co-teaching programs, and effective co-teaching programs for students…

  18. Strengthening management and leadership practices to increase health-service delivery in Kenya: an evidence-based approach

    PubMed Central

    2012-01-01

    Background The purpose of the study was to test the hypothesis that strengthening health systems, through improved leadership and management skills of health teams, can contribute to an increase in health-service delivery outcomes. The study was conducted in six provinces in the Republic of Kenya. Methods The study used a non-randomized design comparing measures of key service delivery indicators addressed by health teams receiving leadership and management training (the intervention) against measures in comparison areas not receiving the intervention. Measurements were taken at three time periods: baseline, endline, and approximately six months post intervention. At the district level, health-service coverage was computed. At the facility level, the percentage change in the number of client visits was computed. The t-test was used to test for significance. Results Results showed significant increases in health-service coverage at the district level (p = <0.05) in the intervention teams compared to the comparison teams. Similarly, there were significant increases in the number of client visits at the facility level in the intervention group versus comparison facilities (P < 0.05). Conclusions Strengthening the leadership and management skills of health teams, through team-based approaches focused on selected challenges, contributed to improved health service delivery outcomes and these improvements were sustained at least for six months. PMID:22931468

  19. Evaluating and improving neonatal transport services.

    PubMed

    Ratnavel, Nandiran

    2013-11-01

    Interfacility transport is a necessary part of hospital care. Neonates often need to access specialist input at different sites necessitating a reliable transfer process. Services have evolved significantly over the last ten years to meet this need. This followed the recognition that ad hoc arrangements were unreliable and often unsafe. Services have significantly improved during this time. Attention has been paid to training, clinical governance, disseminating best practice, setting standards, ring fenced funding and supporting parents. Transport teams have become integral to neonatal network function and quality and performance of transport services needs to be evaluated. National audit creates useful team comparisons and identifies outlier status allowing closer inspection of variations between services. Work is needed in the form of external appraisal in order to maintain service standards. PMID:24094330

  20. Controlled Delivery of FK506 to Improve Nerve Regeneration.

    PubMed

    Labroo, Pratima; Ho, Scott; Sant, Himanshu; Shea, Jill; Gale, Bruce K; Agarwal, Jay

    2016-09-01

    Autologous nerve grafts are the current "gold standard" for repair of large nerve gaps. However, they cause morbidity at the donor nerve site, only a limited amount of nerve can be harvested, and there is the potential for mismatches in size and fascicular patterns between the nerve stumps and the graft. Nerve conduits are a promising alternative to autografts and can act as guidance cues for the regenerating axons and allow for tension free bridging, without the need to harvest donor nerve. Separately, FK506, and FDA-approved small molecule, has been shown to enhance axon growth and peripheral nerve regeneration. This article describes the design of a novel drug delivery apparatus integrated with a poly lactic-co-glycolic acid (PLGA)-based nerve guide conduit for controlled local delivery of FK506. An FK506 dosage curve was acquired to determine the minimum in vitro concentration for optimal axonal outgrowth of dorsal root ganglion (DRG) cells, then PLGA devices were designed and tested in a diffusion chamber, and finally the bioactivity of the released media was evaluated by measuring axon growth in DRG cells exposed to the media for 72 h. The combined drug delivery nerve guide was able to release FK506 for 20 days at concentrations (1-20 ng/mL) that were shown to enhance DRG axon growth. Furthermore, the released FK506 was bioactive and able to enhance DRG axon growth. The combined drug delivery nerve guide can release FK506 for extended periods of time and enhance axon growth, and has the potential to improve nerve regeneration after a peripheral nerve injury. PMID:27058050

  1. Perspectives of HIV agencies on improving HIV prevention, treatment, and care services in the USA.

    PubMed

    Khosla, Nidhi; Zachary, Iris

    2016-10-01

    HIV healthcare services in the USA are made available through a complex funding and delivery system. We present perspectives of HIV agencies on improvements that could lead to an ideal system of HIV prevention, treatment and care. We conducted semi-structured interviews with representatives from 21 HIV agencies offering diverse services in Baltimore, MD. Thematic analysis revealed six key themes: (1) Focusing on HIV prevention, (2) Establishing common entry-points for services, (3) Improving information availability, (4) Streamlining funding streams, (5) Removing competitiveness and (6) Building trust. We recommend that in addition to addressing operational issues regarding service delivery and patient care, initiatives to improve HIV service systems should address underlying social issues such as building trust. PMID:26875546

  2. Improving P2P live-content delivery using SVC

    NASA Astrophysics Data System (ADS)

    Schierl, T.; Sánchez, Y.; Hellge, C.; Wiegand, T.

    2010-07-01

    P2P content delivery techniques for video transmission have become of high interest in the last years. With the involvement of client into the delivery process, P2P approaches can significantly reduce the load and cost on servers, especially for popular services. However, previous studies have already pointed out the unreliability of P2P-based live streaming approaches due to peer churn, where peers may ungracefully leave the P2P infrastructure, typically an overlay networks. Peers ungracefully leaving the system cause connection losses in the overlay, which require repair operations. During such repair operations, which typically take a few roundtrip times, no data is received from the lost connection. While taking low delay for fast-channel tune-in into account as a key feature for broadcast-like streaming applications, the P2P live streaming approach can only rely on a certain media pre-buffer during such repair operations. In this paper, multi-tree based Application Layer Multicast as a P2P overlay technique for live streaming is considered. The use of Flow Forwarding (FF), a.k.a. Retransmission, or Forward Error Correction (FEC) in combination with Scalable video Coding (SVC) for concealment during overlay repair operations is shown. Furthermore the benefits of using SVC over the use of AVC single layer transmission are presented.

  3. Micro-fractional epidermal powder delivery for improved skin vaccination

    PubMed Central

    Chen, Xinyuan; Kositratna, Garuna; Zhou, Chang; Manstein, Dieter; Wu, Mei X.

    2014-01-01

    Skin vaccination has gained increasing attention in the last two decades due to its improved potency compared to intramuscular vaccination. Yet, the technical difficulty and frequent local reactions hamper its broad application in the clinic. In the current study, micro-fractional epidermal powder delivery (EPD) is developed to facilitate skin vaccination and minimize local adverse effects. EPD is based on ablative fractional laser or microneedle treatment of the skin to generate microchannel (MC) arrays in the epidermis followed by topical application of powder drug/vaccine-coated array patches to deliver drug/vaccine into the skin. The novel EPD delivered more than 80% sulforhodamine b (SRB) and model antigen ovalbumin (OVA) into murine, swine, and human skin within 1 hour. EPD of OVA induced anti-OVA antibody titer at a level comparable to intradermal (ID) injection and was much more efficient than tape stripping in both delivery efficiency and immune responses. Strikingly, the micro-fractional delivery significantly reduced local side effects of LPS/CpG adjuvant and BCG vaccine, leading to complete skin recovery. In contrast, ID injection induced severe local reactions that persisted for weeks. While reducing local reactogenicity, EPD of OVA/LPS/CpG and BCG vaccine generated a comparable humoral immune response to ID injection. EPD of vaccinia virus encoding OVA induced significantly higher and long-lasting interferon γ-secreting CD8+ T cells than ID injection. In conclusion, EPD represents a promising technology for needle-free, painless skin vaccination with reduced local reactogenicity and improved immunogenicity. PMID:25135790

  4. Patient Satisfaction with Methadone Maintenance Treatment in Vietnam: A Comparison of Different Integrative-Service Delivery Models

    PubMed Central

    Tran, Bach Xuan; Nguyen, Long Hoang; Phan, Huong Thu Thi; Latkin, Carl A.

    2015-01-01

    Background Patient satisfaction is an important component of quality in healthcare delivery. To inform the expansion of Methadone Maintenance Treatment (MMT) services in Vietnam, we examined the satisfaction of patients with regards to different services delivery models and identified its associated factors. Methods We interviewed 1,016 MMT patients at 5 clinics in Hanoi and Nam Dinh province. The modified SATIS instrument, a 10-item scale, was used to measure three dimensions: “Services quality and convenience”, “Health workers’ capacity and responsiveness” and “Inter-professional care”. Results The average score was high across three SATIS dimensions. However, only one third of patients completely satisfied with general health services and treatment outcomes. Older age, higher education, having any problem in self-care and anxiety/depression were negatively associated with patient’s satisfaction. Meanwhile, patients receiving MMT at clinics, where more comprehensive HIV and general health care services were available, were more likely to report a complete satisfaction. Conclusion Patients were highly satisfied with MMT services in Vietnam. However, treatment for drug users should go beyond methadone maintenance to address complicated health demands of drug users. Integrating MMT with comprehensive HIV and general health services together with improving the capacity of health workers and efficiency of services organisation to provide interconnected health care for drug users are critical for improving the outcomes of the MMT program. PMID:26556036

  5. Improved Biochemical Strategies for Targeted Delivery of Taxoids

    PubMed Central

    Ganesh, Thota

    2008-01-01

    Paclitaxel (Taxol ®) and docetaxel (Taxotere ®) are very important anti-tumor drugs in clinical use for cancer. However, their clinical utility is limited due to systemic toxicity, low solubility and inactivity against drug resistant tumors. To improve chemotherapeutic levels of these drugs, it would be highly desirable to design strategies which bypass the above limitations. In this respect various prodrug and drug targeting strategies have been envisioned either to improve oral bioavailability or tumor specific delivery of taxoids. Abnormal properties of cancer cells with respect to normal cells have guided in designing of these protocols. This review article records the designed biochemical strategies and their biological efficacies as potential taxoid chemotherapeutics. PMID:17419065

  6. Gigabit network-based three-dimensional trial service on media delivery platform

    NASA Astrophysics Data System (ADS)

    Kim, Nac-Woo; Son, Seung-Chul; Lee, Byung-Tak

    2011-09-01

    Recently, as effective demand for high-quality, large-capacity content such as three-dimensional (3D), multiangle, and gigabit-web has increased, a network infrastructure capable of satisfying future broadcast and communication service requirements is required. In this paper, we introduce a convergence service based on a gigabit network and then propose a technique for delivering gigabit 3D content. Here, the term 3D content delivery technique refers to an overlay-multicast-based distributed service platform that is comprised of a media relay agent and a management server. The service platform is designed to back up both live video and file-based video streaming. Using this platform, we can provide 3D remote education and 3D multiangle services via 3D-based video streaming between a service provider and service consumers dispersed at different locations. To evaluate our 3D content delivery technique, we run a series of trials of gigabit network-based 3D trial services to service subscribers. Then, we conduct a survey to measure user satisfaction with the 3D delivery service and simulated network and service quality. From experimental results, we confirm that this type of distributed service platform can be used as the delivery framework for applications such as realistic 3D-based seminars or 3D video conferences.

  7. A Relational Goal-Oriented Model of Optimal Service Delivery to Children and Families

    ERIC Educational Resources Information Center

    King, Gillian

    2009-01-01

    This article presents a Relational Goal-Oriented Model of Service Delivery to Children with physical or mental health difficulties and their families. This research-informed and practice-relevant model provides a broad understanding of what effective service provision entails and requires from practitioners and service organizations. The model…

  8. Assessing the Impact of a Quality Improvement Intervention on Diabetes Self- Management Education Services Provided by Local Health Departments

    PubMed Central

    Dearinger, Angela T.; Ingram, Richard C.; Pendley, Robin P.; Wilding, Sarah

    2015-01-01

    Background As the burden of diabetes continues to overwhelm the public health system, there is increased demand on local health departments (LHDs) to improve public health services. Quality improvement (QI) techniques have been shown to be an effective means to improve the delivery of services by LHDs. Purpose To evaluate the extent to which the adoption of organizational quality improvement (QI) strategies influences the delivery and outreach of Diabetes Self- Management Education (DSME) services provided by LHDs. Methods A change facilitation model which included QI team development and on- site QI training and facilitation was delivered to 6 LHDs who provide DSME during 2010-2011. After training, each LHD developed and implemented a QI project to improve the outreach and delivery of DSME services. Pre- and post- intervention surveys were administered to evaluate the extent of change in DSME outreach and delivery. Results The number of individuals who completed an entire course of DSME increased by > 100%, and 14% more diabetics attended DSME on a monthly basis. Half of LHDs reported receiving increased numbers of referrals per month, and 15% more healthcare providers referred diabetic patients to the LHD for DSME. Conclusions Participation in COACH 4 DM led to improvements in the LHD QI infrastructure, and in the outreach and delivery of services to diabetic patients. The techniques used during COACH-4 DM are applicable to a wide variety of contexts and may be an effective tool to improve the delivery of other clinical and community preventive services. PMID:24237923

  9. Educational Audiology: A Comparison of Service Delivery Systems Utilized by Missouri Schools.

    ERIC Educational Resources Information Center

    Allard, J. Brad; Golden, Diane Cordry

    1991-01-01

    Comparison of three audiology service delivery systems--(1) school-based audiology within the district, (2) non-school-based audiology in the community, and (3) school-based audiology in a remote community--found the local school-based delivery system superior on various quality indicators. (Author/DB)

  10. Astrobotic: Commercial Service for Lunar Resource Payload Delivery

    NASA Astrophysics Data System (ADS)

    Thornton, J.; Huber, S.; Peterson, K.; Hendrickson, D.

    2015-10-01

    This paper describes how commercial delivery is enabling access to the Moon for resource payloads. Topics addressed: impediments to resource development, commercial approaches to delivering resource payloads, and traction seen with the market.

  11. A Brief Introduction of Assistive Technology Service Delivery System in Republic of Korea.

    PubMed

    Lim, MyungJoon; Jung, SungMin

    2015-01-01

    Social participation of People with Disability in Republic of Korea has been grown last few years. Also demand of Assistive Technology has been increased as well. Responding these needs, the public benefits of Assistive Technology Device in Republic of Korea in 2014 was USD 1.7 billion which had been increased by 27 percent during the last five years. Despite an increase in the budget, effort to build Assistive Technology Service Delivery System (ATSDS) was not enough. Therefore, Ministry of Health and Welfare in Korea decided to build ATSDS in Republic of Korea in 2009. In this paper, the process of establishing ATSDS and 2014 outcomes of ATSDS are presented in details. For more than six years efforts of establishing national-wide ATSDS, nine Assistive Technology Centers were actively running in their delivery of service in 2014. As of 2014 outcomes of ATSDS, 14,056 cases were delivered through nine Assistive Technology Centers. The presence of ATSDS proved increase in accessibility for Assistive Technology for People with Disability followed by improvement of the quality of life of them. PMID:26294599

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

    PubMed Central

    2014-01-01

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

  13. Closing the delivery gaps in pediatric HIV care in Togo, West Africa: using the care delivery value chain framework to direct quality improvement.

    PubMed

    Fiori, Kevin; Schechter, Jennifer; Dey, Monica; Braganza, Sandra; Rhatigan, Joseph; Houndenou, Spero; Gbeleou, Christophe; Palerbo, Emmanuel; Tchangani, Elfamozo; Lopez, Andrew; Bensen, Emily; Hirschhorn, Lisa R

    2016-03-01

    Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, improve communication, and coordinate activities. We report on the successful application of the CDVC as a strategy to optimize care delivery and inform quality improvement (QI) efforts with the overall aim of improving care for Pediatric HIV patients in Togo, West Africa. Over the course of 12 months, 13 distinct QI activities in Pediatric HIV/AIDS care delivery were monitored, and 11 of those activities met or exceeded established targets. Examples included: increase in infants receiving routine polymerase chain reaction testing at 2 months (39-95%), increase in HIV exposed children receiving confirmatory HIV testing at 18 months (67-100%), and increase in patients receiving initial CD4 testing within 3 months of HIV diagnosis (67-100%). The CDVC was an effective approach for evaluating existing systems and prioritizing gaps in delivery for QI over the full cycle of Pediatric HIV/AIDS care in three specific ways: (1) facilitating the first comprehensive mapping of Pediatric HIV/AIDS services, (2) identifying gaps in available services, and (3) catalyzing the creation of a responsive QI plan. The CDVC provided a framework to drive meaningful, strategic action to improve Pediatric HIV care in Togo. PMID:27391996

  14. Closing the delivery gaps in pediatric HIV care in Togo, West Africa: using the care delivery value chain framework to direct quality improvement

    PubMed Central

    Fiori, Kevin; Schechter, Jennifer; Dey, Monica; Braganza, Sandra; Rhatigan, Joseph; Houndenou, Spero; Gbeleou, Christophe; Palerbo, Emmanuel; Tchangani, Elfamozo; Lopez, Andrew; Bensen, Emily; Hirschhorn, Lisa R.

    2016-01-01

    ABSTRACT Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, improve communication, and coordinate activities. We report on the successful application of the CDVC as a strategy to optimize care delivery and inform quality improvement (QI) efforts with the overall aim of improving care for Pediatric HIV patients in Togo, West Africa. Over the course of 12 months, 13 distinct QI activities in Pediatric HIV/AIDS care delivery were monitored, and 11 of those activities met or exceeded established targets. Examples included: increase in infants receiving routine polymerase chain reaction testing at 2 months (39–95%), increase in HIV exposed children receiving confirmatory HIV testing at 18 months (67–100%), and increase in patients receiving initial CD4 testing within 3 months of HIV diagnosis (67–100%). The CDVC was an effective approach for evaluating existing systems and prioritizing gaps in delivery for QI over the full cycle of Pediatric HIV/AIDS care in three specific ways: (1) facilitating the first comprehensive mapping of Pediatric HIV/AIDS services, (2) identifying gaps in available services, and (3) catalyzing the creation of a responsive QI plan. The CDVC provided a framework to drive meaningful, strategic action to improve Pediatric HIV care in Togo. PMID:27391996

  15. AAV Hybrid Serotypes: Improved Vectors for Gene Delivery

    PubMed Central

    Choi, Vivian W.; McCarty, Douglas M.; Samulski, R. Jude

    2006-01-01

    In recent years, significant efforts have been made on studying and engineering adeno-associated virus (AAV) capsid, in order to increase efficiency in targeting specific cell types that are non-permissive to wild type (wt) viruses and to improve efficacy in infecting only the cell type of interest. With our previous knowledge of the viral properties of the naturally occurring serotypes and the elucidation of their capsid structures, we can now generate capsid mutants, or hybrid serotypes, by various methods and strategies. In this review, we summarize the studies performed on AAV retargeting, and categorize the available hybrid serotypes to date, based on the type of modification: 1) transcapsidation, 2) adsorption of bi-specific antibody to capsid surface, 3) mosaic capsid, and 4) chimeric capsid. Not only these hybrid serotypes could achieve high efficiency of gene delivery to a specific targeted cell type, which can be better-tailored for a particular clinical application, but also serve as a tool for studying AAV biology such as receptor binding, trafficking and genome delivery into the nucleus. PMID:15975007

  16. Factors impacting the use of antenatal care and hospital child delivery services: a case study of rural residents in the Enshi Autonomous Prefecture, Hubei Province, China.

    PubMed

    Zhang, Yin; Chen, Minxing; Lu, Jun; Hao, Mo; Zhang, Changli; Sun, Mei; Li, Xiaohong; Chang, Fengshui

    2015-01-01

    This study was undertaken to understand the factors that impact whether rural women obtain antenatal care (ANC) and choose to use hospital delivery services in central and western China. We chose to conduct field research with the rural residents in Hubei Province through a combination of random sampling and purposive sampling methods. A mixed method approach was taken to analyze the factors impacting the use of ANC and hospital delivery services from the perspective of the villagers. Our results indicate that the quality of the available ANC services is poor. In particular, women who have special circumstances and unplanned pregnancies or who become pregnant prior to marriage are confronted with inadequate ANC and hospital child delivery services. The factors that impact whether women use or not use ANC and hospital delivery services and that cause women to choose hospital or home delivery can be understood at three levels: macro, middle, and micro. We strongly suggest that the policies and projects that promote maternal healthcare in rural areas be sustained with an added focus on including women with special circumstances. Village doctors can be enlisted to regularly visit pregnant women at home and to provide extra explanation about the ANC services available and the purpose of maternal healthcare. These findings and suggestions can be used by local health providers and decision-makers to improve the quality of ANC and hospital delivery services. PMID:24446091

  17. Overview on gastroretentive drug delivery systems for improving drug bioavailability.

    PubMed

    Lopes, Carla M; Bettencourt, Catarina; Rossi, Alessandra; Buttini, Francesca; Barata, Pedro

    2016-08-20

    In recent decades, many efforts have been made in order to improve drug bioavailability after oral administration. Gastroretentive drug delivery systems are a good example; they emerged to enhance the bioavailability and effectiveness of drugs with a narrow absorption window in the upper gastrointestinal tract and/or to promote local activity in the stomach and duodenum. Several strategies are used to increase the gastric residence time, namely bioadhesive or mucoadhesive systems, expandable systems, high-density systems, floating systems, superporous hydrogels and magnetic systems. The present review highlights some of the drugs that can benefit from gastroretentive strategies, such as the factors that influence gastric retention time and the mechanism of action of gastroretentive systems, as well as their classification into single and multiple unit systems. PMID:27173823

  18. Environmental Monitoring System for Home-Delivery Service of Packages by Using MEMS Sensors

    NASA Astrophysics Data System (ADS)

    Fujita, Takayuki; Masaki, Kentaro; Maenaka, Kazusuke

    Nowadays, home-delivery services of packages are imperative in everyday life. These service industries are trying to provide cheaper, faster and safer service. However, package condition and handling during transportation are not disclosed to a customer. In this study, we realized a prototype system by MEMS technology for measuring the environmental conditions around a package for home-delivery service. The system includes barometric pressure, temperature, relative humidity and three dimensional acceleration (shock) sensing devices, as well as an interface circuitry. The system is a size of 115 × 54 × 10 mm3 and a weight of 50 g. We measured the package conditions during the transportation by three Japanese domestic home-delivery services, and using data mining, we were able to obtain a representation of the package's circumstances.

  19. Measuring the Delivery of Special Education Services in a Large Urban District: Lessons from the Los Angeles Unified School District

    ERIC Educational Resources Information Center

    Harr, Jenifer J.; Oliver, Deborah F.; Ramanathan, Arun; Socias, Miguel

    2008-01-01

    Special education service delivery is often the source of disputes between parents and districts and an issue in special education class-action lawsuits. Despite these controversies, there has been little large-scale research on the delivery of services. This study represents a large-scale assessment of the delivery of special education services…

  20. Road Sediment Production and Delivery: Processes, Rates, and Possible Improvements

    NASA Astrophysics Data System (ADS)

    MacDonald, Lee; Ramos-Scharron, Carlos; Coe, Drew; Stafford, Alexander; Welsh, Matthew; Korte, Abby; Libohova, Zamir; Brown, Ethan; James, Cajun

    2013-04-01

    -dominated area. Connectivity was less than 20% in permeable volcanics in California and coarse-textured soils in the Colorado Front Range. Road-stream crossings accounted for most of the connected segments, as in temperate forests drainage rills and sediment plumes rarely extend for more than 50 m. Few studies have quantified the effects of unpaved roads on watershed-scale sediment yields, but in northern California the estimated sediment yield was 1.4 Mg yr-1 per kilometer of road, while in Colorado the long-term, chronic sediment production from roads was estimated to be about 1 Mg km-2 yr-1. On St. John roads were estimated to increase watershed-scale sediment production by 3-9 times, indicating that the road sediments are a critical stressor to near-shore coral reefs. Relatively simple management actions can greatly reduce sediment production and delivery from unpaved roads, but the necessary improvements are constrained by the lack of political will and funding.

  1. When Special Education Trumps ESL: An Investigation of Service Delivery for ELLs with Disabilities

    ERIC Educational Resources Information Center

    Kangas, Sara E. N.

    2014-01-01

    Through an ethnographic study of one suburban elementary school, the delivery of services to English language learners (ELLs) with disabilities was investigated. The data analysis revealed that often disability-related and English as a Second Language (ESL) services were in contention, as scheduling, teacher expertise, school culture, and ESL…

  2. Going the Extra Mile: Designing a Delivery Service for Remote Borrowers

    ERIC Educational Resources Information Center

    Long, Dallas

    2009-01-01

    This article documents the development of delivery services of library materials to remote borrowers at Milner Library, Illinois State University. Responding to a university mandate and guidelines for distance learning authored by the Association of College and Research Libraries, the Access Services librarians at Milner Library investigated the…

  3. Early Childhood Service Delivery for Families Living with Childhood Disability: Disabling Families through Problematic Implicit Ideology

    ERIC Educational Resources Information Center

    Breen, Lauren J.

    2009-01-01

    The aim of this paper is to unpack the implicit ideology underpinning early childhood service delivery for families living with childhood disability. The family as the unit of care is central to the philosophy and practice of early childhood services. However, the practice of family-centred care can be problematic; it is based upon neo-liberal…

  4. Speech-Language Pathologists' Perceptions of Integrated Service Delivery in School Settings.

    ERIC Educational Resources Information Center

    Elksnin, Linda K.; Capilouto, Gilson J.

    1994-01-01

    This survey of 31 speech-language pathologists who had adopted or were considering adopting integrated service delivery models examined their perceptions of their expertise; classroom teacher expertise; types of speech and language services provided in classrooms; characteristics of students served; and advantages and disadvantages of integrated…

  5. Northeast Conference on Rural HIV Service Delivery (Burlington, Vermont, October 23-24, 2000). Summary Report.

    ERIC Educational Resources Information Center

    McKinney, Martha M.

    The Northeast Conference on Rural HIV Service Delivery was attended by 51 health and social service professionals, people with HIV, and federal and state health officials with expertise or interest in developing HIV care capacity in rural areas. Low population density, low prevalence of HIV/AIDS, rugged topography and climate, and limited health…

  6. Perceptions of International Students on Service Quality Delivery in a Malaysian Public University

    ERIC Educational Resources Information Center

    Njie, Baboucarr; Asimiran, Soaib; Baki, Roselan

    2012-01-01

    Purpose: The purpose of this study is to explore the perceptions of international students of service quality delivery (SQD) in a Malaysian public university. Design/methodology/approach: The study was limited to the University's immediate physical environment and its associated human and systems-based services. The physical environment in this…

  7. Mental Health Services for People with Intellectual Disability: Challenges to Care Delivery

    ERIC Educational Resources Information Center

    Chaplin, Eddie; O'Hara, Jean; Holt, Geraldine; Bouras, Nick

    2009-01-01

    The commissioning and provision of mental health services for people with intellectual disability is often complex and characterised by different service delivery models. This paper looks at the current situation 7 years after the White Paper, Valuing People (From words into action: London learning disabilities strategic framework, Department of…

  8. Improved delivery of the natural anticancer drug tetrandrine.

    PubMed

    Shi, Chen; Ahmad Khan, Saeed; Wang, Kaiping; Schneider, Marc

    2015-02-01

    The study aims at designing a nanoparticle-based delivery system to improve the efficacy of the natural compound tetrandrine against lung cancer. Nanoparticles from poly(lactic-co-glycolic acid) (PLGA) were prepared by the emulsion solvent diffusion method and characterized for their physicochemical properties and drug-loading efficiency. Furthermore, the cellular uptake and the anti-cancerous activity was studied on A549 cell line. To investigate the surface properties and uptake, three different stabilizers were used to analyze the effect on size and zeta potential of nanoparticles as well as the effect on the cellular uptake. Nanoparticles in the size range of 180-200 nm with spherical shape were obtained with polyvinyl alcohol (PVA), Pluronic-F127 (PF127) and didodecyldimethylammonium bromide (DMAB), 2%, 1% and 0.1%, respectively. An entrapment efficiency of 50-60% with a loading of 1.5-2% was observed. In vitro release profile at pH 7.4 PBS solution showed a consistent release over 168 h. All particle systems showed an improved performance over the pure drug at the same drug concentration. DMAB stabilized particles demonstrated the most pronounced effect against A549 cells compared to pure drug while PVA stabilized particles were least effective in terms of antitumor activity. PMID:25510598

  9. What Family Support Specialists Do: Examining Service Delivery

    PubMed Central

    Wisdom, Jennifer P.; Lewandowski, R. Eric; Pollock, Michele; Acri, Mary; Shorter, Priscilla; Olin, S. Serene; Armusewicz, Kelsey; Horwitz, Sarah; Hoagwood, Kimberly E.

    2013-01-01

    This study describes services provided by family support specialists (FSS), peer advocates in programs for children with serious psychiatric conditions, to delineate differences between recommended components of FSS services and services actually provided. An analysis of qualitative interview and observational data and quantitative survey data from 63 staff at 21 mental health programs in New York identified that FSS and other staff have generally similar ideas about FSS services, and that these perceptions of activities are generally congruent with what FSS actually did. Implications of findings are discussed in the context of developing competencies and quality indicators for FSS. PMID:24174330

  10. What family support specialists do: examining service delivery.

    PubMed

    Wisdom, Jennifer P; Lewandowski, R Eric; Pollock, Michele; Acri, Mary; Shorter, Priscilla; Olin, S Serene; Armusewicz, Kelsey; Horwitz, Sarah; Hoagwood, Kimberly E

    2014-01-01

    This study describes services provided by family support specialists (FSS), peer advocates in programs for children with serious psychiatric conditions, to delineate differences between recommended components of FSS services and services actually provided. An analysis of qualitative interview and observational data and quantitative survey data from 63 staff at 21 mental health programs in New York identified that FSS and other staff have generally similar ideas about FSS services, and that these perceptions of activities are generally congruent with what FSS actually did. Implications of findings are discussed in the context of developing competencies and quality indicators for FSS. PMID:24174330