24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2014 CFR

2014-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

24 CFR 583.235 - Renewal grants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... as in effect before October 28, 1992, may be renewed on a noncompetitive basis to continue ongoing leasing, operations, and supportive services for additional years beyond the initial funding period. To be considered for renewal funding for leasing, operating costs, or supportive services, recipients must submit a...

45 CFR 1326.15 - Nutrition services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to...

45 CFR 1326.15 - Nutrition services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to...

45 CFR 1326.15 - Nutrition services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to...

45 CFR 1326.15 - Nutrition services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to...

45 CFR 1326.15 - Nutrition services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Nutrition services. 1326.15 Section 1326.15 Public... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to...

On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems

PubMed Central

García-Valls, Marisol; Touahria, Imad Eddine

2017-01-01

Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded, achieving a low overhead resulting from the addition of ICE compliance. PMID:28594371

On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems.

PubMed

García-Valls, Marisol; Touahria, Imad Eddine

2017-06-08

Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded, achieving a low overhead resulting from the addition of ICE compliance.

Expeditionary Logistics: How the Marine Corps Supports Its Expeditionary Operations

DTIC Science & Technology

2015-06-01

little additional information of value with regard to the U.S. Marine Corps and expeditionary logistics methodology. Since the expeditionary methodology...size and scope, necessitating differing levels of material support. Additionally , the same variables define the level of Combat Service Support that is...lie outside of doctrine and few manuals have been written discussing how the Marine Corps performs expeditionary logistics. Additionally , few sources

45 CFR 1328.15 - Nutrition services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide nutrition...

45 CFR 1328.15 - Nutrition services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide nutrition...

45 CFR 1328.15 - Nutrition services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide nutrition...

45 CFR 1328.15 - Nutrition services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide nutrition...

45 CFR 1328.15 - Nutrition services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Nutrition services. 1328.15 Section 1328.15 Public... SUPPORTIVE AND NUTRITIONAL SERVICES TO OLDER HAWAIIAN NATIVES § 1328.15 Nutrition services. (a) In addition to providing nutrition services to older Hawaiian Natives, a grantee may: (1) Provide nutrition...

A Needs Assessment in Employee Services--Industrial Recreation.

ERIC Educational Resources Information Center

Whitlock, Michael; And Others

1980-01-01

Industrial recreation is becoming an important company support service. Budgets for recreation are modest compared to services offered and additional sources are needed. Employees take an active part in administration of programs. Competitive athletics, special social programs and local services are popular. (JAC)

45 CFR 1357.16 - Annual progress and services reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in the statement of goals and objectives, or to the training plan, if necessary, to reflect changed... support services to be provided in the upcoming fiscal year highlighting any changes in services or... services to be provided in the upcoming fiscal year highlighting any additions or changes in services or...

Investigating preferences for support with life after stroke: a discrete choice experiment.

PubMed

Burton, Christopher R; Fargher, Emily; Plumpton, Catrin; Roberts, Gwerfyl W; Owen, Heledd; Roberts, Eryl

2014-02-08

There is little evidence of service user preferences to guide the commissioning and improvement of services that support life after stroke. We report the first investigation of patients' and family carers' preferences for community services after stroke using a discrete choice experiment (DCE). Two workshops with patients and family carers (n = 8) explored stroke experiences, identifying attributes important in shaping views about service design, and piloted data collection strategies. Attributes were group versus individual support; service provider; additional support for social and leisure activities; and the total time required to access services. Patients and family carers were recruited six months post stroke-onset (mean 331 days) from four stroke services, and invited to participate in the DCE. Patients' general health (EQ5D) and functional dependence (Barthel Index) were also assessed. Of 474 eligible patients, 144 (30%) expressed an interest in the study, and 80 (56%) of these completed the survey questionnaire. 34 of 74 (46%) family carers recruited through patients completed the DCE. All four attributes were significant in shaping patients preferences for stroke support service delivery (p < 0.05), confirming the interpretation of workshop findings. Patients prefer help and support for emotional needs, communication problems and physical difficulties to be provided on an individual basis; and to be offered additional social and leisure activities that they are able to attend on their own. Patients would appear to prefer that voluntary organisations do not provide these services, although this may be linked to lack of experience of these services. Family carers would prefer help and support in their caring role on a one-to-one basis. Whilst health related quality of life is associated with preference for format of service, results were relatively consistent across sub-groups, with the exception of time since stroke, where social and leisure activities had a greater impact on preferences of established service users. The data provide unique insights into how preferences for community services that support life after stroke are shaped. This information can be used to inform both service re-design, and barriers to implementation that will need to be accounted for in policy shifts towards a more mixed economy of service provision.

Department of Defense Annual Report on Sexual Harassment and Violence at the Military Service Academies: Academic Program Year 2013-2014

DTIC Science & Technology

2015-02-01

healthy relationships, active bystander intervention, social courage, and core values that support the establishment of mutual respect. In addition ... values that support the establishment of mutual respect. In addition , describe your efforts to review policies that influence culture and behavior at...and core values that support the establishment of mutual respect. In addition , describe your efforts to review policies that influence culture and

7 CFR 29.3 - Procedures for filing, hearing, and determination of applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of Tobacco Inspection and Price Support Services to New Markets and to Additional Sales on Designated Markets § 29.3 Procedures for filing, hearing, and determination of applications. (a) Time and place of filing. Applications for the extension of tobacco inspection and price support services to new markets...

Unmet needs and service satisfaction of victim support for the direct and indirect victims of serious violence: Results from a cross-sectional survey in Taiwan

PubMed Central

2018-01-01

Victim support services, in mature societies, aim to help victims recover after suffering a traumatic event. The effectiveness of victim support has traditionally been evaluated through rates of service utilization and incidence of psychopathology such as posttraumatic stress disorder. The current study, instead, inquires into service users’ unmet needs and satisfaction, and identifies factors that mediate such subjective measures, using data from a national cross-sectional survey on victims and surviving families of violent crime in Taiwan in 2011. The results reveal: 1) a gap between available and expected services, and 2) a correlation between service utilization and satisfaction, both consistent with previous studies. In addition, the current study identifies unsatisfied service users: They are homicidally bereaved, live with their spouse, suffer from post-crime financial distress and are still waiting for a court verdict on the incident. Victim support that helps victims heal through tailored services incorporating relationship counseling is proposed. PMID:29466463

Warrants, design, and safety of road ranger service patrols : draft final report.

DOT National Transportation Integrated Search

2016-11-01

This research project created a decision support system for managers who must decide if a roadway warrants the addition of the Safety Service Patrol (SSP). Meetings with Florida Department of Transportation (FDOT) service patrol program manager...

New Data Services for Polar Investigators from Integrated Earth Data Applications (IEDA)

NASA Astrophysics Data System (ADS)

Nitsche, F. O.; Ferrini, V.; Morton, J. J.; Arko, R. A.; McLain, K.; O'hara, S. H.; Carbotte, S. M.; Lehnert, K. A.; IEDA Team, I.

2013-12-01

Accessibility and preservation of data is needed to support multi-disciplinary research in the key environmentally sensitive Polar Regions. IEDA (Integrated Earth Data Applications) is a community-based data facility funded by the US National Science Foundation (NSF) to support, sustain, and advance the geosciences by providing data services for observational solid earth data from the Ocean, Earth, and Polar Sciences. IEDA tools and services relevant to the Polar Research Community include the Antarctic and Southern Ocean Data System (ASODS), the U.S. Antarctic Program Data Coordination Center (USAP-DCC), GeoMapApp, as well as a number of services for sample-based data (SESAR and EarthChem). In addition to existing tools, which assist Polar investigators in archiving their data, and creating DIF records for global searches in AMD, IEDA recently added several new tools and services that will provide further support for investigators with the data life cycle process. These include a data management plan (http://www.iedadata.org/compliance/plan) and data compliance reporting tool (http://www.iedadata.org/compliance/report) that will help investigators comply with the requirements of funding agencies such as the National Science Foundation (NSF). Data, especially from challenging Polar Regions, are likely to be used by other scientists for future studies. Therefore, data acknowledgment is an important concern of many investigators. To encourage data acknowledgments by data users, we link references of publications (when known) to datasets and cruises registered within the ASODS system as part of our data curation services (http://www.marine-geo.org/portals/antarctic/references.php). In addition, IEDA offers a data publication service to register scientific data with DOI's, making data sets citable as publications with attribution to investigators as authors. IEDA is a publication agent of the DataCite consortium. Offering such services provides additional incentives for making data available through data centers. Such tools and services are important building blocks of a coherent and comprehensive (cyber) data support structure for Polar investigators.

Development and evaluation of theory-based diabetes support services.

PubMed

Guo, Sophie Huey-Ming; Lin, Yung-Hsiu; Chen, Rong-Rong; Kao, Shu-Fen; Chang, Her-Kun

2013-01-01

Technology-enabled support services for diabetes can fulfill patient demand to care for diabetes independently. Patients benefit from such services after greater adoption of the services in healthcare systems. Unfortunately, conventional service development fails to thoroughly understand patient care support, making it difficult to achieve the desired design, and posing substantial challenges in adopting these services. Thus, previously developed services in many cases are not as patients expected, as evidenced by their low acceptance among patients. To solve this problem, adequate strategies must be developed by incorporating theoretical knowledge as a solid foundation in order to improve service design. This study develops technology-enabled diabetes support services based on the self-care theory. A set of self-care service scenarios is also established and combined with theoretical concepts. The developed services consist of a nurse-led consultation service and a mobile application service. Additionally, user acceptance is confirmed by assessing patient perceptions of the diabetes support services in a group of patients with diabetes (N=27). Results of analysis reveal that patients respond favorably toward the services. Patient preference and perceived ease of use attest to their intention to use the services. Greater adoption of the services can be anticipated, owing to a higher levels of preference and higher perceived ease of use. This study demonstrated that the self-care theory can be linked to nursing informatics research and chronic care clinical practices.

78 FR 71581 - Procurement List; Additions and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-29

... Prime Vendor Supply Chain Management Service [to support production, assembly, receipt, storage... Army, W6QK ACC-APG Natick, Natick, MA. Service Type/Location: Integrated Prime Vendor, Supply Chain...

Expanding roles in a library-based bioinformatics service program: a case study

PubMed Central

Li, Meng; Chen, Yi-Bu; Clintworth, William A

2013-01-01

Question: How can a library-based bioinformatics support program be implemented and expanded to continuously support the growing and changing needs of the research community? Setting: A program at a health sciences library serving a large academic medical center with a strong research focus is described. Methods: The bioinformatics service program was established at the Norris Medical Library in 2005. As part of program development, the library assessed users' bioinformatics needs, acquired additional funds, established and expanded service offerings, and explored additional roles in promoting on-campus collaboration. Results: Personnel and software have increased along with the number of registered software users and use of the provided services. Conclusion: With strategic efforts and persistent advocacy within the broader university environment, library-based bioinformatics service programs can become a key part of an institution's comprehensive solution to researchers' ever-increasing bioinformatics needs. PMID:24163602

The parental attitudes toward psychological services inventory: adaptation and development of an attitude scale.

PubMed

Turner, Erlanger A

2012-08-01

The purpose of this paper is to provide psychometric data on the Parental Attitudes Toward Psychological Services Inventory (PATPSI), which is a revised measure to assess parents' attitudes toward outpatient mental health services. Using a sample of adults (N = 250), Study 1 supported a 3-factor structure (RMSEA = .05, NNFI = .94, and CFI = .94), adequate internal consistency (ranging from .72 to .92), and test-retest reliability (ranging from .66 to .84). Additionally, results indicated that individuals with previous use of mental health services reported more positive views toward child mental health services. Study 2 provided confirming evidence of the 3-factor structure (NNFI = .94, RMSEA = .08, and the CFI = .95) and adequate reliability (ranging from .70 to .90) using a parent-sample (N = 260). Additionally, discriminate validity of the PATPSI was supported. Implications for research and clinical practice are discussed.

76 FR 18189 - Procurement List; Additions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

...: Professional Contract Services, Inc., Austin, TX. Contracting Activity: Dept of the Army, XR W40M Natl Region Contract OFC, Washington, DC. Service Type/Location: Prime Vendor Support for Foreign Military Sales...

Public health for paediatricians: engaging young people from marginalised groups.

PubMed

Rigby, Emma; Starbuck, Lindsay

2017-08-10

Young people from marginalised groups can be excluded from health services because of reduced access, increased stigma and health inequalities. In addition, the stress associated with discrimination and stigma can have serious effects on individual health. This article explores how stigma affects young people's access to services and how health professionals can improve their practice and support for marginalised young people to achieve the best possible health outcomes. A better understanding of local populations of young people and their needs is key to improving services and support. Working in partnership with voluntary and community sector organisations is also important. In addition, improvements can be made by promoting better communication with young people and providing extra support to help them follow treatment plans. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An Examination of the Addition of Video Informed Reflective Practice to the Active Support Toolkit

ERIC Educational Resources Information Center

Baker, Peter; Appleton, Philippa; Williams, Rosie

2017-01-01

Background: This study evaluated a package of Active Support (AS), which included standard training with additional video informed reflective practice. Materials & Methods: The training package was implemented as part of a service improvement initiative in four residential intellectual disability homes, using a concurrent multiple baseline…

Refocusing and Evolving Subseasonal-to-Seasonal Services in NOAA's National Weather Service

NASA Astrophysics Data System (ADS)

Timofeyeva-Livezey, M. M.; Horsfall, F. M. C.; Silva, V.; Mangan, M. R.; Meyers, J. C.; Zdrojewski, J.

2017-12-01

NOAA's National Weather Service (NWS) recently completed a reorganization to better support its goal to build a Weather-Ready Nation. As part of the reorganization, NWS streamlined its 11 national service programs, including climate services, to provide a more structured approach to supporting service delivery needs. As the American public increasingly requests information at sub-seasonal and seasonal time scales for decision making, the NWS Climate Services Program is striving to meet those needs by accelerating transition of research to operations, improving delivery of products and services, and enhancing partnerships to facilitate provision of seamless weather, water, and climate products and services at regional and local scales. Additionally, NWS forecasters are requesting more tools to be able to put severe weather and water events into a climate context to provide more effective impact-based decision support services (IDSS). This paper will describe the activities to more effectively integrate climate services into the NWS suite of environmental information, the roles of the NWS offices supporting or delivering sub-seasonal and seasonal information to the US public, and engaging NWS core and deep-core partners in provision of information on climatological risks and preparedness as a part of IDSS. We will discuss the process by which we collect user requests and/or needs and the NWS process that allows us to move these requests and needs through a formal requirements validation process and thus place the requirement on a path to identify a potential solution for implementation. The validation of a NWS climate-related requirement is also key to identify research, development, and transition mission delivery needs that are supported through the Office of Oceanic and Atmospheric Research (OAR) Climate Program Office (CPO). In addition, we will present the outcomes of key actions of the first ever NWS National Climate Services Meeting (NCSM) that was held in May 2016 with the participation of more than 250 NWS climate services staff and key partners from across the country. The key actions include understanding core and deep-core partners, advancing training for NWS staff focused on IDSS, and better organization of service delivery at regional and local levels.

Do Hospitals Support Second Victims? Collective Insights From Patient Safety Leaders in Maryland.

PubMed

Edrees, Hanan H; Morlock, Laura; Wu, Albert W

2017-09-01

Second victims-defined as health care providers who are emotionally traumatized after a patient adverse event-may not receive needed emotional support. Although most health care organizations have an employee assistance program (EAP), second victims may be reluctant to access this service because of worries about confidentiality. A study was conducted to describe the extent to which organizational support for second victims is perceived as desirable by patient safety officers in acute care hospitals in Maryland and to identify existing support programs. Semistructured interviews (using existing and newly developed questions) were conducted with 43 patient safety representatives from 38 of the 46 acute care hospitals in Maryland (83% response rate). All but one of the responding hospitals offered EAP services to their employees, but there were gaps in the services provided related to timeliness, EAP staff's ability to relate to clinical providers, and physical accessibility. There were no valid measures in place to assess the effectiveness of EAP services. Participants identified a need for peer support, both for the second victim and potentially for individuals who provide that support. Six (16%) of the 38 hospitals had second victim support programs, which varied in structure, accessibility, and outcomes, while an additional 5 hospitals (13%) were developing such a program. Patient safety officers thought their organizations should reevaluate the support currently provided by their EAPs, and consider additional peer support mechanisms. Future research is needed to evaluate the effectiveness of these programs. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... on DoD installations shall be provided logistic support as set forth in 32 CFR part 231. (6) Military... services (to include in-store banking) requiring the outgrant of additional space or logistical support...

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... on DoD installations shall be provided logistic support as set forth in 32 CFR part 231. (6) Military... services (to include in-store banking) requiring the outgrant of additional space or logistical support...

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... on DoD installations shall be provided logistic support as set forth in 32 CFR part 231. (6) Military... services (to include in-store banking) requiring the outgrant of additional space or logistical support...

77 FR 30411 - Connect America Fund; High-Cost Universal Service Support

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-23

... ``benchmarks'' for high cost loop support (HCLS). The methodology the Bureau adopts, builds on the analysis... to support continued broadband investment. The methodology the Bureau adopts today is described in... methodology, HCLS will be recalculated to account for the additional support available under the overall cap...

NASA Customer Data and Operations System

NASA Technical Reports Server (NTRS)

Butler, Madeline J.; Stallings, William H.

1991-01-01

In addition to the currently provided NASA services such as Communications and Tracking and Data Relay Satellite System services, the NASA's Customer Data and Operations System (CDOS) will provide the following services to the user: Data Delivery Service, Data Archive Service, and CDOS Operations Management Service. This paper describes these services in detail and presents respective block diagrams. The CDOS services will support a variety of multipurpose missions simultaneously with centralized and common hardware and software data-driven systems.

Customer Service Analysis of Air Combat Command Vehicle Maintenance Support

DTIC Science & Technology

1993-09-01

the survey, the researchers categorized the services or variables into marketing mix components: product, price, promotion, and customer service...comparing and analyzing the variables identified in the previous three phases to determine a strategic marketing mix (46:9). After analyzing the data...service/physical distribution. Additionally, they found that customer service/physical distribution was an integral component of the marketing mix , and

CCSDS Mission Operations Action Service Core Capabilities

NASA Technical Reports Server (NTRS)

Reynolds, Walter F.; Lucord, Steven A.; Stevens, John E.

2009-01-01

This slide presentation reviews the operations concepts of the command (action) services. Since the consequences of sending the wrong command are unacceptable, the command system provides a collaborative and distributed work environment for flight controllers and operators. The system prescribes a review and approval process where each command is viewed by other individuals before being sent to the vehicle. The action service needs additional capabilities to support he operations concepts of manned space flight. These are : (1) Action Service methods (2) Action attributes (3) Action parameter/argument attributes (4 ) Support for dynamically maintained action data. (5) Publish subscri be capabilities.

Chip-set for quality of service support in passive optical networks

NASA Astrophysics Data System (ADS)

Ringoot, Edwin; Hoebeke, Rudy; Slabbinck, B. Hans; Verhaert, Michel

1998-10-01

In this paper the design of a chip-set for QoS provisioning in ATM-based Passive Optical Networks is discussed. The implementation of a general-purpose switch chip on the Optical Network Unit is presented, with focus on the design of the cell scheduling and buffer management logic. The cell scheduling logic supports `colored' grants, priority jumping and weighted round-robin scheduling. The switch chip offers powerful buffer management capabilities enabling the efficient support of GFR and UBR services. Multicast forwarding is also supported. In addition, the architecture of a MAC controller chip developed for a SuperPON access network is introduced. In particular, the permit scheduling logic and its implementation on the Optical Line Termination will be discussed. The chip-set enables the efficient support of services with different service requirements on the SuperPON. The permit scheduling logic built into the MAC controller chip in combination with the cell scheduling and buffer management capabilities of the switch chip can be used by network operators to offer guaranteed service performance to delay sensitive services, and to efficiently and fairly distribute any spare capacity to delay insensitive services.

Types of support to families of children with disabilities and their influence on family quality of life.

PubMed

Araújo, Clarissa Altina Cunha de; Paz-Lourido, Berta; Gelabert, Sebastià Verger

2016-10-01

Different types of supports to families are among the aspects that contribute to family quality of life. This study aims to identify the types of supports that families of children with disabilities, users of early intervention services, consider relevant and how public administration influences the quality of this support. This is a qualitative study based on a critical social paradigm. Sixteen mothers and four fathers were interviewed and their contributions were analyzed using discourse analysis. The importance of family support and networks of parents of children with disabilities were highlighted. The role of the supports by health professionals is also crucial and, therefore, cuts in public health and social services have exacerbated the inequity in health. In practice this is highlighted in relation to those who can and the ones who cannot afford additional services. Other approaches in the support to families are suggested.

Satellite Communications for ATM

NASA Technical Reports Server (NTRS)

Shamma, Mohammed A.

2003-01-01

This presentation is an overview on Satellite Communication for the Aeronautical Telecommunication Management (ATM) research. Satellite Communications are being considered by the FAA and NASA as a possible alternative to the present and future ground systems supporting Air Traffic Communications. The international Civil Aviation Organization (ICAO) have in place Standards and Recommended Practices (SARPS) for the Aeronautical Mobile Satellite Services (AMSS) which is mainly derived from the pre-existing Inmarsat service that has been in service since the 1980s. The Working Group A of the Aeronautical Mobile Communication Panel of ICAO has also been investigating SARPS for what is called the Next Generation Satellite Service (NGSS) which conforms less to the Inmarsat based architecture and explores wider options in terms of satellite architectures. Several designs are being proposed by Firms such as Boeing, ESA, NASA that are geared toward full or secondary usage of satellite communications for ATM. Satellite communications for ATM can serve several purposes ranging from primary usage where ground services would play a minimal backup role, to an integrated solution where it will be used to cover services, or areas that are less likely to be supported by the proposed and existing ground infrastructure. Such Integrated roles can include usage of satellite communications for oceanic and remote land areas for example. It also can include relieving the capacity of the ground network by providing broadcast based services of Traffic Information Services messages (TIS-B), or Flight Information Services (FIS-B) which can take a significant portion of the ground system capacity. Additionally, satellite communication can play a backup role to support any needs for ground replacement, or additional needed capacity even after the new digital systems are in place. The additional bandwidth that can be provided via satellite communications can also open the door for many new applications that generally will enhance the standard services provided. All of those possibilities were investigated and comments, as well as descriptions of those analyses are put forward, as well as suggestions for future areas of study.

Department of Defense Dictionary of Military and Associated Terms

DTIC Science & Technology

2000-09-01

USSPACECOM USSOCOM USSTRATCOM USTRANSCOM Additional copies should be obtained from the Military Service assigned administrative support responsibility by...and tactics. 2. Internal management of units. short that biological recovery cannot occur. administrative airlift service --The airlift service ACV...internal administration . 5 Joint Pub 1-02 (As Amended through 1 September 2000) administrative control--Direction or exercise service and maintenance areas

UK women's experiences of breastfeeding and additional breastfeeding support: a qualitative study of Baby Café services.

PubMed

Fox, Rebekah; McMullen, Sarah; Newburn, Mary

2015-07-07

Whilst 81 % of UK women initiate breastfeeding, there is a steep decline in breastfeeding rates during the early postnatal period, with just 55 % of women breastfeeding at six weeks. 80 % of these women stopped breastfeeding sooner than they intended, with women citing feeding difficulties and lack of adequate support. As part of efforts to increase breastfeeding continuation rates, many public and voluntary organisations offer additional breastfeeding support services, which provide practical support in the early postnatal period and beyond. This paper focuses on the qualitative experiences of UK users of Baby Café services to examine their experiences of breastfeeding and breastfeeding support. The study was based upon in-depth interviews and focus groups with users of eight Baby Café breastfeeding support groups across the UK. Thirty-six interviews and five focus groups were conducted with a total of fifty-one mothers using the service. Interviews and group discussions were analysed using N Vivo software to draw out key themes and discussions. Whilst each mother's infant feeding journey is unique, reflecting her own personal circumstances and experiences, several themes emerged strongly from the data. Many women felt that they had been given unrealistic expectations of breastfeeding by professionals keen to promote the benefits. This left them feeling unprepared when they encountered pain, problems and relentlessness of early infant feeding, leading to feelings of guilt and inadequacy over their feeding decisions. Mothers valued the combination of expert professional and peer support provided by Baby Café services and emphasised the importance of social support from other mothers in enabling them to continue feeding for as long as they wished. The research emphasises the need for realistic rather than idealistic antenatal preparation and the importance of timely and parent-centred breastfeeding support, particularly in the immediate postnatal weeks. The findings suggest that effective social support, combined with reassurance and guidance from skilled practitioners, can help women to overcome difficulties and find confidence in their own abilities to achieve their feeding goals. However, further work is needed to make sure such services are readily accessible to women from all sectors of the community.

77 FR 29989 - Applications for New Awards; Technology and Media Services for Individuals With Disabilities...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

... limited to, school leadership support, professional development support to school staff, and a plan for... benefits to understanding different student learning styles (Grunwald, 2010). Additionally, Perlman and...

Promoting School Psychologist Participation in Transition Services Using the TPIE Model

ERIC Educational Resources Information Center

Talapatra, Devadrita; Roach, Andrew T.; Varjas, Kris; Houchins, David E.; Crimmins, Daniel B.

2018-01-01

Transition services can be used to forge family, school, and community partnerships and foster a successful shift to adult life for students with intellectual disabilities (ID). School psychologists can play a valuable additive role in supporting the transition process due to their graduate training in interpersonal skills; consultation services;…

Access Services Are Human Services: Collaborating to Provide Textbook Access to Students

ERIC Educational Resources Information Center

McElroy, Kelly; Moore, Dan; Hilterbrand, Lori; Hindes, Nicole

2017-01-01

Despite the clear negative impact of high textbook costs on students, limits--including space, funding, and policies--prevent many academic libraries from fully supporting textbook collections. Partnering with other campus units on textbook lending requires creative thinking but can provide students access to other services in addition to the…

Spaceflight Operations Services Grid Prototype

NASA Technical Reports Server (NTRS)

Bradford, Robert N.; Mehrotra, Piyush; Lisotta, Anthony

2004-01-01

NASA over the years has developed many types of technologies and conducted various types of science resulting in numerous variations of operations, data and applications. For example, operations range from deep space projects managed by JPL, Saturn and Shuttle operations managed from JSC and KSC, ISS science operations managed from MSFC and numerous low earth orbit satellites managed from GSFC that are varied and intrinsically different but require many of the same types of services to fulfill their missions. Also, large data sets (databases) of Shuttle flight data, solar system projects and earth observing data exist which because of their varied and sometimes outdated technologies are not and have not been fully examined for additional information and knowledge. Many of the applications/systems supporting operational services e.g. voice, video, telemetry and commanding, are outdated and obsolete. The vast amounts of data are located in various formats, at various locations and range over many years. The ability to conduct unified space operations, access disparate data sets and to develop systems and services that can provide operational services does not currently exist in any useful form. In addition, adding new services to existing operations is generally expensive and with the current budget constraints not feasible on any broad level of implementation. To understand these services a discussion of each one follows. The Spaceflight User-based Services are those services required to conduct space flight operations. Grid Services are those Grid services that will be used to overcome, through middleware software, some or all the problems that currently exists. In addition, Network Services will be discussed briefly. Network Services are crucial to any type of remedy and are evolving adequately to support any technology currently in development.

Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

PubMed

Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

2013-03-01

In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

AAL service development loom--from the idea to a marketable business model.

PubMed

Kriegel, Johannes; Auinger, Klemens

2015-01-01

The Ambient Assisted Living (AAL) market is still in an early stage of development. Previous approaches of comprehensive AAL services are mostly supply-side driven and focused on hardware and software. Usually this type of AAL solutions does not lead to a sustainable success on the market. Research and development increasingly focuses on demand and customer requirements in addition to the social and legal framework. The question is: How can a systematic performance measurement strategy along a service development process support the market-ready design of a concrete business model for AAL service? Within the EU funded research project DALIA (Assistant for Daily Life Activities at Home) an iterative service development process uses an adapted Osterwalder business model canvas. The application of a performance measurement index (PMI) to support the process has been developed and tested. Development of an iterative service development model using a supporting PMI. The PMI framework is developed throughout the engineering of a virtual assistant (AVATAR) as a modular interface to connect informal carers with necessary and useful services. Future research should seek to ensure that the PMI enables meaningful transparency regarding targeting (e.g. innovative AAL service), design (e.g. functional hybrid AAL service) and implementation (e.g. marketable AAL support services). To this end, a further reference to further testing practices is required. The aim must be to develop a weighted PMI in the context of further research, which supports both the service engineering and the subsequent service management process.

The effect of community-based support services on clinical efficacy and health-related quality of life in HIV/AIDS patients in resource-limited settings in sub-Saharan Africa.

PubMed

Kabore, Inoussa; Bloem, Jeanette; Etheredge, Gina; Obiero, Walter; Wanless, Sebastian; Doykos, Patricia; Ntsekhe, Pearl; Mtshali, Nomantshali; Afrikaner, Eric; Sayed, Rauf; Bostwelelo, John; Hani, Andiswa; Moshabesha, Tiisetso; Kalaka, Agnes; Mameja, Jerry; Zwane, Nompumelelo; Shongwe, Nomvuyo; Mtshali, Phangisile; Mohr, Beryl; Smuts, Archie; Tiam, Appolinaire

2010-09-01

Antiretroviral therapy (ART) for HIV/AIDS in developing countries has been rapidly scaled up through directed public and private resources. Data on the efficacy of ART in developing countries are limited, as are operational research studies to determine the effect of selected nonmedical supportive care services on health outcomes in patients receiving ART. We report here on an investigation of the delivery of medical care combined with community-based supportive services for patients with HIV/AIDS in four resource-limited settings in sub-Saharan Africa, carried out between 2005 and 2007. The clinical and health-related quality of life (HRQOL) efficacy of ART combined with community support services was studied in a cohort of 377 HIV-infected patients followed for 18 months, in community-based clinics through patient interviews, clinical evaluations, and questionnaires. Patients exposed to community-based supportive services experienced a more rapid and greater overall increase in CD4 cell counts than unexposed patients. They also had higher levels of adherence, attributed primarily to exposure to home-based care services. In addition, patients receiving home-based care and/or food support services showed greater improvements in selected health-related QOL indicators. This report discusses the feasibility of effective ART in a large number of patients in resource-limited settings and the added value of concomitant community-based supportive care services.

Family group interventions in an early psychosis program: A re-evaluation of practice after 10 years of service delivery.

PubMed

Day, Kate; Starbuck, Rachael; Petrakis, Melissa

2017-08-01

The role of family in supporting service users in coping with illness and engaging in relapse prevention in early psychosis is important. Taking on this caring though is stressful and challenging, and it has been found that support and information for carers assists in their coping and reduces isolation. To evaluate the current utility of a psychoeducation group program in a public adult mental health service, for the families of people experiencing early psychosis. A purpose-designed pre- and post-intervention questionnaire was administered to quantitatively measure group participants' changes in perceptions of their understanding of mental illness and its treatment through attending the group. Additional qualitative items were used to determine other knowledge, benefits and any critical feedback. The group program continues to result in highly significant improvements in family members' understanding of psychosis, recovery, medications, relapse prevention and substance co-morbidities. Additional feedback reaffirmed previous findings that family members find group peer support valuable and that this reduces isolation and the experience of stigma. The current evaluation, conducted following 10 years of early psychosis group work, found there to be efficacy in family peer support groups and that it is important to provide family interventions in public early psychosis mental health services.

Homeless youth: Barriers and facilitators for service referrals.

PubMed

Black, Emma B; Fedyszyn, Izabela E; Mildred, Helen; Perkin, Rhianna; Lough, Richard; Brann, Peter; Ritter, Cheryl

2018-06-01

Young people who are homeless and experiencing mental health issues are reluctant to use relevant services for numerous reasons. Youth are also at risk of disengaging from services at times of referral to additional or alternative services. This study aimed to identify barriers and facilitators for inter-service referrals for homeless youth with mental health issues who have already engaged with a service. Qualitative, semi-structured interviews were conducted with homeless youth (n = 10), homelessness support workers (n = 10), and mental health clinicians (n = 10). Barriers included: resource shortages; programs or services having inflexible entry criteria; complexity of service systems; homeless youth feeling devalued; and a lack of communication between services, for example, abrupt referrals with no follow up. Referral facilitators included: services providers offering friendly and client-centred support; supported referrals; awareness of other services; and collaboration between services. Relationships with service providers and inter-service collaboration appeared essential for successful referrals for homeless youth. These facilitating factors may be undermined by sector separation and siloing, as well as resource shortages in both the homelessness and mental health sectors. Service transitions may be conceptualised as a genuine service outcome for homeless youth, and as a basis for successful future service provision. Copyright © 2018 Elsevier Ltd. All rights reserved.

Supported employment: cost-effectiveness across six European sites

PubMed Central

Knapp, Martin; Patel, Anita; Curran, Claire; Latimer, Eric; Catty, Jocelyn; Becker, Thomas; Drake, Robert E; Fioritti, Angelo; Kilian, Reinhold; Lauber, Christoph; Rössler, Wulf; Tomov, Toma; van Busschbach, Jooske; Comas-Herrera, Adelina; White, Sarah; Wiersma, Durk; Burns, Tom

2013-01-01

A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment. PMID:23471803

Planning and Implementing a 3D Printing Service in an Academic Library

ERIC Educational Resources Information Center

Gonzalez, Sara Russell; Bennett, Denise Beaubien

2014-01-01

Initiating a 3D printing service in an academic library goes beyond justification of its value and gaining the necessary library and administrative support. Additional aspects such as policies, environmental safety, training, publicizing, maintenance, and scope of service must be considered. This article provides a guide to developing a 3D print…

Measuring the Effect of Tourism Services on Travelers' Quality of Life: Further Validation.

ERIC Educational Resources Information Center

Neal, Janet D.; Sirgy, M. Joseph; Uysal, Muzaffer

2004-01-01

lication and extension study provided additional validational support of the original tourism services satisfaction measure in relation to QOL-related measures.Neal, Sirgy and Uysal (1999) developed a model and a measure to capture the effect of tourism services on travelers' quality of life (QOL). They hypothesized that travelers' overall life…

78 FR 40203 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

...-6820. SUPPLEMENTARY INFORMATION: I. Introduction II. Postal Service's Filings III. Notice of Filings IV. Ordering Paragraphs I. Introduction The Postal Service seeks to add Priority Mail International Regional... public Excel file with redacted financial documentation to support the addition of the new product to the...

Consultation performance of general practitioners when supported by an asthma/COPDC-service

PubMed Central

2012-01-01

Background General practitioners (GPs) can refer patients to an asthma/COPD service (AC-service) for diagnostic assessment of spirometry and medical history and for asthma or COPD monitoring. The AC-service reports diagnostic results and additional information about disease burden (BORG-score for complaints, MRC-dyspnoea score, exacerbation rate), life style, medication and compliance, to the patient’s GP. This study explores how GPs use this additional information when discussing the patient’s disease burden and how this influences GPs’ information and education provision during consultations with asthma/COPD patients. Method Patients with (a suspicion of) asthma or COPD were referred to an AC-service and consulted their GPs after they had received a report from the AC-service. Retrospectively patients answered questions about their GPs’ performance during these consultations. Performances were compared with performances of the same GPs during consultations without support of the AC-service (usual care), earlier that year. Results Of consultations not initiated by an AC-service check-up, 91% focussed on complaints, the initial reason for the consultation. In AC-service supported follow-up consultations, GPs explored disease burden when the (BORG-)score for complaints was high - as reported by the AC-service - even when patients themselves thought it was irrelevant. GPs put significantly less effort in exploring disease burden when the Borg-score was low (BORG 3–4: 69%; BORG1-2: 51%, p = 0,01). GPs mostly ignored MRC-dyspnoea scores: attention to dyspnoea was 18% for MRC-score <3 and 25% for MRC-score ≥3 (p = 0,63). GPs encouraged physical fitness in 13% of patients. Smoking behaviour was discussed with 66% of the actual smokers but only 14% remembered a stop smoking advice. Furthermore, pharmacotherapeutic management education in AC-service supported consultations did not differ from performance in usual care according to patient evaluations. Conclusion Other than taking into account the severity of complaints, there was no difference between GPs’ performance in AC-service supported and in usual care consultations. AC-service reports are thus not effective by themselves. GPs should be encouraged to use the information better and systematically check all relevant aspects that characterize the disease burden of their patients. PMID:22824247

Structured social relationships: a review of volunteer home visiting programs for parents of young children.

PubMed

Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

2016-06-01

Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological limitations, pointing to a need for further rigorous research. What is known about the topic? Volunteer family support programs have been an important part of the service landscape for vulnerable families, both nationally and internationally, for many years. Anecdotal reports suggest that this is a valued form of support that increases a sense of community connectedness and breaks down barriers for families in accessing other community support services. What does this paper add? This paper proposes a model identifying broad service pathways impacting on family health and well being that takes into account the importance of structured social relationships and social connectedness. What are the implications for practitioners? The proposed model may encourage discussion by practitioners and organisations interested in models of support for families who are socially isolated and/or in need of assistance to access and engage with services within the community.

Rapid Building Assessment Project

DTIC Science & Technology

2014-05-01

ongoing management of commercial energy efficiency. No other company offers all of these proven services on a seamless, integrated Software -as-a- Service ...FirstFuel has added a suite of additional Software -as-a- Service analytics capabilities to support the entire energy efficiency lifecycle, including...the client side. In this document, we refer to the service side software as “BUILDER” and the client software as “BuilderRED,” following the Army

Adaptation of the Quality Indicator for Rehabilitative Care (QuIRC) for use in mental health supported accommodation services (QuIRC-SA).

PubMed

Killaspy, Helen; White, Sarah; Dowling, Sarah; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Priebe, Stefan; Shepherd, Geoff; King, Michael

2016-04-14

No standardised tools for assessing the quality of specialist mental health supported accommodation services exist. To address this, we adapted the Quality Indicator for Rehabilitative care-QuIRC-that was originally developed to assess the quality of longer term inpatient and community based mental health facilities. The QuIRC, which is completed by the service manager and gives ratings of seven domains of care, has good psychometric properties. Focus groups with staff of the three main types of supported accommodation in the UK (residential care, supported housing and floating outreach services) were carried out to identify potential amendments to the QuIRC. Additional advice was gained from consultation with three expert panels, two of which comprised service users with lived experience of mental health and supported accommodation services. The amended QuIRC (QuIRC-SA) was piloted with a manager of each of the three service types. Item response variance, inter-rater reliability and internal consistency were assessed in a random sample of 52 services. Factorial structure and discriminant validity were assessed in a larger random sample of 87 services. The QuIRC-SA comprised 143 items of which only 18 items showed a narrow range of response and five items had poor inter-rater reliability. The tool showed good discriminant validity, with supported housing services generally scoring higher than the other two types of supported accommodation on most domains. Exploratory factor analysis showed that the QuIRC-SA items loaded onto the domains to which they had been allocated. The QuIRC-SA is the first standardised tool for quality assessment of specialist mental health supported accommodation services. Its psychometric properties mean that it has potential for use in research as well as audit and quality improvement programmes. A web based application is being developed to make it more accessible which will produce a printable report for the service manager about the performance of their service, comparison data for similar services and suggestions on how to improve service quality.

75 FR 17872 - High-Cost Universal Service Support, Jurisdictional Separations, and Coalition for Equity in...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... make the implementation period explicit in the text of the rules. Additionally, to ensure that ETCs..., and by which states must certify that affected ETCs' support will be used only for the provision...

The effectiveness of skills training for improving outcomes in supported employment.

PubMed

Mueser, Kim T; Aalto, Steve; Becker, Deborah R; Ogden, John S; Wolfe, Rosemarie S; Schiavo, Diane; Wallace, Charles J; Xie, Haiyi

2005-10-01

This study evaluated whether a supplementary skills training program improved work outcomes for clients enrolled in supported employment programs. Thirty-five recently employed clients with severe mental illness who were receiving supported employment services at a free-standing agency were randomly assigned to participate in either the workplace fundamentals program, a skills training program designed to make work more "successful and satisfying," or treatment as usual. Knowledge of workplace fundamentals (for example, identifying workplace stressors, problem solving, and improving job performance) was assessed at baseline and at nine months; employment outcomes and use of additional vocational services were tracked for 18 months. Clients in the workplace fundamentals group (N=17) improved more in knowledge of workplace fundamentals than those in the control group (N=18) at the nine-month follow-up, but the two groups did not differ in the number of hours or days worked, salary earned, or receipt of additional vocational services over the 18-month period. In general, clients in this study had higher educational levels and better employment outcomes than clients in most previous studies of supported employment, making it difficult to detect possible effects of the skills training intervention on work. Supplementary skills training did not improve work outcomes for clients who were receiving supported employment.

Implementation of Age-Specific Services for Transition-Age Youths in California.

PubMed

Ojeda, Victoria D; Hiller, Sarah P; Hurst, Samantha; Jones, Nev; McMenamin, Sara; Burgdorf, James; Gilmer, Todd P

2016-09-01

This study examined the implementation of age-specific services for transition-age youths in California under the Mental Health Services Act (MHSA). This study employed a sequential, exploratory mixed-methods design. Qualitative interviews with 39 mental health service area administrators in California were analyzed to develop an understanding of how the MHSA has facilitated the development of youth-specific programs or services. A quantitative survey of 180 youth-focused programs was also used to describe the range of services that were implemented, the use of evidence-based and promising practices, and the role of youths in the design, planning, delivery, and evaluation of services. Administrators described the MHSA as providing a programmatic focus and financial support for youth-specific services, outlining a stakeholder process to create buy-in and develop a vision for services, and emphasizing the role of youths in service delivery and planning. Youth-specific programs implemented a diverse array of services, including general medical care; employment and education support; housing placement and support; and family, mentoring, and social support. Programs described implementing evidence-based and promising practices and involving youths in service planning, implementation, or quality improvement activities. The MHSA has had a substantial impact on the landscape of youth-specific services in California by expanding both the number of programs and the diversity in types of services and by promoting the engagement of youths in the planning and delivery of services. Additional efforts are necessary to determine the extent to which youth-specific services yield greater improvements in youths' outcomes compared with services designed for adults.

Innovation and Cultural Change Task Group Report

DTIC Science & Technology

2006-05-01

authoritative information sources…common analytic methods… Chief Administrative Officer and Shared Services Problem • Core functions are not well...in a crippling fashion Solution • Chief administrative officer • Shared services (market principles, not primarily consolidation) QDR • Under...Additional Governance Reforms” DoD is said to be considering: – Migrating toward a shared services model for support functions… Defense Business Board

Supporting Pupils with EAL and Their Teachers in Ireland: The Need for a Co-Ordinated Strategy

ERIC Educational Resources Information Center

Murtagh, Lelia; Francis, Tracy

2012-01-01

Since the establishment of a Language Support Service in 1999, all newcomer children with limited English skills arriving in schools in Ireland are entitled to two years of additional English language support. This is provided mainly by designated Language Support Teachers (LSTs). During the peak of the Celtic Tiger, there was a sharp growth in…

Phoenix: SOA based information management services

NASA Astrophysics Data System (ADS)

Grant, Rob; Combs, Vaughn; Hanna, Jim; Lipa, Brian; Reilly, Jim

2009-05-01

The Air Force Research Laboratory (AFRL) has developed a reference set of Information Management (IM) Services that will provide an essential piece of the envisioned final Net-Centric IM solution for the Department of Defense (DoD). These IM Services will provide mission critical functionality to enable seamless interoperability between existing and future DoD systems and services while maintaining a highly available IM capability across the wide spectrum of differing scalability and performance requirements. AFRL designed this set of IM Services for integration with other DoD and commercial SOA environments. The services developed will provide capabilities for information submission, information brokering and discovery, repository, query, type management, dissemination, session management, authorization, service brokering and event notification. In addition, the IM services support common information models that facilitate the management and dissemination of information consistent with client needs and established policy. The services support flexible and extensible definitions of session, service, and channel contexts that enable the application of Quality of Service (QoS) and security policies at many levels within the SOA.

Prevalence of self-management versus formal service use for common mental disorders in Australia: findings from the 2007 National Survey of Mental Health and Wellbeing.

PubMed

Olesen, Sarah C; Butterworth, Peter; Leach, Liana

2010-09-01

To determine the proportion of Australian adults who use non-practitioner led support services and self-management strategies for common mental disorders. Data were drawn from the 2007 National Survey of Mental Health and Wellbeing, a representative survey of 8841 Australian adults aged 16 to 85 years. This survey included the Composite International Diagnostic Instrument to obtain diagnosis of International Classification of Diseases (Version 10; ICD-10) mental disorders. Information about consultations with health professionals for mental health problems and the use of support services and self-management strategies was also collected. Half of all adults who met the criteria for an affective or anxiety disorder in the last 12 months reported using non-practitioner led support services and/or self-management strategies for their mental health problems. Six per cent used support services, including Internet and non-online support groups and telephone counselling, and 51.9% used self-management strategies such as doing 'more of the things you enjoy' to 'help deal with' their mental health problems. Of people with a 12-month common mental disorder, 24% used support services and/or self-management strategies without additional formal services; 29.3% used both. Of adults with a 12-month affective or anxiety disorder, 37% used neither formal services nor self-management strategies. A substantial proportion of people who reported using self-management strategies for their mental health did not have a diagnosable affective or anxiety disorder. The use of non-practitioner led support services and self-management strategies for mental health problems, with and without adjunct use of formal health services, is widespread in Australia. Future research is needed to investigate why people may select these strategies over formal services, or whether self-management reflects the presence of barriers to use of formal services.

Automatic Selective Documentation Services.

ERIC Educational Resources Information Center

George, Ray L.

User needs studies often present figures indicating that documentation services systems which rely on the mails are inherently incapable of effectively supporting more than half of all research and development tasks. In addition to investigating faster ways of transmitting information, DDC has also been developing and testing systems based on…

Critical Zone Services as Environmental Assessment Criteria in Intensively Managed Agricultural Landscapes

NASA Astrophysics Data System (ADS)

Richardson, M.; Kumar, P.

2016-12-01

The critical zone (CZ) includes the biophysical processes occurring from the top of the vegetation canopy to the weathering zone below the groundwater table. CZ services provide a measure for the goods and benefits derived from CZ processes. In intensively managed landscapes (IML), the provisioning, supporting, and regulating services are altered through anthropogenic energy inputs to derive more productivity, as agricultural products, from these landscapes than would be possible under natural conditions. However, the energy or cost equivalents of alterations to CZ functions within landscape profiles are unknown. The valuation of CZ services in energy or monetary terms provides a more concrete tool for characterizing seemingly abstract environmental damages from agricultural production systems. A multi-layer canopy-root-soil model is combined with nutrient and water flux models to simulate the movement of nutrients throughout the soil system. This data enables the measurement of agricultural anthropogenic impacts to the CZ's nutrient cycling supporting services and atmospheric stabilizing regulating services defined by the flux of carbon and nutrients. Such measurements include soil carbon storage, soil carbon respiration, nitrate leaching, and nitrous oxide flux into the atmosphere. Additionally, the socioeconomic values of corn feed and ethanol define the primary productivity supporting services of each crop use.In the debate between feed production and corn-based ethanol production, measured nutrient CZ services can cost up to four times more than traditionally estimated CO2 equivalences for the entire bioenergy production system. Energy efficiency in addition to environmental impacts demonstrate how the inclusion of CZ services is necessary in accounting for the entire life cycle of agricultural production systems. These results conclude that feed production systems are more energy efficient and less environmentally costly than corn-based ethanol systems.

Impact of service delivery model on health care access among HIV-positive women in New York City.

PubMed

Pillai, Nandini V; Kupprat, Sandra A; Halkitis, Perry N

2009-01-01

As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.

Providing a parallel and distributed capability for JMASS using SPEEDES

NASA Astrophysics Data System (ADS)

Valinski, Maria; Driscoll, Jonathan; McGraw, Robert M.; Meyer, Bob

2002-07-01

The Joint Modeling And Simulation System (JMASS) is a Tri-Service simulation environment that supports engineering and engagement-level simulations. As JMASS is expanded to support other Tri-Service domains, the current set of modeling services must be expanded for High Performance Computing (HPC) applications by adding support for advanced time-management algorithms, parallel and distributed topologies, and high speed communications. By providing support for these services, JMASS can better address modeling domains requiring parallel computationally intense calculations such clutter, vulnerability and lethality calculations, and underwater-based scenarios. A risk reduction effort implementing some HPC services for JMASS using the SPEEDES (Synchronous Parallel Environment for Emulation and Discrete Event Simulation) Simulation Framework has recently concluded. As an artifact of the JMASS-SPEEDES integration, not only can HPC functionality be brought to the JMASS program through SPEEDES, but an additional HLA-based capability can be demonstrated that further addresses interoperability issues. The JMASS-SPEEDES integration provided a means of adding HLA capability to preexisting JMASS scenarios through an implementation of the standard JMASS port communication mechanism that allows players to communicate.

'He's hard work, but he's worth it'. The experience of caregivers of individuals with intellectual disabilities and challenging behaviour: a meta-synthesis of qualitative research.

PubMed

Griffith, G M; Hastings, R P

2014-09-01

The purpose of this review is to synthesize the qualitative literature on the perspectives of those caring for a family member with intellectual disabilities and challenging behaviour, with a focus on their experiences of support services. A thorough literature search resulted in 17 studies being selected for inclusion in the meta-synthesis. Five primary themes were identified: (i) love, (ii) altered identity, (iii) crisis management, (iv) support is not just 'challenging behaviour' services, and (v) the future: low expectations, high hopes. Carers spoke of the deep love for their family member and of the chronic strain the demands of caregiving placed upon them. Support services often caused additional problems and high levels of stress for caregivers, although there were also reports of good practice. The findings may inform clinicians and service providers about how best to support families of individuals with challenging behaviour. © 2013 John Wiley & Sons Ltd.

Decision Support for Personalized Cloud Service Selection through Multi-Attribute Trustworthiness Evaluation

PubMed Central

Ding, Shuai; Xia, Chen-Yi; Zhou, Kai-Le; Yang, Shan-Lin; Shang, Jennifer S.

2014-01-01

Facing a customer market with rising demands for cloud service dependability and security, trustworthiness evaluation techniques are becoming essential to cloud service selection. But these methods are out of the reach to most customers as they require considerable expertise. Additionally, since the cloud service evaluation is often a costly and time-consuming process, it is not practical to measure trustworthy attributes of all candidates for each customer. Many existing models cannot easily deal with cloud services which have very few historical records. In this paper, we propose a novel service selection approach in which the missing value prediction and the multi-attribute trustworthiness evaluation are commonly taken into account. By simply collecting limited historical records, the current approach is able to support the personalized trustworthy service selection. The experimental results also show that our approach performs much better than other competing ones with respect to the customer preference and expectation in trustworthiness assessment. PMID:24972237

Decision support for personalized cloud service selection through multi-attribute trustworthiness evaluation.

PubMed

Ding, Shuai; Xia, Cheng-Yi; Xia, Chen-Yi; Zhou, Kai-Le; Yang, Shan-Lin; Shang, Jennifer S

2014-01-01

Facing a customer market with rising demands for cloud service dependability and security, trustworthiness evaluation techniques are becoming essential to cloud service selection. But these methods are out of the reach to most customers as they require considerable expertise. Additionally, since the cloud service evaluation is often a costly and time-consuming process, it is not practical to measure trustworthy attributes of all candidates for each customer. Many existing models cannot easily deal with cloud services which have very few historical records. In this paper, we propose a novel service selection approach in which the missing value prediction and the multi-attribute trustworthiness evaluation are commonly taken into account. By simply collecting limited historical records, the current approach is able to support the personalized trustworthy service selection. The experimental results also show that our approach performs much better than other competing ones with respect to the customer preference and expectation in trustworthiness assessment.

Non-monetary valuation using Multi-Criteria Decision Analysis: Sensitivity of additive aggregation methods to scaling and compensation assumptions

EPA Science Inventory

Analytical methods for Multi-Criteria Decision Analysis (MCDA) support the non-monetary valuation of ecosystem services for environmental decision making. Many published case studies transform ecosystem service outcomes into a common metric and aggregate the outcomes to set land ...

Cash-Strapped Canadian Universities Seek New Ways To Bring in Money.

ERIC Educational Resources Information Center

Lewington, Jennifer

1997-01-01

Struggling to manage under reduced public financial support, many of Canada's universities are turning to entrepreneurial projects to provide supplemental income. In addition to conventional means such as real estate development, investment, and marketing, some are shifting ancillary services (conference facilities, residences, food services,…

The Impact of Using SMS as Learning Support Tool on Students' Learning

ERIC Educational Resources Information Center

Gasaymeh, Al-Mothana M.; Aldalalah, Osamah M.

2013-01-01

This study aimed to investigate the impact of using Short Message Service (SMS) as learning support tool on students' learning in an introductory programming course. In addition, the study examined students' perceptions of the advantages and disadvantages of the use of SMS as a learning support tool in their class. The participants in this study…

U.S. Customs Service technology: past, present, and future

NASA Astrophysics Data System (ADS)

Pennella, John J.; Smith, Douglas E.

2001-02-01

This document describes the law enforcement charter and activities of the United States Customs Service and the internal technology organization that supports it, the Applied Technology Division. The enforcement activities of Customs include interdiction, outbound anti-smuggling, investigation and surveillance, processing of documentation and data, and detection of drugs and other contraband. An overview of the various technologies applied in support of these activities over the past 25 years is provided. Additionally, technologies proposed for implementation in the future are discussed.

Improving the management and care of refugees in Australian hospitals: a descriptive study.

PubMed

Ross, Lindsey; Harding, Catherine; Seal, Alexa; Duncan, Geraldine

2016-01-01

Objectives The aim of the present study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals' views regarding improvements that could be made in this area were also sought. Methods Two-page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site. Results Response rates at the rural and urban sites were 50% and 49%, respectively. Refugees were seen at least monthly by 40% of respondents. Additional support was requested by 70% of respondents. Confidence was associated with being born overseas (P=0.029) and increased time working with refugees (r s =0.418, P<0.001). Only 47% of respondents felt confident managing social and psychological needs of refugees. Midwives saw refugees more than nursing and allied healthcare staff combined, and this was significant at the rural hospital (P<0.001). Rural respondents reported that working with refugees enhanced their practice (P=0.025), although felt significantly less confident (P<0.001) than urban respondents. Themes that arose regarding barriers to care included language and cultural barriers, paucity of knowledge and issues accessing available services, including appropriate interpreters, Medicare eligibility and patient factors, including lack of patient trust in government systems. Desire for support was more pronounced in the rural setting (P=0.001). Conclusions Refugees were seen frequently in both settings and most respondents requested additional support, highlighting that caring for refugees in Australian hospitals is a significant challenge. Additional support and education should be targeted to those caring for refugees most frequently, particularly midwifery services, to reduce barriers to care. What is known about the topic? Refugees are a vulnerable group, often with complex health needs. These needs are often unmet because of issues including language and cultural barriers. What does this paper add? Refugees were seen frequently in the two public hospital settings involved in the present study and most often by midwifery services. Healthcare professionals require more support, more information about available services and better access to interpreter services. These issues were more pronounced in the rural setting where very limited research exists. What are the implications for practitioners? Implementing additional support and education regarding refugee health needs could increase knowledge and confidence when managing refugees, reducing barriers to care and improving quality of care.

Effect of a peer support service on breast-feeding continuation in the UK: a randomised controlled trial.

PubMed

Jolly, Kate; Ingram, Lucy; Freemantle, Nick; Khan, Khalid; Chambers, Jacky; Hamburger, Ros; Brown, Julia; Dennis, Cindy-Lee; Macarthur, Christine

2012-12-01

to assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation. cluster randomised controlled trial (ISRCTN16126175). Primary Care Trust, UK serving a multi-ethnic, socio-economically disadvantaged population. 2,724 women giving birth following antenatal care from 66 clinics: 33 clinics (1,267 women) randomised to the PSW service and 33 clinics (1,457 women) to usual care. 848 women consented to additional follow-up by questionnaire at 6 months. PSW service provided in the antenatal and postnatal period. any and exclusive breast feeding at 10-14 days obtained from routine computerised records and at 6 weeks and 6 months from a questionnaire. follow-up: 94% at 10-14 days, 67.5% at 6 months. There was no difference in any breast feeding at 10-14 days between intervention and usual care, odds ratio (OR) 1.07 (95% CI 0.87-1.31, p=0.54). Proportion of women reporting any breast feeding in the intervention group at 6 weeks was 62.7% and 64.5% in the usual care group OR 0.93 (95% CI 0.64-1.35); and at 6 months was 34.3% and 38.9%, respectively, OR 1.06 (95% CI 0.71-1.58). universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population. with high levels of professional support part of usual maternity care it may not be possible for low intensity peer support to produce additional benefit. More intensive or targeted programmes might be effective, but should have concurrent high quality evaluation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Portage in the UK: recent developments.

PubMed

Russell, F

2007-11-01

Portage provides home-based, early intervention and support to families who have a young child with additional needs. Working in the context of the Every Child Matters agenda, the National Portage Association (NPA) aims to develop inclusive, high-quality provision. This paper reviews their recent work, presents a summary of the findings of a national survey of Portage and discusses their implications. All Portage services known to the NPA and local authorities in England were asked to complete a questionnaire and forward another to families using early years' services to evaluate the support they receive. The survey identified the extent and gaps in Portage provision and the level of unmet need. Families who contributed said they valued Portage because it helped their child and provided support for the whole family. DISCUSSION OF FINDINGS: The survey identified 31 local authorities in England, where Portage is not available. Geographical gaps were most notable in the North East and West Midlands regions. Despite a small increase in the extent of Portage provision, it is estimated that services only meet the needs of a small proportion of families that are eligible. Current work may help overcome geographical gaps through supporting the development of high-quality Portage services but, in endeavouring to meet the needs of families waiting for Portage, it is important not to diminish the quality of support already provided. Portage aims to provide flexible support for families to respond to their individual needs. Evaluating its effectiveness is problematic because of its complex nature but this survey provided an opportunity for families to share their views at a national level. Continued development work can help Portage provision become more accessible and one of the options routinely available to families who have a young child with additional needs.

Dynamic Online Bandwidth Adjustment Scheme Based on Kalai-Smorodinsky Bargaining Solution

NASA Astrophysics Data System (ADS)

Kim, Sungwook

Virtual Private Network (VPN) is a cost effective method to provide integrated multimedia services. Usually heterogeneous multimedia data can be categorized into different types according to the required Quality of Service (QoS). Therefore, VPN should support the prioritization among different services. In order to support multiple types of services with different QoS requirements, efficient bandwidth management algorithms are important issues. In this paper, I employ the Kalai-Smorodinsky Bargaining Solution (KSBS) for the development of an adaptive bandwidth adjustment algorithm. In addition, to effectively manage the bandwidth in VPNs, the proposed control paradigm is realized in a dynamic online approach, which is practical for real network operations. The simulations show that the proposed scheme can significantly improve the system performances.

Reducing inequalities in access to health care: developing a toolkit through action research.

PubMed

Goyder, E C; Blank, L; Ellis, E; Furber, A; Peters, J; Sartain, K; Massey, C

2005-10-01

Healthcare organisations are expected both to monitor inequalities in access to health services and also to act to improve access and increase equity in service provision. Locally developed action research projects with an explicit objective of reducing inequalities in access. Eight different health care services in the Yorkshire and Humber region, including community based palliative care, general practice asthma care, hospital based cardiology clinics, and termination of pregnancy services. Changes in service provision, increasing attendance rates in targeted groups. Local teams identified the population concerned and appropriate interventions using both published and grey literature. Where change to service provision was achieved, local data were collected to monitor the impact of service change. A number of evidence based changes to service provision were proposed and implemented with variable success. Service uptake increased in some of the targeted populations. Interventions to improve access must be sensitive to local settings and need both practical and managerial support to succeed. It is particularly difficult to improve access effectively if services are already struggling to meet current demand. Key elements for successful interventions included effective local leadership, identification of an intervention which is both evidence based and locally practicable, and identification of additional resources to support increased activity. A "toolkit" has been developed to support the identification and implementation of appropriate changes.

The value of compressed air energy storage in energy and reserve markets

DOE PAGES

Drury, Easan; Denholm, Paul; Sioshansi, Ramteen

2011-06-28

Storage devices can provide several grid services, however it is challenging to quantify the value of providing several services and to optimally allocate storage resources to maximize value. We develop a co-optimized Compressed Air Energy Storage (CAES) dispatch model to characterize the value of providing operating reserves in addition to energy arbitrage in several U.S. markets. We use the model to: (1) quantify the added value of providing operating reserves in addition to energy arbitrage; (2) evaluate the dynamic nature of optimally allocating storage resources into energy and reserve markets; and (3) quantify the sensitivity of CAES net revenues tomore » several design and performance parameters. We find that conventional CAES systems could earn an additional 23 ± 10/kW-yr by providing operating reserves, and adiabatic CAES systems could earn an additional 28 ± 13/kW-yr. We find that arbitrage-only revenues are unlikely to support a CAES investment in most market locations, but the addition of reserve revenues could support a conventional CAES investment in several markets. Adiabatic CAES revenues are not likely to support an investment in most regions studied. As a result, modifying CAES design and performance parameters primarily impacts arbitrage revenues, and optimizing CAES design will be nearly independent of dispatch strategy.« less

78 FR 40727 - Procurement List Addition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

... considered for this certification were: 1. The action will not result in any additional reporting... provide the service to the Government. 2. The action will result in authorizing small entity to provide... Support Div., Manpower & Military Personnel Branch, Joint Expeditionary Base Little Creek-Fort Story, Fort...

Telephone helplines as a source of support for eating disorders: Service user, carer, and health professional perspectives.

PubMed

Prior, Amie-Louise; Woodward, Debbie; Hoefkens, Toni; Clayton, Debbie; Thirlaway, Katie; Limbert, Caroline

2018-01-01

Access to care for eating disorders can be problematic for numerous reasons including lack of understanding and delays with treatment referrals. Previous research has highlighted the benefits of telephone helplines as an accessible source of support for those who may not wish to access face-to-face support or to fill a gap for those waiting for treatment. This study aimed to gain an insight into the perspectives of those who may use or refer others to a telephone helpline in order to identify the requirements of such a service. Triangulation of service user, carer and health professionals' perspectives resulted in identification of themes relating to the type of support, delivery and practicalities of a helpline. The findings indicated that telephone helplines may offer numerous benefits for individuals with an eating disorder, whether accessed as a first step, alongside treatment or as an extension of this support when in recovery. Additionally helplines may provide an opportunity for carers to access information and discuss their own experiences, while supporting their loved one. Raising awareness of these services is important to encourage those affected by an eating disorder to access and make the most of this type of support. These findings offer an insight into the key requirements for new and existing service development with regard to both the type of support and the method of communication required by individuals with eating disorders.

Evaluating the Content of Individualized Education Programs and 504 Plans of Young Adolescents with Attention Deficit/Hyperactivity Disorder

PubMed Central

Spiel, Craig F.; Evans, Steven W.; Langberg, Joshua M.

2014-01-01

The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with Attention Deficit/Hyperactivity Disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of students’ present level of academic achievement and functional performance (PLAAFP) and targeted in the students’ measurable annual goals and objectives (MAGOs). In addition, we compared services to lists of recommended services provided by the U.S. Department of Education (ED) and reviews of evidence-based practices. Participants were 97 middle school students with ADHD, 61.9% with an IEP and 38.1% with a 504 Plan. Most (85%) IEP PLAAFP statements described nonacademic/behavior problems, but less than half had MAGOs targeting these areas of need. Services listed on IEPs and Section 504 Plans were frequently consistent with ED recommendations, but had little to no research supporting their effectiveness. In addition, services with evidence supporting benefit to students with ADHD were rarely included on IEPs or 504 Plans. Implications for special education policy and future directions are discussed. PMID:25485467

Recovery Support for Adolescents with Substance use Disorders: The Impact of Recovery Support Telephone Calls Provided by Pre-Professional Volunteers

PubMed Central

Garner, Bryan R; Godley, Mark D; Passetti, Lora L; Funk, Rodney R; White, William L

2014-01-01

The present quasi-experiment examined the direct and indirect effects of recovery support telephone calls following adolescent substance use disorder treatment. Six-month outcome data from 202 adolescents who had received recovery support calls from primarily pre-professional (i.e., college-level social service students) volunteers was compared to 6-month outcome data from a matched comparison sample of adolescents (n = 404). Results suggested adolescents in the recovery support sample had significantly greater reductions in their recovery environment risk relative to the comparison sample (β = -.17). Path analysis also suggested that the reduction in recovery environment risk produced by recovery support calls had indirect impacts (via recovery environment risk) on reductions in social risk (β = .22), substance use (β = .23), and substance-related problems (β = .16). Finally, moderation analyses suggested the effects of recovery support calls did not differ by gender, but were significantly greater for adolescents with lower levels of treatment readiness. In addition to providing rare empirical support for the effectiveness of recovery support services, an important contribution of this study is that it provides evidence that recovery support services do not necessarily have to be “peer-based,” at least in terms of the recovery support service provider having the experiential credentials of being “in recovery.” If replicated, this latter finding may have particularly important implications for helping increase the recovery support workforce. PMID:25574502

Finding Resources to Support Workforce Development Services for Youth

ERIC Educational Resources Information Center

Relave, Nanette

2006-01-01

Funding for youth employment and training has been scaled back during the past few decades. In addition, funding for workforce development services is spread among multiple programs and agencies, resulting in a fragmented funding environment. To address this issue, the youth provisions of the Workforce Investment Act (WIA) aimed to move this…

76 FR 75953 - Homeless Emergency Assistance and Rapid Transition to Housing: Emergency Solutions Grants Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-05

... medium-term rental assistance and services to rapidly re- house homeless people. In addition the new... and stabilization services and short- and medium-term rental assistance to help people avoid becoming... sufficient resources or support networks, e.g., family, friends, faith-based or other social networks...

EnviroAtlas National Layers Master Web Service

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This web service includes layers depicting EnviroAtlas national metrics mapped at the 12-digit HUC within the conterminous United States. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Service oriented architecture for clinical decision support: a systematic review and future directions.

PubMed

Loya, Salvador Rodriguez; Kawamoto, Kensaku; Chatwin, Chris; Huser, Vojtech

2014-12-01

The use of a service-oriented architecture (SOA) has been identified as a promising approach for improving health care by facilitating reliable clinical decision support (CDS). A review of the literature through October 2013 identified 44 articles on this topic. The review suggests that SOA related technologies such as Business Process Model and Notation (BPMN) and Service Component Architecture (SCA) have not been generally adopted to impact health IT systems' performance for better care solutions. Additionally, technologies such as Enterprise Service Bus (ESB) and architectural approaches like Service Choreography have not been generally exploited among researchers and developers. Based on the experience of other industries and our observation of the evolution of SOA, we found that the greater use of these approaches have the potential to significantly impact SOA implementations for CDS.

Service Oriented Architecture for Clinical Decision Support: A Systematic Review and Future Directions

PubMed Central

Loya, Salvador Rodriguez; Kawamoto, Kensaku; Chatwin, Chris; Huser, Vojtech

2017-01-01

The use of a service-oriented architecture (SOA) has been identified as a promising approach for improving health care by facilitating reliable clinical decision support (CDS). A review of the literature through October 2013 identified 44 articles on this topic. The review suggests that SOA related technologies such as Business Process Model and Notation (BPMN) and Service Component Architecture (SCA) have not been generally adopted to impact health IT systems’ performance for better care solutions. Additionally, technologies such as Enterprise Service Bus (ESB) and architectural approaches like Service Choreography have not been generally exploited among researchers and developers. Based on the experience of other industries and our observation of the evolution of SOA, we found that the greater use of these approaches have the potential to significantly impact SOA implementations for CDS PMID:25325996

Data management for interdisciplinary field experiments: OTTER project support

NASA Technical Reports Server (NTRS)

Angelici, Gary; Popovici, Lidia; Skiles, J. W.

1993-01-01

The ability of investigators of an interdisciplinary science project to properly manage the data that are collected during the experiment is critical to the effective conduct of science. When the project becomes large, possibly including several scenes of large-format remotely sensed imagery shared by many investigators requiring several services, the data management effort can involve extensive staff and computerized data inventories. The OTTER (Oregon Transect Ecosystem Research) project was supported by the PLDS (Pilot Land Data System) with several data management services, such as data inventory, certification, and publication. After a brief description of these services, experiences in providing them are compared with earlier data management efforts and some conclusions regarding data management in support of interdisciplinary science are discussed. In addition to providing these services, a major goal of this data management capability was to adopt characteristics of a pro-active attitude, such as flexibility and responsiveness, believed to be crucial for the effective conduct of active, interdisciplinary science. These are also itemized and compared with previous data management support activities. Identifying and improving these services and characteristics can lead to the design and implementation of optimal data management support capabilities, which can result in higher quality science and data products from future interdisciplinary field experiments.

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

Establishing a Center to Support Faculty Research

ERIC Educational Resources Information Center

Goodwin, Laura; Kozleski, Elizabeth; Muth, Rodney; Rhodes, Lynn K.; White, Kim Kennedy

2005-01-01

This article describes the establishment in fall 2002 of a School of Education Research Center designed to support faculty in increasing productivity and quality in research. Details are provided about center goals, services, staffing, space, resources, and logistics during the first year of operation. In addition, data are shared about faculty…

ESA SSA Space Weather Services Supporting Space Surveillance and Tracking

NASA Astrophysics Data System (ADS)

Luntama, Juha-Pekka; Glover, Alexi; Hilgers, Alain; Fletcher, Emmet

2012-07-01

ESA Space Situational Awareness (SSA) Preparatory Programme was started in 2009. The objective of the programme is to support the European independent utilisation of and access to space research or services. This will be performed through providing timely and quality data, information, services and knowledge regarding the environment, the threats and the sustainable exploitation of the outer space surrounding the planet Earth. SSA serves the implementation of the strategic missions of the European Space Policy based on the peaceful uses of the outer space by all states, by supporting the autonomous capacity to securely and safely operate the critical European space infrastructures. The Space Weather (SWE) Segment of the SSA will provide user services related to the monitoring of the Sun, the solar wind, the radiation belts, the magnetosphere and the ionosphere. These services will include near real time information and forecasts about the characteristics of the space environment and predictions of space weather impacts on sensitive spaceborne and ground based infrastructure. The SSA SWE system will also include establishment of a permanent database for analysis, model development and scientific research. These services are will support a wide variety of user domains including spacecraft designers, spacecraft operators, human space flights, users and operators of transionospheric radio links, and space weather research community. The precursor SWE services to be established starting in 2010. This presentation provides an overview of the ESA SSA SWE services focused on supporting the Space Surveillance and Tracking users. This services include estimates of the atmospheric drag and archive and forecasts of the geomagnetic and solar indices. In addition, the SSA SWE system will provide nowcasts of the ionospheric group delay to support mitigation of the ionospheric impact on radar signals. The paper will discuss the user requirements for the services, the data requirements and the foreseen development needs for the ESA SSA SWE system before the full service capability is available.

Cross Support Transfer Service (CSTS) Framework Library

NASA Technical Reports Server (NTRS)

Ray, Timothy

2014-01-01

Within the Consultative Committee for Space Data Systems (CCSDS), there is an effort to standardize data transfer between ground stations and control centers. CCSDS plans to publish a collection of transfer services that will each address the transfer of a particular type of data (e.g., tracking data). These services will be called Cross Support Transfer Services (CSTSs). All of these services will make use of a common foundation that is called the CSTS Framework. This library implements the User side of the CSTS Framework. "User side" means that the library performs the role that is typically expected of the control center. This library was developed in support of the Goddard Data Standards program. This technology could be applicable for control centers, and possibly for use in control center simulators needed to test ground station capabilities. The main advantages of this implementation are its flexibility and simplicity. It provides the framework capabilities, while allowing the library user to provide a wrapper that adapts the library to any particular environment. The main purpose of this implementation was to support the inter-operability testing required by CCSDS. In addition, it is likely that the implementation will be useful within the Goddard mission community (for use in control centers).

Enabling OpenID Authentication for VO-integrated Portals

NASA Astrophysics Data System (ADS)

Plante, R.; Yekkirala, V.; Baker, W.

2012-09-01

To support interoperating services that share proprietary data and other user-specific information, the VAO Project provides login services for browser-based portals built on the open standard, OpenID. To help portal developers take advantage of this service, we have developed a downloadable toolkit for integrating OpenID single sign-on support into any portal. This toolkit provides APIs in a few languages commonly used on the server-side as well as a command-line version for use in any language. In addition to describing how to use this toolkit, we also discuss the general VAO framework for single sign-on. While a portal may, if it wishes, support any OpenID provider, the VAO service provides a few extra features to support VO interoperability. This includes a portal's ability to retrieve (with the user's permission) an X.509 certificate representing the authenticated user so that the portal can access other restricted services on the user's behalf. Other standard features of OpenID allow portals to request other information about the user; this feature will be used in the future for sharing information about a user's group membership to enable sharing within a group of collaborating scientists.

Planning estimates for the provision of core mental health services in Queensland 2007 to 2017.

PubMed

Harris, Meredith G; Buckingham, William J; Pirkis, Jane; Groves, Aaron; Whiteford, Harvey

2012-10-01

To derive planning estimates for the provision of public mental health services in Queensland 2007-2017. We used a five-step approach that involved: (i) estimating the prevalence and severity of mental disorders in Queensland, and the number of people at each level of severity treated by health services; (ii) benchmarking the level and mix of specialised mental health services in Queensland against national data; (iii) examining 5-year trends in Queensland public sector mental health service utilisation; (iv) reviewing Australian and international planning benchmarks; and (v) setting resource targets based on the results of the preceding four steps. Best available evidence was used where possible, supplemented by value judgements as required. Recommended resource targets for inpatient service were: 20 acute beds per 100,000 population, consistent with national average service provision but 13% above Queensland provision in 2005; and 10 non-acute beds per 100,000, 65% below Queensland levels in 2005. Growth in service provision was recommended for all other components. Adult residential rehabilitation service targets were 10 clinical 24-hour staffed beds per 100,000, and 18 non-clinical beds per 100,000. Supported accommodation targets were 35 beds per 100,000 in supervised hostels and 35 places per 100,000 in supported public housing. A direct care clinical workforce of 70 FTE per 100,000 for ambulatory care services was recommended. Fifteen per cent of total mental health funding was recommended for community support services provided by non-government organisations. The recommended targets pointed to specific areas for priority in Queensland, notably the need for additional acute inpatient services for older persons and expansion of clinical ambulatory care, residential rehabilitation and supported accommodation services. The development of nationally agreed planning targets for public mental health services and the mental health community support sector were identified as priorities.

Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs.

PubMed

Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F

2017-06-01

To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P < .05). Adjusted prevalence of using garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

Service, training, mentorship: first report of an innovative education-support program to revitalize primary care social service in Chiapas, Mexico.

PubMed

Van Wieren, Andrew; Palazuelos, Lindsay; Elliott, Patrick F; Arrieta, Jafet; Flores, Hugo; Palazuelos, Daniel

2014-01-01

The Mexican mandatory year of social service following medical school, or pasantía, is designed to provide a safety net for the underserved. However, social service physicians (pasantes) are typically unpracticed, unsupervised, and unsupported. Significant demotivation, absenteeism, and underperformance typically plague the social service year. Compañeros en Salud (CES) aimed to create an education-support package to turn the pasantía into a transformative learning experience. CES recruited pasantes to complete their pasantía in CES-supported Ministry of Health clinics in rural Chiapas. The program aims to: 1) train pasantes to more effectively deliver primary care, 2) expose pasantes to central concepts of global health and social medicine, and 3) foster career development of pasantes. Program components include supportive supervision, on-site mentorship, clinical information resources, monthly interactive seminars, and improved clinic function. We report quantitative and qualitative pasante survey data collected from February 2012 to August 2013 to discuss strengths and weaknesses of this program and its implications for the pasante workforce in Mexico. Pasantes reported that their medical knowledge, and clinical and leadership skills all improved during the CES education-support program. Most pasantes felt the program had an overall positive effect on their career goals and plans, although their self-report of preparedness for the Mexican residency entrance exam (ENARM) decreased during the social service year. One hundred percent reported they were satisfied with the CES-supported pasantía experience and wished to help the poor and underserved in their careers. Education-support programs similar to the CES program may encourage graduating medical students to complete their social service in underserved areas, improve the quality of care provided by pasantes, and address many of the known shortcomings of the pasantía. Additional efforts should focus on developing a strategy to expand this education-support model so that more pasantes throughout Mexico can experience a transformative, career-building, social service year.

Web service activities at the IRIS DMC to support federated and multidisciplinary access

NASA Astrophysics Data System (ADS)

Trabant, Chad; Ahern, Timothy K.

2013-04-01

At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms for data sets spanning multiple centers. To promote the adoption of these standardized services the DMC has developed portable implementations of the software needed to host these interfaces, minimizing the work required at each data center. Within the COOPEUS project framework, the DMC is working with EU partners to install web services implementations at multiple data centers in Europe.

76 FR 19978 - Procurement List; Proposed Addition

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... Location: Base Operation Support Service, Department of Public Works, Fort George D. Meade, MD. NPA..., Mission and Installation Contracting Command, Fort Eustis, VA. End of Certification Patricia Briscoe...

Ecosystem Functions Connecting Contributions from Ecosystem Services to Human Wellbeing in a Mangrove System in Northern Taiwan.

PubMed

Hsieh, Hwey-Lian; Lin, Hsing-Juh; Shih, Shang-Shu; Chen, Chang-Po

2015-06-09

The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network was developed and evaluated by an expert panel consisting of hydrologists, ecologists, and experts in the field of culture, landscape or architecture. The results showed that supporting habitats was the most important function to human wellbeing, while water quality, habitable climate, air quality, recreational opportunities, and knowledge systems were services that were strongly linked to human welfare. Security of continuous supply of services appeared to be the key to a comfortable life. From a bottom-up and top-down perspective, knowledge systems (a service) were most supported by ecosystem functions, while the security of continuous supply of services (wellbeing) had affected the most services. In addition, the overall benefits of mangrove services to human prosperity concentrated on mental health, security of continuous supply of services, and physical health.

Ecosystem Functions Connecting Contributions from Ecosystem Services to Human Wellbeing in a Mangrove System in Northern Taiwan

PubMed Central

Hsieh, Hwey-Lian; Lin, Hsing-Juh; Shih, Shang-Shu; Chen, Chang-Po

2015-01-01

The present study examined a mangrove ecosystem in northern Taiwan to determine how the various components of ecosystem function, ecosystem services and human wellbeing are connected. The overall contributions of mangrove services to specific components of human wellbeing were also assessed. A network was developed and evaluated by an expert panel consisting of hydrologists, ecologists, and experts in the field of culture, landscape or architecture. The results showed that supporting habitats was the most important function to human wellbeing, while water quality, habitable climate, air quality, recreational opportunities, and knowledge systems were services that were strongly linked to human welfare. Security of continuous supply of services appeared to be the key to a comfortable life. From a bottom-up and top-down perspective, knowledge systems (a service) were most supported by ecosystem functions, while the security of continuous supply of services (wellbeing) had affected the most services. In addition, the overall benefits of mangrove services to human prosperity concentrated on mental health, security of continuous supply of services, and physical health. PMID:26067989

A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

PubMed Central

2012-01-01

Background NICE recommends computerised cognitive behavioural therapy (cCBT) for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS) in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks. PMID:22958309

47 CFR 54.503 - Other supported special services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... telecommunications carriers include voice mail, interconnected voice over Internet protocol (VoIP), text messaging, Internet access, and installation and maintenance of internal connections in addition to all reasonable...

Beyond Close Air Support. Forging a New Air-Ground Partnership

DTIC Science & Technology

2005-01-01

15213-1516 RAND URL: http://www.rand.org/ To order RAND documents or to obtain additional information, contact Distribution Services : Telephone: (310) 451...prominence for either partner. It gives the least opportunity for parochial claims and one-sided plead- ing for one’s own service . Its very difficulty...could be a virtue: Once the services have mastered partnership, they can easily revert to sim- pler approaches. Partnership does not, of course, imply

The evaluation of NIMROD, a community-based service for people with mental handicap: revenue costs.

PubMed

Davies, L; Felce, D; Lowe, K; de Paiva, S

1991-11-01

The cost implications of moving from a system of services for people with mental handicaps centred on large institutions to a network of community-based services are not precisely known. The provision of the NIMROD service in a part of Cardiff, with its aim not only to meet the residential needs of adults comprehensively by providing a number of houses in the community but also to develop a support service to people living in their family home, gave an opportunity to investigate and report the revenue costs of a number of service elements with respect to a defined total population. The residential costs of intensively staffed houses in 1986-87, varying in size from two to six places, were found to range between pounds 16,473 and pounds 23,319 per person per year. With the addition of community support costs, such as the provision of day services, the total costs of care per resident averaged pounds 21,708; range, pounds 18,883-pounds 26,009. These compared to the total costs in a minimally staffed house of pounds 9,678 per resident. The costs of community support services for people living in their family homes averaged pounds 5,614 inclusive of DSS benefits, of which pounds 1,743 was accounted for by the NIMROD domiciliary support service, office base and administrative overheads. The residential costs reported were compared to other cost data in the literature. The study supports previous conclusions that there is little evidence of diseconomy attached to small scale per se but that the way staffing levels and therefore staff costs are determined is critical. No evidence was found in this study to link greater cost to better quality.

Update: Providing Quality Family Planning Services - Recommendations from CDC and the U.S. Office of Population Affairs, 2017.

PubMed

Gavin, Loretta; Pazol, Karen; Ahrens, Katherine

2017-12-22

In April 2014, CDC published "Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs" (QFP), which describes the scope of services that should be offered in a family planning visit and how to provide those services (e.g., periodicity of screening, which persons are in need of services, etc.) (1). The sections in QFP include the following: Determining the Client's Need for Services; Contraceptive Services; Pregnancy Testing and Counseling; Clients Who Want to Become Pregnant; Basic Infertility Services; Preconception Health Services; Sexually Transmitted Disease Services; and Related Preventive Health Services. In addition, the QFP includes an appendix entitled Screening Services for Which Evidence Does Not Support Screening.

Culturally competent library services and related factors among health sciences librarians: an exploratory study.

PubMed

Mi, Misa; Zhang, Yingting

2017-04-01

This study investigated the current state of health sciences libraries' provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites ( p =0.04). Those who spoke another language in addition to English had higher self-rated cultural competency ( p =0.01) than those who only spoke English. These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians' perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds.

Culturally competent library services and related factors among health sciences librarians: an exploratory study

PubMed Central

Mi, Misa; Zhang, Yingting

2017-01-01

Objective This study investigated the current state of health sciences libraries’ provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. Methods This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. Results Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites (p=0.04). Those who spoke another language in addition to English had higher self-rated cultural competency (p=0.01) than those who only spoke English. Conclusions These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians’ perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds. PMID:28377675

Interprofessional Work in Early Childhood Education and Care Services to Support Children with Additional Needs: Two Approaches

ERIC Educational Resources Information Center

Wong, Sandie; Press, Frances

2017-01-01

In Australia, over 900,000 children attend some type of early childhood education and care service. Many of these children have learning difficulties and early childhood teachers play a significant role in identifying children's needs and working with other professionals to instigate and/or implement appropriate interventions. When educators and…

Putting Children and Families First: Head Start Programs in 2010. Brief No. 10

ERIC Educational Resources Information Center

Schmit, Stephanie; Ewen, Danielle

2012-01-01

Since its creation in 1965, Head Start has provided high quality early education and comprehensive support services to three- and four-year-olds in poor families. In addition to early learning opportunities, Head Start's comprehensive early childhood development program provides children and families with access to a range of services such as…

ATM over hybrid fiber-coaxial cable networks: practical issues in deploying residential ATM services

NASA Astrophysics Data System (ADS)

Laubach, Mark

1996-11-01

Residential broadband access network technology based on asynchronous transfer modem (ATM) will soon reach commercial availability. The capabilities provided by ATM access network promise integrated services bandwidth available in excess of those provided by traditional twisted pair copper wire public telephone networks. ATM to the side of the home placed need quality of service capability closest to the subscriber allowing immediate support for Internet services and traditional voice telephony. Other services such as desktop video teleconferencing and enhanced server-based application support can be added as part of future evolution of the network. Additionally, advanced subscriber home networks can be supported easily. This paper presents an updated summary of the standardization efforts for the ATM over HFC definition work currently taking place in the ATM forum's residential broadband working group and the standards progress in the IEEE 802.14 cable TV media access control and physical protocol working group. This update is fundamental for establishing the foundation for delivering ATM-based integrated services via a cable TV network. An economic model for deploying multi-tiered services is presenting showing that a single-tier service is insufficient for a viable cable operator business. Finally, the use of an ATM based system lends itself well to various deployment scenarios of synchronous optical networks (SONET).

Internal Branding in Universities and the Lessons Learnt from the Past: The Significance of Employee Brand Support and Transformational Leadership

ERIC Educational Resources Information Center

Sujchaphong, Narissara; Nguyen, Bang; Melewar, T. C.

2015-01-01

The paper reviews the literature on the concept of internal branding and its effects in the service sector in general, as well as in UK universities. In addition, the concept of employee brand support is reviewed, discussing the influence of leadership characteristics on internal branding in universities. Employee brand support is a crucial…

A cross-sectional survey of the prevalence of environmental tobacco smoke preventive care provision by child health services in Australia

PubMed Central

2011-01-01

Background Despite the need for a reduction in levels of childhood exposure to environmental tobacco smoke (ETS) being a recognised public health goal, the delivery of ETS preventive care in child health service settings remains a largely unstudied area. The purpose of this study was to determine the prevalence of ETS preventive care in child health services; differences in the provision of care by type of service; the prevalence of strategies to support such care; and the association between care support strategies and care provision. Method One-hundred and fifty-one (83%) child health service managers within New South Wales, Australia completed a questionnaire in 2002 regarding the: assessment of parental smoking and child ETS exposure; the provision of parental smoking cessation and ETS-exposure reduction advice; and strategies used to support the provision of such care. Child health services were categorised based on their size and case-mix, and a chi-square analysis was performed to compare the prevalence of ETS risk assessment and ETS prevention advice between service types. Logistic regression analysis was used to examine associations between the existence of care support strategies and the provision of ETS risk assessment and ETS exposure prevention advice. Results A significant proportion of services reported that they did not assess parental smoking status (26%), and reported that they did not assess the ETS exposure (78%) of any child. Forty four percent of services reported that they did not provide smoking cessation advice and 20% reported they did not provide ETS exposure prevention advice. Community based child and family health services reported a greater prevalence of ETS preventive care compared to other hospital based units. Less than half of the services reported having strategies to support the provision of ETS preventive care. The existence of such support strategies was associated with greater odds of care provision. Conclusions The existence of major gaps in recommended ETS preventive care provision suggests a need for additional initiatives to increase such care delivery. The low prevalence of strategies that support such care delivery suggests a potential avenue to achieve this outcome. PMID:21575273

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.

Supporting family carers providing end-of-life home care: a qualitative study on the impact of a hospice at home service.

PubMed

Jack, Barbara A; O'Brien, Mary R; Scrutton, Joyce; Baldry, Catherine R; Groves, Karen E

2015-01-01

To explore bereaved family carers' perceptions and experiences of a hospice at home service. The increasing demand for the development of home-based end-of-life services is not confined to the western world; such services are also emerging in resource-poor countries where palliative care services are developing with limited inpatient facilities. Despite this growing trend, studies show a variety of interrelated factors, with an emphasis on the availability of informal carers and their ability to cope, which can influence whether terminally ill patients actually remain at home. A hospice at home service was developed to meet patients' and families' needs by providing individually tailored resources. A qualitative study. Data were collected by semi-structured, digitally recorded interviews from 20 family carers who had experienced the service. Interviews were transcribed verbatim and a thematic approach adopted for analysis. All participants reported a personal positive impact of the service. Family carers commented the service provided a valued presence, they felt in good hands and importantly it helped in supporting normal life. The impact of an individualised, targeted, hospice at home service using dedicated, palliative care trained, staff, is perceived positively by family carers and importantly, supportive of those with additional caring or employment commitments. The emergence of hospice at home services has resulted in more options for patients and their families, when the increased amount of care a family member has to provide in these circumstances needs to be adequately supported, with the provision of a flexible service tailored to individual needs and delivered by appropriately trained staff. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Pacific Southwest Media Center

EPA Pesticide Factsheets

News media, state and local officials, and others can find press releases, media events and contacts in EPA's Pacific Southwest. Additional resources include newsletters, annual reports, and library services that support regional activities.

Tools, Services & Support of NASA Salinity Mission Data Archival Distribution through PO.DAAC

NASA Astrophysics Data System (ADS)

Tsontos, V. M.; Vazquez, J.

2017-12-01

The Physical Oceanography Distributed Active Center (PO.DAAC) serves as the designated NASA repository and distribution node for all Aquarius/SAC-D and SMAP sea surface salinity (SSS) mission data products in close collaboration with the projects. In addition to these official mission products, that by December 2017 will include the Aquarius V5.0 end-of-mission data, PO.DAAC archives and distributes high-value, principal investigator led satellite SSS products, and also datasets from NASA's "Salinity Processes in the Upper Ocean Regional Study" (SPURS 1 & 2) field campaigns in the N. Atlantic salinity maximum and high rainfall E. Tropical Pacific regions. Here we report on the status of these data holdings at PO.DAAC, and the range of data services and access tools that are provided in support of NASA salinity. These include user support and data discovery services, OPeNDAP and THREDDS web services for subsetting/extraction, and visualization via LAS and SOTO. Emphasis is placed on newer capabilities, including PODAAC's consolidated web services (CWS) and advanced L2 subsetting tool called HiTIDE.

Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

PubMed

Lapão, Luís Velez; Correia, Artur

2015-01-01

This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

Support Services for Freshmen with Disabilities at Postsecondary Institutions in Northeast Tennessee

ERIC Educational Resources Information Center

Barberi, Beverly D.

2017-01-01

College can be a challenging time for freshmen students; but for freshmen college students with disabilities, there are additional challenges to overcome. The purpose of this case study was to analyze freshmen students' perceptions of the various student support programs available for college students with mental or cognitive disabilities and the…

The StratusLab cloud distribution: Use-cases and support for scientific applications

NASA Astrophysics Data System (ADS)

Floros, E.

2012-04-01

The StratusLab project is integrating an open cloud software distribution that enables organizations to setup and provide their own private or public IaaS (Infrastructure as a Service) computing clouds. StratusLab distribution capitalizes on popular infrastructure virtualization solutions like KVM, the OpenNebula virtual machine manager, Claudia service manager and SlipStream deployment platform, which are further enhanced and expanded with additional components developed within the project. The StratusLab distribution covers the core aspects of a cloud IaaS architecture, namely Computing (life-cycle management of virtual machines), Storage, Appliance management and Networking. The resulting software stack provides a packaged turn-key solution for deploying cloud computing services. The cloud computing infrastructures deployed using StratusLab can support a wide range of scientific and business use cases. Grid computing has been the primary use case pursued by the project and for this reason the initial priority has been the support for the deployment and operation of fully virtualized production-level grid sites; a goal that has already been achieved by operating such a site as part of EGI's (European Grid Initiative) pan-european grid infrastructure. In this area the project is currently working to provide non-trivial capabilities like elastic and autonomic management of grid site resources. Although grid computing has been the motivating paradigm, StratusLab's cloud distribution can support a wider range of use cases. Towards this direction, we have developed and currently provide support for setting up general purpose computing solutions like Hadoop, MPI and Torque clusters. For what concerns scientific applications the project is collaborating closely with the Bioinformatics community in order to prepare VM appliances and deploy optimized services for bioinformatics applications. In a similar manner additional scientific disciplines like Earth Science can take advantage of StratusLab cloud solutions. Interested users are welcomed to join StratusLab's user community by getting access to the reference cloud services deployed by the project and offered to the public.

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

PubMed Central

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. Conclusions The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

PubMed

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

Social Support, Help-Seeking, and Mental Health Outcomes Among Veterans in Non-VA Facilities: Results from the Veterans’ Health Study

PubMed Central

Adams, Richard E.; Urosevich, Thomas G.; Hoffman, Stuart N.; Kirchner, H. Lester; Hyacinthe, Johanna C.; Figley, Charles R.; Boscarino, Joseph J.; Boscarino, Joseph A.

2017-01-01

Using a stress process model, the authors examined social and psychological resources to better understand mental health outcomes among veterans. For this study, we surveyed 700 U.S. veterans who were outpatients in the Geisinger Health System. Independent variables included demographic factors, stressful and traumatic events, social support measures, and psychosocial factors. Using logistic regression, the authors examined 4 types of social connections: social support, help-seeking support, social capital, and other mental health support to predict mental health outcomes, including posttraumatic stress disorder, depression, suicide ideation, alcohol misuse, mental health service use, and Veterans Affairs service use. Results suggested that help-seeking support since deployment was a risk factor for 5 adverse outcomes, whereas social support was protective for 1 outcome. We concluded that high levels of help-seeking support since deployment among veterans was associated with a higher prevalence of mental health problems. These findings were unexpected and suggest the need for additional social support-related research among veterans. PMID:29098116

Meeting unmet needs of families of persons with mental illness: evaluation of a family peer support helpline.

PubMed

Shor, Ron; Birnbaum, Menachem

2012-08-01

Family members of persons with mental illness experience multiple stressors stemming from the burdens of caring for the ill family member. A potential source of help for this population is a family peer support helpline. Knowledge, however, is lacking about the types of help offered in such a service and its benefit for this population. In a study conducted in Israel, 800 calls made by family members of persons with mental illness to a family peer support helpline were analyzed utilizing an instrument developed for the family peers' evaluation of the calls. In addition, researchers conducted 77 follow-up interviews with callers who agreed to be interviewed. The findings indicate the importance of the life experience, flexibility and anonymity of the family peers in providing types of help that are complementary to the help provided by formal services. The most frequent categories of support provided were emotional support, information and advice. This help could assist family members of persons with mental illness with their care-giving role, as well as provide them with an alternative source of help if they experience difficulties with professionals. It could also serve as a catalyst in encouraging them to establish and maintain contact with the formal mental health services. Recognizing and supporting the contribution of a family peer support helpline would encourage its development within the range of services available for this population.

Employment and educational outcomes in early intervention programmes for early psychosis: a systematic review.

PubMed

Bond, G R; Drake, R E; Luciano, A

2015-10-01

Young adults with early psychosis want to pursue normal roles - education and employment. This paper summarises the empirical literature on the effectiveness of early intervention programmes for employment and education outcomes. We conducted a systematic review of employment/education outcomes for early intervention programmes, distinguishing three programme types: (1) those providing supported employment, (2) those providing unspecified vocational services and (3) those without vocational services. We summarised findings for 28 studies. Eleven studies evaluated early intervention programmes providing supported employment. In eight studies that reported employment outcomes separately from education outcomes, the employment rate during follow-up for supported employment patients was 49%, compared with 29% for patients receiving usual services. The two groups did not differ on enrolment in education. In four controlled studies, meta-analysis showed that the employment rate for supported employment participants was significantly higher than for control participants, odds ratio = 3.66 [1.93-6.93], p < 0.0001. Five studies (four descriptive and one quasi-experimental) of early intervention programmes evaluating unspecified vocational services were inconclusive. Twelve studies of early intervention programmes without vocational services were methodologically heterogeneous, using diverse methods for evaluating vocational/educational outcomes and precluding a satisfactory meta-analytic synthesis. Among studies with comparison groups, 7 of 11 (64%) reported significant vocational/education outcomes favouring early intervention over usual services. In early intervention programmes, supported employment moderately increases employment rates but not rates of enrolment in education. These improvements are in addition to the modest effects early programmes alone have on vocational/educational outcomes compared with usual services.

Supporting Collaborative Model and Data Service Development and Deployment with DevOps

NASA Astrophysics Data System (ADS)

David, O.

2016-12-01

Adopting DevOps practices for model service development and deployment enables a community to engage in service-oriented modeling and data management. The Cloud Services Integration Platform (CSIP) developed the last 5 years at Colorado State University provides for collaborative integration of environmental models into scalable model and data services as a micro-services platform with API and deployment infrastructure. Originally developed to support USDA natural resource applications, it proved suitable for a wider range of applications in the environmental modeling domain. While extending its scope and visibility it became apparent community integration and adequate work flow support through the full model development and application cycle drove successful outcomes.DevOps provide best practices, tools, and organizational structures to optimize the transition from model service development to deployment by minimizing the (i) operational burden and (ii) turnaround time for modelers. We have developed and implemented a methodology to fully automate a suite of applications for application lifecycle management, version control, continuous integration, container management, and container scaling to enable model and data service developers in various institutions to collaboratively build, run, deploy, test, and scale services within minutes.To date more than 160 model and data services are available for applications in hydrology (PRMS, Hydrotools, CFA, ESP), water and wind erosion prediction (WEPP, WEPS, RUSLE2), soil quality trends (SCI, STIR), water quality analysis (SWAT-CP, WQM, CFA, AgES-W), stream degradation assessment (SWAT-DEG), hydraulics (cross-section), and grazing management (GRAS). In addition, supporting data services include soil (SSURGO), ecological site (ESIS), climate (CLIGEN, WINDGEN), land management and crop rotations (LMOD), and pesticides (WQM), developed using this workflow automation and decentralized governance.

Evaluating the content of Individualized Education Programs and 504 Plans of young adolescents with attention deficit/hyperactivity disorder.

PubMed

Spiel, Craig F; Evans, Steven W; Langberg, Joshua M

2014-12-01

The purpose of this study was to evaluate the degree with which Individualized Education Programs (IEPs) and 504 Plans prepared for middle school students with attention deficit/hyperactivity disorder (ADHD) conformed to best practices and included evidence-based services. Specifically, we examined the problem areas identified in the statement of students' present level of academic achievement and functional performance (PLAAFP) and targeted in the students' measurable annual goals and objectives (MAGOs). In addition, we compared services with lists of recommended services provided by the U.S. Department of Education (ED) and reviews of evidence-based practices. Participants were 97 middle school students with ADHD, 61.9% with an IEP, and 38.1% with a 504 Plan. Most (85%) IEP PLAAFP statements described nonacademic/behavior problems, but fewer than half had MAGOs targeting these areas of need. Services listed on IEPs and Section 504 Plans were frequently consistent with ED recommendations, but had little to no research supporting their effectiveness. In addition, services with evidence supporting benefit to students with ADHD were rarely included on IEPs or 504 Plans. Implications for special education policy and future directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A transport level approach for TCP to support differentiated services

NASA Astrophysics Data System (ADS)

Xian, Yong-Ju; Tao, Yang; Xu, Chang-Biao

2004-04-01

Recently, there is an increasing interests in providing differentiated services in Internet. However, research efforts have almost exclusively focused on routers by improving their policies of packet scheduling and queue management. There has been much less work on transport level approaches to support differentiated services. The mechanism presented by Chang-Biao Xu, DSAS-TCP and MulTCP are the only pieces of the works in this direction known to the authors. Up to now, there is no paper to discuss the interrelation between these mechanisms. Regarding throughput as TCP criteria to support proportional-differentiated-services (PDS), this paper deeply explores the variants of AIMD(a,b)-based TCP congestion control and their effect on differentiated services, and presents a transport level approach for TCP to support PDS, namely PDS_TCP which can be obtained by introducing weighted factor to a or b of AIMD(a,b)-based TCP congestion control. PDS_TCP also takes into account the influence of slow start for timeout. From the analysis, this paper draws the conclusion that the existing mechanisms are only variants of PDS_TCP. For the example of PDS_TCP, the principles, implementation and simulation results of PDS_a_TCP are discussed in detail. The theory analysis and simulation results show that the proposed mechanism PDS_TCP can be implemented with lower additional overheads and support controlled PDS very well without the loss of flexibility.

Further Analyses of the Test of Paid Radio Advertising for Armed Services Recruitment. Volume IV,

DTIC Science & Technology

1977-03-01

During Fall 1975, a test was designed and executed to determine the effectiveness of paid radio as an addition to the advertising media mix in...support of military recruiting. A number of markets were matched on the basis of factors related to contracts for accession. Markets were subdivided, some...receiving radio for only a single service, other markets using radio for three different services, and remaining markets serving as controls. The

A Redesign Approach for Improving Animal Care Services for Researchers

PubMed Central

Okpe, Orighomisan; Kovach, Jamison V

2017-01-01

Because a research institution's animal care and use program oversees the provision of services specified in approved protocols designed by researchers, the effective provision of services within these programs is paramount to ensuring the humane care and treatment of research animals in accordance with federal, state, and local regulations and institutional policies. To improve the services provided to researchers through animal care and use programs, we investigated the relationship between the researchers who conduct these types of studies and the veterinary operations that provide care and treatment for research animals. Through a case study conducted at a leading public research university, we used an action-research approach to redesign aspects of the process through which researchers and the veterinary operations interact by using the Design for Six Sigma methodology. Using this structured approach for building quality into the design of a process to better serve customers, we identified and prioritized researchers’ expectations regarding the role of veterinary operations in supporting their animal research activities. In addition, ideas for addressing researchers’ top-rated needs were generated through focus groups. By updating online resources, creating checklists and newsletters, and hiring additional veterinary staff, the services provided were amended to provide researchers with increased access to valuable information, improved clarity regarding the process for obtaining access to research facilities, and enhanced support for animal care services. PMID:28724497

A Redesign Approach for Improving Animal Care Services for Researchers.

PubMed

Okpe, Orighomisan; Kovach, Jamison V

2017-07-01

Because a research institution's animal care and use program oversees the provision of services specified in approved protocols designed by researchers, the effective provision of services within these programs is paramount to ensuring the humane care and treatment of research animals in accordance with federal, state, and local regulations and institutional policies. To improve the services provided to researchers through animal care and use programs, we investigated the relationship between the researchers who conduct these types of studies and the veterinary operations that provide care and treatment for research animals. Through a case study conducted at a leading public research university, we used an action-research approach to redesign aspects of the process through which researchers and the veterinary operations interact by using the Design for Six Sigma methodology. Using this structured approach for building quality into the design of a process to better serve customers, we identified and prioritized researchers' expectations regarding the role of veterinary operations in supporting their animal research activities. In addition, ideas for addressing researchers' top-rated needs were generated through focus groups. By updating online resources, creating checklists and newsletters, and hiring additional veterinary staff, the services provided were amended to provide researchers with increased access to valuable information, improved clarity regarding the process for obtaining access to research facilities, and enhanced support for animal care services.

A new hat for librarians: providing REDCap support to establish the library as a central data hub

PubMed Central

Read, Kevin; LaPolla, Fred Willie Zametkin

2018-01-01

Background REDCap, an electronic data capture tool, supports good research data management, but many researchers lack familiarity with the tool. While a REDCap administrator provided technical support and a clinical data management support unit provided study design support, a service gap existed. Case Presentation Librarians with REDCap expertise sought to increase and improve usage through outreach, workshops, and consultations. In collaboration with a REDCap administrator and the director of the clinical data management support unit, the role of the library was established in providing REDCap training and consultations. REDCap trainings were offered to the medical center during the library’s quarterly data series, which served as a springboard for offering tailored REDCap support to researchers and research groups. Conclusions Providing REDCap support has proved to be an effective way to associate the library with data-related activities in an academic medical center and identify new opportunities for offering data services in the library. By offering REDCap services, the library established strong partnerships with the Information Technology Department, Clinical Data Support Department, and Compliance Office by filling in training gaps, while simultaneously referring users back to these departments when additional expertise was required. These new partnerships continue to grow and serve to position the library as a central data hub in the institution. PMID:29339942

Trends and Milestones: Leveraging Federal Funding in the States To Address Olmstead [and] Growing Waiting Lists.

ERIC Educational Resources Information Center

Hemp, Richard; Parish, Susan; Braddock, David, Ed.; Smith, Gary, Ed.

2001-01-01

This article discusses using existing state resources not currently used for matching purposes to leverage additional federal Medicaid funding for community services and supports for persons with mental retardation. A table is provided that lists state funds potentially available to match additional federal Medicaid funding. (Contains six…

The relationship between older Americans act in-home services and low-care residents in nursing homes.

PubMed

Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

PhysioDirect: Supporting physiotherapists to deliver telephone assessment and advice services within the context of a randomised trial

PubMed Central

Bishop, Annette; Gamlin, Jill; Hall, Jeanette; Hopper, Cherida; Foster, Nadine E.

2013-01-01

Physiotherapy-led telephone assessment and advice services for patients with musculoskeletal problems have been developed in many services in the UK, but high quality trial data on clinical and cost effectiveness has been lacking. In order to address this ‘The PhysioDirect trial’ (ISRCTN55666618), was a pragmatic randomised trial of a PhysioDirect telephone assessment and advice service. This paper describes the PhysioDirect system used in the trial and how physiotherapists were trained and supported to use the system and deliver the PhysioDirect service. The PhysioDirect system used in the trial was developed in Huntingdon and now serves a population of 350,000 people. When initiating or providing physiotherapy-led telephone assessment and advice services training and support for physiotherapists delivering care in this way is essential. An enhanced skill set is required for telephone assessment and advice particularly in listening and communication skills. In addition to an initial training programme, even experienced physiotherapists benefit from a period of skill consolidation to become proficient and confident in assessing patients and delivering care using the telephone. A computer-based system assists the delivery of a physiotherapy-led musculoskeletal assessment and advice service. Clinical Trials Registration Number (ISRCTN55666618). PMID:23219629

Training Health Service Technicians as Teacher Assistants in an Inpatient Residential Emotional/Behavior Disorder Classroom Setting

ERIC Educational Resources Information Center

Banks, Walter E.

2012-01-01

Schools have identified that the use of Teacher Assistants often provides needed additional support in the school setting. In a Health Care Facility that provides inpatient psychiatric services, children ages 5-14 are required to engage in school activities. Currently there are no Teacher Assistants trained in the facility. This study focuses on…

The Lindsay Leg Club: supporting the NHS to provide leg ulcer care.

PubMed

McKenzie, Morag

2013-06-01

Public health services will need to cope with additional demands due to an ageing society and the increasing prevalence of chronic conditions. Lower-limb ulceration is a long-term, life-changing condition and leg ulcer management can be challenging for nursing staff. The Lindsay Leg Club model is a unique partnership between community nurses, members and the local community, which provides quality of care and empowerment for patients with leg ulcers, while also supporting and educating nursing staff. The Leg Club model works in accord with core themes of Government and NHS policy. Patient feedback on the Leg Club model is positive and the Leg Clubs provide a service to members which is well accepted by patients, yet is more economically efficient than the traditional district nursing practice of home visits. Lindsay Leg Clubs provide a valuable support service to the NHS in delivering improved quality of care while improving efficiency.

Sexual health problems of adolescents attending a sexual health service.

PubMed

Black, Christine; McGough, Pauline; Fargie, Fiona; Brown, Beverley Wilson

2012-02-01

To determine whether adolescents who present at a sexual health service aged 13 have more sexual health problems in later years than those who present aged 15. A case-note review was done in 2009 to identify sexual health problems for all 13-year-olds who registered with Sandyford sexual health service from April 2003 until December 2004 (group 1). This was compared with selected notes from adolescents who were 15 years old at the time of registration (group 2). Eighty-eight youths aged 13 and 632 aged 15 registered in the aforementioned period. Ninety records of 15-year-olds were selected for comparison. Twenty two of the 86 girls in group 1 and 31 of the 87 girls in group 2 had at least one pregnancy. Twenty-one adolescents in group 1 and 25 of those in group 2 had a sexually transmitted infection. Thirteen youths in group 1 and one in group 2 had suffered a sexual assault. Adolescents aged 13 at first registration with this service have more sexual health problems and warrant additional support throughout their teenage years. A very young age at first registration should prompt health professionals to provide additional clinical, emotional and social support.

[Who exactly are these "persons with limitations in daily living skills"? : Survey of insured persons based on health insurance data].

PubMed

Runte, Rebecca; Müller, Rolf

2016-12-01

In recent years German long-term care insurance coverage has gradually been extended to include services for people with limitations in daily living skills. Until now, however, it was unclear who exactly people with limited daily living skills are. The study aimed to characterize people with limited daily living skills who use additional support services as defined by § 45b of the Social Services Code XI (SGB XI). This study was based on a survey of 1284 people with limited daily living skills who used additional support services (§ 45b SGB XI). The data were analyzed descriptively. The average recipient was 81 years old, mainly in care level I and the majority of them were exclusively cared for by relatives. Of these recipients 61 % were diagnosed with dementia, 73.4 % had medium cognitive impairments while more than half could no longer carry out the instrumental activities of daily living (IADL). Statistics on people with limited daily living skills should be included in publications and reports so that the need for care and assistance can be estimated more precisely.

EnviroAtlas - Austin, TX - Demographics by Block Group Web Service

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://enviroatlas.epa.gov/EnviroAtlas). This EnviroAtlas dataset is a summary of key demographic groups for the EnviroAtlas community. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Building a science of partnership-focused research: forging and sustaining partnerships to support child mental health prevention and services research.

PubMed

Bradshaw, Catherine P; Haynes, Katherine Taylor

2012-07-01

Building on growing interest in translational research, this paper provides an overview of a special issue of Administration and Policy in Mental Health and Mental Health Service Research, which is focused on the process of forging and sustaining partnerships to support child mental health prevention and services research. We propose that partnership-focused research is a subdiscipline of translational research which requires additional research to better refine the theoretical framework and the core principles that will guide future research and training efforts. We summarize some of the major themes across the eight original articles and three commentaries included in the special issue. By advancing the science of partnership-focused research we will be able to bridge the gap between child mental health prevention and services research and practice.

Financial Health and Mental Health Among Clients of a Community Mental Health Center: Making the Connections.

PubMed

Harper, Annie; Clayton, Ashley; Bailey, Margaret; Foss-Kelly, Louisa; Sernyak, Michael J; Rowe, Michael

2015-12-01

This study evaluated financial challenges, satisfaction with financial-management supports, and interest in additional or alternative supports among clients of a mental health center. Six focus groups were held with 39 clients of an urban community mental health center who reported having difficulty with their finances. Five focus groups were held with direct-care staff who provided services to the clients. Investigators used an inductive analytical approach to distill themes from notes taken during the focus groups. Clients emphasized the challenges of living in poverty and described using complex strategies to sustain themselves, including negotiating benefits systems, carefully planning purchases, and developing and relying on social relationships. They spoke of having uneven access to tools and services for managing their money, such as advice from direct-care staff, representative payees, and bank accounts, and had varying opinions about their value. Noting concerns similar to those of clients, direct-care staff expressed frustration at the lack of support services for helping clients manage their finances. Both clients and staff expressed the need for more services to help clients with their finances. Findings suggest a need for more services to support people with mental illness to manage their finances, particularly a more flexible and broader range of options than are provided by current representative-payee mechanisms.

The association between cognitive impairment and community service use patterns in older people living in Australia.

PubMed

Vecchio, Nerina; Fitzgerald, Janna A; Radford, Katrina; Fisher, Ron

2016-05-01

Family plays a vital role in supporting individuals with dementia to reside in the community, thus delaying institutionalisation. Existing research indicates that the burden of care-giving is particularly high for those caring for a person with dementia. Yet, little is known about the uptake of community services by people with a diagnosis of dementia. Therefore, this study aims to better understand the relationship between cognitive impairment and the receipt of community care services. In order to examine the relationship, secondary data collected across Queensland, Australia, from 59,352 home-care clients aged 65 and over during 2007-2008 are analysed. This cross-sectional study uses regression analyses to estimate the relationship between cognitive impairment and service mix, while controlling for socio-demographic characteristics. The dependent variables include formal services, informal care and total home-care service hours during a 12-month period. The findings of this study demonstrate that cognitive impairment is associated with accessing more hours of respite and day centre care but fewer hours of other formal care services. Additionally, the likelihood of support from an informal caregiver increases when a client becomes cognitively impaired. Therefore, this study demonstrates that there is an increased need for respite programmes to support informal caregivers in the future, as the population of people living with dementia increases. These findings support the need for investigations of new and innovative respite models in the future. © 2015 John Wiley & Sons Ltd.

Signing Avatars: Using Virtual Reality to Support Students with Hearing Loss

ERIC Educational Resources Information Center

Zirzow, Nichole K.

2015-01-01

Students who are deaf or hard of hearing (D/HH) need additional support to learn curricular content and achieve academic outcomes. Students who attend rural schools may face greater challenges since they may have more limited access to services provided specially trained deaf educators. Yet, they need specialized instruction in learning how to use…

The effect of U.S. policies on the economics of libraries.

PubMed Central

Cummings, M M

1985-01-01

The decline in federal support of educational programs has made it difficult for libraries to apply new technologies to improve practices and services. While federal support has declined in constant dollars, there has been a modest increase in grants from private foundations. Current U.S. policies require federal agencies to recover full costs of rendering services (Circular A-25) and require the transfer of many federal service-oriented activities to the commercial sector (Circular A-76). Additionally, the Paperwork Reduction Act of 1980 is inhibiting the production and dissemination of federal publications. Government pursuit of these policies adds a heavy economic burden to libraries and threatens to reduce access to the scholarly and scientific record. PMID:3978292

TRMM Precipitation Application Examples Using Data Services at NASA GES DISC

NASA Technical Reports Server (NTRS)

Liu, Zhong; Ostrenga, D.; Teng, W.; Kempler, S.; Greene, M.

2012-01-01

Data services to support precipitation applications are important for maximizing the NASA TRMM (Tropical Rainfall Measuring Mission) and the future GPM (Global Precipitation Mission) mission's societal benefits. TRMM Application examples using data services at the NASA GES DISC, including samples from users around the world will be presented in this poster. Precipitation applications often require near-real-time support. The GES DISC provides such support through: 1) Providing near-real-time precipitation products through TOVAS; 2) Maps of current conditions for monitoring precipitation and its anomaly around the world; 3) A user friendly tool (TOVAS) to analyze and visualize near-real-time and historical precipitation products; and 4) The GES DISC Hurricane Portal that provides near-real-time monitoring services for the Atlantic basin. Since the launch of TRMM, the GES DISC has developed data services to support precipitation applications around the world. In addition to the near-real-time services, other services include: 1) User friendly TRMM Online Visualization and Analysis System (TOVAS; URL: http://disc2.nascom.nasa.gov/Giovanni/tovas/); 2) Mirador (http://mirador.gsfc.nasa.gov/), a simplified interface for searching, browsing, and ordering Earth science data at GES DISC. Mirador is designed to be fast and easy to learn; 3) Data via OPeNDAP (http://disc.sci.gsfc.nasa.gov/services/opendap/). The OPeNDAP provides remote access to individual variables within datasets in a form usable by many tools, such as IDV, McIDAS-V, Panoply, Ferret and GrADS; and 4) The Open Geospatial Consortium (OGC) Web Map Service (WMS) (http://disc.sci.gsfc.nasa.gov/services/wxs_ogc.shtml). The WMS is an interface that allows the use of data and enables clients to build customized maps with data coming from a different network.

Defining Ecosystem Assets for Natural Capital Accounting

PubMed Central

Hein, Lars; Bagstad, Ken; Edens, Bram; Obst, Carl; de Jong, Rixt; Lesschen, Jan Peter

2016-01-01

In natural capital accounting, ecosystems are assets that provide ecosystem services to people. Assets can be measured using both physical and monetary units. In the international System of Environmental-Economic Accounting, ecosystem assets are generally valued on the basis of the net present value of the expected flow of ecosystem services. In this paper we argue that several additional conceptualisations of ecosystem assets are needed to understand ecosystems as assets, in support of ecosystem assessments, ecosystem accounting and ecosystem management. In particular, we define ecosystems’ capacity and capability to supply ecosystem services, as well as the potential supply of ecosystem services. Capacity relates to sustainable use levels of multiple ecosystem services, capability involves prioritising the use of one ecosystem service over a basket of services, and potential supply considers the ability of ecosystems to generate services regardless of demand for these services. We ground our definitions in the ecosystem services and accounting literature, and illustrate and compare the concepts of flow, capacity, capability, and potential supply with a range of conceptual and real-world examples drawn from case studies in Europe and North America. Our paper contributes to the development of measurement frameworks for natural capital to support environmental accounting and other assessment frameworks. PMID:27828969

Defining ecosystem assets for natural capital accounting

USGS Publications Warehouse

Hein, Lars; Bagstad, Kenneth J.; Edens, Bram; Obst, Carl; de Jong, Rixt; Lesschen, Jan Peter

2016-01-01

In natural capital accounting, ecosystems are assets that provide ecosystem services to people. Assets can be measured using both physical and monetary units. In the international System of Environmental-Economic Accounting, ecosystem assets are generally valued on the basis of the net present value of the expected flow of ecosystem services. In this paper we argue that several additional conceptualisations of ecosystem assets are needed to understand ecosystems as assets, in support of ecosystem assessments, ecosystem accounting and ecosystem management. In particular, we define ecosystems’ capacity and capability to supply ecosystem services, as well as the potential supply of ecosystem services. Capacity relates to sustainable use levels of multiple ecosystem services, capability involves prioritising the use of one ecosystem service over a basket of services, and potential supply considers the ability of ecosystems to generate services regardless of demand for these services. We ground our definitions in the ecosystem services and accounting literature, and illustrate and compare the concepts of flow, capacity, capability, and potential supply with a range of conceptual and real-world examples drawn from case studies in Europe and North America. Our paper contributes to the development of measurement frameworks for natural capital to support environmental accounting and other assessment frameworks.

Defining Ecosystem Assets for Natural Capital Accounting.

PubMed

Hein, Lars; Bagstad, Ken; Edens, Bram; Obst, Carl; de Jong, Rixt; Lesschen, Jan Peter

2016-01-01

In natural capital accounting, ecosystems are assets that provide ecosystem services to people. Assets can be measured using both physical and monetary units. In the international System of Environmental-Economic Accounting, ecosystem assets are generally valued on the basis of the net present value of the expected flow of ecosystem services. In this paper we argue that several additional conceptualisations of ecosystem assets are needed to understand ecosystems as assets, in support of ecosystem assessments, ecosystem accounting and ecosystem management. In particular, we define ecosystems' capacity and capability to supply ecosystem services, as well as the potential supply of ecosystem services. Capacity relates to sustainable use levels of multiple ecosystem services, capability involves prioritising the use of one ecosystem service over a basket of services, and potential supply considers the ability of ecosystems to generate services regardless of demand for these services. We ground our definitions in the ecosystem services and accounting literature, and illustrate and compare the concepts of flow, capacity, capability, and potential supply with a range of conceptual and real-world examples drawn from case studies in Europe and North America. Our paper contributes to the development of measurement frameworks for natural capital to support environmental accounting and other assessment frameworks.

CMIP6 Citation Services and the Data Services of the IPCC Data Distribution Centre for AR6

NASA Astrophysics Data System (ADS)

Stockhause, Martina; Lautenschlager, Michael

2017-04-01

As a result of the experiences from CMIP5 the two services contributed by DKRZ to the CMIP research infrastructure have been improved for CMIP6: the Citation Services and the Services of the IPCC Data Distribution Centre (DDC, http://ipcc-data.org). 1. Data Citation Services: Within CMIP5 it took a couple of years before the data was citable with their DataCite DOIs. The DataCite DOI registration by the WDC Climate at DKRZ (World Data Center Climate at the Climate Computing Center) requires data transfer and long-term archival at DKRZ according to DDC's quality standards. Based on a request from WGCM (Working Group on Climate Models) an additional early citation possibility for the evolving CMIP6 data was added to the citation service (http://cmip6cite.wdc-climate.de). 2. IPCC DDC Services: WDC Climate has been hosting the IPCC DDC's Reference Data Archive for the climate model output underlying the IPCC Assessment Reports (ARs) since the Second Assessment Report in 1995. One task of the DDC is the support of the IPCC Working Groups (WGs) and their authors. The WG support was not sufficient for AR5 resulting in WG I setting up and maintaining their own CMIP5 data repository hosting a data subset. The DDC will open DKRZ's CMIP data pool as an additional DDC service for the IPCC authors using a synergy with the interests of the national climate community. Within the PICO the Citation and the IPCC DDC services will be presented from a user's perspective. The connections to and integration into the infrastructure for CMIP6 (see https://www.earthsystemcog.org/projects/wip/) will be explained.

Fuel cell assembly unit for promoting fluid service and electrical conductivity

DOEpatents

Jones, Daniel O.

1999-01-01

Fluid service and/or electrical conductivity for a fuel cell assembly is promoted. Open-faced flow channel(s) are formed in a flow field plate face, and extend in the flow field plate face between entry and exit fluid manifolds. A resilient gas diffusion layer is located between the flow field plate face and a membrane electrode assembly, fluidly serviced with the open-faced flow channel(s). The resilient gas diffusion layer is restrained against entering the open-faced flow channel(s) under a compressive force applied to the fuel cell assembly. In particular, a first side of a support member abuts the flow field plate face, and a second side of the support member abuts the resilient gas diffusion layer. The support member is formed with a plurality of openings extending between the first and second sides of the support member. In addition, a clamping pressure is maintained for an interface between the resilient gas diffusion layer and a portion of the membrane electrode assembly. Preferably, the support member is spikeless and/or substantially flat. Further, the support member is formed with an electrical path for conducting current between the resilient gas diffusion layer and position(s) on the flow field plate face.

Supporting change in chronic disease risk behaviours for people with a mental illness: a qualitative study of the experiences of family carers.

PubMed

Bailey, Jacqueline M; Hansen, Vibeke; Wye, Paula M; Wiggers, John H; Bartlem, Kate M; Bowman, Jennifer A

2018-03-27

People with a mental illness experience greater chronic disease morbidity and mortality, and associated reduced life expectancy, compared to those without such an illness. A higher prevalence of chronic disease risk behaviours (inadequate nutrition, inadequate physical activity, tobacco smoking, and harmful alcohol consumption) is experienced by this population. Family carers have the potential to support change in such behaviours among those they care for with a mental illness. This study aimed to explore family carers': 1) experiences in addressing the chronic disease risk behaviours of their family members; 2) existing barriers to addressing such behaviours; and 3) perceptions of potential strategies to assist them to provide risk behaviour change support. A qualitative study of four focus groups (n = 31), using a semi-structured interview schedule, was conducted with carers of people with a mental illness in New South Wales, Australia from January 2015 to February 2016. An inductive thematic analysis was employed to explore the experience of carers in addressing the chronic disease risk behaviours. Two main themes were identified in family carers' report of their experiences: firstly, that health behaviours were salient concerns for carers and that they were engaged in providing support, and secondly that they perceived a bidirectional relationship between health behaviours and mental well-being. Key barriers to addressing behaviours were: a need to attend to carers' own well-being; defensiveness on behalf of the family member; and not residing with their family member; with other behaviour-specific barriers also identified. Discussion around strategies which would assist carers in providing support for health risk behaviours identified a need for improved communication and collaboration between carers and health services accessed by their family members. Additional support from general and mental health services accessed by family members is desired to assist carers to address the barriers to providing behaviour change support. Carers have the potential to support and extend health service interventions aimed at improving the chronic disease risk behaviours of people with a mental illness but may require additional information, and collaboration from services. Further research is needed to explore these constructs in a large representative sample.

Sustainable Telemedicine: Designing and Building Infrastructure to Support a Comprehensive Telemedicine Practice.

PubMed

Kreofsky, Beth L H; Blegen, R Nicole; Lokken, Troy G; Kapraun, Susan M; Bushman, Matthew S; Demaerschalk, Bart M

2018-04-16

Telemedicine services in medical institutions are often developed in isolation of one another and not as part of a comprehensive telemedicine program. The Center for Connected Care is the administrative home for a broad range of telehealth services at Mayo Clinic. This article speaks of real-time video services, referenced as telemedicine throughout. This article discusses how a large healthcare system designed and built the infrastructure to support a comprehensive telemedicine practice. Based on analysis of existing services, Mayo Clinic developed a multifaceted operational plan that addressed high-priority areas and outlined clear roles and responsibilities of the Center for Connected Care and that of the clinical departments. The plan set priorities and a direction that would lead to long-term success. The plan articulated the governing and operational infrastructure necessary to support telemedicine by defining the role of the Center for Connected Care as the owner of core administrative operations and the role of the clinical departments as the owners of clinical telemedicine services. Additional opportunities were identified to develop product selection processes, implementation services, and staffing models that would be applied to ensure successful telemedicine deployment. The telemedicine team within the Center for Connected Care completed 45 business cases resulting in 54 implementations. The standardization of core products along with key operational offerings around implementation services, and the establishment of a 24/7 support model resulted in improved provider satisfaction and fewer reported technical issues. The foundation for long-term scalability and growth was developed by centralizing operations of telemedicine services, implementing sustainable processes, employing dedicated qualified personnel, and deploying robust products.

Analysis of High-Speed Vessels for Seventh Fleet Logistics Support

DTIC Science & Technology

2005-03-01

station ships are operating with CSGs in the Sea of Japan (East Sea) and HSV2 is dedicated to service them. The last three station ships operate...with CSGs in the Yellow Sea (West Sea) and HSV1 is dedicated to service them. HSV1 is therefore servicing more customers, so each will receive fewer...hits. Aggravating this situation, 40nm separates the operating areas of HSV1 ’s three station ships, causing additional transit time for multiple CSG

Space Station services and design features for users

NASA Technical Reports Server (NTRS)

Kurzhals, Peter R.; Mckinney, Royce L.

1987-01-01

The operational design features and services planned for the NASA Space Station will furnish, in addition to novel opportunities and facilities, lower costs through interface standardization and automation and faster access by means of computer-aided integration and control processes. By furnishing a basis for large-scale space exploitation, the Space Station will possess industrial production and operational services capabilities that may be used by the private sector for commercial ventures; it could also ultimately support lunar and planetary exploration spacecraft assembly and launch facilities.

Effects of Using Child Personas in the Development of a Digital Peer Support Service for Childhood Cancer Survivors

PubMed Central

Wärnestål, Pontus; Svedberg, Petra; Lindberg, Susanne

2017-01-01

Background Peer support services have the potential to support children who survive cancer by handling the physical, mental, and social challenges associated with survival and return to everyday life. Involving the children themselves in the design process allows for adapting services to authentic user behaviors and goals. As there are several challenges that put critical requirements on a user-centered design process, we developed a design method based on personas adapted to the particular needs of children that promotes health and handles a sensitive design context. Objective The purpose of this study was to evaluate the effects of using child personas in the development of a digital peer support service for childhood cancer survivors. Methods The user group’s needs and behaviors were characterized based on cohort data and literature, focus group interviews with childhood cancer survivors (n=15, 8-12 years), stakeholder interviews with health care professionals and parents (n=13), user interviews, and observations. Data were interpreted and explained together with childhood cancer survivors (n=5) in three explorative design workshops and a validation workshop with children (n=7). Results We present findings and insights on how to codesign child personas in the context of developing digital peer support services with childhood cancer survivors. The work resulted in three primary personas that model the behaviors, attitudes, and goals of three user archetypes tailored for developing health-promoting services in this particular use context. Additionally, we also report on the effects of using these personas in the design of a digital peer support service called Give Me a Break. Conclusions By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that were successfully used to design and develop health-promoting services for children in vulnerable life stages. The child-personas serve as effective collaboration and communication aids for both internal and external purposes. PMID:28526663

Contracting with the Frederick National Lab | FNLCR Staging

Cancer.gov

Our Acquisitions Directorate supports the national laboratory with high quality products and services to achieve its national mission. In addition to engaging large subcontractors, we are also committed to working with small businesses, minority- and

Missing link in the service profit chain: a meta-analytic review of the antecedents, consequences, and moderators of service climate.

PubMed

Hong, Ying; Liao, Hui; Hu, Jia; Jiang, Kaifeng

2013-03-01

Service climate captures employees' consensual perceptions of organizations' emphasis on service quality. Although many studies have examined the foundation issues and outcomes of service climate, there is a lack of a comprehensive model explicating the antecedents, outcomes, and moderators of service climate. The current study fills this void in the literature. By conducting a meta-analysis of 58 independent samples (N = 9,363), we found support for service climate as a critical linkage between internal and external service parameters. In addition, we found differential effects of service-oriented versus general human resource practices and leadership on service climate, as well as disparate impacts of service climate contingent on types of service, measures of service climate, and sources of rating. Research and practical implications are discussed.

Combining Domain-driven Design and Mashups for Service Development

NASA Astrophysics Data System (ADS)

Iglesias, Carlos A.; Fernández-Villamor, José Ignacio; Del Pozo, David; Garulli, Luca; García, Boni

This chapter presents the Romulus project approach to Service Development using Java-based web technologies. Romulus aims at improving productivity of service development by providing a tool-supported model to conceive Java-based web applications. This model follows a Domain Driven Design approach, which states that the primary focus of software projects should be the core domain and domain logic. Romulus proposes a tool-supported model, Roma Metaframework, that provides an abstraction layer on top of existing web frameworks and automates the application generation from the domain model. This metaframework follows an object centric approach, and complements Domain Driven Design by identifying the most common cross-cutting concerns (security, service, view, ...) of web applications. The metaframework uses annotations for enriching the domain model with these cross-cutting concerns, so-called aspects. In addition, the chapter presents the usage of mashup technology in the metaframework for service composition, using the web mashup editor MyCocktail. This approach is applied to a scenario of the Mobile Phone Service Portability case study for the development of a new service.

What parents find important in the support of a child with profound intellectual and multiple disabilities.

PubMed

Jansen, S L G; van der Putten, A A J; Vlaskamp, C

2013-05-01

The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of 'family-centred care'. To what extent family-centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known. The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions. In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non-parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level). Parents rated situations related to 'Respectful and Supportive Care' and 'Enabling and Partnership' with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for 'Providing Specific Information about the Child'. Parents of children in the '6-12 years' age group gave significantly higher scores on this scale than did parents of children in the '≥17 years' age group (U = 288, r = -0.34). This study shows that parents with children with PIMD find family-centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important. © 2012 Blackwell Publishing Ltd.

Lessons learned from the USDA Forest Service, Pacific Southwest Region, sudden oak death management program

Treesearch

Phil Cannon; Susan J. Frankel; Pete Angwin

2017-01-01

Over the past 15 years, the USDA Forest Service, Pacific Southwest Region, State and Private Forestry (S&PF) has provided grants which have supported over 200 projects to address sudden oak death (SOD) in California. To date, over $10 million has been provided by US taxpayers, plus an additional $8 million of non-federal matching funds. These funds...

Research and Resilience: Creating a Research Agenda for Supporting Military Families with Young Children

ERIC Educational Resources Information Center

Williams, Dorinda Silver; Mulrooney, Kathleen

2012-01-01

The decade of war since the attacks of 9-11 have meant lengthy and repeated combat deployment for millions of service members, many of whom are parents of very young children. In addition to the many challenges inherent to the deployment cycle, issues such as injury, combat stress, and the death of a service member parent are important realities…

Supporting 13 years of global change research: the history, technology, and methods of the Aspen FACE Experiment

Treesearch

Mark E. Kubiske; Anita R. Foss; Andrew J. Burton; Wendy S. Jones; Keith F. Lewin; John Nagy; Kurt S. Pregitzer; Donald R. Zak; David F. Karnosky

2015-01-01

This publication is an additional source of metadata for data stored and publicly available in the U.S. Department of Agriculture, Forest Service Research Data Archive. Here, we document the development, design, management, and operation of the experiment. In 1998, a team of scientists from the U.S. Forest Service, Department of Energy (DOE), Michigan Technological...

Spatial dynamics of ecosystem service flows: a comprehensive approach to quantifying actual services

USGS Publications Warehouse

Bagstad, Kenneth J.; Johnson, Gary W.; Voigt, Brian; Villa, Ferdinando

2013-01-01

Recent ecosystem services research has highlighted the importance of spatial connectivity between ecosystems and their beneficiaries. Despite this need, a systematic approach to ecosystem service flow quantification has not yet emerged. In this article, we present such an approach, which we formalize as a class of agent-based models termed “Service Path Attribution Networks” (SPANs). These models, developed as part of the Artificial Intelligence for Ecosystem Services (ARIES) project, expand on ecosystem services classification terminology introduced by other authors. Conceptual elements needed to support flow modeling include a service's rivalness, its flow routing type (e.g., through hydrologic or transportation networks, lines of sight, or other approaches), and whether the benefit is supplied by an ecosystem's provision of a beneficial flow to people or by absorption of a detrimental flow before it reaches them. We describe our implementation of the SPAN framework for five ecosystem services and discuss how to generalize the approach to additional services. SPAN model outputs include maps of ecosystem service provision, use, depletion, and flows under theoretical, possible, actual, inaccessible, and blocked conditions. We highlight how these different ecosystem service flow maps could be used to support various types of decision making for conservation and resource management planning.

What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials.

PubMed

Kotronoulas, Grigorios; Kearney, Nora; Maguire, Roma; Harrow, Alison; Di Domenico, David; Croy, Suzanne; MacGillivray, Stephen

2014-05-10

The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan).

PubMed

Bricknell, Martin C M; Nadin, M

2017-08-01

This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ' the golden thread ' and eight ' silver bullets ' as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Service robots in elderly care. Possible application areas and current state of developments].

PubMed

Graf, B; Heyer, T; Klein, B; Wallhoff, F

2013-08-01

The term "Service robotics" describes semi- or fully autonomous technical systems able to perform services useful to the well-being of humans. Service robots have the potential to support and disburden both persons in need of care as well as nursing care staff. In addition, they can be used in prevention and rehabilitation in order to reduce or avoid the need for help. Products currently available to support people in domestic environments are mainly cleaning or remote-controlled communication robots. Examples of current research activities are the (further) development of mobile robots as advanced communication assistants or the development of (semi) autonomous manipulation aids and multifunctional household assistants. Transport robots are commonly used in many hospitals. In nursing care facilities, the first evaluations have already been made. So-called emotional robots are now sold as products and can be used for therapeutic, occupational, or entertainment activities.

Cost shifting revisited: the case of service intensity.

PubMed

Friesner, Daniel L; Rosenman, Robert

2002-02-01

This paper examines whether a health care provider's choice of service intensity for any patient group affects its cost shifting behavior. Our theoretical models indicate that firms may respond to lower prospective payment by decreasing service intensity to all of its patient groups, thereby giving firms an alternative to cost shifting. Additionally, the conditions under which cost shifting and lower service intensity occur are identical, regardless of profit status. Using a panel of California hospitals, we found that nonprofit hospitals do cost shift, while profit-maximizing hospitals do not. However, both firms respond to lower prospective payment by decreasing service intensity, thus supporting our theoretical conclusion that lower service intensity can be used as an alternative to cost shifting.

Testing if Social Services Prevent Fatal Child Maltreatment Among a Sample of Children Previously Known to Child Protective Services.

PubMed

Douglas, Emily M

2016-08-01

The purpose of this article was to examine the potential impact of child welfare services on the risk for fatal child maltreatment. This was conducted using a subsample of children who were identified as "prior victims" in the National Child Abuse and Neglect Data System from 2008 to 2012. At the multivariate level, the analyses show that case management services act to protect children from death as do family support services, family preservation services, and foster care, but that the results vary by type of maltreatment experienced. The author recommends that before strong conclusions are drawn, additional research in this area is warranted. © The Author(s) 2016.

Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study.

PubMed

Thomas, Elizabeth C; Salzer, Mark S

2017-12-18

The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.

Training for Research Data Management at the Bodleian Libraries: National Contexts and Local Implementation for Researchers and Librarians

ERIC Educational Resources Information Center

Southall, John; Scutt, Catherine

2017-01-01

This article outlines the involvement of the Bodleian Libraries at the University of Oxford in developing new services for research data management. It offers reflections on what such additional support means for academic librarians, specifically considering support offered by subject consultants and a series of research data management (RDM)…

Two Years of Case Management: Final Findings from the Communities in Schools Random Assignment Evaluation

ERIC Educational Resources Information Center

Parise, Leigh M.; Corrin, William; Granito, Kelly; Haider, Zeest; Somers, Marie-Andrée; Cerna, Oscar

2017-01-01

While high school graduation rates are on the rise nationwide, too many students still never reach that milestone, with 7,000 on average dropping out every day. Recognizing that many students need additional support to succeed in school, Communities In Schools (CIS) works to provide and connect students with integrated support services to keep…

Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: interrupted time series analysis with economic evaluation.

PubMed

Bell, Ruth; Glinianaia, Svetlana V; Waal, Zelda van der; Close, Andrew; Moloney, Eoin; Jones, Susan; Araújo-Soares, Vera; Hamilton, Sharon; Milne, Eugene Mg; Shucksmith, Janet; Vale, Luke; Willmore, Martyn; White, Martin; Rushton, Steven

2018-01-01

To evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking. Interrupted time series analysis of routine data before and after introducing the intervention, within-study economic evaluation. Eight acute NHS hospital trusts and 12 local authority areas in North East England. 37 726 records of singleton delivery including 10 594 to mothers classified as smoking during pregnancy. A package of measures implemented in trusts and smoking cessation services, aimed at increasing the proportion of pregnant smokers quitting during pregnancy, comprising skills training for healthcare and smoking cessation staff; universal carbon monoxide monitoring with routine opt-out referral for smoking cessation support; provision of carbon monoxide monitors and supporting materials; and an explicit referral pathway and follow-up protocol. Referrals to smoking cessation services; probability of quitting smoking during pregnancy; additional costs to health services; incremental cost per additional woman quitting. After introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter. The implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The cost-effectiveness of supported employment for adults with autism in the United Kingdom

PubMed Central

Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

2014-01-01

Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings. PMID:24126866

School-based service delivery for homeless students: relevant laws and overcoming access barriers.

PubMed

Sulkowski, Michael L; Joyce-Beaulieu, Diana K

2014-11-01

Schools in the United States are facing a record number of homeless students. These students are highly at-risk for experiencing negative life outcomes, and they face considerable academic and social-emotional functional impairments. To help address the complex needs of homeless students, this article reviews the intersection of laws and practices that impact homeless students, as well as contemporary school-based service delivery efforts to support the academic and social-emotional needs of these students. In addition, this article also reviews several barriers to school-based service delivery for homeless students and ways to overcome these barriers. These barriers include confusion regarding consent and record-sharing procedures, ineffectively utilizing homeless liaisons, and misapplying tenants of Multitiered Systems of Support (MTSS), which is a school-based service-delivery framework that has been adopted by and implemented in many U.S. schools. Ultimately, this article aims to provide members of school communities with practical information that they can use to support the homeless youth they encounter and serve. (c) 2014 APA, all rights reserved.

Adding Value to the Network: Exploring the Software as a Service and Platform as a Service Models for Mobile Operators

NASA Astrophysics Data System (ADS)

Gonçalves, Vânia

The environments of software development and software provision are shifting to Web-based platforms supported by Platform/Software as a Service (PaaS/SaaS) models. This paper will make the case that there is equally an opportunity for mobile operators to identify additional sources of revenue by exposing network functionalities through Web-based service platforms. By elaborating on the concepts, benefits and risks of SaaS and PaaS, several factors that should be taken into consideration in applying these models to the telecom world are delineated.

Acquisition plan for Digital Document Storage (DDS) prototype system

NASA Technical Reports Server (NTRS)

1990-01-01

NASA Headquarters maintains a continuing interest in and commitment to exploring the use of new technology to support productivity improvements in meeting service requirements tasked to the NASA Scientific and Technical Information (STI) Facility, and to support cost effective approaches to the development and delivery of enhanced levels of service provided by the STI Facility. The DDS project has been pursued with this interest and commitment in mind. It is believed that DDS will provide improved archival blowback quality and service for ad hoc requests for paper copies of documents archived and serviced centrally at the STI Facility. It will also develop an operating capability to scan, digitize, store, and reproduce paper copies of 5000 NASA technical reports archived annually at the STI Facility and serviced to the user community. Additionally, it will provide NASA Headquarters and field installations with on-demand, remote, electronic retrieval of digitized, bilevel, bit mapped report images along with branched, nonsequential retrieval of report subparts.

A Case Study of the Technology Use and Information Flow at a Hospital-Driven Telemedicine Service.

PubMed

Smaradottir, Berglind; Fensli, Rune

2017-01-01

Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on information flow and technology use. The methods used were observation and interviews with key informants. The results showed that the technology was perceived as well-functioning for telemedicine support, but the technology used was a standalone system and not integrated with the electronic health record of the hospital. In addition, there was lack of support to provide the patients at home with written instructions on advices of medical treatment and care. The electronic information used for this telemedicine services, allowed shared access of information for teamwork between professional only within the hospital.

A Model-Driven, Science Data Product Registration Service

NASA Astrophysics Data System (ADS)

Hardman, S.; Ramirez, P.; Hughes, J. S.; Joyner, R.; Cayanan, M.; Lee, H.; Crichton, D. J.

2011-12-01

The Planetary Data System (PDS) has undertaken an effort to overhaul the PDS data architecture (including the data model, data structures, data dictionary, etc.) and to deploy an upgraded software system (including data services, distributed data catalog, etc.) that fully embraces the PDS federation as an integrated system while taking advantage of modern innovations in information technology (including networking capabilities, processing speeds, and software breakthroughs). A core component of this new system is the Registry Service that will provide functionality for tracking, auditing, locating, and maintaining artifacts within the system. These artifacts can range from data files and label files, schemas, dictionary definitions for objects and elements, documents, services, etc. This service offers a single reference implementation of the registry capabilities detailed in the Consultative Committee for Space Data Systems (CCSDS) Registry Reference Model White Book. The CCSDS Reference Model in turn relies heavily on the Electronic Business using eXtensible Markup Language (ebXML) standards for registry services and the registry information model, managed by the OASIS consortium. Registries are pervasive components in most information systems. For example, data dictionaries, service registries, LDAP directory services, and even databases provide registry-like services. These all include an account of informational items that are used in large-scale information systems ranging from data values such as names and codes, to vocabularies, services and software components. The problem is that many of these registry-like services were designed with their own data models associated with the specific type of artifact they track. Additionally these services each have their own specific interface for interacting with the service. This Registry Service implements the data model specified in the ebXML Registry Information Model (RIM) specification that supports the various artifacts above as well as offering the flexibility to support customer-defined artifacts. Key features for the Registry Service include: - Model-based configuration specifying customer-defined artifact types, metadata attributes to capture for each artifact type, supported associations and classification schemes. - A REST-based external interface that is accessible via the Hypertext Transfer Protocol (HTTP). - Federation of Registry Service instances allowing associations between registered artifacts across registries as well as queries for artifacts across those same registries. A federation also enables features such as replication and synchronization if desired for a given deployment. In addition to its use as a core component of the PDS, the generic implementation of the Registry Service facilitates its applicability as a core component in any science data archive or science data system.

Supporting women with postpartum anxiety: exploring views and experiences of specialist community public health nurses in the UK.

PubMed

Ashford, Miriam T; Ayers, Susan; Olander, Ellinor K

2017-05-01

Anxiety is common among postpartum women and can have adverse effects on mother's and child's somatic and psychological health if left untreated. In the UK, nurses or midwifes with a specialisation in community public health nursing, also called health visitors (HVs), work with families who have children younger than 5 years of age and are therefore in a key position to identify and support women with postpartum mental health issues. Until recently, postpartum mental health support provided by HVs mainly focused on identifying and managing depression, but the updated clinical guidance by the National Institute for Health and Care Excellence also includes guidance regarding screening and psychological interventions for perinatal anxiety. This study therefore aimed to explore HVs' experiences of supporting women with postpartum anxiety and their views on currently available care. Using a qualitative approach, in-depth semi-structured interviews were conducted with 13 HVs from the UK between May and October 2015. Participants were interviewed in person at their workplace or on the phone/Skype. Using thematic analysis, four main themes emerged: identification and screening issues; importance of training; service usage; and status of current service provision. Women with postpartum anxiety were commonly encountered by HVs in their clinical practice and described as often heavily using their or other related healthcare services, which puts additional strain on HVs' already heavy workload. Issues with identifying and screening for postpartum anxiety were raised and the current lack of perinatal mental health training for HVs was highlighted. In addition, HVs described a current lack of good perinatal mental health services in general and specifically for anxiety. The study highlights the need for HV perinatal mental health training in general and postpartum anxiety specifically, as well as better coverage of specialist mental health services and the need for development of interventions targeted at postpartum anxiety. © 2017 John Wiley & Sons Ltd.

Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan)

PubMed Central

Bricknell, Martin C M; Nadin, M

2017-01-01

This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ‘the golden thread’ and eight ‘silver bullets’ as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. PMID:28062527

Implementation of the MSAT network in Canada

NASA Astrophysics Data System (ADS)

Roscoe, Orest S.

1991-10-01

MSAT will be launched into geostationary orbit at 106.5 degrees west longitude. It will have an aggregate EIRP in excess of 57 dBw, making it the highest powered mobile satellite launched or planned to date. The MSAT ground segment will comprise hundreds of thousands of mobile terminals, as well as numerous feederlink earth stations. This requires a large scale network control system which is unprecedented in a satellite environment. The network control system must support circuit-switched voice and data services and packet-switched data services. In addition to assignment of capacity on demand, the control system must be able to support a variety of service features required by customers, as well as record information for billing. It must operate in a multi-beam, multi-satellite environment as the system grows.

State policy environment and the dental safety net: a case study of professional practice environments' effect on dental service availability in Federally Qualified Health Centers.

PubMed

Maxey, Hannah L; Norwood, Connor W; Liu, Ziyue

2016-09-01

To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment. We then examined the influence of state policy environment on the availability of dental care through generalized linear mixed-effects models. Approximately 80% of FQHCs reported delivering dental services. We consistently observed that FQHCs with favorable levels of state support had the highest proportion of FQHCs that delivered dental services, even more so than FQHCs with extremely high support. FQHCs located in the most restrictive states had 0.28 the odds of delivering dental services as did those located in the most supportive states. The state policy environment for the dental hygiene workforce is likely associated with the availability of dental services at FQHCs. The greatest proportion of FQHCs delivering dental services was found in states with policy provisions supporting professional independence in public health settings. Nevertheless, additional research is needed to understand the specific mechanism by which these policies affect FQHCs. © 2016 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals, Inc. on behalf of American Association of Public Health Dentistry.

Promising practices in vocational services for the community reintegration of returning veterans: The individual placement and support model and beyond.

PubMed

Wewiorski, Nancy J; Gorman, Jay A; Scoglio, Arielle A J; Fukuda, Seiya; Reilly, Erin; Mueller, Lisa; O'Connor, Maureen; Penk, Walter E; Drebing, Charles E

2018-05-01

Supporting returning veterans' job-seeking, hiring, and retention issues has become an essential goal for effective community reintegration. Given both the particular strengths and challenges associated with veterans transitioning from military to civilian life, multiple models for supported employment have become integrated into Veterans Affairs health care facilities across the nation. In this article, we review the state of vocational rehabilitation for veterans, with a particular focus on individual placement and support-supported employment (IPS-SE), the current vocational services model that is considered the gold standard of vocational rehabilitation. Various modifications to the IPS-SE model are presented, including additions such as cognitive rehabilitation, contingency management, motivational interviewing, supported self-employment, and transitional work. Finally, recommendations are made about future directions and strategies to expand access to IPS-SE-based programs and to effectively meet the needs of returning veterans for employment in jobs of their choice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Making Boundaries Great Again: Essentialism and Support for Boundary-Enhancing Initiatives.

PubMed

Roberts, Steven O; Ho, Arnold K; Rhodes, Marjorie; Gelman, Susan A

2017-12-01

Psychological essentialism entails a focus on category boundaries (e.g., categorizing people as men or women) and an increase in the conceptual distance between those boundaries (e.g., accentuating the differences between men and women). Across eight studies, we demonstrate that essentialism additionally entails an increase in support for boundary-enhancing legislation, policies, and social services, and that it does so under conditions that disadvantage social groups, as well as conditions that benefit them. First, individual differences in essentialism were associated with support for legislation mandating that transgender people use restrooms corresponding with their biological sex, and with support for the boundary-enhancing policies of the 2016 then-presumptive Republican presidential nominee (i.e., Donald Trump). Second, essentialism was associated with support for same-gender classrooms designed to promote student learning, as well as support for services designed to benefit LGBTQ (lesbian, gay, bisexual, transgender, queer) individuals. These findings demonstrate the boundary-enhancing implications of essentialism and their social significance.

"HausTeleDienst"--a CATV-based interactive video service for elderly people.

PubMed

Stroetmann, K A; Erkert, T

1999-01-01

Since 1991, 17 elderly persons (aged 75 to over 90) in 15 households have been connected via TV-videophones to a service centre. A standard CATV network was modified to support a reverse channel. This has been world-wide the first fully interactive broadband video communications project implemented in a real setting and operating over an extended period of time. The overall aim has been to prove the ability of frail elderly and mobility-impaired persons to live independently, and to demonstrate strategies for reducing the load on social and health care service resources. Service components include remote care; information and assistance; emergency, counselling, training and exercise services. Practical experience, both from the side of the service provider and that of the users, is discussed. Simplicity of technical design and ease of handling contributed to a feeling of being empowered by the technology. In addition, the very personal and close relationship to the staff--which was strongly supported, not inhibited by the video communications--was a major factor in acceptance of the service. It proved a highly successful activity with a great potential for the future: In different contexts with newer technology, market trials are underway to commercialize this service.

Disease prevention policy under Medicare: a historical and political analysis.

PubMed

Schauffler, H H

1993-01-01

I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.

Resolving mobility constraints impeding rural seniors' access to regionalized services.

PubMed

Ryser, Laura; Halseth, Greg

2012-01-01

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.

The Self-Concept of Students in Remediation in a Rural Community College in Mississippi

ERIC Educational Resources Information Center

Wicks, Corky Fitzgerald

2017-01-01

Identifying students who may require additional assistance and coaching based on their self-concept score will also allow community colleges to provide additional support services for those students. If there is a difference in self-concept among students in a Mississippi community college, leaders might be able to use self-concept as a way of…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Elia, Valerio; Gnoni, Maria Grazia, E-mail: mariagrazia.gnoni@unisalento.it; Tornese, Fabiana

Highlights: • Pay-As-You-Throw (PAYT) schemes are becoming widespread in several countries. • Economic, organizational and technological issues have to be integrated in an efficient PAYT model design. • Efficiency refers to a PAYT system which support high citizen participation rates as well as economic sustainability. • Different steps and constraints have to be evaluated from collection services to type technologies. • An holistic approach is discussed to support PAYT systems diffusion. - Abstract: Pay-As-You-Throw (PAYT) strategies are becoming widely applied in solid waste management systems; the main purpose is to support a more sustainable – from economic, environmental and socialmore » points of view – management of waste flows. Adopting PAYT charging models increases the complexity level of the waste management service as new organizational issues have to be evaluated compared to flat charging models. In addition, innovative technological solutions could also be adopted to increase the overall efficiency of the service. Unit pricing, user identification and waste measurement represent the three most important processes to be defined in a PAYT system. The paper proposes a holistic framework to support an effective design and management process. The framework defines most critical processes and effective organizational and technological solutions for supporting waste managers as well as researchers.« less

Community Pharmacists' Attitudes Toward Palliative Care: An Australian Nationwide Survey

PubMed Central

Hewitt, Lauren Y.; Tuffin, Penelope H.R.

2013-01-01

Abstract Background: Pharmacists are among the most accessible health care professionals in the community, yet are often not involved in community palliative care teams. Objective: We investigated community pharmacists' attitudes, beliefs, feelings, and knowledge about palliative care as a first step towards determining how best to facilitate the inclusion of community pharmacists on the palliative care team. Method: A cross-sectional descriptive survey design was used. Subjects: Community pharmacists around Australia were invited to participate; 250 completed surveys were returned. Measurements: A survey was constructed to measure pharmacists' knowledge and experience, emotions and beliefs about palliative care. Results: Pharmacists were generally positive about providing services and supports for palliative care patients, yet they also reported negative beliefs and emotions about palliative care. In addition, pharmacists had good knowledge of some aspects of palliative care, but misconceptions about other aspects. Pharmacists' beliefs and knowledge about palliative care predicted—and therefore underpinned—a positive attitude towards palliative care and the provision of services and supports for palliative care patients. Conclusion: The results provide evidence that pharmacists need training and support to facilitate their involvement in providing services and supports for palliative care patients, and highlight areas that training and support initiatives should focus on. PMID:24147876

Community pharmacists' attitudes toward palliative care: an Australian nationwide survey.

PubMed

O'Connor, Moira; Hewitt, Lauren Y; Tuffin, Penelope H R

2013-12-01

Pharmacists are among the most accessible health care professionals in the community, yet are often not involved in community palliative care teams. We investigated community pharmacists' attitudes, beliefs, feelings, and knowledge about palliative care as a first step towards determining how best to facilitate the inclusion of community pharmacists on the palliative care team. A cross-sectional descriptive survey design was used. Community pharmacists around Australia were invited to participate; 250 completed surveys were returned. A survey was constructed to measure pharmacists' knowledge and experience, emotions and beliefs about palliative care. Pharmacists were generally positive about providing services and supports for palliative care patients, yet they also reported negative beliefs and emotions about palliative care. In addition, pharmacists had good knowledge of some aspects of palliative care, but misconceptions about other aspects. Pharmacists' beliefs and knowledge about palliative care predicted--and therefore underpinned--a positive attitude towards palliative care and the provision of services and supports for palliative care patients. The results provide evidence that pharmacists need training and support to facilitate their involvement in providing services and supports for palliative care patients, and highlight areas that training and support initiatives should focus on.

300 Area Building Retention Evaluation Mitigation Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

D. J. McBride

2007-07-03

Evaluate the long-term retention of several facilities associated with the PNNL Capability Replacement Laboratory and other Hanfor mission needs. WCH prepared a mitigation plan for three scenarios with different release dates for specific buildings. The evaluations present a proposed plan for providing utility services to retained facilities in support of a long-term (+20 year) lifespan in addition to temporary services to buildings with specified delayed release dates.

Reference architecture of application services for personal wellbeing information management.

PubMed

Tuomainen, Mika; Mykkänen, Juha

2011-01-01

Personal information management has been proposed as an important enabler for individual empowerment concerning citizens' wellbeing and health information. In the MyWellbeing project in Finland, a strictly citizen-driven concept of "Coper" and related architectural and functional guidelines have been specified. We present a reference architecture and a set of identified application services to support personal wellbeing information management. In addition, the related standards and developments are discussed.

Loglines. March-April 2015

DTIC Science & Technology

2015-04-01

Interior, defer to their bureaus, like the Fish and Wildlife Service, the National Park Service, etc. Each of those bureaus gets its own...took the extraordinary step of entering all customer orders for this program into EMALL.” A fire crew digs a fire line near Yosemite National Park ...Program. Additionally, you’ll read about providing fuel anywhere in the world to support agencies like the Coast Guard, FEMA and the National

Leadership and Management of Medical Treatment Facilities: Case Study of Charleston Naval Hospital, 1988-1993

DTIC Science & Technology

1993-06-01

Additional preparations included conducting nurse training in trauma/combat casualty care , streamlining the patient admissions and tracking procedures...departments (i.e. surgery, ambulatory care , operating rooms, maternity ward, etc.) cooperation between the Director of Nursing and the directors of clinical...provide the 107 At quality care , staff support from nursing , administration, and ancillary services was required. s Director for Surgical Services The

Online Guidance, Advice, and Support for Problem Gamblers and Concerned Relatives and Friends: An Evaluation of the "GamAid" Pilot Service

ERIC Educational Resources Information Center

Wood, Richard T. A.; Griffiths, Mark D.

2007-01-01

The paper reports one of the first ever studies to evaluate the effectiveness of an online help and guidance service for problem gamblers. The evaluation utilised a mixed methods design in order to examine both primary and secondary data relating to the client experience. In addition, the researchers posed as problem gamblers in order to obtain…

Barriers and Enablers to the Implementation of School Wellness Policies: An Economic Perspective.

PubMed

Schuler, Brittany R; Saksvig, Brit I; Nduka, Joy; Beckerman, Susannah; Jaspers, Lea; Black, Maureen M; Hager, Erin R

2018-01-01

Local wellness policies (LWPs) are mandated among school systems to enhance nutrition/physical activity opportunities in schools. Prior research notes disparities in LWP implementation. This study uses mixed methods to examine barriers/enablers to LWP implementation, comparing responses by student body income. Schools ( n = 744, 24 systems) completed an LWP implementation barriers/enablers survey. Semistructured interviews ( n = 20 random subsample) described barriers/enablers. Responses were compared by majority of lower (≥50% free/reduced-price meals; lower income [LI]) versus higher income (HI) student body. In surveys, LI and HI schools identified common barriers (parents/families, federal/state regulations, students, time, funding) and enablers (school system, teachers, food service, physical education curriculum/resources, and staff). Interviews further elucidated how staffing and funding served as enablers for all schools, and provide context for how and why barriers differed by income: time, food service (HI schools), and parents/families (LI schools). Findings support commonalities in barriers and enablers among all schools, suggesting that regardless of economic context, schools would benefit from additional supports, such as physical education and nutrition education resources integrated into existing curricula, additional funding, and personnel time dedicated to wellness programming. LI schools may benefit from additional funding to support parent and community involvement.

Inclusive practices for children and youths with communication disorders. Ad Hoc Committee on Inclusion for students with Communication Disorders.

PubMed

1996-01-01

An array of inclusive service delivery models is recommended for the implementation of services to children and youths with communication disorders. Inclusive practices are intervention services that are based on the unique and specific needs of the individual, and provided in a context that is least restrictive. There are a variety of models through which inclusive practices can be provided, including a direct (pull-out) program, in classroom-based service delivery, community-based models, and consultative interventions. These models should be seen as flexible options that may change depending on student needs. The speech-language pathologist, in collaboration with parents, the student, teachers, support personnel, and administrators, is in the ideal position to decide the model or combination of models that best serves each individual student's communication needs. Implementation of inclusive practices requires consideration of multiple issues, including general education reform, cost effectiveness, and program efficacy. In addition, administrative and school system support, personnel qualifications, staff development, flexible scheduling, and the effects of inclusive practices on all learners need to be considered. At present, available research suggests guarded optimism for the effectiveness of inclusive practices. However, many critical questions have not yet been addressed and additional research is needed to assess the full impact of inclusive practices for students with communication disorders.

Using a supportive care framework to understand and improve palliative care among cancer patients in Africa.

PubMed

Busolo, David S; Woodgate, Roberta L

2016-06-01

Cancer incidence and mortality are increasing in Africa, which is leading to greater demands for palliative care. There has been little progress in terms of research, pain management, and policies related to palliative care. Palliative care in Africa is scarce and scattered, with most African nations lacking the basic services. To address these needs, a guiding framework that identifies care needs and directs palliative care services could be utilized. Therefore, using the supportive care framework developed by Fitch (Fitch, 2009), we here review the literature on palliative care for patients diagnosed with cancer in Africa and make recommendations for improvement. The PubMed, Scopus, CINAHL, Web of Science, Embase, PsycINFO, Social Sciences Citation Index, and Medline databases were searched. Some 25 English articles on research from African countries published between 2004 and 2014 were selected and reviewed. The reviewed literature was analyzed and presented using the domains of the supportive care framework. Palliative care patients with cancer in Africa, their families, and caregivers experience increasing psychological, physical, social, spiritual, emotional, informational, and practical needs. Care needs are often inadequately addressed because of a lack of awareness as well as deficient and scattered palliative care services and resources. In addition, there is sparse research, education, and policies that address the dire situation in palliative care. Our review findings add to the existing body of knowledge demonstrating that palliative care patients with cancer in Africa experience disturbing care needs in all domains of the supportive care framework. To better assess and address these needs, holistic palliative care that is multidomain and multi-professional could be utilized. This approach needs to be individualized and to offer better access to services and information. In addition, research, education, and policies around palliative care for cancer patients in Africa could be more comprehensive if they were based on the domains of the supportive care framework.

GeoSciML and EarthResourceML Update, 2012

NASA Astrophysics Data System (ADS)

Richard, S. M.; Commissionthe Management; Application Inte, I.

2012-12-01

CGI Interoperability Working Group activities during 2012 include deployment of services using the GeoSciML-Portrayal schema, addition of new vocabularies to support properties added in version 3.0, improvements to server software for deploying services, introduction of EarthResourceML v.2 for mineral resources, and collaboration with the IUSS on a markup language for soils information. GeoSciML and EarthResourceML have been used as the basis for the INSPIRE Geology and Mineral Resources specifications respectively. GeoSciML-Portrayal is an OGC GML simple-feature application schema for presentation of geologic map unit, contact, and shear displacement structure (fault and ductile shear zone) descriptions in web map services. Use of standard vocabularies for geologic age and lithology enables map services using shared legends to achieve visual harmonization of maps provided by different services. New vocabularies have been added to the collection of CGI vocabularies provided to support interoperable GeoSciML services, and can be accessed through http://resource.geosciml.org. Concept URIs can be dereferenced to obtain SKOS rdf or html representations using the SISSVoc vocabulary service. New releases of the FOSS GeoServer application greatly improve support for complex XML feature schemas like GeoSciML, and the ArcGIS for INSPIRE extension implements similar complex feature support for ArcGIS Server. These improved server implementations greatly facilitate deploying GeoSciML services. EarthResourceML v2 adds features for information related to mining activities. SoilML provides an interchange format for soil material, soil profile, and terrain information. Work is underway to add GeoSciML to the portfolio of Open Geospatial Consortium (OGC) specifications.

Can't get it out of my mind: employee rumination after customer mistreatment and negative mood in the next morning.

PubMed

Wang, Mo; Liu, Songqi; Liao, Hui; Gong, Yaping; Kammeyer-Mueller, John; Shi, Junqi

2013-11-01

Drawing on cognitive rumination theories and conceptualizing customer service interaction as a goal attainment situation for service employees, the current study examined employee rumination about negative service encounters as an intermediate cognitive process that explains the within-person fluctuations in negative emotional reactions resulting from customer mistreatment. Multilevel analyses of 149 call-center employees' 1,189 daily surveys revealed that on days that a service employee received more (vs. less) customer mistreatment, he or she ruminated more (vs. less) at night about negative encounters with customers, which in turn led to higher (vs. lower) levels of negative mood experienced in the next morning. In addition, service rule commitment and perceived organizational support moderated the within-person effect of customer mistreatment on rumination, such that this effect was stronger among those who had higher (vs. lower) levels of service rule commitment but weaker among those who had higher (vs. lower) levels of perceived organizational support. Theoretical and practical implications of these findings are discussed. (c) 2013 APA, all rights reserved.

Contracting with the Frederick National Laboratory | Frederick National Laboratory for Cancer Research

Cancer.gov

Our Acquisitions Directorate supports the national laboratory with high quality products and services to achieve its national mission. In addition to engaging large subcontractors, we are also committed to working with small businesses, minority- and

Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

PubMed

Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

2014-01-01

Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service.

PubMed

Jack, Barbara A; Baldry, Catherine R; Groves, Karen E; Whelan, Alison; Sephton, Janice; Gaunt, Kathryn

2013-10-01

To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients. Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients. An evaluation study. Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey. Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be. Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their place of choice. This service offers various components of a hospice at home service, enabling a tailor made package to meet individual and local area needs. Developing an individually tailored package of care appears to be able to meet specific needs. © 2013 Blackwell Publishing Ltd.

Global fund financing of tuberculosis services delivery in prisons.

PubMed

Lee, Donna; Lal, S S; Komatsu, Ryuichi; Zumla, Alimuddin; Atun, Rifat

2012-05-15

Despite concerted efforts to scale up tuberculosis control with large amounts of international financing in the last 2 decades, tuberculosis continues to be a social issue affecting the world's most marginalized and disadvantaged communities. This includes prisoners, estimated at about 10 million globally, for whom tuberculosis is a leading cause of mortality and morbidity. The Global Fund to Fight AIDS, Tuberculosis and Malaria has emerged as the single largest international donor for tuberculosis control, including funding support in delivering tuberculosis treatment for the confined population. The Global Fund grants database, with an aggregate approved investment of $21.7 billion in 150 countries by the end of 2010, was reviewed to identify tuberculosis and human immunodeficiency virus/tuberculosis grants and activities that monitored the delivery of tuberculosis treatment and support activities in penitentiary settings. The distribution and trend of number of countries with tuberculosis prison support was mapped by year, geographic region, tuberculosis or multidrug-resistant tuberculosis burden, and prison population rate. We examined the types of grant recipients managing program delivery, their performance, and the nature and range of services provided. Fifty-three of the 105 countries (50%) with Global Fund-supported tuberculosis programs delivered services within prison settings. Thirty-two percent (73 of 228) of tuberculosis grants, representing $558 million of all disbursements of Global Fund tuberculosis support by the end of 2010, included output indicators related to tuberculosis services delivered in prisons. Nearly two-thirds (64%) of these grants were implemented by governments, with the remaining by civil society and other partners. In terms of services, half (36 of 73) of grants provided diagnosis and treatment and an additional 27% provided screening and monitoring of tuberculosis for prisoners. The range of services tracked was limited in scope and scale, with 69% offering only 1 type of service and less than one-fifth offering 2 types of service. This study is a preliminary attempt to examine Global Fund investments in the fight against tuberculosis in prison settings. Tuberculosis services delivered in prisons have increased in the last decade, but systematic information on funding levels and gaps, services provided, and cost-effective delivery models for delivering tuberculosis services in prisons are lacking.

The NASA Reanalysis Ensemble Service - Advanced Capabilities for Integrated Reanalysis Access and Intercomparison

NASA Astrophysics Data System (ADS)

Tamkin, G.; Schnase, J. L.; Duffy, D.; Li, J.; Strong, S.; Thompson, J. H.

2017-12-01

NASA's efforts to advance climate analytics-as-a-service are making new capabilities available to the research community: (1) A full-featured Reanalysis Ensemble Service (RES) comprising monthly means data from multiple reanalysis data sets, accessible through an enhanced set of extraction, analytic, arithmetic, and intercomparison operations. The operations are made accessible through NASA's climate data analytics Web services and our client-side Climate Data Services Python library, CDSlib; (2) A cloud-based, high-performance Virtual Real-Time Analytics Testbed supporting a select set of climate variables. This near real-time capability enables advanced technologies like Spark and Hadoop-based MapReduce analytics over native NetCDF files; and (3) A WPS-compliant Web service interface to our climate data analytics service that will enable greater interoperability with next-generation systems such as ESGF. The Reanalysis Ensemble Service includes the following: - New API that supports full temporal, spatial, and grid-based resolution services with sample queries - A Docker-ready RES application to deploy across platforms - Extended capabilities that enable single- and multiple reanalysis area average, vertical average, re-gridding, standard deviation, and ensemble averages - Convenient, one-stop shopping for commonly used data products from multiple reanalyses including basic sub-setting and arithmetic operations (e.g., avg, sum, max, min, var, count, anomaly) - Full support for the MERRA-2 reanalysis dataset in addition to, ECMWF ERA-Interim, NCEP CFSR, JMA JRA-55 and NOAA/ESRL 20CR… - A Jupyter notebook-based distribution mechanism designed for client use cases that combines CDSlib documentation with interactive scenarios and personalized project management - Supporting analytic services for NASA GMAO Forward Processing datasets - Basic uncertainty quantification services that combine heterogeneous ensemble products with comparative observational products (e.g., reanalysis, observational, visualization) - The ability to compute and visualize multiple reanalysis for ease of inter-comparisons - Automated tools to retrieve and prepare data collections for analytic processing

E-service learning: A pedagogic innovation for healthcare management education.

PubMed

Malvey, Donna M; Hamby, Eileen F; Fottler, Myron D

2006-01-01

This paper proposes an innovation in service learning that we identify as e-service learning. By adding the "e" to service learning, we create a service learning model that is dynamic, mediated by technology, and delivered online. This paper begins by examining service learning, which is a distinct learning concept. Service learning furnishes students with opportunities for applied learning through participation in projects and activities in community organizations. The authors then define and conceptualize e-service learning, including the anticipated outcomes of implementation such as enhanced access, quality, and cost effectiveness of healthcare management education. Because e-service learning is mediated by technology, we identify state of the art technologies that support e-service learning activities. In addition, possible e-service learning projects and activities that may be included in healthcare management courses such as finance, human resources, quality, service management/marketing and strategy are identified. Finally, opportunities for future research are suggested.

The role of support staff in promoting the social inclusion of persons with an intellectual disability.

PubMed

McConkey, R; Collins, S

2010-08-01

Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.

Evaluation of a pilot police-led suicide early alert surveillance strategy in the UK.

PubMed

McGeechan, Grant James; Richardson, Catherine; Weir, Kevin; Wilson, Lynn; O'Neill, Gillian; Newbury-Birch, Dorothy

2017-07-19

Those bereaved by suicide are at increased risk of psychological harm, which can be reduced with the provision of timely support. This paper outlines an evaluation of a pilot police-led suicide strategy, in comparison to a coroner-led suicide strategy looking at the number, and length of time it takes for deaths to be recorded for each strategy. Additionally, the police-led strategy offers timely contact from support services for bereaved individuals. We examined what impact this offer of support had on the capacity of support services. A mixed methods evaluation compared how long it took for suspected suicides to be recorded using both strategies. The number of referrals received by support services during the pilot strategy were compared with those from previous years. A feedback focus group, and interviews, were held with key stakeholders. The coroner strategy was more consistent at identifying suspected suicides; however, reports were filed quicker by the police. Bereaved individuals were willing to share contact details with police officers and consent for referral to support services which lead to increased referrals. The focus group and interviews revealed that the pilot police strategy needs better integration into routine police practice. This strategy has the potential to deliver a real benefit to those bereaved by suicide; however, there are still aspects which could be improved. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Spectroscopic analysis in the virtual observatory environment with SPLAT-VO

NASA Astrophysics Data System (ADS)

Škoda, P.; Draper, P. W.; Neves, M. C.; Andrešič, D.; Jenness, T.

2014-11-01

SPLAT-VO is a powerful graphical tool for displaying, comparing, modifying and analysing astronomical spectra, as well as searching and retrieving spectra from services around the world using Virtual Observatory (VO) protocols and services. The development of SPLAT-VO started in 1999, as part of the Starlink StarJava initiative, sometime before that of the VO, so initial support for the VO was necessarily added once VO standards and services became available. Further developments were supported by the Joint Astronomy Centre, Hawaii until 2009. Since end of 2011 development of SPLAT-VO has been continued by the German Astrophysical Virtual Observatory, and the Astronomical Institute of the Academy of Sciences of the Czech Republic. From this time several new features have been added, including support for the latest VO protocols, along with new visualization and spectra storing capabilities. This paper presents the history of SPLAT-VO, its capabilities, recent additions and future plans, as well as a discussion on the motivations and lessons learned up to now.

Roles of Perceived Sexist Events and Perceived Social Support in the Mental Health of Women Seeking Counseling

ERIC Educational Resources Information Center

Moradi, Bonnie; Funderburk, Jamie R.

2006-01-01

The authors of the present study contribute to research on the role of sexist events in women's mental health by examining the sexism-distress relation (a) with a sample of women who are seeking mental health services and (b) in the context of the additional roles of perceived social support in positive self-appraisal (i.e., empowerment and…

Evaluating the Inter-Respondent (Consumer vs. Staff) Reliability and Construct Validity (SIS vs. Vineland) of the Supports Intensity Scale on a Dutch Sample

ERIC Educational Resources Information Center

Claes, C.; Van Hove, G.; van Loon, J.; Vandevelde, S.; Schalock, R. L.

2009-01-01

Background: Despite various reliability studies on the Supports Intensity Scale (SIS), to date there has not been an evaluation of the reliability of client vs. staff judgments. Such determination is important, given the increasing consumer-driven approach to services. Additionally, there has not been an evaluation of the instrument's construct…

Home visits during pregnancy: consequences on pregnancy outcome, use of health services, and women's situations.

PubMed

Blondel, B; Bréart, G

1995-08-01

This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (< 37 weeks) was 1.0 (95% CI: 0.8 to 1.1). Nor did the home visits decrease the rate of hospital admission for women with complications (mainly threatened preterm labor or toxemia); the corresponding summary odds ratio was 0.9 (95% CI: 0.7 to 1.2). Nevertheless in some trials home visits had positive effects on women (medical knowledge, support levels, health habits, and satisfaction). The randomized controlled trials provide little evidence that programs offering home visits are effective in improving either pregnancy outcome or the use of health services. A better integration of hospital and home services might allow a more rational use of health services for women with complications. In addition, we need to define more precisely the content of home visits providing social support. For this, further research is required on how emotional support, health education, and advice influence the health of women and infants and mother-child interactions.

ESnet authentication services and trust federations

NASA Astrophysics Data System (ADS)

Muruganantham, Dhivakaran; Helm, Mike; Genovese, Tony

2005-01-01

ESnet provides authentication services and trust federation support for SciDAC projects, collaboratories, and other distributed computing applications. The ESnet ATF team operates the DOEGrids Certificate Authority, available to all DOE Office of Science programs, plus several custom CAs, including one for the National Fusion Collaboratory and one for NERSC. The secure hardware and software environment developed to support CAs is suitable for supporting additional custom authentication and authorization applications that your program might require. Seamless, secure interoperation across organizational and international boundaries is vital to collaborative science. We are fostering the development of international PKI federations by founding the TAGPMA, the American regional PMA, and the worldwide IGTF Policy Management Authority (PMA), as well as participating in European and Asian regional PMAs. We are investigating and prototyping distributed authentication technology that will allow us to support the "roaming scientist" (distributed wireless via eduroam), as well as more secure authentication methods (one-time password tokens).

Investing in soils as an infrastructure to maintain and enhance food water and carbon services

NASA Astrophysics Data System (ADS)

Davies, Jessica

2017-04-01

Soils are a life support system for global society and our planet. In addition to providing the vast majority of our food; soils regulate water quality and quantity reducing the risk of floods, droughts and pollution; and as the largest store of carbon in the earth system they are critical to climate change. By providing these multiple essential services, soils act a natural form of infrastructure that is critical to supporting both rural and urban communities and economies. Can natural infrastructure and natural capital concepts be used to motivate and enable investment and regulation of soils for purposes such as soil carbon sequestration? What scientific knowledge and tools would we need to support soil infrastructure decision making - in policy arenas and elsewhere? This poster will present progress from a new research project supported by the UK research council (EP/N030532/1) that addresses these questions.

Protective factors for mental disorders and psychological distress in female, compared with male, service members in a representative sample.

PubMed

Mota, Natalie P; Medved, Maria; Whitney, Debbie; Hiebert-Murphy, Diane; Sareen, Jitender

2013-10-01

Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations. Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.

Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

PubMed Central

Dube, Christopher; Hayakawa, Tadao; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B

2010-01-01

Abstract Problem Despite the Government’s effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. Approach The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Local setting Mumbwa is a rural district with an area of 23 000 km2 and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. Relevant changes The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases “lost to follow-up”. This might be due to the closer involvement of the community and the better support offered by these services to rural clients. Lessons learnt These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live. PMID:20931065

Technical Review of Water-Resources Investigations of the Tule Desert, Lincoln County, Southern Nevada

USGS Publications Warehouse

Berger, David L.; Halford, Keith J.; Belcher, Wayne R.; Lico, Michael S.

2008-01-01

The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports. The Nevada State Engineer in Ruling No. 5181 required Lincoln County and Vidler Water Company, Inc., to provide results from additional water-resources studies of Tule Desert in southern Nevada to support water-rights application 64692. As outlined by the ruling, the additional studies were to include the determination of the amount of ground water available from the Tule Desert basin, ground-water recharge to the Tule Desert, and the direction of ground-water flow. Results of these additional studies were published in five reports prepared for Lincoln County and Vidler Water Company, Inc. The National Park Service formally requested that the U.S. Geological Survey provide technical reviews of these five reports.

Updating the National School Lunch Program.

ERIC Educational Resources Information Center

Plewes, Margaretta S.

1983-01-01

Despite a favorable nationwide evaluation of school nutrition programs, budget cuts have forced 3,000 schools to shut down their lunch programs. The American School Food Service Association has organized an effective campaign to forestall additional cuts and reestablish program support. (MLF)

Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.

PubMed

Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M

2015-02-01

Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were used to compare the effects of ALS and BLS on patient survival, neurological performance, and medical spending after cardiac arrest. Survival to hospital discharge, to 30 days, and to 90 days; neurological performance; and incremental medical spending per additional survivor to 1 year. Survival to hospital discharge was greater among patients receiving BLS (13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage point difference). Basic life support was associated with better neurological functioning among hospitalized patients (21.8% vs 44.8% with poor neurological functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference). Incremental medical spending per additional survivor to 1 year for BLS relative to ALS was $154,333. Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.

Parenting and proximity to social services: Lessons from Los Angeles County in the community context of child neglect.

PubMed

Maguire-Jack, Kathryn; Klein, Sacha

2015-07-01

Using a sample of 438 parents in Los Angeles County, CA, this study examines the role of proximity to social services in child neglect. In an extension of social disorganization theory, it seeks to understand the potential sources of support in neighborhoods for families. It uses ordinary least squares regression to examine driving distance from parents' residences to four types of services (child care, domestic violence, mental health/substance abuse, and poverty). The results show an association between proximity to mental health and substance abuse services and parents' self-reported neglectful behaviors. Additionally, higher levels of socioeconomic disadvantage (poverty, unemployment, and low education), having older children, respondents being male, and respondents being older parents are associated with higher levels of child neglect, while being white is associated with lower levels. Overall, the findings suggest a potentially protective role of geographic access to mental health and substance abuse services in child maltreatment. Additional research on the pathways through which proximity to services influences child neglect is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Parenting and Proximity to Social Services: Lessons from Los Angeles County in the Community Context of Child Neglect

PubMed Central

Maguire-Jack, Kathryn; Klein, Sacha

2015-01-01

Using a sample of 438 parents in Los Angeles County, CA, this study examines the role of proximity to social services in child neglect. In an extension of social disorganization theory, it seeks to understand the potential sources of support in neighborhoods for families. It uses ordinary least squares regression to examine driving distance from parents’ residences to four types of services (child care, domestic violence, mental health/substance abuse, and poverty). The results show an association between proximity to mental health and substance abuse services and parents’ self-reported neglectful behaviors. Additionally, higher levels of socioeconomic disadvantage (poverty, unemployment, and low education), having older children, respondents being male, and respondents being older parents are associated with higher levels of child neglect, while being white is associated with lower levels. Overall, the findings suggest a potentially protective role of geographic access to mental health and substance abuse services in child maltreatment. Additional research on the pathways through which proximity to services influences child neglect is needed. PMID:26026359

Extending Climate Analytics as a Service to the Earth System Grid Federation Progress Report on the Reanalysis Ensemble Service

NASA Astrophysics Data System (ADS)

Tamkin, G.; Schnase, J. L.; Duffy, D.; Li, J.; Strong, S.; Thompson, J. H.

2016-12-01

We are extending climate analytics-as-a-service, including: (1) A high-performance Virtual Real-Time Analytics Testbed supporting six major reanalysis data sets using advanced technologies like the Cloudera Impala-based SQL and Hadoop-based MapReduce analytics over native NetCDF files. (2) A Reanalysis Ensemble Service (RES) that offers a basic set of commonly used operations over the reanalysis collections that are accessible through NASA's climate data analytics Web services and our client-side Climate Data Services Python library, CDSlib. (3) An Open Geospatial Consortium (OGC) WPS-compliant Web service interface to CDSLib to accommodate ESGF's Web service endpoints. This presentation will report on the overall progress of this effort, with special attention to recent enhancements that have been made to the Reanalysis Ensemble Service, including the following: - An CDSlib Python library that supports full temporal, spatial, and grid-based resolution services - A new reanalysis collections reference model to enable operator design and implementation - An enhanced library of sample queries to demonstrate and develop use case scenarios - Extended operators that enable single- and multiple reanalysis area average, vertical average, re-gridding, and trend, climatology, and anomaly computations - Full support for the MERRA-2 reanalysis and the initial integration of two additional reanalyses - A prototype Jupyter notebook-based distribution mechanism that combines CDSlib documentation with interactive use case scenarios and personalized project management - Prototyped uncertainty quantification services that combine ensemble products with comparative observational products - Convenient, one-stop shopping for commonly used data products from multiple reanalyses, including basic subsetting and arithmetic operations over the data and extractions of trends, climatologies, and anomalies - The ability to compute and visualize multiple reanalysis intercomparisons

Estimating the value of volunteer-assisted community-based aging services: a case example.

PubMed

Scharlach, Andrew E

2015-01-01

This study demonstrates the use of a social return on investment (SROI) approach in estimating the financial and social value created by volunteer-assisted community-based aging services. An expanded value added statement (EVAS) analysis found that the total value of outputs produced by the Concierge Club of San Diego substantially exceeded the cost of the program, after considering likely secondary and tertiary benefits for a range of affected stakeholders-including elderly service recipients, family members, volunteers, and societal institutions. Additional research is needed regarding the direct and indirect costs and benefits of volunteer support services for vulnerable older adults and their families.

Psychosocial intervention for children with narcolepsy: Parents' expectations and perceived support.

PubMed

Kippola-Pääkkönen, Anu; Härkäpää, Kristiina; Valkonen, Jukka; Tuulio-Henriksson, Annamari; Autti-Rämö, Ilona

2016-04-18

The study focuses on the parents of children who were affected by narcolepsy after a pandemic influenza and vaccination campaign in Finland. The main aim of the study was to clarify parents' expectations and perceived support from the intervention and to assess their need for additional support. The data were gathered using questionnaires. Fifty-eight parents answered the baseline questionnaire and 40 parents the final questionnaire. Parents' expectations of and perceived support from the intervention mainly related to peer support. The intervention offered an arena for sharing information and experiences and provided encouragement for coping in everyday life. Many expectations were not met, especially those concerning information about needed services, financial benefits and availability of local support. The results highlight that for persons with rare disorders and their families, an inpatient psychosocial intervention can offer an important arena to receive both informal and professionally led peer support. Comprehensive psychosocial and other support services are also needed in the community. Listening to parents' perspectives on the intervention and perceived support can help to establish multiform family-centred support for families with children affected by a rare chronic disabling condition. © The Author(s) 2016.

[Psychiatric outpatient consultation-liaison services--how do they work and what are their effects: results of a pilot study?].

PubMed

Kirchen-Peters, Sabine; Fehrenbach, Rosa-Adelinde; Diefenbacher, Albert

2012-11-01

Many patients benefit from interventions performed by the psychiatric liaison service. Prospective longitudinal study of community dwelling elderly patients supplemented by a questionnaire answered by family members, as well as expert interviews with the members of the consultation-liaison team and semi-structured interviews with family members. The majority of patients had some benefit from the liaison psychiatric interventions, access to care was improved and lack of specialist support was reduced. In addition there was some cost offset due to prevention of admissions to nursing homes and inpatient hospital treatment. With regard to demographic developments gerontopsychiatric liaison services should be integrated into the present system of health care. This should be supported by adjusting judicial obstacles that hamper such strategies. © Georg Thieme Verlag KG Stuttgart · New York.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, D.W.; Heinrich, R.R.; Jensen, K.J.

Technical and administrative activities of the Analytical Chemistry Laboratory (ACL) are reported for fiscal year 1984. The ACL is a full-cost-recovery service center, with the primary mission of providing a broad range of technical support services to the scientific and engineering programs at ANL. In addition, ACL conducts a research program in analytical chemistry, works on instrumental and methods development, and provides analytical services for governmental, educational, and industrial organizations. The ACL is administratively within the Chemical Technology Division, the principal user, but provides technical support for all of the technical divisions and programs at ANL. The ACL has threemore » technical groups - Chemical Analysis, Instrumental Analysis, and Organic Analysis. Under technical activities 26 projects are briefly described. Under professional activities, a list is presented for publications and reports, oral presentations, awards and meetings attended. 6 figs., 2 tabs.« less

Simulation Analysis of High Velocity Maintenance for the B-1B

DTIC Science & Technology

2010-03-01

additional personnel to provide the necessary logistical support to track down and preemptively order necessary parts (Pedersen, 2009). Considering that the...and critiques as I completed my thesis. I owe a special thanks to Mr. Edwin Milnes, the Maintenance Supply Liaison of the 28th Logistics Readiness...transactional and service processes, such as accounting, logistics , legal, and purchasing resources. In the article "Turning to Service Sectors", a

Effectiveness of a voluntary family befriending service: a mixed methods evaluation using the Donabedian model.

PubMed

Gentry, S V; Powers, E F J; Azim, N; Maidrag, M

2018-07-01

Voluntary befriending schemes operate in many countries, promoting public health by supporting vulnerable individuals and families. Use of third sector and voluntary services to complement health and social care provision is increasingly important globally in the context of economic and demographic challenges, but the evidence base around such collaborations is limited. This article reports the results of operational evaluation research seeking to use robust routine work to generate transferable findings for use by those commissioning and providing services. The subject of our evaluation research is 'Home-Start Suffolk' (HSS) in Suffolk County, UK, an example of a third sector organisation commissioned to support the public health offer to local families. This evaluation research used the Donabedian framework, which assesses the structure, process and outcome in delivery of health services. Methods included a cross-sectional stakeholder survey with qualitative and quantitative elements (n = 96), qualitative interviews (n = 41) and quantitative analysis of the service's routine data (5740 visits) for the period from 01 July 2014 to 01 July 2016. Triangulation of data from each component revealed that HSS was perceived by diverse stakeholders to successfully support families in need of additional help. HSS service users perceived the service to offer greater flexibility, to be tailored to their needs and to be more trustworthy and supportive than statutory services. Volunteering with HSS enabled people to feel productive in their community and gain new skills. Managers of social care services perceived that HSS activity decreased burden on their staff. These benefits were facilitated through a long-standing organisational HSS structure and relationships between HSS and social care. Challenges posed by service provision by a third sector organisation included the need for volunteers to negotiate the boundary between being a friend and a professional outside of a professional framework. Quantitative analysis of impact was limited by the poor quality of routinely collected administrative data, highlighting the importance of planning processes for data collection with evaluation in mind. We believe that the results of this evaluation research provide transferrable lessons. They demonstrate how a third sector organisation with a long-standing structure and relationships with statutory services was able to reduce perceived service burden while also offering support in a more flexible and tailored way greatly valued by service users. Copyright © 2018 The Royal Society for Public Health. All rights reserved.

Effects of Using Child Personas in the Development of a Digital Peer Support Service for Childhood Cancer Survivors.

PubMed

Wärnestål, Pontus; Svedberg, Petra; Lindberg, Susanne; Nygren, Jens M

2017-05-18

Peer support services have the potential to support children who survive cancer by handling the physical, mental, and social challenges associated with survival and return to everyday life. Involving the children themselves in the design process allows for adapting services to authentic user behaviors and goals. As there are several challenges that put critical requirements on a user-centered design process, we developed a design method based on personas adapted to the particular needs of children that promotes health and handles a sensitive design context. The purpose of this study was to evaluate the effects of using child personas in the development of a digital peer support service for childhood cancer survivors. The user group's needs and behaviors were characterized based on cohort data and literature, focus group interviews with childhood cancer survivors (n=15, 8-12 years), stakeholder interviews with health care professionals and parents (n=13), user interviews, and observations. Data were interpreted and explained together with childhood cancer survivors (n=5) in three explorative design workshops and a validation workshop with children (n=7). We present findings and insights on how to codesign child personas in the context of developing digital peer support services with childhood cancer survivors. The work resulted in three primary personas that model the behaviors, attitudes, and goals of three user archetypes tailored for developing health-promoting services in this particular use context. Additionally, we also report on the effects of using these personas in the design of a digital peer support service called Give Me a Break. By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that were successfully used to design and develop health-promoting services for children in vulnerable life stages. The child-personas serve as effective collaboration and communication aids for both internal and external purposes. ©Pontus Wärnestål, Petra Svedberg, Susanne Lindberg, Jens M Nygren. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.05.2017.

Opportunity for change in the future roles for the health library and information professional: meeting the challenges in NHS Scotland.

PubMed

Maclean, Gerry

2006-12-01

NHS Education for Scotland (NES) is the Special Health Board responsible for supporting best practice in education, training and development for all staff groups within NHS Scotland. As part of its remit, the Knowledge Services Group within NES is responsible for the e-Library, a national electronic resource providing and supporting access to the evidence base. The Knowledge Services Group also supports the national development of library services to NHS Scotland. This article aims to provide a reflective overview of some recent challenges within the health library and information field in Scotland, and the positive role opportunities these have afforded. The information was gathered through extensive professional interaction with staff across the sector over the first year of establishing the new role of Librarian Staff Development Manager. New roles have emerged for health library and information professionals generally; for example, in response to new technology or new user groups. The development of the NHS Scotland e-Library provides examples of role development that emerges symbiotically from core skills applied to a new situation or applied in an innovative way. Role development among health library and information professionals operating at the local service level can be both reactive and proactive. Working together, the partnership between the national Knowledge Services Group and local library and knowledge services for NHS Scotland has resulted in the emergence of additional new roles, extending the role portfolio of the local professional (for example, the Librarian-Tutor role) and supported by other national infrastructures (for example, the competency framework initiative).

A descriptive survey of cancer helplines in the United Kingdom: Who they are, the services offered, and the accessibility of those services.

PubMed

Leydon, Geraldine M; Stuart, Beth; Danquah, Lisa; Ekberg, Katie; Brindle, Lucy; Latter, Sue; Moynihan, Clare; Salmon, Peter; Howe, Sonia; Stokoe, Elizabeth; Little, Paul

2017-08-01

There are more than 1500 UK health helplines in operation, yet we have scant knowledge about the resources in place to support the seeking and delivering of cancer-related telephone help and support. This research aimed to identify and describe cancer and cancer-related helpline service provision: the number of helplines available, the variety of services provided, and the accessibility of those services. This study used online national questionnaire survey sent to 95 cancer and cancer-related helplines in the United Kingdom. A total of 69 (73%) of 95 surveyed cancer and cancer-related helplines completed the survey. Most helplines/organizations were registered charities, supported by donations; 73.5% of helplines had national coverage. Most helplines served all age-groups, ethnic groups, and men and women. Only 13.4% had a number that was free from landlines and most mobile networks, and 56.6% could only be contacted during working hours. More than 50% of helplines reported no provisions for callers with additional needs, and 55% had no clinical staff available to callers. Ongoing support and training for helpline staff was available but variable. Although cancer helplines in the United Kingdom offer reasonably broad coverage across the country, there are still potential barriers to accessibility. There are also opportunities to optimize the training of staff/volunteers across the sector. There are further prospects for helplines to enhance services and sustain appropriate and realistic quality standards. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study

PubMed Central

Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-01-01

Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study.

PubMed

Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-12-01

There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β  = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.

What makes a successful home birth service: an examination of the influential elements by review of one service.

PubMed

Brintworth, Kate; Sandall, Jane

2013-06-01

to evaluate and gain understanding of the service factors that contribute to the relatively high home birth rate found in one inner city NHS Trust providing maternity services in England. a multi-faceted approach encompassing narrative, historical, structural, demographic and cultural elements. an inner city maternity service provided in a large metropolis in England. stakeholders including clinical staff and managers in the service. a review of service provision using secondary quantative data analysis 2005-2009, structural review of the service and semi-structured interviews with staff. the structure of a service with multiple self-managed midwifery practices, mainly operating caseload models strongly supported by senior midwifery leaders, and senior obstetricians enabled the delivery of a responsive, flexible service that was able to deliver choice to women. One element of interest was home assessment in early labour, which kept open the choice around place of birth for women until they were in labour. the organisation of care into multiple small midwifery group practices, providing care using a caseload model, appears to support home birth as a choice for women. In addition the offer of home assessment in early labour whilst poorly researched may be relevant to a flexible woman centred service that can respond to women's choices in realistic way. Copyright © 2012 Elsevier Ltd. All rights reserved.

Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

PubMed

Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

2017-06-01

As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer patients regard psycho-oncology services as a highly reasonable and beneficial addition to medical care. In light of insufficient local coverage with services, difficulties with seamless referrals constitute a major challenge for physicians. Apart from emphasizing the effectiveness of psycho-oncology services and proactive attitudes toward the assessment of unmet needs, future policies should focus on the integration of medical and psychosocial follow-up of cancer survivors, especially in rural areas. © AlphaMed Press 2017.

A New Look at Data Usage by Using Metadata Attributes as Indicators of Data Quality

NASA Astrophysics Data System (ADS)

Won, Y. I.; Wanchoo, L.; Behnke, J.

2016-12-01

NASA's Earth Observing System Data and Information System (EOSDIS) stores and distributes data from EOS satellites, as well as ancillary, airborne, in-situ, and socio-economic data. Twelve EOSDIS data centers support different scientific disciplines by providing products and services tailored to specific science communities. Although discipline oriented, these data centers provide common data management functions of ingest, archive and distribution, as well as documentation of their data and services on their web-sites. The Earth Science Data and Information System (ESDIS) Project collects these metrics from the EOSDIS data centers on a daily basis through a tool called the ESDIS Metrics System (EMS). These metrics are used in this study. The implementation of the Earthdata Login - formerly known as the User Registration System (URS) - across the various NASA data centers provides the EMS additional information about users obtaining data products from EOSDIS data centers. These additional user attributes collected by the Earthdata login, such as the user's primary area of study can augment the understanding of data usage, which in turn can help the EOSDIS program better understand the users' needs. This study will review the key metrics (users, distributed volume, and files) in multiple ways to gain an understanding of the significance of the metadata. Characterizing the usability of data by key metadata elements such as discipline and study area, will assist in understanding how the users have evolved over time. The data usage pattern based on version numbers may also provide some insight into the level of data quality. In addition, the data metrics by various services such as the Open-source Project for a Network Data Access Protocol (OPeNDAP), Web Map Service (WMS), Web Coverage Service (WCS), and subsets, will address how these services have extended the usage of data. Over-all, this study will present the usage of data and metadata by metrics analyses and will assist data centers in better supporting the needs of the users.

The South Eastern Europe Brigade: An Option for NATO-Led Peace Support Operations?

DTIC Science & Technology

2011-06-10

Exercise CSSB Combat Service Support Battalion DOS Day of Supply DRO Disaster Relief Operations EOD Explosive Ordnance Disposal ETF Engineer Task...the adoption of the second Additional Protocol, the SEEBRIG member nations established an Engineer Task Force ( ETF ). The concept embeds purpose...capabilities, like the ETF structure, could be used as niche military capabilities by outside organizations that may need them. SEEBRIG engineer capabilities

78 FR 20697 - New Competitive Product

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Product AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing concerning an addition to the competitive product list. This notice informs the... request and associated supporting information to add Priority Mail Contract 57 to the competitive product...

A survey of North Carolina safety-net dental clinics' methods for communicating with patients of limited english proficiency (LEP).

PubMed

Hammersmith, Kimberly J; Lee, Jessica Y

2009-01-01

Dental providers are increasingly challenged in communicating with patients with limited English proficiency (LEP). Accordingly, the purpose of the study was to examine methods of communicating with patients with LEP in North Carolina (NC) safety-net dental clinics as perceived by dental staff. An anonymous, 36-item, cross-sectional survey was distributed to representatives of 68 NC safety-net dental clinics. Question domains included: a) a perceived need for language services; b) methods of language services provided; c) perceptions of dental staff about dental care experiences for patients with LEP; and d) perceived legal and financial roles in providing language services. Of the 68 clinics, 55 responded (81 percent). All clinics reported treating patients with LEP, and 93 percent of clinics reported a need for providing language services. Many clinics used multiple methods to provide language services. Some clinics reported differences in treatment recommendations (13 percent), treatment provided (19 percent), and visit length (61 percent) for patients with LEP. All responded that additional costs are incurred to treat patients with LEP, and only 69 percent of responding clinics recognized legal obligations of treating patients with LEP. There is a reported need for language services in NC safety-net dental clinics. These services often resulted in additional costs to the dental clinic. To maintain the quality of care and to comply with legal requirements related to dental patients with LEP, additional funding sources might be required to recruit multilingual staff, support language services in dental clinics, and provide language skills training for practicing dentists. Additionally, studies are suggested to measure the perception of the effectiveness of communication methods of patients with LEP.

Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

PubMed

Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

2016-05-01

To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

PubMed

McVilly, K; Webber, L; Paris, M; Sharp, G

2013-08-01

Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

[Voluntary help in dementia - predictors for utilisation and expected quality from a family caregiver's point of view].

PubMed

Grässel, E; Luttenberger, K; Römer, H; Donath, C

2010-09-01

Although support services are considered cost-effective in the relief of care-giving family members of dementia patients, there has been little research to date on the predictors of use and quality expectations. These two questions are examined for the first time based on cross-sectional data of 404 care-giving family members, users and non-users of voluntary help services. Quantitative data are evaluated using binary logistical regression analysis, qualitative data using content analysis. The rating of how helpful the use of a voluntary help service is in the personal situation was found to be the only significant predictor of use. With respect to quality, it is most important that the persons giving support be punctual and well-trained. To increase the rate of use, care-giving family members must be convinced of the relevant benefits of using a voluntary help service. In addition, attention must be paid to the professional organization and training of voluntary helpers. Georg Thieme Verlag KG Stuttgart, New York.

An emergency department-based mental health nurse practitioner outpatient service: part 1, participant evaluation.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

2011-12-01

The mental health liaison nurse role in the emergency department (ED) has demonstrated a range of positive outcomes for both consumers and staff. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based on this model is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. In evaluating this new service, semistructured interviews were conducted with a random selection of study participants and a stratified sample of ED staff. This is the first of a two-part paper that presents an analysis of qualitative data from interviews conducted with study participants (n = 23). Participants reported numerous therapeutic benefits from the service, such as support, understanding, and a focus on solutions rather than problems, and high levels of satisfaction with the accessibility of the service and follow up. Suggestions for improving the service were also offered. Participants emphasized that overall ED service provision would be enhanced through additional resources, especially an extension of operating hours. Findings from these participant interviews provide strong support for an ED-based MHNP outpatient service. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

The effectiveness of Teratology Information Services (TIS).

PubMed

Hancock, Rebecca L; Koren, Gideon; Einarson, Adrienne; Ungar, Wendy J

2007-02-01

Women and their health care providers have few reliable sources of information regarding the safety of exposures in pregnancy and lactation. Evidence-based information on these topics is provided by Teratology Information Services (TIS). Access to TIS, however, is limited in many regions, and many services have difficulty maintaining ongoing funding. The objective of this review is to highlight published reports of the effectiveness of TIS in improving maternal and neonatal health. A search of the Pub Med and Econ Lit databases was performed with no date restriction, using the search terms teratology, information, counseling, pregnancy, effectiveness, birth defects. Information disseminated from TIS has been shown to prevent congenital malformations, unnecessary pregnancy terminations, and occupational risks. TIS support optimal nutritional supplementation in pregnancy and optimal drug therapy in pregnancy and breast-feeding. In addition, they correct misperceptions of risk and facilitate knowledge transfer and translation. TIS have the potential to provide health care cost savings. TIS are vital services in supporting optimal maternal and neonatal health. A formal economic evaluation of TIS is required in order to inform resource allocation decision-making and continued funding of these services.

Collaborating With Businesses to Support and Sustain Research.

PubMed

Moch, Susan Diemert; Jansen, Debra A; Jadack, Rosemary A; Page, Phil; Topp, Robert

2015-10-01

Financial assistance is necessary for sustaining research at universities. Business collaborations are a potential means for obtaining these funds. To secure funding, understanding the process for obtaining these business funds is important for nursing faculty members. Although faculty rarely request funding from businesses, they are often in a position to solicit financial support due to existing relationships with clinical agency administrators, staff, and community leaders. The economic support received from businesses provides outcomes in nursing research, research education, academic-service partnerships, and client health care. This article describes the steps and processes involved in successfully obtaining research funding from businesses. In addition, case examples for securing and maintaining funding from health care agencies (evidence-based practice services) and from a health manufacturing company (product evaluation) are used to demonstrate the process. © The Author(s) 2015.

Development of XML Schema for Broadband Digital Seismograms and Data Center Portal

NASA Astrophysics Data System (ADS)

Takeuchi, N.; Tsuboi, S.; Ishihara, Y.; Nagao, H.; Yamagishi, Y.; Watanabe, T.; Yanaka, H.; Yamaji, H.

2008-12-01

There are a number of data centers around the globe, where the digital broadband seismograms are opened to researchers. Those centers use their own user interfaces and there are no standard to access and retrieve seismograms from different data centers using unified interface. One of the emergent technologies to realize unified user interface for different data centers is the concept of WebService and WebService portal. Here we have developed a prototype of data center portal for digital broadband seismograms. This WebService portal uses WSDL (Web Services Description Language) to accommodate differences among the different data centers. By using the WSDL, alteration and addition of data center user interfaces can be easily managed. This portal, called NINJA Portal, assumes three WebServices: (1) database Query service, (2) Seismic event data request service, and (3) Seismic continuous data request service. Current system supports both station search of database Query service and seismic continuous data request service. Data centers supported by this NINJA portal will be OHP data center in ERI and Pacific21 data center in IFREE/JAMSTEC in the beginning. We have developed metadata standard for seismological data based on QuakeML for parametric data, which has been developed by ETH Zurich, and XML-SEED for waveform data, which was developed by IFREE/JAMSTEC. The prototype of NINJA portal is now released through IFREE web page (http://www.jamstec.go.jp/pacific21/).

Breastfeeding education and support services offered to pediatric residents in the US.

PubMed

Osband, Yardaena B; Altman, Robin L; Patrick, Patricia A; Edwards, Karen S

2011-01-01

The American Academy of Pediatrics (AAP) encourages pediatricians to support the practice of breastfeeding and residency educators to develop formal curricula in breastfeeding education. Few studies, however, describe breastfeeding education or support services currently provided to pediatric residents in the United States. The goals of this study were to investigate breastfeeding training offered during 3-year pediatric residency programs and to describe residency programs' policies and services for residents who breastfeed. We conducted a cross-sectional study using a Web-based survey of pediatric program directors regarding breastfeeding education and support services for residents. Seventy percent of program directors (132 of 189) completed the survey, with 77.3% of respondents (n = 102) estimating the amount of breastfeeding education offered to their pediatric residents. Residents are provided with a median total of 9.0 hours of breastfeeding training over 3 years, primarily in continuity clinic and in lectures and rounds with attendings. At the programs' primary teaching hospitals, breastfeeding residents are provided breastfeeding rooms (67.0%), breast pumps (75.3%), and breast milk storage facilities (87.6%). Only 10 programs reported having an official policy to accommodate breastfeeding residents. Pediatric residents receive approximately 3 hours of breastfeeding training per year. In addition, there is less than universal implementation by residency programs of AAP recommendations for supporting breastfeeding in the workplace. Pediatric residency programs should find ways to improve and assess the quality of breastfeeding education and workplace support to better role model this advocacy standard. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Role perceptions of occupational therapists providing support and education for caregivers of persons with dementia.

PubMed

Toth-Cohen, S

2000-01-01

This pilot study explored occupational therapists' perceptions of their roles as interventionists providing education and support for caregivers of persons with dementia. The intervention was provided in caregivers' homes as part of a larger funded study. Interviews were conducted with four occupational therapists to elicit their reflections on practice and their views on occupational therapy services on the basis of their experiences providing support and education for caregivers in the funded study. Key themes consisted of the contrasts between the therapists' roles in the study and their customary practices and the professional and personal impact of their role in the study. Their recommendations for occupational therapy services emphasized the need to (a) collaborate with patients, families, and other health care staff members to solve problems; (b) acknowledge others as experts; (c) include family perspectives; and (d) fully address the needs of patients and families in their home environments. Providing support and education for caregivers in the community can be a major transition for therapists accustomed to practicing in more traditional settings. Additional research is needed to explore the ways in which specific practice contexts influence delivery of occupational therapy services.

Avoiding institutional outcomes for older adults living with disability: the use of community-based aged care supports.

PubMed

Ellison, Caroline; White, Amy; Chapman, Libby

2011-09-01

Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived access to community-based aged care supports assisted with avoiding receiving more institutional models of service as they age. Qualitative research processes were used to explore the perceptions of 60 individuals with a disability aged 50 years and over, in relation to ageing and the value of community-based aged care. Findings indicated that participants receiving community-based aged care supports reported benefits including opportunities to develop relationships, maintain daily living skills and participate in community activities. Due to a lack of confidence in the availability of access to mainstream community-based aged care services, many participants felt vulnerable or unsure about their future and ability to remain living in their own home. Several participants commented that this meant that an undesired early relocation into residential aged care or congregate disability services appeared inevitable.

Modeling the Impact of School-based Universal Depression Screening on Additional Service Capacity Needs: A System Dynamics Approach

PubMed Central

Lyon, Aaron R.; Maras, Melissa A.; Pate, Christina M.; Igusa, Takeru; Stoep, Ann Vander

2016-01-01

Although it is widely known that the occurrence of depression increases over the course of adolescence, symptoms of mood disorders frequently go undetected. While schools are viable settings for conducting universal screening to systematically identify students in need of services for common health conditions, particularly those that adversely affect school performance, few school districts routinely screen their students for depression. Among the most commonly referenced barriers are concerns that the number of students identified may exceed schools’ service delivery capacities, but few studies have evaluated this concern systematically. System dynamics (SD) modeling may prove a useful approach for answering questions of this sort. The goal of the current paper is therefore to demonstrate how SD modeling can be applied to inform implementation decisions in communities. In our demonstration, we used SD modeling to estimate the additional service demand generated by universal depression screening in a typical high school. We then simulated the effects of implementing “compensatory approaches” designed to address anticipated increases in service need through (1) the allocation of additional staff time and (2) improvements in the effectiveness of mental health interventions. Results support the ability of screening to facilitate more rapid entry into services and suggest that improving the effectiveness of mental health services for students with depression via the implementation of an evidence-based treatment protocol may have a limited impact on overall recovery rates and service availability. In our example, the SD approach proved useful in informing systems’ decision-making about the adoption of a new school mental health service. PMID:25601192

Space Station flight telerobotic servicer functional requirements development

NASA Technical Reports Server (NTRS)

Oberright, John; Mccain, Harry; Whitman, Ruth I.

1987-01-01

The Space Station flight telerobotic servicer (FTS), a flight robotic system for use on the first Space Station launch, is described. The objectives of the FTS program include: (1) the provision of an alternative crew EVA by supporting the crew in assembly, maintenance, and servicing activities, and (2) the improvement of crew safety by performing hazardous tasks such as spacecraft refueling or thermal and power system maintenance. The NASA/NBS Standard Reference Model provides the generic, hierarchical, structured functional control definition for the system. It is capable of accommodating additional degrees of machine intelligence in the future.

Social impact analysis: monetary valuation

USGS Publications Warehouse

Wainger, Lisa A.; Johnston, Robert J.; Bagstad, Kenneth J.; Casey, Frank; Vegh, Tibor

2014-01-01

This section provides basic guidance for using and conducting economic valuation, including criteria for judging whether valuation is appropriate for supporting decisions. It provides an introduction to the economic techniques used to measure changes in social welfare and describes which methods may be most appropriate for use in valuing particular ecosystem services. Rather than providing comprehensive valuation instructions,it directs readers to additional resources.More generally, it establishes that the valuation of ecosystem services is grounded in a long history of non-market valuation and discusses how ecosystem services valuation can be conducted within established economic theory and techniques.

Music Education Suites

ERIC Educational Resources Information Center

Kemp, Wayne

2009-01-01

This publication describes options for designing and equipping middle and high school music education suites, and suggests ways of gaining community support for including full service music suites in new and renovated school facilities. In addition to basic music suites, and practice rooms, other options detailed include: (1) small ensemble…

State Funding Mechanisms for English Language Learners

ERIC Educational Resources Information Center

Millard, Maria

2015-01-01

Research is clear that English language learners (ELLs) perform better academically and achieve greater language proficiency when they have high-quality English language instruction.1 Like all supplemental services, these necessary supports require additional funding above the average per-student amount. The federal government provides grant…

39 CFR 3020.72 - Supporting justification.

Code of Federal Regulations, 2010 CFR

2010-07-01

...(c); (c) Explain why, as to competitive products, the addition, subtraction, or transfer will not... classify as competitive a product over which the Postal Service exercises sufficient market power that it can, without risk of losing a significant level of business to other firms offering similar products...

Interprofessional education about patient decision support in specialty care.

PubMed

Politi, Mary C; Pieterse, Arwen H; Truant, Tracy; Borkhoff, Cornelia; Jha, Vikram; Kuhl, Laura; Nicolai, Jennifer; Goss, Claudia

2011-11-01

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care - aimed at providing continuous, comprehensive care - specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients' care. Interprofessional care involves multiple professionals from different disciplines collaborating to provide an integrated approach to patient care. For patients to experience continuity of care across interprofessional providers, providers need to communicate and maintain a shared sense of responsibility to their patients. In this article, we describe challenges inherent in providing interprofessional patient decision support in specialty care. We propose ways for providers to engage in interprofessional decision support and discuss promising approaches to teaching an interprofessional decision support to specialty care providers. Additional evaluation and empirical research are required before further recommendations can be made about education for interprofessional decision support in specialty care.

Return to learn: Transitioning to school and through ascending levels of academic support for students following a concussion.

PubMed

McAvoy, Karen; Eagan-Johnson, Brenda; Halstead, Mark

2018-01-01

The purpose of this article is to familiarize healthcare providers and parents with educational language, laws, and processes as they relate to a comprehensive ascending level of academic supports as it pertains to promoting a smooth and supported transition to school following a concussion. Returning to learn (RTL) following a concussion is of parallel importance to returning to sport (RTS). A successful RTL is a critical part of concussion management. Many RTL articles advise healthcare providers and parents to request formalized educational supports, also known as Tier 2 or Tier 3 services, for children with concussion as they return to school. Premature requests for formal (Tier 2 or 3) educational services, rather than allowing for immediate informal educational supports (known as Tier 1), can actually delay academic supports and have the potential to cause adversarial relationships between parents and schools. Additionally, this practice contradicts current research demonstrating the need for fast, flexible, temporary academic supports within the first month post-injury. Allowing school districts to direct the application of existing ascending levels of educational support for students with concussion as they return to school can promote robust and positive outcomes.

DoD Force & Infrastructure Categories: A FYDP-Based Conceptual Model of Department of Defense Programs and Resources

DTIC Science & Technology

2002-09-01

Support 0605160D Counterproliferation Support (H) 0901502A Service Support to DTSA 0901502F Service Support to DTSA 0901502N Service Support to DTSA ...Base Operations Support 0901502A Service Support to DTSA (1F2C) Int’l Engagement & Threat Reduction 0901502F Service Support to DTSA (1F2C...Int’l Engagement & Threat Reduction 0901502N Service Support to DTSA (1F2C) Int’l Engagement & Threat Reduction 0901503A Service Support to OSD

Housing first on a large scale: Fidelity strengths and challenges in the VA's HUD-VASH program.

PubMed

Kertesz, Stefan G; Austin, Erika L; Holmes, Sally K; DeRussy, Aerin J; Van Deusen Lukas, Carol; Pollio, David E

2017-05-01

Housing First (HF) combines permanent supportive housing and supportive services for homeless individuals and removes traditional treatment-related preconditions for housing entry. There has been little research describing strengths and shortfalls of HF implementation outside of research demonstration projects. The U.S. Department of Veterans Affairs (VA) has transitioned to an HF approach in a supportive housing program serving over 85,000 persons. This offers a naturalistic window to study fidelity when HF is adopted on a large scale. We operationalized HF into 20 criteria grouped into 5 domains. We assessed 8 VA medical centers twice (1 year apart), scoring each criterion using a scale ranging from 1 ( low fidelity ) to 4 ( high fidelity ). There were 2 HF domains (no preconditions and rapidly offering permanent housing) for which high fidelity was readily attained. There was uneven progress in prioritizing the most vulnerable clients for housing support. Two HF domains (sufficient supportive services and a modern recovery philosophy) had considerably lower fidelity. Interviews suggested that operational issues such as shortfalls in staffing and training likely hindered performance in these 2 domains. In this ambitious national HF program, the largest to date, we found substantial fidelity in focusing on permanent housing and removal of preconditions to housing entry. Areas of concern included the adequacy of supportive services and adequacy in deployment of a modern recovery philosophy. Under real-world conditions, large-scale implementation of HF is likely to require significant additional investment in client service supports to assure that results are concordant with those found in research studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Family functioning, health and social support assessed by aged home care clients and their family members.

PubMed

Hautsalo, Katja; Rantanen, Anja; Astedt-Kurki, Päivi

2013-10-01

The aim of this study was to describe aged home care clients' and their family members' experiences of their family functioning, family health and social support received. An additional purpose was to determine which factors are connected with social support. Increasing life expectancy and ageing of the population require consideration of the adequacy of home care services and the role of family members as care providers. The older population is a very heterogeneous group because of their variable needs and several disabilities. To ensure the quality of home care, experimental information is needed from clients and their family members. A survey design with convenience sampling. The home care client and a family member of his/her answered a questionnaire together, including background questions, the Family Functioning, Health and Social Support instrument and an open question about support received from home care. Statistical methods were used to describe quantitative data, and content analysis was used in analysing the replies to the open question. Family health was noted as good, and family functioning and overall social support fairly good. An older person's higher basic education, higher age of the family member, better family health and male gender were connected with better social support received. The relationship of the older person and the family member as well as the duration of home care service use had an effect on social support received. The content analysis raised expectations related to time, planning of service, organisational factors and caring practise. Home care clients' and families' needs for support vary, and therefore, the assessment of needs, care planning and updating are important. The variable support needs of older people and their family members require flexible and adaptable home services. Cooperation between all participants involved in care would promote the well-being of the older person and the entire family. © 2012 Blackwell Publishing Ltd.

Redesigning a home oxygen assessment and review service.

PubMed

Wrench, Christine; Darwin, Ruth; Lawson, Rod

2015-03-01

The Sheffield home oxygen assessment and review service was developed as a nurse-led, protocol-driven service, offering high standards of care to a limited number of patients. In line with national changes to oxygen provision in 2011, the service team was approached to address inconsistencies and inequalities in the existing care pathway, with a view to becoming a fully commissioned service. This required a complete redesign of the service, using a collaborative approach to include relevant interested parties in planning and decision making. Additional support was gained through participation in the NHS Improvement lung national improvement project. This article outlines the process of service redesign, including some of the major challenges as well as the main learning points. It has led to the provision of an equitable and efficient service for all oxygen patients across the city, offering more community clinics and robust cost controls, while maintaining quality of care.

Mental/Behavioral Health Services: Medicaid Home and Community-Based Services 1915(c) Waiver Allocation for People With Intellectual and Developmental Disabilities.

PubMed

Friedman, Carli; Lulinski, Amie; Rizzolo, Mary C

2015-08-01

Research has indicated that people who have intellectual and developmental disabilities (IDD) appear to be more vulnerable to having a co-existing psychiatric diagnosis. This study examined Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver applications for people with IDD to determine the mental/behavioral health services proposed. We found that a large variance exists across states in projected spending for services, spending per participant, annual hours of service per participant, and hourly reimbursement rates. Moreover, compared to overall funding we found a general lack of state commitment to mental/behavioral services. States must shore up the capacity of their HCBS 1915 (c) waivers to support people with behavioral challenges in addition to IDD in order to assure that services continue to be delivered in the least restrictive environment appropriate.

Rescuing DoD From Too Much of a Good Thing: The Wrong Kind of Disaster Response

DTIC Science & Technology

2006-05-25

educating its members in relevant legislation that governs the military in domestic disaster response operations, the military could institutionalize the...additional section on civil support appears on page 39. 55 DoD Strategy for Homeland Defense and Civil Support, June 2005, p.39. 25 With education ...actual JFO. He provided this information under the SAMS Non-attribution Policy. 93 All Services have professional military education systems that

Executing Military Family Programs in the New Fiscal Reality

DTIC Science & Technology

2013-03-01

these family programs to the Army’s Installation Management Command (IMCOM) G9, Family Moral Welfare and Recreation. IMCOM G9 refines policy and... Family Support Centers manages Navy Family Support Initiatives. 35F36 Additionally, to ensure that family needs are met, the Navy places family ...service members and their families . The 2008 DOD survey of active duty spouses concluded that managing childcare during deployment was a problem for 65

Elderly patients discharged from an accident and emergency department--their dependency and support.

PubMed Central

Currie, C T; Lawson, P M; Robertson, C E; Jones, A

1984-01-01

One hundred elderly patients who had attended an accident and emergency department and had been discharged were visited at home shortly afterwards. Compared to their previous level of function, 52 showed a minor or major increase in dependency, usually related to trauma. Scrutiny of accident and emergency records showed only scanty documentation of dependency, function and support arrangements. Available statutory services for dependent elderly in the community were under-utilized by these patients. In 39 of the 52 cases with increased dependency relatives had provided additional support. PMID:6100354

An evolutionary solution to anesthesia automated record keeping.

PubMed

Bicker, A A; Gage, J S; Poppers, P J

1998-08-01

In the course of five years the development of an automated anesthesia record keeper has evolved through nearly a dozen stages, each marked by new features and sophistication. Commodity PC hardware and software minimized development costs. Object oriented analysis, programming and design supported the process of change. In addition, we developed an evolutionary strategy that optimized motivation, risk management, and maximized return on investment. Besides providing record keeping services, the system supports educational and research activities and through a flexible plotting paradigm, supports each anesthesiologist's focus on physiological data during and after anesthesia.

Stormwater Management Effects on Ecosystem Services: A Literature Review

NASA Astrophysics Data System (ADS)

Prudencio, L.; Null, S. E.

2016-12-01

Managing stormwater provides benefits for enhancing water supplies while reducing urban runoff. Yet, there has been little research focused on understanding how stormwater management affects ecosystem services, the benefits that ecosystems provide to humans. Garnering more knowledge of the changes to ecosystem services from stormwater management will ultimately improve management and decision-making. The objective of this research is to review and synthesize published literature on 1) ecosystem services and stormwater management and 2) changes in ecosystem services from anthropogenic impacts and climate warming, to establish a foundation for research at the intersection of ecosystems services, stormwater management, and global environmental change. We outline four research areas for ecosystem services and stormwater management that should be further explored. These four areas, named after the four types of ecosystem services, highlight context-specific research questions and human and climate change effects. We conclude that effective and sustainable stormwater management requires incorporating engineering, social, and environmental criteria to quantify benefits of provisioning, regulating, cultural, and supporting ecosystem services. Lastly, improved current and potential stormwater management policy may better support sustainable stormwater methods at the institutional level. Stormwater quality and monitoring could be improved through the use of the Clean Water Act (e.g. Total Maximum Daily Loads), the Endangered Species Act, and public health measures. Additional policies regulating groundwater quantity and quality have been and may continue to be implemented by states, encouraging sustainable and cleaner stormwater practices.

Impact of a population based intervention to increase the adoption of multiple physical activity practices in centre based childcare services: a quasi experimental, effectiveness study

PubMed Central

2012-01-01

Background There is considerable scope to improve the delivery of practices that increase the physical activity of children in centre based childcare services. Few studies have reported the effectiveness of interventions to address this, particularly at a population level. The primary aim of this study was to describe the impact of an intervention to increase the adoption of multiple policies and practices to promote physical activity in centre based childcare services. Methods A quasi experimental study was conducted in centre based childcare services (n =228) in New South Wales (NSW), Australia and involved a three month intervention to increase the adoption of eight practices within childcare services that have been suggested to promote child physical activity. Intervention strategies to support the adoption of practices included staff training, resources, incentives, follow-up support and performance monitoring and feedback. Randomly selected childcare services in the remainder of NSW acted as a comparison group (n = 164) and did not receive the intervention but may have been exposed to a concurrent NSW government healthy eating and physical activity initiative. Self reported information on physical activity policies, fundamental movement skills sessions, structured physical activity opportunities, staff involvement in active play and provision of verbal prompts to encourage physical activity, small screen recreation opportunities, sedentary time, and staff trained in physical activity were collected by telephone survey with childcare service managers at baseline and 18 months later. Results Compared with the comparison area, the study found significantly greater increases in the prevalence of intervention services with a written physical activity policy, with policy referring to placing limits on small screen recreation, and with staff trained in physical activity. In addition, non-significant trends towards a greater increase in the proportion of intervention services conducting daily fundamental movement skill sessions, and such services having a physical activity policy supporting physical activity training for staff were also evident. Conclusion The intervention was effective in improving a number of centre based childcare service policies and practices associated with promoting child physical activity. Adoption of a broader range of practices may require more intensive and prolonged intervention support. PMID:22929434

An approach to efficient mobility management in intelligent networks

NASA Technical Reports Server (NTRS)

Murthy, K. M. S.

1995-01-01

Providing personal communication systems supporting full mobility require intelligent networks for tracking mobile users and facilitating outgoing and incoming calls over different physical and network environments. In realizing the intelligent network functionalities, databases play a major role. Currently proposed network architectures envision using the SS7-based signaling network for linking these DB's and also for interconnecting DB's with switches. If the network has to support ubiquitous, seamless mobile services, then it has to support additionally mobile application parts, viz., mobile origination calls, mobile destination calls, mobile location updates and inter-switch handovers. These functions will generate significant amount of data and require them to be transferred between databases (HLR, VLR) and switches (MSC's) very efficiently. In the future, the users (fixed or mobile) may use and communicate with sophisticated CPE's (e.g. multimedia, multipoint and multisession calls) which may require complex signaling functions. This will generate volumness service handling data and require efficient transfer of these message between databases and switches. Consequently, the network providers would be able to add new services and capabilities to their networks incrementally, quickly and cost-effectively.

High profile rail clearances in the State of Pennsylvania : report 6 : executive summary

DOT National Transportation Integrated Search

1992-11-10

The most important findings are: the expenditure of almost $81 million on construction over the next three years will results in some 900 new construction jobs available in 1993. Around 2100 additional jobs in service and support industries will be r...

Geostationary platform systems concepts definition study. Volume 2A: Appendixes, book 2

NASA Technical Reports Server (NTRS)

1980-01-01

Various investigations and support data concerning geostationary platform feasibility are presented. Servicing flight analyses, platform cost model runs, and funding spread analyses are included. In addition, investigations of the radiation environment at synchronous altitude and its effects on satellite communication are reported.

75 FR 33270 - Procurement List; Proposed Additions and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

.... Contracting Activity: Federal Acquisition Service, GSA/FSS OFC SUP CTR--Paper Products, New York, NY. Coverage... Support Center--Paper Products. Microfiber and Metallic Scrubber Sponges (3-Pack) NSN: MR 999. NPA: New York City Industries for the Blind, Inc., Brooklyn, NY. Contracting Activity: Defense Commissary Agency...

EnviroAtlas: Incorporation of Community-Scale Data for Additional Communities

EPA Science Inventory

EnviroAtlas is ORD’s online spatial decision support tool for viewing and analyzing the supply, demand, and drivers of change related to natural and built infrastructure at multiple scales for the nation. Maps and text identify known relationships between the goods and services ...

12 CFR 1282.14 - Special Affordable Housing Goal.

Code of Federal Regulations, 2010 CFR

2010-01-01

...”) Insurance Program, 12 U.S.C. 1715z-20; mortgages guaranteed under the Rural Housing Service's Single Family...-going, sustainable efforts to ensure that additional loans that meet the goal are originated. (iv... of the Community Support Program; or (B) Community development credit unions; community development...

Nutrition in primary health care: using a Delphi process to design new interdisciplinary services.

PubMed

Brauer, Paula; Dietrich, Linda; Davidson, Bridget

2006-01-01

A modified Delphi process was used to identify key features of interdisciplinary nutrition services, including provider roles and responsibilities for Ontario Family Health Networks (FHNs), a family physician-based type of primary care. Twenty-three representatives from interested professional organizations, including three FHN demonstration sites, completed a modified Delphi process. Participants reviewed evidence from a systematic literature review, a patient survey, a costing analysis, and key informant interview results before undertaking the Delphi process. Statements describing various options for services were developed at an in-person meeting, which was followed by two rounds of e-mail questionnaires. Teleconference discussions were held between rounds. An interdisciplinary model with differing and complementary roles for health care providers emerged from the process. Additional key features addressing screening for nutrition problems, health promotion and disease prevention, team collaboration, planning and evaluation, administrative support, access to care, and medical directives/delegated acts were identified. Under the proposed model, the registered dietitian is the team member responsible for managing all aspects of nutrition services, from needs assessment to program delivery, as well as for supporting all providers' nutrition services. The proposed interdisciplinary nutrition services model merits evaluation of cost, effectiveness, applicability, and sustainability in team-based primary care service settings.

The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs.

PubMed

Shelby, Rebecca A; Taylor, Kathryn L; Kerner, Jon F; Coleman, Ellen; Blum, Diane

2002-01-01

We examined information from community-based and philanthropic organizations to document the cancer-related services that are currently available, establish which services are still needed, and determine who utilizes these formal support networks. In Phase I, 32 of 41 eligible organizations participated in a survey conducted from December 1999 to March 2000. The most common mission focus among participating organizations was information/referral-centered. The most common services provided were referrals to information resources and provision of cancer-related information. Only two of the organizations in Phase I provided client demographic information and both indicated that client populations were predominantly white, female, and over age 40. Phase II of the study involved analyzing patient data from Cancer Care, Inc., a national service organizations for cancer patients. Between 1983 and 1997, there were 2,714 prostate cancer patients and 9,451 breast cancer patients included in the Cancer Care database. Their most commonly reported problems were related to personal adjustment to illness, financial, home care, and transportation needs. There were significant differences in problems reported depending upon age and disease status. In addition, the results of this study support the idea that those at highest risk for developing and dying of cancer are the least likely to utilize formal support networks. Further, a gap in service provision for assistance with practical needs (e.g., transportation, home care, child care, psychosocial support) was identified. Due to the increasing use of outpatient care for cancer patients, a greater demand for practical assistance can be expected in the future. The availability of practical services will need to be increased in order to effectively meet cancer patient needs.

Elementary school parents'/guardians' perceptions of school health service personnel and the services they provide.

PubMed

Kirchofer, Gregg; Telljohann, Susan K; Price, James H; Dake, Joseph A; Ritchie, Martin

2007-11-01

The school nurse, the school social worker, and the school counselor play an important role in promoting the health of children. Health services in the school setting provide opportunities to appraise, protect, and promote student health. The purpose of this study was to identify parents' or caregivers' perceptions and beliefs regarding the importance of schools providing various health services to their elementary school-aged children. In addition, the study examined the levels of parental support for, perceptions of, and contact with school health service personnel. In 2005, a nationally representative random sample of 369 (51% return rate) parents of elementary school-aged children completed the questionnaire developed for this study. A majority of parents/caregivers reported that their child's school had a school nurse (78.8%) and counselor (60.5%), but only 22.6% reported their school had a social worker. A majority of parents/caregivers perceived full-time school nurses (86.3%), school counselors (78.6%), and school social workers (56.3%) as important or extremely important and that schools should be held responsible for having each in their child's elementary school. A majority of parents/caregivers were willing to pay an increase in yearly tax dollars to have full-time school health personnel. This study established a level of parental support for, perceptions of, and contact with school health service personnel. Parents were most supportive of school nurses and should be perceived as allies in ensuring job security.

Reciprocity of agonistic support in ravens.

PubMed

Fraser, Orlaith N; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim's likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals.

Childhood bereavement services: a survey of UK provision.

PubMed

Rolls, L; Payne, S

2003-07-01

The purpose of the study was to identify the location, range and type of childhood bereavement service provision in the UK. A questionnaire was mailed to 127 services who were either solely dedicated to childhood bereavement or who offered a service within the range of work of a host organization and for which there was a supporting organizational structure. Responses were received from 108 services (a response rate of 85%). The findings identified that 85% of childhood bereavement services are located in the voluntary sector; 14% are dedicated childhood bereavement services, while 86% are offered as part of a host organization. Forty-four per cent of host organizations are hospices. The majority of services (73%) relied on both paid and unpaid staff, with 11% relying entirely on paid staff and 14% of services relying entirely on unpaid staff. The interventions offered ranged from individual family work (86%), individual child work (62%), groupwork with families (53%) and groupwork with children (45%). In addition, services offered prebereavement support (64%), a 'drop-in' service (17%), information and advice (95%), training (32%) and the provision of resources (88%). As well as offering a service to children and their families, 74% of childhood bereavement services provided a service to 'secondary users', such as schools (66%), the emergency services (28%) and other professionals (63%). In terms of funding, 12% of services relied solely on external sources of funding, including donations, legacies, revenue from the host organization or grants, while 12% of services relied solely on internal sources of funding, including fundraising and training. The majority of services (73%), however, gained income from a range of sources. The study identifies the diversity of provision that has implications for the evaluation of childhood bereavement services.

Fixing the system? The experience of service users of the quasi-market in disability services in Australia.

PubMed

Spall, Pam; McDonald, Catherine; Zetlin, Di

2005-01-01

A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

PubMed Central

Strother, R. Matthew; Ndiangui, Francis; Chumba, David; Jacobson, William; Dodson, Cecelia; Resnic, Murray B.; Strate, Randall W.; Smith, James W.

2016-01-01

Background Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service. Objectives, methods and outcomes Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to a resource-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme. Conclusion Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment. PMID:28879100

Family engagement in the perinatal period and infant rights.

PubMed

Tsantefski, Menka; Humphreys, Cathy; Jackson, Alun C

2011-01-01

The meaning of human rights for children is a contested issue; the notion of rights for unborn babies poses additional complexity. Drawing on data from a prospective case study of a specialist drug and alcohol obstetric provider and the statutory child protection service, this article discusses family engagement within a child-rights framework, and demonstrates how adherence to the "best interests" principle, in the absence of an appropriate service provision, excludes vulnerable mother/infant dyads from drawing on extended family support.

How rude! Emotional labor as a mediator between customer incivility and employee outcomes.

PubMed

Sliter, Michael; Jex, Steve; Wolford, Katherine; McInnerney, Joanne

2010-10-01

Because of the large number of people employed in service occupations, customer incivility has become an increasingly prevalent and important workplace stressor. Unfortunately, relatively little research has examined the effects of customer incivility; of the research that does exist, virtually all of it has focused solely on employee mental health outcomes. The present study was designed to replicate previous research linking customer incivility to the emotional exhaustion dimension of burnout and to expand on previous research by examining the effects of customer incivility on customer service quality. In addition, two models were proposed and tested in which emotional labor mediated the relationship between customer incivility and outcomes. Data from 120 bank tellers revealed that customer incivility was positively related to emotional exhaustion and negatively related to customer service performance. In addition, both proposed models were supported. Theoretical and practical implications of the findings and future directions are discussed. © 2010 APA, all rights reserved.

Defense Finance and Accounting Service Commercial Activities Program

DTIC Science & Technology

1999-07-08

Defns 19980g7 Additional Copies To obtain additional copies of the draft report, contact the Secondary Reports Distribution Unit of the Audit ...www.dodig.osd.mil. Suggestions for Future Audits To suggest ideas for or to request audits , contact the Audit Followup and Technical Support Directorate at...703) 604-8940 (DSN 664-8940) or fax (703) 604-8932. Ideas and requests can also be mailed to: OAIG-AUD (ATTN: AFTS Audit Suggestions) Inspector General

Quality of life for chronic psychiatric illnesses and home care

PubMed Central

Molu, Nesibe Gunay; Ozkan, Birgul; Icel, Sema

2016-01-01

Nowadays, mental illnesses are gradually increasing and so does chronic psychiatric patients. As a result of this increase, chronic psychiatric disorders lead the burden of patients and their families. To reduce the burden of mental illnesses on individuals and their families, treatment and care are given including psychosocial, physiological and medical support and social services. To begin with, home care enables both the patient and his or her family to stay at their own houses and not to be bothered with residents or long-term, institutional-based nursing homes. In addition, the home care providers deliver services to the patient’s at their own house. The other advantages of taking care at home is that it eases financial issues in terms of reducing the cost, reduces the patient’s symptoms and improve the individual’s quality of life (QoL). In addition to these, home care also minimizes the burden on outpatient services and provides help for the patient and the family in order to solve their problems and give support. Home care services help patients to get their freedom back and enhance the quality of their lives. Thus, it is necessary to procure and implement these services and supply both the patient and his or her family a high-quality life. Sources of data/ study selection: Literature review was done by using the keywords “home care, patient with chronic mental illness, quality of life, home care nursing” from the sources including PsychINFO, PsychARTICLES, MEDLINE, PubMED, EBSCOHOST and The COCHRANE LIBRARY in the time period of 2005- 2015. PMID:27182272

Lunar lander ground support system

NASA Technical Reports Server (NTRS)

1991-01-01

This year's project, like the previous Aerospace Group's project, involves a lunar transportation system. The basic time line will be the years 2010-2030 and will be referred to as a second generation system, as lunar bases would be present. The project design completed this year is referred to as the Lunar Lander Ground Support System (LLGSS). The area chosen for analysis encompasses a great number of vehicles and personnel. The design of certain elements of the overall lunar mission are complete projects in themselves. For this reason the project chosen for the Senior Aerospace Design is the design of specific servicing vehicles and additions or modifications to existing vehicles for the area of concern involving servicing and maintenance of the lunar lander while on the surface.

Real-time distributed scheduling algorithm for supporting QoS over WDM networks

NASA Astrophysics Data System (ADS)

Kam, Anthony C.; Siu, Kai-Yeung

1998-10-01

Most existing or proposed WDM networks employ circuit switching, typically with one session having exclusive use of one entire wavelength. Consequently they are not suitable for data applications involving bursty traffic patterns. The MIT AON Consortium has developed an all-optical LAN/MAN testbed which provides time-slotted WDM service and employs fast-tunable transceivers in each optical terminal. In this paper, we explore extensions of this service to achieve fine-grained statistical multiplexing with different virtual circuits time-sharing the wavelengths in a fair manner. In particular, we develop a real-time distributed protocol for best-effort traffic over this time-slotted WDM service with near-optical fairness and throughput characteristics. As an additional design feature, our protocol supports the allocation of guaranteed bandwidths to selected connections. This feature acts as a first step towards supporting integrated services and quality-of-service guarantees over WDM networks. To achieve high throughput, our approach is based on scheduling transmissions, as opposed to collision- based schemes. Our distributed protocol involves one MAN scheduler and several LAN schedulers (one per LAN) in a master-slave arrangement. Because of propagation delays and limits on control channel capacities, all schedulers are designed to work with partial, delayed traffic information. Our distributed protocol is of the `greedy' type to ensure fast execution in real-time in response to dynamic traffic changes. It employs a hybrid form of rate and credit control for resource allocation. We have performed extensive simulations, which show that our protocol allocates resources (transmitters, receivers, wavelengths) fairly with high throughput, and supports bandwidth guarantees.

Consensus statement: Supporting Safer Conception and Pregnancy For Men And Women Living with and Affected by HIV.

PubMed

Matthews, Lynn T; Beyeza-Kashesya, Jolly; Cooke, Ian; Davies, Natasha; Heffron, Renee; Kaida, Angela; Kinuthia, John; Mmeje, Okeoma; Semprini, Augusto E; Weber, Shannon

2018-06-01

Safer conception interventions reduce HIV incidence while supporting the reproductive goals of people living with or affected by HIV. We developed a consensus statement to address demand, summarize science, identify information gaps, outline research and policy priorities, and advocate for safer conception services. This statement emerged from a process incorporating consultation from meetings, literature, and key stakeholders. Three co-authors developed an outline which was discussed and modified with co-authors, working group members, and additional clinical, policy, and community experts in safer conception, HIV, and fertility. Co-authors and working group members developed and approved the final manuscript. Consensus across themes of demand, safer conception strategies, and implementation were identified. There is demand for safer conception services. Access is limited by stigma towards PLWH having children and limits to provider knowledge. Efficacy, effectiveness, safety, and acceptability data support a range of safer conception strategies including ART, PrEP, limiting condomless sex to peak fertility, home insemination, male circumcision, STI treatment, couples-based HIV testing, semen processing, and fertility care. Lack of guidelines and training limit implementation. Key outstanding questions within each theme are identified. Consumer demand, scientific data, and global goals to reduce HIV incidence support safer conception service implementation. We recommend that providers offer services to HIV-affected men and women, and program administrators integrate safer conception care into HIV and reproductive health programs. Answers to outstanding questions will refine services but should not hinder steps to empower people to adopt safer conception strategies to meet reproductive goals.

Layer 1 VPN services in distributed next-generation SONET/SDH networks with inverse multiplexing

NASA Astrophysics Data System (ADS)

Ghani, N.; Muthalaly, M. V.; Benhaddou, D.; Alanqar, W.

2006-05-01

Advances in next-generation SONET/SDH along with GMPLS control architectures have enabled many new service provisioning capabilities. In particular, a key services paradigm is the emergent Layer 1 virtual private network (L1 VPN) framework, which allows multiple clients to utilize a common physical infrastructure and provision their own 'virtualized' circuit-switched networks. This precludes expensive infrastructure builds and increases resource utilization for carriers. Along these lines, a novel L1 VPN services resource management scheme for next-generation SONET/SDH networks is proposed that fully leverages advanced virtual concatenation and inverse multiplexing features. Additionally, both centralized and distributed GMPLS-based implementations are also tabled to support the proposed L1 VPN services model. Detailed performance analysis results are presented along with avenues for future research.

Prioritization of Evidence-Based Preventive Health Services During Periodic Health Examinations

PubMed Central

Shires, Deirdre A.; Stange, Kurt C.; Divine, George; Ratliff, Scott; Vashi, Ronak; Tai-Seale, Ming; Lafata, Jennifer Elston

2011-01-01

Background Delivery of preventive services sometimes falls short of guideline recommendations. Purpose To evaluate the multilevel factors associated with evidence-based preventive service delivery during periodic health examinations (PHE). Methods Primary care physicians were recruited from an integrated delivery system in southeast Michigan. Office visit audio-recordings of PHE visits conducted from 2007–2009 were used to ascertain physician recommendation for or delivery of 19 guideline-recommended preventive services. Alternating logistic regression was used to evaluate factors associated with service delivery. Data analyses were completed in 2011. Results Among 484 PHE visits to 64 general internal medicine and family physicians by insured patients aged 50–80 years, there were 2662 services for which patients were due; 54% were recommended or delivered. Regression analyses indicated that the likelihood of service delivery decreased with patient age and with each concern the patient raised, and increased with increasing BMI and with each additional minute after scheduled appointment time the physician first presented. The likelihood was greater with patient/physician gender concordance and less if the physician used the electronic medical record in the exam room and had seen the patient in the past 12 months. Conclusions A combination of patient, physician, visit and contextual factors are associated with preventive service delivery. Additional studies are warranted to understand the complex interplay of factors that support and compromise preventive service delivery. PMID:22261213

Examination of the Open Market Corridor

DTIC Science & Technology

2003-12-01

105 D. BENEFITS OF THE PURCHASE CARD PROGRAM ..........................107 1. List of Benefits ...107 2. Additional Benefits and How OMC Can Increase the Benefits ...107 E. WEAKNESSES OF...software licenses and support services. Estimated life-cycle costs for FY 1995 through FY 2005 are $3.7 billion. Operational benefits from SPS are

Cornell University Library Distance Learning White Paper.

ERIC Educational Resources Information Center

Davis, Philip; Finlay, Constance; Cosgrave, Tony; McDonald, Peter

This report identifies potential issues that the Cornell University Library (CUL) might face in supporting distance learning, and recommends solutions. While the precise budgetary implications are uncertain, additional resources, services, and personnel will need to be accounted for in the cost of serving distance learners. The report addresses:…

75 FR 37811 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Health and Human Services' (HHS) high priority programs and is supportive of HHS Strategic Goal 1: Health...- prescribing and quality reporting functionalities, and the number of providers who have become meaningful.... Additionally, it allows for the synergy of grantee business processes and technology to increase transparency...

77 FR 14859 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-13

... of State, and the Secretary of Homeland Security when designating and blocking the property and... assisting in, or providing financial or technological support for or to, or providing goods or services in.... BAQBANI, Mohammad Akhusa); DOB 5 Jan 1961; alt. DOB 1947; POB Zabol, Iran; citizen Iran; Islamic...

Toward Strengthening North Dakota's Fiscal System.

ERIC Educational Resources Information Center

Stocker, Frederick D.

This report describes and evaluates the North Dakota state/local fiscal system, especially as it relates to financing public education. It identifies and evaluates various fiscal policy options for raising additional tax revenue for support of schools and other public services in ways consistent with the basic characteristics of the North Dakota…

48 CFR 837.7003 - Funeral authorization.

Code of Federal Regulations, 2013 CFR

2013-10-01

... be of sufficient strength to support the weight of an adult human body. Cardboard or press paper or... provided. The services must consist of the following: (1) Preparation of the body, embalming. (2) Clothing...) accompanies the casket to the place of burial. (c) An additional allowance for transportation of the body to...

48 CFR 837.7003 - Funeral authorization.

Code of Federal Regulations, 2012 CFR

2012-10-01

... be of sufficient strength to support the weight of an adult human body. Cardboard or press paper or... provided. The services must consist of the following: (1) Preparation of the body, embalming. (2) Clothing...) accompanies the casket to the place of burial. (c) An additional allowance for transportation of the body to...

48 CFR 837.7003 - Funeral authorization.

Code of Federal Regulations, 2014 CFR

2014-10-01

... be of sufficient strength to support the weight of an adult human body. Cardboard or press paper or... provided. The services must consist of the following: (1) Preparation of the body, embalming. (2) Clothing...) accompanies the casket to the place of burial. (c) An additional allowance for transportation of the body to...

77 FR 12231 - Electronic On-Board Recorders and Hours of Service Supporting Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... consider as it addresses the distinction between productivity and harassment: what will prevent harassment... be used to monitor productivity of the operators. The court's expectation about how the Agency should address harassment and productivity under the statutory directive included the following: In addition, an...

77 FR 22443 - Farm Loan Programs; Clarification and Improvement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

... addition, supporting this change is the fact that at the end of fiscal year 2010, the dollar delinquency on... remarkably positive statistics in light of FSA's mission to serve those who cannot get credit elsewhere. This... been several policies that have brought the delinquencies and losses down: The extensive servicing...

48 CFR 837.7003 - Funeral authorization.

Code of Federal Regulations, 2011 CFR

2011-10-01

... be of sufficient strength to support the weight of an adult human body. Cardboard or press paper or... provided. The services must consist of the following: (1) Preparation of the body, embalming. (2) Clothing...) accompanies the casket to the place of burial. (c) An additional allowance for transportation of the body to...

48 CFR 837.7003 - Funeral authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be of sufficient strength to support the weight of an adult human body. Cardboard or press paper or... provided. The services must consist of the following: (1) Preparation of the body, embalming. (2) Clothing...) accompanies the casket to the place of burial. (c) An additional allowance for transportation of the body to...

Planning Guidelines for Primary Schools, Issue 1.

ERIC Educational Resources Information Center

Department of Education and Science, Tullamore (Ireland). Planning and Building Unit.

This planning guide, reflecting recent changes in the educational system in Ireland, offers guidelines for designing primary schools that need to provide additional space for the growing range of teaching and support services. It addresses increased sizes of general purpose rooms, extra floor area provision for classroom storage, administration,…

Incorporating SAT® Writing into Admission and Placement Decisions

ERIC Educational Resources Information Center

Shaw, Emily

2010-01-01

Presented at the College Board National Forum in Washington, D.C., October 2010. This presentation examines the recent national validity evidence that supports the use of SAT Writing in college admissions and English placement. Additionally it includes information on the College Board's free online Admitted Class Evaluation Service (ACES) system,…

39 CFR 3020.32 - Supporting justification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... factors of 39 U.S.C. 3622(c); (c) Explain why, as to competitive products, the addition, deletion, or... change does not classify as competitive a product over which the Postal Service exercises sufficient market power that it can, without risk of losing a significant level of business to other firms offering...

75 FR 48235 - Rural Health Care Universal Service Support Mechanism

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... references to recognized broadband mapping studies, such as NTIA's national broadband map, State or local... network area. In addition to referencing such NTIA or State broadband mapping studies, the applicant would... network design studies (but not in excess of the cap identified below); (2) engineering, materials and...

21 CFR 58.215 - Alternative or additional actions to disqualification.

Code of Federal Regulations, 2011 CFR

2011-04-01

... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... against a testing facility and/or against the sponsor of a nonclinical laboratory study that has been... nonclinical laboratory study in support of an application for a research or marketing permit, if it finds that...

21 CFR 58.215 - Alternative or additional actions to disqualification.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... against a testing facility and/or against the sponsor of a nonclinical laboratory study that has been... nonclinical laboratory study in support of an application for a research or marketing permit, if it finds that...

Data as a Service: A Seismic Web Service Pipeline

NASA Astrophysics Data System (ADS)

Martinez, E.

2016-12-01

Publishing data as a service pipeline provides an improved, dynamic approach over static data archives. A service pipeline is a collection of micro web services that each perform a specific task and expose the results of that task. Structured request/response formats allow micro web services to be chained together into a service pipeline to provide more complex results. The U.S. Geological Survey adopted service pipelines to publish seismic hazard and design data supporting both specific and generalized audiences. The seismic web service pipeline starts at source data and exposes probability and deterministic hazard curves, response spectra, risk-targeted ground motions, and seismic design provision metadata. This pipeline supports public/private organizations and individual engineers/researchers. Publishing data as a service pipeline provides a variety of benefits. Exposing the component services enables advanced users to inspect or use the data at each processing step. Exposing a composite service enables new users quick access to published data with a very low barrier to entry. Advanced users may re-use micro web services by chaining them in new ways or injecting new micros services into the pipeline. This allows the user to test hypothesis and compare their results to published results. Exposing data at each step in the pipeline enables users to review and validate the data and process more quickly and accurately. Making the source code open source, per USGS policy, further enables this transparency. Each micro service may be scaled independent of any other micro service. This ensures data remains available and timely in a cost-effective manner regardless of load. Additionally, if a new or more efficient approach to processing the data is discovered, this new approach may replace the old approach at any time, keeping the pipeline running while not affecting other micro services.

Supporting in- and off-Hospital Patient Management Using a Web-based Integrated Software Platform.

PubMed

Spyropoulos, Basile; Botsivali, Maria; Tzavaras, Aris; Pierros, Vasileios

2015-01-01

In this paper, a Web-based software platform appropriately designed to support the continuity of health care information and management for both in and out of hospital care is presented. The system has some additional features as it is the formation of continuity of care records and the transmission of referral letters with a semantically annotated web service. The platform's Web-orientation provides significant advantages, allowing for easily accomplished remote access.

Experiences in Bridging the Gap between Science and Decision Making at NASA's GSFC Earth Science Data and Information Services Center (GES DISC)

NASA Technical Reports Server (NTRS)

Kempler, Steven; Teng, Bill; Friedl, Lawrence; Lynnes, Chris; Leptoukh, Gregory

2008-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet s natural environment, NASA has implemented the Decision Support Through Earth Science Research Results program (NASA ROSES solicitations). a) This successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations. b) The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. c) In addition, GES DISC s understanding of Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, enables the GES DISC to identify challenges that come with bringing science data to decision makers. d) The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding of how decisions are made, and the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that really evaluate success will be exemplified.

Identifying User Needs and the Participative Design Process

NASA Astrophysics Data System (ADS)

Meiland, Franka; Dröes, Rose-Marie; Sävenstedt, Stefan; Bergvall-Kåreborn, Birgitta; Andersson, Anna-Lena

As the number of persons with dementia increases and also the demands on care and support at home, additional solutions to support persons with dementia are needed. The COGKNOW project aims to develop an integrated, user-driven cognitive prosthetic device to help persons with dementia. The project focuses on support in the areas of memory, social contact, daily living activities and feelings of safety. The design process is user-participatory and consists of iterative cycles at three test sites across Europe. In the first cycle persons with dementia and their carers (n = 17) actively participated in the developmental process. Based on their priorities of needs and solutions, on their disabilities and after discussion between the team, a top four list of Information and Communication Technology (ICT) solutions was made and now serves as the basis for development: in the area of remembering - day and time orientation support, find mobile service and reminding service, in the area of social contact - telephone support by picture dialling, in the area of daily activities - media control support through a music playback and radio function, and finally, in the area of safety - a warning service to indicate when the front door is open and an emergency contact service to enhance feelings of safety. The results of this first project phase show that, in general, the people with mild dementia as well as their carers were able to express and prioritize their (unmet) needs, and the kind of technological assistance they preferred in the selected areas. In next phases it will be tested if the user-participatory design and multidisciplinary approach employed in the COGKNOW project result in a user-friendly, useful device that positively impacts the autonomy and quality of life of persons with dementia and their carers.

Are consumer-directed home care beneficiaries satisfied? Evidence from Washington state.

PubMed

Wiener, Joshua M; Anderson, Wayne L; Khatutsky, Galina

2007-12-01

This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study, we developed an 8-item Satisfaction With Paid Personal Assistance Scale as the measure of satisfaction. In predicting satisfaction with personal assistance services, we estimated an ordinary least squares regression model that was right-censored to account for the large percentage of respondents who were highly satisfied with their care. Among the older population, but not younger people with disabilities, beneficiaries receiving consumer-directed services were more satisfied than individuals receiving agency-directed care. There was no evidence that quality of care was less with consumer-directed services. In addition, overall satisfaction levels with paid home care were very high. This study supports the premise that consumer satisfaction, an important measure of quality, in consumer-directed home care is not inferior to that in agency-directed care. The positive effect of consumer direction for older people underlines the fact that this service option is relevant for this population. In addition, this research provides evidence that home- and community-based services are of high quality, at least on one dimension.

Pimp your landscape: a tool for qualitative evaluation of the effects of regional planning measures on ecosystem services.

PubMed

Fürst, Christine; Volk, Martin; Pietzsch, Katrin; Makeschin, Franz

2010-12-01

The article presents the platform "Pimp your landscape" (PYL), which aims firstly at the support of planners by simulating alternative land-use scenarios and by an evaluation of benefits or risks for regionally important ecosystem services. Second, PYL supports an integration of information on environmental and landscape conditions into impact assessment. Third, PYL supports the integration of impacts of planning measures on ecosystem services. PYL is a modified 2-D cellular automaton with GIS features. The cells have the major attribute "land-use type" and can be supplemented with additional information, such as specifics regarding geology, topography and climate. The GIS features support the delineation of non-cellular infrastructural elements, such as roads or water bodies. An evaluation matrix represents the core element of the system. In this matrix, values in a relative scale from 0 (lowest value) to 100 (highest value) are assigned to the land-use types and infrastructural elements depending on their effect on ecosystem services. The option to configure rules for describing the impact of environmental attributes and proximity effects on cell values and land-use transition probabilities is of particular importance. User interface and usage of the platform are demonstrated by an application case. Constraints and limits of the recent version are discussed, including the need to consider in the evaluation, landscape-structure aspects such as patch size, fragmentation and spatial connectivity. Regarding the further development, it is planned to include the impact of land management practices to support climate change adaptation and mitigation strategies in regional planning.

Supported education for individuals with psychiatric disabilities: State of the practice and policy implications.

PubMed

Ringeisen, Heather; Langer Ellison, Marsha; Ryder-Burge, Amy; Biebel, Kathleen; Alikhan, Shums; Jones, Emily

2017-06-01

Supported education (SEd) is a promising practice that supports and encourages educational goals and attainment among individuals with psychiatric disabilities. This paper provides insights into how SEd objectives are pursued in different settings, assesses the evidence base, and discusses policy implications. Insights from 3 data sources were synthesized: published literature, an environmental scan, and 3 site visits to programs that support the education goals of individuals with psychiatric disabilities. While setting, target populations, level of coordination with supported employment, and financing strategies varied, common SEd components emerged: specialized and dedicated staffing, one-on-one and group skill-building activities, assistance with navigating the academic setting and coordinating different services, and linkages with mental health counseling. The evidence base is growing; however, many published studies to date do not employ rigorous methodology. Conclusions and Implications for Policy and Practice: Continued specification, operationalization, and testing of SEd core components are needed. The components of the evolving SEd model would benefit from rigorous testing to evaluate impact on degree completion and other key impacts such as employment; health, mental health, or recovery; and community participation. In addition to funding streams from special education and Medicaid, new opportunities for increasing the availability of SEd include the Workforce Innovation and Opportunities Act (WIOA) reauthorization, which requires state vocational rehabilitation agencies to fund preemployment services for transition-age individuals. New "set-aside" requirements for the Mental Health Services Block Grant will increase funding for early intervention services for individuals with serious mental illness, potentially including SEd. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Geosynchronous Orbit Optical Communications Relay Architecture

NASA Technical Reports Server (NTRS)

Edwards, Bernard L.; Israel, David J.

2014-01-01

NASA is planning to fly a Next Generation Tracking and Data Relay Satellite (TDRS) next decade. While the requirements and architecture for that satellite are unknown at this time, NASA is investing in communications technologies that could be deployed on the satellite to provide new communications services. One of those new technologies is optical communications. The Laser Communications Relay Demonstration (LCRD) project, scheduled for launch in December 2017 as a hosted payload on a commercial communications satellite, is a critical pathfinder towards NASA providing optical communications services on the Next Generation TDRS. While it is obvious that a small to medium sized optical communications terminal could be flown on a GEO satellite to provide support to Near Earth missions, it is also possible to deploy a large terminal on the satellite to support Deep Space missions. Onboard data processing and Delay Tolerant Networking (DTN) are two additional technologies that could be used to optimize optical communications link services and enable additional mission and network operations. This paper provides a possible architecture for the optical communications augmentation of a Next Generation TDRS and touches on the critical technology work currently being done at NASA. It will also describe the impact of clouds on such an architecture and possible mitigation techniques.

Counsellors' perspectives on the experience of providing HIV counselling in Kenya and Tanzania: the Voluntary HIV-1 Counselling and Testing Efficacy Study.

PubMed

Grinstead, O A; van der Straten, A

2000-10-01

Demand for HIV counselling services is increasing in developing counties, but there have been few previous studies that describe counsellors' roles and experiences providing HIV-related counselling in developing countries. Such information can be used to better supervise and support counsellors and thereby improve counselling services. As a sub-study of the Voluntary Counseling and Testing Efficacy Study, we conducted focus groups and individual interviews with 11 counsellors and counselling supervisors providing HIV counselling services in Kenya and Tanzania. Counsellors told us that their jobs were both rewarding and stressful. In addition to their obligations in the counselling relationship (providing information, protecting confidentiality and being non-judgemental), they perceived pressure to provide information and be good role models in their communities. Additional stresses were related to external (economic and political) conditions, 'spillover' of HIV issues from their personal lives and providing counselling in a research setting. Counsellor stress might be reduced and their effectiveness and retention improved by (1) allowing work flexibility; (2) providing supportive, non-evaluative supervision; (3) offering alternatives to client behaviour change as the indication of counsellor performance; (4) acknowledging and educating about 'emotional labour' in counselling; (5) providing frequent information updates and intensive training; and (6) encouraging counsellor participation in the development of research protocols.

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

PubMed Central

Bowers, Gillian; Bowers, John

2018-01-01

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success. PMID:29724040

Enhancements to TauDEM to support Rapid Watershed Delineation Services

NASA Astrophysics Data System (ADS)

Sazib, N. S.; Tarboton, D. G.

2015-12-01

Watersheds are widely recognized as the basic functional unit for water resources management studies and are important for a variety of problems in hydrology, ecology, and geomorphology. Nevertheless, delineating a watershed spread across a large region is still cumbersome due to the processing burden of working with large Digital Elevation Model. Terrain Analysis Using Digital Elevation Models (TauDEM) software supports the delineation of watersheds and stream networks from within desktop Geographic Information Systems. A rich set of watershed and stream network attributes are computed. However limitations of the TauDEM desktop tools are (1) it supports only one type of raster (tiff format) data (2) requires installation of software for parallel processing, and (3) data have to be in projected coordinate system. This paper presents enhancements to TauDEM that have been developed to extend its generality and support web based watershed delineation services. The enhancements of TauDEM include (1) reading and writing raster data with the open-source geospatial data abstraction library (GDAL) not limited to the tiff data format and (2) support for both geographic and projected coordinates. To support web services for rapid watershed delineation a procedure has been developed for sub setting the domain based on sub-catchments, with preprocessed data prepared for each catchment stored. This allows the watershed delineation to function locally, while extending to the full extent of watersheds using preprocessed information. Additional capabilities of this program includes computation of average watershed properties and geomorphic and channel network variables such as drainage density, shape factor, relief ratio and stream ordering. The updated version of TauDEM increases the practical applicability of it in terms of raster data type, size and coordinate system. The watershed delineation web service functionality is useful for web based software as service deployments that alleviate the need for users to install and work with desktop GIS software.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, D.W.; Heinrich, R.R.; Graczyk, D.G.

The purpose of this report is to summarize the activities of the Analytical Chemistry Laboratory (ACL) at Argonne National Laboratory (ANL) for fiscal year 1988 (October 1987 through September 1988). The Analytical Chemistry Laboratory is a full-cost recovery service center, with the primary mission of providing a broad range of analytical chemistry support services to the scientific and engineering programs at ANL. In addition, the ACL conducts a research program in analytical chemistry, works on instrumental and methods development, and provides analytical services for governmental, educational, and industrial organizations. The ACL handles a wide range of analytical problems, from routinemore » standard analyses to unique problems that require significant development of methods and techniques.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, D.W.; Heinrich, R.R.; Graczyk, D.G.

The purpose of this report is to summarize the activities of the Analytical Chemistry Laboratory (ACL) at Argonne National Laboratory (ANL) for Fiscal Year 1989 (October 1988 through September 1989). The Analytical Chemistry Laboratory is a full-cost-recovery service center, with the primary mission of providing a broad range of analytical chemistry support services to the scientific and engineering programs at ANL. In addition, the ACL conducts a research program in analytical chemistry, works on instrumental and methods development, and provides analytical services for governmental, educational, and industrial organizations. The ACL handles a wide range of analytical problems, from routine standardmore » analyses to unique problems that require significant development of methods and techniques.« less

Parents’ views on how health professionals should work with them now to get the best for their child in the future

PubMed Central

Marshall, Joyce L.; Green, Josephine M.; Spiby, Helen

2012-01-01

Abstract Background  Pregnancy and the first years of life are important times for future child well‐being. Early identification of families and children who might be likely to experience poorer outcomes could enable health professionals and parents to work together to promote each child’s well‐being. Little is known about the acceptability and feasibility of such an approach to parents. Objective  To investigate parents’ views about how health professionals should identify and work with families who may benefit from additional input to maximize their children’s future health and well‐being. Design  A qualitative study using focus groups. Setting and participants  Eleven focus groups were conducted with a total of 54 parents; 42 mothers and 12 fathers living in the north of England. Results  Parents welcomed the idea of preventive services. They strongly believed that everyone should have access to services to enhance child well‐being whilst recognizing that some families need additional support. Making judgements about who should receive additional services based on specific criteria evoked powerful emotions because of the implication of failure. Parents projected a belief in themselves as ‘good parents’ even in adverse circumstances. Conclusions  Targeted additional preventive services can be acceptable and welcome if health professionals introduce them sensitively, in the context of an existing relationship, providing parents are active participants. PMID:22512709

Role of Islamic religious and cultural beliefs regarding intellectual impairment and service use: a South Asian parental perspective.

PubMed

Kaur-Bola, Kulwinder; Randhawa, Gurch

2012-01-01

Empirical research has shown that some South Asian families from Muslim backgrounds may use fewer additional support services for their severely impaired children compared to other non-Muslim families. Often this has been attributed to socioeconomic factors and stereotypical views such as "the family's faith prohibits the use of specific services". This paper focuses on clarifying what Islam purports to say about impairment and considers how cultural influences may inadvertently influence some South Asian parents' decisions to use services for their severely impaired children. This work aims to improve professional-parent/patient communication by enhancing better understanding of Islam on impairment, and supporting non-Muslim professionals to appreciate the differences between Islamic religion and general South Asian cultural beliefs regarding disability. Fourteen parents from ten Pakistani and Bangladeshi families took part in semi-structured open-ended interviews. Grounded theory was used to analyse the data. The emerging theory suggested most first generation Muslim families from rural villages were unable to distinguish between Islamic religious and cultural beliefs on impairment, and risked missing out on essential services due to poor professional-parent/patient communication.

Medicaid program; home and community-based services. Health Care Financing Administration (HCFA), HHS. Final rule with comment period.

PubMed

2000-10-10

This final rule with comment period expands State flexibility in providing prevocational, educational, and supported employment services under the Medicaid home and community-based services waiver provisions currently found in section 1915(c) of the Social Security Act (the Act); and incorporates the self-implementing provisions of section 4743 of the Balanced Budget Act of 1997 that amends section 1915(c)(5) of the Act to delete the requirements that an individual have prior institutionalization in a nursing facility or intermediate care facility for the mentally retarded before becoming eligible for the expanded habilitation services. In addition, we are making a number of technical changes to update or correct the regulations.

Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

PubMed

Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

2015-11-01

NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. There were 202,804 cases included in secondary analysis and 3075 in the prospective study. A combination of behavioural support and stop smoking medication delivered by SSS practitioners. Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected. Stop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012-13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites. The National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

Setting the record straight.

PubMed

Moran, T

1998-12-01

This article examines the effect of the proposed limitation of funds for family planning direct services by the Texas Department of Health (TDH). A plan was unveiled by the TDH that called for cuts from Title V (Maternal and Child Health) to phase out family planning direct service delivery and increase population-based services. This proposal would mean that by 2000 at least 28,500 low-income women would have difficulty in receiving family planning services and obstetrical and gynecological services. During the 1998 Scripps Howard Texas poll, it was shown that majority of Texans support addition in public funding of family planning services for poor women, but it would result to a more expensive tax increase. Advocates of family planning were apprehensive on the effect of inaccessible family planning services among young and poor women. On the other hand, promoters of the Title V cuts claimed that family planning service is like any other clinical service that would be ineffective unless it takes into account the community and prevention dynamics.

Rural women caregivers in Canada.

PubMed

Crosato, Kay E; Leipert, Beverly

2006-01-01

Informal caregiving within rural contexts in Canada is increasing. This is due in part to a number of factors related to the restructuring of the Canadian health care system, the regionalization of services to urban locations, the increased population of people 65 years and older, and the desire of this population to age within their rural homes. Most often, the informal caregiving role is assumed by rural women. Women tend to fall into the role of informal caregiver to elders because of the many societal and gender expectations and values that are present within the rural culture. The purpose of this literature review is to identify the context in which women provide care for an elder in rural Canada. Illustrating these issues will help to uncover challenges and barriers rural women face when providing care and highlight recommendations and implications for rural women caregivers and nurses employed within rural settings. Many rural women share similar caregiving experiences as urban informal caregivers, but rural women are faced with additional challenges in providing quality care for an elder. Rural women caregivers are faced with such issues as limited access to adequate and appropriate healthcare services, culturally incongruent health care, geographical distance from regionalized centers and health services, transportation challenges, and social/geographical isolation. In addition to these issues, many rural women are faced with the multiple role demands that attend being a wife, mother, caregiver and employee. The pile up of these factors leaves rural women caregivers susceptible to additional stresses and burn out, with limited resources on which to depend. Through reviewing pertinent literature, appropriate implications and recommendations can be made that may assist rural women caregivers and rural nurses. Nurses working within rural communities are in ideal settings to work collaboratively in building supportive relationships with rural women in order to promote the health and wellbeing of caregivers, as well as the elders for which they provide care. More research is needed regarding rural women and their caregiving experiences of elders. In addition, rural and remote courses and practicums should be made available to nursing students in order to encourage them and to support them in nursing careers in rural settings, thereby providing rural women caregivers with additional appropriate and consistent healthcare services. Also, governments and policy makers should consider the rural context and the challenges that are associated with providing care to an elder in a rural setting to ensure that rural women caregivers and their care recipients are well supported within their rural communities.

Signal and image processing algorithm performance in a virtual and elastic computing environment

NASA Astrophysics Data System (ADS)

Bennett, Kelly W.; Robertson, James

2013-05-01

The U.S. Army Research Laboratory (ARL) supports the development of classification, detection, tracking, and localization algorithms using multiple sensing modalities including acoustic, seismic, E-field, magnetic field, PIR, and visual and IR imaging. Multimodal sensors collect large amounts of data in support of algorithm development. The resulting large amount of data, and their associated high-performance computing needs, increases and challenges existing computing infrastructures. Purchasing computer power as a commodity using a Cloud service offers low-cost, pay-as-you-go pricing models, scalability, and elasticity that may provide solutions to develop and optimize algorithms without having to procure additional hardware and resources. This paper provides a detailed look at using a commercial cloud service provider, such as Amazon Web Services (AWS), to develop and deploy simple signal and image processing algorithms in a cloud and run the algorithms on a large set of data archived in the ARL Multimodal Signatures Database (MMSDB). Analytical results will provide performance comparisons with existing infrastructure. A discussion on using cloud computing with government data will discuss best security practices that exist within cloud services, such as AWS.

The role of physician staffing of helicopter emergency medical services in prehospital trauma response.

PubMed

Garner, Alan A

2004-08-01

The crewing of Helicopter Emergency Medical Service (HEMS) for scene response to trauma patients is generally considered to be controversial, particularly regarding the role of physicians. This is reflected in HEMS in Australia with some services utilizing physician crewing for all prehospital missions. Others however, use physicians for selected missions only whilst others do not use physicians at all. This review seeks to determine whether the literature supports using physicians in addition to paramedics in HEMS teams for prehospital trauma care. Studies were excluded if they compared physician teams with basic life support teams (BLS) teams rather than paramedics. Ambulance officers were considered to be paramedics where they were able to administer intravenous fluids and use a method of airway management beyond bag-valve-mask ventilation. Studies were excluded if the skill set of the ambulance team was not defined, the level of staffing of the helicopter service was not stated, team composition varied without reporting outcomes for each team type, patient outcome data were not reported, or the majority of the transports were interhospital rather than prehospital transports.

Effect of Total Quality Management on the Quality and Productivity of Human Resources

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Sari, R. M.

2017-03-01

Human resources is the main factor in improving company performance not only in industrial products but also services. Therefore, all of the organization performers involved must work together to achieve product quality services expected by consumers. Educational institutions are the service industries which are educators and instructor involved in it. Quality of product and services produced depends on the education organization performers. This study did a survey of instructors in public and private universities in North Sumatra to obtain the factors that affect quality of human resources and productivity of human resources. Human resources quality is viewed by the elements of TQM. TQM elements that are discussed in this study are leadership, communication, training and education, support structure, measurement and reward and recognition. The results of this study showed a correlation numbers across the exogenous variables on endogenous variables relationships tend to be strong and be positive. In addition, elements of TQM are discussed except the support structure which has a direct influence on the quality of human resources. Variable leadership, reward and recognition and quality of human resources have a significant effect on productivity.

Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya

PubMed Central

Watson-Jones, Deborah; Mugo, Nelly; Lees, Shelley; Mathai, Muthoni; Vusha, Sophie; Ndirangu, Gathari; Ross, David A.

2015-01-01

Background Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. Methods Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. Results Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. Conclusions Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school-based delivery, with vaccine offered at multiple venues, potentially through a campaign approach. PMID:26115523

An exploratory study of engagement in a technology-supported substance abuse intervention

PubMed Central

2010-01-01

Background The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. Methods This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. Results The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. Conclusions The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions. Additional investigation into ways technology may be useful to enhance treatment access for certain subgroups is needed. PMID:20529338

Effect of Social Support and Disclosure of Child Abuse on Adult Suicidal Ideation: Findings From a Population-Based Study.

PubMed

Baiden, Philip; Fallon, Barbara; Antwi-Boasiako, Kofi

2017-11-16

To examine the proportion of Canadian adults with a history of child abuse who disclosed the abuse to child protection services before age 16 years and identify the effect of social support and disclosure of child abuse on lifetime suicidal ideation. Data for this study came from the Statistics Canada 2012 Canadian Community Health Survey-Mental Health (N = 9,076). Binary logistic regression was conducted to identify the effect of social support and disclosure of child abuse on suicidal ideation while simultaneously adjusting for the effect of type of child abuse and demographic, socioeconomic, health, and mental health factors. Of the 9,076 respondents who experienced at least one child abuse event, 21.5% reported ever experiencing suicidal ideation. Fewer than 6% of the respondents disclosed the abuse to someone from a child protection service before age 16 years. In the multivariate logistic regression model, respondents who disclosed the abuse to someone from child protection services were 1.37 times more likely to report lifetime suicidal ideation (95% CI, 1.10-1.71) than those who did not. Each additional unit increase in social support decreased the odds of lifetime suicidal ideation by a factor of 3% (95% CI, 0.95-0.98). Social support interventions that are effective in improving individuals' perception that support is available to them may help reduce suicidal ideation among those with a history of child abuse. © Copyright 2017 Physicians Postgraduate Press, Inc.

ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

NASA Astrophysics Data System (ADS)

Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi

2017-04-01

End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme (http://swe.ssa.esa.int/) the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) (http://swe.ssa.esa.int/space-radiation) and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

PubMed Central

Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

2015-01-01

Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802

Service-linked scholarships, loans, and loan repayment programs for nurses in the southeast.

PubMed

Thaker, Samir I; Pathman, Donald E; Mark, Barbara A; Ricketts, Thomas C

2008-01-01

A variety of public and private programs provide financial support for the costs of nurses' training in exchange for service commitments to work in rural, underserved, and other needy areas. Little is known about the number, size, and operations of these support-for-service programs for nurses. We identified and in this article describe such programs in eight southeastern states. Eligible programs were those that in 2004 paid for all or a portion of nurses' education costs in exchange for a period of clinical nursing service within one or more of the eight targeted states. Programs obligating nurses to a specific hospital, practice, or community or to teaching roles were excluded. Programs were identified through available compendia, online searches, and telephone contacts with program directors, nursing school administrators, and state officials. Additional data on eligible programs were gathered through telephone interviews and questionnaires mailed to program staff and from publicly available documents. Data were double coded, and qualitative and quantitative analyses were conducted. Twenty-four nursing support-for-service programs met our eligibility criteria in the eight-state region: nine scholarship programs; six loan repayment programs; five service-cancelable loan programs; two loan interest rate reduction programs; and two direct incentive programs. These programs had fiscal year 2004 budgets totaling approximately $28.8-31.8 million; collectively, they received approximately 11,700 applications from nurses, signed approximately 8,300 contracts, and had a combined field strength of approximately 4,900 nurses working to fulfill their program obligations. Individual states offered between zero and five eligible programs each. Support-for-service programs are a substantial component of federal and state nursing workforce distribution efforts in the Southeast. Future research should identify and describe these programs for other regions, measure outcomes, and offer recommendations to maximize their effectiveness in alleviating nursing shortages.

Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.

PubMed

Choi, Bryan Y; Blumberg, Charles; Williams, Kenneth

2016-03-01

Mobile integrated health care and community paramedicine are models of health care delivery that use emergency medical services (EMS) personnel to fill gaps in local health care infrastructure. Community paramedics may perform in an expanded role and require additional training in the management of chronic disease, communication skills, and cultural sensitivity, whereas other models use all levels of EMS personnel without additional training. Currently, there are few studies of the efficacy, safety, and cost-effectiveness of mobile integrated health care and community paramedicine programs. Observations from existing program data suggest that these systems may prevent congestive heart failure readmissions, reduce EMS frequent-user transports, and reduce emergency department visits. Additional studies are needed to support the clinical and economic benefit of mobile integrated health care and community paramedicine. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Improving Outcomes through Transformational Health and Social Care Integration - The Scottish Experience.

PubMed

Hendry, Anne; Taylor, Alison; Mercer, Stewart; Knight, Peter

2016-01-01

The Scottish Parliament recently passed legislation on integrating healthcare and social care to improve the quality and outcomes of care and support for people with multiple and complex needs across Scotland. This ambitious legislation provides a national framework to accelerate progress in person-centred and integrated care and support for the growing number of people who have multiple physical and mental health conditions and complex needs. Additional investment and improvement capacity is helping to commission support and services that are designed and delivered with people in local communities and in partnership with housing, community, voluntary and independent sectors.

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are more likely to provide remote outreach services. The RHOF, as a formally structured comprehensive subsidy, further targets the provision of priority services into such locations on a regular, ongoing basis.

Coping with cancer - finding the support you need

MedlinePlus

Cancer support - home care services; Cancer support - travel services; Cancer support - financial services; Cancer support - counseling ... air travel for people who need long-distance cancer services. Other groups offer lodging for people getting ...

47 CFR 54.625 - Support for telecommunications services beyond the maximum supported distance for rural health...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Support for telecommunications services beyond... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Telecommunications Program § 54.625 Support...

47 CFR 54.625 - Support for telecommunications services beyond the maximum supported distance for rural health...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Support for telecommunications services beyond... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Telecommunications Program § 54.625 Support...

Maternity services in multi-cultural Britain: using Q methodology to explore the views of first- and second-generation women of Pakistani origin.

PubMed

Cross-Sudworth, Fiona; Williams, Amanda; Herron-Marx, Sandy

2011-08-01

to explore first- and second-generation Pakistani women's experiences of maternity services and the inter generational differences/comparisons. a retrospective Q methodology study of Pakistani women following childbirth. two Children's Centres in an inner city in the West Midlands. women self-identified following distribution of information leaflets at Children's Centres. Fifteen women took part in interviews (Stage one) using a semi-structured design and 16 women participated in the completion of the Q grid sorting (Stage four). a standard five-stage Q methodology process took place: (1) initial data were gathered using a combination of individual face-to-face and focus group semi-structured community-based interviews (developing the concourse); (2) transcribed interviews were analysed for 'themes'; (3) the themes were reduced to 'statements' that reflected the overall content of the concourse using an unstructured evolving approach (giving the Q set); (4) participants were asked to sort the statements (Q sorting) according to a pre-designed distribution grid providing individual participant response grids; and (5) the response grids were factor analysed using PQ Method (V2.11), which generates clusters of participants rather than clusters of variables. Factor loadings were calculated using factor analysis by principal components with varimax rotation. This produced a list of factors, each of which represents a 'story' of women's experiences of maternity services. Throughout the process, an Urdu interpreter was involved. six factors were identified: (1) confidence and empowerment of women who had attended higher education and had family support; (2) isolation of some women from both family and maternity services; (3) women who had poor experiences of maternity services but good family support, and wanted opportunities to be involved in service development; (4) women with positive experiences of maternity care and influenced by traditional cultural practices; (5) importance of information and support from health-care professionals; and (6) importance of midwifery care to women. there were no clear inter generational differences identified, but a breadth of opinion and experience that seemed to be influenced by level of both education and social support was found. Whereas some women had few demands of maternity services, those who had less support and those with language barriers had additional needs. care given should be based on individual need but given within a wider collaborative context in order to support women effectively. Increased maternity service user involvement would also be welcomed for future planning of maternity services. Copyright © 2010 Elsevier Ltd. All rights reserved.

CITYZER - Services for effective decision making and environmental resilience

NASA Astrophysics Data System (ADS)

Harri, Ari-Matti; Turtiainen, Heikki; Turpeinen, Jani; Viitala, Erkki; Janka, Kauko; Palonen, Henry; Rönkkö, Topi; Laiho, Tiina; Laitinen, Teija; Haukka, Harri; Schmidt, Walter; Nousiainen, Timo

2016-04-01

The CITYZER project develops new digital services and products to support decision making processes related to weather and air quality in cities. This includes, e.g., early warnings and forecasts (0-24 h), which allow for avoiding weather-related accidents, mitigate human distress and costs from weather-related damage and bad air quality, and generally improve the resilience and safety of the society. The project takes advantage of the latest scientific know-how and directly exploits the expertise obtained from, e.g., Tekes-funded (MMEA [1], RAVAKE) and EU-funded (HAREN, EDHIT [2]) projects. Central to the project is the Observation Network Manager NM10 [3] developed by Vaisala Oyj within the Tekes/MMEA project, on which CITYZER defines and builds new commercial services and connects new sensor networks (e.g., air quality). The target groups of the services and products (e.g., public sector, real estate and energy companies, and distributors) and related business models will be analyzed and developed in collaboration with local player (e.g., Asia, South America) taking advantage of the pre-existing contacts by the Haaga-Helia, Vaisala Oyj and CLIC Innovation. Service models are designed to account for and adapt to the special needs of different areas and customers. The developed services will be scalable (most common platforms) and responsive. CITYZER project partners include Vaisala Oyj (observation instrumentation, systems and products), Sasken Ltd (mobile products), Emtele Ltd (Portable IoT ICT Service Operation Center/Environment and remote intelligent cabinet for sensor network-GW and connections), HSY (urban services), Haaga-Helia University of Applied Sciences (service business models including digital services), Finnish Meteorological Institute (implementation of and scientific research on meteorological & air quality products), and the Tampere University of Technology (definition of and scientific research on air quality products), Pegasor Ltd (support for air quality instrumentation and products), INNO-W Ltd (providing business services support), as well as the CLIC Innovation Ltd as a subcontractor for arranging cooperation with international partners and project information dissemination, as well as composing the consortium agreement and other legal issues. Additional project partners are welcomed to join the project and current consortium encourage all potential partners to contact project management for further details. The business impact of this project to existing markets is estimated to be substantial and it will also create totally new markets especially for weather information related services. The existing whole target market size at this point is estimated to be several billion USD and the size of the market is growing steadily. The key CITYZER outcomes are the piloted services and products with envisaged great commercial and export potential. Development of the services will be managed by Sasken, Emtele, Pegasor and Vaisala and supported by INNO-W. The user profiling and market assessment, including the most potential market area either from Asia or South America, will be led by Haaga-Helia and supported by industrial partners. FMI, Vaisala and Pegasor will use their expertise and current business relations to those foreign markets to speed up and guide the user and market evaluation. Essential potential players are local actors in e.g. Brazil, China and India that will be subcontracted to bring in local expertise in the user profiling and market assessment processes. This three year project is scheduled such that, overall, the first two years focus on implementing the technical basis as well as customer and market analyses. Throughout the course of the project a CityzerDemo test bed environment will be developed in the Helsinki metropolitan area, demonstrating the observational and modeling system and services built on them. In addition, the services and business models will be evaluated. Acknowledgements The project has received funding from TEKES, the Finnish Funding Agency for Innovation. References [1] http://mmea.fi/ [2] http://edhit.eu/ [3] http://www.vaisala.com/en/products/metdatamanagementsystems/Pages/NM10.aspx

Barriers to Male Involvement in Antenatal Care in Rural Mozambique

PubMed Central

Audet, Carolyn M.; Chire, Yazalde Manual; Vaz, Lara; Bechtel, Ruth; Carlson-Bremer, Daphne; Wester, C. William; Amico, K. Rivet; Calvo, Lázaro

2015-01-01

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. Additionally, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged; (1) gender inequality in decision making and responsibility for pregnancy and (2) community beliefs that uptake of ANC services, particularly if supported by a male partner, reflects a woman’s HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed. PMID:25854615

Towards an effective co-operation between companies and occupational safety and health services.

PubMed

van der Drift, Dorine Willy

2002-01-01

In the Dutch Working Conditions Act, every employer is required to organize preventive occupational safety and health services (OSH-Services). The OSH-Services need to have a certification that can be compared with ISO-9000. This article is focused on the question: How can companies and OSH-Services co-operate more effectively to obtain a better OSH management system inside the companies? To answer this question, TNO has developed an approach to support organisations in the health care branch to obtain a better service from their OSH-Service. TNO has chosen to focus on supporting the companies, because of the recognition that the effectiveness of OSH-Services has been found in effects on their customers, the companies. As a result of the research project a stepwise approach with several tools was developed. After the development phase, parts of the approach and the tools were used in several other consultancy projects. Evaluative studies have not been performed yet. However, from the development activities and several consultancy projects some remarkable evaluative findings can be given. The approach can be useful for companies and OSH-Services to make their goals and expectations more explicit. The approach also helps to make the management of companies clear that their own behaviour is relevant to the achievement of their goals in occupational health and safety policy, in addition to the services provided by the OSH-Service and their professionals. The approach cannot fulfil the possible need for qualification of OSH professionals. However, the approach can make the OSH professionals clear in what way they have qualification needs.

Examining public knowledge and preferences for adult preventive services coverage.

PubMed

Williams, Jessica A R; Ortiz, Selena E

2017-01-01

To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015-2017. A 17-item survey instrument was designed and used to evaluate respondents' knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small-around one service less than those with liberal ideologies. Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered.

Examining public knowledge and preferences for adult preventive services coverage

PubMed Central

Ortiz, Selena E.

2017-01-01

Introduction To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. Methods An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015–2017. A 17-item survey instrument was designed and used to evaluate respondents’ knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Results Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small—around one service less than those with liberal ideologies. Conclusions Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered. PMID:29261757

Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia

PubMed Central

2012-01-01

Background People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. Methods A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO’s in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively. Results Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area. Conclusions There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. PMID:23216835

Unmet counselling need amongst women accessing an induced abortion service in KwaZulu-Natal, South Africa.

PubMed

Birdsey, Graeme; Crankshaw, Tamaryn L; Mould, Sean; Ramklass, Serela S

2016-11-01

Provision of objective, evidence-based counselling in the context of induced abortion services is considered global good practise. However, there is limited understanding over the counselling needs of women accessing abortion services, particularly in sub-Saharan Africa. This study aimed to explore the content and quality of pre-abortion counselling amongst women accessing an abortion service in South Africa as well as client experience of the counselling process. Perceptions of nurse counsellors were also sought. This was a mixed methods study conducted at a Choice of Termination of Pregnancy clinic based at a district level hospital in KwaZulu-Natal, South Africa. Sixty women requesting an abortion were interviewed via a semi-structured questionnaire. In-depth interviews were conducted with four nurses who provided pre-abortion counselling at the clinic. Interviews were coded for emergent themes and categories. Clinic nurses had widely variable counselling training and experience, ranging from less than 2 months to 8 years, but all clients reported that they had been treated with respect at their counselling session. The group-based counselling format and biomedical and health promotion content did not accommodate clients' differential counselling needs, which included requests for support from women experiencing intimate partner violence (IPV). There was limited provider awareness of client's additional counselling needs. Abortion counselling services should be tailored to clients' differential counselling needs. Group-based counselling followed by optional one-on-one counselling sessions is one possible strategy to address unmet client need in South Africa. Provision of abortion provider training in IPV is recommended as well as establishment of referral pathways for women experiencing IPV. Paying attention to the differential counselling needs of women seeking an abortion should be a key component to the provision of abortion services. In this way, abortion services can provide a gateway to additional support for women living in violent relationships and/or other adverse social circumstances. Copyright © 2016 Elsevier Inc. All rights reserved.

CCSDS Time-Critical Onboard Networking Service

NASA Technical Reports Server (NTRS)

Parkes, Steve; Schnurr, Rick; Marquart, Jane; Menke, Greg; Ciccone, Massimiliano

2006-01-01

The Consultative Committee for Space Data Systems (CCSDS) is developing recommendations for communication services onboard spacecraft. Today many different communication buses are used on spacecraft requiring software with the same basic functionality to be rewritten for each type of bus. This impacts on the application software resulting in custom software for almost every new mission. The Spacecraft Onboard Interface Services (SOIS) working group aims to provide a consistent interface to various onboard buses and sub-networks, enabling a common interface to the application software. The eventual goal is reusable software that can be easily ported to new missions and run on a range of onboard buses without substantial modification. The system engineer will then be able to select a bus based on its performance, power, etc and be confident that a particular choice of bus will not place excessive demands on software development. This paper describes the SOIS Intra-Networking Service which is designed to enable data transfer and multiplexing of a variety of internetworking protocols with a range of quality of service support, over underlying heterogeneous data links. The Intra-network service interface provides users with a common Quality of Service interface when transporting data across a variety of underlying data links. Supported Quality of Service (QoS) elements include: Priority, Resource Reservation and Retry/Redundancy. These three QoS elements combine and map into four TCONS services for onboard data communications: Best Effort, Assured, Reserved, and Guaranteed. Data to be transported is passed to the Intra-network service with a requested QoS. The requested QoS includes the type of service, priority and where appropriate, a channel identifier. The data is de-multiplexed, prioritized, and the required resources for transport are allocated. The data is then passed to the appropriate data link for transfer across the bus. The SOIS supported data links may inherently provide the quality of service support requested by the intra-network layer. In the case where the data link does not have the required level of support, the missing functionality is added by SOIS. As a result of this architecture, re-usable software applications can be designed and used across missions thereby promoting common mission operations. In addition, the protocol multiplexing function enables the blending of multiple onboard networks. This paper starts by giving an overview of the SOIS architecture in section 11, illustrating where the TCONS services fit into the overall architecture. It then describes the quality of service approach adopted, in section III. The prototyping efforts that have been going on are introduced in section JY. Finally, in section V the current status of the CCSDS recommendations is summarized.

Opal web services for biomedical applications.

PubMed

Ren, Jingyuan; Williams, Nadya; Clementi, Luca; Krishnan, Sriram; Li, Wilfred W

2010-07-01

Biomedical applications have become increasingly complex, and they often require large-scale high-performance computing resources with a large number of processors and memory. The complexity of application deployment and the advances in cluster, grid and cloud computing require new modes of support for biomedical research. Scientific Software as a Service (sSaaS) enables scalable and transparent access to biomedical applications through simple standards-based Web interfaces. Towards this end, we built a production web server (http://ws.nbcr.net) in August 2007 to support the bioinformatics application called MEME. The server has grown since to include docking analysis with AutoDock and AutoDock Vina, electrostatic calculations using PDB2PQR and APBS, and off-target analysis using SMAP. All the applications on the servers are powered by Opal, a toolkit that allows users to wrap scientific applications easily as web services without any modification to the scientific codes, by writing simple XML configuration files. Opal allows both web forms-based access and programmatic access of all our applications. The Opal toolkit currently supports SOAP-based Web service access to a number of popular applications from the National Biomedical Computation Resource (NBCR) and affiliated collaborative and service projects. In addition, Opal's programmatic access capability allows our applications to be accessed through many workflow tools, including Vision, Kepler, Nimrod/K and VisTrails. From mid-August 2007 to the end of 2009, we have successfully executed 239,814 jobs. The number of successfully executed jobs more than doubled from 205 to 411 per day between 2008 and 2009. The Opal-enabled service model is useful for a wide range of applications. It provides for interoperation with other applications with Web Service interfaces, and allows application developers to focus on the scientific tool and workflow development. Web server availability: http://ws.nbcr.net.

47 CFR 54.807 - Interstate access universal service support.

Code of Federal Regulations, 2011 CFR

2011-10-01

... supported service within the study area of a price cap local exchange carrier shall receive Interstate Access Universal Service Support for each line that it serves within that study area. (b) In any study... Service Support Per Line by dividing Study Area Access Universal Service Support by twelve times all...

Improving access to eye health services in rural Timor-Leste.

PubMed

Pereira, Sara M; Blignault, Ilse; du Toit, Renee; Ramke, Jacqueline

2012-01-01

Delivering eye health services to people in rural areas, especially in fragile, post-conflict countries, is a major challenge. This article reports on the implementation and evaluation of an innovative district-based outreach service. The main project partners were the Timor-Leste Ministry of Health and an international non-government organization, with assistance from a local non-government organization. An eye care nurse in Covalima District, a remote location 178 km from Timor-Leste's capital, Dili, was provided with a motor-bike for transport and regular support for outreach eye services to sub-district facilities. Data collected over the first year of operation were examined and included: services provided, spectacles dispensed, health promotion activities conducted and the cost of providing these. The project was also evaluated for its relevance, effectiveness, efficiency, impact and sustainability. In the first 12 months, 55 outreach visits were conducted across the district's seven sub-districts during which 1405 people received vision screening, and 777 spectacles were dispensed. In addition to meeting the five evaluation criteria, compared with the hospital-based eye clinic the outreach service resulted in significantly greater gender equity among eye health service beneficiaries. This pilot project demonstrates what can be achieved when a Ministry of Health (central and district level) and non-government organizations (international and local) work in partnership to support a dedicated health care provider.

Four Supportive Pillars in Career Exploration and Development for Adolescents with LD and EBD

ERIC Educational Resources Information Center

Trainor, Audrey A.; Smith, Shane Anthony; Kim, Sunyoung

2012-01-01

In addition to typical career development and vocational programs in general education, providing school-based programs that are directly linked to employment and career development for youth with learning and emotional and behavioral disabilities is a legally mandated service in special education. Several broad research-based strategies are…

Reading for Learning: Literacy Supports for 21st-Century Work

ERIC Educational Resources Information Center

Gomez, Louis M.; Gomez, Kimberley

2007-01-01

The U.S. work force is changing. Professional and related occupations and service occupations will be the fastest-growing sectors for the foreseeable future. Both demand strong communication skills for sharing complex ideas across diverse communities. In addition, the 21st-century economy will require its members to think creatively and critically…

ADDITIONAL BENEFICIAL OUTCOMES OF IMPLEMENTING THE CHESAPEAKE BAY TMDL: Quantification and description of ecosystem services not monetized

EPA Science Inventory

Over the last 60 years, the Chesapeake Bay water quality and seagrass beds have diminished to the point that the system is less able to support abundant crabs and diverse fish, feed waterfowl, and produce safe recreational opportunities. Further, the long-term resilience of the B...

An Architecture to Support Wearables in Education and Wellbeing

ERIC Educational Resources Information Center

Luis-Ferreira, Fernando; Artifice, Andreia; McManus, Gary; Sarraipa, João

2017-01-01

Technological devices help extending a person's sensory experience of the environment. From sensors to cameras, devices currently use embedded systems that can be used for the main goal they were designed but they can also be used for other objectives without additional costs of material or service subscription. Emotional assessment is a useful…

Supporting Young Children in Combat-Injured Families: Call to Action

ERIC Educational Resources Information Center

Arata-Maiers, Teresa L.; Stafford, Elisabeth M.

2010-01-01

Military families are currently facing the longest period of combat in the history of the nation, along with the attendant challenges of prolonged or repeated deployment. With the return of 36,000-plus service members wounded in action, including nearly 11,000 requiring medical evacuation and those with additional "invisible injuries," there are…

Annotated Bibliography of Strategies for Infusing Transition Skills into Academic Instruction

ERIC Educational Resources Information Center

Holzberg, Debra G.; Rusher, Dana E.

2017-01-01

Since 1990, transition planning has been a requirement under the Individuals with Disabilities Education Act (IDEA). Students receiving services under IDEA must have an individualized education program (IEP) with goals aligned to grade-level content standards. In addition, the IEP must ensure the student has the supports necessary, including…

7 CFR 279.6 - Legal advice and extensions of time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Legal advice and extensions of time. 279.6 Section 279.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... discretion, additional time is required for the firm to fully present information in support of its position...

The Price Differential's Impact on Retention, Recruitment, and Quality in a Public University.

ERIC Educational Resources Information Center

Little, Michale W.; O'Toole, Dennis; Wetzel, James

1997-01-01

A survey of 467 business students at Virginia Commonwealth University investigated results of the business school's tuition differential pricing strategy, which charges a higher tuition in order to provide students with strong computer and technological instruction and support. Results indicated the additional services created added value for…

Childhood Depression: Rethinking the Role of the School

ERIC Educational Resources Information Center

Herman, Keith C.; Reinke, Wendy M.; Parkin, Jason; Traylor, Karen B.; Agarwal, Geetika

2009-01-01

Schools play a privileged and strategic role in the lives of children acting as their principle environment away from home. Additionally, schools act as part of the community linking families and neighborhoods. These characteristics make schools a relevant setting for mental health service delivery and support to children and parents. In this…

Self-Regulated Learning and Ethnic/Racial Variables: Predicting Minority First-Generation College Students' Persistence

ERIC Educational Resources Information Center

Moore, John S., III.

2013-01-01

The purpose of this study was to investigate how self-regulated learning and ethnic/racial variables predict minority first-generation college student persistence and related constructs. Participants were drawn nationally from the U.S. Department of Education funded TRiO Student Support Services Programs. Additional participants from the Talent…

International Space Station USOS Waste and Hygiene Compartment Development

NASA Technical Reports Server (NTRS)

Link, Dwight E., Jr.; Broyan, James Lee, Jr.; Gelmis, Karen; Philistine, Cynthia; Balistreri, Steven

2007-01-01

The International Space Station (ISS) currently provides human waste collection and hygiene facilities in the Russian Segment Service Module (SM) which supports a three person crew. Additional hardware is planned for the United States Operational Segment (USOS) to support expansion of the crew to six person capability. The additional hardware will be integrated in an ISS standard equipment rack structure that was planned to be installed in the Node 3 element; however, the ISS Program Office recently directed implementation of the rack, or Waste and Hygiene Compartment (WHC), into the U.S. Laboratory element to provide early operational capability. In this configuration, preserved urine from the WHC waste collection system can be processed by the Urine Processor Assembly (UPA) in either the U.S. Lab or Node 3 to recover water for crew consumption or oxygen production. The human waste collection hardware is derived from the Service Module system and is provided by RSC-Energia. This paper describes the concepts, design, and integration of the WHC waste collection hardware into the USOS including integration with U.S. Lab and Node 3 systems.

Supporting women's empowerment in Djibouti.

PubMed

Rasul, Z

1999-01-01

This article reports on the work carried out by the UN Population Fund (UNFPA) in the small island of Djibouti, Africa. The republic's population has been plagued with problems of high levels of unemployment, poverty, malnutrition, an almost non-existent family reproductive health care service, 100% prevalence rate of female genital mutilation and low literacy rate, especially for women. In addition, refugees from Ethiopia and Eritrea have settled in the country increasing the risks of sexually transmitted diseases (STDs), HIV/AIDS, prostitution, and other social ills. In 1983, UNFPA started funding family planning and later reproductive health projects aimed at assuring access to services for a majority of Djiboutan women. The first country population program of assistance was started in 1992. This would help the government with health care for its population and to conduct a population census. In addition, the Fund has paid for training of doctors, midwives, and traditional birth assistants in the country and for rehabilitating maternity clinics and information centers. Moreover, it has supported agencies concerned with educating people on STDs, HIV/AIDS, safe motherhood and reproductive health for men and women, and other important issues.

Challenges to neurosurgery service delivery. Who moved my cheese?

PubMed

Palmer, J D

2007-04-01

The change programme in the National Health Service has moved the Acute Trusts providing neurosurgical services to very different ways of delivering healthcare. The process of reform has been supported by investment but the next few years will see far less additional money, and success and failure of services will be dependent upon the approach to those reforms. The 'payment by results' system of funding through tariff, the 'plurality of providers' policy of forcing commissioners to purchase activity from independent providers, the 'patient choice' process of encouraging patients to select treatment from a number of providers, and the '18-week wait' target of bringing down referral to treatment times are all major shifts in the way services are delivered and developed. The reforms have not been made with neurosurgery in mind, how will they affect the way this small specialty is delivered?

Identification of the condition of crops based on geospatial data embedded in graph databases

NASA Astrophysics Data System (ADS)

Idziaszek, P.; Mueller, W.; Górna, K.; Okoń, P.; Boniecki, P.; Koszela, K.; Fojud, A.

2017-07-01

The Web application presented here supports plant production and works with the graph database Neo4j shell to support the assessment of the condition of crops on the basis of geospatial data, including raster and vector data. The adoption of a graph database as a tool to store and manage the data, including geospatial data, is completely justified in the case of those agricultural holdings that have a wide range of types and sizes of crops. In addition, the authors tested the option of using the technology of Microsoft Cognitive Services at the level of produced application that enables an image analysis using the services provided. The presented application was designed using ASP.NET MVC technology and a wide range of leading IT tools.

Giving you every reason to SMiLE.

PubMed

Marsh, Wendy

2013-10-01

This article outlines the plans to develop a student midwife integrated learning environment (SMILE) which will focus upon the delivery of postnatal (PN) care to women and families whilst also creating an innovative clinical learning environment for students. The SMiLE PN hub (facilitated by student midwives, supervised by a qualified midwife/sign-off mentor) has been designed to fuse seamlessly with current PN provision and provide an alternative environment for women to access a wide range of PN services. This service proposal not only increases the amount of PN learning opportunities and experience of students but also provides a much needed hub of PN activity for women and their families. It provides drop-in breastfeeding support, signposting to additional support networks and scheduled daily parenting workshops, such as baby bathing and safe sleeping advice.

Reforming funding for chronic illness: Medicare-CDM.

PubMed

Swerissen, Hal; Taylor, Michael J

2008-02-01

Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

Reciprocity of agonistic support in ravens

PubMed Central

Fraser, Orlaith N.; Bugnyar, Thomas

2012-01-01

Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim’s likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals. PMID:22298910

Pharmacy users’ expectations of pharmacy encounters: a Q‐methodological study

PubMed Central

Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Åsa; Tully, Mary P.

2010-01-01

Abstract Background  Pharmacy practice is evolving according to general health‐care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients’ expectations of service encounters at pharmacies is an under‐explored topic but crucial to understanding how pharmacy practice can evolve efficiently. Objective  To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Methods  Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Setting and participants  Eighty‐five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Results  Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual’s own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health‐care and lifestyle support. Discussion and conclusions  The systematic Q‐methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients’ expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. PMID:21199199

Pharmacy users' expectations of pharmacy encounters: a Q-methodological study.

PubMed

Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Asa; Tully, Mary P

2011-12-01

Pharmacy practice is evolving according to general health-care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients' expectations of service encounters at pharmacies is an under-explored topic but crucial to understanding how pharmacy practice can evolve efficiently. To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Eighty-five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual's own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health-care and lifestyle support. The systematic Q-methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients' expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. © 2010 Blackwell Publishing Ltd.

Virtualized Multi-Mission Operations Center (vMMOC) and its Cloud Services

NASA Technical Reports Server (NTRS)

Ido, Haisam Kassim

2017-01-01

His presentation will cover, the current and future, technical and organizational opportunities and challenges with virtualizing a multi-mission operations center. The full deployment of Goddard Space Flight Centers (GSFC) Virtualized Multi-Mission Operations Center (vMMOC) is nearly complete. The Space Science Mission Operations (SSMO) organizations spacecraft ACE, Fermi, LRO, MMS(4), OSIRIS-REx, SDO, SOHO, Swift, and Wind are in the process of being fully migrated to the vMMOC. The benefits of the vMMOC will be the normalization and the standardization of IT services, mission operations, maintenance, and development as well as ancillary services and policies such as collaboration tools, change management systems, and IT Security. The vMMOC will also provide operational efficiencies regarding hardware, IT domain expertise, training, maintenance and support.The presentation will also cover SSMO's secure Situational Awareness Dashboard in an integrated, fleet centric, cloud based web services fashion. Additionally the SSMO Telemetry as a Service (TaaS) will be covered, which allows authorized users and processes to access telemetry for the entire SSMO fleet, and for the entirety of each spacecrafts history. Both services leverage cloud services in a secure FISMA High and FedRamp environment, and also leverage distributed object stores in order to house and provide the telemetry. The services are also in the process of leveraging the cloud computing services elasticity and horizontal scalability. In the design phase is the Navigation as a Service (NaaS) which will provide a standardized, efficient, and normalized service for the fleet's space flight dynamics operations. Additional future services that may be considered are Ground Segment as a Service (GSaaS), Telemetry and Command as a Service (TCaaS), Flight Software Simulation as a Service, etc.

47 CFR 54.502 - Supported telecommunications services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Supported telecommunications services. 54.502 Section 54.502 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Schools and Libraries § 54.502 Supported...

Human Behavior and Performance Support for ISS Operations and Astronaut Selections: NASA Operational Psychology for Six-Crew Operations

NASA Technical Reports Server (NTRS)

VanderArk, Steve; Sipes, Walter; Holland, Albert; Cockrell, Gabrielle

2010-01-01

The Behavioral Health and Performance group at NASA Johnson Space Center provides psychological support services and behavioral health monitoring for ISS astronauts and their families. The ISS began as an austere outpost with minimal comforts of home and minimal communication capabilities with family, friends, and colleagues outside of the Mission Control Center. Since 1998, the work of international partners involved in the Space Flight Human Behavior and Performance Working Group has prepared high-level requirements for behavioral monitoring and support. The "buffet" of services from which crewmembers can choose has increased substantially. Through the process of development, implementation, reviewing effectiveness and modifying as needed, the NASA and Wyle team have proven successful in managing the psychological health and well being of the crews and families with which they work. Increasing the crew size from three to six brought additional challenges. For the first time, all partners had to collaborate at the planning and implementation level, and the U.S. served as mentor to extrapolate their experiences to the others. Parity in available resources, upmass, and stowage had to be worked out. Steady progress was made in improving off-hours living and making provisions for new technologies within a system that has difficulty moving quickly on certifications. In some respect, the BHP support team fell victim to its previous successes. With increasing numbers of crewmembers in training, requests to engage our services spiraled upward. With finite people and funds, a cap had to placed on many services to ensure that parity could be maintained. The evolution of NASA BHP services as the ISS progressed from three- to six-crew composition will be reviewed, and future challenges that may be encountered as the ISS matures in its assembly-complete state will be discussed.

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.

PubMed

Heslehurst, Nicola; Dinsdale, Sarah; Brandon, Helene; Johnston, Camilla; Summerbell, Carolyn; Rankin, Judith

2017-06-01

to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. one NHS Trust maternity and dietetic services, North East England, UK. fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m 2 . four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base. it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quadrennial Review of Military Compensation (5th). Volume 1B. Supporting Appendixes to Uniformed Services Retirement System (H-N)

DTIC Science & Technology

1984-01-01

Increased performance Y.* requirements over the course of a c~areer. In addition to training poli- ~~ ~ v cies, the Services provide policies that impact on...8217.hiER(S) Ca. NAME OF PERFORMING ORGANiZArION 6b OFFICE SYMBOL .7a. NAM~E OF MONITORING ORGA5iZATION Fifth Quadrennial R-view of (if applicable) Office... employee by some per- centage of the benefits payable under social security; and (3) providing retirement benefits only on earnings in excess of

Implementation of an EPN-TAP Service to Improve Accessibility to the Planetary Science Archive

NASA Astrophysics Data System (ADS)

Macfarlane, A.; Barabarisi, I.; Docasal, R.; Rios, C.; Saiz, J.; Vallejo, F.; Martinez, S.; Arviset, C.; Besse, S.; Vallat, C.

2017-09-01

The re-engineered PSA has a focus on improved access and search-ability to ESA's planetary science data. In addition to the new web interface released in January 2017, the new PSA supports several common planetary protocols in order to increase the visibility and ways in which the data may be queried and retrieved. Work is on-going to provide an EPN-TAP service covering as wide a range of parameters as possible to facilitate the discovery of scientific data and interoperability of the archive.

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research.

PubMed

Goeman, Dianne; King, Jordan; Koch, Susan

2016-12-07

To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the 'SDN' model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relay Telecommunications for the Coming Decade of Mars Exploration

NASA Technical Reports Server (NTRS)

Edwards, C.; DePaula, R.

2010-01-01

Over the past decade, an evolving network of relay-equipped orbiters has advanced our capabilities for Mars exploration. NASA's Mars Global Surveyor, 2001 Mars Odyssey, and Mars Reconnaissance Orbiter (MRO), as well as ESA's Mars Express Orbiter, have provided telecommunications relay services to the 2003 Mars Exploration Rovers, Spirit and Opportunity, and to the 2007 Phoenix Lander. Based on these successes, a roadmap for continued Mars relay services is in place for the coming decade. MRO and Odyssey will provide key relay support to the 2011 Mars Science Laboratory (MSL) mission, including capture of critical event telemetry during entry, descent, and landing, as well as support for command and telemetry during surface operations, utilizing new capabilities of the Electra relay payload on MRO and the Electra-Lite payload on MSL to allow significant increase in data return relative to earlier missions. Over the remainder of the decade a number of additional orbiter and lander missions are planned, representing new orbital relay service providers and new landed relay users. In this paper we will outline this Mars relay roadmap, quantifying relay performance over time, illustrating planned support scenarios, and identifying key challenges and technology infusion opportunities.

NOAA's National Water Model - Integration of National Water Model with Geospatial Data creating Water Intelligence

NASA Astrophysics Data System (ADS)

Clark, E. P.; Cosgrove, B.; Salas, F.

2016-12-01

As a significant step forward to transform NOAA's water prediction services, NOAA plans to implement a new National Water Model (NWM) Version 1.0 in August 2016. A continental scale water resources model, the NWM is an evolution of the WRF-Hydro architecture developed by the National Center for Atmospheric Research (NCAR). The NWM will provide analyses and forecasts of flow for the 2.7 million stream reaches nationwide in the National Hydrography Dataset Plus v2 (NHDPlusV2) jointly developed by the USGS and EPA. The NWM also produces high-resolution water budget variables of snow, soil moisture, and evapotranspiration on a 1-km grid. NOAA's stakeholders require additional decision support application to be built on these data. The Geo-intelligence division of the Office of Water Prediction is building new products and services that integrate output from the NWM with geospatial datasets such as infrastructure and demographics to better estimate the impacts dynamic water resource states on community resiliency. This presentation will detail the methods and underlying information to produce prototypes water resources intelligence that is timely, actionable and credible. Moreover, it will to explore the NWM capability to support sector-specific decision support services.

An innovative program to address learning barriers in small schools: Washington State School Nurse Corps.

PubMed

Fast, Gail Ann; Gray, Lorali; Miles-Koehler, Mona

2013-01-01

While all schools in Washington State have had to deal with shrinking financial resources, small, rural school districts, with fewer than 2,000 students, face unique circumstances that further challenge their ability to meet rising student health needs. This article will explore how small districts utilize the services of the Washington State School Nurse Corps (SNC), an innovative program that supports student health and safety while reducing barriers to learning. Through direct registered nursing services and regional nurse administrative consultation and technical assistance, the SNC strengthens rural school districts' capacity to provide a safe and healthy learning environment. In addition, we will examine current research that links health and learning to discover how the SNC model is successful in addressing health risks as barriers to learning. Lastly, as resources continue to dwindle, partnerships between schools, the SNC, and state and local health and education organizations will be critical in maintaining health services and learning support to small, rural schools.

Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators.

PubMed

Zimmerman, Sheryl; Love, Karen; Cohen, Lauren W; Pinkowitz, Jackie; Nyrop, Kirsten A

2014-01-01

As a result of the Centers for Medicare & Medicaid Services (CMS) interest in creating a unifying definition of "community living" for its Medicaid Home and Community Based Services and Support (HCBS) programs, it needed clarifying descriptors of person-centered (PC) practices in assisted living to distinguish them from institutional ones. Additionally, CMS's proposed language defining "community living" had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This manuscript describes the consensus process through which clarifying language for "community living" and a framework for HCBS PC domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring PC practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing PC indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.

The Meaning of Social Support for Persons with Serious Mental Illness

PubMed Central

Chronister, Julie; Chou, Chih-Chin; Kwan, Kwong-Liem Karl; Lawton, Melissa; Silver, Kurt

2015-01-01

Aim This study sought to better understand the population-specific types of social support relevant to adults living with serious mental illness (SMI). Our study was exploratory and used a qualitative approach that centered on uncovering the types of social support meaningful and relevant to persons with SMI. Method The sample comprised of 52 adults receiving county mental health services in the San Francisco Bay Area. Data was gathered from six focus groups and analyzed using NVivo10 and Consensual Qualitative Research (CQR; Hill et al., 2005; Hill et al., 1997). Results Six qualitative domains were identified: a) Supportive Conditions, b) Day-to-Day Living, c) Illness Management, d) Resources and Information, e) Guidance and Advice, and f) Community Participation Support. Discussion While the six support domains share some broad-based conceptual underpinnings with traditional models of emotional and instrumental support, the domains emerging from our study represent supports uniquely tied to the stressors associated with living with an SMI, and therefore hold conceptual distinction from traditional types of support. Conclusions/Implications Findings from this study offer a conceptual framework for understanding social support for persons living with SMI and lay the groundwork for the development of a SMI-specific measure of social support. In addition, our research permits future researchers to investigate the conditions under which social support buffers the impact of SMI stressors, assisting service providers in more effective identification of individual support needs for clinical intervention. PMID:26009778

Generic Sensor Data Fusion Services for Web-enabled Environmental Risk Management and Decision-Support Systems

NASA Astrophysics Data System (ADS)

Sabeur, Zoheir; Middleton, Stuart; Veres, Galina; Zlatev, Zlatko; Salvo, Nicola

2010-05-01

The advancement of smart sensor technology in the last few years has led to an increase in the deployment of affordable sensors for monitoring the environment around Europe. This is generating large amounts of sensor observation information and inevitably leading to problems about how to manage large volumes of data as well as making sense out the data for decision-making. In addition, the various European Directives (Water Framework Diectives, Bathing Water Directives, Habitat Directives, etc.. ) which regulate human activities in the environment and the INSPIRE Directive on spatial information management regulations have implicitely led the designated European Member States environment agencies and authorities to put in place new sensor monitoring infrastructure and share information about environmental regions under their statutory responsibilities. They will need to work cross border and collectively reach environmental quality standards. They will also need to regularly report to the EC on the quality of the environments of which they are responsible and make such information accessible to the members of the public. In recent years, early pioneering work on the design of service oriented architecture using sensor networks has been achieved. Information web-services infrastructure using existing data catalogues and web-GIS map services can now be enriched with the deployment of new sensor observation and data fusion and modelling services using OGC standards. The deployment of the new services which describe sensor observations and intelligent data-processing using data fusion techniques can now be implemented and provide added value information with spatial-temporal uncertainties to the next generation of decision support service systems. The new decision support service systems have become key to implement across Europe in order to comply with EU environmental regulations and INSPIRE. In this paper, data fusion services using OGC standards with sensor observation data streams are described in context of a geo-distributed service infrastructure specialising in multiple environmental risk management and decision-support. The sensor data fusion services are deployed and validated in two use cases. These are respectively concerned with: 1) Microbial risks forecast in bathing waters; and 2) Geohazards in urban zones during underground tunneling activities. This research was initiated in the SANY Integrated Project(www.sany-ip.org) and funded by the European Commission under the 6th Framework Programme.

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists

PubMed Central

2017-01-01

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that “overload and conflict in customer service,” “emotional disharmony and hurt,” and “lack of a supportive and protective system in the organization” were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout. PMID:28776336

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists.

PubMed

Jeung, Da Yee; Lee, Hyun Ok; Chung, Won Gyun; Yoon, Jin Ha; Koh, Sang Baek; Back, Chi Yun; Hyun, Dae Sung; Chang, Sei Jin

2017-09-01

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that "overload and conflict in customer service," "emotional disharmony and hurt," and "lack of a supportive and protective system in the organization" were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout. © 2017 The Korean Academy of Medical Sciences.

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research

PubMed Central

Goeman, Dianne; King, Jordan; Koch, Susan

2016-01-01

Objective To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. Setting An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. Participants People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Data collection and analysis Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Results Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the ‘SDN’ model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Conclusions Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services. PMID:27927662

Prototyping an online wetland ecosystem services model using open model sharing standards

USGS Publications Warehouse

Feng, M.; Liu, S.; Euliss, N.H.; Young, Caitlin; Mushet, D.M.

2011-01-01

Great interest currently exists for developing ecosystem models to forecast how ecosystem services may change under alternative land use and climate futures. Ecosystem services are diverse and include supporting services or functions (e.g., primary production, nutrient cycling), provisioning services (e.g., wildlife, groundwater), regulating services (e.g., water purification, floodwater retention), and even cultural services (e.g., ecotourism, cultural heritage). Hence, the knowledge base necessary to quantify ecosystem services is broad and derived from many diverse scientific disciplines. Building the required interdisciplinary models is especially challenging as modelers from different locations and times may develop the disciplinary models needed for ecosystem simulations, and these models must be identified and made accessible to the interdisciplinary simulation. Additional difficulties include inconsistent data structures, formats, and metadata required by geospatial models as well as limitations on computing, storage, and connectivity. Traditional standalone and closed network systems cannot fully support sharing and integrating interdisciplinary geospatial models from variant sources. To address this need, we developed an approach to openly share and access geospatial computational models using distributed Geographic Information System (GIS) techniques and open geospatial standards. We included a means to share computational models compliant with Open Geospatial Consortium (OGC) Web Processing Services (WPS) standard to ensure modelers have an efficient and simplified means to publish new models. To demonstrate our approach, we developed five disciplinary models that can be integrated and shared to simulate a few of the ecosystem services (e.g., water storage, waterfowl breeding) that are provided by wetlands in the Prairie Pothole Region (PPR) of North America.

Social costs of expanding access to evidence-based supported employment: concepts and interpretive review of evidence.

PubMed

Salkever, David

2013-02-01

A recent policy analysis argued that expanding access to evidence-based supported employment can provide savings in major components of social costs. This article extends the scope of this policy analysis by placing the argument within a recently developed economic framework for social cost-effectiveness analysis that defines a program's social cost impact as its effect on net consumption of all goods and services. A total of 27 studies over the past two decades are reviewed to synthesize evidence of the social cost impacts of expanding access to the individual placement and support model of supported employment (IPS-SE). Most studies have focused primarily on agency costs of providing IPS-SE services, cost offsets when clients shift from "traditional" rehabilitation to IPS-SE, and impacts on clients' earnings. Because costs and cost offsets are similar in magnitude, incremental costs of expanding services to persons who would otherwise receive traditional services are probably small or even negative. The population served by an expansion could be sizable, but the feasibility of a policy targeting IPS-SE expansion in this way has yet to be demonstrated. IPS-SE has positive impacts on competitive job earnings, but these may not fully translate into social cost offsets. Additional empirical support is needed for the argument that large-scale expansion would yield substantial mental health treatment cost offsets. Other gaps in evidence of policy impacts include take-up rate estimates, cost impact estimates from longer-term studies (exceeding two years), and longer-term studies of whether IPS-SE prevents younger clients from becoming recipients of Supplemental Security Income or Social Security Disability Insurance

An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

2011-12-01

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Support Service Use and Interest in Support Services among Lung Cancer Patients

PubMed Central

Mosher, Catherine E.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Einhorn, Lawrence H.; Birdas, Thomas J.; Kesler, Kenneth A.; Champion, Victoria L.

2013-01-01

Summary Objectives This study examined support service use and interest in support services among lung cancer patients (N = 165) at two comprehensive medical centers in the midwestern United States. Materials and Methods Patients completed an assessment of support service use (i.e., receipt of mental health services, complementary and alternative medicine [CAM], and help from a spiritual leader), interest in support services, and physical and psychological symptoms. Results Only 40% of patients with significant anxiety and depressive symptoms and 28% of the entire sample reported current mental health service use. However, nearly half (47%) of all patients were receiving support from a spiritual leader. Having late-stage lung cancer and a religious affiliation predicted receipt of spiritual support. Few patients who were not receiving mental health services or spiritual support were interested in these services (range = 4% to 18%). Conversely, although interest in CAM was expressed by a substantial minority of patients (27%) who were not using these services, rates of CAM use were relatively low (22%). Conclusion Findings suggest that distressed lung cancer patients underuse mental health services, but many patients receive help from spiritual leaders. Given the lack of interest in mental health services among patients who are not receiving them, efforts are needed to enhance palatability of services and identify and reduce barriers to evidence-based service use. PMID:23932457

Low Earth Orbiter: Terminal

NASA Technical Reports Server (NTRS)

Kremer, Steven E.; Bundick, Steven N.

1999-01-01

In response to the current government budgetary environment that requires the National Aeronautics and Space Administration (NASA) to do more with less, NASA/Goddard Space Flight Center's Wallops Flight Facility has developed and implemented a class of ground stations known as a Low Earth Orbiter-Terminal (LEO-T). This development thus provides a low-cost autonomous ground tracking service for NASA's customers. More importantly, this accomplishment provides a commercial source to spacecraft customers around the world to purchase directly from the company awarded the NASA contract to build these systems. A few years ago, NASA was driven to provide more ground station capacity for spacecraft telemetry, tracking, and command (TT&C) services with a decreasing budget. NASA also made a decision to develop many smaller, cheaper satellites rather than a few large spacecraft as done in the past. In addition, university class missions were being driven to provide their own TT&C services due to the increasing load on the NASA ground-tracking network. NASA's solution for this ever increasing load was to use the existing large aperture systems to support those missions requiring that level of performance and to support the remainder of the missions with the autonomous LEO-T systems. The LEO-T antenna system is a smaller, cheaper, and fully autonomous unstaffed system that can operate without the existing NASA support infrastructure. The LEO-T provides a low-cost, reliable space communications service to the expanding number of low-earth orbiting missions around the world. The system is also fostering developments that improve cost-effectiveness of autonomous-class capabilities for NASA and commercial space use. NASA has installed three LEO-T systems. One station is at the University of Puerto Rico, the second system is installed at the Poker Flat Research Range near Fairbanks, Alaska, and the third system is installed at NASA's Wallops Flight Facility in Virginia. This paper will describe the current NASA implementation of the LEO-T network of antenna systems, the customers now being supported, and the services NASA can now offer with this new breed of autonomous ground stations. In addition, the paper will define the technical capabilities of the system and the cost effectiveness of using the systems including the capital costs of installation.

Predictors of Help-Seeking Intentions in Operation Enduring Freedom and Operation Iraqi Freedom Veterans and Service Members.

PubMed

Porcari, Carole; Koch, Ellen I; Rauch, Sheila A M; Hoodin, Flora; Ellison, Grant; McSweeney, Lauren

2017-05-01

Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year. All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined. Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources. Documentation of a mental health problem on one's record was found to be a significant barrier to help seeking and participants indicated they would most likely seek help in the next year from their partner/spouse, family, or friends versus formal VA or non-VA sources. This is one of the first studies to examine attitudes toward psychotherapy as contributing to help-seeking intentions of veterans and service members and results provide strong support for inclusion of this variable in future studies in addition to social support and stigma. Limitations of the study are discussed as well as suggestions for future research. It is our hope that findings from this study may inform administrators and providers regarding assessment, outreach, and program development for our country's veterans and service members. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

bioGUID: resolving, discovering, and minting identifiers for biodiversity informatics

PubMed Central

Page, Roderic DM

2009-01-01

Background Linking together the data of interest to biodiversity researchers (including specimen records, images, taxonomic names, and DNA sequences) requires services that can mint, resolve, and discover globally unique identifiers (including, but not limited to, DOIs, HTTP URIs, and LSIDs). Results bioGUID implements a range of services, the core ones being an OpenURL resolver for bibliographic resources, and a LSID resolver. The LSID resolver supports Linked Data-friendly resolution using HTTP 303 redirects and content negotiation. Additional services include journal ISSN look-up, author name matching, and a tool to monitor the status of biodiversity data providers. Conclusion bioGUID is available at . Source code is available from . PMID:19900301

Revitalizing academic-service partnerships to resolve nursing faculty shortages.

PubMed

Connolly, Maria A; Wilson, Carol Jo

2008-01-01

Vacancy rates of nursing faculty are on the increase as fewer educators are being prepared and nurses at the bedside are in short supply. Advanced practice nurses--uniquely suited to provide clinical education for undergraduate and graduate students--are underutilized. However, without release time, preparation as educators, ongoing support from education and administration, and remuneration for providing both evidence-based education and evidence-based patient care, they can hardly be expected to assume additional responsibilities. This article reviews academic-service partnerships, noting a general lack of published efficacy and cost-effectiveness data, and highlights 21st-century innovations for academia and service to share resources for the benefit of all stakeholders--especially patients and students.

Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

PubMed

Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

2018-02-01

To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

Changing practice to support self-management and recovery in mental illness: application of an implementation model.

PubMed

Harris, Melanie; Jones, Phil; Heartfield, Marie; Allstrom, Mary; Hancock, Janette; Lawn, Sharon; Battersby, Malcolm

2015-01-01

Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

Interactive Tree Of Life v2: online annotation and display of phylogenetic trees made easy.

PubMed

Letunic, Ivica; Bork, Peer

2011-07-01

Interactive Tree Of Life (http://itol.embl.de) is a web-based tool for the display, manipulation and annotation of phylogenetic trees. It is freely available and open to everyone. In addition to classical tree viewer functions, iTOL offers many novel ways of annotating trees with various additional data. Current version introduces numerous new features and greatly expands the number of supported data set types. Trees can be interactively manipulated and edited. A free personal account system is available, providing management and sharing of trees in user defined workspaces and projects. Export to various bitmap and vector graphics formats is supported. Batch access interface is available for programmatic access or inclusion of interactive trees into other web services.

Integrated HIV care and service engagement among people living with HIV who use drugs in a setting with a community-wide treatment as prevention initiative: a qualitative study in Vancouver, Canada

PubMed Central

Collins, Alexandra B; Parashar, Surita; Hogg, Robert S; Fernando, Saranee; Worthington, Catherine; McDougall, Patrick; Turje, Rosalind Baltzer; McNeil, Ryan

2017-01-01

Abstract Introduction: Social-structural inequities impede access to, and retention in, HIV care among structurally vulnerable people living with HIV (PLHIV) who use drugs. The resulting disparities in HIV-related outcomes among PLHIV who use drugs pose barriers to the optimization of HIV treatment as prevention (TasP) initiatives. We undertook this study to examine engagement with, and impacts of, an integrated HIV care services model tailored to the needs of PLHIV who use drugs in Vancouver, Canada – a setting with a community-wide TasP initiative. Methods: We conducted qualitative interviews with 30 PLHIV who use drugs recruited from the Dr. Peter Centre, an HIV care facility operating under an integrated services model and harm reduction approach. We employed novel analytical techniques to analyse participants’ service trajectories within this facility to understand how this HIV service environment influences access to, and retention in, HIV care among structurally vulnerable PLHIV who use drugs. Results: Our findings demonstrate that participants’ structural vulnerability shaped their engagement with the HIV care facility that provided access to resources that facilitated retention in HIV care and antiretroviral treatment adherence. Additionally, the integrated service environment helped reduce burdens associated with living in extreme poverty by meeting participants’ subsistence (e.g. food, shelter) needs. Moreover, access to multiple supports created a structured environment in which participants could develop routine service use patterns and have prolonged engagement with supportive care services. Our findings demonstrate that low-barrier service models can mitigate social and structural barriers to HIV care and complement TasP initiatives for PLHIV who use drugs. Conclusions: These findings highlight the critical role of integrated service models in promoting access to health and support services for structurally vulnerable PLHIV. Complementing structural interventions with integrated service models that are tailored to the needs of structurally vulnerable PLHIV who use drugs will be pursuant to the goals of TasP. PMID:28426185

Effect of a new social support program by voluntary organization in pediatric oncology department in a developing country.

PubMed

Nair, Manjusha; Parukkutty, Kusumakumary; Kommadath, Sheethal

2014-04-01

Comprehensive childhood cancer treatment in the modern era means not only strenuous treatment regimens and meticulous nursing care, it also implies attention to social, psychological, and financial aspects of disease and treatment. In a developing country like ours, though it is possible to provide good medical and nursing care in government set-up, there is always shortage of workforce and financial support, leading to nonadherence to treatment regimens by patients and parents, resulting in suboptimal treatment outcomes. Overcrowding of pediatric cancer patients along with general patients for lab tests and other hospital services, poor drug compliance, treatment abandonment, and lost to follow-up, lack of funding to meet nonmedical expenses and inadequate facility for providing psychological support were some of the major reasons we could identify as lacunae in our pediatric oncology division (POD). We introduced a new social support program with the help of additional staff supported by a nongovernmental agency, and new quality improvement services were introduced. The impact was demonstrable as reduction in waiting time in the hospital, allayed anxiety of painful procedures, better drug compliance, less treatment abandonment, and improved follow-up. This can be emulated in similar other resource-limited centers.

Low-threshold support services for people with dementia within the scope of respite care in Germany - A qualitative study on different stakeholders' perspective.

PubMed

Hochgraeber, Iris; von Kutzleben, Milena; Bartholomeyczik, Sabine; Holle, Bernhard

2017-07-01

Low-threshold support services are provided within the basket of services of German long-term care insurance as a part of respite care to support family carers and people with dementia. This study investigates various stakeholders' (providers, coordinators, volunteers, family carers and people with dementia) perspectives on low-threshold support service regarding its organisation and conceptualisation as well as how stakeholders and users value low-threshold support service using a qualitative approach. Twelve guided interviews and group discussions were conducted with 31 participants. Organisation and conceptualisation are characterised by the lowness of the service thresholds, which is perceived to be quick and simple forms of support with no user requirements. Multiple barriers such as the challenging behaviour of people with dementia and their initial refusal as well as their holding low-threshold support service in low esteem can hinder the utilisation of these services. Low-threshold support service within the scope of the long-term care insurance law can be separated into two types: low-cost (non-professional) services and high-cost services with comprehensive training for 'employed' volunteers (professional). Both types are constantly developing within the landscape of the German long-term care system, and low-threshold support service appears to be adapted to diverse needs. Therefore, it is important to avoid replacing non-professional services with professional services.

Variation in Older Americans Act Caregiver Service Use, Unmet Hours of Care, and Independence Among Hispanics, African Americans, and Whites

PubMed Central

Herrera, Angelica P.; George, Rebecca; Angel, Jacqueline L.; Markides, Kyriakos; Torres-Gil, Fernando

2013-01-01

Home- and community-based services (HCBS) are underused by minority seniors and their caregivers, despite greater rates of disability. We examined racial/ethnic variation among 1,749 Hispanic, African American, and Whites receiving Older Americans Act Title III caregiver services in 2009. In addition, we identified the volume of services used by caregivers, their unmet hours of respite care, and the relationship between service use and seniors’ ability to live independently. Minority caregivers cared for seniors in urban areas who had higher rates of disability, poverty, and Medicaid coverage. Hispanics had the highest rate of unmet hours of care, while caregiver services were less likely to help African Americans remain at home. Minorities sought services through community agencies and were more educated than demographically similar national cohorts. Greater efforts to reach minority caregivers of less educated, disabled seniors in urban areas and through community agencies may reduce unmet needs and support independent living. PMID:23438508

Unique and common elements of the role of peer support in the context of traditional mental health services.

PubMed

Crane, Dushka A; Lepicki, Traci; Knudsen, Kraig

2016-09-01

The goal of this report is to clarify the unique role of peer support providers (PSPs) and define peer support as a distinct occupation in the context of traditional mental health services. A systematic methodology was used to compare roles of PSPs with those of similarly situated case managers (CMs). Key informants including 12 incumbent CMs and 11 incumbent PSPs participated in focus groups and responded to a set of prompts based on the Discovering a Curriculum (DACUM) methodology (Norton & Moser, 2014), an innovative approach to identifying and comparing duties and tasks associated with distinct occupations. Task analyses were validated through a survey of 71 CM and 29 PSP subject matter experts, including workers, supervisors, trainers, and consumers. The results revealed a variety of duties and tasks specific to the PSP occupation, particularly within the domains of empowering consumers, promoting consumers' educational growth, and supporting personal development. The results also reveal areas of overlapping responsibility between PSPs and CMs, including aspects of each role that promote consumers' development, wellness and recovery, administrative tasks, and care coordination activities. These findings may address the role ambiguity that currently challenges efforts to establish peer support as a legitimate service in the field of behavioral health. In addition, the findings demonstrate how the roles of PSPs and CMs could be synergistic in complex organizational settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

47 CFR 54.502 - Eligible services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... pursuant to paragraphs (b)(1) through (6) of this section. (1) Five-year budget. Each eligible school or... SERVICE Universal Service Support for Schools and Libraries § 54.502 Eligible services. (a) Supported services. All supported services are listed in the Eligible Services List as updated annually in accordance...

75 FR 26137 - High-Cost Universal Service Support, Federal-State Joint Board on Universal Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... 10-56] High-Cost Universal Service Support, Federal-State Joint Board on Universal Service AGENCY... high-cost support mechanism comports with the requirements of section 254. The Commission also grants... Office of Consumer Advocate for supplemental high-cost universal service support for rural residential...

The effectiveness of simulated robots for supporting the learning of introductory programming: a multi-case case study

NASA Astrophysics Data System (ADS)

Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

2014-07-01

This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants (aged 16-18) in addition to 23 pre-service, and 3 in-service, teachers took part. The effectiveness of this intervention was determined by considering opinions, attitudes, and motivation as well as by analysing students' programming performance. Pre- and post-questionnaires, in- and post-workshop exercises, and interviews were used. Participants enjoyed learning using the simulator and believed the approach to be valuable and engaging. The performance of students indicates that the simulator aids learning as most completed tasks to a satisfactory standard. Evidence suggests robot simulators can offer an effective means of introducing programming. Recommendations to support the development of other simulators are provided.

Space construction base support requirements for environmental control and life support systems

NASA Technical Reports Server (NTRS)

Thiele, R. J.; Secord, T. C.; Murphy, G. L.

1977-01-01

A Space Station analysis study is being performed for NASA which identifies cost-effective Space Station options that can provide a space facility capable of performing space construction, space manufacturing, cosmological research, earth services, and other functions. A space construction base concept for the construction of large structures, such as those needed to implement satellite solar power for earth usage, will be used as a basis for discussing requirements that impact the design selection, level of integration, and operation of environmental control and life support systems (ECLSS). The space construction base configuration also provides a basic Space Station facility that can accommodate biological manufacturing modules, ultrapure glasses manufacturing modules, and modules for other services in a building-block fashion. Examples of special problems that could dictate hardware required to augment the basic ECLSS for autonomous modules will be highlighted. Additionally, overall intravehicular (IVA) and extravehicular (EVA) activities and requirements that could impact the basic station ECLSS degree of closure are discussed.

[Strengthening primary health care: a strategy to maximize coordination of care].

PubMed

de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

2011-02-01

To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

Considering the Role of K-2 Teachers' Mathematical Knowledge for Teaching Place Value in Mathematics Intervention

ERIC Educational Resources Information Center

Juenke, Carl W.

2017-01-01

A significant number of students receive special education services for mathematics learning disabilities, however, many additional students need mathematics intervention to support their learning in the regular education classroom. A Response to Intervention (RtI) model has been identified as effective in addressing these students' needs;…

Stakeholders' Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings

ERIC Educational Resources Information Center

Buchanan, Rohanna; Nese, Rhonda N. T.; Clark, Miriam

2016-01-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible…

Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

ERIC Educational Resources Information Center

Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

2012-01-01

Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

Enhancing Junior Faculty Research Productivity through Multiinstitution Collaboration: Participants' Impressions of the School Psychology Research Collaboration Conference

ERIC Educational Resources Information Center

Rush, S. Craig; Wheeler, Joanna

2011-01-01

In addition to teaching and service responsibilities, junior faculty members are required to be productive researchers. Despite the demand on junior faculty to produce published research, studies suggest that they often do not receive adequate assistance with their research endeavors. Mentoring is an effective form of support for junior faculty…

Cibola High Levee Pond annual report 2004

USGS Publications Warehouse

Mueller, Gordon A.; Carpenter, Jeanette; Marsh, Paul C.

2005-01-01

Remaining work will be finished this coming summer and a final report describing CHLP and the ecology of these fish will be completed by the end of 2005. We offer our assistance to the Fish and Wildlife Service in the pond’s renovation and support for the creation of additional refuge ponds. Funding for this work ends September 2005.

A Phenomenological Study of the Experiences of Helping Professionals with Learning Disabilities

ERIC Educational Resources Information Center

Peters, Madeline Lorraine

2010-01-01

The purpose of this study is to explore the extent, to which professionals in helping professions (PHPS) with learning disabilities are able to name the support, services, and assistance that they require to successfully engage in the full range of activities for their daily living. Additionally, the study explores how PHPS describe their…

School-Public Library Services within a Community; Problems & Questions on Consolidation. A Policy Statement. Bulletin No. 6539.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison. Div. of Library Services.

Wisconsin state library, school library, and public school agencies advise against the consolidation of school and public libraries as a response to budget pressures. Adult library use generally declines under such arrangements. Inequity of support for various geographical areas could result. In addition, legal questions concerning the use of…

Standing with People in Support, Not Control: Training toward Self-Reliance, Inc. Sacramento, CA.

ERIC Educational Resources Information Center

Walker, Pam

This report describes a program designed to increase opportunities for people with developmental disabilities to lead good lives in places of their own, strengthen their communities, and enjoy a genuine sense of self-worth. In addition to offering independent services, the Training Toward Self-Reliance (TTSR) program staff have increased their…

47 CFR 54.611 - Distributing support.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.611 Distributing support. (a) A telecommunications carrier providing services eligible for support under this subpart to eligible health care...

Co-Leadership - A Management Solution for Integrated Health and Social Care.

PubMed

Klinga, Charlotte; Hansson, Johan; Hasson, Henna; Sachs, Magna Andreen

2016-05-23

Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.

A pilot demonstration of comprehensive mental health services in inner-city public schools.

PubMed

Walter, Heather J; Gouze, Karen; Cicchetti, Colleen; Arend, Richard; Mehta, Tara; Schmidt, Janet; Skvarla, Madelynn

2011-04-01

National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in 2 public elementary schools in inner-city neighborhoods. The program, based upon a national model for comprehensive school mental health services, comprised universal and indicated preventive as well as clinical interventions designed to target needs identified in a baseline screening survey. The program was implemented over 1 school year by mental health professionals in collaboration with school teachers. Mental health outcomes comparing baseline to follow-up data were assessed in multiple domains among students and teachers. After 1 year of intervention, students had significantly fewer mental health difficulties, less functional impairment, and improved behavior, and reported improved mental health knowledge, attitudes, beliefs, and behavioral intentions. Teachers reported significantly greater proficiency in managing mental health problems in their classrooms. School staff overwhelmingly endorsed satisfaction with the program. If the observed favorable findings from this pilot demonstration can be replicated in methodologically rigorous studies, additional support would be garnered for national policy recommendations about comprehensive school mental health services. © 2011, American School Health Association.

Co-Leadership – A Management Solution for Integrated Health and Social Care

PubMed Central

Hansson, Johan; Hasson, Henna; Sachs, Magna Andreen

2016-01-01

Introduction: Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers – each manager representing one of the two principal organizations in integrated health and social care services – was explored. Aim: To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. Method: Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. Results: Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. Conclusion and discussion: Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability. PMID:27616963

Mobile information and communication in the hospital outpatient service.

PubMed

Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

2007-08-01

Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

A Bookmarking Service for Organizing and Sharing URLs

NASA Technical Reports Server (NTRS)

Keller, Richard M.; Wolfe, Shawn R.; Chen, James R.; Mathe, Nathalie; Rabinowitz, Joshua L.

1997-01-01

Web browser bookmarking facilities predominate as the method of choice for managing URLs. In this paper, we describe some deficiencies of current bookmarking schemes, and examine an alternative to current approaches. We present WebTagger(TM), an implemented prototype of a personal bookmarking service that provides both individuals and groups with a customizable means of organizing and accessing Web-based information resources. In addition, the service enables users to supply feedback on the utility of these resources relative to their information needs, and provides dynamically-updated ranking of resources based on incremental user feedback. Individuals may access the service from anywhere on the Internet, and require no special software. This service greatly simplifies the process of sharing URLs within groups, in comparison with manual methods involving email. The underlying bookmark organization scheme is more natural and flexible than current hierarchical schemes supported by the major Web browsers, and enables rapid access to stored bookmarks.

EnviroAtlas - Recreation, Culture, and Aesthetics Metrics for Conterminous United States

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The Recreation, Culture, and Aesthetics category in this web service includes layers illustrating the ecosystems and natural resources that provide inherent cultural and aesthetic value or recreation opportunity, the need or demand for these amenities, the impacts associated with their presence and accessibility, and factors that place stress on the natural environment's capability to provide these benefits. EnviroAtlas allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the conterminous United States. Additional descriptive information about each attribute in this web service is located within each web service layer (see Full Metadata hyperlink) or can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence.

PubMed

Sulaberidze, Lela; Green, Stuart; Chikovani, Ivdity; Uchaneishvili, Maia; Gotsadze, George

2018-02-13

Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers. Data generated from interviews and focus groups were analysed using an existing framework that outlines a range of economic and financial barriers to improving mental health practice. In addition, the study utilised health financing and programmatic data. The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the mental health workforce and services due to inflexible resources; the variable and limited provision of services across the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation to access mental health services. Whilst scarcity of financial resources exists in Georgia, as in many other countries, there are clear opportunities to improve the effectiveness of the current mental health programme. Addressing system-wide barriers could enable the delivery of services that aim to meet the needs of patients. The use of existing data to assess the implementation of the mental health programme offers opportunities to benchmark and improve services and to support the appropriate commissioning and reconfiguration of services.

Real-time GIS data model and sensor web service platform for environmental data management.

PubMed

Gong, Jianya; Geng, Jing; Chen, Zeqiang

2015-01-09

Effective environmental data management is meaningful for human health. In the past, environmental data management involved developing a specific environmental data management system, but this method often lacks real-time data retrieving and sharing/interoperating capability. With the development of information technology, a Geospatial Service Web method is proposed that can be employed for environmental data management. The purpose of this study is to determine a method to realize environmental data management under the Geospatial Service Web framework. A real-time GIS (Geographic Information System) data model and a Sensor Web service platform to realize environmental data management under the Geospatial Service Web framework are proposed in this study. The real-time GIS data model manages real-time data. The Sensor Web service platform is applied to support the realization of the real-time GIS data model based on the Sensor Web technologies. To support the realization of the proposed real-time GIS data model, a Sensor Web service platform is implemented. Real-time environmental data, such as meteorological data, air quality data, soil moisture data, soil temperature data, and landslide data, are managed in the Sensor Web service platform. In addition, two use cases of real-time air quality monitoring and real-time soil moisture monitoring based on the real-time GIS data model in the Sensor Web service platform are realized and demonstrated. The total time efficiency of the two experiments is 3.7 s and 9.2 s. The experimental results show that the method integrating real-time GIS data model and Sensor Web Service Platform is an effective way to manage environmental data under the Geospatial Service Web framework.

Rural health care support mechanism. Final rule; denial of petition for reconsideration.

PubMed

2003-12-24

In this document, the Commission modifies its rules to improve the effectiveness of the rural health care support mechanism, which provides discounts to rural health care providers to access modern telecommunications for medical and health maintenance purposes. Because participation in the rural health care support mechanism has not met the Commission's initial projections, the Commission amends its rules to improve the program, increase participation by rural health care providers, and ensure that the benefits of the program continue to be distributed in a fair and equitable manner. In addition, the Commission denies Mobile Satellite Ventures Subsidiary's petition for reconsideration of the 1997 Universal Service Order.

A survey of nurse staffing levels in interventional radiology units throughout the UK.

PubMed

Christie, A; Robertson, I

2016-07-01

To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. Copyright © 2016. Published by Elsevier Ltd.

WDS Knowledge Network Architecture in Support of International Science

NASA Astrophysics Data System (ADS)

Mokrane, M.; Minster, J. B. H.; Hugo, W.

2014-12-01

ICSU (International Council for Science) created the World Data System (WDS) as an interdisciplinary body at its General Assembly in Maputo in 2008, and since then the membership of the WDS has grown to include 86 members, of whom 56 are institutions or data centers focused on providing quality-assured data and services to the scientific community, and 10 more are entire networks of such data facilities and services. In addition to its objective of providing universal and equitable access to scientific data and services, WDS is also active in promoting stewardship, standards and conventions, and improved access to products derived from data and services. Whereas WDS is in process of aggregating and harmonizing the metadata collections of its membership, it is clear that additional benefits can be obtained by supplementing such traditional metadata sources with information about members, authors, and the coverages of the data, as well as metrics such as citation indices, quality indicators, and usability. Moreover, the relationships between the actors and systems that populate this metadata landscape can be seen as a knowledge network that describes a subset of global scientific endeavor. Such a knowledge network is useful in many ways, supporting both machine-based and human requests for contextual information related to a specific data set, institution, author, topic, or other entities in the network. Specific use cases that can be realized include decision and policy support for funding agencies, identification of collaborators, ranking of data sources, availability of data for specific coverages, and many more. The paper defines the scope of and conceptual background to such a knowledge network, discusses some initial work done by WDS to establish the network, and proposes an implementation model for rapid operationalization. In this model, established interests such as DataCite, ORCID, and CrossRef have well-defined roles, and the standards, services, and registries required to build a community-maintained, scalable knowledge network is presented. We conclude with a short discussion on feasibility and sustainability of global data infrastructure, the role of the WDS Knowledge Network in this infrastructure, and the necessary conditions for success.

Research data management support for large-scale, long-term, interdisciplinary collaborative research centers with a focus on environmental sciences

NASA Astrophysics Data System (ADS)

Curdt, C.; Hoffmeister, D.; Bareth, G.; Lang, U.

2017-12-01

Science conducted in collaborative, cross-institutional research projects, requires active sharing of research ideas, data, documents and further information in a well-managed, controlled and structured manner. Thus, it is important to establish corresponding infrastructures and services for the scientists. Regular project meetings and joint field campaigns support the exchange of research ideas. Technical infrastructures facilitate storage, documentation, exchange and re-use of data as results of scientific output. Additionally, also publications, conference contributions, reports, pictures etc. should be managed. Both, knowledge and data sharing is essential to create synergies. Within the coordinated programme `Collaborative Research Center' (CRC), the German Research Foundation offers funding to establish research data management (RDM) infrastructures and services. CRCs are large-scale, interdisciplinary, multi-institutional, long-term (up to 12 years), university-based research institutions (up to 25 sub-projects). These CRCs address complex and scientifically challenging research questions. This poster presents the RDM services and infrastructures that have been established for two CRCs, both focusing on environmental sciences. Since 2007, a RDM support infrastructure and associated services have been set up for the CRC/Transregio 32 (CRC/TR32) `Patterns in Soil-Vegetation-Atmosphere-Systems: Monitoring, Modelling and Data Assimilation' (www.tr32.de). The experiences gained have been used to arrange RDM services for the CRC1211 `Earth - Evolution at the Dry Limit' (www.crc1211.de), funded since 2016. In both projects scientists from various disciplines collect heterogeneous data at field campaigns or by modelling approaches. To manage the scientific output, the TR32DB data repository (www.tr32db.de) has been designed and implemented for the CRC/TR32. This system was transferred and adapted to the CRC1211 needs (www.crc1211db.uni-koeln.de) in 2016. Both repositories support secure and sustainable data storage, backup, documentation, publication with DOIs, search, download, statistics as well as web mapping features. Moreover, RDM consulting and support services as well as training sessions are carried out regularly.

Enabling Large-Scale IoT-Based Services through Elastic Publish/Subscribe.

PubMed

Vavassori, Sergio; Soriano, Javier; Fernández, Rafael

2017-09-19

In this paper, we report an algorithm that is designed to leverage the cloud as infrastructure to support Internet of Things (IoT) by elastically scaling in/out so that IoT-based service users never stop receiving sensors' data. This algorithm is able to provide an uninterrupted service to end users even during the scaling operation since its internal state repartitioning is transparent for publishers or subscribers; its scaling operation is time-bounded and depends only on the dimension of the state partitions to be transmitted to the different nodes. We describe its implementation in E-SilboPS, an elastic content-based publish/subscribe (CBPS) system specifically designed to support context-aware sensing and communication in IoT-based services. E-SilboPS is a key internal asset of the FIWARE IoT services enablement platform, which offers an architecture of components specifically designed to capture data from, or act upon, IoT devices as easily as reading/changing the value of attributes linked to context entities. In addition, we discuss the quantitative measurements used to evaluate the scale-out process, as well as the results of this evaluation. This new feature rounds out the context-aware content-based features of E-SilboPS by providing, for example, the necessary middleware for constructing dashboards and monitoring panels that are capable of dynamically changing queries and continuously handling data in IoT-based services.

Enabling Large-Scale IoT-Based Services through Elastic Publish/Subscribe

PubMed Central

2017-01-01

In this paper, we report an algorithm that is designed to leverage the cloud as infrastructure to support Internet of Things (IoT) by elastically scaling in/out so that IoT-based service users never stop receiving sensors’ data. This algorithm is able to provide an uninterrupted service to end users even during the scaling operation since its internal state repartitioning is transparent for publishers or subscribers; its scaling operation is time-bounded and depends only on the dimension of the state partitions to be transmitted to the different nodes. We describe its implementation in E-SilboPS, an elastic content-based publish/subscribe (CBPS) system specifically designed to support context-aware sensing and communication in IoT-based services. E-SilboPS is a key internal asset of the FIWARE IoT services enablement platform, which offers an architecture of components specifically designed to capture data from, or act upon, IoT devices as easily as reading/changing the value of attributes linked to context entities. In addition, we discuss the quantitative measurements used to evaluate the scale-out process, as well as the results of this evaluation. This new feature rounds out the context-aware content-based features of E-SilboPS by providing, for example, the necessary middleware for constructing dashboards and monitoring panels that are capable of dynamically changing queries and continuously handling data in IoT-based services. PMID:28925967

Technology management: a perspective on system support, procurement, and replacement planning.

PubMed

Dickerson, M L; Jackson, M E

1992-01-01

The escalating costs associated with medical technology present a host of challenges for the hospital clinical engineering department. As service and support costs comprise ever larger portions of a system's life cycle cost, innovative management of service provider mix and mechanisms can provide substantial savings in operating expenses. In addition to full-service contracts, the use of demand service and independents has become commonplace. Medical equipment maintenance insurance programs provide yet another service alternative, combining the flexibility of demand service with the safety of a capped budget. These programs have gained acceptance among hospitals as their providers have become more focused on the healthcare market and its many needs. In view of the long-term cost impact surrounding technology procurement, the authors recommend that hospitals refine system evaluation methodologies and develop more comprehensive techniques directed at capital equipment replacement planning. One replacement planning approach, based on an estimation of system value changes, is described and illustrated using data collected through client consultations. Although the validity of this method has not been demonstrated, it represents a simplified approach to life cycle cost analysis and is intended to provide a standard method by which system replacement planning may be quantified. As a departure from system devaluation based solely on depreciation, this method estimates prospective system values derived from anticipated operations and maintenance costs, projected revenue, and the availability of new technology.

Older Adults' Social Relationships and Health Care Utilization: A Systematic Review.

PubMed

Valtorta, Nicole K; Moore, Danielle Collingridge; Barron, Lynn; Stow, Daniel; Hanratty, Barbara

2018-04-01

Deficiencies in older people's social relationships (including loneliness, social isolation, and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. To determine whether social relationships are associated with older adults' use of health services, independently of health-related needs. We searched 8 electronic databases (MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, the Cochrane Library, and the Centre for Reviews and Dissemination) for data published between 1983 and 2016. We also identified relevant sources from scanning the reference lists of included studies and review articles, contacting authors to identify additional studies, and searching the tables of contents of key journals. Studies met inclusion criteria if more than 50% of participants were older than 60 years or mean age was older than 60 years; they included a measure of social networks, received social support, or perceived support; and they reported quantitative data on the association between social relationships and older adults' health service utilization. Two researchers independently screened studies for inclusion. They extracted data and appraised study quality by using standardized forms. In a narrative synthesis, we grouped the studies according to the outcome of interest (physician visits, hospital admissions, hospital readmissions, emergency department use, hospital length of stay, utilization of home- and community-based services, contact with general health services, and mental health service use) and the domain of social relationships covered (social networks, received social support, or perceived support). For each service type and social relationship domain, we assessed the strength of the evidence across studies according to the quantity and quality of studies and consistency of findings. The literature search retrieved 26 077 citations, 126 of which met inclusion criteria. Data were reported across 226 678 participants from 19 countries. We identified strong evidence of an association between weaker social relationships and increased rates of readmission to hospital (75% of high-quality studies reported evidence of an association in the same direction). In evidence of moderate strength, according to 2 high-quality and 3 medium-quality studies, smaller social networks were associated with longer hospital stays. When we considered received and perceived social support separately, they were not linked to health care use. Overall, the evidence did not indicate that older patients with weaker social relationships place greater demands on ambulatory care (including physician visits and community- or home-based services) than warranted by their needs. Current evidence does not support the view that, independently of health status, older patients with lower levels of social support place greater demands on ambulatory care. Future research on social relationships would benefit from a consensus on clinically relevant concepts to measure. Public Health Implications. Our findings are important for public health because they challenge the notion that lonely older adults are a burden on all health and social care services. In high-income countries, interventions aimed at reducing social isolation and loneliness are promoted as a means of preventing inappropriate service use. Our review cautions against assuming that reductions in care utilization can be achieved by intervening to strengthen social relationships.

Acceptance of Swedish e-health services.

PubMed

Jung, Mary-Louise; Loria, Karla

2010-11-16

To investigate older people's acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people's intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens' needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.

Acceptance of Swedish e-health services

PubMed Central

Jung, Mary-Louise; Loria, Karla

2010-01-01

Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

Exploring the experiences of pregnant women using an NHS stop smoking service: a qualitative study.

PubMed

Pledger, Anne B

2015-05-01

The purpose of this article was to explore women's experiences of attempting to stop smoking while pregnant using National Health Service (NHS) support. A qualitative methodological approach was adopted to enable the researcher to develop an understanding of the women's experiences. Six individual semi-structured interviews were conducted with women who accessed an NHS stop smoking service while pregnant. The data were analysed using comparative analysis. Five themes were identified: health risks, motivations to stop smoking, influences on smoking behaviour, feelings about smoking and experiences of using NHS stop smoking support. Motivation to stop smoking was predominantly due to concerns about their unborn baby's health, and knowledge of health risks was generally good. Limited information relating to the associated health risks of continued smoking in pregnancy from healthcare professionals appeared to be a common experience. External pressures both positively and negatively influenced the smoking status of the women. Stress was cited by all the women as a significant challenge to smoking cessation and something which they all struggled with. The women's experiences of using NHS support while pregnant was varied; some felt it adequately met their needs, while others felt that their expectations were not met. Continued smoking in pregnancy is complex, and it appears that successful smoking cessation is related to a number of internal and external factors which present significant challenges for expectant mothers who smoke. Stress was found to be a major contributor in continued smoking; therefore, NHS stop smoking services should incorporate stress management techniques into stop smoking interventions. In addition, services should be flexible, adapting service provision to meet women's needs. © Royal Society for Public Health 2015.

Obesity services planning framework for interprofessional primary care organizations.

PubMed

Brauer, Paula; Royall, Dawna; Dwyer, John; Edwards, A Michelle; Hussey, Tracy; Kates, Nick; Smith, Heidi; Kirkconnell, Ross

2017-03-01

Aim We report on a formative project to develop an organization-level planning framework for obesity prevention and management services. It is common when developing new services to first develop a logic model outlining expected outcomes and key processes. This can be onerous for single primary care organizations, especially for complex conditions like obesity. The initial draft was developed by the research team, based on results from provider and patient focus groups in one large Family Health Team (FHT) in Ontario. This draft was reviewed and activities prioritized by 20 FHTs using a moderated electronic consensus process. A national panel then reviewed the draft. Findings Providers identified five main target groups: pregnancy to 2, 3-12, 13-18, 18+ years at health risk, and 18+ with complex care needs. Desired outcomes were identified and activities were prioritized under categories: raising awareness (eg, providing information and resources on weight-health), identification and initial management (eg, wellness care), follow-up management (eg, group programs), expanded services (eg, availability of team services), and practice initiatives (eg, interprofessional education). Overall, there was strong support for raising awareness by providing information on the weight-health connection and on community services. There was also strong support for growth assessment in pediatric care. In adults, there was strong support for wellness care/health check visits and episodic care to identify people for interventions, for group programs, and for additional provider education. Joint development by different teams proved useful for consensus on outcomes and for ensuring relevancy across practices. While priorities will vary depending on local context, the basic descriptions of care processes were endorsed by reviewers. Key next steps are to trial the use of the framework and for further implementation studies to find optimally effective approaches for obesity prevention and management across the lifespan.

Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as "family planning champions" increases referrals and uptake of family planning among HIV-infected mothers.

PubMed

Mudiope, Peter; Musingye, Ezra; Makumbi, Carolyne Onyango; Bagenda, Danstan; Homsy, Jaco; Nakitende, Mai; Mubiru, Mike; Mosha, Linda Barlow; Kagawa, Mike; Namukwaya, Zikulah; Fowler, Mary Glenn

2017-06-27

In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic. The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification and referral of HIV Positive mothers in need of FP services; and accompanied referred mothers to FP clinics. We compiled and compared the average proportions of mothers in need that were referred and took up FP in the pre-intervention (3 months), intervention (6 months), and post-intervention(3 months) periods using interrupted time series with segmented regression models with an autoregressive term of one. Overall, during the intervention, the proportion of referred mothers in need of FP increased by 30.4 percentage points (P < 0.001), from 52.7 to 83.2 percentage points. FP uptake among mothers in need increased by over 31 percentage points (P < 0.001) from 47.2 to 78.5 percentage points during the intervention. There was a positive non-significant change in the weekly trend of referral β 3  = 2.9 percentage points (P = 0.077) and uptake β 3  = 1.9 percentage points (P = 0.176) during the intervention as compared to the pre-intervention but this was reversed during the post intervention. Over 57% (2494) mothers took up Depo-Provera injectable-FP method during the study. To support overstrained health care work force in post-natal clinics, peers in trained effective family planning can be a valuable addition to clinic staff in limited-resource settings. The study provides additional evidence on the utilization of peer mothers in HIV care, improves health services uptake including family planning which is a common practice in many donor supported programs. It also provides evidence that may be used to advocate for policy revisions in low-income countries to include peers as support staff especially in busy clinic settings with poor services uptake.

Lung cancer, caring for the caregivers. A qualitative study of providing pro-active social support targeted to the carers of patients with lung cancer.

PubMed

Ryan, P J; Howell, V; Jones, J; Hardy, E J

2008-04-01

Carers of patients with lung cancer often have a short time to access the support they require. The Macmillan Carers Project (MCP) was set up to provide non-clinical social support targeted in the community to the carers of patients with lung cancer and this study describes its evaluation. Prospective case study using interviews with the carers, project workers and health and social care professionals to obtain qualitative data for thematic analysis. 81 patients' carers received support from the MCP; 20 carers, 2 MCP workers and their manager and 10 other professionals (chest consultant physician, lung cancer clinical nurse specialist, GP, four Macmillan nurses, hospice social worker and two community social workers) were interviewed. Patients were predominantly male (62%), mean age 71 years and carers were predominantly female (70%) mean age 63 years. Carers identified the MCP as providing emotional support, more time, practical help, financial advice, information and back-up for a myriad of problems. Although there was some overlap with other services, the MCP was valued by carers and professionals as filling a gap in social care. The unique aspect of this study was support targeted to the carers of a single cancer site (lung) rather than generic cancer support. As lung cancer may progress rapidly, patients and their carers have a short time to gather new information, access services and adjust to their new circumstances and roles. By focusing on the needs of carers from the time of lung cancer diagnosis, we have shown that the MCP was a valued additional service, well received by carers, patients and professionals.

Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)

PubMed Central

2014-01-01

Background Musculoskeletal pain is a major contributor to short and long term work absence. Patients seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with work issues. Providing a vocational case management service in primary care, to support patients with musculoskeletal problems to remain at or return to work, is one potential solution but requires robust evaluation to test clinical and cost-effectiveness. Methods/Design This protocol describes a cluster randomised controlled trial, with linked qualitative interviews, to investigate the effect of introducing a vocational advice service into general practice, to provide a structured approach to managing work related issues in primary care patients with musculoskeletal pain who are absent from work or struggling to remain in work. General practices (n = 6) will be randomised to offer best current care or best current care plus a vocational advice service. Adults of working age who are absent from or struggling to remain in work due to a musculoskeletal pain problem will be invited to participate and 330 participants will be recruited. Data collection will be through patient completed questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost per additional QALY gained and incremental net benefits. A linked interview study will explore the experiences of the vocational advice service from the perspectives of GPs, nurse practitioners (NPs), patients and vocational advisors. Discussion This paper presents the rationale, design, and methods of the Study of Work And Pain (SWAP) trial. The results of this trial will provide evidence to inform primary care practice and guide the development of services to provide support for musculoskeletal pain patients with work-related issues. Trial registration Current Controlled Trials ISRCTN52269669. PMID:25012813

Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669).

PubMed

Bishop, Annette; Wynne-Jones, Gwenllian; Lawton, Sarah A; van der Windt, Danielle; Main, Chris; Sowden, Gail; Burton, A Kim; Lewis, Martyn; Jowett, Sue; Sanders, Tom; Hay, Elaine M; Foster, Nadine E

2014-07-10

Musculoskeletal pain is a major contributor to short and long term work absence. Patients seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with work issues. Providing a vocational case management service in primary care, to support patients with musculoskeletal problems to remain at or return to work, is one potential solution but requires robust evaluation to test clinical and cost-effectiveness. This protocol describes a cluster randomised controlled trial, with linked qualitative interviews, to investigate the effect of introducing a vocational advice service into general practice, to provide a structured approach to managing work related issues in primary care patients with musculoskeletal pain who are absent from work or struggling to remain in work. General practices (n = 6) will be randomised to offer best current care or best current care plus a vocational advice service. Adults of working age who are absent from or struggling to remain in work due to a musculoskeletal pain problem will be invited to participate and 330 participants will be recruited. Data collection will be through patient completed questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost per additional QALY gained and incremental net benefits. A linked interview study will explore the experiences of the vocational advice service from the perspectives of GPs, nurse practitioners (NPs), patients and vocational advisors. This paper presents the rationale, design, and methods of the Study of Work And Pain (SWAP) trial. The results of this trial will provide evidence to inform primary care practice and guide the development of services to provide support for musculoskeletal pain patients with work-related issues. Current Controlled Trials ISRCTN52269669.

Psychosocial support services for family medicine resident physicians.

PubMed

Addison, Richard B; Riesenberg, Lee Ann; Rosenbaum, Paula

2004-02-01

The stress of residency is well documented. Some residency programs recognize the importance of addressing resident stress and provide psychosocial support services. This study assesses the current state of support services offered to family medicine residents and documents historical trends of support. All US family medicine residency programs were surveyed about program characteristics and the presence or absence of 21 psychosocial support services. The prevalence of current services was compared to that of 10 and 20 years ago. The percentage of family medicine programs offering 17 of 19 support services increased over the previous decades. However, percentages of some key services, especially those that address family life, are still quite low. Increases in services may be due to programs' desire to offer more positive and supportive educational experiences. Offering supportive and reflective opportunities may lessen stress, increase flexibility and balance, create enthusiasm for learning, encourage compassion for patients, and promote future well-being. In times of decreasing interest in family medicine, the presence of effective psychosocial support services may be important for attracting and training the best possible family physicians.

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

PubMed

English, Mike

2013-03-28

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. 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. 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 providing the necessary understanding, knowledge, and skills for mid-level managers to work effectively with senior managers and frontline staff to improve services. The intervention will include development of an information system, feedback mechanisms, and discussion fora that promote positive change. The vehicle for such an intervention is a collaborative network partnering government and national professional associations. This case is presented to promote discussion on approaches to developing context appropriate interventions particularly in international health.

Snohomish County Public Utility District Geothermal Energy Exploration Study Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lewis, Adam; Collar, Craig W.

2012-10-04

Supported by funds from this award, the District thoroughly explored the feasibility of a hydrothermal geothermal development within its service territory. The District successfully planned and drilled six exploratory geothermal wells and added significantly to the knowledge of the geology of the area. The Straight Creek Fault region, which was the sole location that showed significant potential for hydrothermal development in the District's service territory, was determined not to be feasible for development. The District subsequently expanded its search for geothermal development locations to include all of Washington State. Mount Baker has been identified as the area of the statemore » with the greatest potential for geothermal development. Having gathered additional information about the Mount Baker region with support from this award, the District is actively pursuing exploration and development in the area.« less

In-service and pre-service teacher education in IBSE: The ESTABLISH approach

NASA Astrophysics Data System (ADS)

Ješková, Zuzana; Kireš, Marián; McLoughlin, Eilish; Finlayson, Odilla; Ottander, Christina; Ekborg, Margareta

2016-05-01

One of the main goals of the ESTABLISH 7fp project (available on line at http://www.establish-fp7.eu/) was the development and implementation of the professional development teacher education programmes (TEP) to support teachers in adopting inquiry-based strategies in their teaching. Within the project there was a model for in-service and pre-service teacher training in IBSE designed and implemented across 12 participating countries. The programme is based on 4 core elements and 4 additional elements that are built around the IBSE teaching units developed within the project. As accepted by ESTABLISH partners, all teacher training programmes include the minimum of the four elements, i.e. introduction to IBSE, industrial content knowledge, teacher as implementer and teacher as developer of IBSE teaching materials. There are also four additional elements designed in detail, i.e. ICT for IBSE, argumentation in the classroom, research and design projects for students, assessment of IBSE. These can be added to the programme optionally with regard to the level of teachers' IBSE skills and current situation in education and teachers' professional development within the country. This ESTABLISH model of TEP was followed in participating countries in order to change teachers' attitudes from traditional ways of teaching towards adopting inquiry strategies and their successful implementation in the classroom. Within the face-to-face workshops teachers experienced and developed their inquiry based teaching strategies using specifically developed materials. In addition, the e-platform has been developed to provide on-line support. This platform provides educators and teachers with all the necessary materials for the training and IBSE teaching units and other teaching materials for teachers' ongoing help. The teacher training programme was successfully implemented in Slovakia. There were two runs of teacher training workshops on IBSE already carried out. Moreover, the additional element ICT in IBSE was developed more deeply designing a separate teacher training course for it. The contribution discusses in more details the success and problems of implementation in the context of Slovak educational environment.

Peer support: helping to influence cultural change.

PubMed

Whitmore, Mary

2015-02-01

Breastfeeding peer support schemes in Blackpool and Lancashire work closely with midwifery and other partners to offer additional support and encouragement to breastfeeding mothers. Employed and volunteer peer supporters deliver a systematic service in target areas delivering workshops to pregnant mothers, supporting new mothers in hospital, including in the neonatal units, in mothers' homes and in groups at children's centres. Working with health, children's centres, public health and councils, the peer supporters were instrumental in Fleetwood town agreeing to always welcome breastfeeding. They worked with teachers, public health and infant feeding coordinators to deliver a month-long breastfeeding campaign at a local college and, working with health visitors, have engaged with grandmothers to find out how they feel they can help support new mothers. Skilled supervision is essential to ensuring peer supporters work safely and continue to develop their skills and knowledge. Volunteer coordinators play a key role in valuing and organising volunteers.

Lunar lander ground support system

NASA Technical Reports Server (NTRS)

1991-01-01

The design of the Lunar Lander Ground Support System (LLGSS) is examined. The basic design time line is around 2010 to 2030 and is referred to as a second generation system, as lunar bases and equipment would have been present. Present plans for lunar colonization call for a phased return of personnel and materials to the moons's surface. During settlement of lunar bases, the lunar lander is stationary in a very hostile environment and would have to be in a state of readiness for use in case of an emergency. Cargo and personnel would have to be removed from the lander and transported to a safe environment at the lunar base. An integrated system is required to perform these functions. These needs are addressed which center around the design of a lunar lander servicing system. The servicing system could perform several servicing functions to the lander in addition to cargo servicing. The following were considered: (1) reliquify hydrogen boiloff; (2) supply power; and (3) remove or add heat as necessary. The final design incorporates both original designs and existing vehicles and equipment on the surface of the moon at the time considered. The importance of commonality is foremost in the design of any lunar machinery.

EnviroAtlas - Austin, TX - Tree Cover Configuration and Connectivity, Water Background Web Service

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://enviroatlas.epa.gov/EnviroAtlas). The EnviroAtlas Austin, TX tree cover configuration and connectivity map categorizes forest land cover into structural elements (e.g. core, edge, connector, etc.). In this community, Forest is defined as Trees & Forest (Trees & Forest - 40 = 1; All Else = 0). Water was considered background (value 129) during the analysis to create this dataset, however it has been converted into value 10 to distinguish it from land area background. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Service-Based Extensions to an OAIS Archive for Science Data Management

NASA Astrophysics Data System (ADS)

Flathers, E.; Seamon, E.; Gessler, P. E.

2014-12-01

With new data management mandates from major funding sources such as the National Institutes for Health and the National Science Foundation, architecture of science data archive systems is becoming a critical concern for research institutions. The Consultative Committee for Space Data Systems (CCSDS), in 2002, released their first version of a Reference Model for an Open Archival Information System (OAIS). The CCSDS document (now an ISO standard) was updated in 2012 with additional focus on verifying the authenticity of data and developing concepts of access rights and a security model. The OAIS model is a good fit for research data archives, having been designed to support data collections of heterogeneous types, disciplines, storage formats, etc. for the space sciences. As fast, reliable, persistent Internet connectivity spreads, new network-available resources have been developed that can support the science data archive. A natural extension of an OAIS archive is the interconnection with network- or cloud-based services and resources. We use the Service Oriented Architecture (SOA) design paradigm to describe a set of extensions to an OAIS-type archive: purpose and justification for each extension, where and how each extension connects to the model, and an example of a specific service that meets the purpose.

The COMPOSE Project

NASA Astrophysics Data System (ADS)

Balletta, P.; Biagini, M.; Gallinaro, G.; Vernucci, A.

2003-07-01

This paper provides an overview of the on-going project COMPOSE, an EC co-funded project aiming to define, specify and validate an innovative mobile-services scenario in support of travellers, and to demonstrate the effectiveness of the new proposed location-based value-added services. COMPOSE is supported by organisations belonging to numerous categories covering, as a whole, the entire value-chain of infomobility services provision to the final user. The project team comprises, in addition to the affiliations of the authors, also Teleatlas (NL), ARS T&TT (NL), Alcatel-Bell Space (B), Skysoft (P), Hitech Marketing (A) and MobileGis (IR). The paper describes the services that will be offered to users, encompassing both the pre-trip and the on-trip framework, presents the overall hybrid system architecture also including a via-satellite component based upon the Wideband-CDMA (W-CDMA) technique adopted in UMTS, discusses the access solutions envisaged for that component permitting multiple feeder-link stations to share the CDMA multiplex capacity by directly transmitting their codes to the satellite, and illustrates the results of some computer simulations intended to assess the performance of said access solutions, with regard to the effects of the inevitable up- link frequency errors and transponder non-linearity.

Project success: A methodological and evaluative case study of the early alert program interventions

NASA Astrophysics Data System (ADS)

Larkins, Randy James

The purpose of this study was twofold. First, to methodologically examine the use of three types of focus groups 1), traditional face-to face, 2), online video and audio, and 3) online text only. Second, to examine the impact of academic intervention attempts offered by university and department support services. Methodologically, the three types of focus groups were compared in terms of ease of use, comfort, richness of data and ethical considerations. Contextually, support services for a general chemistry course taken primarily by new students were examined using an evaluation method involving effort, monitoring, process, component and treatment specification types of implementation. For this research, fourteen students enrolled in the general chemistry course at Rocky Mountain University in fall term 2014 participated in one of the three types of focus groups to discuss support services for the course. Since the increase of technological advances in the late twentieth century, the use of electronic focus groups has been viewed as a viable alternative to traditional in-person meetings. However, different methods within a methodology might produce different results for both students and researchers. This study inspected differences in ease of use for participants and the researcher, comfort in terms of using technology and in discussing academic issues and support services, richness of the data, and ethical issues surrounding privacy and confidentiality. For this case study, methodological findings were that in-person groups still had relevance in this age of advanced technology. Audio-video groups were more limited than in-person groups in terms of interaction and administration, while text-only groups were easiest to transcribe, but seemed to be the most limited in terms of all other aspects of the research. Finally, ethical concerns were not considered important by members in any group; therefore, it is incumbent on the researcher to provide the best ethical environment possible in whatever form the focus group takes place. Suggestions for future research include recruiting participants from online classes and attempting to engage more disenfranchised students in other studies. Similar to new types of focus group methods due to technological advances, academic interventions for students facing failing grades are also increasing due to the internet and new methods of service delivery. The contextual aspect of this research involved asking students to participate in an initial focus group session, four weeks of email updates, and a final focus group session in which students participated in the same group as the initial session. The purpose of the focus groups was to evaluate whether or not the universities' attempts to help students succeed in a course known in the past for high failure rates through a program known as the Early Alert Project was succeeding. Interview data were analyzed using thematic coding to evaluate available support services using a comprehensive implementation evaluation model which included effort, monitoring, process, components; and treatment specification. The primary findings were although students believed the university was trying to help them succeed, Early Alert Project efforts were adversely received. In addition, participants felt that although there were enough support services to help them succeed in the course, the components of the support system were confusing and not organized in any systematic manner. Suggestions for further research included researching delivery of this type of communication that might be more amenable to the students who received it and applying this research to other courses to examine whether the same results occur. Finally, implications of the use of traditional methods and academic support services are discussed in addition to the effect of the research itself upon its participants.

Modeling Adaptable Business Service for Enterprise Collaboration

NASA Astrophysics Data System (ADS)

Boukadi, Khouloud; Vincent, Lucien; Burlat, Patrick

Nowadays, a Service Oriented Architecture (SOA) seems to be one of the most promising paradigms for leveraging enterprise information systems. SOA creates opportunities for enterprises to provide value added service tailored for on demand enterprise collaboration. With the emergence and rapid development of Web services technologies, SOA is being paid increasing attention and has become widespread. In spite of the popularity of SOA, a standardized framework for modeling and implementing business services are still in progress. For the purpose of supporting these service-oriented solutions, we adopt a model driven development approach. This paper outlines the Contextual Service Oriented Modeling and Analysis (CSOMA) methodology and presents UML profiles for the PIM level service-oriented architectural modeling, as well as its corresponding meta-models. The proposed PIM (Platform Independent Model) describes the business SOA at a high level of abstraction regardless of techniques involved in the application employment. In addition, all essential service-specific concerns required for delivering quality and context-aware service are covered. Some of the advantages of this approach are that it is generic and thus not closely allied with Web service technology as well as specifically treating the service adaptability during the design stage.

20 CFR 663.800 - What are supportive services for adults and dislocated workers?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated workers? Supportive...

20 CFR 663.800 - What are supportive services for adults and dislocated workers?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are supportive services for adults and..., DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Supportive Services § 663.800 What are supportive services for adults and dislocated workers? Supportive...

What factors influence the decisions of mental health professionals to release service users from seclusion?

PubMed

Jackson, Haley; Baker, John; Berzins, Kathyrn

2018-06-22

Mental health policy stipulates seclusion should only be used as an intervention of last resort and for the minimum possible duration. Current evidence details which service users are more likely to be secluded, why they are secluded, and what influences the decision to seclude them. However, very little is known about the decision to release service users from seclusion. An integrative review was undertaken to explore the decision-making processes of mental health professionals which guide the ending of seclusion. The review used a systematic approach to gather and thematically analyse evidence within a framework approach. The twelve articles identified generated one overriding theme, maintaining safety. In addition, several subthemes emerged including the process of risk assessing which was dependent upon interaction and control, mediated by factors external to the service user such as the attitude and experience of staff and the acuity of the environment. Service users were expected to demonstrate compliance with the process ultimately ending in release and reflection. Little evidence exists regarding factors influencing mental health professionals in decisions to release service users from seclusion. There is no evidence-based risk assessment tool, and service users are not routinely involved in the decision to release them. Support from experienced professionals is vital to ensure timely release from seclusion. Greater insight into influences upon decisions to discontinue episodes may support initiatives aimed at reducing durations and use of seclusion. © 2018 Australian College of Mental Health Nurses Inc.

Employment Outcomes of Chemical Dependency Treatment and Additional Vocational Services Publicly Funded by Washington State. A Four-and-a-Half Year Follow-up Study of Indigent Persons served by Washington State's Alcoholism and Drug Addiction Treatment and Support Act (ADATSA). Key Findings. Briefing Paper.

ERIC Educational Resources Information Center

Brown, Marsha; Longhi, Dario; Luchansky, Bill

In 1987, the state of Washington created a program--the Alcohol and Drug Addiction Treatment and Support Act (ADATSA)--to treat adults addicted to alcohol or other drugs. This paper sows the results of a four-and-a-half year follow-up study of clients receiving treatment and reviews the effectiveness of ADATSA. Whereas the immediate goal of the…

The role of non-governmental organizations in the social and the health system.

PubMed

Piotrowicz, Maria; Cianciara, Dorota

2013-01-01

The article presents the definitions, objectives, fields and tasks of non-governmental organizations in social life, health system and health policy. In addition, the article addresses the issue of effectiveness and quality of NGOs' activity. The term "NGOs" (Non-governmental Organizations) includes different categories of entities that operate not to obtain financial gain, and also do not belong to the government sector. Non-governmental Organizations' fields of activity were described in the International Classification of Non-Profit Organizations (ICNPO). NGOs are an integral part of a democratic society. Sociological sciences emphasize their importance in enhancing social integration, implementation of the principle of subsidiarity, building civil society, social dialogue and participatory democracy. The main tasks of NGOs in the health system are providing services and health advocacy. Provision of services includes medical, social and psychological services as well as, integration activities, care and nursing, material and financial support, educational and information services and training. Health advocacy is a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program. An important task carried out by NGOs is participation in the formation of health policy. The increasing role of NGOs in providing social services and the participation in political processes, result in the need to confirm the validity and credibility of their operation. One of the ways could be to introduce the mechanisms to assess quality and efficiency, such as registration as a part of a legal system, self-regulatory activities (card rules, codes of ethics), certification, participation in networks, monitoring and audit.

Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

PubMed Central

Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

2006-01-01

Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

Support as a complement, intrusion and right--evidence from ageing and disability support service users in Sweden and Australia.

PubMed

Laragy, Carmel; Fisher, Karen R; Cedersund, Elisabet; Campbell-McLean, Carolyn

2011-12-01

How service users conceptualise their personal support services is under researched, even though this understanding is important for responsive policy development and service implementation. This paper tests the proposition that service users understand formal support in three ways: support is a complement to their other arrangements, an intrusion into their personal life and a right. These three concepts were identified using discourse analysis in a Swedish study of older people wanting in-home support services. To test generalisability of these concepts, they were applied to data from an Australian study of people using disability personal support. The analysis found that the three concepts were core to people's views of their support, although the construction of the concepts differed in the two countries. Service users in Sweden asserted their right to services more forcefully than those in Australia, and they had higher expectations that their support needs would be met. These differences reflect the impact of each country's social policy environment on service users' expectations. The analysis suggests that service users and their families want to control their formal support arrangements to complement their informal care and their life preferences and to minimise the intrusive aspects of formal support. The findings imply that the three concepts have utility for theorising service users' perspectives, informing policy and developing implementation strategies which enhance peoples' quality of life. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

A coastal information system to propel emerging science and ...

EPA Pesticide Factsheets

The Estuary Data Mapper (EDM) is a free, interactive virtual gateway to coastal data aimed to promote research and aid in environmental management. The graphical user interface allows users to custom select and subset data based on their spatial and temporal interests giving them easy access to visualize, retrieve, and save data for further analysis. Data are accessible across estuarine systems of the Atlantic, Gulf of Mexico and Pacific regions of the United States and includes: (1) time series data including tidal, hydrologic, and weather, (2) water and sediment quality, (3) atmospheric deposition, (4) habitat, (5) coastal exposure indices, (6) historic and projected land-use and population, (7) historic and projected nitrogen and phosphorous sources and load summaries. EDM issues Web Coverage Service Interface Standard queries (WCS; simple, standard one-line text strings) to a public web service to quickly obtain data subsets by variable, for a date-time range and area selected by user. EDM is continuously being enhanced with updated data and new options. Recent additions include a comprehensive suite of nitrogen source and loading data, and inputs for supporting a modeling approach of seagrass habitat. Additions planned for the near future include 1) support for Integrated Water Resources Management cost-benefit analysis, specifically the Watershed Management Optimization Support Tool and 2) visualization of the combined effects of climate change, land-use a

Estuary Data Mapper: A coastal information system to propel ...

EPA Pesticide Factsheets

The Estuary Data Mapper (EDM) is a free, interactive virtual gateway to coastal data aimed to promote research and aid in environmental management. The graphical user interface allows users to custom select and subset data based on their spatial and temporal interests giving them easy access to visualize, retrieve, and save data for further analysis. Data are accessible across estuarine systems of the Atlantic, Gulf of Mexico and Pacific regions of the United States and includes: (1) time series data including tidal, hydrologic, and weather, (2) water and sediment quality, (3) atmospheric deposition, (4) habitat, (5) coastal exposure indices, (6) historic and projected land-use and population, (7) historic and projected nitrogen and phosphorous sources and load summaries. EDM issues Web Coverage Service Interface Standard queries (WCS; simple, standard one-line text strings) to a public web service to quickly obtain data subsets by variable, for a date-time range and area selected by user. EDM is continuously being enhanced with updated data and new options. Recent additions include a comprehensive suite of nitrogen source and loading data, and inputs for supporting a modeling approach of seagrass habitat. Additions planned for the near future include 1) support for Integrated Water Resources Management cost-benefit analysis, specifically the Watershed Management Optimization Support Tool and 2) visualization of the combined effects of climate change, land-use a

47 CFR 54.523 - Payment for the non-discount portion of supported services.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Schools and Libraries § 54.523 Payment for the non-discount portion of supported services. An eligible school, library, or... discounts. An eligible school, library, or consortium may not receive rebates for services or products...

47 CFR 54.523 - Payment for the non-discount portion of supported services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Schools and Libraries § 54.523 Payment for the non-discount portion of supported services. An eligible school, library, or... discounts. An eligible school, library, or consortium may not receive rebates for services or products...