Victoria's Child FIRST and IFS differential response system: progress and issues.

PubMed

Lonne, Bob; Brown, Gerry; Wagner, Ingrid; Gillespie, Kerri

2015-01-01

Differential response has long been utilized by statutory child protection systems in Australia. This article describes the advent and history of Victoria's differential response system, with a particular focus on the Child FIRST and IFS programme. This program entails a partnership arrangement between the Department of Human Services child protection services and community-based, not-for-profit agencies to provide a diverse range of early intervention and prevention services. The findings of a recent external service system evaluation, a judicial inquiry, and the large-scale Child and Family Services Outcomes Survey of parents/carers perspectives of their service experiences are used to critically examine the effectiveness of this differential response approach. Service-user perspectives of the health and wellbeing of children and families are identified, as well as the recognized implementation issues posing significant challenges for the goal of an integrated partnership system. The need for ongoing reform agendas is highlighted along with the policy, program and structural tensions that exist in differential response systems, which are reliant upon partnerships and shared responsibilities for protecting children and assisting vulnerable families. Suggestions are made for utilizing robust research and evaluation that gives voice to service users and promotes their rights and interests. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quality of service routing in the differentiated services framework

NASA Astrophysics Data System (ADS)

Oliveira, Marilia C.; Melo, Bruno; Quadros, Goncalo; Monteiro, Edmundo

2001-02-01

In this paper we present a quality of service routing strategy for network where traffic differentiation follows the class-based paradigm, as in the Differentiated Services framework. This routing strategy is based on a metric of quality of service. This metric represents the impact that delay and losses verified at each router in the network have in application performance. Based on this metric, it is selected a path for each class according to the class sensitivity to delay and losses. The distribution of the metric is triggered by a relative criterion with two thresholds, and the values advertised are the moving average of the last values measured.

Contracting in the National Health Service (NHS): recognizing the need for co-operation.

PubMed

Joslyn, E

1997-05-01

Within the reorganized National Health Service hierarchical relationships between Health Authorities and Trusts have been replaced by functional differentiation. However, differentiation of function cannot be seen as an end in itself and management of the relationship between purchasers and providers must include managing the differentiation as well as the function. This paper suggests that collaborative and administrative activities have a distinct role to play in health service management. The paper suggests that in health service management market strategies are likely to dominate in relation to resource allocation activities. The paper also argues that administrative strategies are likely to be necessary within the internal market system--to bridge the gap resulting from the differentiation of function.

Hospital image and the positioning of service centers: an application in market analysis and strategy development.

PubMed

Smith, S M; Clark, M

1990-09-01

The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.

The Effect of Military Enlistment on Earnings and Education

DTIC Science & Technology

2011-01-01

to compensate individuals for their sacrifice and service (a “compensating wage differential ”). We do not directly test these alternative hypotheses...earnings effects are attributable to a compensating wage differential . For Category I and II enlistees, it seems likely that this differential explains...the need for the military to pay a compensating wage differential to attract young men and women to endure the hardships of military service. Some of

Future-proofing the pharmacy profession in a hypercompetitive market.

PubMed

Singleton, Judith A; Nissen, Lisa M

2014-01-01

This paper highlights the hypercompetitive nature of the current pharmacy landscape in Australia and to suggest either a superior level of differentiation strategy or a focused differentiation strategy targeting a niche market as two viable, alternative business models to cost leadership for small, independent community pharmacies. A description of the Australian health care system is provided as well as background information on the current community pharmacy environment in Australia. The authors propose a differentiation or focused differentiation strategy based on cognitive professional services (CPS) which must be executed well and of a superior quality to competitors' services. Market research to determine the services valued by target customers and that they are willing to pay for is vital. To achieve the superior level of quality that will engender high patient satisfaction levels and loyalty, pharmacy owners and managers need to develop, maintain and clearly communicate service quality specifications to the staff delivering these services. Otherwise, there will be a proliferation of pharmacies offering the same professional services with no evident service differential. However, to sustain competitive advantage over the long-term, these smaller, independent community pharmacies will need to exploit a broad core competency base in order to be able to continuously introduce new sources of competitive advantage. With the right expertise, the authors argue that smaller, independent community pharmacies can successfully deliver CPS and sustain profitability in a hypercompetitive market. Copyright © 2014 Elsevier Inc. All rights reserved.

Industry structures in private dental markets in Finland.

PubMed

Widström, E; Mikkola, H

2012-12-01

To use industrial organisation and organisational ecology research methods to survey industry structures and performance in the markets for private dental services and the effect of competition. Data on practice characteristics, performance, and perceived competition were collected from full-time private dentists (n = 1,121) using a questionnaire. The response rate was 59.6%. Cluster analysis was used to identify practice type based on service differentiation and process integration variables formulated from the questionnaire. Four strategic groups were identified in the Finnish markets: Solo practices formed one distinct group and group practices were classified into three clusters Integrated practices, Small practices, and Loosely integrated practices. Statistically significant differences were found in performance and perceived competitiveness between the groups. Integrated practices with the highest level of process integration and service differentiation performed better than solo and small practices. Moreover, loosely integrated and small practices outperformed solo practises. Competitive intensity was highest among small practices which had a low level of service differentiation and was above average among solo practises. Private dental care providers that had differentiated their services from public services and that had a high number of integrated service production processes enjoyed higher performance and less competitive pressures than those who had not.

Understanding the Impact of Organizational Differentiation in High-Poverty Schools with Alternative Models of Title I Service Delivery.

ERIC Educational Resources Information Center

Meyer, Stephen J.

American public schools historically have used a range of differentiating mechanisms to meet the needs of diverse groups of students. Examples from Title I service delivery include pullout, in-class, add-on, and replacement programs. These models have elements that differentiate the educational experience of Title I students to varying degrees and…

Discovering new points of differentiation.

PubMed

MacMillan, I C; McGrath, R G

1997-01-01

Most profitable strategies are built on differentiation: offering customers something they value that competitors don't have. But most companies concentrate only on their products or services. In fact, a company can differentiate itself every point where it comes in contact with its customers--from the moment customers realize they need a product or service to the time when they dispose of it. The authors believe that if companies open up their thinking to their customer's entire experience with a product or service--the consumption chain--they can uncover opportunities to position their offerings in ways that neither they nor their competitors though possible. The authors show how even a mundane product such as candles can be successfully differentiated. By analyzing its customers' experiences and exploring various options, Blyth Industries, for example, has grown from a $2 million U.S. candle manufacturer into a global candle and accessory business with nearly $500 million in sales and a market value of $1.2 billion. Finding ways to differentiate one's company is a skill that can be nurtured, the authors contend. In this Manager's Tool Kit, they have designed a two-part approach that can help companies continually identify new points of differentiation and develop the ability to generate successful differentiation strategies. "Mapping the Consumption Chain" captures the customer's total experience with a product or service. "Analyzing Your Customer's Experience" shows managers how directed brainstorming about each step in the consumption chain can elicit numerous ways to differentiate any offering.

Effect of organizational and environmental factors on service differentiation strategy of integrated healthcare networks.

PubMed

Lin, Y J; Wan, T T

2001-02-01

During the past decade, the missions/goals of medical providers of healthcare services in the United States have shifted--from emphasizing individual, independent illness treatments to focusing on the continuum of care, population-based wellness, and providing the appropriate care in the most efficient way. Integrated healthcare networks (IHNs)--or integrated healthcare delivery systems--have been focusing heavily on their level of various partnership integration (i.e. service differentiation strategy) in order to offer a full continuum of care. The aim of this study, using the individual IHN as the unit of analysis, was to identify organizational and environmental factors that influence IHN administrators to focus on their service differentiation of market lines, including the establishment of third-party payers' contracts, the affiliation of managed-care organizations, and the alliances of various nonhospital medical providers, to provide a continuum of care. The study findings show that tax status of an IHN, its age, and market competition affect its service differentiation strategy in the provision of a full continuum of care.

Site selection plan and installation guidelines for a nationwide differential GPS service

DOT National Transportation Integrated Search

1997-08-05

The Global Positioning System (GPS), in its current form, is used within the transportation industry for vehicle tracking and navigation. With the advent of a nationwide differential GPS (DGPS) service, this role will expand to include public safety,...

47 CFR 87.151 - Special requirements for differential GPS receivers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Special requirements for differential GPS receivers. 87.151 Section 87.151 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES Technical Requirements § 87.151 Special requirements for...

On service differentiation in mobile Ad Hoc networks.

PubMed

Zhang, Shun-liang; Ye, Cheng-qing

2004-09-01

A network model is proposed to support service differentiation for mobile Ad Hoc networks by combining a fully distributed admission control approach and the DIFS based differentiation mechanism of IEEE802.11. It can provide different kinds of QoS (Quality of Service) for various applications. Admission controllers determine a committed bandwidth based on the reserved bandwidth of flows and the source utilization of networks. Packets are marked when entering into networks by markers according to the committed rate. By the mark in the packet header, intermediate nodes handle the received packets in different manners to provide applications with the QoS corresponding to the pre-negotiated profile. Extensive simulation experiments showed that the proposed mechanism can provide QoS guarantee to assured service traffic and increase the channel utilization of networks.

DS-MAC: differential service medium access control design for wireless medical information systems.

PubMed

Yuan, Xiaojing; Bagga, Sumegha; Shen, Jian; Balakrishnan, M; Benhaddou, D

2008-01-01

The integration of wireless networking technologies with medical information systems (telemedicine) have a significant impact on healthcare services provided to our society. Applications of telemedicine range from personalized medicine to affordable healthcare for underserved population. Though wireless technologies and medical informatics are individually progressing rapidly, wireless networking for healthcare systems is still at a very premature stage. In this paper we first present our open architecture for medical information systems that integrates both wired and wireless networked data acquisition systems. We then present the implementation at the physical layer and differential service MAC design that adapts channel provisioning based on the information criticality. Performance evaluation using analytical modeling and simulation shows that our DS-MAC provides differentiated services for emergency, warning, and normal traffic.

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.

47 CFR 87.139 - Emission limitations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... lines through the above points. (j) When using G7D for differential GPS in the 112-118 MHz band, the... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES... in the frequency bands 1435-1535 MHz and 2310-2390 MHz or digital modulation (G7D) for differential...

47 CFR 87.139 - Emission limitations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... lines through the above points. (j) When using G7D for differential GPS in the 112-118 MHz band, the... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES AVIATION SERVICES... in the frequency bands 1435-1535 MHz and 2310-2390 MHz or digital modulation (G7D) for differential...

End-to-End QoS for Differentiated Services and ATM Internetworking

NASA Technical Reports Server (NTRS)

Su, Hongjun; Atiquzzaman, Mohammed

2001-01-01

The Internet was initially design for non real-time data communications and hence does not provide any Quality of Service (QoS). The next generation Internet will be characterized by high speed and QoS guarantee. The aim of this paper is to develop a prioritized early packet discard (PEPD) scheme for ATM switches to provide service differentiation and QoS guarantee to end applications running over next generation Internet. The proposed PEPD scheme differs from previous schemes by taking into account the priority of packets generated from different application. We develop a Markov chain model for the proposed scheme and verify the model with simulation. Numerical results show that the results from the model and computer simulation are in close agreement. Our PEPD scheme provides service differentiation to the end-to-end applications.

Keeping the medical practice financially viable: a marketer's approach.

PubMed

Patrick, Michelle L; Capraro, Anthony J; Credito, Candace M

2002-01-01

This paper explores a way that medical practices might develop a higher margin revenue source by offering a differentiated service that caters to patients who value more personalized service. Using SERVQUAL, German patients were surveyed to determine if there is a relationship between a desire for personalized service and a willingness to pay a premium for medical care. The results indicate that a greater desire for personalized care distinguishes those who pay a premium for medical care from those who do not. This suggests that medical practices can differentiate their service based on more personalized care and charge a higher fee for this service.

7 CFR 52.51 - Charges for inspection services on a contract basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 40 hours per week for each inspector assigned to perform the inspection services in accordance with... assigned at their regular hourly rate. When work is performed, an additional hour at the regular hourly rate will be charged for each hour worked. (4) Night differential. A 10 percent night differential...

The Effects of Differentiated Instruction Support Inclusion Services on Fifth Grade Reading/Language Arts Achievement

ERIC Educational Resources Information Center

Wendt, Stephanie L.

2012-01-01

Using a causal-comparative research design, this study investigated the effectiveness of Differentiated Instruction Support Inclusion Services on fifth grade regular education and gifted students' Reading/Language Arts achievement. The study analyzed and compared the achievement of the regular education students who received no inclusion support…

Service differentiated and adaptive CSMA/CA over IEEE 802.15.4 for Cyber-Physical Systems.

PubMed

Xia, Feng; Li, Jie; Hao, Ruonan; Kong, Xiangjie; Gao, Ruixia

2013-01-01

Cyber-Physical Systems (CPS) that collect, exchange, manage information, and coordinate actions are an integral part of the Smart Grid. In addition, Quality of Service (QoS) provisioning in CPS, especially in the wireless sensor/actuator networks, plays an essential role in Smart Grid applications. IEEE 802.15.4, which is one of the most widely used communication protocols in this area, still needs to be improved to meet multiple QoS requirements. This is because IEEE 802.15.4 slotted Carrier Sense Multiple Access/Collision Avoidance (CSMA/CA) employs static parameter configuration without supporting differentiated services and network self-adaptivity. To address this issue, this paper proposes a priority-based Service Differentiated and Adaptive CSMA/CA (SDA-CSMA/CA) algorithm to provide differentiated QoS for various Smart Grid applications as well as dynamically initialize backoff exponent according to traffic conditions. Simulation results demonstrate that the proposed SDA-CSMA/CA scheme significantly outperforms the IEEE 802.15.4 slotted CSMA/CA in terms of effective data rate, packet loss rate, and average delay.

Service Differentiated and Adaptive CSMA/CA over IEEE 802.15.4 for Cyber-Physical Systems

PubMed Central

Gao, Ruixia

2013-01-01

Cyber-Physical Systems (CPS) that collect, exchange, manage information, and coordinate actions are an integral part of the Smart Grid. In addition, Quality of Service (QoS) provisioning in CPS, especially in the wireless sensor/actuator networks, plays an essential role in Smart Grid applications. IEEE 802.15.4, which is one of the most widely used communication protocols in this area, still needs to be improved to meet multiple QoS requirements. This is because IEEE 802.15.4 slotted Carrier Sense Multiple Access/Collision Avoidance (CSMA/CA) employs static parameter configuration without supporting differentiated services and network self-adaptivity. To address this issue, this paper proposes a priority-based Service Differentiated and Adaptive CSMA/CA (SDA-CSMA/CA) algorithm to provide differentiated QoS for various Smart Grid applications as well as dynamically initialize backoff exponent according to traffic conditions. Simulation results demonstrate that the proposed SDA-CSMA/CA scheme significantly outperforms the IEEE 802.15.4 slotted CSMA/CA in terms of effective data rate, packet loss rate, and average delay. PMID:24260021

Timely and Needed Perspectives on Differential Response in Child Protective Services

ERIC Educational Resources Information Center

Ellett, Alberta J.

2013-01-01

This article is an invited commentary and analysis of the authors' completed systematic evaluation of Child Protective Services (CPS) differential response (DR) models. I write this commentary based on 25 years of public child welfare experience followed by 13 years as a social work professor and researcher. In their review of DR, the…

Differentiated Instruction at Work. Reinforcing the Art of Classroom Observation through the Creation of a Checklist for Beginning and Pre-Service Teachers

ERIC Educational Resources Information Center

Subban, Pearl; Round, Penny

2015-01-01

Professional experience is viewed as integral to shaping philosophy and acquiring skills in the area of classroom teaching. Classrooms are complex places, with educators implementing differentiated strategies to cater for student diversity. Pre-service teachers who observe these lessons often miss the intuitive practices, as there is much to…

Changes in Low-Value Services in Year 1 of the Medicare Pioneer Accountable Care Organization Program.

PubMed

Schwartz, Aaron L; Chernew, Michael E; Landon, Bruce E; McWilliams, J Michael

2015-11-01

Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services. To assess whether the first year of the Medicare Pioneer ACO program was associated with a reduction in use of low-value services. In a difference-in-differences analysis, we compared use of low-value services between Medicare fee-for-service beneficiaries attributed to health care provider groups that entered the Pioneer program (ACO group) and beneficiaries attributed to other health care providers (control group) before (2009-2011) vs after (2012) Pioneer ACO contracts began. Data analysis was conducted from December 1, 2014, to June 27, 2015. Comparisons were adjusted for beneficiaries' sociodemographic and clinical characteristics as well as for geography. We decomposed estimates according to service characteristics (clinical category, price, and sensitivity to patient preferences) and compared estimates between subgroups of ACOs with higher vs lower baseline use of low-value services. Use of, and spending on, 31 services in instances that provide minimal clinical benefit, measured as annual service counts per 100 beneficiaries and price-standardized annual service spending per 100 beneficiaries. During the precontract period, trends in the use of low-value services were similar for the ACO and control groups. The first year of ACO contracts was associated with a differential reduction (95% CI) of 0.8 low-value services per 100 beneficiaries for the ACO group (-1.2 to -0.4; P < .001), corresponding to a 1.9% differential reduction in service quantity (-2.9% to -0.9%) and a 4.5% differential reduction in spending on low-value services (-7.5% to -1.4%; P = .004). Differential reductions were similar for services less sensitive vs more sensitive to patient preferences and for higher- vs lower-priced services. The ACOs with higher than their markets' mean baseline levels of low-value service use experienced greater service reductions (-1.2 services per 100 beneficiaries; -1.7 to -0.7; P < .001) than did ACOs with use below the mean (-0.2 services per 100 beneficiaries, -0.6 to -0.2; P = .41; P = .003 for test of difference between subgroups). During its first year, the Pioneer ACO program was associated with modest reductions in low-value services, with greater reductions for organizations providing more low-value care. Accountable care organization-like risk contracts may be able to discourage use of low-value services even without specifying services to target.

Does Head Start differentially benefit children with risks targeted by the program’s service model?☆

PubMed Central

Miller, Elizabeth B.; Farkas, George; Duncan, Greg J.

2015-01-01

Data from the Head Start Impact Study (N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program’s comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children’s pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed. PMID:26379369

5 CFR 575.114 - Recruitment bonus service agreements in effect before May 1, 2005.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Recruitment bonus service agreements in... MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT INCENTIVES Recruitment Incentives § 575.114 Recruitment bonus service...

The health status of adolescents in Ecuador and the country's response to the need for differentiated healthcare for adolescents.

PubMed

Svanemyr, Joar; Guijarro, Susana; Riveros, Betzabe Butron; Chandra-Mouli, Venkatraman

2017-02-28

Adolescents face a range of health problems but many barriers block their access to health services, and in particular to sexual and reproductive health services. The objective of this study was to assess the health needs of adolescents in Ecuador and to draw lessons from the ways the country has responded to their need for differentiated care. We conducted a literature review and consulted key stakeholders. Adolescents in Ecuador today have a wide range of health care needs, in particular related to sexual and reproductive health. A major concern is the high rates of adolescent pregnancy. A national programme was established in 2007 to offer differentiated health care for adolescents-an effort that featured specially trained staff, enclaved facilities, respect for adolescents' privacy and confidentiality, a friendly atmosphere, and a dedication to establishing trust. It resulted in rapid increases in visits by young persons both for preventive and curative services. In 2011, the government initiated a model for "integrated family and community health care" which led to a disruption of the central support for capacity building and follow-up of adolescent friendly services. The Ecuadorian experience has demonstrated the need for institutionalised differentiated care for adolescents who are facing a wide range of health issues.

21 CFR 866.2320 - Differential culture medium.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Differential culture medium. 866.2320 Section 866.2320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2320 Differential culture...

21 CFR 866.2320 - Differential culture medium.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Differential culture medium. 866.2320 Section 866.2320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2320 Differential culture...

21 CFR 866.2320 - Differential culture medium.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Differential culture medium. 866.2320 Section 866.2320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2320 Differential culture...

21 CFR 866.2320 - Differential culture medium.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Differential culture medium. 866.2320 Section 866.2320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2320 Differential culture...

21 CFR 866.2320 - Differential culture medium.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Differential culture medium. 866.2320 Section 866.2320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2320 Differential culture...

Investigating Pre-service Science Teachers' Developing Professional Knowledge Through the Lens of Differentiated Instruction

NASA Astrophysics Data System (ADS)

Goodnough, Karen

2010-03-01

In this study, the author implemented a problem-based learning (PBL) experience that allowed students in an advanced science methodology course to explore differentiated instruction. Through working systematically in small, collaborative groups, students explored the nature of differentiated instruction. The objective of the study was to examine pre-service teachers’ developing conceptions of differentiated instruction (DI) as a way to teach for diversity. The author adopted action research as a strategy to explore students’ perceptions of DI in the context of science teaching and learning. Several data collection methods and sources were adopted in the study, including student-generated products, student interviews, classroom observation, and journal writing. Outcomes report on students’ perceptions of both the potential and challenges associated with adopting a DI approach to science teaching and learning.

A call for differentiated approaches to delivering HIV services to key populations.

PubMed

Macdonald, Virginia; Verster, Annette; Baggaley, Rachel

2017-07-21

Key populations (KPs) are disproportionally affected by HIV and have low rates of access to HIV testing and treatment services compared to the broader population. WHO promotes the use of differentiated approaches for reaching and recruiting KP into the HIV services continuum. These approaches may help increase access to KPs who are often criminalized or stigmatized. By catering to the specific needs of each KP individual, differentiated approaches may increase service acceptability, quality and coverage, reduce costs and support KP members in leading the HIV response among their communities. WHO recommends the implementation of community-based and lay provider administered HIV testing services. Together, these approaches reduce barriers and costs associated with other testing strategies, allow greater ownership in HIV programmes for KP members and reach more people than do facility-based services. Despite this evidence availability and support for them is limited. Peer-driven interventions have been shown to be effective in engaging, recruiting and supporting clients. Some programmes employ HIV-positive or non-PLHIV "peer navigators" and other staff to provide case management, enrolment and/or re-enrolment in care and treatment services. However, a better understanding of the impact, cost effectiveness and potential burden on peer volunteers is required. Task shifting and non-facility-based service locations for antiretroviral therapy (ART) initiation and maintenance and antiretroviral (ARV) distribution are recommended in both the consolidated HIV treatment and KP guidelines of WHO. These approaches are accepted in generalized epidemics and for the general population where successful models exist; however, few organizations provide or initiate ART at KP community-based services. The application of a differentiated service approach for KP could increase the number of people who know their status and receive effective and sustained prevention and treatment for HIV. However, while community-based and lay provider testing are effective and affordable, they are not implemented to scale. Furthermore regulatory barriers to legitimizing lay and peer providers as part of healthcare delivery systems need to be overcome in many settings. WHO recommendations on task shifting and decentralization of ART treatment and care are often not applied to KP settings.

Customer service: the key to market differentiation.

PubMed

Stahl, D A

1997-06-01

Fierce competition in the subacute care environment makes customer service orientation essential. Four steps help to achieve quality customer service are: (1) institute core values; (2) identify your customers; (3) understand human resources; and (4) establish an efficient system.

Analyzing a Service-Learning Experience Using a Social Justice Lens

ERIC Educational Resources Information Center

Tinkler, Barri; Hannah, C. Lynne; Tinkler, Alan; Miller, Elizabeth

2014-01-01

This mixed methods study explores a service-learning experience embedded in a social foundations course in a teacher education program. The authors differentiate learning outcomes for social justice and charity service-learning, and utilize this framework to examine whether the service-learning experience fosters a social justice perspective. The…

Boosting ART uptake and retention among HIV-infected pregnant and breastfeeding women and their infants: the promise of innovative service delivery models.

PubMed

Srivastava, Meena; Sullivan, David; Phelps, B Ryan; Modi, Surbhi; Broyles, Laura N

2018-01-01

With the rapid scale-up of antiretroviral treatment (ART) in the "Treat All" era, there has been increasing emphasis on using differentiated models of HIV service delivery. The gaps within the clinical cascade for mothers and their infants suggest that current service delivery models are not meeting families' needs and prompt re-consideration of how services are provided. This article will explore considerations for differentiated care and encourage the ongoing increase of ART coverage through innovative strategies while also addressing the unique needs of mothers and infants. Service delivery models should recognize that the timing of the mother's HIV diagnosis is a critical aspect of determining eligibility. Women newly diagnosed with HIV require a more intensive approach so that adequate counselling and monitoring of ART initiation and response can be provided. Women already on ART with evidence of virologic failure are also at high risk of transmitting HIV to their infants and require close follow-up. However, women stable on ART with a suppressed viral load before conception have a very low likelihood of HIV transmission and thus are strong candidates for multi-month ART dispensing, community-based distribution of ART, adherence clubs, community adherence support groups and longer intervals between clinical visits. A number of other factors should be considered when defining eligibility of mothers and infants for differentiated care, including location of services, viral load monitoring and duration on ART. To provide differentiated care that is client-centred and driven while encompassing a family-based approach, it will be critical to engage mothers, families and communities in models that will optimize client satisfaction, retention in care and quality of services. Differentiated care for mothers and infants represents an opportunity to provide client-centred care that reduces the burden on clients and health systems while improving the quality and uptake of services for families. However, with decreasing funding, stable HIV incidence, and aspirations for sustainability, it is critical to consider efficient, customized and cost-effective models of care for these populations as we aspire to eliminate mother-to-child transmission of HIV. Published 2018. This article is a U.S. Government work and is in the public domain in the USA. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.

A novel dynamic wavelength bandwidth allocation scheme over OFDMA PONs

NASA Astrophysics Data System (ADS)

Yan, Bo; Guo, Wei; Jin, Yaohui; Hu, Weisheng

2011-12-01

With rapid growth of Internet applications, supporting differentiated service and enlarging system capacity have been new tasks for next generation access system. In recent years, research in OFDMA Passive Optical Networks (PON) has experienced extraordinary development as for its large capacity and flexibility in scheduling. Although much work has been done to solve hardware layer obstacles for OFDMA PON, scheduling algorithm on OFDMA PON system is still under primary discussion. In order to support QoS service on OFDMA PON system, a novel dynamic wavelength bandwidth allocation (DWBA) algorithm is proposed in this paper. Per-stream QoS service is supported in this algorithm. Through simulation, we proved our bandwidth allocation algorithm performs better in bandwidth utilization and differentiate service support.

Financial Services and the Internet: What Does Cyberspace Mean for the Financial Services Industry?

ERIC Educational Resources Information Center

Birch, David; Young, Michael A.

1997-01-01

More than 30 million households own PCs and more than 20% of these use PCs to manage their finances. This article examines the Internet and financial services, consumer needs, and differentiation in service products and predicts future trends in retail financial services (cheaper niche products, cross-border selling, selling knowledge, payments,…

Differentiated Instruction: Are Hong Kong In-Service Teachers Ready?

ERIC Educational Resources Information Center

Wan, Sally Wai-Yan

2017-01-01

Differentiated instruction (DI) is nothing new and is believed to be an effective research-based strategy to cater for learner diversity. Differentiation involves finding multiple ways to structure a lesson so that each student is provided with an opportunity to work at a moderately challenging level. Previous studies, however, found that teachers…

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

PubMed

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

2013-07-01

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

78 FR 52854 - Use of Differential Income Stream as an Application of the Income Method and as a Consideration...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

... Differential Income Stream as an Application of the Income Method and as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations and removal of... differential income stream as a consideration in assessing the best method in connection with a cost sharing...

76 FR 80309 - Use of Differential Income Stream as an Application of the Income Method and as a Consideration...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... Use of Differential Income Stream as an Application of the Income Method and as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed... guidance on how an analysis of the differential income stream may provide a best method consideration for...

Differential Response: What to Make of the Existing Research? A Response to Hughes et al.

ERIC Educational Resources Information Center

Drake, Brett

2013-01-01

This article is a response to "Issues in Differential Response", a review of the current evidence pertaining to differential response (DR) programs in child protective services (CPS). In my view, the Hughes, Rycus, Saunders-Adams, Hughes, and Hughes article suffers from several weaknesses. First, DR programs are critiqued as if they were…

The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

ERIC Educational Resources Information Center

Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

2007-01-01

Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

Armed Services Vocational Aptitude Battery: Differential Item Functioning on the High School Form.

DTIC Science & Technology

1988-04-01

AD-RI93 693 ARMED SERVICES VOCATIONAL APTITUDE BATTERY:1/ DIFFERENTIAL ITEM FUNCTIONING..(U) UNIYERSAL ENERGY SYSTEMS INC DAYTON OH R L LINN ET AL...FUNCTIONING ON THE HIGH SCHOOL FORM - H U Robert L. Linn C. Nicholas Hastings Pei-Hua Gillian HuMKatherine E. Ryan A Universal Energy Systems , Inc. 40 Dayton...Period October 1985 - Ky 1987 0 U Approved for public release; distribution is unlimited. R ,. CES LABORATORY 1>2 Se DTIC AIR FORCE SYSTEMS COMMAND 0

NASA's global differential GPS system and the TDRSS augmentation service for satellites

NASA Technical Reports Server (NTRS)

Bar-Sever, Yoaz; Young, Larry; Stocklin, Frank; Rush, John

2004-01-01

NASA is planning to launch a new service for Earth satellites providing them with precise GPS differential corrections and other ancillary information enabling decimeter level orbit determination accuracy, and nanosecond time-transfer accuracy, onboard, in real-time. The TDRSS Augmentation Service for Satellites (TASS) will broadcast its message on the S-band multiple access channel of NASA's Tracking and Data Relay Satellite System (TDRSS). The satellite's phase array antenna has been configured to provide a wide beam, extending coverage up to 1000 km altitude over the poles. Global coverage will be ensured with broadcast from three or more TDRSS satellites. The GPS differential corrections are provided by the NASA Global Differential GPS (GDGPS) System, developed and operated by NASA's Jet Propulsion Laboratory. The GDGPS System employs a global ground network of more than 70 GPS receivers to monitor the GPS constellation in real time. The system provides real-time estimates of the GPS satellite states, as well as many other real-time products such as differential corrections, global ionospheric maps, and integrity monitoring. The unique multiply redundant architecture of the GDGPS System ensures very high reliability, with 99.999% demonstrated since the inception of the system in Early 2000. The estimated real time GPS orbit and clock states provided by the GDGPS system are accurate to better than 20 cm 3D RMS, and have been demonstrated to support sub-decimeter real time positioning and orbit determination for a variety of terrestrial, airborne, and spaceborne applications. In addition to the GPS differential corrections, TASS will provide real-time Earth orientation and solar flux information that enable precise onboard knowledge of the Earth-fixed position of the spacecraft, and precise orbit prediction and planning capabilities. TASS will also provide 5 seconds alarms for GPS integrity failures based on the unique GPS integrity monitoring service of the GDGPS System.

The Influence of Community-Based Services on the Burden of Spouses Caring for Their Partners with Dementia

ERIC Educational Resources Information Center

Sussman, Tamara; Regehr, Cheryl

2009-01-01

Despite the vast literature on caregiver stress, few studies have explored how community services affect the stress process for spousal caregivers. The current study explores the differential effects of emotional and tangible support provided by family and friends and by formal services, and caregivers' perceptions of community services on spousal…

Differentiated protection method in passive optical networks based on OPEX

NASA Astrophysics Data System (ADS)

Zhang, Zhicheng; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

2011-12-01

Reliable service delivery becomes more significant due to increased dependency on electronic services all over society and the growing importance of reliable service delivery. As the capability of PON increasing, both residential and business customers may be included in a PON. Meanwhile, OPEX have been proven to be a very important factor of the total cost for a telecommunication operator. Thus, in this paper, we present the partial protection PON architecture and compare the operational expenditures (OPEX) of fully duplicated protection and partly duplicated protection for ONUs with different distributed fiber length, reliability requirement and penalty cost per hour. At last, we propose a differentiated protection method to minimize OPEX.

The Impact of Service Sector Growth on Changing Patterns of Stratification among Communities.

ERIC Educational Resources Information Center

Kassab, Cathy

This paper examines the impact of increasing service sector employment and decreasing manufacturing employment on the distribution of income across communities on the urban-rural continuum. Changes in the differential distribution of industries and family income across this continuum have important consequences for local services, including…

Peer Attitudes toward Students with Disabilities: A Comparison of the In-Class and Pull-Out Models of Service Delivery.

ERIC Educational Resources Information Center

Noland, Emily N.; And Others

1993-01-01

This study compared the differential effects of in-class and pull-out service delivery models on attitudes of students (n=194) in grades four through six toward students with disabilities. Results revealed that students from classrooms where services were being delivered through in-class service delivery models had more positive attitudes.…

The Use of University Services and Student Retention: Differential Links for Student Service Members or Veterans and Civilian Students

ERIC Educational Resources Information Center

Southwell, Kenona H.; Whiteman, Shawn D.; MacDermid Wadsworth, Shelley M.; Barry, Adam E.

2018-01-01

Grounded in research and theory on college student retention, this study assessed differences in the use of various university services and the influence of key personnel on retention-related outcomes of student service members or veterans (SSM/Vs) compared with civilian students. Participants included 386 students, 199 (154 male, 45 female) of…

Differentiated optical services: a quality of optical service model for WDM networks

NASA Astrophysics Data System (ADS)

Ndousse, Thomas D.; Golmie, Nada

1999-08-01

This paper addresses the issues of guaranteed and scalable end-to-end QoS in Metropolitan DWDM networks serving as transit networks for IP access networks. DWDM offering few wavelengths have in the past been deployed in backbone networks to upgrade point-to-point transmission where sharing is based on coarse granularity. This type of DWDM backbone networks, offering few lightpaths, provides no support for QoS services traversing the network. As DWDM networks with larger numbers of wavelengths penetrate the data-centric Metro environment, specific IP service requirements such as priority restoration, scalability, dynamic provisioning of capacity and routes, and support for coarse-grain QoS capabilities will have to be addressed in the optical domain in order to support end-to-end Service- Level Agreements. In this paper, we focus on the support of QoS in the optical domain in order to achieve end-to-end QoS over a DWDM network. We propose a QoS service model in the optical domain called Differentiated Optical Services (DOS). Service classification in DOS is based on a set of optical parameters that captures the quality and reliability of the optical lightpath.

Phased implementation of spaced clinic visits for stable HIV-positive patients in Rwanda to support Treat All.

PubMed

Nsanzimana, Sabin; Remera, Eric; Ribakare, Muhayimpundu; Burns, Tracy; Dludlu, Sibongile; Mills, Edward J; Condo, Jeanine; Bucher, Heiner C; Ford, Nathan

2017-07-21

In 2016, Rwanda implemented "Treat All," requiring the national HIV programme to increase antiretroviral (ART) treatment coverage to all people living with HIV. Approximately half of the 164,262 patients on ART have been on treatment for more than five years, and long-term retention of patients in care is an increasing concern. To address these challenges, the Ministry of Health has introduced a differentiated service delivery approach to reduce the frequency of clinical visits and medication dispensing for eligible patients. This article draws on key policy documents and the views of technical experts involved in policy development to describe the process of implementation of differentiated service delivery in Rwanda. Implementation of differentiated service delivery followed a phased approach to ensure that all steps are clearly defined and agreed by all partners. Key steps included: definition of scope, including defining which patients were eligible for transition to the new model; definition of the key model components; preparation for patient enrolment; considerations for special patient groups; engagement of implementing partners; securing political and financial support; forecasting drug supply; revision, dissemination and implementation of ART guidelines; and monitoring and evaluation. Based on the outcomes of the evaluation of the new service delivery model, the Ministry of Health will review and strategically reduce costs to the national HIV program and to the patient by exploring and implementing adjustments to the service delivery model.

Department of Defense Use of Commercial Cloud Computing Capabilities and Services

DTIC Science & Technology

2015-11-01

models (Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service ( SaaS )), and four deployment models (Public...NIST defines three main models for cloud computing: IaaS, PaaS, and SaaS . These models help differentiate the implementation responsibilities that fall...and SaaS . 3. Public, Private, Community, and Hybrid Clouds Cloud services come in different forms, depending on the customer’s specific needs

Issues in Differential Response

ERIC Educational Resources Information Center

Hughes, Ronald C.; Rycus, Judith S.; Saunders-Adams, Stacey M.; Hughes, Laura K.; Hughes, Kelli N.

2013-01-01

Differential response (DR), also referred to as alternative response (AR), family assessment response (FAR), or multiple track response, was developed to incorporate family-centered, strengths-based practices into child protective services (CPS), primarily by diverting lower risk families into an assessment track rather than requiring the…

Healthcare Financial Management Association, Principles and Practices Board. Statement no. 15: Valuation and financial statement presentation of charity service and bad debts by institutional healthcare providers.

PubMed

1993-02-01

Principles and Practices Board (P&P Board) Statement No. 2, issued in 1978, provided a basis for differentiating between charity service and bad debts. The statement acknowledged that, while the differentiation was helpful, the financial accounting and reporting of charity service and bad debts were the same. In 1990, the American Institute of Certified Public Accountants (AICPA) published (after review and approval by the Financial Accounting Standards Board and the Governmental Accounting Standards Board) an extensive revision of the guide titled "Audits of Providers of Health Care Services." The revised guide substantially changed the reporting of bad debts and eliminated charity service from revenue. Disclosure of the entity's policy for providing charity service and the level of charity service provided is required by the revised guide. The P&P Board decided that a substantive revision of its Statement No. 2 was required to bring it into conformity with the revised guide and to provide direction on implementation of the revised guide's requirements. This statement supersedes Statement No. 2 and deals with the same issues, including bad debts.

Differences across payors in charges for agency-based home health services: evidence from the National Home and Hospice Care Survey.

PubMed Central

Freedman, V A; Reschovsky, J D

1997-01-01

OBJECTIVE: To investigate charge and payment differentials for home health services across different payors. DATA SOURCES: The 1992 National Home and Hospice Care Survey, a nationally representative survey of home and hospice care agencies and their patients, collected by the National Center for Health Statistics. STUDY DESIGN: We compare the average charge for a Medicare home health visit to the average charge for patients with other sources of payment. In making such comparisons, we control for differences across payors in service mix and agency characteristics. PRINCIPAL FINDINGS: Agencies charge various payors different amounts for similar services, and Medicare is consistently charged more than other payors. CONCLUSIONS: Findings imply the potential existence of payment differentials across payors for home health services, with Medicare and privately insured patients likely to be paying more than others for similar services. Such conclusions raise the possibility that, as in other segments of the healthcare market, cost-shifting and price discrimination might exist within the home health industry. Future research should explore these issues, along with the question of whether Medicare is paying too much for home health services. PMID:9327812

Are ecosystem services stabilized by differences among species? A test using crop pollination.

PubMed

Winfree, Rachael; Kremen, Claire

2009-01-22

Biological diversity could enhance ecosystem service provision by increasing the mean level of services provided, and/or by providing more consistent (stable) services over space and time. Ecological theory predicts that when an ecosystem service is provided by many species, it will be stabilized against disturbance by a variety of 'stabilizing mechanisms.' However, few studies have investigated whether stabilizing mechanisms occur in real landscapes affected by human disturbance. We used two datasets on crop pollination by wild native bees to screen for and differentiate among three stabilizing mechanisms: density compensation (negative co-variance among species' abundances); response diversity (differential response to environmental variables among species); and cross-scale resilience (response to the same environmental variable at different scales by different species). In both datasets, we found response diversity and cross-scale resilience, but not density compensation. We conclude that stabilizing mechanisms may contribute to the stability of pollination services in our study areas, emphasizing the insurance value of seemingly 'redundant' species. Furthermore, the absence of density compensation that we found at the landscape scale contrasts with findings of previous small-scale experimental and modelling work, suggesting that we should not assume that density compensation will stabilize ecosystem services in real landscapes.

21 CFR 866.2660 - Microorganism differentiation and identification device.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Microorganism differentiation and identification device. 866.2660 Section 866.2660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices...

21 CFR 866.2660 - Microorganism differentiation and identification device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Microorganism differentiation and identification device. 866.2660 Section 866.2660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices...

21 CFR 866.2660 - Microorganism differentiation and identification device.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Microorganism differentiation and identification device. 866.2660 Section 866.2660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices...

21 CFR 866.2660 - Microorganism differentiation and identification device.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Microorganism differentiation and identification device. 866.2660 Section 866.2660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices...

21 CFR 866.2660 - Microorganism differentiation and identification device.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Microorganism differentiation and identification device. 866.2660 Section 866.2660 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices...

7 CFR 1001.61 - Computation of producer price differential.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Computation of producer price differential. 1001.61 Section 1001.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE NORTHEAST...

Value of ecosystem hydropower service and its impact on the payment for ecosystem services.

PubMed

Fu, B; Wang, Y K; Xu, P; Yan, K; Li, M

2014-02-15

Hydropower is an important service provided by ecosystems. We surveyed all the hydropower plants in the Zagunao River Basin, Southwest China. Then, we assessed the hydropower service by using the InVEST (The Integrated Value and Tradeoff of Ecosystem Service Tools) model. Finally, we discussed the impact on ecological compensation. The results showed that: 1) hydropower service value of ecosystems in the Zagunao River Basin is 216.29 Euro/hm(2) on the average, of which the high-value area with more than 475.65 Euro/hm(2) is about 750.37 km(2), accounting for 16.12% of the whole watershed, but it provides 53.47% of the whole watershed service value; 2) ecosystem is an ecological reservoir with a great regulation capacity. Dams cannot completely replace the reservoir water conservation function of ecosystems, and has high economic and environmental costs that must be paid as well. Compensation for water conservation services should become an important basis for ecological compensation of hydropower development. 3) In the current PES cases, the standard of compensation is generally low. Cascade development makes the value of upstream ecosystem services become more prominent, reflecting the differential rent value, and the value of ecosystem services should be based on the distribution of differentiated ecological compensation. Copyright © 2013 Elsevier B.V. All rights reserved.

48 CFR 47.303-5 - F.o.b. origin, with differentials.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., within reach of the ship's loading tackle, when the shipping point is within a port area having water transportation service) or the carrier's freight station; (iii) To a U.S. Postal Service facility; or (iv) If...

48 CFR 47.303-5 - F.o.b. origin, with differentials.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., within reach of the ship's loading tackle, when the shipping point is within a port area having water transportation service) or the carrier's freight station; (iii) To a U.S. Postal Service facility; or (iv) If...

48 CFR 47.303-5 - F.o.b. origin, with differentials.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., within reach of the ship's loading tackle, when the shipping point is within a port area having water transportation service) or the carrier's freight station; (iii) To a U.S. Postal Service facility; or (iv) If...

48 CFR 47.303-5 - F.o.b. origin, with differentials.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., within reach of the ship's loading tackle, when the shipping point is within a port area having water transportation service) or the carrier's freight station; (iii) To a U.S. Postal Service facility; or (iv) If...

Bidding on Railcars for Grain: A Strategic Analysis

DOT National Transportation Integrated Search

1997-05-01

Many of the U.S. railroads have introduced highly differentiated services for grain shipments in recent years, generally in the area of forward guaranteed car service. Taken together with other alternatives, these mechanisms have had the effect of es...

The Internationalization of Industry. Annex B. Offshore Production in the International Semiconductor Industry,

DTIC Science & Technology

1981-11-01

essence of these arrangements is specialization based in international differentials in * 379 the costs of labor services. The availability of low...of electronic equipment vary with the complexity and cost of the equipment, a differentiated market for chips of varying densities, for use in...level of chip density, while more complex products will be most economically produced with higher levels of chip density. Thuse a differentiated

7 CFR 1001.52 - Adjusted Class I differentials.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Adjusted Class I differentials. 1001.52 Section 1001.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE NORTHEAST MARKETING AREA Order Regulating...

Evaluation of Hematological Parameters in the Differentiation of Subarachnoid Hemorrhage and Other Headache Syndromes.

PubMed

Goktekin, Mehmet C; Yilmaz, Mustafa

2018-06-01

In this research, the aim was to compare hematological data for the differentiation of subarachnoid hemorrhage, migraine attack, and other headache syndromes during consultation in emergency service. In this research, which was designed as retrospective case control study, hematological parameters (WBC, HgB, HCT, PLT, lymphocyte and neutrophile counts and neutrophile/lymphocyte rates) of the patients consulting to emergency service with SAH and migraine and other consulting patients complaining mainly from headache and having normal cranial CT were analysed. Sixty migraine attack patients (F/M:47/13), 57 SAH patients (F/M:30/27), and 53 patients except migraine having normal brain CT (F/M:36/17) who were consulted to emergency service with headache complaint were included in our research. WBC, Hct, HgB, MCV, PLT, MPV, LY, Neu counts, and NY/LY rates were found to differentiate between SAH and migraine. WBC, PLT, MPV, LY, and Neu rates were found to differentiate between SAH and HS patients. Only Hct, HgB, MCV, and NY/LY rates were found to differ meaningfully between SAH and migraine patients but these rates were not found to have meaningful difference between SAH and HS patients. In addition, an increase in WBC counts and NY/LY rates and decrease in MPV counts in ROC analysis were found to be more specific for SAH. WBC, HgB, HCT, PLT, lymphocyte and Neu counts, and NY/LY rates can indicate distinguishing SAH and migraine. WBC, HgB, HCT, PLT, lymphocyte and Neu counts can indicate to the clinician a differentiation of SAH and other headache syndromes.

Is an "ideal" service institution image the same for all referral sources? The case of chemical dependency treatment programs.

PubMed

Johnson, K; LaTour, M S

1993-01-01

In a competitive market like chemical dependency treatment, segmenting the professional referral market according to an "ideal" service image may offer a service institution a strategic advantage. Results of this study suggest that while different professionals in a referral market may attach differential importance to the same service feature, a favorable or unfavorable "image" seems to encompass how well both the professional and the professionals' client are treated by the service institution.

Administrative Compensation: An Investigation of Factors Accounting for Salary Differentials.

ERIC Educational Resources Information Center

Tracy, Saundra J.; Sheehan, Robert

A study was done to determine whether administrator salaries in 14 Ohio school districts were a reflection of administrator responsibilities or of length of service, and to find what factors accounted for salary differentials. Although previous research suggests factors for assigning value to administrative positions, traditional salary structures…

Primary Teachers' Professional Training in the System of Postgraduate Education in the Light of Differentiating Teaching: Irish Experience

ERIC Educational Resources Information Center

Gotsuliak, Kateryna

2015-01-01

Different information sources, namely National Strategy for Higher Education to 2030 (Ireland), Introduction to Primary School Curriculum (1999), (Ireland), Primary Professional Development Service--Differentiation in Action, Ireland's official postgraduate study website, the Strategic Plan 2012-2016 of Mary Immaculate College, Limerick…

Space Operations Center system analysis study extension. Volume 4, book 1: SOC system analysis report

NASA Technical Reports Server (NTRS)

1982-01-01

The Space Operations Center (SOC) orbital space station missions are analyzed. Telecommunications missions, space science, Earth sensing, and space testing missions, research and applications missions, defense missions, and satellite servicing missions are modeled and mission needs discussed. The satellite servicing missions are analyzed in detail, including construction and servicing equipment requirements, mission needs and benefits, differential drag characteristics of co-orbiting satellites, and satellite servicing transportation requirements.

Combining service marketing and strategic alliances in health care.

PubMed

Lazarus, I R

1993-11-01

With or without federal health care reform to impact the delivery of health care services in the U.S., hospitals must commit to service marketing and strategic alliances as a fundamental business strategy. Service marketing not only differentiates the provider, but with the proper programs in place, it may actually facilitate the formation of strategic alliances. The combination of these strategies will be particularly effective in preparing for any health care policy change.

Creative pricing strategies for medical services.

PubMed

Tellis, G J

1987-01-01

This paper discusses the strategic role of the pricing of medical services. Strategic pricing is a creative process that can be a vital means of defining marketing segments, differentiating services, and gaining a competitive advantage. The central issue in strategic pricing is creatively using the principle of cross-subsidies or shared economies over consumer groups, service sets, or competitors. This principle yields a rich set of pricing strategies that can be used in response to various environments.

5 CFR 575.110 - Service agreement requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... recruitment incentive before the employee enters on duty in the position. However, the service agreement must... agreement) and the conditions under which the employee must repay a recruitment incentive under § 575.111... RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT...

Spanish Faculty Preferences and Usage of Library Services in the Field of Science and Technology

ERIC Educational Resources Information Center

Pinto, Maria; Fernandez-Ramos, Andres

2010-01-01

The authors compare Spanish faculty use of library services and the interest they express in value-added services and improvement actions. The results are based on data from a survey of 546 faculty in the field of science and technology. The study differentiates between the areas of pure science, engineering and architecture, and life sciences.…

Differentiated Instruction: Hong Kong Prospective Teachers' Teaching Efficacy and Beliefs

ERIC Educational Resources Information Center

Wan, Sally Wai-Yan

2016-01-01

Catering for learner diversity is one of the key areas in the recent educational reform in Hong Kong. Pre-service teacher education acts as a fundamental way to equip pre-service teachers ready for accommodating diverse learning needs and to build up pre-service teachers' self-efficacy. The purpose of the study is to examine prospective teachers'…

Reliability Analysis of Differential Relay as Main Protection Transformer Using Fuzzy Logic Algorithm

NASA Astrophysics Data System (ADS)

Mulyadi, Y.; Sucita, T.; Sumarto; Alpani, M.

2018-02-01

Electricity supply demand is increasing every year. It makes PT. PLN (Persero) is required to provide optimal customer service and satisfaction. Optimal service depends on the performance of the equipment of the power system owned, especially the transformer. Power transformer is an electrical equipment that transforms electricity from high voltage to low voltage or vice versa. However, in the electrical power system, is inseparable from interference included in the transformer. But, the disturbance can be minimized by the protection system. The main protection transformer is differential relays. Differential relays working system using Kirchoff law where inflows equal outflows. If there are excessive currents that interfere then the relays will work. But, the relay can also experience decreased performance. Therefore, this final project aims to analyze the reliability of the differential relay on the transformer in three different substations. Referring to the standard applied by the transmission line protection officer, the differential relay shall have slope characteristics of 30% in the first slope and 80% in the second slope when using two slopes and 80% when using one slope with an instant time and the corresponding ratio. So, the results obtained on the Siemens differential release have a reliable slope characteristic with a value of 30 on the fuzzy logic system. In a while, ABB a differential relay is only 80% reliable because two experiments are not reliable. For the time, all the differential relays are instant with a value of 0.06 on the fuzzy logic system. For ratios, the differential relays ABB have a better value than others brand with a value of 151 on the fuzzy logic system.

Differentiation and specialization in the California hospital industry 1983 to 1988.

PubMed

Zwanziger, J; Melnick, G A; Simonson, L

1996-04-01

This article examines changes in the service mix of California hospitals as part of their response to shifts in the system of reimbursement between 1983 and 1988. The Hospital Discharge Data Set and the Annual Hospital Disclosure Report produced by California Office of Statewide Health Planning and Development were used in this study. Characteristics of inpatient hospital services in California before and after the introduction of new reimbursement mechanisms (including the Medicare Prospective Payment System [PPS] and the growth of selective contracting plans) were compared. The factors that influence two measures of hospital service mix, one focusing on specialization and the other on differentiation, were studied. The factors included hospital characteristics and changes in hospital reimbursement. Variables describing a hospital's service mix and the level in its market were constructed from data in the annual discharge abstracts. Data pertaining to average hospital costs and reimbursements under the Medicare PPS were drawn from a file containing a 20% sample of hospital stay records for the year of PPS. Other hospital data, such as ownership and bed size, were taken from the California Annual Disclosure Report data set. The results indicate that completion among hospitals tended to increase differentiation whereas higher financial PPS pressure is associated with increased specialization. Hospitals tend to adopt some high visibility services offered by their competitors while filling market niches selectively overall. It also appears that the cost savings expected for specialization may prevail only for narrowly defined services. Study of subsequent data sets should show whether the cost containment strategies used by the hospitals to achieve these results have been maintained over a period of sustained financial pressure.

Online Searching: An Analysis of Marketing Issues.

ERIC Educational Resources Information Center

Dunn, Ronald G.; Boyle, Harry F.

1984-01-01

This essay addresses factors that influence a customer's perception of the value of online information delivery services: evident costs, uncertain return, long-term return, not directly productive, overhead expense, and differential use. Roles assumed in acquiring and using information services (purchasers, searchers, consumers), price, and…

42 CFR 493.1273 - Standard: Histopathology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... differential or special stains, a control slide of known reactivity must be stained with each patient slide or...

42 CFR 493.1273 - Standard: Histopathology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... differential or special stains, a control slide of known reactivity must be stained with each patient slide or...

42 CFR 493.1273 - Standard: Histopathology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... differential or special stains, a control slide of known reactivity must be stained with each patient slide or...

42 CFR 493.1273 - Standard: Histopathology.

Code of Federal Regulations, 2011 CFR

2011-10-01

... recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... differential or special stains, a control slide of known reactivity must be stained with each patient slide or...

42 CFR 493.1273 - Standard: Histopathology.

Code of Federal Regulations, 2010 CFR

2010-10-01

... recognized system of disease nomenclature in reporting results. (f) The laboratory must document all control... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... differential or special stains, a control slide of known reactivity must be stained with each patient slide or...

Analysis of RDSS positioning accuracy based on RNSS wide area differential technique

NASA Astrophysics Data System (ADS)

Xing, Nan; Su, RanRan; Zhou, JianHua; Hu, XiaoGong; Gong, XiuQiang; Liu, Li; He, Feng; Guo, Rui; Ren, Hui; Hu, GuangMing; Zhang, Lei

2013-10-01

The BeiDou Navigation Satellite System (BDS) provides Radio Navigation Service System (RNSS) as well as Radio Determination Service System (RDSS). RDSS users can obtain positioning by responding the Master Control Center (MCC) inquiries to signal transmitted via GEO satellite transponder. The positioning result can be calculated with elevation constraint by MCC. The primary error sources affecting the RDSS positioning accuracy are the RDSS signal transceiver delay, atmospheric trans-mission delay and GEO satellite position error. During GEO orbit maneuver, poor orbit forecast accuracy significantly impacts RDSS services. A real-time 3-D orbital correction method based on wide-area differential technique is raised to correct the orbital error. Results from the observation shows that the method can successfully improve positioning precision during orbital maneuver, independent from the RDSS reference station. This improvement can reach 50% in maximum. Accurate calibration of the RDSS signal transceiver delay precision and digital elevation map may have a critical role in high precise RDSS positioning services.

Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

PubMed

De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

2017-04-01

Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

76 FR 80249 - Use of Differential Income Stream as a Consideration in Assessing the Best Method

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... Differential Income Stream as a Consideration in Assessing the Best Method AGENCY: Internal Revenue Service... method in connection with a cost sharing arrangement. The text of these temporary regulations also serves... unreasonable positions in applying the income method by using relatively low licensing discount rates, and...

The Manifest and Latent Functions of Differential Response in Child Welfare

ERIC Educational Resources Information Center

Ji, Daniel; Sullivan, Richard

2016-01-01

Although previous research has explored the efficacy of differential response (DR) programs in child welfare, there have been no studies to date about coding decisions between designations by child protection service agencies. Research has explored client satisfaction with DR as well as rates of recidivism and removal/placement but with limited…

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…

Geographically differentiated pay in the labour market for nurses.

PubMed

Elliott, Robert F; Ma, Ada H Y; Scott, Anthony; Bell, David; Roberts, Elizabeth

2007-01-01

This novel application of spatial wage theory to health service labour markets analyses the competitiveness of nurse's pay and how this differs between local labour markets in Britain. A switching regression model is estimated to derive standardised spatial wage differentials (SSWDs) for nurses and their comparators. An SSWD gap is constructed and its relationship to vacancies estimated. A reduction in the gap in a local area is shown to result in an increase in the long-term vacancy rate for National Health Service (NHS) nurses. The competitiveness of nursing pay is shown to have a strong effect on the ability of the NHS to attract and retain nurses.

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.

Flexibility in community pharmacy: a qualitative study of business models and cognitive services.

PubMed

Feletto, Eleonora; Wilson, Laura K; Roberts, Alison S; Benrimoj, Shalom I

2010-04-01

To identify the capacity of current pharmacy business models, and the dimensions of organisational flexibility within them, to integrate products and services as well as the perceptions of viability of these models. Fifty-seven semi-structured interviews were conducted with community pharmacy owners or managers and support staff in 30 pharmacies across Australia. A framework of organisational flexibility was used to analyse their capacity to integrate services and perceptions of viability. Data were analysed using the method of constant comparison by two independent researchers. The study found that Australian community pharmacies have used the four types of flexibility to build capacity in distinct ways and react to changes in the local environment. This capacity building was manifested in four emerging business models which integrate services to varying degrees: classic community pharmacy, retail destination pharmacy, health care solution pharmacy and networked pharmacy. The perception of viability is less focused on dispensing medications and more focused on differentiating pharmacies through either a retail or services focus. Strategic flexibility appeared to offer pharmacies the ability to integrate and sustainably deliver services more successfully than other types, as exhibited by health care solution and networked pharmacies. Active support and encouragement to transition from being dependent on dispensing to implementing services is needed. The study showed that pharmacies where services were implemented and showed success are those strategically differentiating their businesses to become focused health care providers. This holistic approach should inevitably influence the sustainability of services.

Impact of Resource-Based Practice Expenses on the Medicare Physician Volume

PubMed Central

Maxwell, Stephanie; Zuckerman, Stephen

2007-01-01

In 1999, Medicare implemented a resource-based relative value unit (RVU) system for physician practice expense payments, and increased the number of services for which practice expense payments differ by site. Using 1998-2004 data, we examined RVU growth and decomposed that growth into resource-based RVUs, site of service, and service quantity and mix. We found that the number services with site of service differentials doubled, and that shifts in site of service and introduction of resource-based practice expenses (RBPE) were important sources of change in practice expense RVU volume. Service quantity and mix remained the largest source of growth in total RVU volume. PMID:18435224

Adolescent aggression and differentiation of self: guided mindfulness meditation in the service of individuation.

PubMed

Birnbaum, Liora

2005-06-23

This paper presents adolescent aggression as mediated by the level of differentiation of self. No research has directly addressed Bowen's notion that level of differentiation impacts child functioning including aggression. Level of differentiation is discussed in conjunction with social, gender and cultural norms as manifested in aggressive behavior. Female adolescent aggression is described as mainly relationship focused and expressed via verbal threats, intimidation and manipulation, while male aggression is described mainly as overt physical violence involving dominance and competitiveness. Research on differentiation focuses mainly on Western cultures that tend to be individualistic. Jewish-Israeli society is in transition from collectivistic to individualistic cultural values in the midst of ongoing hostilities. These processes create conflict regarding togetherness and individuality needs among adolescents, who are exposed to contradictory messages regarding separating and staying close. External as well as internal expressions of aggression (depression, suicide) are presented as coping strategies in the service of a wounded self-negotiating with the world. Guided mindfulness meditation is a powerful technique for facilitating healing and growth toward autonomy by helping adolescents connect to their inner voice. This technique may be especially useful in the adolescent search for self-awareness, meaning and life purpose. Bodily, cognitive and emotional experiences are treated as informative regarding the 'self' and facilitate expansion of self-perception and individuality.

The Effect of Community on Distributed Bio-inspired Service Composition

NASA Astrophysics Data System (ADS)

Carroll, Raymond; Balasubramaniam, Sasitharan; Botvich, Dmitri; Donnelly, William

The Future Internet is expected to cater for both a larger number and variety of services, which in turn will make basic tasks such as service lifecycle management increasingly important and difficult. At the same time, the ability for users to efficiently discover and compose these services will become a key factor for service providers to differentiate themselves in a competitive market. In previous work, we examined the effect adding biological mechanisms to services had on service management and discovery. In this paper we examine the effects of community on services, specifically in terms of composing services in a distributed fashion. By introducing aspects of community we aim to demonstrate that services can further improve their sustainability and indeed their efficiency.

Community Schools: It Takes a Village

ERIC Educational Resources Information Center

Garrett, Kristi

2012-01-01

Lately educators are hearing more about full-service community schools, which pair schools with other community resources in pursuit of the long-term goal of improving academic performance. (These full-service schools are differentiated from the community day schools that serve expelled students.) The focus on academics is what makes today's…

Use of Inpatient Mental Health Services by Members of Ethnic Minority Groups.

ERIC Educational Resources Information Center

Snowden, Lonnie R.; Cheung, Freda K.

1990-01-01

Discusses the ethnic-related differences in mental hospitalization admittance rates, diagnoses, and length of treatment. Explores reasons other than ethnic origin that may account for these differences, including socioeconomic standing, access to alternative services, bias in practitioners' assignment of diagnostic labels, and differential stigma…

A Comparison of Burnout in Selected Occupational Fields.

ERIC Educational Resources Information Center

Matthews, Doris B.

1990-01-01

Examined whether degree or extent of burnout is differentiated among workers in six people-oriented fields: health services, banking, social welfare, industry, education, and postal service. Findings from 244 employees in these 6 fields indicated that employees in social welfare tended to experience more burnout than some persons in education,…

Not Just Location: LEAs and Inequalities among Schools

ERIC Educational Resources Information Center

Yair, Gad

2005-01-01

Purpose: With growing decentralization, local education authorities (LEAs) face new tasks and responsibilities in providing schools with administrative services and resources. This study aims to use a multilevel framework to assess the extent to which LEAs differentially affect the provision of resources and administrative services to schools, and…

Differential Exposure to Early Childhood Education Services and Mother-Toddler Interaction

ERIC Educational Resources Information Center

Klebanov, P.K.; Brooks-Gunn, J.

2008-01-01

This study examined the associations of exposure to early childhood education (ECE) services upon 2.5-year-old children's task persistence and enthusiasm and their mothers' authoritative and authoritarian behavior and support stimulation. Families participated in the Infant Health and Development Program, an eight-site randomized comprehensive ECE…

49 CFR 232.103 - General requirements for all train brake systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the air compressor governor starting or loading pressure. (l) Except as otherwise provided in this... brake pipe air pressure: Road Service 90 Switch Service 60 (2) Minimum differential between brake pipe and main reservoir air pressures, with brake valve in running position 15 (3) Safety valve for...

49 CFR 232.103 - General requirements for all train brake systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the air compressor governor starting or loading pressure. (l) Except as otherwise provided in this... brake pipe air pressure: Road Service 90 Switch Service 60 (2) Minimum differential between brake pipe and main reservoir air pressures, with brake valve in running position 15 (3) Safety valve for...

78 FR 62426 - Use of Differential Income Stream as an Application of the Income Method and as a Consideration...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... Differential Income Stream as an Application of the Income Method and as a Consideration in Assessing the Best Method; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correcting amendment... method in connection with a cost sharing arrangement and as a specified application of the income method...

5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false What adjustment factors does OPM add to the price indexes? 591.227 Section 591.227 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances §...

26 CFR 1.809-9 - Computation of the differential earnings rate and the recomputed differential earnings rate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED... the amount equal to the product of— (i) The life insurance company's average equity base for the... the excess of— (i) The imputed earnings rate for the taxable year; over (ii) The average mutual...

The Infusion of Dust Model Model Outputs into Public Health Decision Making - an Examination of Differential Adoption of SOAP and Open Geospatial Consortium Service Products into Public Health Decision Support Systems

NASA Astrophysics Data System (ADS)

Benedict, K. K.

2008-12-01

Since 2004 the Earth Data Analysis Center, in collaboration with the researchers at the University of Arizona and George Mason University, with funding from NASA, has been developing a services oriented architecture (SOA) that acquires remote sensing, meteorological forecast, and observed ground level particulate data (EPA AirNow) from NASA, NOAA, and DataFed through a variety of standards-based service interfaces. These acquired data are used to initialize and set boundary conditions for the execution of the Dust Regional Atmospheric Model (DREAM) to generate daily 48-hour dust forecasts, which are then published via a combination of Open Geospatial Consortium (OGC) services (WMS and WCS), basic HTTP request-based services, and SOAP services. The goal of this work has been to develop services that can be integrated into existing public health decision support systems (DSS) to provide enhanced environmental data (i.e. ground surface particulate concentration estimates) for use in epidemiological analysis, public health warning systems, and syndromic surveillance systems. While the project has succeeded in deploying these products into the target systems, there has been differential adoption of the different service interface products, with the simple OGC and HTTP interfaces generating much greater interest by DSS developers and researchers than the more complex SOAP service interfaces. This paper reviews the SOA developed as part of this project and provides insights into how different service models may have a significant impact on the infusion of Earth science products into decision making processes and systems.

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

PubMed

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

2015-12-01

A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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.

Effects of a cost-sharing exemption on use of preventive services at one large employer.

PubMed

Busch, Susan H; Barry, Colleen L; Vegso, Sally J; Sindelar, Jody L; Cullen, Mark R

2006-01-01

In 2004, Alcoa introduced a new health benefit for a portion of its workforce, which eliminated cost sharing for preventive care while increasing cost sharing for many other services. In this era of increased consumerism, Alcoa's benefit redesign constituted an effort to reduce health care costs while preserving use of targeted services. Taking advantage of a unique natural experiment, we find that Alcoa was able to maintain rates of preventive service use. This evidence suggests that differential cost sharing can be used to preserve the use of critical health care services.

College Students, Diversity, and Community Service Learning

ERIC Educational Resources Information Center

Seider, Scott; Huguley, James P.; Novick, Sarah

2013-01-01

Background/Context: Over the past two decades, more than 200 studies have been published on the effects of community service learning on university students. However, the majority of these studies have focused on the effects of such programming on White and affluent college students, and few have considered whether there are differential effects…

Employee Health Service for Teaching and Nonteaching Staff: A Needs Assessment.

ERIC Educational Resources Information Center

Long, Bonita C.; And Others

1986-01-01

A needs assessment was conducted to identify the health needs of school district employees in planning a comprehensive employee health service. Survey questionnaires were analyzed to determine characteristics of those individuals who may be at greatest health risk. Results indicate that degree of stress can differentiate health risk predictors.…

Functional Requirements Study

DTIC Science & Technology

2008-07-01

Identification System, AIS, Vessel Traffic Services, VTS, Transmit, Broadcast, Functional Requirements, United States Coast Guard, USCG, Mariner, Electronic ...Chart Systems, ECS, Vessel Operators, National Oceanic Atmospheric Administration, NOAA, US Army Corp of Engineers , USACE, ECDIS 18. Distribution...and River Information Service COPT Captain of the Port DGPS Differential Global Positioning System ECDIS Electronic Chart Display Information System

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

ERIC Educational Resources Information Center

Aarons, Gregory A.; Sommerfeld, David H.

2012-01-01

Objective: Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on…

Providing Services for Handicapped Persons in Rural/Sparsely Populated Areas.

ERIC Educational Resources Information Center

Weatherman, Richard

The experiences of the 3-year Minnesota Severely Handicapped Delivery System Project have led to a model which utilizes resources of regional systems as key elements of a differentiated system for educational service delivery to the handicapped in rural areas and involves state education agencies, statewide regional centers, local education units,…

Do Business Students' Culturally Anchored Values Shape Student-Driven or Teacher-Driven Learning Style Preferences?

ERIC Educational Resources Information Center

Mitsis, Ann; Foley, Patrick W.

2009-01-01

University education is part of a globally competitive service industry and contributes more to Australia's export earnings than agriculture. This article argues that a deeper understanding of diverse cultural student groups is important for Australian and other universities that wish to differentiate their education service offerings by…

[Marketing for hospitals--an issue?].

PubMed

Schindler, Achim W; Schindler, Nicola; Vagts, Dierk

2007-09-01

Since economization of medicine continues, marketing is becoming more and more important. To shape marketing activities in correspondence with their professional ethics, physicians need some basic knowledge about marketing. The process of marketing consists of SWOT-analysis, market segmentation, market differentiation, positioning and the marketing-mix with ist most important component, the marketing communication. Specific aspects in the marketing of medical services derive from their nature as a service and the determinants of perceived service quality.

Evolution and diversification of National Cleaner Production Centres (NCPCs).

PubMed

Van Berkel, Rene

2010-07-01

Since 1994 UNIDO and UNEP cooperate in a Programme to establish National Cleaner Production Centres (NCPCs) as a mechanism for delivery of Cleaner Production (CP) services to businesses, governments and other organisations. In 2007, 38 NCPCs were operational in 37 developing and transition countries. While initially set up in near-identical ways in each country, over time NCPCs evolved in response to both programme-internal and country-level factors. The resulting diversity among NCPCs is described and analysed here. Differentiation and specialisation had occurred in service areas or topics both within and between NCPCs, however without a clear strategy for integration and synergy. NCPCs were becoming part of expanding networks of business services providers nationally forcing some to focus on audit and training services (tier 1), and others on specialist services in CP technology and/or policy (tier 2) and/or networking services (tier 3). All NCPCs were on a trajectory from a project management organisation to a nationally-owned entity. The different management requirements were not proactively managed and technical aspects of CP service delivery overshadowed institutional and governance aspects of establishing and operating the NCPC institution. Differences in service delivery methods between NCPCs are most evident in three service areas: CP assessments; policy advice; and transfer of Environmentally Sound Technologies. It is argued here that understanding root causes and benefits of this presently-observed differentiation, could lay the foundation for capturing and advancing best practice CP concepts, methods and policies. This in turn would enable strategic planning for customised interventions and support at the national level. Copyright 2010 Elsevier Ltd. All rights reserved.

26 CFR 1.809-9 - Computation of the differential earnings rate and the recomputed differential earnings rate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Gain and Loss... equal to the product of— (i) The life insurance company's average equity base for the taxable year...— (i) The imputed earnings rate for the taxable year; over (ii) The average mutual earning rate for the...

Using theories of practice to understand HIV-positive persons varied engagement with HIV services: a qualitative study in six Sub-Saharan African countries

PubMed Central

Wringe, Alison; Seeley, Janet; Renju, Jenny; Paparini, Sara; Wamoyi, Joyce; Moshabela, Mosa; Ddaaki, William; Nyamukapa, Constance; Ondenge, Kenneth; Bernays, Sarah; Bonnington, Oliver

2017-01-01

Objectives This article considers the potential of ‘theories of practice’ for studying and understanding varied (dis)engagement with HIV care and treatment services and begins to unpack the assemblage of elements and practices that shape the nature and duration of individuals’ interactions with HIV services. Methods We obtained data from a multicountry qualitative study that explores the use of HIV care and treatment services, with a focus on examining the social organisation of engagement with care as a practice and as manifested in the lives of people living with HIV in sub-Saharan Africa. The dataset comprised of 356 interviews with participants from six countries. Results We noted fluctuating interactions with HIV services in all countries. In line with theories of practice, we found that such varied engagement can be explained by (1) the availability, absence and connections between requisite ‘materialities’ (eg, health infrastructure, medicines), ‘competencies’ (eg, knowing how to live with HIV) and ‘meanings’ (eg, trust in HIV services, stigma, normalisation of HIV) and (2) a host of other life practices, such as working or parenting. These dynamics either facilitated or inhibited engagement with HIV services and were intrinsically linked to the discursive, cultural, political and economic fabric of the participating countries. Conclusion Practice theory provides HIV researchers and practitioners with a useful vocabulary and analytical tools to understand and steer people’s differentiated HIV service (dis)engagement. Our application of practice theory to engagement in HIV care, as experienced by HIV service users and providers in six sub-Saharan African countries, highlights the need for a practice-based approach in the delivery of differentiated and patient-centred HIV services. PMID:28736396

Hidden-service Statistics Reported by Relays

DTIC Science & Technology

2015-06-01

received, then 7 an adversary that knows the . onion address of a hidden service (and thus can obtain its Introduction Points) could infer how many...hide any single or repeated 9 publication of any given group of at most 8 onion services (e.g. a set of 8 or fewer related onion addresses that are... onion router. In Proceedings of the 13th USENIX Security Symposium, 2004. [5] Cynthia Dwork. Differential privacy. In in ICALP, 2006. [6] Cynthia Dwork

EXPLAINING THE GAP IN ANTENATAL CARE SERVICE UTILIZATION BETWEEN YOUNGER AND OLDER MOTHERS IN GHANA.

PubMed

Boamah, Sheila A; Amoyaw, Jonathan; Luginaah, Isaac

2016-05-01

Over two-thirds of pregnant women (69%) have at least one antenatal care (ANC) coverage contact in sub-Saharan Africa. However, to achieve the full life-saving potential that ANC promises for women and babies, a nuanced understanding of age-specific gaps in utilization of ANC services is required. Using the 2008 Ghana Demographic and Health Survey of 1456 individuals, this study examined the disparities in the use of ANC services between younger and older mothers by applying four counterfactual decomposition techniques. The results show that cross-group differences in the explanatory variables largely account for the differentials in ANC service utilization between younger and older mothers. Birth order (parity) accounts for the largest share of the contribution to the overall explained gap in ANC utilization between the younger and older mothers, suggesting that ANC differentials between the two groups are probably due to biosocial factors. To a lesser extent, wealth status of the two groups also contributes to the overall explained gap in ANC service utilization. The policy implications of these findings are that in order to bridge the ANC service utilization gap between the two groups, policymakers must systematically address gaps in cross-group differences in the explanatory variables in order to increase the utilization of ANC to attain the minimum recommendation of four visits as per World Health Organization guidelines.

Patient-centered care as value-added service by compounding pharmacists.

PubMed

McPherson, Timothy B; Fontane, Patrick E; Day, Jonathan R

2013-01-01

The term "value-added" is widely used to describe business and professional services that complement a product or service or that differentiate it from competing products and services. The objective of this study was to determine compounding pharmacists' self-perceptions of the value-added services they provide. A web-based survey method was used. Respondents' perceptions of their most important value-added service frequently fell into one of two categories: (1) enhanced pharmacist contribution to developing and implementing patient therapeutic plans and (2) providing customized medications of high pharmaceutical quality. The results were consistent with a hybrid community clinical practice model for compounding pharmacists wherein personalization of the professional relationship is the value-added characteristic.

Encouraging Pattern Language Development in a Pre-Service Inclusive Education Course: A Comparative Study

ERIC Educational Resources Information Center

Lancaster, Julie; Auhl, Greg

2013-01-01

This study investigated the ability of students in a pre-service teacher education course to deploy pattern language (or professional lexicon) related to specific inclusive teaching strategies. The study sought to determine whether there were differential effects of two approaches to learning, one based on a field-based placement (Applied…

2010 ESGR Employer Support Freedom Awards

Science.gov Websites

business consistently offers seamless customer service even when office manager, U.S. Navy Petty Officer continues to provide full differential pay and health benefits to its only Guard and Reserve member when he respect for me and the duties required of Reservists. He likes to tell people about my service. This is

What Do Croatian Pre-Service Teachers Remember from Their Calculus Course?

ERIC Educational Resources Information Center

Jukic, Ljerka; Brückler, Franka Miriam

2014-01-01

This paper reports a study on retention of core concepts in differential and integral calculus by examining the knowledge of two pre-service mathematics students. The study is conducted using a mixed method approach and the obtained data were analyzed using theory of three worlds of mathematics. The results showed that having good understanding of…

Aspects of Training and Remuneration in the Accommodation Industry: A Comparison between Australian and Singaporean Providers

ERIC Educational Resources Information Center

Taylor, Ruth; Davies, Doug

2004-01-01

It has long been recognised that effective staff training and remuneration allows an organisation to provide a unique and differentiating standard of service in industry, resulting in increased profitability to service providers. The purpose of this research study is to investigate the training strategies, and hence the training profile, of…

Outsourcing the Gender Factory: Living Arrangements and Service Expenditures on Female and Male Tasks

ERIC Educational Resources Information Center

de Ruijter, Esther; Treas, Judith K.; Cohen, Philip N.

2005-01-01

Using data from the U.S. Consumer Expenditure Survey 1998, this study analyzes how much money different types of households spend for domestic services on "female" and "male" tasks. We test alternative hypotheses based on economic and sociological theories of gender differentiation. Contrary to arguments that marriage lowers the risk to one…

Clinical Investigation Service Annual Research Progress Report Fiscal Year 1980,

DTIC Science & Technology

1980-10-01

Capillary (Heelstick) and Central ( Venous ) 136 Total White Blood Cell Counts and Differentials in Normal Newborn Infants (0) PHYSICAL MEDICINE...Comparison of Capillary (Heelstick) and Central ( Venous ) Total White Blood Cell Counts and Differentials in Normal Newborn Infants PRINCIPAL INVESTIGATOR...tolerance tests with renal glycosuria shall be evaluated. Day 1: History , physical examination, routine CBC, chest x-ray, STS, regular hospital diet (300 gm

Agent-Based Framework for Personalized Service Provisioning in Converged IP Networks

NASA Astrophysics Data System (ADS)

Podobnik, Vedran; Matijasevic, Maja; Lovrek, Ignac; Skorin-Kapov, Lea; Desic, Sasa

In a global multi-service and multi-provider market, the Internet Service Providers will increasingly need to differentiate in the service quality they offer and base their operation on new, consumer-centric business models. In this paper, we propose an agent-based framework for the Business-to-Consumer (B2C) electronic market, comprising the Consumer Agents, Broker Agents and Content Agents, which enable Internet consumers to select a content provider in an automated manner. We also discuss how to dynamically allocate network resources to provide end-to-end Quality of Service (QoS) for a given consumer and content provider.

Assessment Study of Using Online (CSRS) GPS-PPP Service for Mapping Applications in Egypt

NASA Astrophysics Data System (ADS)

Abd-Elazeem, Mohamed; Farah, Ashraf; Farrag, Farrag

2011-09-01

Many applications in navigation, land surveying, land title definitions and mapping have been made simpler and more precise due to accessibility of Global Positioning System (GPS) data, and thus the demand for using advanced GPS techniques in surveying applications has become essential. The differential technique was the only source of accurate positioning for many years, and remained in use despite of its cost. The precise point positioning (PPP) technique is a viable alternative to the differential positioning method in which a user with a single receiver can attain positioning accuracy at the centimeter or decimeter scale. In recent years, many organizations introduced online (GPS-PPP) processing services capable of determining accurate geocentric positions using GPS observations. These services provide the user with receiver coordinates in free and unlimited access formats via the internet. This paper investigates the accuracy of the Canadian Spatial Reference System (CSRS) Precise Point Positioning (PPP) (CSRS-PPP) service supervised by the Geodetic Survey Division (GSD), Canada. Single frequency static GPS observations have been collected at three points covering time spans of 60, 90 and 120 minutes. These three observed sites form baselines of 1.6, 7, and 10 km, respectively. In order to assess the CSRS-PPP accuracy, the discrepancies between the CSRS-PPP estimates and the regular differential GPS solutions were computed. The obtained results illustrate that the PPP produces a horizontal error at the scale of a few decimeters; this is accurate enough to serve many mapping applications in developing countries with a savings in both cost and experienced labor.

Differential impact of current diagnosis and clinical stage on attendance at a youth mental health service.

PubMed

Cross, Shane P M; Hermens, Daniel F; Scott, Jan; Salvador-Carulla, Luis; Hickie, Ian B

2017-06-01

To examine whether clinical stage of illness and current diagnosis influence appointment behaviour in a specialized primary-level youth mental health service. Factors associated with attendance at 8697 appointments made by 828 young people (females = 497) aged 12-25 years over a 1-year period were analysed. The number of appointments made did not correlate with the rates of attendance. However, those with more severe psychiatric morbidity made significantly more appointments and missed significantly more appointments than those with less severe presentations. Impaired social functioning was the best predictor of female attendance rates, whereas age and clinical stage of illness best predicted male attendance rates. Current diagnosis rather than functional impairment appeared to influence the level of input offered by clinicians. Age, gender, severity of illness, functioning and psychological distress had differential associations with both planned treatment intensity and attendance rates. These differences are likely to have implications for service provision in this youth population. © 2016 John Wiley & Sons Australia, Ltd.

Differential Outcomes for American College Students Engaged in Community Service-Learning Involving Youth and Adults

ERIC Educational Resources Information Center

Seider, Scott; Rabinowicz, Samantha; Gillmor, Susan

2012-01-01

The Serve Program at Ignatius University is a community service-learning program that combines academic study of philosophy with a yearlong field-based project at one of approximately 50 different sites. Half of these projects entail working with youth, while the other half entail working with adults. This mixed methods analysis found that college…

Interpersonal and Relational Orientation among Pre-Service Educators: Differential Effects on Attitudes toward Inclusion of Students with Disabilities

ERIC Educational Resources Information Center

McWhirter, Paula T.; Brandes, Joyce A.; Williams-Diehm, Kendra L.; Hackett, Shannon

2016-01-01

The purpose of this investigation was to determine the extent to which pre-service educators' interpersonal characteristics affected their attitudes toward teaching students with disabilities (inclusion), as measured by the FIRO-B and ATIES pre- and post-course. The FIRO-B was administered to assess expressed and wanted aspects of three…

Successful Information Technology Outsourcing: A Case Study on How a U.S.-Based Company Achieves Success

ERIC Educational Resources Information Center

Daluisio, Stephen C.

2014-01-01

In the late 1980s, the Eastman Kodak company initiated what would become one of the biggest trends in information technology (IT): outsourcing. IT outsourcing (ITO) allows a company to focus on the services that will differentiate it from its competitors and farm out nondifferentiating services. ITO has grown from the initial landmark effort at…

Report on the Task Force Meeting on Task Analysis and Role Definition. (Indiana State Univ., October 1967).

ERIC Educational Resources Information Center

Jordan, Daniel C.

If education is to keep up with social and technological change, teachers must be learning and developing at a rate similar to that of students, requiring the educational staff to render highly diverse and wide-ranging services. The basic strategy essential to such services is the development of differentiated staffing patterns which will allow…

Efficient and Competitive Rationing

DTIC Science & Technology

1988-05-01

that state S enterprises can organize markets that implement priority service efficiently. In Section 5 we study the operation of competitive markets ...exposition.) 5. COMPETITIVE RATIONING We examine next the incentives for profit-maximizing firms in competitive markets to offer priority service. Our...importantly, those equilibria that do exist show that firms have an incentive not to differentiate. It seems clear, 59 therefore, that in competitive markets

Therapeutic Components and Differential Treatment Outcomes among Clients of Israeli Services for Substance Abusers

ERIC Educational Resources Information Center

Schiff, Miriam; Katz, Katalin

2007-01-01

Objective: This study is the first in a comprehensive examination of therapeutic components and outcome of interventions in a public, nonresidential service for drug addicts in Jerusalem (SHALEM). Method: Data were gathered from 153 clients (35 women, 128 men; 35 Arabs, 118 Jews; median age = 39) using clinical data mining. Results: Men who had…

Costing and competition.

PubMed

Bates, K; Brignall, S

1994-01-01

Working for patients established a new system of contracts between providers and purchasers of healthcare, with prices based on full costs, avoiding cross-subsidization. The new regime necessitates greatly improved costing systems, to improve the efficiency of service provision by creating price competition between providers. Ken Bates and Stan Brignall argue that non-price competition also occurs, with providers 'differentiating' on quality of service/product, flexibility or innovation.

A Three-Tier Diagnostic Test to Assess Pre-Service Teachers' Misconceptions about Global Warming, Greenhouse Effect, Ozone Layer Depletion, and Acid Rain

NASA Astrophysics Data System (ADS)

Ozge Arslan, Harika; Cigdemoglu, Ceyhan; Moseley, Christine

2012-07-01

This study describes the development and validation of a three-tier multiple-choice diagnostic test, the atmosphere-related environmental problems diagnostic test (AREPDiT), to reveal common misconceptions of global warming (GW), greenhouse effect (GE), ozone layer depletion (OLD), and acid rain (AR). The development of a two-tier diagnostic test procedure as described by Treagust constitutes the framework for this study. To differentiate a lack of knowledge from a misconception, a certainty response index is added as a third tier to each item. Based on propositional knowledge statements, related literature, and the identified misconceptions gathered initially from 157 pre-service teachers, the AREPDiT was constructed and administered to 256 pre-service teachers. The Cronbach alpha reliability coefficient of the pre-service teachers' scores was estimated to be 0.74. Content and face validations were established by senior experts. A moderate positive correlation between the participants' both-tiers scores and their certainty scores indicated evidence for construct validity. Therefore, the AREPDiT is a reliable and valid instrument not only to identify pre-service teachers' misconceptions about GW, GE, OLD, and AR but also to differentiate these misconceptions from lack of knowledge. The results also reveal that a majority of the respondents demonstrated limited understandings about atmosphere-related environmental problems and held six common misconceptions. Future studies could test the AREPDiT as a tool for assessing the misconceptions held by pre-service teachers from different programs as well as in-service teachers and high school students.

Differentiated strategies for improving streaming service quality

NASA Astrophysics Data System (ADS)

An, Hui; Chen, Xin-Meng

2005-02-01

With the explosive growth of streaming services, users are becoming more and more sensitive to its quality of service. To handle these problems, the research community focuses of the application of caching and replication techniques. But most approaches try to find specific strategies of caching of replication that suit for streaming service characteristics and to design some kind of universal policy to deal with all streaming objects. This paper explores the combination of caching and replication for improving streaming service quality and demonstrates that it makes sense to incorporate two technologies. It provides a system model and discusses some related issues of how to determining a refreshable streaming object and which refreshment policies a refreshable object should use.

Dynamic quality of service differentiation using fixed code weight in optical CDMA networks

NASA Astrophysics Data System (ADS)

Kakaee, Majid H.; Essa, Shawnim I.; Abd, Thanaa H.; Seyedzadeh, Saleh

2015-11-01

The emergence of network-driven applications, such as internet, video conferencing, and online gaming, brings in the need for a network the environments with capability of providing diverse Quality of Services (QoS). In this paper, a new code family of novel spreading sequences, called a Multi-Service (MS) code, has been constructed to support multiple services in Optical- Code Division Multiple Access (CDMA) system. The proposed method uses fixed weight for all services, however reducing the interfering codewords for the users requiring higher QoS. The performance of the proposed code is demonstrated using mathematical analysis. It shown that the total number of served users with satisfactory BER of 10-9 using NB=2 is 82, while they are only 36 and 10 when NB=3 and 4 respectively. The developed MS code is compared with variable-weight codes such as Variable Weight-Khazani Syed (VW-KS) and Multi-Weight-Random Diagonal (MW-RD). Different numbers of basic users (NB) are used to support triple-play services (audio, data and video) with different QoS requirements. Furthermore, reference to the BER of 10-12, 10-9, and 10-3 for video, data and audio, respectively, the system can support up to 45 total users. Hence, results show that the technique can clearly provide a relative QoS differentiation with lower value of basic users can support larger number of subscribers as well as better performance in terms of acceptable BER of 10-9 at fixed code weight.

Retrospective economic analysis of the transfer of services from hospitals to the community: an application to an enhanced eye care service.

PubMed

Mason, Thomas; Jones, Cheryl; Sutton, Matt; Konstantakopoulou, Evgenia; Edgar, David F; Harper, Robert A; Birch, Stephen; Lawrenson, John G

2017-07-10

This research aims to evaluate the wider health system effects of the introduction of an intermediate-tier service for eye care. This research employs the Minor Eye Conditions Scheme (MECS), an intermediate-tier eye care service introduced in two London boroughs, Lewisham and Lambeth, in April 2013. Retrospective difference-in-differences analysis comparing changes over time in service use and costs between April 2011 and October 2014 in two commissioning areas that introduced an intermediate-tier service programme with changes in a neighbouring area that did not introduce the programme. MECS audit data; unit costs for MECS visits; volumes of first and follow-up outpatient attendances to hospital ophthalmology; the national schedule of reference costs. Volumes and costs of patients treated. In one intervention area (Lewisham), general practitioner (GP) referrals to hospital ophthalmology decreased differentially by 75.2% (95% CI -0.918% to -0.587%) for first attendances, and by 40.3% for follow-ups (95% CI -0.489% to -0.316%). GP referrals to hospital ophthalmology decreased differentially by 30.2% (95% CI -0.468% to -0.137%) for first attendances in the other intervention area (Lambeth). Costs increased by 3.1% in the comparison area between 2011/2012 and 2013/2014. Over the same period, costs increased by less (2.5%) in one intervention area and fell by 13.8% in the other intervention area. Intermediate-tier services based in the community could potentially reduce volumes of patients referred to hospitals by GPs and provide replacement services at lower unit costs. © 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.

Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

PubMed

Fekadu, Melaku; Regassa, Nigatu

2014-12-01

Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

Effects of approach and services under differential response on long term child safety and welfare.

PubMed

Loman, L Anthony; Siegel, Gary L

2015-01-01

An outcome analysis was conducted based on an extended follow-up of the implementation of differential response program reforms in Child Protective Services offices in 10 counties in a Midwestern U.S. State. Random assignment was conducted of families that were first determined to be appropriate for family assessments. Experimental families (n=2,382) were each assigned to a non-forensic family assessment, and control families (n=2,247) each received a forensic investigation. Families were assigned continuously over a 15-month period and then tracked from 45 to 60 months from the date of assignment. Detailed information on services provided and family responses was obtained via two subsamples of experimental and control families. Measures of family engagement and service reception and utilization were utilized to determine instrumental outcomes introduced through family assessments. Improved family engagement and increased and broadened services were found to have occurred, and it was theorized that these changes mediated extended outcomes. Extended outcomes included reductions of rates of subsequent screened-in reports of child maltreatment, proportions of families that experienced child removals, and instances of new safety threats and problems in parenting. Differences in outcomes were found among the participating counties with 4 counties accounting for most outcome differences. The relationships between instrumental and extended outcomes were discussed with suggestions for further research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Using theories of practice to understand HIV-positive persons varied engagement with HIV services: a qualitative study in six Sub-Saharan African countries.

PubMed

Skovdal, Morten; Wringe, Alison; Seeley, Janet; Renju, Jenny; Paparini, Sara; Wamoyi, Joyce; Moshabela, Mosa; Ddaaki, William; Nyamukapa, Constance; Ondenge, Kenneth; Bernays, Sarah; Bonnington, Oliver

2017-07-01

This article considers the potential of 'theories of practice' for studying and understanding varied (dis)engagement with HIV care and treatment services and begins to unpack the assemblage of elements and practices that shape the nature and duration of individuals' interactions with HIV services. We obtained data from a multicountry qualitative study that explores the use of HIV care and treatment services, with a focus on examining the social organisation of engagement with care as a practice and as manifested in the lives of people living with HIV in sub-Saharan Africa. The dataset comprised of 356 interviews with participants from six countries. We noted fluctuating interactions with HIV services in all countries. In line with theories of practice, we found that such varied engagement can be explained by (1) the availability, absence and connections between requisite 'materialities' (eg, health infrastructure, medicines), 'competencies' (eg, knowing how to live with HIV) and 'meanings' (eg, trust in HIV services, stigma, normalisation of HIV) and (2) a host of other life practices, such as working or parenting. These dynamics either facilitated or inhibited engagement with HIV services and were intrinsically linked to the discursive, cultural, political and economic fabric of the participating countries. Practice theory provides HIV researchers and practitioners with a useful vocabulary and analytical tools to understand and steer people's differentiated HIV service (dis)engagement. Our application of practice theory to engagement in HIV care, as experienced by HIV service users and providers in six sub-Saharan African countries, highlights the need for a practice-based approach in the delivery of differentiated and patient-centred HIV services. © 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.

Social capital, collective efficacy and the provision of social support services and amenities by municipalities in the Netherlands.

PubMed

Waverijn, Geeke; Groenewegen, Peter P; de Klerk, Mirjam

2017-03-01

Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and amenities in Dutch municipalities, against a background of decentralisation of long-term care to municipalities. We used data on neighbourhood social capital, collective efficacy (the extent to which people are willing to work for the common good), and the provision of services and amenities in 2012. We included the services municipalities provide to support informal caregivers (e.g. respite care), individual services and support (e.g. domiciliary help), and general and collective services and amenities (e.g. lending point for wheelchairs). Data for social capital were collected between May 2011 and September 2012. Social capital was measured by focusing on contacts between neighbours. A social capital measure was estimated for 414 municipalities with ecometric measurements. A measure of collective efficacy was constructed based on information about the experienced responsibility for the liveability of the neighbourhood by residents in 2012, average charity collection returns in municipalities in 2012, voter turnout at the municipal elections in 2010 and the percentage of blood donors in 2012. We conducted Poisson regression and negative binomial regression to test our hypotheses. We found no relationship between social capital and the provision of services and amenities in municipalities. We found an interaction effect (coefficient = 3.11, 95% CI = 0.72-5.51, P = 0.011) of social capital and collective efficacy on the provision of support services for informal caregivers in rural municipalities. To gain more insight in the relationship between social capital and health, it will be important to study the relationship between social capital and differential provision of services and amenities more extensively and in different contexts. © 2016 John Wiley & Sons Ltd.

Network coding based joint signaling and dynamic bandwidth allocation scheme for inter optical network unit communication in passive optical networks

NASA Astrophysics Data System (ADS)

Wei, Pei; Gu, Rentao; Ji, Yuefeng

2014-06-01

As an innovative and promising technology, network coding has been introduced to passive optical networks (PON) in recent years to support inter optical network unit (ONU) communication, yet the signaling process and dynamic bandwidth allocation (DBA) in PON with network coding (NC-PON) still need further study. Thus, we propose a joint signaling and DBA scheme for efficiently supporting differentiated services of inter ONU communication in NC-PON. In the proposed joint scheme, the signaling process lays the foundation to fulfill network coding in PON, and it can not only avoid the potential threat to downstream security in previous schemes but also be suitable for the proposed hybrid dynamic bandwidth allocation (HDBA) scheme. In HDBA, a DBA cycle is divided into two sub-cycles for applying different coding, scheduling and bandwidth allocation strategies to differentiated classes of services. Besides, as network traffic load varies, the entire upstream transmission window for all REPORT messages slides accordingly, leaving the transmission time of one or two sub-cycles to overlap with the bandwidth allocation calculation time at the optical line terminal (the OLT), so that the upstream idle time can be efficiently eliminated. Performance evaluation results validate that compared with the existing two DBA algorithms deployed in NC-PON, HDBA demonstrates the best quality of service (QoS) support in terms of delay for all classes of services, especially guarantees the end-to-end delay bound of high class services. Specifically, HDBA can eliminate queuing delay and scheduling delay of high class services, reduce those of lower class services by at least 20%, and reduce the average end-to-end delay of all services over 50%. Moreover, HDBA also achieves the maximum delay fairness between coded and uncoded lower class services, and medium delay fairness for high class services.

Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs

PubMed Central

Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C.

2017-01-01

Abstract Introduction: Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). Methods: A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Results: Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076–16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12–255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. Conclusions: The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting. PMID:28770590

Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.

PubMed

Ssonko, Charles; Gonzalez, Lucia; Mesic, Anita; da Fonseca, Marcio Silveira; Achar, Jay; Safar, Nadia; Martin, Beatriz; Wong, Sidney; Casas, Esther C

2017-07-21

Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC). A descriptive analysis from CAR, DRC and RoSS programmes reviewing methodology and strategies of HIV care integration between 2010 and 2015 was performed. We describe HIV care models integrated within the provision of general health care and highlight best practices and challenges. Services included provision of general health care, with out-patient care (range between countries 43,343 and 287,163 consultations/year in 2015) and in-patient care (range 1076-16,595 in 2015). By the end of 2015 antiretroviral therapy (ART) initiations reached 12-255 patients/year. A total of 1101 and 1053 patients were on ART in CAR and DRC, respectively. In RoSS 186 patients were on ART when conflict recommenced late in 2013. While ART initiation and monitoring were mostly clinically driven in the early phase of the programmes, DRC implemented CD4 monitoring and progressively HIV viral load (VL) monitoring during study period. Attacks to health care facilities in CAR and RoSS disrupted service provision temporarily. Programmatic challenges include: competing health priorities influencing HIV care and need to integrate within general health services. Differentiated care approaches that support continuity of care in these programmes include simplification of medical protocols, multi-month ART prescriptions, and community strategies such as ART delivery groups, contingency plans and peer support activities. The principles of differentiated HIV care for high-quality ART delivery can successfully be applied in challenging operating environments. However, success heavily depends on specific adaptations to each setting.

The behavioral consequences of service quality: an empirical study in the Chinese retail pharmacy industry.

PubMed

Chen, Yuwen; Fu, Frank Q

2015-01-01

This study focuses on the impacts of service quality and examines the mediating effects of customer satisfaction and customer loyalty on willingness to pay more. The authors collected survey data from 479 actual retail pharmacy customers in China and used the structural equation modeling approach to test the hypotheses. The results reveal six dimensions of service quality and the differential impact of these dimensions on customer satisfaction and behavioral intentions. This study contributes to the existing literature by exploring the dimensionality of the service quality construct and mediating effects of customer satisfaction and customer loyalty in a non-Western setting.

Scalable service architecture for providing strong service guarantees

NASA Astrophysics Data System (ADS)

Christin, Nicolas; Liebeherr, Joerg

2002-07-01

For the past decade, a lot of Internet research has been devoted to providing different levels of service to applications. Initial proposals for service differentiation provided strong service guarantees, with strict bounds on delays, loss rates, and throughput, but required high overhead in terms of computational complexity and memory, both of which raise scalability concerns. Recently, the interest has shifted to service architectures with low overhead. However, these newer service architectures only provide weak service guarantees, which do not always address the needs of applications. In this paper, we describe a service architecture that supports strong service guarantees, can be implemented with low computational complexity, and only requires to maintain little state information. A key mechanism of the proposed service architecture is that it addresses scheduling and buffer management in a single algorithm. The presented architecture offers no solution for controlling the amount of traffic that enters the network. Instead, we plan on exploiting feedback mechanisms of TCP congestion control algorithms for the purpose of regulating the traffic entering the network.

Contested understandings of recovery in mental health.

PubMed

McCabe, Rhiannah; Whittington, Richard; Cramond, Laura; Perkins, Elizabeth

2018-05-17

The concept of recovery is contested throughout the existing literature and in mental health services. Little research exists that gives voice to service user perspectives of recovery. This paper explores how service users in two recovery oriented services run by the National Health Service in North West England talked about recovery and what it meant to them. 14 service users accessing these services took part in semi-structured qualitative interviews focusing on the concept of recovery. Data were analysed using an interpretive phenomenological analysis approach. Service users talked about recovery as a dynamic, day to day process as well as an outcome; specifically related to being discharged from inpatient settings. A number of factors including relationships and medication were cited to have the potential to make or break recovery. The study highlights the continued dominance of the biomedical model in mental health services. Service users appear to have internalised staff and services' understanding of recovery perhaps unsurprisingly given the power differential in these relationships. Implications for clinical practice are explored.

Managing imperfect competition by pay for performance and reference pricing.

PubMed

Mak, Henry Y

2018-01-01

I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics. However, pay for performance may not outperform prospective payment when consumers are rational and providers are profit maximizing, or when one of the service qualities is not contractible. Copyright © 2017 Elsevier B.V. All rights reserved.

Accountable care organizations and radiology: threat or opportunity?

PubMed

Abramson, Richard G; Berger, Paul E; Brant-Zawadzki, Michael N

2012-12-01

Although the anticipated rise of accountable care organizations brings certain potential threats to radiologists, including direct threats to revenue and indirect systemic changes jeopardizing the bargaining leverage of radiology groups, accountable care organizations, and other integrated health care delivery models may provide radiology with an important opportunity to reassert its leadership and assume a more central role within health care systems. Capitalizing on this potential opportunity, however, will require radiology groups to abandon the traditional "film reader" mentality and engage actively in the design and implementation of nontraditional systems service lines aimed at adding differentiated value to larger health care organizations. Important interlinked and mutually reinforcing components of systems service lines, derived from radiology's core competencies, may include utilization management and decision support, IT leadership, quality and safety assurance, and operational enhancements to meet organizational goals. Such systems-oriented service products, tailored to the needs of individual integrated care entities and supported by objective performance metrics, may provide market differentiation to shield radiology from commoditization and could become an important source of new nonclinical revenue. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Assessing administrative costs of mental health and substance abuse services.

PubMed

Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

2004-05-01

Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care.

Analysis of integrated healthcare networks' performance: a contingency-strategic management perspective.

PubMed

Lin, B Y; Wan, T T

1999-12-01

Few empirical analyses have been done in the organizational researches of integrated healthcare networks (IHNs) or integrated healthcare delivery systems. Using a contingency derived contact-process-performance model, this study attempts to explore the relationships among an IHN's strategic direction, structural design, and performance. A cross-sectional analysis of 100 IHNs suggests that certain contextual factors such as market competition and network age and tax status have statistically significant effects on the implementation of an IHN's service differentiation strategy, which addresses coordination and control in the market. An IHN's service differentiation strategy is positively related to its integrated structural design, which is characterized as integration of administration, patient care, and information system across different settings. However, no evidence supports that the development of integrated structural design may benefit an IHN's performance in terms of clinical efficiency and financial viability.

Evidence of Product Differentiation in the Microfinance Industry

DTIC Science & Technology

2011-05-09

financial services, which include deposits and more importantly credit. Access to credit allows the poor to overcome initial capital barriers when...of microfinance provides financial access to the poorest regions of the world and is seen by many as a means of creating self-sustaining markets. The...that as more for- profit MFI enter the microfinance industry, non-profit MFIs will be crowded out, reducing borrowers‟ access to financial services

Effects on the medical revenue of comprehensive pricing reform in Chinese urban public hospitals after removing drug markups: case of Nanjing.

PubMed

Tang, Wenxi; Xie, Jing; Lu, Yijuan; Liu, Qizhi; Malone, Daniel; Ma, Aixia

2018-04-01

The State Council of China requires that all urban public hospitals must eliminate drug markups by September 2017, and that hospital drugs must be sold at the purchase price. Nanjing-one of the first provincial capital cities to implement the reform-is studied to evaluate the effects of the comprehensive reform on drug prices in public hospitals, and to explore differential compensation plans. Sixteen hospitals were selected, and financial data were collected over the 48-month period before the reform and for 12 months after the reform. An analysis was carried out using a simple linear interrupted time series model. The average difference ratio of drug surplus fell 13.39% after the reform, and the drug markups were basically eliminated. Revenue from medical services showed a net growth of 28.25%. The overall compensation received from government financial budget and medical service revenue growth was 103.69% for the loss from policy-permitted 15% markup sales, and 116.48% for the net loss. However, there were large differences in compensation levels at different hospitals, ranging from -21.92% to 413.74% by medical services revenue growth, causing the combined rate of both financial and service compensation to vary from 28.87-413.74%, There was a significant positive correlation between the services compensation rate and the proportion of medical service revenue (p < .001), and the compensation rate increased by 8% for every 1% increase in the proportion of services revenue. Nanjing's pricing and compensation reform has basically achieved the policy targets of eliminating the drug markups, promoting the growth of medical services revenue, and adjusting the structure of medical revenue. However, the growth rate of service revenue of hospitals varied significantly from one another. Nanjing's reform represents successful pricing and compensation reform in Chinese urban public hospitals. It is recommended that a differentiated and dynamic compensation plan should be established in accordance with the revenue structure of different hospitals.

Legg-Calvé-Perthes disease.

PubMed

Carpenter, B N

1975-03-01

The incidence, pathology, etiology, clinical characteristics, differential diagnosis, and treatment of Legg-Calvé-Perthes disease are reviewed. Physical therapy and follow-up care are discussed, with emphasis on the relationship between orthopedic and physical therapy services.

5 CFR 575.101 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... payment of recruitment incentives. An agency may pay a recruitment incentive to a newly appointed employee... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT INCENTIVES Recruitment Incentives...

The state of health services in China and India: a larger context.

PubMed

Bardhan, Pranab

2008-01-01

In this paper the problems of health services in China and India are related to some structural features of the two economies. Some similarities and differences exist across these two countries in terms of political economy, with differential results. Both countries have experienced remarkable economic growth during the past quarter-century, but this has not always translated into improvements in health for the poor. Although China used to have an egalitarian basic public health service, the system has become quite inegalitarian during the past quarter-century, with the disintegration of the communes and adoption of fee-based services under a system of decentralized public finance. India's health system has remained inegalitarian throughout.

Unified Charging and Billing Solution. Unified - Next Generation of Charging Systems in Mobile Networks

NASA Astrophysics Data System (ADS)

Donhefner, Daniel

The mobile market evolves from commodity voice and simple messaging services to value-added data and multimedia services. This not only implies to move from pure telecom to IT/IP- environment, but to exploit their markets with innovative and differentiated offerings to keep the churn rate low and attract new customers. Communication Service Providers (CSP) must focus increasingly on meeting individual needs and higher expectations of their subscribers. They expect service packages that can be tailored to meet the specific demands of their personal situation, preferences and lifestyle. This requires a flexible customer-centric approach instead of the legacy historical grown and diversed system architecture and organizations of CSPs.

Decentralized Stackelberg Strategies for Interconnected Stochastic Dynamic Systems

DTIC Science & Technology

1977-10-01

Solutions" IM, Vol.8, No.6, p.413- 430, 1971. (42) Rhodes, I.B., and Luenberger, D.G., "Differential Games with Imperfect State Information", E Trans...34, Proc. Systems E for Power, ERDA Conf. Henniker, New Hampshire, 1975. [47) Starr, A.W., and Ho, Y.C., "Nonzero-Sum Differential Games ", Jt_., [ Vol.3, p...CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE October, 1977 Joint Services Electronics Program ,3. NUMSEROWPAGES 97 14. MONITORiNG &GENCY NAME 1

Fertility differentials in rural Bangladesh.

PubMed

Khan, H T; Islam, S M; Khan, H M; Bari, R

1993-01-01

"Data from two sources in rural Bangladesh have been used in this study to examine the differentials in fertility by selected socio-economic and demographic factors. Results [indicate] that age at first marriage, education of spouses and availability of electricity in the household...have [an] inverse relationship with fertility. Higher fertility is observed for Muslim women than for non-Muslims. It has been found that fertility is the lowest to those women whose husbands are service holders and the highest for agriculture." excerpt

Outcomes of a service teaching module on ODEs for physics students

NASA Astrophysics Data System (ADS)

Hyland, Diarmaid; van Kampen, Paul; Nolan, Brien C.

2018-07-01

This paper reports on the first part of a multiphase research project that seeks to identify and address the difficulties encountered by physics students when studying differential equations. Differential equations are used extensively by undergraduate physics students, particularly in the advanced modules of their degree. It is, therefore, necessary that students develop conceptual understanding of differential equations in addition to procedural skills. We have investigated the difficulties encountered by third-year students at Dublin City University in an introductory differential equations module. We developed a survey to identify these difficulties and administered it to students who had recently completed the module. We found that students' mathematical ability in relation to procedural competence is an issue in their study of differential equations, but not as severe an issue as their conceptual understanding. Mathematical competence alone is insufficient if we expect our students to be able to recognize the need for differential equations in a physical context and to be able to set up, solve and interpret the solutions of such equations. We discuss the implications of these results for the next stages of the research project.

Differentiating Science Instruction: Secondary science teachers' practices

NASA Astrophysics Data System (ADS)

Maeng, Jennifer L.; Bell, Randy L.

2015-09-01

This descriptive study investigated the implementation practices of secondary science teachers who differentiate instruction. Participants included seven high school science teachers purposefully selected from four different schools located in a mid-Atlantic state. Purposeful selection ensured participants included differentiated instruction (DI) in their lesson implementation. Data included semi-structured interviews and field notes from a minimum of four classroom observations, selected to capture the variety of differentiation strategies employed. These data were analyzed using a constant-comparative approach. Each classroom observation was scored using the validated Differentiated Instruction Implementation Matrix-Modified, which captured both the extent to which critical indicators of DI were present in teachers' instruction and the performance levels at which they engaged in these components of DI. Results indicated participants implemented a variety of differentiation strategies in their classrooms with varying proficiency. Evidence suggested all participants used instructional modifications that required little advance preparation to accommodate differences in students' interests and learning profile. Four of the seven participants implemented more complex instructional strategies that required substantial advance preparation by the teacher. Most significantly, this study provides practical strategies for in-service science teachers beginning to differentiate instruction and recommendations for professional development and preservice science teacher education.

Returns to Scale in the Production of Hospital Services

PubMed Central

Berry, Ralph E.

1967-01-01

The primary purpose of this article is to investigate whether or not economies of scale exist in the production of hospital services. In previous studies the results have implied the existence of economies of scale, but the question has not been satisfactorily resolved. The factor most responsible for clouding the issue is the overwhelming prevalence of product differences in the outputs of hospitals. In this study a method which avoids the problem of product differentiation is developed. The analysis strongly supports the conclusion that hospital services are produced subject to economies of scale. PMID:6054380

Game on: creating competitive advantages.

PubMed

Riskind, Patricia; Foreman, M Shane

2004-01-01

Whether you are opening a new imaging center or trying to keep an existing center competitive, there are 3 critical factors: customer service, marketing, and a "what's next?" attitude. Customer service: Outstanding customer service is what sticks in the minds of referring physicians and patients. Not only does providing better service differentiate you from the competition, but it also boosts employee morale and motivates people to acquire new skills. Marketing: From the front office staff to the radiologists,promoting the center should be part of every employee's job description. Simply paying lip service to the concept of marketing will not cut it. A "what's next?" attitude: Complacency is a luxury that does not exist in today's competitive health care arena. Three facilities provide examples of how these factors applied to their success.

5 CFR 591.229 - How does OPM inform agencies and employees of COLA rate changes?

Code of Federal Regulations, 2010 CFR

2010-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post... COLA rate changes? OPM publishes COLA area survey summary reports, MEG and PEG indexes, and COLA rates...

Evaluation Plan -- The Minneapolis Ridesharing Commuter Services Demonstration

DOT National Transportation Integrated Search

1978-05-01

In April 1977, the Metropolitan Transit Commission initiated a two-year demonstration project designed to increase work trip-vehicle occupancy at selected employment sites in the Twin Cities region. Key elements of this demonstration which differenti...

Evaluation of Thermal Stability of Ausferrite in Austempered Ductile Iron Using Differential Scanning Calorimetry

NASA Astrophysics Data System (ADS)

Warsinski, Karl C.

Austempered Ductile Iron (ADI) is prone to changes in microstructure and mechanical properties when exposed to elevated service temperatures. Differential Scanning Calorimetry has been used to evaluate the stabilizing effects of copper, nickel, molybdenum, and cobalt on the ausferrite structure. Previous studies have conflated the effects of various alloy additions, and little effort has been made to systematically catalog the effects of individual elements. The focus of the current research has been to identify alloying elements that more strongly stabilize the ausferrite structure in order to improve service life of ADI at elevated temperatures. Nickel has been shown to have a moderate stabilizing effect, while copper and molybdenum cause a much sharper increase in activation energy. Cobalt has a high stabilizing effect at 0.5% addition by weight, but a further increase to 2.36% results in a slight decrease in activation energy.

76 FR 44320 - Buckeye Power, Inc. v. American Transmission Systems, Incorporated; Notice of Complaint

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

... Respondent) alleging that ATSI's voltage-differentiated rates for transmission service in the ATSI Zone of..., regardless of voltage. Buckeye certifies that copies of the complaint were served on ATSI, PJM, and the...

Communications technologies for automated dependent surveillance

DOT National Transportation Integrated Search

1995-01-01

In this work a new concept known as Automated Dependent Surveillance or ADS was introduced. ADS was an improvement to current Vessel Traffic Service (VTS) operations. One of the enabling technologies for the ADS concept was the advent of differential...

46 CFR 252.42 - Appeals procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Appeals procedures. 252.42 Section 252.42 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Subsidy...

46 CFR 252.11 - Application forms.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Application forms. 252.11 Section 252.11 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Eligibility...

A Belief-based Trust Model for Dynamic Service Selection

NASA Astrophysics Data System (ADS)

Ali, Ali Shaikh; Rana, Omer F.

Provision of services across institutional boundaries has become an active research area. Many such services encode access to computational and data resources (comprising single machines to computational clusters). Such services can also be informational, and integrate different resources within an institution. Consequently, we envision a service rich environment in the future, where service consumers can intelligently decide between which services to select. If interaction between service providers/users is automated, it is necessary for these service clients to be able to automatically chose between a set of equivalent (or similar) services. In such a scenario trust serves as a benchmark to differentiate between service providers. One might therefore prioritize potential cooperative partners based on the established trust. Although many approaches exist in literature about trust between online communities, the exact nature of trust for multi-institutional service sharing remains undefined. Therefore, the concept of trust suffers from an imperfect understanding, a plethora of definitions, and informal use in the literature. We present a formalism for describing trust within multi-institutional service sharing, and provide an implementation of this; enabling the agent to make trust-based decision. We evaluate our formalism through simulation.

A population ecology perspective on the functioning and future of health information organizations.

PubMed

Vest, Joshua R; Menachemi, Nir

2017-11-01

Increasingly, health care providers need to exchange information to meet policy expectations and business needs. A variety of health information organizations (HIOs) provide services to facilitate health information exchange (HIE). However, the future of these organizations is unclear. The aim of this study was to explore the environmental context, potential futures, and survivability of community HIOs, enterprise HIEs, and electronic health record vendor-mediated exchange using the population ecology theory. Qualitative interviews with 33 key informants representing each type of HIE organization were analyzed using template analysis. Community HIOs, enterprise HIEs, and electronic health record vendors exhibited a high degree of competition for resources, especially in the area of exchange infrastructure services. Competition resulted in closures in some areas. In response to environmental pressures, each organizational type was endeavoring to differentiate its services and unique use case, as well as pursing symbiotic relationships or attempting resource partitioning. HIOs compete for similar resources and are reacting to environmental pressures to better position themselves for continued survival and success. Our ecological research perspective helps move the discourse away from situation of a single exchange organization type toward a view of the broader dynamics and relationships of all organizations involved in facilitating HIE activities. HIOs are attempting to partition the environment and differentiate services. HIE options should not be construed as an "either/or" decision, but one where multiple and complementary participation may be required.

Multiple Response System: Evaluation of Policy Change in North Carolina's Child Welfare System.

PubMed

Lawrence, C Nicole; Rosanbalm, Katie D; Dodge, Kenneth A

2011-11-01

Systemic challenges within child welfare have prompted many states to explore new strategies aimed at protecting children while meeting the needs of families, but doing so within the confines of shrinking budgets. Differential Response has emerged as a promising practice for low or moderate risk cases of child maltreatment. This mixed methods evaluation explored various aspects of North Carolina's differential response system, known as the Multiple Response System (MRS), including: child safety, timeliness of response and case decision, frontloading of services, case distribution, implementation of Child and Family Teams, collaboration with community-based service providers and Shared Parenting. Utilizing Child Protective Services (CPS) administrative data, researchers found that compared to matched control counties, MRS: had a positive impact on child safety evidenced by a decline in the rates of substantiations and re-assessments; temporarily disrupted timeliness of response in pilot counties but had no effect on time to case decision; and increased the number of upfront services provided to families during assessment. Qualitative data collected through focus groups with providers and phone interviews with families provided important information on key MRS strategies, highlighting aspects that families and social workers like as well as identifying areas for improvement. This information is useful for continuous quality improvement efforts, particularly related to the development of training and technical assistance programs at the state and local level.

The effect of performance-based financing on illness, care-seeking and treatment among children: an impact evaluation in Rwanda.

PubMed

Skiles, Martha Priedeman; Curtis, Siân L; Basinga, Paulin; Angeles, Gustavo; Thirumurthy, Harsha

2015-09-14

Performance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty. Districts were allocated to intervention and comparison for PBF implementation in Rwanda. Using Demographic Health Survey data from 2005 to 2007-08, a community-level panel dataset of 5781 children less than 5 years of age from intervention and comparison districts was created. The impacts of PBF on reported childhood illness, facility care-seeking, and treatment received were estimated using a difference-in-differences model with community fixed effects. An interaction term between poverty and the program was estimated to identify the differential effect of PBF among children from poorer families. There was no measurable difference in estimated probability of reporting illness with diarrhea, fever or acute respiratory infections between the intervention and comparison groups. Seeking care at a facility for these illnesses increased over time, however no differential effect by PBF was seen. The estimated effect of PBF on receipt of treatment for poor children is 45 percentage points higher (p = 0.047) compared to the non-poor children seeking care for diarrhea or fever. PBF, a supply-side incentive program, improved the quality of treatment received by poor children conditional on patients seeking care, but it did not impact the propensity to seek care. These findings provide additional evidence that PBF incentivizes the critical role staff play in assuring quality services, but does little to influence consumer demand for these services. Efforts to improve child health need to address both supply and demand, with additional attention to barriers due to poverty if equity in service use is a concern.

Environmental services generated by organic agriculture: A view from the air

NASA Astrophysics Data System (ADS)

Bigeriego, Elena; Cabezas, José; Labrador, Juana; María Moreno, Marta

2017-04-01

This work aims to develop an alternative methodology that enables monitoring the environmental differential that agroecological management involves in order to consolidate feasible payments for environmental services generated by organic agriculture. For this purpose, LANDSAT images have been used, and the Normalized Difference Vegetation Index (NDVI) of organic fruit farms, all of them with the same species and the similar edaphic and climatic characteristics, has been compared with the NDVI obtained at other nearby fruit farms under conventional management, all of them in Extremadura (Spain). As a result, we obtained a series of statistical data that allows us to clearly differentiate between these two types of management. Among these data, remarkable differences have been detected regarding the minimum values of NDVI in the non-productive periods of the fruit, which is higher in the organic farms due to the permanent vegetation soil cover, with the subsequent effects on soil protection and carbon sequestration. The conclusions of the paper show that it is possible to distinguish different models of crop management by using satellite images obtained in a quick and inexpensive way. Keywords: LANDSAT images; NDVI; environmental services; agroecology; organic agriculture.

Admission and Preventive Load Control for Delivery of Multicast and Broadcast Services via S-UMTS

NASA Astrophysics Data System (ADS)

Angelou, E.; Koutsokeras, N.; Andrikopoulos, I.; Mertzanis, I.; Karaliopoulos, M.; Henrio, P.

2003-07-01

An Admission Control strategy is proposed for unidirectional satellite systems delivering multicast and broadcast services to mobile users. In such systems, both the radio interface and the targeted services impose particular requirements on the RRM task. We briefly discuss the RRM requirements that stem from the services point of view and from the features of the SATIN access scheme that differentiate it from the conventional T-UMTS radio interface. The main functional entities of RRM and the alternative modes of operation are outlined and the proposed Admission Control algorithm is described in detail. The results from the simulation study that demonstrate its performance for a number of different scenarios are finally presented and conclusions derived.

5 CFR 591.405 - Responsibilities of agencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Responsibilities of agencies. 591.405 Section 591.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.405...

Cardiology needs good planning for the future.

PubMed

Goodroe, J H; Hicks, K J

1990-08-01

In today's health care environment, hospitals have to develop strategies to maintain their market share, especially in cardiac services. The authors share generic strategies in cost leadership, product differentiation and technological leadership that can be adapted and implemented in cardiac centers.

A new three-dimensional manufacturing service composition method under various structures using improved Flower Pollination Algorithm

NASA Astrophysics Data System (ADS)

Zhang, Wenyu; Yang, Yushu; Zhang, Shuai; Yu, Dejian; Chen, Yong

2018-05-01

With the growing complexity of customer requirements and the increasing scale of manufacturing services, how to select and combine the single services to meet the complex demand of the customer has become a growing concern. This paper presents a new manufacturing service composition method to solve the multi-objective optimization problem based on quality of service (QoS). The proposed model not only presents different methods for calculating the transportation time and transportation cost under various structures but also solves the three-dimensional composition optimization problem, including service aggregation, service selection, and service scheduling simultaneously. Further, an improved Flower Pollination Algorithm (IFPA) is proposed to solve the three-dimensional composition optimization problem using a matrix-based representation scheme. The mutation operator and crossover operator of the Differential Evolution (DE) algorithm are also used to extend the basic Flower Pollination Algorithm (FPA) to improve its performance. Compared to Genetic Algorithm, DE, and basic FPA, the experimental results confirm that the proposed method demonstrates superior performance than other meta heuristic algorithms and can obtain better manufacturing service composition solutions.

Female victims of domestic violence: which victims do police refer to crisis intervention?

PubMed

Kernic, Mary A; Bonomi, Amy E

2007-01-01

Factors associated with activation of a volunteer-based crisis intervention services program for victims of police-reported intimate partner violence (IPV) were examined to determine if those for whom services were activated were representative of the overall eligible population. The study population comprised 2,092 adult female victims of male-perpetrated police-reported IPV. Crisis intervention services were requested by responding patrol officers in 415 (19.8%) of these incidents. Activation of crisis intervention services was more likely for victims who were married to their abusive partner, pregnant, or of Latina or Asian race/ethnicity and among IPV incidents involving physical abuse, visible victim injuries, and arrest of the abusive partner. Additionally, one of the city's five police precincts was less likely than the remaining four to utilize these services. Activation of crisis intervention services was associated with factors related to need and feasibility of service delivery, but differential activation at the precinct level was also found to be influential.

5 CFR 575.212 - Internal monitoring requirements and revocation or suspension of authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Internal monitoring requirements and... MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT INCENTIVES Relocation Incentives § 575.212 Internal monitoring...

5 CFR 575.312 - Internal monitoring requirements and revocation or suspension of authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Internal monitoring requirements and... MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT INCENTIVES Retention Incentives § 575.312 Internal monitoring...

Medical Service Clinical Laboratory Procedures--Bacteriology.

ERIC Educational Resources Information Center

Department of the Army, Washington, DC.

This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…

7 CFR 1033.54 - Equivalent price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1033.54 Section 1033.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1033.54 Equivalent price. See § 1000.54. Producer Price Differential ...

7 CFR 1032.54 - Equivalent price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential ...

7 CFR 1126.54 - Equivalent price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1126.54 Section 1126.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1126.54 Equivalent price. See § 1000.54. Producer Price Differential ...

5 CFR 591.401 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 591.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.401 Purpose and... States Code, to authorize payment of a separate maintenance allowance to assist an employee assigned to...

5 CFR 591.406 - Records and reports.

Code of Federal Regulations, 2010 CFR

2010-01-01

....406 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.406 Records and reports. So that the Office of Personnel Management can evaluate agencies' use of this authority and provide the...

5 CFR 591.402 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.402 Definitions. Adult, a term used in the... separate maintenance allowance, but who does not receive from the Government an allowance similar to that...

5 CFR 575.401 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND... payment of a supervisory differential to an employee under the General Schedule who has supervisory responsibility for one or more civilian employees not under the General Schedule if one or more of the...

Investing in Elder Craftsmen.

ERIC Educational Resources Information Center

Schreter, Carol A.; Hudson, Nadine

1981-01-01

Describes an Elder Craftsman Shop, established by an urban senior citizens center, to provide aged artisans with a sales outlet for handmade goods. Analyzes program resources, pricing systems, and earning patterns of consignors to identify elements which differentiate this quasisocial service from competitive handicraft shops. (Author/JAC)

46 CFR 252.4 - Waivers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Waivers. 252.4 Section 252.4 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Introduction § 252.4 Waivers. In...

46 CFR 252.10 - Eligibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Eligibility. 252.10 Section 252.10 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Eligibility and Agreement § 252.10...

46 CFR 252.13 - Contract.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Contract. 252.13 Section 252.13 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Eligibility and Agreement § 252.13...

46 CFR 252.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Purpose. 252.1 Section 252.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Introduction § 252.1 Purpose. This...

5 CFR 591.302 - Coverage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Coverage. 591.302 Section 591.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.302 Coverage. (a) Agencies. This subpart applies to...

5 CFR 591.302 - Coverage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Coverage. 591.302 Section 591.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.302 Coverage. (a) Agencies. This subpart applies to...

5 CFR 591.302 - Coverage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Coverage. 591.302 Section 591.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.302 Coverage. (a) Agencies. This subpart applies to...

5 CFR 591.302 - Coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Coverage. 591.302 Section 591.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.302 Coverage. (a) Agencies. This subpart applies to...

5 CFR 591.302 - Coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Coverage. 591.302 Section 591.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.302 Coverage. (a) Agencies. This subpart applies to...

5 CFR 575.107 - Agency recruitment incentive plan and approval levels.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Agency recruitment incentive plan and... SERVICE REGULATIONS RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES; SUPERVISORY DIFFERENTIALS; AND EXTENDED ASSIGNMENT INCENTIVES Recruitment Incentives § 575.107 Agency recruitment incentive plan and...

Guarded self-disclosure predicts psychological distress and willingness to use psychological services among East Asian immigrants in the United States.

PubMed

Barry, Declan T; Mizrahi, Trina C

2005-08-01

This study examined the relationship between guarded self-disclosure, psychological distress, and willingness to use psychological services if distressed among 170 (88 male, 82 female) East Asian immigrants in the United States. Participants were administered a battery of psychometrically established measures. Participants who endorsed overall guarded self-disclosure, self-concealment (i.e., unwillingness to reveal affect to others), or conflict avoidance (i.e., maintenance of harmony via suppression of feelings) were significantly more likely to report psychological distress and were significantly less likely to report willingness to use psychological services. While conflict avoidance was a significant independent predictor of psychological distress, self-concealment was a significant independent predictor of willingness to use psychological services. These findings point to the importance of assessing multiple facets of guarded self-disclosure, which appear to be differentially associated with psychological distress and willingness to use psychological services.

The State of Client-Centered Public Service Delivery in the Netherlands

NASA Astrophysics Data System (ADS)

Jansen, Jurjen; de Vries, Sjoerd; van der Geest, Thea; Arendsen, Rex; van Dijk, Jan

Businesses and citizens demand a better and more client-centered way of service delivery from public organizations. As society becomes more complex, dynamic and diverse, public organizations need to adapt to this demand. Conversely, our perception is that public organizations might still treat their target groups as one. However, the need for client-centered public service delivery is growing. This is widely debated in literature. Nonetheless, little empirical evidence is available about the state of client-centeredness of public organizations. The objective of the present study is to identify the state of client-centered public service delivery in the Netherlands. In order to research this topic 400 people from 194 Dutch public organizations were invited to complete an electronic questionnaire. 105 people responded. According to the respondents the state of client-centeredness is acceptable. However, only 25% of the public organizations seem to take differentiation as the point of departure for their service delivery.

Customer and service profitability

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

Ballaban, M.; Kelly, K.; Wisniewski, L.

1996-03-01

The rapid pace of competitive change in the generation sector has pushed electric utilities to rethink the concept of being obligated to serve all customers and with this change, the notion of measuring customer profitability is also being redefined. Traditionally, uniform services were provided to all customers. Rates were based on each customer classes` contribution to average costs, and consequently return was equally allocated across all customer segments. Profitability was defined strictly on an aggregate basis. The increasing demand for choice by electric customers will require electricity providers to redefine if not who they serve, than certainly how they providemore » differentiated services tailored to specific customer segments. Utilities are beginning to analyze the value, or profitability, of offering these services. Aggregate data no longer provides an accurate assessment of how resources should be allocated most efficiently. As services are unbundled, so too must costs be disaggregated to effectively measure the profitability of various options.« less

Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning: still a long way to go.

PubMed

Nouwens, P J G; Smulders, N B M; Embregts, P J C M; van Nieuwenhuizen, C

2017-12-01

Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning. Five (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files. Persons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non-verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services. The support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

7 CFR 1124.54 - Equivalent price.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1124.54 Section 1124.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Class Prices § 1124.54 Equivalent price. See § 1000.54. Producer Price Differential ...

5 CFR 591.404 - Method of payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

....404 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.404 Method of payment. (a) Separate maintenance allowance rates are paid from the employee's date of arrival at Johnston Island to the...

5 CFR 591.403 - Amount of payment.

Code of Federal Regulations, 2010 CFR

2010-01-01

....403 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Separate Maintenance Allowance for Duty at Johnston Island § 591.403 Amount of payment. (a) The annual rate of the separate maintenance allowance paid to an employee shall be determined by the number...

33 CFR 401.20 - Automatic Identification System.

Code of Federal Regulations, 2010 CFR

2010-07-01

...' maritime Differential Global Positioning System radiobeacon services; or (7) The use of a temporary unit... Identification System. (a) Each of the following vessels must use an Automatic Identification System (AIS... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Automatic Identification System...

Customizing Curriculum with Digital Resources

ERIC Educational Resources Information Center

Miller, Jeffrey

2011-01-01

To effectively use digital resources in the classroom, teachers must customize the information, merge it with pre-existing curriculum, differentiate it for diverse student populations, and still meet standards-based learning goals. This article describes a solution to these challenges: the Curriculum Customization Service, which provides access to…

Distributed Multiple Access Control for the Wireless Mesh Personal Area Networks

NASA Astrophysics Data System (ADS)

Park, Moo Sung; Lee, Byungjoo; Rhee, Seung Hyong

Mesh networking technologies for both high-rate and low-rate wireless personal area networks (WPANs) are under development by several standardization bodies. They are considering to adopt distributed TDMA MAC protocols to provide seamless user mobility as well as a good peer-to-peer QoS in WPAN mesh. It has been, however, pointed out that the absence of a central controller in the wireless TDMA MAC may cause a severe performance degradation: e. g., fair allocation, service differentiation, and admission control may be hard to achieve or can not be provided. In this paper, we suggest a new framework of resource allocation for the distributed MAC protocols in WPANs. Simulation results show that our algorithm achieves both a fair resource allocation and flexible service differentiations in a fully distributed way for mesh WPANs where the devices have high mobility and various requirements. We also provide an analytical modeling to discuss about its unique equilibrium and to compute the lengths of reserved time slots at the stable point.

A hybrid credibility-based fuzzy multiple objective optimisation to differential pricing and inventory policies with arbitrage consideration

NASA Astrophysics Data System (ADS)

Ghasemy Yaghin, R.; Fatemi Ghomi, S. M. T.; Torabi, S. A.

2015-10-01

In most markets, price differentiation mechanisms enable manufacturers to offer different prices for their products or services in different customer segments; however, the perfect price discrimination is usually impossible for manufacturers. The importance of accounting for uncertainty in such environments spurs an interest to develop appropriate decision-making tools to deal with uncertain and ill-defined parameters in joint pricing and lot-sizing problems. This paper proposes a hybrid bi-objective credibility-based fuzzy optimisation model including both quantitative and qualitative objectives to cope with these issues. Taking marketing and lot-sizing decisions into account simultaneously, the model aims to maximise the total profit of manufacturer and to improve service aspects of retailing simultaneously to set different prices with arbitrage consideration. After applying appropriate strategies to defuzzify the original model, the resulting non-linear multi-objective crisp model is then solved by a fuzzy goal programming method. An efficient stochastic search procedure using particle swarm optimisation is also proposed to solve the non-linear crisp model.

MicroRNA Expression Profiling of the Armed Forces Health Surveillance Branch Cohort for Identification of "Enviro-miRs" Associated With Deployment-Based Environmental Exposure.

PubMed

Dalgard, Clifton L; Polston, Keith F; Sukumar, Gauthaman; Mallon, Col Timothy M; Wilkerson, Matthew D; Pollard, Harvey B

2016-08-01

The aim of this study was to identify serum microRNA (miRNA) biomarkers that indicate deployment-associated exposures in service members at military installations with open burn pits. Another objective was to determine detection rates of miRNAs in Department of Defense Serum Repository (DoDSR) samples with a high-throughput methodology. Low-volume serum samples (n = 800) were profiled by miRNA-capture isolation, pre-amplification, and measurement by a quantitative PCR-based OpenArray platform. Normalized quantitative cycle values were used for differential expression analysis between groups. Assay specificity, dynamic range, reproducibility, and detection rates by OpenArray passed target desired specifications. Serum abundant miRNAs were consistently measured in study specimens. Four miRNAs were differentially expressed in the case deployment group subjects. miRNAs are suitable RNA species for biomarker discovery in the DoDSR serum specimens. Serum miRNAs are candidate biomarkers for deployment and environmental exposure in military service members.

Home and Community-Based Service Use by Vulnerable Older Adults.

PubMed

Weaver, Raven H; Roberto, Karen A

2017-06-01

The purpose of this study was to identify different types of clients who use home and community-based services. Enrollment characteristics of 76 clients at risk of nursing home placement and Medicaid spend-down who were enrolled in the Virginia Community Living Program were analyzed. Two-step cluster analysis identified 4 groups of service users. Enabling resources (caregiver relationship to participant, participant living arrangement, and length of time caregiver provided assistance to participant) and disability type (physical, cognitive, traumatic brain injury, or other) differentiated the client groups. Groups differed on average service cost per day and likelihood of nursing home placement if services were not provided. Findings point to the value of having practitioners assist vulnerable clients in tailoring services to meet different care needs and the need for refining policies guiding home and community-based care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

PubMed

Afifi, Ladan; Shinkai, Kanade

2017-03-01

Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

Access to Recovery and Recidivism among Former Prison Inmates

PubMed Central

Ray, Bradley; Grommon, Eric; Buchanan, Victoria; Brown, Brittany

2015-01-01

Access to Recovery (ATR) is a SAMHSA-funded initiative that offers a mix of clinical and supportive services for substance abuse. ATR clients choose which services will help to overcome barriers in their road to recovery, and a recovery consultant provides vouchers and helps link the client to these community resources. One of ATR's goals was to provide services to those involved in the criminal justice system in the hopes that addressing substance abuse issues could reduce subsequent criminal behaviors. This study examines this goal by looking at recidivism among a sample of clients in one state's ATR program who returned to the community after incarceration. Results suggest there were few differential effects of service selections on subsequent recidivism. However, there are significant differences in recidivism rates among the agencies that provided ATR services. Agencies with more resources and a focus on prisoner reentry had better recidivism outcomes than those that focus only on substance abuse services. PMID:26385191

Understanding Service Utilization in Cases of Elder Abuse to Inform Best Practices.

PubMed

Burnes, David; Rizzo, Victoria M; Gorroochurn, Prakash; Pollack, Martha H; Lachs, Mark S

2016-10-01

Elder abuse (EA) case resolution is contingent upon victims accepting and pursuing protective service interventions. Refusal/underutilization of services is a major problem. This study explored factors associated with extent of EA victim service utilization (SU). Data were collected from a random sample of EA cases (n = 250) at a protective service program in New York City. In cases involving financial abuse, higher SU was associated with females, poor health, perceived danger, previous help-seeking, and self or family referral. In physical abuse cases, higher SU was associated with family referral and previous help-seeking; lower SU was related to Hispanic race/ethnicity, being married, and child/grandchild perpetrator. In emotional abuse cases, higher SU was associated with self or family referral, victim-perpetrator gender differential, perceived danger, and previous help-seeking; lower SU was related to child/grandchild perpetrator. Findings carry implications for best practices to retain and promote service use among elder victims of abuse. © The Author(s) 2014.

A cost-constrained model of strategic service quality emphasis in nursing homes.

PubMed

Davis, M A; Provan, K G

1996-02-01

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.

Cure-in-place process for seals

DOEpatents

Hirasuna, Alan R.

1981-01-01

A cure-in-place process which allows a rubber seal element to be deformed to its service configuration before it is cross-linked and, hence, is a plastic and does not build up internal stress as a result of the deformation. This provides maximum residual strength to resist the differential pressure. Furthermore, the process allows use of high modulus formulations of the rubber seal element which would otherwise crack if cured and then deformed to its service configuration, resulting in a seal which has better gap bridging capability. Basically, the process involves positioning an uncured seal element in place, deforming it to its service configuration, heating the seal element, curing it in place, and then fully seating the seal.

Implications of differentiated care for successful ART scale-up in a concentrated HIV epidemic in Yangon, Myanmar.

PubMed

Mesic, Anita; Fontaine, Julie; Aye, Theingy; Greig, Jane; Thwe, Thin Thin; Moretó-Planas, Laura; Kliesckova, Jarmila; Khin, Khin; Zarkua, Nana; Gonzalez, Lucia; Guillergan, Erwin Lloyd; O'Brien, Daniel P

2017-07-21

National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)-supported programmes and reports its outcomes. A descriptive cohort analysis of adult patients on antiretroviral treatment was performed. We assessed stability of patients as of 31 December 2014 and introduced an intervention of reduced frequency of physicians' consultations for stable patients, and fast tract ART refills. We measured a number of saved physician's visits as the result of this intervention. Main outcomes, remained under care, death, lost to follow up, treatment failure, were assessed on 31 December 2015 and reported as rates for different stable groups. On 31 December 2014, our programme counted 16, 272 adult patients enrolled in HIV care, of whom 80.34% were stable. The model allowed for an increase in the average number of patients one medical team could care for - from 745 patients in 2011 to 1, 627 in 2014 - and, thus, a reduction in the number of teams needed. An assessment of stable patients enrolled on ART one year after the implementation of the new model revealed excellent outcomes, aggregated for stable patients as 98.7% remaining in care, 0.4% dead, 0.8% lost to follow-up, 0.8% clinical treatment failure and 5.8% with immunological treatment failure. Implementation of a differentiated model reduced the number of visits between stable clients and physicians, reduced the medical resources required for treatment and enabled integrated treatment of the main co-morbidities. We hope that these findings will encourage other stakeholders to implement innovative models of HIV care in Myanmar, further expediting the scale up of ART services, the decentralization of treatment and the integration of care for the main HIV co-morbidities in this context.

The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study.

PubMed

Baldwin, Richard; Duffield, Christine Margaret; Fry, Margaret; Roche, Michael; Stasa, Helen; Solman, Annette

2013-03-01

The NSW Health Policy Directive (NSW Department of Health, 2000) lists clinical service and consultancy; clinical leadership; research; education; clinical services planning and management as the five domains of practice for nurses appointed as Clinical Nurse Consultants (CNCs), an Australian advanced practice nurse (APN) role. However, there is no clear definition of what is meant by advanced practice in the Australian nursing context. Nowhere is this more evident than in differentiating between the roles of Clinical Nurse Consultants (CNCs) and Nurse Practitioners (NP) in NSW. To date, limited empirical research has been done to characterise or delineate CNC role activity and responsibility. To investigate (i) the nature of CNC roles, activities and responsibilities, (ii) differentiate between CNCs by their work patterns and activities, and (iii) empirically conceptualize and differentiate ways CNCs practice in terms of an APN typology. The study sample was 56 CNCs at one tertiary level public hospital in Australia. A descriptive exploratory cohort study was conducted to explore CNC role characteristics and patterns of activity. Data were triangulated using an online survey, a follow-up survey, and semi-structured interviews. The data were analysed using descriptive statistics to examine differences between CNC work patterns and role activities. The survey data and the individual reports were thematically analysed to investigate for difference across the population of CNCs. Interpretation of survey and interview data led to an analyst-developed CNC typology of four CNC categories based on the work patterns and activities of Sole Practitioner, Clinic Coordinator, Clinical Team Coordinator and Clinical Leader. The typology was based on the themes interprofessional, role focus, clinical focus and setting as these themes distinguished and differentiated CNC roles. The study provides evidence of great diversity and prioritization within CNC roles. The CNC typology identified in this study is similar to the categorisation of the roles of APNs reported by other researchers. With further testing, the CNC typology could be useful to service managers and policy makers in making decision on the category of CNC required for a position and may also be able to be applied to other APN roles. Copyright © 2012 Elsevier Ltd. All rights reserved.

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Charges for maternity services: associations with provider type and payer source in a university teaching hospital.

PubMed

Carr, C A

2000-01-01

Considerable evidence exists that payer status influences the type and cost of services provided. If payer status influences care, consumers may receive differential care secondary to presence and type of payer. This study examines the effect of payer status on certified nurse-midwives (CNMs) and obstetricians (OBs), correcting for methodologic problems that have been noted in previous studies. Participants were 715 low-risk pregnant women seen in the CNM or OB practice in a university hospital service. All billed charges from the initial prenatal visit through two months postpartum were compared by payer. Charges by provider were also examined to determine the presence of differential payer effect. Unexpectedly, charges by payer did not show significant variance, nor did payer differently affect providers. Charges by provider type varied significantly, with CNMs having lower mean charges than OBs. Differences in practice by payer source were not found for either provider group. This may reflect a lack of financial incentives to alter practice based on the payer, the homogeneity of the participants, or the large number of payers. The findings indicate that provider decision-making styles are likely due to non-payer factors in a system that lacks clear incentives to alter care patterns.

Towards Internet QoS provisioning based on generic distributed QoS adaptive routing engine.

PubMed

Haikal, Amira Y; Badawy, M; Ali, Hesham A

2014-01-01

Increasing efficiency and quality demands of modern Internet technologies drive today's network engineers to seek to provide quality of service (QoS). Internet QoS provisioning gives rise to several challenging issues. This paper introduces a generic distributed QoS adaptive routing engine (DQARE) architecture based on OSPFxQoS. The innovation of the proposed work in this paper is its undependability on the used QoS architectures and, moreover, splitting of the control strategy from data forwarding mechanisms, so we guarantee a set of absolute stable mechanisms on top of which Internet QoS can be built. DQARE architecture is furnished with three relevant traffic control schemes, namely, service differentiation, QoS routing, and traffic engineering. The main objective of this paper is to (i) provide a general configuration guideline for service differentiation, (ii) formalize the theoretical properties of different QoS routing algorithms and then introduce a QoS routing algorithm (QOPRA) based on dynamic programming technique, and (iii) propose QoS multipath forwarding (QMPF) model for paths diversity exploitation. NS2-based simulations proved the DQARE superiority in terms of delay, packet delivery ratio, throughput, and control overhead. Moreover, extensive simulations are used to compare the proposed QOPRA algorithm and QMPF model with their counterparts in the literature.

Towards Internet QoS Provisioning Based on Generic Distributed QoS Adaptive Routing Engine

PubMed Central

Haikal, Amira Y.; Badawy, M.; Ali, Hesham A.

2014-01-01

Increasing efficiency and quality demands of modern Internet technologies drive today's network engineers to seek to provide quality of service (QoS). Internet QoS provisioning gives rise to several challenging issues. This paper introduces a generic distributed QoS adaptive routing engine (DQARE) architecture based on OSPFxQoS. The innovation of the proposed work in this paper is its undependability on the used QoS architectures and, moreover, splitting of the control strategy from data forwarding mechanisms, so we guarantee a set of absolute stable mechanisms on top of which Internet QoS can be built. DQARE architecture is furnished with three relevant traffic control schemes, namely, service differentiation, QoS routing, and traffic engineering. The main objective of this paper is to (i) provide a general configuration guideline for service differentiation, (ii) formalize the theoretical properties of different QoS routing algorithms and then introduce a QoS routing algorithm (QOPRA) based on dynamic programming technique, and (iii) propose QoS multipath forwarding (QMPF) model for paths diversity exploitation. NS2-based simulations proved the DQARE superiority in terms of delay, packet delivery ratio, throughput, and control overhead. Moreover, extensive simulations are used to compare the proposed QOPRA algorithm and QMPF model with their counterparts in the literature. PMID:25309955

Accuracy and coverage of the modernized Polish Maritime differential GPS system

NASA Astrophysics Data System (ADS)

Specht, Cezary

2011-01-01

The DGPS navigation service augments The NAVSTAR Global Positioning System by providing localized pseudorange correction factors and ancillary information which are broadcast over selected marine reference stations. The DGPS service position and integrity information satisfy requirements in coastal navigation and hydrographic surveys. Polish Maritime DGPS system has been established in 1994 and modernized (in 2009) to meet the requirements set out in IMO resolution for a future GNSS, but also to preserve backward signal compatibility of user equipment. Having finalized installation of the new technology L1, L2 reference equipment performance tests were performed.The paper presents results of the coverage modeling and accuracy measuring campaign based on long-term signal analyses of the DGPS reference station Rozewie, which was performed for 26 days in July 2009. Final results allowed to verify the coverage area of the differential signal from reference station and calculated repeatable and absolute accuracy of the system, after the technical modernization. Obtained field strength level area and position statistics (215,000 fixes) were compared to past measurements performed in 2002 (coverage) and 2005 (accuracy), when previous system infrastructure was in operation.So far, no campaigns were performed on differential Galileo. However, as signals, signal processing and receiver techniques are comparable to those know from DGPS. Because all satellite differential GNSS systems use the same transmission standard (RTCM), maritime DGPS Radiobeacons are standardized in all radio communication aspects (frequency, binary rate, modulation), then the accuracy results of differential Galileo can be expected as a similar to DGPS.Coverage of the reference station was calculated based on unique software, which calculate the signal strength level based on transmitter parameters or field signal strength measurement campaign, done in the representative points. The software works based on Baltic sea vector map, ground electric parameters and models atmospheric noise level in the transmission band.

Gender and Regional Differentials in Health Expectancy in Greece

PubMed Central

Bagavos, Christos

2013-01-01

Background Differentials and inequalities in heath status are closely related to the implementation and the sustainability of public health policies. The paper investigates differences in health expectancy as an indicator of population health among regions and between genders. Design and Methods Based on activity limitation, we compute Healthy Life Years indicator by applying the prevalence-based Sullivan method. The analysis is based on data from the National Health Survey conducted in Greece in 2009 by the Hellenic Statistical Authority, carried out on a multistage probability sample of 6172 individuals. Results The results show that men are more likely than women to live a greater part of their life in good health. When regions are considered (NUTS_1 and NUTS_2 levels), the resulting diversities in healthy life years are more pronounced than those in life expectancy. Conclusions The paper provides additional insights about health status discrepancies among Greek geographic regions and between genders. The results indicate that men are more likely to report to be in good health than women, and the differences by gender are more pronounced at regional than at national level. This empirical evidence can be used for monitoring both, the population health status and the undesired differentials in health expectancy, and may therefore be a useful tool for health policies aiming at reducing heath inequalities among individuals. Significance for public health Health expectancy differentials challenge the debate about health policies aiming at reducing heath inequalities among individuals. The paper suggests that health status discrepancies measured by healthy life years’ indicator are pronounced among regions and between genders. Our findings have implications for several issues related to public health policies and, in particular, those referring to prevention, the universal access to health services as well as the quality of the provision of health care services. Monitoring both the health status of the population and the undesired differentials in health expectancy should help to avoid an expansion of morbidity and to reduce the unequal distribution of population’s health status. PMID:25170483

Perceptions of a Tri-Racial Community: Adults vs. Adolescents.

ERIC Educational Resources Information Center

Deseran, Forrest A.; Stokley, Gary M.

The study explored the differential levels of satisfaction between adults and adolescents with such dimensions of community life as services, recreation, social environment, family situations, housing, and medical care. Information was also acquired on work status, material possessions, and participation in organizations. Comparisons were made…

Structure, Function, and Training the Rehabilitation Team.

ERIC Educational Resources Information Center

Settles, Robert B.; Crisler, Jack R.

The traditional team concept in rehabilitation is a differentiated team in which each member performs a different function. In practice, such teams are rarely cooperative and their additive services are disjointed. Presented is the philosophic rationale for the revitalization of a large rehabilitation center serving mental patients. Reorganization…

9 CFR 354.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... supervisor means the officer in charge of the rabbit inspection service in a circuit consisting of a group of... characteristics that differentiate between major groups of the same kind. (i) Condition means any condition... not lost its identity as an inspected and certified product. (r) Inspection certificate means a...

9 CFR 354.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... supervisor means the officer in charge of the rabbit inspection service in a circuit consisting of a group of... characteristics that differentiate between major groups of the same kind. (i) Condition means any condition... not lost its identity as an inspected and certified product. (r) Inspection certificate means a...

9 CFR 354.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... supervisor means the officer in charge of the rabbit inspection service in a circuit consisting of a group of... characteristics that differentiate between major groups of the same kind. (i) Condition means any condition... not lost its identity as an inspected and certified product. (r) Inspection certificate means a...

9 CFR 354.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... supervisor means the officer in charge of the rabbit inspection service in a circuit consisting of a group of... characteristics that differentiate between major groups of the same kind. (i) Condition means any condition... not lost its identity as an inspected and certified product. (r) Inspection certificate means a...

5 CFR 575.402 - Delegation of authority.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Delegation of authority. 575.402 Section 575.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT... Supervisory Differentials § 575.402 Delegation of authority. (a) The head of an agency may pay a supervisory...

Analyzing the Effectiveness of Targeted Instruction

ERIC Educational Resources Information Center

Hibbs, Eric Michael

2010-01-01

This action research study examines targeted instruction and its effect on academic referrals to elementary intervention and referral service committees. The West Harvard School District was not effectively utilizing targeted instruction, and there was a distinct lack of a differentiated vision throughout the district. This lack of differentiation…

Evaluation of Prevention Programs: A Basic Guide for Practitioners.

ERIC Educational Resources Information Center

Moberg, D. Paul

This guide is intended for professionals, laypersons, funding agents and others involved in planning and delivering local prevention services. Chapter 1 defines prevention, and differentiates between prevention strategies and programs targeted toward individuals or to general populations. Program evaluation and evaluation research are defined and…

9 CFR 354.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... supervisor means the officer in charge of the rabbit inspection service in a circuit consisting of a group of... characteristics that differentiate between major groups of the same kind. (i) Condition means any condition..., association, business trust, corporation, or any organized group of persons, whether incorporated or not. (x...

Cloud computing applications for biomedical science: A perspective.

PubMed

Navale, Vivek; Bourne, Philip E

2018-06-01

Biomedical research has become a digital data-intensive endeavor, relying on secure and scalable computing, storage, and network infrastructure, which has traditionally been purchased, supported, and maintained locally. For certain types of biomedical applications, cloud computing has emerged as an alternative to locally maintained traditional computing approaches. Cloud computing offers users pay-as-you-go access to services such as hardware infrastructure, platforms, and software for solving common biomedical computational problems. Cloud computing services offer secure on-demand storage and analysis and are differentiated from traditional high-performance computing by their rapid availability and scalability of services. As such, cloud services are engineered to address big data problems and enhance the likelihood of data and analytics sharing, reproducibility, and reuse. Here, we provide an introductory perspective on cloud computing to help the reader determine its value to their own research.

Cloud computing applications for biomedical science: A perspective

PubMed Central

2018-01-01

Biomedical research has become a digital data–intensive endeavor, relying on secure and scalable computing, storage, and network infrastructure, which has traditionally been purchased, supported, and maintained locally. For certain types of biomedical applications, cloud computing has emerged as an alternative to locally maintained traditional computing approaches. Cloud computing offers users pay-as-you-go access to services such as hardware infrastructure, platforms, and software for solving common biomedical computational problems. Cloud computing services offer secure on-demand storage and analysis and are differentiated from traditional high-performance computing by their rapid availability and scalability of services. As such, cloud services are engineered to address big data problems and enhance the likelihood of data and analytics sharing, reproducibility, and reuse. Here, we provide an introductory perspective on cloud computing to help the reader determine its value to their own research. PMID:29902176

Interdisciplinary teamwork and leadership: issues for psychiatrists.

PubMed

Rosen, Alan; Callaly, Tom

2005-09-01

To review the constructs and applications of interdisciplinary teams in mental health services, with a particular view to ascertaining the most effective types of teams and their leadership. Some of the most challenging questions from a psychiatrist's viewpoint regarding the functions of interdisciplinary teams in the mental health service are addressed. The effectiveness of the interdisciplinary team in mental health services is supported by an extensive literature that is much more qualitative and descriptive than quantitative and empirically rigorous, except as part of packages of variables subjected to randomized controlled trials. Effective interdisciplinary teamwork in mental health services involves both retaining differentiated disciplinary roles and developing shared core tasks. It requires sound leadership, effective team management, clinical supervision and explicit mechanisms for resolving role conflicts and ensuring safe practices. No one profession should hold a monopoly on leadership.

Specialized Prisons and Services: Results From a National Survey

PubMed Central

Cropsey, Karen L.; Wexler, Harry K.; Melnick, Gerald; Taxman, Faye S.; Young, Douglas W.

2008-01-01

Findings from the National Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) National Criminal Justice Treatment Practices survey are examined to describe types of services provided by three types of prisons: those that serve a cross-section of offenders, those that specialize in serving offenders with special psychosocial and medical needs, and those that specialize in serving legal status or gender specific populations. Information is presented on the prevalence and type of specialized prisons and services provided to offenders as reported by wardens and other facility directors drawn from a nationally representative sample of prisons. Additional analyses explore organizational factors that differentiate prisons that serve specialized populations including staffing, training, other resources, leadership, and climate for change and innovation. Implications for expanding and improving services for special populations in correctional settings and the values of specialized prisons are discussed. PMID:18443650

Exploring sex differences in drug use, health and service use characteristics among young urban crack users in Brazil.

PubMed

Bertoni, Neilane; Burnett, Chantal; Cruz, Marcelo Santos; Andrade, Tarcisio; Bastos, Francisco I; Leal, Erotildes; Fischer, Benedikt

2014-08-28

Studies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. Crack use is prevalent in Brazil; however, few comparative data by sex exist. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18-24 years), regular and marginalized crack users in Brazil. Study participants (total n = 159; n = 124 males and n = 35 females) were recruited by community-based methods from impoverished neighborhoods in Rio de Janeiro and Salvador. Assessments occurred by an anonymous interviewer-administered questionnaire and serum collection for blood-borne virus testing between November 2010 and June 2011. Descriptive statistics and differences for key variables by sex were computed; in addition, a 'chi-squared automatic interaction detector' ('CHAID') analysis explored potential primary factors differentiating male and female participants. Most participants were non-white, and had low education and multiple income sources. More women had unstable housing and income from sex work and/or panhandling/begging, whereas more men were employed. Both groups indicated multi-year histories of and frequent daily crack use, but virtually no drug injection histories. Men reported more co-use of other drugs. More women were: involved in sex-for-drug exchanges; blood-borne virus (BBV) tested and HIV+. Both groups reported similar physical and mental health patterns; however women more commonly utilized social or health services. The CHAID analysis identified sex work; paid work; begging/panhandling; as well as physical and mental health status (all at p < 0.05) as primary differentiating factors by sex. Crack users in our study showed notable differences by sex, including socio-economic indicators, drug co-use patterns, sex risks/work, BBV testing and status, and service utilization. Results emphasize the need for targeted special interventions and services for males and female crack users in Brazil.

Continuing social disparities despite upward trends in sexual and reproductive health service use among young women in the United States.

PubMed

Hall, Kelli Stidham; Moreau, Caroline; Trussell, James

2012-12-01

Building upon previous work describing declining rates and socioeconomic disparities in sexual and reproductive health (SRH) service use among young women in the United States, we reexamined patterns and determinants of SRH service use in 2006-2010. We used the latest data from the National Survey of Family Growth to evaluate SRH service use including contraceptive, sexually transmitted infection (STI) and other gynecological exam services among 3780 women ages 15-24 years. We compared proportions of service use across survey years and employed multiple logistic regression to estimate the influence of time and women's sociodemographic characteristics on the likelihood of SRH service use. The proportion of women using SRH services increased from 50% (2006-2007) to 54% (2007-2008) and 57% (2008-2010) [all year odds ratios (ORs) 1.4, p values<.03]. Among sexually experienced women, the proportions using SRH and contraceptive services were unchanged, while STI service use increased from 22% (2006-2007) to 33% (2008-2009) (OR 1.7, confidence interval 1.1-2.4, p=.009). Differentials in service use existed across sociodemographic groups, largely with lower proportions of service use among women of social disadvantage. Our results suggest a reversal of negative trends but continuing social disparities in young women's use of SRH services in the United States. Copyright © 2012 Elsevier Inc. All rights reserved.

Assessing Treatment Acceptability with Consumers of Outpatient Child Behavior Management Services.

ERIC Educational Resources Information Center

Miltenberger, Raymond G.; And Others

1989-01-01

Parents' and grandparents' ratings of alternative treatments for children with behavior disorders were assessed. Differential reinforcement of other behavior (DRO), time-out, response cost, spanking, and medication were applied to noncompliance, aggression, tantrums, and hyperactivity. DRO, response cost, and time-out were found significantly more…

Predicting the Unpredictable? Identifying High-Risk versus Low-Risk Parents with Intellectual Disabilities

ERIC Educational Resources Information Center

McGaw, Sue; Scully, Tamara; Pritchard, Colin

2010-01-01

Objectives: This study set out to identify risk factors affecting parents with intellectual disabilities (IDs) by determining: (i) whether perception of family support differs between parents with IDs, referring professionals, and a specialist parenting service; (ii) whether multivariate familial and demographic factors differentiates "high-risk"…

5 CFR 591.202 - Why does the Government pay COLAs?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Why does the Government pay COLAs? 591.202 Section 591.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Allowances and Post Differentials § 591.202 Why does the Government pay COLAs? The Government pays COLAs as...

5 CFR 591.202 - Why does the Government pay COLAs?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Why does the Government pay COLAs? 591.202 Section 591.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Allowances and Post Differentials § 591.202 Why does the Government pay COLAs? The Government pays COLAs as...

5 CFR 591.202 - Why does the Government pay COLAs?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Why does the Government pay COLAs? 591.202 Section 591.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Allowances and Post Differentials § 591.202 Why does the Government pay COLAs? The Government pays COLAs as...

5 CFR 591.202 - Why does the Government pay COLAs?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Why does the Government pay COLAs? 591.202 Section 591.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Allowances and Post Differentials § 591.202 Why does the Government pay COLAs? The Government pays COLAs as...

5 CFR 591.202 - Why does the Government pay COLAs?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Why does the Government pay COLAs? 591.202 Section 591.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... Allowances and Post Differentials § 591.202 Why does the Government pay COLAs? The Government pays COLAs as...

Investigating Pre-Service Gifted Education Teachers' Self-Efficacy toward Science Teaching and Scientific Attitudes

ERIC Educational Resources Information Center

Camci-Erdogan, Sezen

2015-01-01

Problem Statement: Education of gifted has attracted attention for a few decades. Components of gifted education environments like identification, differentiation of teaching processes, social-emotional characteristics of gifted students and educating teachers of gifted students etc. have been studied in different studies. Gifted students have…

General Child Benefit Fund Experiments in Providing Differentiated Services

ERIC Educational Resources Information Center

Serres, Anne-Marie

2005-01-01

Populations not autonomous in their administrative relations has difficulties with access to social benefits of the Caisses d'Allocations Familiales (CAFs). These difficulties, whether rooted in cultural, educational, social, or other issues, disrupt the management of their documents of social benefits and thereby weigh on their economic…

Science, Policy, and Practice: Three Cultures in Search of a Shared Mission.

ERIC Educational Resources Information Center

Shonkoff, Jack P.

2000-01-01

Discusses how child development research, social policy design, and human service delivery for children and families reflect three separate yet related cultures. Argues that transmitting knowledge from the academy to social policy and practice could be facilitated by a simple taxonomy differentiating established knowledge from both reasonable…

Tobacco Advertising and the First Amendment.

ERIC Educational Resources Information Center

Hanauer, Peter; Pertschuk, Michael

1988-01-01

Presents an argument for the recently proposed ban on advertising of tobacco products. Differentiates between commercial speech, used to sell products and services, and political speech, which relates to ideas. Argues that tobacco is the only legal product that is dangerous when used as intended, therefore First Amendment rights regarding other…

49 CFR 178.338-14 - Gauging devices.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., a fixed trycock line, or a differential pressure liquid level gauge must be used as the primary... control for filling. (2) The design pressure of each liquid level gauging device must be at least that of... openings for dip tube gauging devices and pressure gauges in flammable cryogenic liquid service must be...

Through the Looking Glass: One School's Reflection on Differentiation

ERIC Educational Resources Information Center

Tieso, Carol

2004-01-01

Teachers must deal with a diversity of students' abilities, strengths, and interests in their classrooms while at the same time covering the material, prepping students for standardized tests, and preparing themselves to be "highly qualified." Legislation requiring services for gifted and talented students and the paucity of quality programs for…

Gender Politics and Privatization in the London Borough of Camden.

ERIC Educational Resources Information Center

Brush, Lisa D.

1986-01-01

This article examines the differential impact of the privatization of social services on women in the London borough of Camden. Concludes that women will suffer greater decline than men in employment, wages, and status as a result of the privatization taking place in Great Britain. (JDH)

Customer service: moving from slogan to point of differentiation.

PubMed

Thies, S

1999-01-01

To make its commitment to customer-centered care real, Dean Medical Center interviewed patients and created a "Vital Signs" scorecard. Performance is now measured according to those key areas specified by patients. Face-to-face communication from upper management to all employees and employee training has facilitated the program.

46 CFR 282.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-DIFFERENTIAL SUBSIDY FOR LINER VESSELS ENGAGED IN ESSENTIAL SERVICES IN THE FOREIGN COMMERCE OF THE UNITED... the absent seaman's work) is not paid for the missing men. (m) Region Director means the Region... covered by an ODSA. (p) U.S. foreign commerce means the commerce or trade between the United States, its...

Examining Response to Intervention (RTI) Models in Secondary Education

ERIC Educational Resources Information Center

Epler, Pam, Ed.

2015-01-01

Response to Intervention (RTI) is an intervention model designed to assist all students regardless of their academic ability. It seeks to assist students who are struggling in academics by providing them with targeted assistance in the form of tutoring, pull-out services, and differentiated classroom instruction. "Examining Response to…

33 CFR 164.43 - Automatic Identification System Shipborne Equipment-Prince William Sound.

Code of Federal Regulations, 2011 CFR

2011-07-01

...GPS) receiver; (2) Marine band Non-Directional Beacon receiver capable of receiving dGPS error... frequency; and (4) Control unit. (b) An AISSE must have the following capabilities: (1) Use dGPS to sense... Recommended Standards for Differential NAVSTAR GPS Service in determining the required information; (3...

21 CFR 868.2550 - Pneumotachometer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Pneumotachometer. 868.2550 Section 868.2550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... pressure differential across a known resistance. The device may use a set of capillaries or a metal screen...

21 CFR 868.2550 - Pneumotachometer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumotachometer. 868.2550 Section 868.2550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... pressure differential across a known resistance. The device may use a set of capillaries or a metal screen...

Developing Strategic Planning for the Retail Market.

ERIC Educational Resources Information Center

Greenawalt, Richard A.

1983-01-01

Retailers need a strategic plan that will enable them to adapt to changing trends and work with new ideas. Questions retailers should ask to shape the strategic plan and generic strategies--overall cost leadership, differentiation, and marketing to a particular group or offering a special service--are discussed. (SR)

Marketing Segmentation Analysis.

ERIC Educational Resources Information Center

Weeks, Ann A.

A study was conducted to differentiate by cities and towns the various demographic characteristics of students that Dutchess Community College (DCC) was receiving from its major service area, Dutchess County, in order to ascertain if DCC was receiving its expected share of students from these cities and towns. All the students enrolling at DCC…

Participation in an Intergenerational Service Learning Course and Implicit Biases

ERIC Educational Resources Information Center

Kogan, Lori R.; Schoenfeld-Tacher, Regina M.

2018-01-01

Biases against the elderly and people with disabilities can lead to discriminatory behaviors. One way to conceptualize attitudes toward the elderly and people with disabilities is through the differentiation of explicit (conscious) and implicit (unconscious) factors. Although both explicit and implicit attitudes and biases contribute to the full…

5 CFR 591.210 - What are weights?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false What are weights? 591.210 Section 591.210 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS... What are weights? (a) A weight is the relative importance or share of a subpart of a group compared...

47 CFR 87.171 - Class of station symbols.

Code of Federal Regulations, 2014 CFR

2014-10-01

... systems AXO—Aeronautical operational fixed DGP—Differential GPS DLT—Aircraft data link land test FA...—Radionavigation land test RLW—Microwave landing system RNV—Radio Navigation Land/DME RPC—Ramp Control TJ—Aircraft earth station in the Aeronautical Mobile-Satellite Service UAT—Universal Access Transceiver [53 FR 28940...

Validation of a new measure of availability and accommodation of health care that is valid for rural and urban contexts.

PubMed

Haggerty, Jeannie L; Levesque, Jean-Frédéric

2017-04-01

Patients are the most valid source for evaluating the accessibility of services, but a previous study observed differential psychometric performance of instruments in rural and urban respondents. To validate a measure of organizational accessibility free of differential rural-urban performance that predicts consequences of difficult access for patient-initiated care. Sequential qualitative-quantitative study. Qualitative findings used to adapt or develop evaluative and reporting items. Quantitative validation study. Primary data by telephone from 750 urban, rural and remote respondents in Quebec, Canada; follow-up mailed questionnaire to a subset of 316. Items were developed for barriers along the care trajectory. We used common factor and confirmatory factor analysis to identify constructs and compare models. We used item response theory analysis to test for differential rural-urban performance; examine individual item performance; adjust response options; and exclude redundant or non-discriminatory items. We used logistic regression to examine predictive validity of the subscale on access difficulty (outcome). Initial factor resolution suggested geographic and organizational dimensions, plus consequences of access difficulty. After second administration, organizational accommodation and geographic indicators were integrated into a 6-item subscale of Effective Availability and Accommodation, which demonstrates good variability and internal consistency (α = 0.84) and no differential functioning by geographic area. Each unit increase predicts decreased likelihood of consequences of access difficulties (unmet need and problem aggravation). The new subscale is a practical, valid and reliable measure for patients to evaluate first-contact health services accessibility, yielding valid comparisons between urban and rural contexts. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Gender differentials in readiness and use of mHealth services in a rural area of Bangladesh.

PubMed

Khatun, Fatema; Heywood, Anita E; Hanifi, Syed Manzoor Ahmed; Rahman, M Shafiqur; Ray, Pradeep K; Liaw, Siaw-Teng; Bhuiya, Abbas

2017-08-18

Traditional gender roles result in women lagging behind men in the use of modern technologies, especially in developing countries. Although there is rapid uptake of mobile phone use in Bangladesh, investigation of gender differences in the ownership, access and use of mobile phones in general and mHealth in particular has been limited. This paper presents gender differentials in the ownership of mobile phones and knowledge of available mHealth services in a rural area of Bangladesh. We interviewed 4915 randomly selected respondents aged 18 years and above. Associations between gender and knowledge of available mHealth services, use of existing mHealth services and intentions to use mHealth services in the future were examined by multivariate logistic regression analysis, controlling for the effect of categorised covariates. Of the 4915 respondents to the survey, 61.8% of men (1213/1964) and 34.4% of women (1015/2951) owned a mobile phone. For men, mobile phone ownership was highest among those aged 18-29 years (n = 663, 76.3%), and for women among those aged 30-39 years (n = 825, 44.7%). A higher proportion of men owned phones compared to women, irrespective of socioeconomic status (SES) as indicated by asset index (p < 0.001). Although mobile phone ownership on average was lower among women, they were more likely to share their mobile phone with their family members (19.7%) compared to men (11.6%, p < 0.001). Greater number of men were more likely to be aware of the use of mobile phones for healthcare compared to women (38.5% vs 26.5%, p < 0.001). Knowledge about available mHealth services was lower among women than men; however, intention to use mHealth services in the future was high for both genders, irrespective of age, education and socioeconomic status. Compared to men, women are less likely to own a mobile phone and less aware of available mHealth services, despite high intention to use mHealth among both genders. To optimise the use of mHealth services and to achieve equity of use, uptake strategies should target women, with a focus on the poorer and less educated groups.

[Displaced people's healthcare use in Bucaramanga, Colombia].

PubMed

Ruiz-Rodríguez, Myriam; López-Moreno, Sergio; Avila-Burgos, Leticia; Acosta-Ramírez, Naydú

2006-01-01

Analysing the factors and barriers associated with the population displaced by armed conflict using medical services in Bucaramanga, Colombia. Data from the "Diagnosing the health of both displaced and non-displaced populations in Bucaramanga and its metropolitan area" study, designed and executed by the Industrial University of Santander and financed by the Pan-American Health Organisation, analysed medical service use in individuals aged over 15 years. This agreed with Andersen and Newman's model and evaluated the effect of associated factors by means of multiple logistical regression. One out of each five people who became ill during the fifteen days prior to the survey had used the medical services. This percentage was smaller than that found in the Colombian population as a whole. The type of social security regime (contributory health insurance), previous service use and being from the region were associated with greater service use. Displaced people having subsidised health insurance did not present differences in service use compared to those who had no access to such insurance. The distance from dwelling to institution was another barrier against using health services (RM = 0.64; IC 0.42-0.97). There was differential medical service use amongst the displaced population, determined by their health insurance coverage and economic position.

The Analysis of Competitive Strategy and Suggestions for Didi under the Background of the New Car-hailing Regulation

NASA Astrophysics Data System (ADS)

Wang, Tingting; Zhao, Lei

2017-10-01

The emergence of car-hailing service satisfies the need of public travel in Internet era. Didi—the representative of car-hailing service, provides users with cost-effective service and great travel experience and quickly became the leader in the field of mobile travel depending on its price advantage, market segmentation, fast respond and some other competitive strategies. However, the promulgation of the new car-hailing regulation brings many challenges to Didi. After the new regulation, it is hard for Didi to gap away significantly from its competitors in scale and price. Thus the differentiated service is the competitive focus for all platforms. So there is an urgent need for Didi to do something to make difference, such as improving the interface design of the platform and the process of order allocation, establishing exclusive ‘station’, increasing the interaction between drivers and passengers. By doing so, Didi can reduce the information asymmetry and increase the user engagement and loyalty with high quality service.

Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.

PubMed

Chen, Wan-Yi; Corvo, Kenneth; Lee, Yookyong; Hahm, Hyeouk Chris

2017-01-01

Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

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

PubMed

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

2004-03-01

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

[Healthcare for adolescents: perceptions by physicians and nurses in family health teams].

PubMed

Ferrari, Rosângela Aparecida Pimenta; Thomson, Zuleika; Melchior, Regina

2006-11-01

This descriptive qualitative study was conducted in basic healthcare units to analyze the perceptions of physicians and nurses from family health teams concerning healthcare for adolescents, using content analysis with an emphasis on thematic analysis. The discourse of these health professionals showed that care exists for adolescents in the family health service, but that: it is not systematized because of other priorities; adolescents fail to use the service; the health professionals feel unprepared to draw adolescents to the service and treat them; and in order to implement a healthcare program for adolescents in the family health strategy it would be necessary to reorganize the service to train the existing team members and hire other professionals. Thus, the interviewees value differentiated care for adolescents, and even while recognizing their limitations and reporting not having been trained, they conduct joint actions with other areas beyond health, demonstrating that they transcend the limits of the health service and seek new ways of treating adolescents holistically.

Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

PubMed

Ruy, Hosihn; Young, Wendy B; Kwak, Hoil

2002-01-01

The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

An Automated End-To Multi-Agent Qos Based Architecture for Selection of Geospatial Web Services

NASA Astrophysics Data System (ADS)

Shah, M.; Verma, Y.; Nandakumar, R.

2012-07-01

Over the past decade, Service-Oriented Architecture (SOA) and Web services have gained wide popularity and acceptance from researchers and industries all over the world. SOA makes it easy to build business applications with common services, and it provides like: reduced integration expense, better asset reuse, higher business agility, and reduction of business risk. Building of framework for acquiring useful geospatial information for potential users is a crucial problem faced by the GIS domain. Geospatial Web services solve this problem. With the help of web service technology, geospatial web services can provide useful geospatial information to potential users in a better way than traditional geographic information system (GIS). A geospatial Web service is a modular application designed to enable the discovery, access, and chaining of geospatial information and services across the web that are often both computation and data-intensive that involve diverse sources of data and complex processing functions. With the proliferation of web services published over the internet, multiple web services may provide similar functionality, but with different non-functional properties. Thus, Quality of Service (QoS) offers a metric to differentiate the services and their service providers. In a quality-driven selection of web services, it is important to consider non-functional properties of the web service so as to satisfy the constraints or requirements of the end users. The main intent of this paper is to build an automated end-to-end multi-agent based solution to provide the best-fit web service to service requester based on QoS.

Marketing service guarantees for health care.

PubMed

Levy, J S

1999-01-01

The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.

Achieving QoS for TCP Traffic in Satellite Networks with Differentiated Services

NASA Technical Reports Server (NTRS)

Durresi, Arjan; Kota, Sastri; Goyal, Mukul; Jain, Raj; Bharani, Venkata

2001-01-01

Satellite networks play an indispensable role in providing global Internet access and electronic connectivity. To achieve such a global communications, provisioning of quality of service (QoS) within the advanced satellite systems is the main requirement. One of the key mechanisms of implementing the quality of service is traffic management. Traffic management becomes a crucial factor in the case of satellite network because of the limited availability of their resources. Currently, Internet Protocol (IP) only has minimal traffic management capabilities and provides best effort services. In this paper, we presented a broadband satellite network QoS model and simulated performance results. In particular, we discussed the TCP flow aggregates performance for their good behavior in the presence of competing UDP flow aggregates in the same assured forwarding. We identified several factors that affect the performance in the mixed environments and quantified their effects using a full factorial design of experiment methodology.

Aligning internal organizational factors with a service excellence mission: an exploratory investigation in health care.

PubMed

Ford, Robert C; Sivo, Stephen A; Fottler, Myron D; Dickson, Duncan; Bradley, Kenneth; Johnson, Lee

2006-01-01

In today's competitive health care environment, service excellence is rapidly becoming a major differentiating advantage between health care providers. Too often, senior executives talk about their commitment to a mission statement that extols the virtues of providing world class service to their patients only to undermine those statements with what they do, write, and say. This article presents an exploratory investigation into a new application of an internal mission alignment instrument that seeks to assess the extent to which an organization's internal processes are aligned with its service mission. This instrument was sent to 250 randomly selected employees from all clinical departments of a large southeastern hospital to explore the underlying alignment factors. A factor analysis of the data revealed eight factors that predicted beneficial employee outcomes such as organizational commitment and satisfaction with the job and organization.

Transplant programs, centers, and institutes: what does it all mean?

PubMed

Abouljoud, Marwan; Whitehouse, Sarah

2013-04-01

There are more than 250 transplant centers in the USA, but variation continues to exist in organizational structure for transplant multidisciplinary services. We reviewed the literature to explore the definitions for transplant organizational structures and address existing rationale for the development of the integrated transplant service line. No standard definitions exist to differentiate the use of program, center, institute, or service line. A survey of 20 multiorgan transplant centers in the USA showed that most were named centers or institutes, but some were organized as departments and service lines. The prevailing themes were the perceived need for autonomy of the transplant entity, alignment among services and finances, and the alignment of authority with responsibility. In addition, perceived benefits included growth, alignment, efficiency, and resource allocation. The multidisciplinary nature of transplantation generally has been fit into the matrix organizational model, although many hospitals today have departments, centers, institutes, and service lines structures. Integration has been viewed as beneficial by most transplant entities reviewed, with a sense that it is better adapted for the evolving healthcare climate.

[Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

PubMed

Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

2015-10-01

The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Psychological Distress among Victimized Women on Probation and Parole: A Latent Class Analysis

PubMed Central

Golder, Seana; Engstrom, Malitta; Hall, Martin T.; Higgins, George; Logan, TK

2015-01-01

Latent class analysis was used to identify subgroups of victimized women (N=406) on probation and parole differentiated by levels of general psychological distress. The nine primary symptom dimensions from the Brief Symptom Inventory (BSI) were used individually as latent class indicators (Derogatis, 1993). Results identified three classes of women characterized by increasing levels of psychological distress; classes were further differentiated by posttraumatic stress disorder symptoms, cumulative victimization, substance use and other domains of psychosocial functioning (i.e., sociodemographic characteristics; informal social support and formal service utilization; perceived life stress; and resource loss). The present research was effective in uncovering important heterogeneity in psychological distress using a highly reliable and easily accessible measure of general psychological distress. Differentiating levels of psychological distress and associated patterns of psychosocial risk can be used to develop intervention strategies targeting the needs of different subgroups of women. Implications for treatment and future research are presented. PMID:25915692

A Practitioner's Guide to Implementing a Differential Reinforcement of Other Behaviors Procedure

ERIC Educational Resources Information Center

Gongola, Leah C.; Daddario, Rosemarie

2010-01-01

The use of interventions to create behavior change among students with disabilities has an extended and complex history (Horner et al., 2005). Practitioners involved in the field of special education often debate best practices from an immense array of available interventions (Heflin & Simpson, 1998). Service providers express concern about…

A Co-Creation Shift in Learning Management: Work Design for Institutional Commitment and Personal Growth

ERIC Educational Resources Information Center

Wardley, Leslie J.; Bélanger, Charles H.; Nadeau, John

2017-01-01

Some higher education management departments have started to implement customer service orientation strategies in their marketing activities in order to solidify value exchange perceptions, differentiate themselves, and improve retention rates. However, if students are to get the most out of their academic experiences, they need to become…

Educational Price Differentials: A Clarification of the Issues.

ERIC Educational Resources Information Center

Chambers, Jay G.

This paper provides a clarification of two factors--the differences in pupil need (as reflected by the proportion of disadvantaged or handicapped pupils in a district) and the differences in the prices of school inputs across districts--that affects the cost of educational services and a conceptual framework that may be useful in making welfare…

Knowledge and Beliefs of Early Childhood Education Students at Different Levels of Professional Preparation

ERIC Educational Resources Information Center

Goble, Carla B.; Horm, Diane M.; Atanasov, Amy M.; Williamson, Amy C.; Choi, Ji Young

2015-01-01

The expansion of early childhood education programming has heightened the focus on teachers' educational preparation and its role in providing high-quality services for young children. The interest in teachers' education is especially relevant in early childhood since differentiated levels of preparation are commonly used in quality rating and…

Differential Impact of Abortion on Adolescents and Adults.

ERIC Educational Resources Information Center

Franz, Wanda; Reardon, David

1992-01-01

Compared adolescent and adult reactions to abortion among 252 women. Compared to adults, adolescents were significantly more likely to be dissatisfied with choice of abortion and with services received, to have abortions later in gestational period, to feel forced by circumstances to have abortion, to report being misinformed at time of abortion,…

Resilience in Parentally Bereaved Children and Adolescents Seeking Preventive Services

ERIC Educational Resources Information Center

Lin, Kirk K.; Sandler, Irwin N.; Ayers, Tim S.; Wolchik, Sharlene A.; Luecken, Linda J.

2004-01-01

This study examined environmental stress, family, and child variables that differentiate resilient children and adolescents from those with mental health problems following the death of a primary caregiver. The community-based sample included 179 bereaved children ages 8 to 16 years and their surviving caregivers who completed a test battery of…

Searching for the Grand Unifying Theory: Reflections on the Field of LD

ERIC Educational Resources Information Center

Rueda, Robert

2005-01-01

A recent overview of the field of learning disabilities (Torgesen, 2004) laid out several issues that will likely consume the field for the foreseeable future, including problems of definition and etiology, differentiation of learning disabilities from other disabilities, and issues in identification and service delivery. It has been approximately…

Rural Issues in Rehabilitation Service Delivery: A Goodwill Industries of America Study.

ERIC Educational Resources Information Center

Larsen, Carmen O.; Foley, Jeffrey C.

1992-01-01

This article uses survey data to describe some common elements among rural vocational rehabilitation programs and differentiate them from their urban counterparts. The survey of 173 Goodwill Industries centers brought 78 responses. Thirteen centers (17%) characterized themselves as entirely rural; 22 (28%) as nonrural, and 43 organizations said…

Health, SES, and the Timing of Education among Military Retirees

ERIC Educational Resources Information Center

Edwards, Ryan D.

2016-01-01

The timing of education across the life cycle is differentially associated with older age health outcomes and socioeconomic status among military retirees, a subpopulation with common levels of adolescent health, but variation in educational timing. A year of education obtained before military service lowers the probability of poor health in…

Report of the Defense Task Force on Sexual Harassment and Violence at the Military Service Academies

DTIC Science & Technology

2005-06-01

Differentials,” International Journal of Intercultural Relations 15 (1991): 445–57; Margaret S. Stockdale, ed., Sexual Harassment in the Workplace (Thousand...Journal 107, no. 6 (1998): 1683–1805; Margaret S. Stockdale, ed., Sexual Harassment in the Workplace (Thousand Oaks, CA: Sage, 1996); and Sandy Welsh

Application of Business Intelligence System in Company Restructuring Process: The Case of Croatia

ERIC Educational Resources Information Center

Bakula, Iva; Curko, Katarina; Bach, Mirjana Pejic; Vukšic, Vesna Bosilj

2016-01-01

After Croatian accession to the EU, Croatian companies have faced tough competition and all other challenges posed by doing business in open markets. These companies must increase competitiveness and take their position on developed globalized markets through differentiation of their products and services and/or creation of cost advantage. For…

What Works in Gifted Education-Documenting the Model-Based Curriculum for Gifted Students

ERIC Educational Resources Information Center

Oh, Sarah; Hailey, Emily; Azano, Amy; Callahan, Carolyn; Moon, Tonya

2012-01-01

The heart of effective programming for gifted services lies in the development of curricula that will challenge and enhance learning outcomes for gifted students. Educators have voiced concerns about the lack of differentiated curricula and instruction in gifted classrooms and the paucity of empirical evidence to support their effectiveness for…

The Effects of Environmental Characteristics on the Structure of Hospital Clusters.

ERIC Educational Resources Information Center

Fennell, Mary L.

1980-01-01

The population ecology view that variation in sets or clusters of organizations should be isomorphic with variation in cluster environment was used to explain structural variation among hospital clusters. Cluster differentiation seems to be casually affected by range of services, average hospital size, and the periodic closing of hospitals.…

A Comparative Analysis of Recidivism with Propensity Score Matching of Informal and Formal Juvenile Probationers

ERIC Educational Resources Information Center

Onifade, Eyitayo; Wilkins, Jeffrey; Davidson, William; Campbell, Christina; Petersen, Jodi

2011-01-01

Given service costs and evidence suggesting mixing young offenders of different risk levels increases recidivism, this study determined the extent to which differential disposition and risk determined subsequent recidivism. Furthermore, this study entailed a comparison of offense outcomes for informal probationers (n = 581) and formal probationers…

48 CFR 52.247-33 - F.o.b. Origin, With Differentials.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., and placed on, the carrier's wharf (at shipside, within reach of the ship's loading tackle, when the shipping point is within a port area having water transportation service) or the carrier's freight station... lading shall show— (i) A description of the shipment in terms of the governing freight classification or...

A Study of ESEA, Title I Impact Components on Urban Elementary Schools and Their Pupils.

ERIC Educational Resources Information Center

Brown, Edward K.

A systematic study of the composition and dispersement of Title I projects assigned to elementary schools in Philadelphia was conducted. Categorical variables were identified from four major derived variables (program density code, school aggregate fund, pupil service component, achievement-growth differential score) and four major demographic…

The Importance of Financial Education Today

ERIC Educational Resources Information Center

Greenspan, Alan

2005-01-01

Today's financial world is highly complex as compared with that of a generation ago. Twenty-five years ago, knowing how to maintain a checking and savings account at a local financial institution was sufficient for many Americans. Today's consumers, however, must be able to differentiate among a wide range of products, services, and providers of…

Inclusive Reform as a Response to High-Stakes Pressure? Leading toward Inclusion in the Age of Accountability

ERIC Educational Resources Information Center

Theoharis, George; Causton, Julie; Tracy-Bronson, Chelsea P.

2016-01-01

Students identified with disabilities are increasingly being educated with the assistance of support services within heterogeneous (i.e., general education) classrooms (United States Department of Education, 2011). Yet, in this era of high stakes accountability, students are labeled, sorted, and differentially treated according to their academic…

Differentiated Effects of Community Schooling on Cognitive and Social-Emotional Learning Outcomes

ERIC Educational Resources Information Center

Heers, Marieke; Ghysels, Joris; Groot, Wim; van den Brink, Henriëtte Maassen

2015-01-01

Community schools are becoming increasingly popular. They aim to enhance children's educational performance by offering extended educational and social services. As community schools mainly focus on disadvantaged children, this study evaluates the effects of community schooling on the educational outcomes of these pupils. We focus on care pupils…

78 FR 64968 - Center for Scientific Review; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Cardiovascular Differentiation and Development Study Section, October 09, 2013, 08:00 a.m. to October 09, 2013, 06:00 p.m., Hyatt...

Strategies for achieving orthopedic service line success.

PubMed

Lang, Stacey; Powers, Kristi

2013-12-01

Healthcare finance leaders can work with orthopedic surgeons to support better outcomes, clinically and financially, by: Establishing innovative partnerships among hospital leaders, orthopedic surgeons, and implant vendors. Developing and enforcing expectations around contracting and vendor behavior. Establishing a forum for open communication. Building a bundled payment structure. Finding ways to differentiate from the competition.

The New Venture Growth: Functional Differentiation and the Need for Human Resource Development Interventions.

ERIC Educational Resources Information Center

Ardichvili, Alexander; Harmon, Brian; Cardozo, Richard N.; Reynolds, Paul D.; Williams, Mary L.

1998-01-01

New businesses (n=539) were surveyed in 1986-87 and 1992-93. People responsible for start-up retained responsibility for marketing and related functions. Production, service delivery, purchasing, shipping, and computer functions were most often delegated, usually to internal employees. Organization size did not influence functional…

76 FR 48870 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

... selection inclusion and exclusion criteria section. The revisions define and differentiate the required... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0428] Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document...

A randomized community trial of enhanced family planning outreach in Rakai, Uganda.

PubMed

Lutalo, Tom; Kigozi, Godfrey; Kimera, Edward; Serwadda, David; Wawer, Maria J; Zabin, Laurie Schwab; Gray, Ronald H

2010-03-01

A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community-based family planning outreach program was implemented in two phases--1999-2000 (early) and 2001(late)--and its impact was evaluated by means of population surveys in 2002-03. At follow-up, hormonal contraceptive prevalence was 23 percent in the intervention communities, compared with 20 percent in the control communities. The differential was greater in the early-intervention communities than the late-intervention communities. Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities. No differentials in condom use were found between study arms. Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates, but the impact of this outreach program was modest.

Differentially Private Distributed Sensing

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

Fink, Glenn A.

The growth of the Internet of Things (IoT) creates the possibility of decentralized systems of sensing and actuation, potentially on a global scale. IoT devices connected to cloud networks can offer Sensing and Actuation as a Service (SAaaS) enabling networks of sensors to grow to a global scale. But extremely large sensor networks can violate privacy, especially in the case where IoT devices are mobile and connected directly to the behaviors of people. The thesis of this paper is that by adapting differential privacy (adding statistically appropriate noise to query results) to groups of geographically distributed sensors privacy could bemore » maintained without ever sending all values up to a central curator and without compromising the overall accuracy of the data collected. This paper outlines such a scheme and performs an analysis of differential privacy techniques adapted to edge computing in a simulated sensor network where ground truth is known. The positive and negative outcomes of employing differential privacy in distributed networks of devices are discussed and a brief research agenda is presented.« less

Informatics in radiology: radiology gamuts ontology: differential diagnosis for the Semantic Web.

PubMed

Budovec, Joseph J; Lam, Cesar A; Kahn, Charles E

2014-01-01

The Semantic Web is an effort to add semantics, or "meaning," to empower automated searching and processing of Web-based information. The overarching goal of the Semantic Web is to enable users to more easily find, share, and combine information. Critical to this vision are knowledge models called ontologies, which define a set of concepts and formalize the relations between them. Ontologies have been developed to manage and exploit the large and rapidly growing volume of information in biomedical domains. In diagnostic radiology, lists of differential diagnoses of imaging observations, called gamuts, provide an important source of knowledge. The Radiology Gamuts Ontology (RGO) is a formal knowledge model of differential diagnoses in radiology that includes 1674 differential diagnoses, 19,017 terms, and 52,976 links between terms. Its knowledge is used to provide an interactive, freely available online reference of radiology gamuts ( www.gamuts.net ). A Web service allows its content to be discovered and consumed by other information systems. The RGO integrates radiologic knowledge with other biomedical ontologies as part of the Semantic Web. © RSNA, 2014.

Can differentiated care models solve the crisis in HIV treatment financing? Analysis of prospects for 38 countries in sub-Saharan Africa.

PubMed

Barker, Catherine; Dutta, Arin; Klein, Kate

2017-07-21

Rapid scale-up of antiretroviral therapy (ART) in the context of financial and health system constraints has resulted in calls to maximize efficiency in ART service delivery. Adopting differentiated care models (DCMs) for ART could potentially be more cost-efficient and improve outcomes. However, no study comprehensively projects the cost savings across countries. We model the potential reduction in facility-level costs and number of health workers needed when implementing two types of DCMs while attempting to reach 90-90-90 targets in 38 sub-Saharan African countries from 2016 to 2020. We estimated the costs of three service delivery models: (1) undifferentiated care, (2) differentiated care by patient age and stability, and (3) differentiated care by patient age, stability, key vs. general population status, and urban vs. rural location. Frequency of facility visits, type and frequency of laboratory testing, and coverage of community ART support vary by patient subgroup. For each model, we estimated the total costs of antiretroviral drugs, laboratory commodities, and facility-level personnel and overhead. Certain groups under four-criteria differentiation require more intensive inputs. Community-based ART costs were included in the DCMs. We take into account underlying uncertainty in the projected numbers on ART and unit costs. Total five-year facility-based ART costs for undifferentiated care are estimated to be US$23.33 billion (95% confidence interval [CI]: $23.3-$23.5 billion). An estimated 17.5% (95% CI: 17.4%-17.7%) and 16.8% (95% CI: 16.7%-17.0%) could be saved from 2016 to 2020 from implementing the age and stability DCM and four-criteria DCM, respectively, with annual cost savings increasing over time. DCMs decrease the full-time equivalent (FTE) health workforce requirements for ART. An estimated 46.4% (95% CI: 46.1%-46.7%) fewer FTE health workers are needed in 2020 for the age and stability DCM compared with undifferentiated care. Adopting DCMs can result in significant efficiency gains in terms of reduced costs and health workforce needs, even with the costs of scaling up community-based ART support under DCMs. Efficiency gains remained flat with increased differentiation. More evidence is needed on how to translate analyzed efficiency gains into implemented cost reductions at the facility level.

Multi-month prescriptions, fast-track refills, and community ART groups: results from a process evaluation in Malawi on using differentiated models of care to achieve national HIV treatment goals.

PubMed

Prust, Margaret L; Banda, Clement K; Nyirenda, Rose; Chimbwandira, Frank; Kalua, Thokozani; Jahn, Andreas; Eliya, Michael; Callahan, Katie; Ehrenkranz, Peter; Prescott, Marta R; McCarthy, Elizabeth A; Tagar, Elya; Gunda, Andrews

2017-07-21

In order to facilitate scale-up of antiretroviral therapy (ART) in Malawi, innovative and pragmatic models have been developed to optimize the efficiency of HIV service delivery. In particular, three models of differentiated care have emerged for stable patients: adjusted appointment spacing through multi-month scripting (MMS); fast-track drug refills (FTRs) on alternating visits; and community ART groups (CAGs) where group members rotate in collecting medications at the facility for all members. This study aimed to assess the extent to which ART patients in Malawi are differentiated based on clinical stability and describe the characteristics and costs associated with the models of differentiated care offered. A mixed methods process evaluation was conducted from 30 purposefully selected ART facilities. Cross-sectional data for this evaluation was collected between February and May 2016. The following forms of data collection are reported here: structured surveys with 136 health care workers; reviews of 75,364 patient clinical records; 714 observations of visit time and flow; and 30 questionnaires on facility characteristics. Among ART patients, 77.5% (95% confidence interval [CI] 74.1-80.6) were eligible for differentiated models of care based on criteria for clinical stability from national guidelines. Across all facilities, 69% of patients were receiving MMS. In facilities offering FTRs and CAGs, 67% and 6% of patients were enrolled in the models, respectively. However, eligibility criteria were used inconsistently: 72.9% (95% CI 66.3-78.6) of eligible patients and 42.3% (95% CI 33.1-52.0) ineligible patients received MMS. Results indicated that patient travel and time costs were reduced by 67%, and the unit costs of ART service delivery through the MMS, FTR and CAG models were similar, representing a reduction of approximately 10% in the annual unit cost of providing care to stable patients that receive no model. MMS is being implemented nationally and has already generated cost savings and efficiencies in Malawi for patients and the health system, but could be improved by more accurate patient differentiation. While expanding FTRs and CAGs may not offer significant further cost savings in Malawi, future studies should investigate if such alternative models lead to improvements in patient satisfaction or clinical outcomes that might justify their implementation.

A test of the California competency-based differentiated role model.

PubMed

Keating, Sarah B; Rutledge, Dana N; Sargent, Arlene; Walker, Polly

2003-01-01

To address the incongruence between the expectations of nursing service and education in California, the Education Industry Interface Task Force of the California Strategic Planning Committee for Nursing developed descriptions to assist employers and educators in clearly differentiating practice and educational competencies. The completion of the Competency-Based Role Differentiation Model resulted in the need to test the model for its utility in the service setting, in education, and for career planning for nurses. Three alpha demonstration sites were selected based on representative geographical regions of California. The sites were composed of tri-partnerships consisting of a medical center, an associate degree in nursing program, and a baccalaureate nursing program. Observers rated senior students and new graduates in medical-surgical units on their behaviors in teacher and leadership care provider and care coordinator roles. The alpha demonstration study results were as expected. That is, senior students practice predominantly at a novice level in teacher and management/leadership care provider functions and new graduates practice predominately at the competent level. New graduates are more likely to take on novice and competent care coordinator roles. The CBRDM may be useful for practice and education settings to evaluate student and nurse performance, to define role expectations, and to identify the preparation necessary for the roles. It is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and carrier planning.

Adaptive Information Dissemination Control to Provide Diffdelay for the Internet of Things.

PubMed

Liu, Xiao; Liu, Anfeng; Huang, Changqin

2017-01-12

Applications running on the Internet of Things, such as the Wireless Sensor and Actuator Networks (WSANs) platform, generally have different quality of service (QoS) requirements. For urgent events, it is crucial that information be reported to the actuator quickly, and the communication cost is the second factor. However, for interesting events, communication costs, network lifetime and time all become important factors. In most situations, these different requirements cannot be satisfied simultaneously. In this paper, an adaptive communication control based on a differentiated delay (ACCDS) scheme is proposed to resolve this conflict. In an ACCDS, source nodes of events adaptively send various searching actuators routings (SARs) based on the degree of sensitivity to delay while maintaining the network lifetime. For a delay-sensitive event, the source node sends a large number of SARs to actuators to identify and inform the actuators in an extremely short time; thus, action can be taken quickly but at higher communication costs. For delay-insensitive events, the source node sends fewer SARs to reduce communication costs and improve network lifetime. Therefore, an ACCDS can meet the QoS requirements of different events using a differentiated delay framework. Theoretical analysis simulation results indicate that an ACCDS provides delay and communication costs and differentiated services; an ACCDS scheme can reduce the network delay by 11.111%-53.684% for a delay-sensitive event and reduce the communication costs by 5%-22.308% for interesting events, and reduce the network lifetime by about 28.713%.

Answering the big questions about differential response in Colorado: safety and cost outcomes from a randomized controlled trial.

PubMed

Winokur, Marc; Ellis, Raquel; Drury, Ida; Rogers, John

2015-01-01

Over the past 20 years, jurisdictions across the United States have implemented differential response (DR), which provides child protective services with the flexibility to tailor their response to reports of child abuse or neglect based on the level of risk. Given the widespread adoption of DR, there has been an increasing demand from policymakers, practitioners, and community stakeholders to build the evidence base for this innovative child welfare approach. This study was designed to answer the big questions regarding the effect of differential response on child welfare outcomes and costs using a randomized controlled trial in five Colorado counties. Specifically, the study examined the safety outcomes and costs of families who were randomly assigned to either a family assessment response (FAR) or an investigation response (IR). According to the regression results, there were no differences between the tracks on measures of system re-involvement. However, survival analysis findings indicate that FAR families were 18% less likely, over time, to have a high risk assessment after their initial accepted referral than were IR families. The cost study revealed no differences between the tracks on initial costs for caseworker contacts, services, and out-of-home placements. However, the results suggest that follow-up costs for IR cases were significantly higher (p<0.001) than for FAR cases. The authors discuss policy and practice implications for jurisdictions considering DR. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adaptive Information Dissemination Control to Provide Diffdelay for the Internet of Things

PubMed Central

Liu, Xiao; Liu, Anfeng; Huang, Changqin

2017-01-01

Applications running on the Internet of Things, such as the Wireless Sensor and Actuator Networks (WSANs) platform, generally have different quality of service (QoS) requirements. For urgent events, it is crucial that information be reported to the actuator quickly, and the communication cost is the second factor. However, for interesting events, communication costs, network lifetime and time all become important factors. In most situations, these different requirements cannot be satisfied simultaneously. In this paper, an adaptive communication control based on a differentiated delay (ACCDS) scheme is proposed to resolve this conflict. In an ACCDS, source nodes of events adaptively send various searching actuators routings (SARs) based on the degree of sensitivity to delay while maintaining the network lifetime. For a delay-sensitive event, the source node sends a large number of SARs to actuators to identify and inform the actuators in an extremely short time; thus, action can be taken quickly but at higher communication costs. For delay-insensitive events, the source node sends fewer SARs to reduce communication costs and improve network lifetime. Therefore, an ACCDS can meet the QoS requirements of different events using a differentiated delay framework. Theoretical analysis simulation results indicate that an ACCDS provides delay and communication costs and differentiated services; an ACCDS scheme can reduce the network delay by 11.111%–53.684% for a delay-sensitive event and reduce the communication costs by 5%–22.308% for interesting events, and reduce the network lifetime by about 28.713%. PMID:28085097

Social Disparities in Women’s Health Service Utilization in the United States: A Population-Based Analysis

PubMed Central

Johnson, Timothy; Dalton, Vanessa

2013-01-01

Purpose Poor and disparate reproductive health outcomes in the United States may be related to inadequate and differential women’s health care utilization. We investigated trends in and determinants of adult U.S. women’s health service use, 2006–2010. Methods We analyzed population data from 7,897 women aged 25–44yrs in the National Survey of Family Growth from 2006 to 2010 using multivariable logistic regression. Results Women’s health service utilization in the past year was reported by 74% of the sample. Among non-fertile, sexually active women, 47% used contraceptive services; fewer used pregnancy (21%) and STI (14%) services. In multivariable models, the odds of service use were greater among older, poor, unemployed women and women with less educational attainment than younger and socioeconomically advantaged women. Black women had greater odds of using pregnancy, STI and gynecological exam services than White women (ORs 1.4–1.6). Lack of insurance was associated with service use in all models (ORs 0.4–0.8). Conclusion While age-related differences in women’s health service use may reflect fertility transitions, social disparities mirror reproductive inequalities among U.S. women. Research on women’s health service utilization and outcomes across the reproductive life course and forthcoming sociopolitical climates is needed. PMID:24332620

Exploring spatial change and gravity center movement for ecosystem services value using a spatially explicit ecosystem services value index and gravity model.

PubMed

He, Yingbin; Chen, Youqi; Tang, Huajun; Yao, Yanmin; Yang, Peng; Chen, Zhongxin

2011-04-01

Spatially explicit ecosystem services valuation and change is a newly developing area of research in the field of ecology. Using the Beijing region as a study area, the authors have developed a spatially explicit ecosystem services value index and implemented this to quantify and spatially differentiate ecosystem services value at 1-km grid resolution. A gravity model was developed to trace spatial change in the total ecosystem services value of the Beijing study area from a holistic point of view. Study results show that the total value of ecosystem services for the study area decreased by 19.75% during the period 1996-2006 (3,226.2739 US$×10(6) in 1996, 2,589.0321 US$×10(6) in 2006). However, 27.63% of the total area of the Beijing study area increased in ecosystem services value. Spatial differences in ecosystem services values for both 1996 and 2006 are very clear. The center of gravity of total ecosystem services value for the study area moved 32.28 km northwestward over the 10 years due to intensive human intervention taking place in southeast Beijing. The authors suggest that policy-makers should pay greater attention to ecological protection under conditions of rapid socio-economic development and increase the area of green belt in the southeastern part of Beijing.

Multiple service use: the impact of consistency in service quality for vulnerable youth.

PubMed

Sanders, Jackie; Munford, Robyn; Liebenberg, Linda; Ungar, Michael

2014-04-01

Little is known about the way in which variations in service quality influence outcomes when youth are clients of more than one service system. This article reports on a study of 1,210 adolescents (aged 13-17 years), half were concurrent clients of two or more services and half were not involved in two or more services. Youth completed a self-report questionnaire administered by a trained interviewer. It was hypothesized that youth reporting two positive service experiences would report lower risks, higher resilience, and better outcomes than youth reporting inconsistent or two negative service experiences and that their resilience, risks, and outcomes would be similar to those of youth not involved in two or more services. MANCOVA was used to determine the relationship among service quality and resilience, risk, and outcomes with four covariates that assessed family and neighborhood environments, history of abuse and neglect, and chronic need. Results indicate that service quality had an effect on resilience, risks, and outcomes. These relationships were mediated quite strongly by the influence of the risks youth faced in their neighborhoods and to a lesser extent by the other three covariates. Of the three dependent variables, risk appeared to be the most consistently influenced by all the covariates, and it also differentiated service experience groups. Results point to the importance of services developing strategies to effectively address risks confronted by youth and also to ensure that when more than one service is involved with youth, consistency in service delivery is achieved. Copyright © 2013 Elsevier Ltd. All rights reserved.

A rough set-based association rule approach implemented on a brand trust evaluation model

NASA Astrophysics Data System (ADS)

Liao, Shu-Hsien; Chen, Yin-Ju

2017-09-01

In commerce, businesses use branding to differentiate their product and service offerings from those of their competitors. The brand incorporates a set of product or service features that are associated with that particular brand name and identifies the product/service segmentation in the market. This study proposes a new data mining approach, a rough set-based association rule induction, implemented on a brand trust evaluation model. In addition, it presents as one way to deal with data uncertainty to analyse ratio scale data, while creating predictive if-then rules that generalise data values to the retail region. As such, this study uses the analysis of algorithms to find alcoholic beverages brand trust recall. Finally, discussions and conclusion are presented for further managerial implications.

PWFQ: a priority-based weighted fair queueing algorithm for the downstream transmission of EPON

NASA Astrophysics Data System (ADS)

Xu, Sunjuan; Ye, Jiajun; Zou, Junni

2005-11-01

In the downstream direction of EPON, all ethernet frames share one downlink channel from the OLT to destination ONUs. To guarantee differentiated services, a scheduling algorithm is needed to solve the link-sharing issue. In this paper, we first review the classical WFQ algorithm and point out the shortcomings existing in the fair queueing principle of WFQ algorithm for EPON. Then we propose a novel scheduling algorithm called Priority-based WFQ (PWFQ) algorithm which distributes bandwidth based on priority. PWFQ algorithm can guarantee the quality of real-time services whether under light load or under heavy load. Simulation results also show that PWFQ algorithm not only can improve delay performance of real-time services, but can also meet the worst-case delay bound requirements.

Multi-layer service function chaining scheduling based on auxiliary graph in IP over optical network

NASA Astrophysics Data System (ADS)

Li, Yixuan; Li, Hui; Liu, Yuze; Ji, Yuefeng

2017-10-01

Software Defined Optical Network (SDON) can be considered as extension of Software Defined Network (SDN) in optical networks. SDON offers a unified control plane and makes optical network an intelligent transport network with dynamic flexibility and service adaptability. For this reason, a comprehensive optical transmission service, able to achieve service differentiation all the way down to the optical transport layer, can be provided to service function chaining (SFC). IP over optical network, as a promising networking architecture to interconnect data centers, is the most widely used scenarios of SFC. In this paper, we offer a flexible and dynamic resource allocation method for diverse SFC service requests in the IP over optical network. To do so, we firstly propose the concept of optical service function (OSF) and a multi-layer SFC model. OSF represents the comprehensive optical transmission service (e.g., multicast, low latency, quality of service, etc.), which can be achieved in multi-layer SFC model. OSF can also be considered as a special SF. Secondly, we design a resource allocation algorithm, which we call OSF-oriented optical service scheduling algorithm. It is able to address multi-layer SFC optical service scheduling and provide comprehensive optical transmission service, while meeting multiple optical transmission requirements (e.g., bandwidth, latency, availability). Moreover, the algorithm exploits the concept of Auxiliary Graph. Finally, we compare our algorithm with the Baseline algorithm in simulation. And simulation results show that our algorithm achieves superior performance than Baseline algorithm in low traffic load condition.

Service Usage Typologies in a Clinical Sample of Trauma-Exposed Adolescents: A Latent Class Analysis.

PubMed

Choi, Kristen R; Briggs, Ernestine C; Seng, Julia S; Graham-Bermann, Sandra A; Munro-Kramer, Michelle L; Ford, Julian D

2017-11-27

The purpose of this study is to describe typologies of service utilization among trauma-exposed, treatment-seeking adolescents and to examine associations between trauma history, trauma-related symptoms, demographics, and service utilization. Latent class analysis was used to derive a service utilization typologies based on 10 service variables using a sample of 3,081 trauma-exposed adolescents ages 12 to 16 from the National Child Traumatic Stress Network Core Dataset. Services used 30 days prior to the initial assessment from 5 sectors were examined (health care, mental health, school, social services, and juvenile justice). A 5-class model was selected based on statistical fit indices and substantive evaluation of classes: (a) High intensity/multisystem, 9.5%; (b) Justice-involved, 7.2%; (c) Low intensity/multisystem, 19.9%; (d) Social service and mental health, 19.9%; and (e) Low service usage/reference, 43.5%. The classes could be differentiated based on cumulative trauma, maltreatment history, PTSD, externalizing and internalizing symptoms, and age, gender, race/ethnicity and place of residence. This study provides new evidence about patterns of service utilization by trauma exposed, treatment seeking adolescents. Most of these adolescents appear to be involved with at least 2 service systems prior to seeking trauma treatment. Higher cumulative exposure to multiple types of trauma was associated with greater service utilization intensity and complexity, but trauma symptomatology was not. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care.

PubMed

Surís, Alina; Lind, Lisa; Kashner, T Michael; Borman, Patricia D; Petty, Frederick

2004-01-01

This study examines the differential impact of military, civilian adult, and childhood sexual assault on the likelihood of developing posttraumatic stress disorder (PTSD). It also examines the relationship of military sexual assault (MSA) to service utilization and health care costs among women who access services through Veterans Affairs (VA). A convenience sample of 270 veteran women receiving medical and/or mental health treatment at the VA North Texas Healthcare System participated in the study. Participants were interviewed using the Clinician Administered PTSD Scale (CAPS) and categorized into a sexual assault group using the Interview of Sexual Experiences (ISE). A chart review was also conducted to determine the frequency of diagnoses among the women. Data regarding health care utilization was obtained from self-report using the Utilization and Cost Patient Questionnaire (UAC-PQ) and VA administrative records. Compared with those without a history of sexual assault, women veterans were 9 times more likely to have PTSD if they had a history of MSA, 7 times more likely if they had childhood sexual assault (CSA) histories, and 5 times more likely if they had civilian sexual assault histories. An investigation of medical charts revealed that PTSD is diagnosed more often for women with a history of MSA than CSA. CSA was associated with a significant increase in health care utilization and cost for services, but there was no related increase in use or cost associated with MSA. Women veterans have differential rates of PTSD due to sexual assault, with higher rates found among those assaulted while on active duty. Although women with MSA are more likely to have PTSD, results suggest that they are receiving fewer health care services.

Attributing variance in supportive care needs during cancer: culture-service, and individual differences, before clinical factors.

PubMed

Fielding, Richard; Lam, Wendy Wing Tak; Shun, Shiow Ching; Okuyama, Toru; Lai, Yeur Hur; Wada, Makoto; Akechi, Tatsuo; Li, Wylie Wai Yee

2013-01-01

Studies using the Supportive Care Needs Survey (SCNS) report high levels of unmet supportive care needs (SCNs) in psychological and less-so physical & daily living domains, interpreted as reflecting disease/treatment-coping deficits. However, service and culture differences may account for unmet SCNs variability. We explored if service and culture differences better account for observed SCNs patterns. Hong Kong (n = 180), Taiwanese (n = 263) and Japanese (n = 109) CRC patients' top 10 ranked SCNS-34 items were contrasted. Mean SCNS-34 domain scores were compared by sample and treatment status, then adjusted for sample composition, disease stage and treatment status using multivariate hierarchical regression. All samples were assessed at comparable time-points. SCNs were most prevalent among Japanese and least among Taiwanese patients. Japanese patients emphasized Psychological (domain mean = 40.73) and Health systems and information (HSI) (38.61) SCN domains, whereas Taiwanese and Hong Kong patients emphasized HSI (27.41; 32.92) and Patient care & support (PCS) (19.70; 18.38) SCN domains. Mean Psychological domain scores differed: Hong Kong = 9.72, Taiwan = 17.84 and Japan = 40.73 (p<0.03-0.001, Bonferroni). Other SCN domains differed only between Chinese and Japanese samples (all p<0.001). Treatment status differentiated Taiwanese more starkly than Hong Kong patients. After adjustment, sample origin accounted for most variance in SCN domain scores (p<0.001), followed by age (p = 0.01-0.001) and employment status (p = 0.01-0.001). Treatment status and Disease stage, though retained, accounted for least variance. Overall accounted variance remained low. Health service and/or cultural influences, age and occupation differences, and less so clinical factors, differentially account for significant variation in published studies of SCNs.

Empirically and Clinically Useful Decision Making in Psychotherapy: Differential Predictions with Treatment Response Models

ERIC Educational Resources Information Center

Lutz, Wolfgang; Saunders, Stephen M.; Leon, Scott C.; Martinovich, Zoran; Kosfelder, Joachim; Schulte, Dietmar; Grawe, Klaus; Tholen, Sven

2006-01-01

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research…

Assessment and Intervention for English Language Learners with Primary Language Impairment: Research-Based Best Practices

ERIC Educational Resources Information Center

Pieretti, Robert A.; Roseberry-McKibbin, Celeste

2016-01-01

Speech-language pathologists (SLPs) are experiencing the exciting challenge of serving increasing numbers of English Language Learners (ELLs) in U.S. schools. When ELLs struggle in school, they may be overreferred for speech-language services. SLPs are routinely expected to differentiate a language difference based on cultural, linguistic, and…

Counseling the Client on Wheels: A Primer for Mental Health Counselors New to Spinal Cord Injury.

ERIC Educational Resources Information Center

Hayes, Richard L.; And Others

1995-01-01

As people with disabilities gain greater access to the broader community, mental health counselors will be called on to differentiate between related and marginally related services. Using the example of spinal cord injury (SCI), dynamics of loss are discussed, illustrating how mental health counselors might work with clients with disabilities.…

Armed Services Vocational Aptitude Battery (ASVAB): The Equity of ASVAB Form 14 in the Prediction of High School Course Grades

DTIC Science & Technology

1990-08-01

differential validity 612 ASVAB test constru~tion, 16 .PRIC’E CODE bias 17. SECURITY CLASSIFICATION 18. SECURITY CLASSIFICATION jig. SECURITY CLAS...15 Juniors 1985-86 .............................. 15 Seniors 1984-85 .............................. 16 Algebra... 16 Freshmen 1984-85 ............................. 16 Freshmen 1 85-86 ............................. 16 Sophomores 1984-85

Using MMPI-A Profiles to Predict Success in a Military-Style Residential Treatment Program for Adolescents with Academic and Conduct Problems

ERIC Educational Resources Information Center

Weis, Robert; Crockett, Thomas E.; Vieth, Sasha

2004-01-01

Military-style residential treatment for adolescents with academic and conduct problems is an increasingly popular alternative to traditional school-based services. However, dropout from "boot camp" programs is a primary reason for their high cost. Social-emotional functioning before referral may differentiate adolescents who…

Cheating in Online Courses for Financial Aid Fraud in the U.S.

ERIC Educational Resources Information Center

Owen, Robert S.

2016-01-01

This manuscript reviews issues that differentiate traditional academic cheating from course misconduct that is motivated by a desire to defraud financial aid services in the U.S. Past research on college student cheating has assumed that cheaters are driven by an incentive to obtain undeserved grades in college in order to ultimately obtain a…

Enhancing Precision in the Prediction of Voluntary Turnover and Retirement

ERIC Educational Resources Information Center

Smith, Daryl R.; Holtom, Brooks C.; Mitchell, Terence R.

2011-01-01

The present research examines the differential validity of the facets of organizational commitment and job embeddedness to predict who will reenlist or retire from a branch of the armed services. We tested hypotheses with survey data from 1839 enlisted personnel in the U.S. Air Force. For personnel facing the decision to reenlist or separate,…

Unfair Treatment? The Case of Freedle, the SAT, and the Standardization Approach to Differential Item Functioning

ERIC Educational Resources Information Center

Santelices, Maria Veronica; Wilson, Mark

2010-01-01

In 2003, the "Harvard Educational Review" published a controversial article by Roy Freedle that claimed bias against African American students in the SAT college admissions test. Freedle's work stimulated national media attention and faced an onslaught of criticism from experts at the Educational Testing Service (ETS), the agency…

Mental Illness Stigma as a Mediator of Differences in Caucasian and South Asian College Students' Attitudes toward Psychological Counseling

ERIC Educational Resources Information Center

Loya, Fred; Reddy, Radhika; Hinshaw, Stephen P.

2010-01-01

Previous research has established that Asian Americans use mental health services less frequently and hold poorer attitudes toward psychological counseling than Caucasians. The authors directly tested whether stigmatizing beliefs regarding mental illness might explain such differential attitudes toward counseling in a South Asian and Caucasian…

Self-Directed Support: Impact of Hiring Practices on Adults with Intellectual and Developmental Disabilities and Families

ERIC Educational Resources Information Center

Heller, Tamar; Arnold, Catherine K.; van Heumen, Lieke; McBride, Elizabeth L.; Factor, Alan

2012-01-01

The study examined the differential experiences and outcomes for people with intellectual and developmental disabilities and their families receiving self-directed services based on the type of personal support worker hired (parents, siblings, other relatives, friends, and agency staff). The sample consisted of 372 participants in a self-directed…

5 CFR 591.303 - Responsibilities of agencies and the Office of Personnel Management.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Responsibilities of agencies and the Office of Personnel Management. 591.303 Section 591.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Allowance Based on Duty at Remote Worksites § 591.303 Responsibilities of agencies and...

Funding models for outreach ophthalmology services.

PubMed

Turner, Angus W; Mulholland, Will; Taylor, Hugh R

2011-01-01

This paper aims to describe funding models used and compare the effects of funding models for remuneration on clinical activity and cost-effectiveness in outreach eye services in Australia. Cross-sectional case study based in remote outreach ophthalmology services in Australia. Key stake-holders from eye services in nine outreach regions participated in the study. Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' funding mechanisms. Records of clinical activity were used to statistically compare funding models. Workforce availability (supply of ophthalmologists), costs of services, clinical activity (surgery and clinic consultation rates) and waiting times. The supply of ophthalmologists (full-time equivalence) to all remote regions was below the national average (up to 19 times lower). Cataract surgery rates were also below national averages (up to 10 times lower). Fee-for-service funding significantly increased clinical activity. There were also trends to shorter waiting times and lower costs per attendance. For outreach ophthalmology services, the funding model used for clinician reimbursement may influence the efficiency and costs of the services. Fee-for-service funding models, safety-net funding options or differential funding/incentives need further exploration to ensure isolated disadvantaged areas prone to poor patient attendance are not neglected. In order for outreach eye health services to be sustainable, remuneration rates need to be comparable to those for urban practice. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Quality differentials and reproductive health service utilisation determinants in India.

PubMed

Anand, Sandip; Sinha, R K

2010-01-01

This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Dynamics of Ecosystem Services during Forest Transitions in Reventazón, Costa Rica.

PubMed

Vallet, Améline; Locatelli, Bruno; Levrel, Harold; Brenes Pérez, Christian; Imbach, Pablo; Estrada Carmona, Natalia; Manlay, Raphaël; Oszwald, Johan

2016-01-01

The forest transition framework describes the temporal changes of forest areas with economic development. A first phase of forest contraction is followed by a second phase of expansion once a turning point is reached. This framework does not differentiate forest types or ecosystem services, and describes forests regardless of their contribution to human well-being. For several decades, deforestation in many tropical regions has degraded ecosystem services, such as watershed regulation, while increasing provisioning services from agriculture, for example, food. Forest transitions and expansion have been observed in some countries, but their consequences for ecosystem services are often unclear. We analyzed the implications of forest cover change on ecosystem services in Costa Rica, where a forest transition has been suggested. A review of literature and secondary data on forest and ecosystem services in Costa Rica indicated that forest transition might have led to an ecosystem services transition. We modeled and mapped the changes of selected ecosystem services in the upper part of the Reventazón watershed and analyzed how supply changed over time in order to identify possible transitions in ecosystem services. The modeled changes of ecosystem services is similar to the second phase of a forest transition but no turning point was identified, probably because of the limited temporal scope of the analysis. Trends of provisioning and regulating services and their tradeoffs were opposite in different spatial subunits of our study area, which highlights the importance of scale in the analysis of ecosystem services and forest transitions. The ecosystem services transition framework proposed in this study is useful for analyzing the temporal changes of ecosystem services and linking socio-economic drivers to ecosystem services demand at different scales.

Dynamics of Ecosystem Services during Forest Transitions in Reventazón, Costa Rica

PubMed Central

Vallet, Améline; Locatelli, Bruno; Levrel, Harold; Brenes Pérez, Christian; Imbach, Pablo; Estrada Carmona, Natalia; Manlay, Raphaël; Oszwald, Johan

2016-01-01

The forest transition framework describes the temporal changes of forest areas with economic development. A first phase of forest contraction is followed by a second phase of expansion once a turning point is reached. This framework does not differentiate forest types or ecosystem services, and describes forests regardless of their contribution to human well-being. For several decades, deforestation in many tropical regions has degraded ecosystem services, such as watershed regulation, while increasing provisioning services from agriculture, for example, food. Forest transitions and expansion have been observed in some countries, but their consequences for ecosystem services are often unclear. We analyzed the implications of forest cover change on ecosystem services in Costa Rica, where a forest transition has been suggested. A review of literature and secondary data on forest and ecosystem services in Costa Rica indicated that forest transition might have led to an ecosystem services transition. We modeled and mapped the changes of selected ecosystem services in the upper part of the Reventazón watershed and analyzed how supply changed over time in order to identify possible transitions in ecosystem services. The modeled changes of ecosystem services is similar to the second phase of a forest transition but no turning point was identified, probably because of the limited temporal scope of the analysis. Trends of provisioning and regulating services and their tradeoffs were opposite in different spatial subunits of our study area, which highlights the importance of scale in the analysis of ecosystem services and forest transitions. The ecosystem services transition framework proposed in this study is useful for analyzing the temporal changes of ecosystem services and linking socio-economic drivers to ecosystem services demand at different scales. PMID:27390869

Navigation Architecture For A Space Mobile Network

NASA Technical Reports Server (NTRS)

Valdez, Jennifer E.; Ashman, Benjamin; Gramling, Cheryl; Heckler, Gregory W.; Carpenter, Russell

2016-01-01

The Tracking and Data Relay Satellite System (TDRSS) Augmentation Service for Satellites (TASS) is a proposed beacon service to provide a global, space-based GPS augmentation service based on the NASA Global Differential GPS (GDGPS) System. The TASS signal will be tied to the GPS time system and usable as an additional ranging and Doppler radiometric source. Additionally, it will provide data vital to autonomous navigation in the near Earth regime, including space weather information, TDRS ephemerides, Earth Orientation Parameters (EOP), and forward commanding capability. TASS benefits include enhancing situational awareness, enabling increased autonomy, and providing near real-time command access for user platforms. As NASA Headquarters Space Communication and Navigation Office (SCaN) begins to move away from a centralized network architecture and towards a Space Mobile Network (SMN) that allows for user initiated services, autonomous navigation will be a key part of such a system. This paper explores how a TASS beacon service enables the Space Mobile Networking paradigm, what a typical user platform would require, and provides an in-depth analysis of several navigation scenarios and operations concepts.

Modified weighted fair queuing for packet scheduling in mobile WiMAX networks

NASA Astrophysics Data System (ADS)

Satrya, Gandeva B.; Brotoharsono, Tri

2013-03-01

The increase of user mobility and the need for data access anytime also increases the interest in broadband wireless access (BWA). The best available quality of experience for mobile data service users are assured for IEEE 802.16e based users. The main problem of assuring a high QOS value is how to allocate available resources among users in order to meet the QOS requirement for criteria such as delay, throughput, packet loss and fairness. There is no specific standard scheduling mechanism stated by IEEE standards, which leaves it for implementer differentiation. There are five QOS service classes defined by IEEE 802.16: Unsolicited Grant Scheme (UGS), Extended Real Time Polling Service (ertPS), Real Time Polling Service (rtPS), Non Real Time Polling Service (nrtPS) and Best Effort Service (BE). Each class has different QOS parameter requirements for throughput and delay/jitter constraints. This paper proposes Modified Weighted Fair Queuing (MWFQ) scheduling scenario which was based on Weighted Round Robin (WRR) and Weighted Fair Queuing (WFQ). The performance of MWFQ was assessed by using above five QoS criteria. The simulation shows that using the concept of total packet size calculation improves the network's performance.

A Systematic Scheme for Multiple Access in Ethernet Passive Optical Access Networks

NASA Astrophysics Data System (ADS)

Ma, Maode; Zhu, Yongqing; Hiang Cheng, Tee

2005-11-01

While backbone networks have experienced substantial changes in the last decade, access networks have not changed much. Recently, passive optical networks (PONs) seem to be ready for commercial deployment as access networks, due to the maturity of a number of enabling technologies. Among the PON technologies, Ethernet PON (EPON) standardized by the IEEE 802.3ah Ethernet in the First Mile (EFM) Task Force is the most attractive one because of its high speed, low cost, familiarity, interoperability, and low overhead. In this paper, we consider the issue of upstream channel sharing in the EPONs. We propose a novel multiple-access control scheme to provide bandwidth-guaranteed service for high-demand customers, while providing best effort service to low-demand customers according to the service level agreement (SLA). The analytical and simulation results prove that the proposed scheme performs best in what it is designed to do compared to another well-known scheme that has not considered providing differentiated services. With business customers preferring premium services with guaranteed bandwidth and residential users preferring low-cost best effort services, our scheme could benefit both groups of subscribers, as well as the operators.

Staff views on wellbeing for themselves and for service users.

PubMed

Schrank, Beate; Brownell, Tamsin; Riches, Simon; Chevalier, Agnes; Jakaite, Zivile; Larkin, Charley; Lawrence, Vanessa; Slade, Mike

2015-02-01

Wellbeing is an important outcome in the context of recovery from mental illness. The views of mental health professionals on wellbeing may influence their approach to supporting recovery. This study aims to explore views held by mental health staff about factors influencing their own wellbeing and that of service users with psychosis. Semi-structured interviews were conducted with 14 mental health staff in South London who had worked with people with psychosis. Thematic analysis was used to analyse the data and comparisons were made between staff views of wellbeing for themselves and service users. Staff participants held similar conceptualisations of wellbeing for themselves and for service users. However, they suggested a differential impact on wellbeing for a number of factors, such as balance, goals and achievement, and work. Staff employed a more deficit-based perspective on wellbeing for service users and a more strengths-based view for themselves. Staff stated a recovery orientation in principle, but struggled to focus on service user strengths in practice. A stronger emphasis in clinical practice on amplifying strengths to foster self-management is indicated, and staff may need support to achieve this emphasis, e.g. through specific interventions and involvement of peer support workers.

Perspectives for Web Service Intermediaries: How Influence on Quality Makes the Difference

NASA Astrophysics Data System (ADS)

Scholten, Ulrich; Fischer, Robin; Zirpins, Christian

In the service-oriented computing paradigm and the Web service architecture, the broker role is a key facilitator to leverage technical capabilities of loose coupling to achieve organizational capabilities of dynamic customer-provider-relationships. In practice, this role has quickly evolved into a variety of intermediary concepts that refine and extend the basic functionality of service brokerage with respect to various forms of added value like platform or market mechanisms. While this has initially led to a rich variety of Web service intermediaries, many of these are now going through a phase of stagnation or even decline in customer acceptance. In this paper we present a comparative study on insufficient service quality that is arguably one of the key reasons for this phenomenon. In search of a differentiation with respect to quality monitoring and management patterns, we categorize intermediaries into Infomediaries, e-Hubs, e-Markets and Integrators. A mapping of quality factors and control mechanisms to these categories depicts their respective strengths and weaknesses. The results show that Integrators have the highest overall performance, followed by e-Markets, e-Hubs and lastly Infomediaries. A comparative market survey confirms the conceptual findings.

Usability and trust in e-banking.

PubMed

Pravettoni, Gabriella; Leotta, Salvatore Nuccio; Lucchiari, Claudio; Misuraca, Raffaella

2007-12-01

This study assessed the role of usability in trust of e-banking services. A questionnaire was administered to 185 Italian undergraduate working students who volunteered for the experiment (M age = 30.5 yr., SD = 3.1). Participants were differentiated on computer ability (Expert, n = 104; Nonexpert, n = 81) and e-banking use (User, n = 93; Nonusers, n = 92). Analysis showed that the website usability of e-banking services did not play a very important role for the User group. Instead, institution-based trust, e.g., the trust in the security policy of the Web merchant, customers, and the overall trust of the bank were the crucial factors in the adoption of e-banking.

Channel systems: an idea whose time has come in health care marketing.

PubMed

Trombetta, W L

1989-09-01

Channel systems is beginning to emerge as a strategy that binds various entities in the delivery for health care, particularly hospitals and physicians. Hospitals are beginning to organize their efforts to help physicians in a channel systems context by focusing on value-added services to doctors that differentiate a hospital from its competitors and bind the doctors to the value-added hospitals. At the same time, doctors are beginning to realize their opportunity to leverage their admissions, purchasing, and patronage power in terms of obtaining value-added benefits and services that can help them compete more effectively in an increasingly aggressive health care marketplace.

Sectoral transitions - modeling the development from agrarian to service economies

NASA Astrophysics Data System (ADS)

Lutz, Raphael; Spies, Michael; Reusser, Dominik E.; Kropp, Jürgen P.; Rybski, Diego

2013-04-01

We consider the sectoral composition of a country's GDP, i.e the partitioning into agrarian, industrial, and service sectors. Exploring a simple system of differential equations we characterise the transfer of GDP shares between the sectors in the course of economic development. The model fits for the majority of countries providing 4 country-specific parameters. Relating the agrarian with the industrial sector, a data collapse over all countries and all years supports the applicability of our approach. Depending on the parameter ranges, country development exhibits different transfer properties. Most countries follow 3 of 8 characteristic paths. The types are not random but show distinct geographic and development patterns.

From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

USGS Publications Warehouse

Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

2014-01-01

Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic valuation and policy applications than studies that consider only theoretical service provision and/or use.

How the blind cope with problems of medicine utilization: a study in Bangkok, Thailand.

PubMed

Riewpaiboon, Arthorn

2009-08-01

This project is aimed at studying medicine utilization among blind people in Bangkok, Thailand. The study was designed as a cross-sectional descriptive research. The study group comprised visually impaired persons, aged at least 18 years, and living in Bangkok. Data were collected via face-to-face interviews in 2007. The study included 86 people. The majority of the subjects were 31-50 years old (65%) and male (61%). During the two weeks before the interview, the most frequently used medicines were anti-inflammatory drugs and muscle relaxants (26%), followed by antipyretics. Most of the subjects received their medicines from drugstores. During the three months before the interview, 75% of the subjects received pharmacy information through various channels. The major source was drugstores, followed by radio. With regard to procurement of medication, 79% of the subjects went to hospitals and 57% acquired the medicines by themselves. Approximately 20% of the subjects received medicines with touchable-differentiated packaging. For purposes of self-medication, the subjects were able to differentiate types, doses, and durations of drug use based on memory. Regarding pharmaceutical services, 81% of the subjects required special services intended for the disabled, as well as further explanation of the medicine's use, including drug labeling. Based on the study results, most of the blind did not receive assistance regarding medicine use. Their use of medicine was based on memory, and they were in need of improved pharmaceutical services. Copyright 2009 John Wiley & Sons, Ltd.

Variable weight spectral amplitude coding for multiservice OCDMA networks

NASA Astrophysics Data System (ADS)

Seyedzadeh, Saleh; Rahimian, Farzad Pour; Glesk, Ivan; Kakaee, Majid H.

2017-09-01

The emergence of heterogeneous data traffic such as voice over IP, video streaming and online gaming have demanded networks with capability of supporting quality of service (QoS) at the physical layer with traffic prioritisation. This paper proposes a new variable-weight code based on spectral amplitude coding for optical code-division multiple-access (OCDMA) networks to support QoS differentiation. The proposed variable-weight multi-service (VW-MS) code relies on basic matrix construction. A mathematical model is developed for performance evaluation of VW-MS OCDMA networks. It is shown that the proposed code provides an optimal code length with minimum cross-correlation value when compared to other codes. Numerical results for a VW-MS OCDMA network designed for triple-play services operating at 0.622 Gb/s, 1.25 Gb/s and 2.5 Gb/s are considered.

Charge Master: Friend or Foe?

PubMed

Wan, Wenshuai; Itri, Jason

2016-01-01

Prices charged for imaging services can be found in the charge master, a catalog of retail list prices for medical goods and services. This article reviews the evolution of reimbursement in the United States and provides a balanced discussion of the factors that influence charge master prices. Reduced payments to hospitals have pressured hospitals to generate additional revenue by increasing charge master prices. An unfortunate consequence is that those least able to pay for health care, the uninsured, are subjected to the highest charges. Yet, differences in pricing also represent an opportunity for radiology practices, which provide imaging services that are larger in scope or superior in quality to promote product differentiation. Physicians, hospital executives, and policy makers need to work together to improve the existing reimbursement system to promote high-quality, low-cost imaging. Copyright © 2016 Mosby, Inc. All rights reserved.

An overview of 5G network slicing architecture

NASA Astrophysics Data System (ADS)

Chen, Qiang; Wang, Xiaolei; Lv, Yingying

2018-05-01

With the development of mobile communication technology, the traditional single network model has been unable to meet the needs of users, and the demand for differentiated services is increasing. In order to solve this problem, the fifth generation of mobile communication technology came into being, and as one of the key technologies of 5G, network slice is the core technology of network virtualization and software defined network, enabling network slices to flexibly provide one or more network services according to users' needs[1]. Each slice can independently tailor the network functions according to the requirements of the business scene and the traffic model and manage the layout of the corresponding network resources, to improve the flexibility of network services and the utilization of resources, and enhance the robustness and reliability of the whole network [2].

Proposal of Secure VoIP System Using Attribute Certificate

NASA Astrophysics Data System (ADS)

Kim, Jin-Mook; Jeong, Young-Ae; Hong, Seong-Sik

VoIP is a service that changes the analogue audio signal into a digital signal and then transfers the audio information to the users after configuring it as a packet; and it has an advantage of lower price than the existing voice call service and better extensibility. However, VoIP service has a system structure that, compared to the existing PSTN (Public Switched Telephone Network), has poor call quality and is vulnerable in the security aspect. To make up these problems, TLS service was introduced to enhance the security. In practical system, however, since QoS problem occurs, it is necessary to develop the VoIP security system that can satisfy QoS at the same time in the security aspect. In this paper, a user authentication VoIP system that can provide a service according to the security and the user through providing a differential service according to the approach of the users by adding AA server at the step of configuring the existing VoIP session is suggested. It was found that the proposed system of this study provides a quicker QoS than the TLS-added system at a similar level of security. Also, it is able to provide a variety of additional services by the different users.

Current issues in Scandinavian acute psychiatric wards.

PubMed

Ruud, Torleif; Lindefors, Nils; Lindhardt, Anne

2006-01-01

The aim of the paper is to provide an overview of some of the most important issues faced by acute inpatient facilities in three Scandinavian countries, including reflections and critical remarks for discussion in this field. Information was drawn from scientific articles and official reports published in recent years, as well as the authors' own knowledge of acute facilities in their home countries. Acute inpatient facilities, including General Hospital Psychiatric Units (GHPUs), in all Scandinavian countries have several issues and problems in common, which include the organisation and capacity of acute services, the assessment of dangerousness and suicidality, the use of coercion and efforts to reduce coercion, the need to define and improve the quality of acute services, and the necessity to improve collaboration and continuity between acute services and other services. Although the emphasis some of these issues receive can vary across the three countries, Scandinavian mental health professionals (and policy makers) have begun to systematically share their experiences in developing a growing spirit of collaboration. Despite the role of welfare state and the deployment of substantial resources in Scandinavian countries, mental health practitioners are struggling to implement best practices in acute wards, to develop differentiated forms of acute services, and to reach the right balance and coordination between acute services and other services.

Do they see eye to eye? Management and employee perspectives of high-performance work systems and influence processes on service quality.

PubMed

Liao, Hui; Toya, Keiko; Lepak, David P; Hong, Ying

2009-03-01

Extant research on high-performance work systems (HPWSs) has primarily examined the effects of HPWSs on establishment or firm-level performance from a management perspective in manufacturing settings. The current study extends this literature by differentiating management and employee perspectives of HPWSs and examining how the two perspectives relate to employee individual performance in the service context. Data collected in three phases from multiple sources involving 292 managers, 830 employees, and 1,772 customers of 91 bank branches revealed significant differences between management and employee perspectives of HPWSs. There were also significant differences in employee perspectives of HPWSs among employees of different employment statuses and among employees of the same status. Further, employee perspective of HPWSs was positively related to individual general service performance through the mediation of employee human capital and perceived organizational support and was positively related to individual knowledge-intensive service performance through the mediation of employee human capital and psychological empowerment. At the same time, management perspective of HPWSs was related to employee human capital and both types of service performance. Finally, a branch's overall knowledge-intensive service performance was positively associated with customer overall satisfaction with the branch's service. (c) 2009 APA, all rights reserved.

The future of almanac services --- an HMNAO perspective

NASA Astrophysics Data System (ADS)

Bell, S.; Nelmes, S.; Prema, P.; Whittaker, J.

2015-08-01

This talk will explore the means for delivering almanac data currently under consideration by HM Nautical Almanac Office in the near to medium future. While there will be a need to continue printed almanacs, almanac data must be available in a variety of forms ranging from paper almanacs to traditional web services through to applications for mobile devices and smartphones. The supply of data using applications may call for a different philosophy in supplying ephemeris data, one that differentiates between an application that calls on a web server for its data and one that has built-in ephemerides. These ephemerides need to be of a reasonably high precision while maintaining a modest machine footprint. These services also need to provide a wide range of applications ranging from traditional sunrise/set data though to more specialized services such as celestial navigation. The work necessary to meet these goals involves efficient programming, intuitive user interfaces, compact and efficient ephemerides and a suitable range of tools to meet the user's needs.

Estimating the effects of the Balanced Budget act of 1997 on the home health care use of the dually eligible: a natural experiments approach.

PubMed

Williamson, James M

2013-01-01

This research examines the use of home health agency services used by older adults after the implementation of changes to Medicare's payment scheme mandated by the Balanced Budget Act (BBA) of 1997. The objective of this study is to identify differential effects the BBA may have had on home health service use between dually eligible and Medicare-only beneficiaries. The results of this study suggest that although dually eligible and Medicare-only beneficiaries experienced a substantial decline in home health service use, the dually eligible had a relatively larger decline. Following the BBA, the dually eligible had more office-based physician visits but fewer inpatient hospital days, relative to the Medicare-only population. Finally, the author estimates cost savings to Medicare due to the BBA to be $1 billion in the 2 years following the legislation, whereas Medicaid programs shouldered a larger percentage of the home health service bill.

A longitudinal analysis of the impact of hospital service line profitability on the likelihood of readmission.

PubMed

Navathe, Amol S; Volpp, Kevin G; Konetzka, R Tamara; Press, Matthew J; Zhu, Jingsan; Chen, Wei; Lindrooth, Richard C

2012-08-01

Quality of care may be linked to the profitability of admissions in addition to level of reimbursement. Prior policy reforms reduced payments that differentially affected the average profitability of various admission types. The authors estimated a Cox competing risks model, controlling for the simultaneous risk of mortality post discharge, to determine whether the average profitability of hospital service lines to which a patient was admitted was associated with the likelihood of readmission within 30 days. The sample included 12,705,933 Medicare Fee for Service discharges from 2,438 general acute care hospitals during 1997, 2001, and 2005. There was no evidence of an association between changes in average service line profitability and changes in readmission risk, even when controlling for risk of mortality. These findings are reassuring in that the profitability of patients' admissions did not affect readmission rates, and together with other evidence may suggest that readmissions are not an unambiguous quality indicator for in-hospital care.

Ethnic density and depressive symptoms among African Americans: threshold and differential effects across social and demographic subgroups.

PubMed

Bécares, Laia; Nazroo, James; Jackson, James

2014-12-01

We examined the association between Black ethnic density and depressive symptoms among African Americans. We sought to ascertain whether a threshold exists in the association between Black ethnic density and an important mental health outcome, and to identify differential effects of this association across social, economic, and demographic subpopulations. We analyzed the African American sample (n = 3570) from the National Survey of American Life, which we geocoded to the 2000 US Census. We determined the threshold with a multivariable regression spline model. We examined differential effects of ethnic density with random-effects multilevel linear regressions stratified by sociodemographic characteristics. The protective association between Black ethnic density and depressive symptoms changed direction, becoming a detrimental effect, when ethnic density reached 85%. Black ethnic density was protective for lower socioeconomic positions and detrimental for the better-off categories. The masking effects of area deprivation were stronger in the highest levels of Black ethnic density. Addressing racism, racial discrimination, economic deprivation, and poor services-the main drivers differentiating ethnic density from residential segregation-will help to ensure that the racial/ethnic composition of a neighborhood is not a risk factor for poor mental health.

Need, access, and the reach of integrated care: A typology of patients.

PubMed

Bridges, Ana J; Villalobos, Bianca T; Anastasia, Elizabeth A; Dueweke, Aubrey R; Gregus, Samantha J; Cavell, Timothy A

2017-06-01

This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC). A total of 105 adult primary care patients referred for same-day behavioral health appointments completed a brief self-report questionnaire assessing past-year behavioral health concerns, service utilization, and perceived barriers to utilization. Hierarchical and k-means cluster analyses revealed 3 groups: (a) Well-Served patients, characterized by high perceived need for services, high service use, and low barriers to service use (40%); (b) Underserved patients, characterized by high perceived need, low service utilization, and high barriers to service use (20%); and (c) Subclinical patients, characterized by low perceived need, low service use, and low barriers to service use (20%). Clusters were reliably differentiated by age, primary language, insurance status, and global functioning. We found primary care patients could be grouped into 3 categories and that 60% (Underserved and Subclinical) represented groups less commonly seen in traditional mental health (MH) settings. IBHC may be a promising approach for extending the reach of MH care, and partnerships between FQHCs and university-based research teams may be a promising approach for conducting research on the IBHC service-delivery model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Differential Utilization of Selected Community Resources by Abused Wives.

ERIC Educational Resources Information Center

Heintzelman, Carol A.

Wife abuse is a social problem that confronts all sectors of the human services network. It is not known what life factors influence an abused wife's initial choice to leave home and seek help in a shelter agency or to stay home and seek help in a non-shelter agency. This study was conducted to examine the relative importance of various factors…

77 FR 50742 - Self-Regulatory Organizations; New York Stock Exchange LLC; Order Approving a Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... multiples of six (e.g., six, twelve, eighteen or twenty-four cross connects). The Exchange proposes to... monthly to furnish and install one cross connect between cabinets. For a bundle of six cross connects, the... differentiation among Users regarding the fees charged for a particular product, service or piece of equipment. In...

Differentiating Second Language Acquisition from Specific Learning Disability: An Observational Tool Assessing Dual Language Learners' Pragmatic Competence

ERIC Educational Resources Information Center

Farnsworth, Megan

2018-01-01

Overrepresentation of Dual Language Learners (DLLs) in special education remains a problem even after 40 years of inquiry. One factor is that the U.S. federal government has neither clearly explained the definition of Specific Learning Disability (SLD) nor operationally defined it to identify children for special education services. This lack of…

Improving Student Achievement in Science... The NSRC Blueprint: Science Education Reform for School Districts and States...

ERIC Educational Resources Information Center

National Science Resources Center, 2006

2006-01-01

Systemic reform requires leaders with technical knowledge of the five essential components of science education reform, as well as access to products and services that can be used to move leaders through the various stages of reform. During the past two decades, the National Science Resources Center (NSRC) has developed differentiated products and…

A Four-Level Hierarchy for Organizing Wildland Stream Resource Information

Treesearch

Harry Parrott; Daniel A. Marion; R. Douglas Perkinson

1989-01-01

An analysis of current USDA Forest Service methods of collecting and using wildland stream resource data indicates that required information can be organized into a four-level hierarchy. Information at each level is tiered with information at the preceding level. Level 1 is the ASSOCIATION, which is differentiated by stream size and flow regime. Level 2, STREAM TYPE,...

Re-Engaging Marginalised Young People in Learning: The Contribution of Informal Learning and Community-Based Collaborations

ERIC Educational Resources Information Center

Hayes, Debra

2012-01-01

In the twenty-first century, a socially just system of schooling prepares all young people to adapt to new technologies, and participate in a global economy that is highly differentiated at the local level. In Australia and other countries where local markets have become heavily dependent on service economies, "working-class" families…

42 CFR 411.161 - Prohibition against taking into account Medicare eligibility or entitlement or differentiating...

Code of Federal Regulations, 2010 CFR

2010-10-01

... provides. (2) Example— Mr. Smith works for employer A, and he and his wife are covered through employer A's GHP (Plan A). Neither is eligible for Medicare nor has ESRD. Mrs. Smith works for employer B, and is... items and services which Plan B does not cover, such as prescription drugs. If Mrs. Smith obtains a...

Pre-Service Teachers' Impact on Student Learning: Three-Year Study of the Impact on Student Learning Project

ERIC Educational Resources Information Center

Meister, Denise G.

2011-01-01

With the demand for a demonstration of continuous progress as an accountability gauge in public schools, teachers are compelled to examine assessment data for each of their pupils. This data analysis, in turn, should help teachers gauge their instructional practices and differentiate instruction so that all can reach proficient levels of…

E-Learning Teacher Training Courses for Differentiated Instruction in Multicultural Classrooms: Reflections upon the Participants' Experiences

ERIC Educational Resources Information Center

Dimitriadou, Catherine; Nari, Eirini; Palaiologou, Nektaria

2012-01-01

The focus and purpose of this paper is to present an e-learning teacher training course, including its aims and main results from teachers' interviews. The case study presented here examines the effectiveness of an in-service training seminar which was targeted toward teachers at multicultural schools. It concerns qualitative research that…

The regulation of health care providers' payments when horizontal and vertical differentiation matter.

PubMed

Bardey, David; Canta, Chiara; Lozachmeur, Jean-Marie

2012-09-01

This paper analyzes the regulation of payment schemes for health care providers competing in both quality and product differentiation of their services. The regulator uses two instruments: a prospective payment per patient and a cost reimbursement rate. When the regulator can only use a prospective payment, the optimal price involves a trade-off between the level of quality provision and the level of horizontal differentiation. If this pure prospective payment leads to underprovision of quality and overdifferentiation, a mixed reimbursement scheme allows the regulator to improve the allocation efficiency. This is true for a relatively low level of patients' transportation costs. We also show that if the regulator cannot commit to the level of the cost reimbursement rate, the resulting allocation can dominate the one with full commitment. This occurs when the transportation cost is low or high enough, and the full commitment solution either implies full or zero cost reimbursement. Copyright © 2012 Elsevier B.V. All rights reserved.

Design and Implementation of BDS RTCM SSR Message

NASA Astrophysics Data System (ADS)

Xiao, Xia; Cheng, Fang; Liu, Feng; Lu, XiaoChun

2017-09-01

Based on the real-time differential positioning system of Beidou wide area, a set of Beidou high-precision differential information transmission protocol is studied and designed. After the system generates satellite precise orbit and clock difference products, it needs to be sent to the users in a certain data format through C band GEO communication satellite. The transport protocol should be designed according to the data volume and update rate of the system. At the same time, it is necessary to combine the signal system, satellite resources and the restriction and restriction of the receiver implementation technology. It refers to the relevant fields and international similar systems of technology and standards to design. This paper establishes a set of technical indicators which can measure the pros and cons of differential message organization and broadcasting strategy. Through modeling, simulation and actual test, this paper makes a comprehensive comparison of different strategies. Finally, a transmission protocol design scheme which has good performance and meets the system service requirements is presented.

Multiple sclerosis in US veterans of the Vietnam era and later military service: race, sex, and geography.

PubMed

Wallin, Mitchell T; Page, William F; Kurtzke, John F

2004-01-01

We identified 5345 cases of multiple sclerosis (MS) among US veterans who first entered military service between 1960 and 1994, and who were "service-connected" for MS by the Department of Veterans Affairs (VA). Two controls per case were matched on age, date of service entry, and branch of service. Available for service and VA files were demographic and military data for 4951 cases and 9378 controls. Versus white men, relative risk of MS was significantly higher for all women, at 2.99 for whites, 2.86 for blacks, and 3.51 for those of other races. This was a significant increase from our prior series of veterans of World War II and the Korean Conflict, where white women had a relative risk of 1.79. Risk for black men was higher now (0.67 vs 0.44), while other men remained low (0.30 vs 0.22). Residence at service entry in the northern tier of states had a relative risk of 2.02 versus the southern tier, which was significantly less than the 2.64 for the earlier series. Residence by individual state at birth and service entry for white men further supported this decreasing geographic differential. Such marked changes in geography, sex, and race in such a short interval strongly imply a primary environmental factor in the cause or precipitation of this disease.

Ethnic differences in women's use of mental health services: do social networks play a role? Findings from a national survey.

PubMed

Kapadia, Dharmi; Nazroo, James; Tranmer, Mark

2018-04-01

The reasons for ethnic differences in women's mental health service use in England remain unclear. The aims of this study were to ascertain: ethnic differences in women's usage of mental health services, if social networks are independently associated with service use, and if the association between women's social networks and service use varies between ethnic groups. Logistic regression modelling of nationally representative data from the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) survey conducted in England. The analytic sample (2260 women, aged 16-74 years) was drawn from the representative subsample of 2340 women in EMPIRIC for whom data on mental health services, and social networks were available. Pakistani and Bangladeshi women were less likely than White women to have used mental health services (Pakistani OR = 0.23, CI = 0.08-0.65, p = .005; Bangladeshi OR = 0.25, CI = 0.07-0.86, p = .027). Frequent contact with relatives reduced mental health service use (OR = 0.45, CI = 0.23-0.89, p = .023). An increase in perceived inadequate support in women's close networks was associated with increased odds of using mental health services (OR = 1.91, CI = 1.11-3.27, p = .019). The influence of social networks on mental health service use did not differ between ethnic groups. The differential treatment of women from Pakistani and Bangladeshi ethnic groups in primary care settings could be a possible reason for the observed differences in mental health service use.

Global investigations of the satellite-based Fugro OmniSTAR HP service

NASA Astrophysics Data System (ADS)

Pflugmacher, Andreas; Heister, Hansbert; Heunecke, Otto

2009-12-01

OmniSTAR is one of the world's leading suppliers of satellite-based augmentation services for onshore and offshore GNSS applications. OmniSTAR currently offers three services: VBS, HP and XP. OmniSTAR VBS is the code-based service, suitable for sub-metre positioning accuracy. The HP and XP services provide sub-decimetre accuracy, with the HP service based on a precise differential methodology and the XP service uses precise absolute positioning. The sub-decimetre HP and XP services both have distinctive convergence behaviour, and the positioning task is essentially a time-dependent process during which the accuracy of the estimated coordinates continuously improves over time. To validate the capabilities of the OmniSTAR services, and in particular the HP (High Performance) service, globally distributed measurement campaigns were performed. The results of these investigations confirm that the HP service satisfies its high accuracy specification, but only after a sufficient initialisation phase. Two kinds of disturbances can handicap HP operation: lack of GNSS observations and outages of the augmentation signal. The most serious kind of disturbance is the former. Within a few seconds the achieved convergence level is completely lost. Outages in the reception of augmentation data merely affect the relevant period of the outage - the accuracy during the outage is degraded. Only longer interruptions lead to a loss of the HP solution. When HP convergence is lost, the HP process has to be re-initialized. If there are known points (so-called “seed points”) available, a shortened “kick-start”-initialization is possible. With the aid of seed points it only takes a few minutes to restore convergence.

Service collaboration and hospital cost performance: direct and moderating effects.

PubMed

Proenca, E Jose; Rosko, Michael D; Dismuke, Clara E

2005-12-01

Growing reliance on service provision through systems and networks creates the need to better understand the nature of the relationship between service collaboration and hospital performance and the conditions that affect this relationship. We examine 1) the effects of service provision through health systems and health networks on hospital cost performance and 2) the moderating effects of market conditions and service differentiation on the collaboration-cost relationship. We used moderated regression analysis to test the direct and moderating effects. Data on 1368 private hospitals came from the 1998 AHA Annual Survey, Medicare Cost Reports, and Solucient. Service collaboration was measured as the proportion of hospital services provided at the system level and at the network level. Market conditions were measured by the levels of managed care penetration and competition in the hospital's market. The proportion of hospital services provided at the system level had a negative relationship with hospital cost. The relationship was curvilinear for network use. Degree of managed care penetration moderated the relationship between network-based collaboration and hospital cost. The benefits of service collaboration through systems and networks, as measured by reduced cost, depend on degree of collaboration rather than mere membership. In loosely structured collaborations such as networks, costs reduce initially but increase later as the extent of collaboration increases. The effect of network-based collaboration is also tempered by managed care penetration. These effects are not seen in more tightly integrated forms such as systems.

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change.

PubMed

Lee, Tae-Jin; Cheong, Chelim

2017-11-01

To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

[Is the structure of surgical clinics in Germany changing? A current investigation into the structure of surgical clinics in the Federal Republic of Germany].

PubMed

Lob, G; Lob, T; Bauer, H; Niethard, F; Polonius, J; Siebert, H

2009-04-01

Medical developments have led to extensive specialization in the field of surgery. This has already been reflected for many years in altered structure and organization forms of surgical clinics. Indispensable quality standards, statutory general conditions, increasing competition in service providers and health insurance with transparency of the service procedure all intensify this trend. The aim of this investigation was, therefore, to determine how far this differentiation of service supply in the field of surgery is also reflected in the area and in surgical departments and clinics of basic and routine supply. To achieve this, all available published information on the structure and organization of surgical clinics in the Federal Republic of Germany was classified according to current departmentalization into "undivided" or general/visceral surgery facilities compared to orthopedic/trauma surgery departments.

Data-centric multiobjective QoS-aware routing protocol for body sensor networks.

PubMed

Razzaque, Md Abdur; Hong, Choong Seon; Lee, Sungwon

2011-01-01

In this paper, we address Quality-of-Service (QoS)-aware routing issue for Body Sensor Networks (BSNs) in delay and reliability domains. We propose a data-centric multiobjective QoS-Aware routing protocol, called DMQoS, which facilitates the system to achieve customized QoS services for each traffic category differentiated according to the generated data types. It uses modular design architecture wherein different units operate in coordination to provide multiple QoS services. Their operation exploits geographic locations and QoS performance of the neighbor nodes and implements a localized hop-by-hop routing. Moreover, the protocol ensures (almost) a homogeneous energy dissipation rate for all routing nodes in the network through a multiobjective Lexicographic Optimization-based geographic forwarding. We have performed extensive simulations of the proposed protocol, and the results show that DMQoS has significant performance improvements over several state-of-the-art approaches.

A long-reach WDM passive optical network enabling broadcasting service with centralized light source

NASA Astrophysics Data System (ADS)

Liu, D.; Tang, M.; Fu, S.; Liu, D.; Shum, P.

2012-02-01

We propose a long-reach wavelength-division-multiplexed (WDM) passive optical network (PON) to provide conventional point-to-point (P2P) data and downstream broadcasting service simultaneously by superimposing, for each WDM channel, the differential-phase-shift-keying (DPSK) broadcasting signal with the subcarrier multiplexing (SCM) modulated downstream P2P signal, at the optical line terminal (OLT). In the optical network units (ONUs), by re-modulating part of the downstream signal with a reflective semiconductor optical amplifier (RSOA), we realize color-less ONUs for upstream data transmission. The proposed scheme is numerically verified with a 5 Gb/s downstream P2P signal and broadcasting services, as well as 2.5 Gb/s upstream data through a 60 km bidirectional fiber link. In particular, the influence of the downstream lightwave's optical carrier-subcarrier ratio (OCSR) on the system performance is also investigated.

Pricing Resources in LTE Networks through Multiobjective Optimization

PubMed Central

Lai, Yung-Liang; Jiang, Jehn-Ruey

2014-01-01

The LTE technology offers versatile mobile services that use different numbers of resources. This enables operators to provide subscribers or users with differential quality of service (QoS) to boost their satisfaction. On one hand, LTE operators need to price the resources high for maximizing their profits. On the other hand, pricing also needs to consider user satisfaction with allocated resources and prices to avoid “user churn,” which means subscribers will unsubscribe services due to dissatisfaction with allocated resources or prices. In this paper, we study the pricing resources with profits and satisfaction optimization (PRPSO) problem in the LTE networks, considering the operator profit and subscribers' satisfaction at the same time. The problem is modelled as nonlinear multiobjective optimization with two optimal objectives: (1) maximizing operator profit and (2) maximizing user satisfaction. We propose to solve the problem based on the framework of the NSGA-II. Simulations are conducted for evaluating the proposed solution. PMID:24526889

Pricing resources in LTE networks through multiobjective optimization.

PubMed

Lai, Yung-Liang; Jiang, Jehn-Ruey

2014-01-01

The LTE technology offers versatile mobile services that use different numbers of resources. This enables operators to provide subscribers or users with differential quality of service (QoS) to boost their satisfaction. On one hand, LTE operators need to price the resources high for maximizing their profits. On the other hand, pricing also needs to consider user satisfaction with allocated resources and prices to avoid "user churn," which means subscribers will unsubscribe services due to dissatisfaction with allocated resources or prices. In this paper, we study the pricing resources with profits and satisfaction optimization (PRPSO) problem in the LTE networks, considering the operator profit and subscribers' satisfaction at the same time. The problem is modelled as nonlinear multiobjective optimization with two optimal objectives: (1) maximizing operator profit and (2) maximizing user satisfaction. We propose to solve the problem based on the framework of the NSGA-II. Simulations are conducted for evaluating the proposed solution.

Has climate change driven urbanization in Africa?

PubMed

Henderson, J Vernon; Storeygard, Adam; Deichmann, Uwe

2017-01-01

This paper documents strong but differentiated links between climate and urbanization in large panels of districts and cities in Sub-Saharan Africa, which has dried substantially in the past fifty years. The key dimension of heterogeneity is whether cities are likely to have manufacturing for export outside their regions, as opposed to being exclusively market towns providing local services to agricultural hinterlands. In regions where cities are likely to be manufacturing centers (25% of our sample), drier conditions increase urbanization and total urban incomes. There, urban migration provides an "escape" from negative agricultural moisture shocks. However, in the remaining market towns (75% of our sample), cities just service agriculture. Reduced farm incomes from negative shocks reduce demand for urban services and derived demand for urban labor. There, drying has little impact on urbanization or total urban incomes. Lack of structural transformation in Africa inhibits a better response to climate change.

Has climate change driven urbanization in Africa?

PubMed Central

Henderson, J. Vernon; Storeygard, Adam; Deichmann, Uwe

2017-01-01

This paper documents strong but differentiated links between climate and urbanization in large panels of districts and cities in Sub-Saharan Africa, which has dried substantially in the past fifty years. The key dimension of heterogeneity is whether cities are likely to have manufacturing for export outside their regions, as opposed to being exclusively market towns providing local services to agricultural hinterlands. In regions where cities are likely to be manufacturing centers (25% of our sample), drier conditions increase urbanization and total urban incomes. There, urban migration provides an “escape” from negative agricultural moisture shocks. However, in the remaining market towns (75% of our sample), cities just service agriculture. Reduced farm incomes from negative shocks reduce demand for urban services and derived demand for urban labor. There, drying has little impact on urbanization or total urban incomes. Lack of structural transformation in Africa inhibits a better response to climate change. PMID:28458445

Global Patterns in the Implementation of Payments for Environmental Services

PubMed Central

Ezzine-de-Blas, Driss; Wunder, Sven; Ruiz-Pérez, Manuel; Moreno-Sanchez, Rocio del Pilar

2016-01-01

Assessing global tendencies and impacts of conditional payments for environmental services (PES) programs is challenging because of their heterogeneity, and scarcity of comparative studies. This meta-study systematizes 55 PES schemes worldwide in a quantitative database. Using categorical principal component analysis to highlight clustering patterns, we reconfirm frequently hypothesized differences between public and private PES schemes, but also identify diverging patterns between commercial and non-commercial private PES vis-à-vis their service focus, area size, and market orientation. When do these PES schemes likely achieve significant environmental additionality? Using binary logistical regression, we find additionality to be positively influenced by three theoretically recommended PES ‘best design’ features: spatial targeting, payment differentiation, and strong conditionality, alongside some contextual controls (activity paid for and implementation time elapsed). Our results thus stress the preeminence of customized design over operational characteristics when assessing what determines the outcomes of PES implementation. PMID:26938065

Installation and service manual for the U.S. Geological Survey manometers

USGS Publications Warehouse

Craig, James D.

1983-01-01

The purpose of this manual is to describe the installation, operation, and maintenance of the bubble-gage manometers currently (1982) used by the U.S. Geological Survey. Other applications of these devices, such as the long manometer and differential manometer, are discussed, and accessories available for them are described. The bubble gage (water-stage manometer with gas-purge system) described in the Installation and Service Manual, October 1962, has been extensively modified and developed into the STACOM (stabilized and temperature compensated) device. This chapter is the manual for the STACOM unit and an update of the manual for the screw-type bubble gage. A parts list is included for both units.

The pediatric intensive care unit business model.

PubMed

Schleien, Charles L

2013-06-01

All pediatric intensivists need a primer on ICU finance. The author describes potential alternate revenue sources for the division. Differentiating units by size or academic affiliation, the author describes drivers of expense. Strategies to manage the bottom line including negotiations for hospital services are covered. Some of the current trends in physician productivity and its described metrics, with particular focus on clinical FTE management is detailed. Methods of using this data to enhance revenue are discussed. Some of the other current trends in the ICU business related to changes at the federal and state level as well as in the insurance sector, moving away from fee-for-service are covered. Copyright © 2013 Elsevier Inc. All rights reserved.

Naval Justice School Procedure Study Guide. Revision

DTIC Science & Technology

1992-10-01

301(a), MCM, 1984 [hereinafter R.C.M. __]. Note: It is important to differentiate between initiating a complaint and preferring charges. The... preferred charges on DD Form 458). 4. Duty to report offenses Article 1137, U.S. Navy Regulations (1990), requires personnel of the naval service...instruction, disposition does not the Navy, include appellate action. For court-martial. disposition means either dismissal of preferred R) (4) Only

77 FR 50734 - Self-Regulatory Organizations; NYSE MKT LLC; Order Approving a Proposed Rule Change Amending the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... cross connect or several cross connects in multiples of six (e.g., six, twelve, eighteen or twenty-four.... For a bundle of six cross connects, the monthly charge would be $1,500; 12 cross connects would be $2... differentiation among Users regarding the fees charged for a particular product, service or piece of equipment. In...

[Ways of improving medical services for schoolchildren].

PubMed

Korenev, N M; Novikova, V N; Gaĭdaĭ, V Ia; Bulaga, L P; Komlik, P V

1990-01-01

The protection and promotion of schoolchildren's health might be ensured by means of differential approach to the use of different forms of organization of medical provision and its further improvement with due regard for regional conditions. The development of All-union programme "Schoolchildren" is needed which would provide for a scientific base for improving organizational and health-promoting activities at general education schools and boarding schools.

76 FR 7633 - Endangered and Threatened Wildlife and Plants; 12-Month Finding on a Petition to List the Pacific...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

... approved in the case of Center for Biological Diversity v. U.S. Fish and Wildlife Service, et al. (3:08-cv.... The earliest studies of food habits were based on examination of stomachs from walruses killed by..., these early studies did not take into account the differential rate of digestion of prey items...

"We Were Not Part of Apartheid": Rationalisations Used by Four White Pre-Service Teachers to Make Sense of Race and Their Own Racial Identities

ERIC Educational Resources Information Center

le Roux, Adré

2014-01-01

Despite fundamental reforms to South African education, large performance gaps still prevail between former black schools and former white schools. Nineteen years into a democracy and education in post-apartheid South Africa still retains a strong racial dimension between poorer communities and more affluent communities. Differential access to…

Universities and Fields of Study in Argentina: A Public-Private Comparison from the Supply and Demand Side. PROPHE Working Paper Series. WP No. 15

ERIC Educational Resources Information Center

Rabossi, Marcelo

2010-01-01

Private higher education literature recognizes large public-private differentiation in terms of field of study. Relative to public counterparts, private universities tend to offer their services in fields that require low initial investments and present at least relatively attractive internal private rates of return. Thus, the main objective of…

Intra-regional amenities, wages, and home prices: The role of forests in the Southwest

Treesearch

Michael S. Hand; Jennifer A. Thacher; Daniel W. McCollum; Robert P. Berrens

2008-01-01

Forests provide non-market goods and services that people are implicitly willing to pay for through hedonic housing and labor markets. But it is unclear if compensating differentials arise in these markets at the regional level. This empirical question is addressed in a study of Arizona and New Mexico. Hedonic regressions of housing prices and wages using census and...

The Differential Effects of Selected Programs on the Performance, Degree of Satisfaction and Retention of Community College Women Students. Final Report.

ERIC Educational Resources Information Center

Gillie, Angelo C.

This study, by examining how female post-secondary students view themselves within their college environment, attempts to determine how education can become more relevant for these women. Random samples of freshmen women students from four community colleges were selected according to the type of program in which they were enrolled--human service,…

Reading Instruction in Tier 1: Bridging the Gaps by Nesting Evidence-Based Interventions within Differentiated Instruction

ERIC Educational Resources Information Center

Jones, Ruth E.; Yssel, Nina; Grant, Christina

2012-01-01

Response to Intervention (RtI) has brought about many changes in the way educational services are being provided to students who are at risk of school failure. Schools are seeking strategies that will be beneficial to more and more students, including those students whose instruction is primarily in the core, or Tier 1. Nesting proven,…

The Role of the A* Grade at a Level as a Predictor of University Performance in the United Kingdom

ERIC Educational Resources Information Center

Vidal Rodeiro, Carmen; Zanini, Nadir

2015-01-01

In summer 2010, the A* grade at A level was awarded for the first time. This grade was introduced to help higher education institutions to differentiate between the highest achieving candidates and to promote and reward greater stretch and challenge. Exploring data from the Higher Education Statistics Service and making use of multilevel…

How to sell services more profitably.

PubMed

Reinartz, Werner; Ulaga, Wolfgang

2008-05-01

When products become commodities, manufacturing companies may seek to differentiate themselves with value-added services--a potentially profitable strategy. Unfortunately, companies often stumble in the effort. Reinartz and Ulaga conducted in-depth studies of 18 leading companies in a broad variety of product markets to learn what distinguished the successes from the rest. They discovered four steps to developing a profitable services capability. RECOGNIZE THAT YOU ALREADY HAVE A SERVICE COMPANY: You can identify and charge for simple services--as Merck did when it stopped quietly absorbing shipping costs. Switching services from free to fee clarifies their value for managers as well as for customers. INDUSTRIALIZE THE BACK OFFICE: To prevent delivery costs from eating up service-offering margins, build flexible service platforms, closely monitor process costs, and exploit new technologies that enable process innovations. The Swedish bearings manufacturer SKF provided off-site access to an online monitoring tool that could warn of potential failure in customers' machines. CREATE A SERVICE-SAVVY SALES FORCE: Services require longer sales cycles and, often, decisions from high up in a customer's hierarchy; what's more, product salespeople may be inimical to change. Schneider-Electric did a major overhaul of its sales organization and trained its people to switch from cost-plus pricing to value-based pricing. FOCUS ON CUSTOMERS' PROCESSES AND THE OPPORTUNITIES THEY AFFORD FOR NEW SERVICE OFFERINGS: You may need to acquire new capabilities to take advantage of those opportunities: The industrial coatings specialist PPG had to learn how painting robots function after it offered to take over Fiat's Torino paint shop. Services can both lock in customers and help acquire new accounts. They should be developed with care and attention.

Social Networks as the Context for Understanding Employment Services Utilization among Homeless Youth

PubMed Central

Barman-Adhikari, Anamika; Rice, Eric

2014-01-01

Little is known about the factors associated with use of employment services among homeless youth. Social network characteristics have been known to be influential in motivating people's decision to seek services. Traditional theoretical frameworks applied to studies of service use emphasize individual factors over social contexts and interactions. Using key social network, social capital, and social influence theories, this paper developed an integrated theoretical framework that could capture the social network processes that act as barriers or facilitators of use of employment services by homeless youth, and understand empirically, the salience of each of these constructs in influencing the use of employment services among homeless youth. We used the “Event based-approach” strategy to recruit a sample of 136 homeless youth at one drop-in agency serving homeless youth in Los Angeles, California in 2008. The participants were queried regarding their individual and network characteristics. Data were entered into NetDraw 2.090 and the spring embedder routine was used to generate the network visualizations. Logistic regression was used to assess the influence of the network characteristics on use of employment services. The study findings suggest that social capital is more significant in understanding why homeless youth use employment services, relative to network structure and network influence. In particular, bonding and bridging social capital were found to have differential effects on use of employment services among this population. The results from this study provide specific directions for interventions aimed to increase use of employment services among homeless youth. PMID:24780279

Social networks as the context for understanding employment services utilization among homeless youth.

PubMed

Barman-Adhikari, Anamika; Rice, Eric

2014-08-01

Little is known about the factors associated with use of employment services among homeless youth. Social network characteristics have been known to be influential in motivating people's decision to seek services. Traditional theoretical frameworks applied to studies of service use emphasize individual factors over social contexts and interactions. Using key social network, social capital, and social influence theories, this paper developed an integrated theoretical framework that capture the social network processes that act as barriers or facilitators of use of employment services by homeless youth, and understand empirically, the salience of each of these constructs in influencing the use of employment services among homeless youth. We used the "Event based-approach" strategy to recruit a sample of 136 homeless youth at one drop-in agency serving homeless youth in Los Angeles, California in 2008. The participants were queried regarding their individual and network characteristics. Data were entered into NetDraw 2.090 and the spring embedder routine was used to generate the network visualizations. Logistic regression was used to assess the influence of the network characteristics on use of employment services. The study findings suggest that social capital is more significant in understanding why homeless youth use employment services, relative to network structure and network influence. In particular, bonding and bridging social capital were found to have differential effects on use of employment services among this population. The results from this study provide specific directions for interventions aimed to increase use of employment services among homeless youth. Copyright © 2014 Elsevier Ltd. All rights reserved.

Profiles of family needs of children and youth with cerebral palsy.

PubMed

Almasri, N; Palisano, R J; Dunst, C; Chiarello, L A; O'Neil, M E; Polansky, M

2012-11-01

To identify profiles of family needs of families of children and youth with cerebral palsy (CP), and determine whether profile membership is related to child, family and service characteristics. Participants were mostly mothers (80%) of 579 children and youth with CP. A family member completed modified version of the Family Needs Survey and questionnaires about their child, family and services. Research assistants determined the Gross Motor Function Classification System levels. K-means cluster analysis identified profiles of needs. Cluster membership was analysed to examine differences in clusters based on selected characteristics. Four profiles of needs were identified: Low needs, Needs related to community and financial resources, Needs related to child health condition and High needs. Profile membership was differentiated based on child/youth gross motor function, adaptive behaviour, family relationships, family income, access and effort to co-ordinate services. Despite heterogeneity among individuals with CP and their families, four profiles of family needs were identified. In total, 51% of families had low needs suggesting that they are effectively managing their children's health conditions while 11% of families had high needs that may require high levels of services and supports. Service providers are encouraged to partner with families, provide anticipatory guidance and co-ordinate services. © 2011 Blackwell Publishing Ltd.

Mastery of mothering skills and satisfaction with associated health services: an ethnocultural comparison.

PubMed

Whitley, Rob

2009-09-01

In this paper, I examine the mastery of mothering skills and satisfaction with associated health services in women who had recently given birth in Montreal (n = 33). I compare experience between women of two distinct ethnocultural groups: Anglophone Euro-Canadian and Anglophone Afro-Caribbean. The overall aim is to discern differentials in the mastery of mothering skills and associated satisfaction with maternal and child health services. The study is framed by neo-Weberian social theory suggesting that modernization and bureaucratization increasingly eviscerate everyday skills and knowledge. These processes also lead to changes regarding what is considered credible 'authoritative knowledge.' I found that older Anglophone Euro-Canadians expressed the greatest skill deficits. They attempted to redress these deficits through consultation of professionally authored books, medical Web sites and health professionals. Older Anglophone Euro-Canadians saw these resources as sources of 'authoritative knowledge.' They also expressed dissatisfaction with related health services. In contrast, Anglophone Afro-Caribbeans and younger lower-income Anglophone Euro-Canadians expressed satisfaction with their skills. This derived from widespread previous experience with children and more extensive and readily available kith and kin networks. These were considered sources of 'authoritative knowledge' in this group. This group expressed less dissatisfaction with health services, as they did not need, or expect, these services to redress skill deficits.

Targeted doctors, missing patients: obstetric health services and sectarian conflict in northern Pakistan.

PubMed

Varley, Emma

2010-01-01

The spectre of exclusionary medical service provision, restricted clinic access and physician targeting in sectarian-divided Iraq underscores the crucial and timely need for qualitative research into the inter-relationship between conflict, identity and health. In response, this paper provides a critical ethnography of obstetric service provision and patient access during Shia-Sunni hostilities in Gilgit Town, capital of Pakistan's Northern Areas (2005). I analyse how services were embedded in and constrained by sectarian affiliation in ways that detrimentally impacted Sunni women patients and hospital staff, resulting in profoundly diminished clinic access, reduced physician coverage and a higher observed incidence of maternal morbidity and mortality. The paper first situates obstetric medicine at the interstices of contested sectarian terrain and competing historical projects of sectarian identity. Gilgiti Sunnis' high clinical reliance is argued to be a response to and consequence of, inter-sectarian dissonance and the ascendance of biomedicine during three decades of regional development. In 2005, conflict-incurred service deprivations and the enactment and strategic use of sectarian identity in clinical settings were associated with differential treatment and patient-perceived adverse health outcomes, leading Sunnis to generate alternative sect-specific health services. Obstetric morbidity and mortality during sectarian conflict are analyzed as distinctive manifestations of the wide range of direct harms routinely associated with violence and political strife.

Regional differences in usage of antenatal care and safe delivery services in Indonesia: findings from a nationally representative survey.

PubMed

Tripathi, Vrijesh; Singh, Rajvir

2017-02-03

Indonesia has shown a nominal increase in antenatal care (ANC) coverage from 93% to 96% in the Indonesia Demographic Health Survey (IDHS)-2012. This is high but for a comprehensive assessment of maternal health coverage in Indonesia, safe delivery services need to be assessed in conjunction with ANC coverage. The study uses survey data from the IDHS-2012 that was conducted among women aged 15-49 years who gave birth during the past 3 years preceding the survey. Socioeconomic and demographic factors affecting ANC coverage and safe delivery services are analysed by segregating the data into 7 regions of Indonesia. Multivariate results show that besides wealth and education differentials, regional differences significantly affect the usage of ANC and safe delivery services across the 7 regions. Univariate analyses show that Sulawesi, Maluku and Western New Guinea islands are at a disadvantage in accessing ANC and safe delivery services. The study recommends that disaggregated regional targets be set in order to further reduce maternal mortality rates in Indonesia. 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/.

The language of risk: common understanding or diverse perspectives?

PubMed

Clancy, Leonie; Happell, Brenda; Moxham, Lorna

2014-07-01

Risk as a concept now takes high priority in contemporary mental health services, with increasing pressure on mental health services to develop risk assessment and management practices. This focus on risk has been criticised for its over-reliance on measurement and management at the expense of therapeutic care and is perpetuated by the language of risk which reinforces power differentials and limits capacity for consumers and carers to influence discussions and debates. Furthermore, to date, most work in this area reflects adult settings with limited consideration of the unique needs of older people and the impact of risk assessment on the care they receive. A qualitative, exploratory approach was undertaken using individual interviews and focus groups to enhance understanding of how risk is conceptualised within an older persons' setting. Managers, clinicians, consumers, and carers from a large metropolitan service participated (n = 57). The language of risk was a major theme emerging from this work. This language, so familiar to providers of services, was not familiar to consumers and carers. A reframing of risk is necessary to reflect consumers' and carers' experiences and understandings. This approach will be essential in promoting consumer and carer participation within recovery-based services, reflecting significant goals of government policy.

Do Science Teachers Distinguish Between Their own Learning and the Learning of Their Students?

NASA Astrophysics Data System (ADS)

Brauer, Heike; Wilde, Matthias

2018-02-01

Learning beliefs influence learning and teaching. For this reason, teachers and teacher educators need to be aware of them. To support students' knowledge construction, teachers must develop appropriate learning and teaching beliefs. Teachers appear to have difficulties when analysing students' learning. This seems to be due to the inability to differentiate the beliefs about their students' learning from those about their own learning. Both types of beliefs seem to be intertwined. This study focuses on whether pre-service teachers' beliefs about their own learning are identical to those about their students' learning. Using a sample of pre-service teachers, we measured general beliefs about "constructivist" and "transmissive" learning and science-specific beliefs about "connectivity" and "taking pre-concepts into account". We also analysed the development of these four beliefs during teacher professionalisation by comparing beginning and advanced pre-service teachers. Our results show that although pre-service teachers make the distinction between their own learning and the learning of their students for the general tenets of constructivist and transmissive learning, there is no significant difference for science-specific beliefs. The beliefs pre-service teachers hold about their students' science learning remain closely tied to their own.

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

PubMed

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

Designing services for frequent attenders to the emergency department: a characterisation of this population to inform service design.

PubMed

Jacob, Rebecca; Wong, Mai Luen; Hayhurst, Catherine; Watson, Peter; Morrison, Cecily

2016-08-01

Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders. Results showed an increase in frequent attendance from 2.59% to 4.12% over 8 years. Moderate frequent attenders accounted for 97%. Of the 100 frequent attenders studied, 45% had medically unexplained symptoms (MUS), associated with younger age (p<0.001) but not with gender (p>0.05). In conclusion, the ED is a useful hub for identifying frequent attenders with MUS, particularly among moderate frequent attenders; service design for this group should consider a 'whole-systems approach' with integration between primary and secondary care, including specialist liaison psychiatry services where appropriate. © 2016 Royal College of Physicians.

Development and validation of the client engagement and service use scale: A pilot study.

PubMed

Kline, Emily R; DeTore, Nicole R; Keefe, Kristen; Seidman, Larry J; Srihari, Vinod H; Keshavan, Matcheri S; Guyer, Margaret

2018-05-12

Specialized treatment for first episode psychosis offers clients a menu of services coordinated within a specialized treatment team. To enhance the impact of these services, promoting engagement and preventing early treatment drop-out is critical. However, engagement is poorly tracked and typically quantified through proxy variables such as session attendance, medication adherence, or working alliance. The aim of this study is to introduce and pilot a new measure of engagement for first episode psychosis coordinated specialty care, the Client Engagement and Service Use Scale (CENSUS). The CENSUS was evaluated for reliability and validated against the Service Engagement Scale and an appointment count for a small sample (N = 10) of first episode clients. The measure was also evaluated for acceptability by a consumer advocacy group. Clinicians achieved high inter-rater reliability after minimal training. CENSUS items demonstrated medium to large correlations with other measures of engagement. Feedback from the consumer group emphasized that clinicians should ask questions in a way that is nonjudgmental and successfully elicits authentic client feedback about their service preferences. This pilot study yielded preliminary evidence of reliability and validity, suggesting that the CENSUS is a useful and novel tool for tracking and differentiating degrees of client engagement across multiple intervention components and for facilitating structured discussions regarding clients' service utilization and preferences. Copyright © 2018. Published by Elsevier B.V.

Switched Broadband Services For The Home

NASA Astrophysics Data System (ADS)

Sawyer, Don M.

1990-01-01

In considering the deployment of fiber optics to the residence, two critical questions arise: what are the leading services that could be offered to justify the required investment; and what is the nature of the business that would offer these services to the consumer ? This talk will address these two questions together with the related issue of how the "financial engine" of today's television distribution infrastructure - TV advertising - would be affected by an open access system based on fiber optics coupled with broadband switching. On the business side, the talk concludes that the potential for open ended capacity expansion, fair competition between service providers, and new interactive services inherent in an open access, switched broadband system are the critical items in differentiating it from existing video and TV distribution systems. On the question of broadband services, the talk will highlight several new opportunities together with some findings from recent market research conducted by BNR. The talk will show that there are variations on existing services plus many new services that could be offered and which have real consumer appeal. The postulated open access system discussed here is visualized as having ultimately 1,000 to 2,000 video channels available to the consumer. Although this may appear to hopelessly fragment the TV audience and destroy the current TV advertising infrastructure, the technology of open access, switched broadband will present many new advertising techniques, which have the potential to be far more effective than those available today. Some of these techniques will be described in this talk.

Food and housing insecurity and health status among U.S. adults with and without prior military service.

PubMed

Schure, Marc B; Katon, Jodie G; Wong, Edwin; Liu, Chuan-Fen

2016-12-01

Food and housing insecurity may contribute to poorer mental and physical health. It is unclear as to whether those with prior military service, compared to those without, are more vulnerable to these current stressors. The objective of this study was to use U.S. population-based data to determine whether prior military service moderates the association of food and housing insecurity with poor mental and physical health. We analyzed data from nine states administering the Social Context module from the 2011 and 2012 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to examine the associations of housing and food insecurity with poor mental and physical health and potential modification by military service. Compared with those with a history of military service, those without had higher prevalence of food insecurity (23.1% versus 13.7%) and housing insecurity (36.0% versus 22.5%). Food insecurity was associated with poor mental and physical health (mental health: odds ratio (OR)=3.47, 95% confidence interval (CI)=[3.18-3.77]; physical health: OR=3.21, 95% CI=[2.92-3.53]). Similar associations were observed between housing insecurity and poor mental and physical health. Prior military service was significantly associated with poor physical health. Interaction terms of prior military service with food and housing were not statistically significant. Food and housing insecurity does not appear to differentially impact mental and physical health among those with and without military service.

Performing statistical analyses on quantitative data in Taverna workflows: an example using R and maxdBrowse to identify differentially-expressed genes from microarray data.

PubMed

Li, Peter; Castrillo, Juan I; Velarde, Giles; Wassink, Ingo; Soiland-Reyes, Stian; Owen, Stuart; Withers, David; Oinn, Tom; Pocock, Matthew R; Goble, Carole A; Oliver, Stephen G; Kell, Douglas B

2008-08-07

There has been a dramatic increase in the amount of quantitative data derived from the measurement of changes at different levels of biological complexity during the post-genomic era. However, there are a number of issues associated with the use of computational tools employed for the analysis of such data. For example, computational tools such as R and MATLAB require prior knowledge of their programming languages in order to implement statistical analyses on data. Combining two or more tools in an analysis may also be problematic since data may have to be manually copied and pasted between separate user interfaces for each tool. Furthermore, this transfer of data may require a reconciliation step in order for there to be interoperability between computational tools. Developments in the Taverna workflow system have enabled pipelines to be constructed and enacted for generic and ad hoc analyses of quantitative data. Here, we present an example of such a workflow involving the statistical identification of differentially-expressed genes from microarray data followed by the annotation of their relationships to cellular processes. This workflow makes use of customised maxdBrowse web services, a system that allows Taverna to query and retrieve gene expression data from the maxdLoad2 microarray database. These data are then analysed by R to identify differentially-expressed genes using the Taverna RShell processor which has been developed for invoking this tool when it has been deployed as a service using the RServe library. In addition, the workflow uses Beanshell scripts to reconcile mismatches of data between services as well as to implement a form of user interaction for selecting subsets of microarray data for analysis as part of the workflow execution. A new plugin system in the Taverna software architecture is demonstrated by the use of renderers for displaying PDF files and CSV formatted data within the Taverna workbench. Taverna can be used by data analysis experts as a generic tool for composing ad hoc analyses of quantitative data by combining the use of scripts written in the R programming language with tools exposed as services in workflows. When these workflows are shared with colleagues and the wider scientific community, they provide an approach for other scientists wanting to use tools such as R without having to learn the corresponding programming language to analyse their own data.

Performing statistical analyses on quantitative data in Taverna workflows: An example using R and maxdBrowse to identify differentially-expressed genes from microarray data

PubMed Central

Li, Peter; Castrillo, Juan I; Velarde, Giles; Wassink, Ingo; Soiland-Reyes, Stian; Owen, Stuart; Withers, David; Oinn, Tom; Pocock, Matthew R; Goble, Carole A; Oliver, Stephen G; Kell, Douglas B

2008-01-01

Background There has been a dramatic increase in the amount of quantitative data derived from the measurement of changes at different levels of biological complexity during the post-genomic era. However, there are a number of issues associated with the use of computational tools employed for the analysis of such data. For example, computational tools such as R and MATLAB require prior knowledge of their programming languages in order to implement statistical analyses on data. Combining two or more tools in an analysis may also be problematic since data may have to be manually copied and pasted between separate user interfaces for each tool. Furthermore, this transfer of data may require a reconciliation step in order for there to be interoperability between computational tools. Results Developments in the Taverna workflow system have enabled pipelines to be constructed and enacted for generic and ad hoc analyses of quantitative data. Here, we present an example of such a workflow involving the statistical identification of differentially-expressed genes from microarray data followed by the annotation of their relationships to cellular processes. This workflow makes use of customised maxdBrowse web services, a system that allows Taverna to query and retrieve gene expression data from the maxdLoad2 microarray database. These data are then analysed by R to identify differentially-expressed genes using the Taverna RShell processor which has been developed for invoking this tool when it has been deployed as a service using the RServe library. In addition, the workflow uses Beanshell scripts to reconcile mismatches of data between services as well as to implement a form of user interaction for selecting subsets of microarray data for analysis as part of the workflow execution. A new plugin system in the Taverna software architecture is demonstrated by the use of renderers for displaying PDF files and CSV formatted data within the Taverna workbench. Conclusion Taverna can be used by data analysis experts as a generic tool for composing ad hoc analyses of quantitative data by combining the use of scripts written in the R programming language with tools exposed as services in workflows. When these workflows are shared with colleagues and the wider scientific community, they provide an approach for other scientists wanting to use tools such as R without having to learn the corresponding programming language to analyse their own data. PMID:18687127

Utilising a collective case study system theory mixed methods approach: a rural health example

PubMed Central

2014-01-01

Background Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research. PMID:25066241

Utilising a collective case study system theory mixed methods approach: a rural health example.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2014-07-28

Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.

Profile of patients with genitourinary anomalies treated in a clinical genetics service in the Brazilian unified health system

PubMed Central

Gazzaneo, Ilanna Fragoso Peixoto; de Queiroz, Camila Maia Costa; Goes, Larissa Clara Vieira; Lessa, Victor José Correia; de Omena, Reinaldo Luna; do Nascimento, Diogo Lucas Lima; Petroli, Reginaldo José; Zanotti, Susane Vasconcelos; Monlleó, Isabella Lopes

2016-01-01

Abstract Objective: To describe the profile of patients with genitourinary abnormalities treated at a tertiary hospital genetics service. Methods: Cross-sectional study of 1068 medical records of patients treated between April/2008 and August/2014. A total of 115 cases suggestive of genitourinary anomalies were selected, regardless of age. A standardized clinical protocol was used, as well as karyotype, hormone levels and genitourinary ultrasound for basic evaluation. Laparoscopy, gonadal biopsy and molecular studies were performed in specific cases. Patients with genitourinary malformations were classified as genitourinary anomalies (GUA), whereas the others, as Disorders of Sex Differentiation (DSD). Chi-square, Fisher and Kruskal–Wallis tests were used for statistical analysis and comparison between groups. Results: 80 subjects met the inclusion criteria, 91% with DSD and 9% with isolated/syndromic GUA. The age was younger in the GUA group (p<0.02), but these groups did not differ regarding external and internal genitalia, as well as karyotype. Karyotype 46,XY was verified in 55% and chromosomal aberrations in 17.5% of cases. Ambiguous genitalia occurred in 45%, predominantly in 46,XX patients (p<0.006). Disorders of Gonadal Differentiation accounted for 25% and congenital adrenal hyperplasia, for 17.5% of the sample. Consanguinity occurred in 16%, recurrence in 12%, lack of birth certificate in 20% and interrupted follow-up in 31% of cases. Conclusions: Patients with DSD predominated. Ambiguous genitalia and abnormal sexual differentiation were more frequent among infants and prepubertal individuals. Congenital adrenal hyperplasia was the most prevalent nosology. Younger patients were more common in the GUA group. Abandonment and lower frequency of birth certificate occurred in patients with ambiguous or malformed genitalia. These characteristics corroborate the literature and show the biopsychosocial impact of genitourinary anomalies. PMID:26522823

Attributing Variance in Supportive Care Needs during Cancer: Culture-Service, and Individual Differences, before Clinical Factors

PubMed Central

Fielding, Richard; Lam, Wendy Wing Tak; Shun, Shiow Ching; Okuyama, Toru; Lai, Yeur Hur; Wada, Makoto; Akechi, Tatsuo; Li, Wylie Wai Yee

2013-01-01

Background Studies using the Supportive Care Needs Survey (SCNS) report high levels of unmet supportive care needs (SCNs) in psychological and less-so physical & daily living domains, interpreted as reflecting disease/treatment-coping deficits. However, service and culture differences may account for unmet SCNs variability. We explored if service and culture differences better account for observed SCNs patterns. Methods Hong Kong (n = 180), Taiwanese (n = 263) and Japanese (n = 109) CRC patients’ top 10 ranked SCNS-34 items were contrasted. Mean SCNS-34 domain scores were compared by sample and treatment status, then adjusted for sample composition, disease stage and treatment status using multivariate hierarchical regression. Results All samples were assessed at comparable time-points. SCNs were most prevalent among Japanese and least among Taiwanese patients. Japanese patients emphasized Psychological (domain mean = 40.73) and Health systems and information (HSI) (38.61) SCN domains, whereas Taiwanese and Hong Kong patients emphasized HSI (27.41; 32.92) and Patient care & support (PCS) (19.70; 18.38) SCN domains. Mean Psychological domain scores differed: Hong Kong = 9.72, Taiwan = 17.84 and Japan = 40.73 (p<0.03–0.001, Bonferroni). Other SCN domains differed only between Chinese and Japanese samples (all p<0.001). Treatment status differentiated Taiwanese more starkly than Hong Kong patients. After adjustment, sample origin accounted for most variance in SCN domain scores (p<0.001), followed by age (p = 0.01–0.001) and employment status (p = 0.01–0.001). Treatment status and Disease stage, though retained, accounted for least variance. Overall accounted variance remained low. Conclusions Health service and/or cultural influences, age and occupation differences, and less so clinical factors, differentially account for significant variation in published studies of SCNs. PMID:23741467

Exploratory Factor Analyses of the CAHPS® Hospital Pilot Survey Responses across and within Medical, Surgical, and Obstetric Services

PubMed Central

O'Malley, A James; Zaslavsky, Alan M; Hays, Ron D; Hepner, Kimberly A; Keller, San; Cleary, Paul D

2005-01-01

Objectives To estimate the associations among hospital-level scores from the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) Hospital pilot survey within and across different services (surgery, obstetrics, medical), and to evaluate differences between hospital- and patient-level analyses. Data Source CAHPS Hospital pilot survey data provided by the Centers for Medicare and Medicaid Services. Study Design Responses to 33 questionnaire items were analyzed using patient- and hospital-level exploratory factor analytic (EFA) methods to identify both a patient-level and hospital-level composite structures for the CAHPS Hospital survey. The latter EFA was corrected for patient-level sampling variability using a hierarchical model. We compared results of these analyses with each other and to separate EFAs conducted at the service level. To quantify the similarity of assessments across services, we compared correlations of different composites within the same service with those of the same composite across different services. Data Collection Cross-sectional data were collected during the summer of 2003 via mail and telephone from 19,720 patients discharged from November 2002 through January 2003 from 132 hospitals in three states. Principal Findings Six factors provided the best description of inter-item covariation at the patient level. Analyses that assessed variability across both services and hospitals suggested that three dimensions provide a parsimonious summary of inter-item covariation at the hospital level. Hospital-level factor structures also differed across services; as much variation in quality reports was explained by service as by composite. Conclusions Variability of CAHPS scores across hospitals can be reported parsimoniously using a limited number of composites. There is at least as much distinct information in composite scores from different services as in different composite scores within each service. Because items cluster slightly differently in the different services, service-specific composites may be more informative when comparing patients in a given service across hospitals. When studying individual-level variability, a more differentiated structure is probably more appropriate. PMID:16316439

US Coast Guard GPS Information Center (GPSIC) and its function within the Civil GPS Service (CGS)

NASA Technical Reports Server (NTRS)

1993-01-01

In 1987, the U.S. Department of Defense (DOD) formally requested that the U.S. Department of Transportation (DOT) take responsibility for providing an office that would respond to nonmilitary user needs for GPS information, data, and assistance. DOT accepted this responsibility and in February 1989, named the Coast Guard as their lead agency for the project. Since that time, the U.S. Coast Guard has worked with the U.S. Space Command to develop requirements and implement a plan for providing the requested interface with the civil GPS community. The Civil GPS Service (CGS) consists of four main elements: GPS Information Center (GPSIC) - provides GPS status information to civilian users of the system: Civil GPS Service Interface Committee (CGSIC) - established to identify civil GPS user technical information needs in support of the CGS program; Differential GPS (DGPS) - Coast Guard Research and Development Project; and PPS Program Office (PPSPO) - (Under development) will administer the program allowing qualified civil users to have access to the PPS signal. Details about the services these organizations provide are described.

[Methods in health services research. The example of the evaluation of the German disease management programmes].

PubMed

Morfeld, M; Wirtz, M

2006-02-01

According to the established definition of Pfaff, health services research analyses patients' path through the institutions of the health care system. The focus is on development, evaluation and implementation of innovative measures of health care. By increasing its quality health services research strives for an improvement of efficacy and efficiency of the health care system. In order to allow for an appropriate evaluation it is essential to differentiate between structure, process and outcome quality referring to (1) the health care system in its entirety, (2) specific health care units as well as (3) processes of communication in different settings. Health services research comprises a large array of scientific disciplines like public health, medicine, social sciences and social care. For the purpose of managing its tasks adequately a special combination of instruments and methodological procedures is needed. Thus, diverse techniques of evaluation research as well as special requirements for study designs and assessment procedures are of vital importance. The example of the German disease management programmes illustrates the methodical requirements for a scientific evaluation.

Water system unreliability and diarrhea incidence among children in Guatemala.

PubMed

Trudeau, Jennifer; Aksan, Anna-Maria; Vásquez, William F

2018-03-01

This article examines the effect of water system unreliability on diarrhea incidence among children aged 0-5 in Guatemala. We use secondary data from a nationally representative sample of 7579 children to estimate the effects of uninterrupted and interrupted water services on diarrhea incidence. The national scope of this study imposes some methodological challenges due to unobserved geographical heterogeneity. To address this issue, we estimate mixed-effects logit models that control for unobserved heterogeneity by estimating random effects of selected covariates that can vary across geographical areas (i.e. water system reliability). Compared to children without access to piped water, children with uninterrupted water services have a lower probability of diarrhea incidence by approximately 33 percentage points. Conversely, there is no differential effect between children without access and those with at least one day of service interruptions in the previous month. Results also confirm negative effects of age, female gender, spanish language, and garbage disposal on diarrhea incidence. Public health benefits of piped water are realized through uninterrupted provision of service, not merely access. Policy implications are discussed.

Reference Network Real-Time Services Control Techniques

NASA Astrophysics Data System (ADS)

Nykiel, Grzegorz; Szolucha, Marcin

2013-04-01

Differential corrections and services for real-time kinematic method (RTK) in many cases are used to support survey being base for administration decision. For that reason, services which allow to perform GNSS measurements should be constantly monitored to minimize the risk of any errors or unexpected gap in observation. System providing such control is the subject of the work carried out under a grant NR09-0010-10/2010 conducted by the Military University of Technology. This study was made to develop the concept of monitoring real-time services of Polish reference network ASG-EUPOS and the implementation of software providing users information on system accuracy. The main objectives of all concepts were: maximum use of existing infrastructure while minimizing the cost of installation of new elements, providing users calculation results via the ASG-EUPOS website. In the same time concept assume openness of the module that allow the successive development of applications and integration with existing solutions. This paper present several solutions and algorithms which have been implemented and tested. It also consist some examples of data visualization methods.

Architectural Principles for Orchestration of Cross-Organizational Service Delivery: Case Studies from the Netherlands

NASA Astrophysics Data System (ADS)

van Veenstra, Anne Fleur; Janssen, Marijn

One of the main challenges for e-government is to create coherent services for citizens and businesses. Realizing Integrated Service Delivery (ISD) requires government agencies to collaborate across their organizational boundaries. The coordination of processes across multiple organizations to realize ISD is called orchestration. One way of achieving orchestration is to formalize processes using architecture. In this chapter we identify architectural principles for orchestration by looking at three case studies of cross-organizational service delivery chain formation in the Netherlands. In total, six generic principles were formulated and subsequently validated in two workshops with experts. These principles are: (i) build an intelligent front office, (ii) give processes a clear starting point and end, (iii) build a central workflow application keeping track of the process, (iv) differentiate between simple and complex processes, (v) ensure that the decision-making responsibility and the overview of the process are not performed by the same process role, and (vi) create a central point where risk profiles are maintained. Further research should focus on how organizations can adapt these principles to their own situation.

Analysis of psychological factors for quality assessment of interactive multimodal service

NASA Astrophysics Data System (ADS)

Yamagishi, Kazuhisa; Hayashi, Takanori

2005-03-01

We proposed a subjective quality assessment model for interactive multimodal services. First, psychological factors of an audiovisual communication service were extracted by using the semantic differential (SD) technique and factor analysis. Forty subjects participated in subjective tests and performed point-to-point conversational tasks on a PC-based TV phone that exhibits various network qualities. The subjects assessed those qualities on the basis of 25 pairs of adjectives. Two psychological factors, i.e., an aesthetic feeling and a feeling of activity, were extracted from the results. Then, quality impairment factors affecting these two psychological factors were analyzed. We found that the aesthetic feeling is mainly affected by IP packet loss and video coding bit rate, and the feeling of activity depends on delay time and video frame rate. We then proposed an opinion model derived from the relationships among quality impairment factors, psychological factors, and overall quality. The results indicated that the estimation error of the proposed model is almost equivalent to the statistical reliability of the subjective score. Finally, using the proposed model, we discuss guidelines for quality design of interactive audiovisual communication services.

Differentiated models of care for postpartum women on antiretroviral therapy in Cape Town, South Africa: a cohort study.

PubMed

Myer, Landon; Iyun, Victoria; Zerbe, Allison; Phillips, Tamsin K; Brittain, Kirsty; Mukonda, Elton; Allerton, Joanna; Kalombo, Cathy D; Nofemela, Andile; Abrams, Elaine J

2017-07-21

The numbers of women initiating lifelong antiretroviral therapy (ART) during pregnancy and postpartum is increasing rapidly, presenting a burden on health systems and an urgent need for scalable models of care for this population. In a pilot project, we referred postpartum women who initiated ART during pregnancy to a community-based model of differentiated ART services. Eligible women (on ART for at least 3 months with viral load (VL)<1000 copies/mL) were offered a choice of two ART models of care: (i) referral to an existing system of community-based 'adherence clubs', operated by lay counsellors with medication collection every 2-4 months; or (ii) referral to local primary healthcare clinics (PHC) with services provided by clinicians and medication collection every 1-2 months (local standard of care for postpartum ART). For evaluation, women were followed through 6-months postpartum with VL testing separate from either ART service. Through September 2015, n  = 129 women were enrolled (median age, 28 years; median time postpartum, 10 days). Overall, 65% ( n  = 84) chose adherence clubs and 35% ( n  = 45) chose PHCs; there were no demographic or clinical predictors of this choice. Location of service delivery was commonly cited as a reason for choice by women selecting either model of care; shorter waiting times, ability to receive ART from lay counsellors and less frequent appointments were motivations for choosing adherence clubs. Among women choosing adherence clubs, 15% never attended the service and another 11% attended the service but were not retained through six months postpartum. Overall, 86% of women ( n  = 111) remained in the evaluation through 6 months postpartum; in this group, there were no differences in VL<1000 copies/mL at six months postpartum between women choosing PHCs (88%) vs. adherence clubs (92%; p  = 0.483), but women who were not retained in adherence clubs were more likely to have VL≥1000 copies/mL compared to those who remained ( p  = 0.002). Adherence clubs may be a valuable model for postpartum women initiating ART in pregnancy, with good short-term outcomes observed during this critical period. To support optimal implementation, further research is needed into patient preferences for models of care, with consideration of integration of maternal and child health services, while ART adherence and retention require ongoing consideration in this population.

Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

PubMed

Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

2009-02-01

The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

Differential Vocational Rehabilitation Service Patterns Related to the Job Retention and Job-Seeking Needs of Individuals with Multiple Sclerosis

ERIC Educational Resources Information Center

Tansey, Timothy N.; Strauser, David; Frain, Michael P.; Bishop, Malachy; Chiu, Chung-Yi; Kaya, Cahit; Chan, Fong

2015-01-01

The experience of living with multiple sclerosis (MS) can have a profound effect on employment. The impact of MS is a complex interaction of personal, medical, functional, financial, and psychosocial variables that ultimately results in up to 80% of persons with MS leaving their jobs within 10 years of their diagnosis. The aim of this study was to…

Coordination and Control for Multi-Quadrotor UAV Missions

DTIC Science & Technology

2012-03-01

space equation uses a set of matrices to set up a series of first-order differential equations of the vehicle states. Some flexibility exists in...challenges with autonomous micro aerial vehicles.” Int. Symp. On Robotics Research, 2011 [11] M. Turpin , N. Michael, & V. Kumar, (2012). “Trajectory design...Mathematics and Engineer- ingAnalysis, TechnicalDocumentMEA-LR-085. Boeing Information and Support Services, The Boeing Company, Seattle ( 1997 ) [23] O

Quantifying and Mitigating Privacy Threats in Wireless Protocols and Services

DTIC Science & Technology

2009-07-01

with an AP in given area typically occurs by listening for beacons transmitted by APs nearby or by broadcasting wild card query probes and listening...linkage because these capabilities differentiate different 802.11 cards and drivers. Prior research has shown that peer-to-peer file sharing traffic...behavior of wireless cards . For example, Intel corporation issues similar corporate laptops to its employees. We consider a enterprise network where

Naval Justice Procedure Study Guide. Revised

DTIC Science & Technology

1994-05-01

differentiate between initiating a complaint and preferring charges. The preferral of charges is accomplished by the signing and swearing to charges...Investigative Service (NCIS) or similar agency; or upon receipt of signed and sworn charges (i.e., preferred charges on DD Form 458). 4. Duty to report...will suffer no serious injury and that the place of confinement will not be injurious to the accused. Diminished rations is a restricted diet of 2100

Procedure Study Guide

DTIC Science & Technology

1998-08-01

differentiate between initiating a complaint and preferring charges. The preferral of charges is accomplished by the signing and swearing to charges in Block...Criminal Investigative Service (NCIS) or similar agency; or upon receipt of signed and sworn charges (i.e., preferred charges on DD Form 458). 4. Duty to...including, if appropriate in the interest of justice and discipline, the preferring of such charges as appear to you to be sustained by expected

Electron Interactions with Non-Linear Polyatomic Molecules and Their Radicals

DTIC Science & Technology

1993-12-01

developed which generates SCE quantities from molecular wave functions. This progress was realized in terms of some actual calculations on some molecules...section 4.A describes the basics of the Partial Differential Equation Theory; section 4.B describes the generalization to a finite element...Information Service (NTIS). At NTIS, it will be available to the general public, including foreign nations. This technical report has been reviewed and

Monopolistic structures and industrial analysis in Spain: the case of the pharmaceutical industry.

PubMed

Lobo, F

1979-01-01

This article seeks to illustrate the monopolistic structure of the Spanish pharmaceutical industry, focusing on its many dimensions. The basic conditions of technology and demand, product differentiation, effect of advertising, and barriers to entry are considered, as is financial and economic concentration. Although economic conditions are emphasized, the ways they affect public and private health, the quality of health services, and health education are also highlighted.

NAFTA and the Mexican Economy

DTIC Science & Technology

2008-11-04

Paper, GDP Growth, Potential Output, and Output Gaps in Mexico, by Ebrima Faal, May 2005. 12 EIU, Country Reports: Mexico, various years. 13 EIU...positive overall effect on the Mexican economy, narrowing the U.S.-Mexico gap in prices of goods and services and the differential in real wages...improve economic conditions in Mexico and narrow the income gap between Mexico and the United States. Studies that have addressed the issue of

Experiments in Social Welfare: An Empirical Evaluation of the "Mississippi Project". Mississippi State University, Social Science Research Center Report 38.

ERIC Educational Resources Information Center

Wilkinson, Kenneth P.; Ross, Peggy J.

Focusing on a 2-county rural area of Mississippi, 230 female Aid to Families with Dependent Children (AFDC) recipients were divided into 4 groups to ascertain the differential effects that additions of higher levels of financial assistance and/or services over a period of a year (1967-68) would have on life styles and potentials for upward…

Determinants of Market Structure and the Airline Industry

NASA Technical Reports Server (NTRS)

Raduchel, W.

1972-01-01

The general economic determinants of market structure are outlined with special reference to the airline industry. Included are the following facets: absolute size of firms; distributions of firms by size; concentration; entry barriers; product and service differentiation; diversification; degrees of competition; vertical integration; market boundaries; and economies of scale. Also examined are the static and dynamic properties of market structure in terms of mergers, government policies, and economic growth conditions.

Health Vulnerability Index and newborn hearing screening: urban inequality.

PubMed

Januário, Gabriela Cintra; Alves, Claudia Regina Lindgren; Lemos, Stela Maris Aguiar; Almeida, Maria Cristina de Mattos; Cruz, Ramon Costa; Friche, Amélia Augusta de Lima

To analyze the intra-urban differentials related to the outcome of the Newborn Hearing Screening (NHS) of children living in Belo Horizonte tested in a reference service using the Health Vulnerability Index (HVI). cross-sectional study with children living in Belo Horizonte evaluated by a Newborn Hearing Screening Reference Service (NHSRS) between 2010 and 2011. The HVI of the census tract of each child was obtained by the georeferencing of their respective addresses. Multivariate analysis was conducted using the decision tree technique, considering a statistical model for each response. A thematic map of points representing the geographic distribution of the children evaluated by the NHS program was also developed. The NHS failure rate for children living in areas with very high HVI, or without HVI data, was 1.5 times higher than that for children living in other census tracts. For children living in areas of low, medium, and high HVI, who underwent NHS after 30 days of life, the NHS failure rate was 2.1 times higher in children that presented Risk Indicator for Hearing Loss (RIHL) (17.2%) than in those who did not (8.1%). Uneven distribution was observed between areas for children that underwent the NHS and those who failed it. Significant intra-urban differentials were found in Belo Horizonte, indicating correlation between health vulnerability and NHS outcomes.

Failure probability analysis of optical grid

NASA Astrophysics Data System (ADS)

Zhong, Yaoquan; Guo, Wei; Sun, Weiqiang; Jin, Yaohui; Hu, Weisheng

2008-11-01

Optical grid, the integrated computing environment based on optical network, is expected to be an efficient infrastructure to support advanced data-intensive grid applications. In optical grid, the faults of both computational and network resources are inevitable due to the large scale and high complexity of the system. With the optical network based distributed computing systems extensive applied in the processing of data, the requirement of the application failure probability have been an important indicator of the quality of application and an important aspect the operators consider. This paper will present a task-based analysis method of the application failure probability in optical grid. Then the failure probability of the entire application can be quantified, and the performance of reducing application failure probability in different backup strategies can be compared, so that the different requirements of different clients can be satisfied according to the application failure probability respectively. In optical grid, when the application based DAG (directed acyclic graph) is executed in different backup strategies, the application failure probability and the application complete time is different. This paper will propose new multi-objective differentiated services algorithm (MDSA). New application scheduling algorithm can guarantee the requirement of the failure probability and improve the network resource utilization, realize a compromise between the network operator and the application submission. Then differentiated services can be achieved in optical grid.

Has the Copayment Ceiling Improved Financial Protection in the Korean National Health Insurance System? Evidence From the 2009 Policy Change

PubMed Central

2017-01-01

Objectives To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a “copayment ceiling,” which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients’ income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design. PMID:29207446

Mothers', fathers', and siblings' perceptions of parents' differential treatment of siblings: Links with family relationship qualities.

PubMed

Jensen, Alexander C; McHale, Susan M

2017-10-01

A family systems perspective directs attention to the potentially different experiences and perspectives of family members. This study examined parents' differential treatment (PDT) of siblings, discrepancies between parent and youth reports of PDT, and their links with relationships between adolescents and their mothers and fathers across three years. Participants were first- (Time 1 M age = 15.71, SD = 1.07) and secondborn (Time 1 M age = 13.18, SD = 1.29) siblings from 381, predominately white, working and middle class families. Analyses revealed that siblings' perceptions of being favored predicted less conflict with and greater warmth from both mothers and fathers, primarily for secondborn adolescents. Larger discrepancies between maternal and youth reports of differential affection were linked to more maternal conflict and less warmth for firstborns. These findings may suggest a hierarchy within families: parents may serve as referents for firstborns and firstborns as referents for secondborns. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

A pragmatic approach to monitor and evaluate implementation and impact of differentiated ART delivery for global and national stakeholders.

PubMed

Ehrenkranz, Peter D; Calleja, Jesus Mg; El-Sadr, Wafaa; Fakoya, Ade O; Ford, Nathan; Grimsrud, Anna; Harris, Kate L; Jed, Suzanne L; Low-Beer, Daniel; Patel, Sadhna V; Rabkin, Miriam; Reidy, William John; Reinisch, Annette; Siberry, George K; Tally, Leigh A; Zulu, Isaac; Zaidi, Irum

2018-03-01

The World Health Organization's (WHO) recommendation of "Treat All" has accelerated the call for differentiated antiretroviral therapy (ART) delivery, a method of care that efficiently uses limited resources to increase access to HIV treatment. WHO has further recommended that stable individuals on ART receive refills every 3 to 6 months and attend clinical visits every 3 to 6 months. However, there is not yet consensus on how to ensure that the quality of services is maintained as countries strive to meet these standards. This commentary responds to this gap by defining a pragmatic approach to the monitoring and evaluation (M&E) of the scale up of differentiated ART delivery for global and national stakeholders. Programme managers need to demonstrate that the scale up of differentiated ART delivery is achieving the desired effectiveness and efficiency outcomes to justify continued support by national and global stakeholders. To achieve this goal, the two existing global WHO HIV treatment indicators of ART retention and viral suppression should be augmented with two broad aggregate measures. The addition of indicators measuring the frequency of (1) clinical and (2) refill visits by PLHIV per year will allow evaluation of the pace of scale up while monitoring its overall effect on the quality and efficiency of services. The combination of these four routinely collected aggregate indicators will also facilitate the comparison of outcomes among facilities, regions or countries implementing different models of ART delivery. Enhanced monitoring or additional assessments will be required to answer other critical questions on the process of implementation, acceptability, effectiveness and efficiency. These proposed outcomes are useful markers for the effectiveness and efficiency of the health system's attempts to deliver quality treatment to those who need it-and still reserve as much of the available resource pool as possible for other key elements of the HIV response. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Evolution of the INMARSAT aeronautical system: Service, system, and business considerations

NASA Technical Reports Server (NTRS)

Sengupta, Jay R.

1995-01-01

A market-driven approach was adopted to develop enhancements to the Inmarsat-Aeronautical system, to address the requirements of potential new market segments. An evolutionary approach and well differentiated product/service portfolio was required, to minimize system upgrade costs and market penetration, respectively. The evolved system definition serves to minimize equipment cost/size/mass for short/medium range aircraft, by reducing the antenna gain requirement and relaxing the performance requirements for non safety-related communications. A validation program involving simulation, laboratory tests, over-satellite tests and flight trials is being conducted to confirm the system definition. Extensive market research has been conducted to determine user requirements and to quantify market demand for future Inmarsat Aero-1 AES, using sophisticated computer assisted survey techniques.

Are the poor differentially benefiting from provision of priority public health services? A benefit incidence analysis in Nigeria

PubMed Central

2012-01-01

Background The paper presents evidence about the distribution of the benefits of public expenditures on a subset of priority public health services that are supposed to be provided free of charge in the public sector, using the framework of benefit incidence analysis. Methods The study took place in 2 rural and 2 urban Local Government Areas from Enugu and Anambra states, southeast Nigeria. A questionnaire was used to collect data on use of the priority public health services by all individuals in the households (n=22,169). The level of use was disaggregated by socio-economic status (SES), rural-urban location and gender. Benefits were valued using the cost of providing the service. Net benefit incidence was calculated by subtracting payments made for services from the value of benefits. Results The results showed that 3,281 (14.8%) individuals consumed wholly free services. There was a greater consumption of most free services by rural dwellers, females and those from poorer SES quintiles (but not for insecticide-treated nets and ante-natal care services). High levels of payment were observed for immunisation services, insecticide-treated nets, anti-malarial medicines, antenatal care and childbirth services, all of which are supposed to be provided for free. The net benefits were significantly higher for the rural residents, males and the poor compared to the urban residents, females and better-off quintiles. Conclusion It is concluded that coverage of all of these priority public health services fell well below target levels, but the poorer quintiles and rural residents that are in greater need received more benefits, although not so for females. Payments for services that are supposed to be delivered free of charge suggests that there may have been illegal payments which probably hindered access to the public health services. PMID:23158434

Use of Medicare services before and after introduction of the prospective payment system.

PubMed

Manton, K G; Woodbury, M A; Vertrees, J C; Stallard, E

1993-08-01

The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 provide health and health service use data for 12-month periods before and after the introduction of PPS. Case-mix differences between pre- and post-periods are controlled by using the Grade of Membership model to identify health groups from the NLTCS data. Differences in timing (e.g., hospital length of stay) were controlled using life table models estimated for each health group, that is, service use patterns pre- and post-PPS are compared within groups. Hospital LOS and admission rates declined post-PPS. Changes in the timing and location of death occurred but, overall, mortality did not increase. Changes in post-acute care service use by elderly, chronically disabled Medicare beneficiaries were observed: home health service use increased overall and among the unmarried disabled population. PPS did not adversely affect quality of care as reflected in mortality or in hospital readmissions. Moreover, the differential use of post-acute care, and changes in hospital LOS by health group, indicate that the system responded, specific to marital status and age, to the severity of needs of chronically disabled persons.

Partitioning Stakeholders for the Economic Valuation of Ecosystem Services: Examples of a Mangrove System

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

Micheletti, Tatiane, E-mail: micheletti@forst.tu-dresden.de; Jost, François; Berger, Uta

Although the importance of ecosystem services provided by natural forests, especially mangroves, is well known, the destruction of these environments is still ubiquitous and therefore protection measures are urgently needed. The present study compares the current approach of economic valuation of ecosystem services to a proposed one, using a study case of a mangrove system as an example. We suggest that a cost-benefit analysis for economically valuing environmental services should be performed with three additional modifications consisting of (i) a categorization of local stakeholders as demanders of particular ecosystem services, (ii) acknowledgement of the government as one of these demandermore » groups, and (iii) the inclusion of opportunity costs in the valuation. The application of this approach to the mangrove area in the east portion of Great Abaco Island, the Bahamas, reveals that not only the ecosystem services received differ between demander groups, but the monetary benefits and costs are also specific to each of these groups. We show that the economic valuation of the ecosystem should be differentiated for each category, instead of being calculated as a net ‘societal value’ as it is currently. Applying this categorization of demanders enables a better understanding of the cost and benefit structure of the protection of a natural area. The present paper aims to facilitate discussions regarding benefit and cost sharing related to the protection of natural areas.« less

Web-based health services and clinical decision support.

PubMed

Jegelevicius, Darius; Marozas, Vaidotas; Lukosevicius, Arunas; Patasius, Martynas

2004-01-01

The purpose of this study was the development of a Web-based e-health service for comprehensive assistance and clinical decision support. The service structure consists of a Web server, a PHP-based Web interface linked to a clinical SQL database, Java applets for interactive manipulation and visualization of signals and a Matlab server linked with signal and data processing algorithms implemented by Matlab programs. The service ensures diagnostic signal- and image analysis-sbased clinical decision support. By using the discussed methodology, a pilot service for pathology specialists for automatic calculation of the proliferation index has been developed. Physicians use a simple Web interface for uploading the pictures under investigation to the server; subsequently a Java applet interface is used for outlining the region of interest and, after processing on the server, the requested proliferation index value is calculated. There is also an "expert corner", where experts can submit their index estimates and comments on particular images, which is especially important for system developers. These expert evaluations are used for optimization and verification of automatic analysis algorithms. Decision support trials have been conducted for ECG and ophthalmology ultrasonic investigations of intraocular tumor differentiation. Data mining algorithms have been applied and decision support trees constructed. These services are under implementation by a Web-based system too. The study has shown that the Web-based structure ensures more effective, flexible and accessible services compared with standalone programs and is very convenient for biomedical engineers and physicians, especially in the development phase.

Economic Evaluation of Sevelamer versus Calcium-Based Phosphate Binders in Hemodialysis Patients: A Secondary Analysis using Centers for Medicare & Medicaid Services Data

PubMed Central

Fan, Qiao; Weinhandl, Eric; Liu, Jiannong

2009-01-01

Background and objectives: A secondary analysis of the Dialysis Clinical Outcomes Revisited (DCOR) trial suggested that sevelamer reduced hospitalizations relative to calcium-based phosphate binders. However, whether changed medical costs associated with reduced hospitalizations or other medical services offset the higher cost of sevelamer is unclear. This DCOR secondary analysis aimed to (1) evaluate Medicare total, inpatient, outpatient, skilled nursing facility, and other costs in sevelamer-treated versus calcium-treated patients; (2) examine Medicare costs in specific categories to determine cost drivers; and (3) estimate and incorporate sevelamer and calcium binder costs. Design, setting, participants, & measurements: DCOR trial participants were linked to the Centers for Medicare & Medicaid Services ESRD database. Medicare costs for 1895 dosed Medicare-primary-payer participants were evaluated. Phosphate binder costs were incorporated. Costs were indexed to 2001 (study base year). Sensitivity analyses were performed with randomized participants, two follow-up periods, and 2004 as index year. Results: Inflation-adjusted Medicare per member per month (PMPM) costs were lower for sevelamer-treated than for calcium-treated participants by a mean differential of $199 PMPM (mean, $5236 versus $5435; median, $4653 versus $4933), mainly because of lower inpatient costs for the sevelamer group (mean, $1461 versus $1644; median, $909 versus $1144). However, after phosphate binder costs were incorporated, costs trended lower for calcium-treated than for sevelamer-treated patients (differential −$81, 95% confidence interval −$321 to $157 PMPM, using average wholesale price; −$25, −$256 to $213 PMPM, using wholesale acquisition cost). Conclusions: Sevelamer reduced inpatient Medicare costs compared with calcium binders. However, when binder costs were added, overall PMPM costs favored calcium-treated over sevelamer-treated participants. PMID:19833904

Effects of Ethnic Attributes on the Quality of Family Planning Services in Lima, Peru: A Randomized Crossover Trial

PubMed Central

Planas, Maria-Elena; García, Patricia J.; Bustelo, Monserrat; Carcamo, Cesar P.; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0·7% (p = 0·23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima. PMID:25671664

Effects of ethnic attributes on the quality of family planning services in Lima, Peru: a randomized crossover trial.

PubMed

Planas, Maria-Elena; García, Patricia J; Bustelo, Monserrat; Carcamo, Cesar P; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0.7% (p = 0.23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima.

Department of Defense Financial Management Regulation. Volume 8. Civilian Pay Policy Procedures

DTIC Science & Technology

1999-08-01

servicing HRO perform a review of employee records to ensure that previously reported retirement plans are correct. Ensure that frozen CSRS accounts... meal periods) occur during the hours specified. See 53 Comp. Gen. 814 (1974) (reference (p)). Shift differential also is payable when an employee is: 1...Temporary Quarters Subsistence Allowance. The TQSA is an allowance granted to an employee for the reasonable cost of temporary quarters, meals and laundry

A Review of Robotics Technologies for On-Orbit Services

DTIC Science & Technology

2013-01-01

The SpaceX vehicle has successfully accomplished its first docking with the ISS in May 2012, delivered about 1,200 lbs of water, food , and other...algorithms, which can generate collision-free robot motion paths. Recently, Franch et al [101] have employed flatness theory to plan trajectories...3713–3719 (2005). [101] Franch J, Agrawal S, Fattah A, "Design of Differentially Flat Planar Space Robots: a Step Forward in Their Planning and

Promotion Opportunities of Minorities to the Controlled Grades in the Navy Nurse Corps

DTIC Science & Technology

1992-12-01

and Smith, in their book Modern Labor Economics (1991), note two types of wage differential with different sources and, therefore, potentially...Role Strain," Health Services Research, Vol. 24, No. 5, December, 1989, p. 693-707. Ehrenberg, Ronald G., and Smith, Robert S., Modern Labor ... Economics : Theory and Public Policy, Fourth Edition, HarperCollins Publishers, New York, 1991. Felder, Emma, and Riesch, Susan, "The Status of Minority Nurses

Broadcast control of air traffic

NASA Technical Reports Server (NTRS)

Litchford, G. B.

1971-01-01

Concepts of increased pilot participation in air traffic control are presented. The design of an air traffic control system for pilot usage is considered. The operating and safety benefits of LF/VLF approaches in comparison to current nonprecision approach procedures and systems are discussed. With a good national system plan, flight testing and validation, and the use of local differential, or general diurnal, corrections, the LF/VLF system would provide service superior to that presently available.

Treatment for cases of violence by Brazilian emergency services focusing on family relationships and life cycles.

PubMed

Avanci, Joviana Quintes; Pinto, Liana Wernersbach; Assis, Simone Gonçalves de

2017-09-01

This article analyzes data regarding cases of domestic violence treated by the emergency services through the following: the sociodemographic characteristics of the people who were treated; the events themselves; the evolution of care (from childhood to old age by gender); and the factors that differentiate cases of domestic violence compared to those committed by non-family members. Data from 24 Brazilian state capitals and the Federal District were analyzed, comprising 86 emergency services: a total of 4,893 individuals were surveyed. Of those people who were treated by emergency services, 26.6% suffered domestic violence: 40.0% were children/adolescents, 57.2% were adults and 2.8% were elderly. The adjusted model, which compared victims of violence committed by other family members with those who were not family members, showed that males were less likely to suffer from domestic violence; those that had fewer years of education were at increased risk; and that women were more likely to commit domestic violence compared to the category of "both genders". This study reinforces the fact that health sector professionals need to be able to deal with domestic violence by providing support, performing good practices, abiding by care protocols, taking care of injuries, and facilitating access to other services.

Are Small Reimbursement Changes Enough to Change Cancer Care? Reimbursement Variation in Prostate Cancer Treatment.

PubMed

Ellis, Shellie D; Chen, Ronald C; Dusetzina, Stacie B; Wheeler, Stephanie B; Jackson, George L; Nielsen, Matthew E; Carpenter, William R; Weinberger, Morris

2016-04-01

The Centers for Medicare and Medicaid Services recently initiated small reimbursement adjustments to improve the value of care delivered under fee-for-service. To estimate the degree to which reimbursement influences physician decision making, we examined utilization of gonadotropin-releasing hormone (GnRH) agonists among urologists as Part B drug reimbursement varied in a fee-for-service environment. We analyzed treatment patterns of urologists treating 15,128 men included in SEER-linked Medicare claims who were diagnosed with localized prostate cancer between January 1, 2000, and December 31, 2003. We calculated a reimbursement generosity index to measure differences in GnRH agonist reimbursement among regional Medicare carriers and over time. We used multilevel analysis to control for patient and provider characteristics. Among urologists treating early-stage and lower grade prostate cancer, variation in reimbursement was not associated with overuse of GnRH agonists from 2000 to 2003, a period of guideline stability (odds ratio, 1.00; 95% CI, 0.99 to 1.00). Small differences in androgen-deprivation therapy reimbursement generosity were not associated with differential use. Fee-for-service reimbursement changes currently being implemented to improve quality in fee-for-service Medicare may not affect patterns of cancer care. Copyright © 2016 by American Society of Clinical Oncology.

Implementing guideline based heart failure care in the Northern Territory: challenges and solutions.

PubMed

Iyngkaran, Pupalan; Harris, Melanie; Ilton, Marcus; Kangaharan, Nadarajan; Battersby, Malcolm; Stewart, Simon; Brown, Alex

2014-05-01

The Northern Territory of Australia is a vast area serviced by two major tertiary hospitals. It has both a unique demography and geography, which pose challenges for delivering optimal heart failure services. The prevalence of congestive heart failure continues to increase, imposing a significant burden on health infrastructure and health care costs. Specific patient groups suffer disproportionately from increased disease severity or service related issues often represented as a "health care gap". The syndrome itself is characterised by ongoing symptoms interspersed with acute decompensation requiring lifelong therapy and is rarely reversible. For the individual client the overwhelming attention to heart failure care and the impact of health care gaps can be devastating. This gap may also contribute to widening socio-economic differentials for families and communities as they seek to take on some of the care responsibilities. This review explores the challenges of heart failure best practice in the Northern Territory and the opportunities to improve on service delivery. The discussions highlighted could have implications for health service delivery throughout regional centres in Australia and health systems in other countries. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Inequities in under-five mortality in Nigeria: differentials by religious affiliation of the mother.

PubMed

Antai, Diddy; Ghilagaber, Gebrenegus; Wedrén, Sara; Macassa, Gloria; Moradi, Tahereh

2009-09-01

Observations in Nigeria have indicated polio vaccination refusal related to religion that ultimately affected child morbidity and mortality. This study assessed the role of religion in under-five (0-59 months) mortality using a cross-sectional, nationally representative sample of 7,620 women aged 15-49 years from the 2003 Nigeria Demographic and Health Survey and included 6,029 children. Results show that mother's affiliation to Traditional indigenous religion is significantly associated with increased under-five mortality. Multivariable modelling demonstrated that this association is explained by differential use of maternal and child health services, specifically attendance to prenatal care. To reduce child health inequity, these results need to be incorporated in the formulation of child health policies geared towards achieving a high degree of attendance to prenatal care, irrespective of religious affiliation.

IEEE 802.11e EDCF performance evaluation

NASA Astrophysics Data System (ADS)

Huang, Benxiong; Zhang, Fan; Wang, Yan; Wang, Xiaoling

2004-04-01

This paper evaluates the performances of the contention-based channel access mechanism of IEEE 802.11e, called enhanced distributed coordination function (EDCF), compared with the 802.11 legacy MAC in supporting voice, video and data applications through network simulation of a scenario of 802.11e. Then we discuss the effects of Contention Window (CW) and Arbitration Inter-Frame Space (AIFS) on service differentiation and total throughput. We also consider an optional feature of the EDCF, called contention-free burst (CFB). Through our simulation study, we can draw a conclusion that the EDCF with TXOP can provide better-differentiated channel access for different traffic types than EDCF without TXOP especially at high traffic load conditions. But the movements caused by the parameters in CFB seem a lot bouncing and instability when in different application and configuration.

Integration and collaboration in public health--a conceptual framework.

PubMed

Axelsson, Runo; Axelsson, Susanna Bihari

2006-01-01

With the increasing differentiation of organisations involved in the pursuit of public health, there is also a growing need for inter-organisational integration. Starting from the concepts of differentiation and integration, this article is attempting a theoretical reconstruction based on published research on inter-organisational integration in public health and related welfare services. Different forms of integration are defined and related to each other in a conceptual framework, which is in itself an integration of different theoretical perspectives. According to this framework, integration in the field of public health requires inter-organisational collaboration across different sectors of the society. Such intersectoral collaboration can be organised mainly in the form of multidisciplinary teams across the boundaries of different organisations and sectors. Such an organisation is fragile and volatile, however, which means that it needs a lot of management support in order to survive.

Interprofessional collaboration - a matter of differentiation and integration? Theoretical reflections based in the context of Norwegian childcare.

PubMed

Willumsen, Elisabeth

2008-08-01

This paper presents a selection of theoretical approaches illuminating some aspects of interprofessional collaboration, which will be related to theory of contingency as well as to the concepts of differentiation and integration. Theories that describe collaboration on an interpersonal as well as inter-organizational level are outlined and related to dynamic and contextual factors. Implications for the organization of welfare services are elucidated and a categorization of internal and external collaborative forms is proposed. A reflection model is presented in order to analyse the degree of integration in collaborative work and may serve as an analytical tool for addressing the linkage between different levels of collaboration and identifying opportunities and limitations. Some implications related to the legal mandate(s) given to childcare agencies are discussed in relation to the context of childcare in Norway.

A template for a clinico-pathological audit of medical liver biopsies.

PubMed

Colling, Richard; Fryer, Eve; Cobbold, Jeremy; Collier, Jane; Collantes, Elena; Wang, Lai Mun; Hubscher, Stefan; Wyatt, Judith; Fleming, Kenneth

2015-11-01

With changing indications for performing medical liver biopsies, we aimed to develop a tool to allow pathologists to evaluate the current usefulness, value and impact of their medical liver biopsy service. We designed and piloted a questionnaire-based clinico-pathological audit for medical liver biopsies. The audit tool was simple to implement and provided useful information about our service. Hepatologists felt that 96% of reports were clinically useful. 56% of biopsies confirmed clinical diagnoses, 46% helped differentiate between diagnoses and 42% were able to exclude possible diagnoses. 74% resulted in a change of management and 27% of liver biopsies resulted in a diagnosis which was not clinically suspected. We demonstrate the usefulness of an audit tool in providing evidence of the value of the liver pathology service in a large UK regional centre. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Space-based Networking Technology Developments in the Interplanetary Network Directorate Information Technology Program

NASA Technical Reports Server (NTRS)

Clare, Loren; Clement, B.; Gao, J.; Hutcherson, J.; Jennings, E.

2006-01-01

Described recent development of communications protocols, services, and associated tools targeted to reduce risk, reduce cost and increase efficiency of IND infrastructure and supported mission operations. Space-based networking technologies developed were: a) Provide differentiated quality of service (QoS) that will give precedence to traffic that users have selected as having the greatest importance and/or time-criticality; b) Improve the total value of information to users through the use of QoS prioritization techniques; c) Increase operational flexibility and improve command-response turnaround; d) Enable new class of networked and collaborative science missions; e) Simplify applications interfaces to communications services; and f) Reduce risk and cost from a common object model and automated scheduling and communications protocols. Technologies are described in three general areas: communications scheduling, middleware, and protocols. Additionally developed simulation environment, which provides comprehensive, quantitative understanding of the technologies performance within overall, evolving architecture, as well as ability to refine & optimize specific components.

A revised taxonomy of assistance animals

PubMed Central

Parenti, Lindsay; Foreman, Anne; Meade, B. Jean; Wirth, Oliver

2015-01-01

The use of animals in various assistive, therapeutic, and emotional support roles has contributed to the uncoordinated expansion of labels used to distinguish these animals. To address the inconsistent vocabulary and confusion, this article proposes a concise taxonomy for classifying assistance animals. Several factors were identified to differentiate categories, including (1) whether the animal performs work or tasks related to an individual’s disability; (2) the typical level of skill required by the animal performing the work or task; (3) whether the animal is used by public service, military, or healthcare professionals; (4) whether training certifications or standards are available; and (5) the existence of legal public access protections for the animal and handler. Acknowledging that some category labels have already been widely accepted or codified, six functional categories were identified: (1) service animal; (2) public service animal; (3) therapy animal; (4) visitation animal; (5) sporting, recreational, or agricultural animal; and (6) support animal. This taxonomy provides a clear vocabulary for use by consumers, professionals working in the field, researchers, policy makers, and regulatory agencies. PMID:24203538

A revised taxonomy of assistance animals.

PubMed

Parenti, Lindsay; Foreman, Anne; Meade, B Jean; Wirth, Oliver

2013-01-01

The use of animals in various assistive, therapeutic, and emotional support roles has contributed to the uncoordinated expansion of labels used to distinguish these animals. To address the inconsistent vocabulary and confusion, this article proposes a concise taxonomy for classifying assistance animals. Several factors were identified to differentiate categories, including (1) whether the animal performs work or tasks related to an individual's disability; (2) the typical level of skill required by the animal performing the work or task; (3) whether the animal is used by public service, military, or healthcare professionals; (4) whether training certifications or standards are available; and (5) the existence of legal public access protections for the animal and handler. Acknowledging that some category labels have already been widely accepted or codified, six functional categories were identified: (1) service animal; (2) public service animal; (3) therapy animal; (4) visitation animal; (5) sporting, recreational, or agricultural animal; and (6) support animal. This taxonomy provides a clear vocabulary for use by consumers, professionals working in the field, researchers, policy makers, and regulatory agencies.

Life-cycle cost as basis to optimize waste collection in space and time: A methodology for obtaining a detailed cost breakdown structure.

PubMed

Sousa, Vitor; Dias-Ferreira, Celia; Vaz, João M; Meireles, Inês

2018-05-01

Extensive research has been carried out on waste collection costs mainly to differentiate costs of distinct waste streams and spatial optimization of waste collection services (e.g. routes, number, and location of waste facilities). However, waste collection managers also face the challenge of optimizing assets in time, for instance deciding when to replace and how to maintain, or which technological solution to adopt. These issues require a more detailed knowledge about the waste collection services' cost breakdown structure. The present research adjusts the methodology for buildings' life-cycle cost (LCC) analysis, detailed in the ISO 15686-5:2008, to the waste collection assets. The proposed methodology is then applied to the waste collection assets owned and operated by a real municipality in Portugal (Cascais Ambiente - EMAC). The goal is to highlight the potential of the LCC tool in providing a baseline for time optimization of the waste collection service and assets, namely assisting on decisions regarding equipment operation and replacement.