42 CFR 413.337 - Methodology for calculating the prospective payment rates.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.337 Methodology for calculating the...

42 CFR 413.345 - Publication of Federal prospective payment rates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.345 Publication of Federal prospective payment rates...

42 CFR 413.337 - Methodology for calculating the prospective payment rates.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.337 Methodology for calculating the...

42 CFR 413.157 - Return on equity capital of proprietary providers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES... percentage equal to one and one-half times the average of the rates of interest on special issues of public... inpatient hospital services is a percentage of the average of the rates of interest described in paragraph...

42 CFR 413.157 - Return on equity capital of proprietary providers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES... percentage equal to one and one-half times the average of the rates of interest on special issues of public... inpatient hospital services is a percentage of the average of the rates of interest described in paragraph...

42 CFR 413.157 - Return on equity capital of proprietary providers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES... percentage equal to one and one-half times the average of the rates of interest on special issues of public... inpatient hospital services is a percentage of the average of the rates of interest described in paragraph...

42 CFR 413.124 - Reduction to hospital outpatient operating costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES... after October 1, 1990 and until the first date that the prospective payment system under part 419 of...

42 CFR 413.149 - Depreciation: Allowance for depreciation on assets financed with Federal or public funds.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR... depreciation is not treated as a reduction of allowable interest expense under § 413.153(a). ...

42 CFR 413.149 - Depreciation: Allowance for depreciation on assets financed with Federal or public funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR... depreciation is not treated as a reduction of allowable interest expense under § 413.153(a). ...

42 CFR 413.149 - Depreciation: Allowance for depreciation on assets financed with Federal or public funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR... depreciation is not treated as a reduction of allowable interest expense under § 413.153(a). ...

42 CFR 413.149 - Depreciation: Allowance for depreciation on assets financed with Federal or public funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR... depreciation is not treated as a reduction of allowable interest expense under § 413.153(a). ...

42 CFR 413.149 - Depreciation: Allowance for depreciation on assets financed with Federal or public funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR... function of payment of depreciation to provide funds that make it possible to maintain the assets and...

Assessment and management of refractory breathlessness in interstitial lung disease.

PubMed

Speakman, Lucy; Walthall, Helen

2017-09-02

Interstitial lung disease (ILD) refers to a cluster of fibroinflammatory conditions. There are limited treatment options and most patients have severe dyspnoea. The prognosis is poor. This study aims to evaluate current literature on the assessment and management of refractory breathlessness in ILD. Few tools are available to assess dyspnoea in advanced respiratory disease. Holistic assessment requires a combination of tools but there are few disease specific tools. The role of opioids is well established in the reduction of breathlessness, but there is insufficient evidence that benzodiazepines are beneficial. Non-pharmcolological breathlessness intervention services can give patients mastery of their disease, reduced distress due to breathlessness and were more cost effective. More research on holistic interventions for use in advanced disease needs to be done. Patient-reported outcome measures could elicit valuable evidence to describe the benefit of breathlessness management services in advanced respiratory disease.

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

42 CFR 413.153 - Interest expense.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Interest expense. 413.153 Section 413.153 Public... PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Capital-Related Costs § 413.153 Interest...

Paediatric liver transplantation for children treated at public health facilities in South Africa: time for change.

PubMed

Lala, S G; Britz, R; Botha, J; Loveland, J

2014-11-01

Paediatric liver transplantation (PLT) is the only therapeutic option for many children with end-stage chronic liver disease or irreversible fulminant hepatic failure, and is routinely considered as a therapy by paediatric gastroenterologists and surgeons working in developed countries. In South Africa (SA), a PLT programme has been available at Red Cross War Memorial Children's Hospital in Cape Town since November 1991, and another has rapidly developed at the Wits Donald Gordon Medical Centre in Johannesburg over the past decade. However, for most children with progressive chronic liver disease who are reliant on the services provided at state facilities in SA, PLT is not an option because of a lack of resources in a mismanaged public health system. This article briefly outlines the services offered at Chris Hani Baragwanath Academic Hospital--which is typical of state facilities in SA--and proposes that resources be allocated to establish an innovative, nationally funded centre that would enable greater numbers of children access to a PLT programme.

49 CFR 375.301 - What service options may I provide?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false What service options may I provide? 375.301... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Service Options Provided § 375.301 What service options may I provide? (a) You may design your household goods service to...

[Patients' preferences for information in health care decision-making].

PubMed

Borracci, Raúl A; Manente, Diego; Giorgi, Mariano A; Calderón, Gustavo; Ciancio, Alejandro; Doval, Hernán C

2012-01-01

A survey was carried out among patients who concurred to cardiologic services to know how patients preferred to be informed about their health status, and the demographic characteristics associated to these preferences, considering the following items: knowledge about the disease, information about different therapeutic options and decision-making. From 770 people surveyed, 738 (95.8%) answered the form completely. A trend to trust only in the doctor's knowledge to obtain information (81.7%), in wanting to know the options of treatment and express one's point of view (85.9%), and to involve the family in the decisions (63.2%) was observed. 9.6% preferred to receive the minimum necessary information or "to know nothing" about an alleged serious disease. Males tended less to request options and give opinion on the subject (or: 0.64), giving less freedom to family involvement (or: 1.31). people with a lower social and economical level claim fewer options (or: 0.48) and gave less family participation (or = 1.79). Natives from other South American countries had a minor tendency to demand for options and express their thoughts (or: 0.60); and the ones with lower education level trusted less in the doctor's knowledge (or: 1.81), demanded fewer options (or: 0.45) and chose not to know the severity of the disease (or: 0.56). the analysis of the demographical variables allowed to define preferences associated to age, sex, origin, education, religion and health status. In conclusion, although it is imperative to promote the patient's autonomy, individual preferences must be taken into account before informing and compromising the patient in decision-making about his disease.

[The telemedical service centre as an essential element of the conceptual approach for telemonitoring of cardiac patients : Requirements on the service, quality, and technical realization of telemonitoring].

PubMed

Helms, T M; Müller, A; Perings, C; Köhler, F; Leonhardt, V; Rybak, K; Sack, S; Stockburger, M

2017-09-01

Telemonitoring as part of a treatment strategy supports and facilitates the monitoring, disease management and education of patients with heart failure and cardiac arrhythmias. Therefore, telemonitoring affects quality and success of the therapy. Thus, meeting the needs of the patients and of the involved health care professionals is important for the success of the telemonitoring service. Moreover, a high quality of the service has to be ensured. The following article describes several configuration options for telemonitoring services considering technical as well as quality- and service-related aspects.

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

49 CFR 375.301 - What service options may I provide?

Code of Federal Regulations, 2014 CFR

2014-10-01

... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Service Options... provide at least the following five service options: (1) Space reservation. (2) Expedited service. (3...

49 CFR 375.301 - What service options may I provide?

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Service Options... provide at least the following five service options: (1) Space reservation. (2) Expedited service. (3...

49 CFR 375.301 - What service options may I provide?

Code of Federal Regulations, 2013 CFR

2013-10-01

... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Service Options... provide at least the following five service options: (1) Space reservation. (2) Expedited service. (3...

49 CFR 375.301 - What service options may I provide?

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION OF HOUSEHOLD GOODS IN INTERSTATE COMMERCE; CONSUMER PROTECTION REGULATIONS Service Options... provide at least the following five service options: (1) Space reservation. (2) Expedited service. (3...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.355 - Additional payment: QIO photocopy and mailing costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.355 Additional payment: QIO photocopy and mailing costs. An additional payment is made to a skilled nursing facility in accordance with § 476.78 of this...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

42 CFR 413.355 - Additional payment: QIO photocopy and mailing costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Prospective Payment for Skilled Nursing Facilities § 413.355 Additional payment: QIO photocopy and mailing costs. An additional payment is made to a skilled nursing facility in accordance with § 476.78 of this...

Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

PubMed

Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

2013-01-01

The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child health programmes.

42 CFR 413.76 - Direct GME payments: Calculation of payments for GME costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING... nursing and allied health payment “pool” for the current calendar year as described at § 413.87(f), to the projected total Medicare+Choice direct GME payments made to all hospitals for the current calendar year. (e...

42 CFR 413.76 - Direct GME payments: Calculation of payments for GME costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING... nursing and allied health payment “pool” for the current calendar year as described at § 413.87(f), to the projected total Medicare+Choice direct GME payments made to all hospitals for the current calendar year. (e...

42 CFR 413.76 - Direct GME payments: Calculation of payments for GME costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING... nursing and allied health payment “pool” for the current calendar year as described at § 413.87(f), to the projected total Medicare+Choice direct GME payments made to all hospitals for the current calendar year. (e...

42 CFR 413.76 - Direct GME payments: Calculation of payments for GME costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING... nursing and allied health payment “pool” for the current calendar year as described at § 413.87(f), to the projected total Medicare+Choice direct GME payments made to all hospitals for the current calendar year. (e...

42 CFR 413.76 - Direct GME payments: Calculation of payments for GME costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING... nursing and allied health payment “pool” for the current calendar year as described at § 413.87(f), to the projected total Medicare+Choice direct GME payments made to all hospitals for the current calendar year. (e...

Mortality risks and limits to population growth of fishers

Treesearch

Rick A. Sweitzer; Viorel D. Popescu; Craig M. Thompson; Kathryn L. Purcell; Reginald H. Barrett; Greta M. Wengert; Mourad W. Gabriel; Leslie W. Woods

2015-01-01

Fishers (Pekania pennanti) in the west coast states of Washington, Oregon, and California, USA have not recovered from population declines and the United States Fish and Wildlife Service has proposed options for listing them as threatened. Our objectives were to evaluate differences in survival and mortality risk from natural (e.g., predation, disease, injuries,...

42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Ceiling on the rate of increase in hospital...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Limits on Cost Reimbursement § 413.40 Ceiling on the rate of increase in hospital inpatient costs...

42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Ceiling on the rate of increase in hospital...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Limits on Cost Reimbursement § 413.40 Ceiling on the rate of increase in hospital inpatient costs...

42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Ceiling on the rate of increase in hospital...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Limits on Cost Reimbursement § 413.40 Ceiling on the rate of increase in hospital inpatient costs...

42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Ceiling on the rate of increase in hospital...-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Limits on Cost Reimbursement § 413.40 Ceiling on the rate of increase in hospital inpatient costs...

A Cost Analysis of Kidney Replacement Therapy Options in Palestine

PubMed Central

Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. PMID:25765018

A cost analysis of kidney replacement therapy options in Palestine.

PubMed

Younis, Mustafa; Jabr, Samer; Al-Khatib, Abdallah; Forgione, Dana; Hartmann, Michael; Kisa, Adnan

2015-01-01

This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16,277 for the first year; the estimated cost of HD per patient averaged US$16,085 per year--nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life. © The Author(s) 2015.

48 CFR 252.236-7009 - Option for supervision and inspection services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Option for supervision and... CLAUSES Text of Provisions And Clauses 252.236-7009 Option for supervision and inspection services. As prescribed in 236.609-70, use the following clause: Option for Supervision and Inspection Services (DEC 1991...

48 CFR 252.236-7009 - Option for supervision and inspection services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Option for supervision and... CLAUSES Text of Provisions And Clauses 252.236-7009 Option for supervision and inspection services. As prescribed in 236.609-70, use the following clause: Option for Supervision and Inspection Services (DEC 1991...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2011 CFR

2011-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2013 CFR

2013-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2014 CFR

2014-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2012 CFR

2012-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

48 CFR 52.222-43 - Fair Labor Standards Act and Service Contract Act-Price Adjustment (Multiple Year and Option...

Code of Federal Regulations, 2010 CFR

2010-10-01

... and Service Contract Act-Price Adjustment (Multiple Year and Option Contracts). 52.222-43 Section 52... Standards Act and Service Contract Act—Price Adjustment (Multiple Year and Option Contracts). As prescribed...—Price Adjustment (Multiple Year and Option Contracts) (SEP 2009) (a) This clause applies to both...

The incompatibility of healthcare services and end-of-life needs in advanced liver disease: A qualitative interview study of patients and bereaved carers.

PubMed

Hudson, Benjamin; Hunt, Victoria; Waylen, Andrea; McCune, Catherine Anne; Verne, Julia; Forbes, Karen

2018-05-01

Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care. Qualitative study - semi-structured interviews analysed using thematic analysis. Settings/participants: A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol. Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care. The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.

Exploring the impact of word-of-mouth about Physicians' service quality on patient choice based on online health communities.

PubMed

Lu, Naiji; Wu, Hong

2016-11-26

Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians' information, such as Word-of-Mouth (WOM), particularly on physicians' service quality evaluated by other patients. Existing studies from other service domains have proved that WOM impacts consumer choice. However, how patients make a choice based on physicians' WOM has not been studied, particularly with reference to different patient characteristics and by using real data. One thousand eight hundred fifty three physicians' real data were collected from a Chinese online health community. The data were analyzed using ordinary least squares (OLS) method. The study found that functional quality negatively moderated the relationship between technical quality and patient choice, and disease risk moderated the relationship between physicians' service quality and patient choice. Our study recommends that hospital managers need to consider the roles of both technical quality and functional quality seriously. Physicians should improve their medical skills and bedside manners based on the severity and type of disease to provide better service.

75 FR 29893 - Business Reply Mail Online Application Option

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... POSTAL SERVICE 39 CFR Part 111 Business Reply Mail Online Application Option AGENCY: Postal Service TM . ACTION: Final rule. SUMMARY: The Postal Service TM will revise the Mailing Standards of the... option to obtain a Business Reply Mail[supreg] (BRM) permit online. Additionally, the electronic version...

Evaluating technology service options.

PubMed

Blumberg, D F

1997-05-01

Four service and support options are available to healthcare organizations for maintaining their growth arsenals of medical and information technology. These options include maintaining and servicing all equipment using a facility-based biomedical engineering and MIS service department; using a combination of facility-based service and subcontracted service; expanding facility-based biomedical and MIS service departments to provide service to other healthcare organizations to achieve economies of scale; and outsourcing all maintenance, repair, and technical support services. Independent service companies and original equipment manufacturers (OEMs) are offering healthcare organizations a wider array of service and support capabilities than ever before. However, some health systems have successfully developed their own independent service organizations to take care of their own--and other healthcare organizations'--service and support needs.

75 FR 41790 - Address Management Services-Elimination of the Manual Card Option for Address Sequencing Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... Electronic Address Sequencing (EAS) service processes a customer's addresses file for walk sequence and/or... POSTAL SERVICE 39 CFR Part 111 Address Management Services--Elimination of the Manual Card Option for Address Sequencing Services AGENCY: Postal Service TM . ACTION: Proposed rule. SUMMARY: The Postal...

Understanding Consistency Maintenance in Service Discovery Architectures during Communication Failure

DTIC Science & Technology

2002-07-01

our general model include: (1) service user (SU), (2) service manager (SM), and (3) service cache manager ( SCM ), where the SCM is an optional...maintained by SMs that satisfy specific requirements. Where employed, the SCM operates as an intermediary, matching advertised SDs of SMs to...Directory Service Agent (optional) not applicableLookup ServiceService Cache Manager ( SCM ) Service URL Service Type Service Attributes Template URL

Medicaid program; self-directed personal assistance services program State Plan option (cash and counseling). Final rule.

PubMed

2008-10-03

This final rule provides guidance to States that want to administer self-directed personal assistance services through their State Plans, as authorized by the Deficit Reduction Act of 2005. The State plan option allows beneficiaries, through an approved self-directed services plan and budget, to purchase personal assistance services. The rule also provides guidance to ensure beneficiary health and welfare and financial accountability of the State Plan option.

Understanding Consistency Maintenance in Service Discovery Architectures in Response to Message Loss

DTIC Science & Technology

2002-07-01

manager (SM), and (3) service cache manager ( SCM ). The SCM is an optional element not supported by all discovery protocols. These components participate...the SCM operates as an intermediary, matching advertised SDs of SMs to requirements provided by SUs. Table 1 shows how these general concepts map...Service DescriptionService ItemService Description (SD) Directory Service Agent (optional) not applicableLookup ServiceService Cache Manager ( SCM

42 CFR 408.65 - Payment options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment options. 408.65 Section 408.65 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Individual Payment § 408.65 Payment options...

47 CFR 76.981 - Negative option billing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Negative option billing. 76.981 Section 76.981 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.981 Negative option billing. (a) A cable operator...

42 CFR 438.356 - State contract options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false State contract options. 438.356 Section 438.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.356 State contract options...

Systems for the management of respiratory disease in primary care--an international series: United Kingdom.

PubMed

Worth, Allison; Pinnock, Hilary; Fletcher, Monica; Hoskins, Gaylor; Levy, Mark L; Sheikh, Aziz

2011-03-01

The UK National Health Service (NHS) is essentially publicly funded through general taxation. Challenges facing the NHS include the rise in prevalence of long-term conditions and financial pressures. NATIONAL POLICY TRENDS: Political devolution within the UK has led to variations in the way services are organised and delivered between the four nations. PRIMARY CARE RESPIRATORY SERVICES IN THE UK: Primary care is the first point of contact with services. Most respiratory conditions are managed here, including prevention, diagnosis, treatment and palliative care. Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually. Equitable access to care is an ongoing challenge: telehealthcare is being tried as a possible solution for monitoring of asthma and COPD. REFERRAL AND ACCESS TO SPECIALIST CARE: Referrals for specialist advice are usually to a secondary care respiratory physician, though respiratory General Practitioners with a Special Interest (GPwSIs) are an option in some localities. Prevalence of asthma and COPD is high. Asthma services are predominantly nurse-led. Self-management strategies are widely promoted but poorly implemented. COPD is high on the policy agenda with a shift in focus to preventive lung health and longterm condition management.

Nutrigenomics and ethics interface: direct-to-consumer services and commercial aspects.

PubMed

Ries, Nola M; Castle, David

2008-12-01

A growing variety and number of genetic tests are advertised and sold directly to consumers (DTC) via the Internet, including nutrigenomic tests and associated products and services. Consumers have more access to genetic information about themselves, but access does not entail certainty about the implications of test results. Potential personal and public health harms and benefits are associated with DTC access to genetic testing services. Early policy responses to direct-to-consumer (DTC) genetic testing often involved calls for bans, and some jurisdictions prohibited DTC genetic tests. Recent policy responses by oversight bodies acknowledge expansion in the range of DTC tests available and suggest that a "one-size-fits-all" regulatory approach is not appropriate for all genetic tests. This review discusses ethical and regulatory aspects of DTC genetic testing, focusing particularly on nutrigenomic tests. We identify policy options for regulating DTC genetic tests, including full or partial prohibitions, enforcement of existing truth-in-advertising laws, and more comprehensive information disclosure about genetic tests. We advocate the latter option as an important means to improve transparency about current evidence on the strengths and limits of gene-disease associations and allow consumers to make informed purchasing decisions in the DTC marketplace.

48 CFR 552.217-71 - Notice Regarding Option(s).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

African Americans’ Access to Healthy Food Options in South Los Angeles Restaurants

PubMed Central

Lewis, LaVonna Blair; Sloane, David C.; Nascimento, Lori Miller; Diamant, Allison L.; Guinyard, Joyce Jones; Yancey, Antronette K.; Flynn, Gwendolyn

2005-01-01

Objectives. We examined availability and food options at restaurants in less affluent (target area) and more affluent (comparison area) areas of Los Angeles County to compare residents’ access to healthy meals prepared and purchased away from home. We also considered environmental prompts that encourage the purchase of various foods. Methods. We designed an instrument to assess the availability, quality, and preparation of food in restaurants. We also assessed advertisements and promotions, cleanliness, and service for each restaurant. We assessed 659 restaurants: 348 in the target area and 311 in the comparison area. Results. The nutritional resource environment in our target area makes it challenging for residents to eat healthy away from home. Poorer neighborhoods with a higher proportion of African American residents have fewer healthy options available, both in food selections and in food preparation; restaurants in these neighborhoods heavily promote unhealthy food options to residents. Conclusions. Environment is important in understanding health status: support for the healthy lifestyle associated with lower risks for disease is difficult in poorer communities with a higher proportion of African American residents. PMID:15798128

42 CFR 447.51 - Requirements and options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Requirements and options. 447.51 Section 447.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., Premium Or Similar Cost Sharing Charge § 447.51 Requirements and options. (a) The plan must provide that...

75 FR 47710 - TRICARE; Extended Care Health Option

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... TRICARE; Extended Care Health Option AGENCY: Office of the Secretary, Department of Defense. ACTION: Final... Care Health Option (ECHO) from $2,500 per month to $36,000 per year, and for other non-legislated... services, inpatient and outpatient care, comprehensive home health care, respite care, and other services...

42 CFR 422.105 - Special rules for self-referral and point of service option.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for self-referral and point of service option. 422.105 Section 422.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and...

38 CFR 36.4319 - Servicer loss-mitigation options and incentives.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Servicer loss-mitigation... Reporting § 36.4319 Servicer loss-mitigation options and incentives. (a) The Secretary will pay a servicer in tiers one, two, or three an incentive payment for each of the following successful loss-mitigation...

38 CFR 36.4319 - Servicer loss-mitigation options and incentives.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Servicer loss-mitigation... Reporting § 36.4319 Servicer loss-mitigation options and incentives. (a) The Secretary will pay a servicer in tiers one, two, or three an incentive payment for each of the following successful loss-mitigation...

38 CFR 36.4319 - Servicer loss-mitigation options and incentives.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Servicer loss-mitigation... Reporting § 36.4319 Servicer loss-mitigation options and incentives. (a) The Secretary will pay a servicer in tiers one, two, or three an incentive payment for each of the following successful loss-mitigation...

38 CFR 36.4319 - Servicer loss-mitigation options and incentives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Servicer loss-mitigation... Reporting § 36.4319 Servicer loss-mitigation options and incentives. (a) The Secretary will pay a servicer in tiers one, two, or three an incentive payment for each of the following successful loss-mitigation...

Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany.

PubMed

Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias

2018-02-09

Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.

Position paper: improving governance for effective veterinary services in developing countries--a priority for donor funding.

PubMed

Forman, S; Plante, C; Murray, G; Rey, B; Belton, D; Evans, B; Steinmetz, P

2012-08-01

Livestock contributes significantly to the world economy. However, animal diseases and food safety are still major constraints on livestock-sector productivity, economic growth, the reduction of poverty and food security. Efficient and effective governance of Veterinary Services throughout the world is a fundamental requirement for addressing the global animal health and related public health threats. Recent work by the World Organisation for Animal Health (OIE) through the application of the Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) and related Gap Analysis (both of which form part of the PVS Pathway) has indicated that a significant proportion of the national Veterinary Services worldwide do not meet the essential requirements for good governance. This shortcoming poses a significant risk for many developing countries and their trading partners when considered in the context of the growing trade in animal-source foods, and the burgeoning global livestock population. Well-managed, transparent and credible Veterinary Services, in both the public and private sector, are essential for mitigating animal disease risks and ensuring sustainable incomes for vulnerable producers. They are also vital for limiting the public health risks posed by zoonotic diseases. This paper is intended to highlight the impact of governance on the delivery of veterinary services in a development context and the benefits generated by improving veterinary governance. It recognises 'global public good' elements embedded in the good governance of Veterinary Services, and it could also provide an operational development investment roadmap that builds on the OIE PVS Pathway, and innovative financing options based on government commitments supported by donor programmes.

Secure Genomic Computation through Site-Wise Encryption

PubMed Central

Zhao, Yongan; Wang, XiaoFeng; Tang, Haixu

2015-01-01

Commercial clouds provide on-demand IT services for big-data analysis, which have become an attractive option for users who have no access to comparable infrastructure. However, utilizing these services for human genome analysis is highly risky, as human genomic data contains identifiable information of human individuals and their disease susceptibility. Therefore, currently, no computation on personal human genomic data is conducted on public clouds. To address this issue, here we present a site-wise encryption approach to encrypt whole human genome sequences, which can be subject to secure searching of genomic signatures on public clouds. We implemented this method within the Hadoop framework, and tested it on the case of searching disease markers retrieved from the ClinVar database against patients’ genomic sequences. The secure search runs only one order of magnitude slower than the simple search without encryption, indicating our method is ready to be used for secure genomic computation on public clouds. PMID:26306278

Secure Genomic Computation through Site-Wise Encryption.

PubMed

Zhao, Yongan; Wang, XiaoFeng; Tang, Haixu

2015-01-01

Commercial clouds provide on-demand IT services for big-data analysis, which have become an attractive option for users who have no access to comparable infrastructure. However, utilizing these services for human genome analysis is highly risky, as human genomic data contains identifiable information of human individuals and their disease susceptibility. Therefore, currently, no computation on personal human genomic data is conducted on public clouds. To address this issue, here we present a site-wise encryption approach to encrypt whole human genome sequences, which can be subject to secure searching of genomic signatures on public clouds. We implemented this method within the Hadoop framework, and tested it on the case of searching disease markers retrieved from the ClinVar database against patients' genomic sequences. The secure search runs only one order of magnitude slower than the simple search without encryption, indicating our method is ready to be used for secure genomic computation on public clouds.

A Program for Caregivers in the Workplace.

ERIC Educational Resources Information Center

Ingersoll-Dayton, Berit; And Others

1990-01-01

Four demonstration sites offered educational seminar series to employed caregivers, followed by choice of service options (care planning, support group, buddy system). Increase in absenteeism and knowledge of aging services was associated with attendance at seminars. Among service options, only care planning and support groups were used by…

Hybrid options for treating cardiac disease.

PubMed

Umakanthan, Ramanan; Leacche, Marzia; Zhao, David X; Gallion, Anna H; Mishra, Prabodh C; Byrne, John G

2011-01-01

The options for treating heart disease have greatly expanded during the course of the last 2 1/2 decades with the advent of hybrid technology. The hybrid option for treating cardiac disease implies using the technology of both interventional cardiology and cardiac surgery to treat cardiac disease. This rapidly developing technology has given rise to new and creative techniques to treat cardiac disease involving coronary artery disease, coronary artery disease and cardiac valve disease, and atrial fibrillation. It has also led to the establishment of new procedural suites called hybrid operating rooms that facilitate the integration of technologies of interventional cardiology catheterization laboratories with those of cardiac surgery operating rooms. The development of hybrid options for treating cardiac disease has also greatly augmented teamwork and collaboration between interventional cardiologists and cardiac surgeons. Copyright © 2011 Elsevier Inc. All rights reserved.

Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services: Preprint

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

Neubauer, J.; Pesaran, A.

2013-03-01

Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratorymore » has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.« less

Techno-Economic Analysis of BEV Service Providers Offering Battery Swapping Services

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

Neubauer, J. S.; Pesaran, A.

2013-01-01

Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but high upfront costs, battery-limited vehicle range, and concern over high battery replacement costs may discourage potential buyers. A subscription model in which a service provider owns the battery and supplies access to battery swapping infrastructure could reduce upfront and replacement costs for batteries with a predictable monthly fee, while expanding BEV range. Assessing the costs and benefits of such a proposal are complicated by many factors, including customer drive patterns, the amount of required infrastructure, battery life, etc. The National Renewable Energy Laboratorymore » has applied its Battery Ownership Model to compare the economics and utility of BEV battery swapping service plan options to more traditional direct ownership options. Our evaluation process followed four steps: (1) identifying drive patterns best suited to battery swapping service plans, (2) modeling service usage statistics for the selected drive patterns, (3) calculating the cost-of-service plan options, and (4) evaluating the economics of individual drivers under realistically priced service plans. A service plan option can be more cost-effective than direct ownership for drivers who wish to operate a BEV as their primary vehicle where alternative options for travel beyond the single-charge range are expensive, and a full-coverage-yet-cost-effective regional infrastructure network can be deployed. However, when assumed cost of gasoline, tax structure, and absence of purchase incentives are factored in, our calculations show the service plan BEV is rarely more cost-effective than direct ownership of a conventional vehicle.« less

The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

PubMed

Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

2018-01-01

Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

ERIC Educational Resources Information Center

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

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

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

An evaluation of a palliative care outreach programme for children with Burkitt lymphoma in rural Cameroon.

PubMed

Tamannai, Mona; Kaah, Joel; Mbah, Glenn; Ndimba, Joseph; D'Souza, Catherine; Wharin, Paul; Hesseling, Peter B

2015-07-01

Palliative care (PC) is the most appropriate treatment for patients with life-limiting, incurable diseases, but it is a relatively new concept in sub-Saharan Africa (SSA). A lack of curative treatment options for some conditions creates a great need for PC, but such services are rarely provided in SSA. More research into PC in SSA is urgently needed to create an evidence base to confirm the importance of appropriate PC services. To gain a better understanding of the needs of patients and their families visited by a children's PC nurse in Cameroon and to identify aspects of the service that can be improved. A qualitative study design with semi-structured interviews was used. Tape-recorded interviews were transcribed and thematically analysed. Twelve interviews were conducted with patients, carers and nurses. Financial aid, general disease improvement and prayers were the directly expressed needs of service recipients. Specialist training in children's PC was the main need expressed by the nurses. Open communication about clinical status and treatment failure, more detailed counselling, more distraction for patients and respite for carers were identified as underlying needs. It is possible to provide an effective children's PC service that meets the most urgent needs of recipients in a rural setting in SSA. Recommendations include improved counselling, specialist education for staff, expansion of local support networks and more frequent home visits. More studies are needed to help define the need for PC in children with life-limiting diseases.

Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options.

PubMed

Tanna, Preena; Strauss, Rupert W; Fujinami, Kaoru; Michaelides, Michel

2017-01-01

Stargardt disease (STGD1; MIM 248200) is the most prevalent inherited macular dystrophy and is associated with disease-causing sequence variants in the gene ABCA4 Significant advances have been made over the last 10 years in our understanding of both the clinical and molecular features of STGD1, and also the underlying pathophysiology, which has culminated in ongoing and planned human clinical trials of novel therapies. The aims of this review are to describe the detailed phenotypic and genotypic characteristics of the disease, conventional and novel imaging findings, current knowledge of animal models and pathogenesis, and the multiple avenues of intervention being explored. 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/.

76 FR 10735 - Medicaid Program; Community First Choice Option

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-25

... Vol. 76 Friday, No. 38 February 25, 2011 Part III Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option...; [[Page 10736

78 FR 29795 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc ; Notice of Filing of Proposed Rule Change for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

... To Permit BX Options To Accept Inbound Options Orders From NASDAQ OMX PHLX LLC and NASDAQ Options... to permit the BX Options System to accept inbound options orders routed by Nasdaq Options Services LLC (``NOS'') from NASDAQ OMX PHLX LLC (``Phlx'') and The NASDAQ Stock Market LLC's NASDAQ Options...

Research options for controlling zoonotic disease in India, 2010-2015.

PubMed

Sekar, Nitin; Shah, Naman K; Abbas, Syed Shahid; Kakkar, Manish

2011-02-25

Zoonotic infections pose a significant public health challenge for low- and middle-income countries and have traditionally been a neglected area of research. The Roadmap to Combat Zoonoses in India (RCZI) initiative conducted an exercise to systematically identify and prioritize research options needed to control zoonoses in India. Priority setting methods developed by the Child Health and Nutrition Research Initiative were adapted for the diversity of sectors, disciplines, diseases and populations relevant for zoonoses in India. A multidisciplinary group of experts identified priority zoonotic diseases and knowledge gaps and proposed research options to address key knowledge gaps within the next five years. Each option was scored using predefined criteria by another group of experts. The scores were weighted using relative ranks among the criteria based upon the feedback of a larger reference group. We categorized each research option by type of research, disease targeted, factorials, and level of collaboration required. We analysed the research options by tabulating them along these categories. Seventeen experts generated four universal research themes and 103 specific research options, the majority of which required a high to medium level of collaboration across sectors. Research options designated as pertaining to 'social, political and economic' factorials predominated and scored higher than options focussing on ecological, genetic and biological, or environmental factors. Research options related to 'health policy and systems' scored highest while those related to 'research for development of new interventions' scored the lowest. We methodically identified research themes and specific research options incorporating perspectives of a diverse group of stakeholders. These outputs reflect the diverse nature of challenges posed by zoonoses and should be acceptable across diseases, disciplines, and sectors. The identified research options capture the need for 'actionable research' for advancing the prevention and control of zoonoses in India.

The effect of disease risk probability and disease type on interest in clinic-based versus direct-to-consumer genetic testing services.

PubMed

Sherman, Kerry; Shaw, Laura-Kate; Champion, Katrina; Caldeira, Fernanda; McCaskill, Margaret

2015-10-01

The effect of disease-specific cognitions on interest in clinic-based and direct-to-consumer (DTC) genetic testing was assessed. Participants (N = 309) responded to an online hypothetical scenario and received genetic testing-related messages that varied by risk probability (25, 50, 75 %) and disease type (Alzheimer's disease vs. Type 2 Diabetes). Post-manipulation interest increased for both testing types, but was greater for clinic-based testing. Interest was greater for Type 2 Diabetes than for Alzheimer's disease, the latter perceived as more severe and likely, and less treatable and preventable. For DTC testing only, participants allocated to the high risk condition (75 %) had greater testing interest than those in the low (25 %) category. DTC testing is perceived as a viable, but less preferred, option compared with clinic-based testing. Particularly when considering DTC genetic testing, there is a need to emphasize subjective disease-related perceptions, including risk probability.

Pricing the property claim service (PCS) catastrophe insurance options using gamma distribution

NASA Astrophysics Data System (ADS)

Noviyanti, Lienda; Soleh, Achmad Zanbar; Setyanto, Gatot R.

2017-03-01

The catastrophic events like earthquakes, hurricanes or flooding are characteristics for some areas, a properly calculated annual premium would be closely as high as the loss insured. From an actuarial perspective, such events constitute the risk that are not insurable. On the other hand people living in such areas need protection. In order to securitize the catastrophe risk, futures or options based on a loss index could be considered. Chicago Board of Trade launched a new class of catastrophe insurance options based on new indices provided by Property Claim Services (PCS). The PCS-option is based on the Property Claim Service Index (PCS-Index). The index are used to determine and payout in writing index-based insurance derivatives. The objective of this paper is to price PCS Catastrophe Insurance Option based on PCS Catastrophe index. Gamma Distribution is used to estimate PCS Catastrophe index distribution.

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Optional extended area revenue. 32.5002 Section... Optional extended area revenue. This account shall include total revenue derived from the provision of optional extended area service. ...

Variation in the use of definitive treatment options in the management of Graves' disease: a UK clinician survey.

PubMed

Hookham, Jessica; Collins, Emma E; Allahabadia, Amit; Balasubramanian, Sabapathy P

2017-04-01

Graves' disease can be treated with antithyroid drugs (ATDs), radioiodine or surgery. Use of definitive treatments (radioiodine or surgery) varies widely across centres. Specific clinical circumstances, local facilities, patient and clinician preferences and perceptions will affect the choice of treatment. Detailed understanding of UK clinicians' views and their rationale for different treatments is lacking. To study the preferences and perceptions of UK clinicians on the role of surgery and radioiodine in the management of Graves' disease. 'British Thyroid Association' (BTA), 'Society for Endocrinology' (SFE) and 'British Association of Endocrine and Thyroid Surgeons' (BAETS) members were invited to complete an online survey examining their management decisions in Graves' disease and factors that influenced their decisions. 158 responses from UK consultants were included. The ratio of physicians to surgeons was 11:5 and males to females was 12:4. Most clinicians would commence ATDs in uncomplicated first presentation of Graves' disease. A wide range of risk estimates on the effectiveness and risks of treatment was given by clinicians. Radioiodine was used most frequently in relapsed Graves' disease. However, severe eye disease and pregnancy strongly influenced choice in favour of surgery. Surgeons underestimated the success of radioiodine (p<0.01) and were more likely to recommend thyroidectomy than physicians. This survey demonstrates significant variation in clinicians' perceptions of risks of treatment and their choice of management options for relapsed Graves' disease. The variation appeared to be dependent on patient and disease-specific factors as well as physician experience, gender and specialty. 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/.

48 CFR 1517.207 - Exercise of options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Exercise of options. 1517... CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 1517.207 Exercise of options. (a) Unless otherwise approved by the Chief of the Contracting Office, contracts for services employing option...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

78 FR 17868 - Noncompensatory Partnership Options; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... Noncompensatory Partnership Options; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... noncompensatory options and convertible instruments issued by a partnership. The final regulations generally provide that the exercise of a noncompensatory option does not cause the recognition of immediate income...

78 FR 35559 - Noncompensatory Partnership Options; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... Noncompensatory Partnership Options; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... noncompensatory options and convertible instruments issued by a partnership. The final regulations generally provide that the exercise of a noncompensatory option does not cause the recognition of immediate income...

48 CFR 517.202 - Use of options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Use of options. 517.202... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.202 Use of options. (a) Supplies or services. (1) You should use options when they meet one or more of the following objectives: (i) Reduce...

76 FR 1203 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... elect to have CBOE perform certain marketing services and/or billing services on behalf of the... Participating CBOE TPH, if a Participating Non-CBOE TPH elects to have CBOE perform marketing services on its... default destination for an order to be the U.S. options exchange with the best bid or offer, except CBOE...

Diagnosis and management of von Willebrand disease: a developing country perspective.

PubMed

Nair, Sukesh Chandran; Viswabandya, Auro; Srivastava, Alok

2011-07-01

Special challenges exist in the management of patients with von Willebrand disease (VWD) because of limitations in diagnostic facilities and therapeutic options. However, even within these limitations, it is possible to establish comprehensive services for this condition. Our data show that among 202 patients with VWD, 107 were type 3, 62 were type 1, and the others different categories of type 2. Basic tests such as bleeding time and activated partial thromboplastin time with factor (F)VIII coagulant are able to diagnose most of those with severe disease. We have been able to adapt the specific tests such as von Willebrand factor (VWF) ristocetin cofactor and VWF antigen from the tedious batched manual methods to cost-effective automated methods on advanced coagulometers. Discriminatory tests such as VWF collagen binding, VWF:FVIIIB, ristocetin-induced platelet agglutination (RIPA) are done in batches. Therapeutic options and for the treatment of bleeding include desmopressin, cryoprecipitate, and intermediate purity VWF-containing clotting factor concentrates. Tranexamic acid is also widely used as well as hormonal therapy for menorrhagia. We have also shown that modest doses of intermediate purity FVIII (Koate DVI; Talecris Biotherapeutics, Raleigh, NC, USA) at 35 IU/kg preoperatively and 10 to 20 IU/kg after that are sufficient for surgical hemostasis in these patients. © Thieme Medical Publishers.

The comprehensiveness care of sickle cell disease.

PubMed

Okpala, Iheanyi; Thomas, Veronica; Westerdale, Neil; Jegede, Tina; Raj, Kavita; Daley, Sadie; Costello-Binger, Hilda; Mullen, Jean; Rochester-Peart, Collis; Helps, Sarah; Tulloch, Emense; Akpala, Mary; Dick, Moira; Bewley, Susan; Davies, Mark; Abbs, Ian

2002-03-01

Millions of people across the world have sickle cell disease (SCD). Although the true prevalence of SCD in Europe is not certain, London (UK) alone had an estimated 9000 people with the disorder in 1997. People affected by SCD are best managed by a multidisciplinary team of professionals who deliver comprehensive care: a model of healthcare based on interaction of medical and non-medical services with the affected persons. The components of comprehensive care include patient/parent information, genetic counselling, social services, prevention of infections, dietary advice and supplementation, psychotherapy, renal and other specialist medical care, maternal and child health, orthopaedic and general surgery, pain control, physiotherapy, dental and eye care, drug dependency services and specialist sickle cell nursing. The traditional role of haematologists remains to co-ordinate overall management and liase with other specialities as necessary. Co-operation from the affected persons is indispensable to the delivery of comprehensive care. Working in partnership with the hospital or community health service administration and voluntary agencies enhances the success of the multidisciplinary team. Holistic care improves the quality of life of people affected by SCD, and reduces the number as well as length of hospital admissions. Disease-related morbidity is reduced by early detection and treatment of chronic complications. Comprehensive care promotes awareness of SCD among affected persons who are encouraged to take greater control of their own lives, and achieves better patient management than the solo efforts of any single group of professionals. This cost-effective model of care is an option for taking haemoglobinopathy services forward in the new millennium.

Research Options for Controlling Zoonotic Disease in India, 2010–2015

PubMed Central

Sekar, Nitin; Shah, Naman K.; Abbas, Syed Shahid; Kakkar, Manish

2011-01-01

Background Zoonotic infections pose a significant public health challenge for low- and middle-income countries and have traditionally been a neglected area of research. The Roadmap to Combat Zoonoses in India (RCZI) initiative conducted an exercise to systematically identify and prioritize research options needed to control zoonoses in India. Methods and Findings Priority setting methods developed by the Child Health and Nutrition Research Initiative were adapted for the diversity of sectors, disciplines, diseases and populations relevant for zoonoses in India. A multidisciplinary group of experts identified priority zoonotic diseases and knowledge gaps and proposed research options to address key knowledge gaps within the next five years. Each option was scored using predefined criteria by another group of experts. The scores were weighted using relative ranks among the criteria based upon the feedback of a larger reference group. We categorized each research option by type of research, disease targeted, factorials, and level of collaboration required. We analysed the research options by tabulating them along these categories. Seventeen experts generated four universal research themes and 103 specific research options, the majority of which required a high to medium level of collaboration across sectors. Research options designated as pertaining to ‘social, political and economic’ factorials predominated and scored higher than options focussing on ecological, genetic and biological, or environmental factors. Research options related to ‘health policy and systems’ scored highest while those related to ‘research for development of new interventions’ scored the lowest. Conclusions We methodically identified research themes and specific research options incorporating perspectives of a diverse group of stakeholders. These outputs reflect the diverse nature of challenges posed by zoonoses and should be acceptable across diseases, disciplines, and sectors. The identified research options capture the need for ‘actionable research’ for advancing the prevention and control of zoonoses in India. PMID:21364879

48 CFR 517.207 - Exercise of options.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Exercise of options. 517.207 Section 517.207 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.207 Exercise of options. Before...

48 CFR 517.207 - Exercise of options.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Exercise of options. 517.207 Section 517.207 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.207 Exercise of options. Before...

48 CFR 517.207 - Exercise of options.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Exercise of options. 517.207 Section 517.207 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.207 Exercise of options. Before...

48 CFR 517.207 - Exercise of options.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Exercise of options. 517.207 Section 517.207 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.207 Exercise of options. Before...

Supply chain dynamics in healthcare services.

PubMed

Samuel, Cherian; Gonapa, Kasiviswanadh; Chaudhary, P K; Mishra, Ananya

2010-01-01

The purpose of this paper is to analyse health service supply chain systems. A great deal of literature is available on supply chain management in finished goods inventory situations; however, little research exists on managing service capacity when finished goods inventories are absent. System dynamics models for a typical service-oriented supply chain such as healthcare processes are developed, wherein three service stages are presented sequentially. Just like supply chains with finished goods inventory, healthcare service supply chains also show dynamic behaviour. Comparing options, service reduction, and capacity adjustment delays showed that reducing capacity adjustment and service delays gives better results. The study is confined to health service-oriented supply chains. Further work includes extending the study to service-oriented supply chains with parallel processing, i.e. having more than one stage to perform a similar operation and also to study the behaviour in service-oriented supply chains that have re-entrant orders and applications. Specific case studies can also be developed to reveal factors relevant to particular service-oriented supply chains. The paper explains the bullwhip effect in healthcare service-oriented supply chains. Reducing stages and capacity adjustment are strategic options for service-oriented supply chains. The paper throws light on policy options for managing healthcare service-oriented supply chain dynamics.

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

78 FR 68868 - First-Class Mail Postage Payment Option

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

.... The Postal Service states that participating businesses will produce and distribute pre-approved envelopes and postcards according to specific design requirements established by the Postal Service and have the option of increasing the value of the pre-approved envelopes by applying a customized Picture...

45 CFR 1306.34 - Combination program option.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Combination program option. 1306.34 Section 1306.34 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1306.34 - Combination program option.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Combination program option. 1306.34 Section 1306.34 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1306.34 - Combination program option.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Combination program option. 1306.34 Section 1306.34 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1306.34 - Combination program option.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Combination program option. 1306.34 Section 1306.34 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

Scleral Lenses in the Management of Corneal Irregularity and Ocular Surface Disease.

PubMed

Shorter, Ellen; Harthan, Jennifer; Nau, Cherie B; Nau, Amy; Barr, Joseph T; Hodge, David O; Schornack, Muriel M

2017-09-29

To describe current practice patterns regarding the use of scleral lens therapy in the management of corneal irregularity and ocular surface disease among eye care providers who fit scleral lenses. The Scleral Lenses in Current Ophthalmic Practice: an Evaluation (SCOPE) study group conducted an electronic survey of eye care providers from January 15 to March 31, 2015. Respondents ranked management options for corneal irregularity in the order in which they would generally consider their use. Respondents also ranked options for the management of ocular surface disease in the order in which they would use each of the treatments. Results for each option were analyzed as percentage first-place ranking; percentage first-, second-, or third-place ranking; and mean rank score. Survey responses were obtained from 723 providers who had fit 5 or more scleral lenses. Of these respondents, 629 ranked options for management of corneal irregularity and 612 ranked options for management of ocular surface disease. Corneal rigid gas-permeable lenses were the first option for management of corneal irregularity for 44% of respondents, and scleral lenses were the first option for 34% of respondents. Lubricant drops were the first therapeutic recommendation for ocular surface disease for 84% of respondents, and scleral lenses were ranked first by 6% of respondents. Scleral lenses rank second only to corneal rigid gas-permeable lenses for management of corneal irregularity. Scleral lenses are generally considered after other medical intervention and before surgery for the management of ocular surface disease.

Up and running. Choosing the right equipment service option.

PubMed

2011-08-01

If you're trying to decide between servicing your equipment in-house or using an outside party, you know that finding the best option can be complicated. To help manage the decision process, this article includes a matrix to organize and assess all relevant factors. We also discuss equipment maintenance insurance, which allows you to cap your service costs for some or all of your equipment.

Climatological Data Option in My Weather Impacts Decision Aid (MyWIDA) Overview

DTIC Science & Technology

2017-07-18

rules. It consists of 2 databases, a data service server, a collection of web service, and web applications that show weather impacts on selected...3.1.2 ClimoDB 5 3.2 Data Service 5 3.2.1 Data Requestor 5 3.2.2 Data Decoder 6 3.2.3 Post Processor 6 3.2.4 Job Scheduler 6 3.3 Web Service 6...6.1 Additional Data Option 9 6.2 Impact Overlay Web Service 9 6.3 Graphical User Interface 9 7. References 10 List of Symbols, Abbreviations, and

78 FR 39046 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Order Approving a Proposed Rule Change for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... Permit BX Options To Accept Inbound Options Orders From NASDAQ OMX PHLX LLC and NASDAQ Options Market... permanent approval of the Exchange's pilot program that permits the BX Options System to accept inbound orders routed by Nasdaq Options Services LLC (``NOS'') from the NASDAQ OMX PHLX LLC (``PHLX'') and The...

42 CFR § 414.1435 - Qualifying APM participant determination: Medicare option.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1435 Qualifying APM participant determination: Medicare option. (a) Payment amount method. The...

42 CFR 435.300 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Scope. 435.300 Section 435.300 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... AMERICAN SAMOA Optional Coverage of the Medically Needy § 435.300 Scope. This subpart specifies the option...

45 CFR 1306.36 - Additional Head Start program option variations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Additional Head Start program option variations. 1306.36 Section 1306.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

45 CFR 1306.36 - Additional Head Start program option variations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Additional Head Start program option variations. 1306.36 Section 1306.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

45 CFR 1306.36 - Additional Head Start program option variations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Additional Head Start program option variations. 1306.36 Section 1306.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

45 CFR 1306.36 - Additional Head Start program option variations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Additional Head Start program option variations. 1306.36 Section 1306.36 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN...

Involving Corporations in Dispensing During Mass Prophylaxis

DTIC Science & Technology

2007-03-01

BLANK xi LIST OF TABLES Table 3.1 SWOT for Current Public Health Response Option............................ 34 Table 3.2 SWOT for the Postal...Service Option .................................................. 36 Table 3.3 SWOT for the Corporate Support Option...39 Table 3.4 SWOT for the Composite Support Option .......................................... 41 xii

Cash and counseling: a promising option for consumer direction of home- and community-based services and supports.

PubMed

Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen

2006-01-01

The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.

Cadaveric Tissue Supply to the Commercial Sector For Research: Collaboration between NHS Pathology and NBS Tissue Services in the U.K., Extending the Options for Donors.

PubMed

Womack, C; Gray, N M; Pearson, J E; Fehily, D

2001-01-01

The Peterborough Hospital Human Tissue Bank (PHHTB) and National Blood Service Tissue Services (London and South East Zone) (NBSTS) operate within the U.K. National Health Service (NHS) and have a system in place to retrieve cadaveric tissues for commercial sector research. The collaboration meets the aims of PHHTB and NBSTS and is legal, ethical and safe. This paper presents the results of the first 20 successful retrievals referred from NBSTS to PHHTB. Cadaveric retrieval of tissue for research extends the options for donors and their relatives. The research option is particularly welcomed in cases where clinical retrieval for tissue transplantation is contraindicated. We believe the system is applicable to other centres.

45 CFR 1306.36 - Additional Head Start program option variations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN..., home-based, combination programs, and family child care options defined in this part, the Director of the Office of Head Start retains the right to fund alternative program variations to meet the unique...

Energy Services Company | Climate Neutral Research Campuses | NREL

Science.gov Websites

different corporate and ownership structures. While many are large engineering or equipment manufacturers Services Company Options Performance-based contracts can take different forms including guaranteed energy different financing options for energy performance contracting, please refer to page 13 of the April 2009

14 CFR 1214.104 - Reimbursement for optional services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... General Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable... be escalated in accordance with the provisions of § 1214.103(d). (c) Schedules of payments. NASA will... agreement at the time a particular optional service is agreed to between the customer and NASA. (d) Late...

14 CFR 1214.104 - Reimbursement for optional services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... General Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable... be escalated in accordance with the provisions of § 1214.103(d). (c) Schedules of payments. NASA will... agreement at the time a particular optional service is agreed to between the customer and NASA. (d) Late...

14 CFR 1214.104 - Reimbursement for optional services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... General Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable... be escalated in accordance with the provisions of § 1214.103(d). (c) Schedules of payments. NASA will... agreement at the time a particular optional service is agreed to between the customer and NASA. (d) Late...

14 CFR 1214.104 - Reimbursement for optional services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... General Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable... be escalated in accordance with the provisions of § 1214.103(d). (c) Schedules of payments. NASA will... agreement at the time a particular optional service is agreed to between the customer and NASA. (d) Late...

7 CFR 3555.304 - Special servicing options.

Code of Federal Regulations, 2014 CFR

2014-01-01

... consider a mortgage recovery advance under this section in addition to the extended-term loan modification... required for taxes and insurance. (6) The following terms apply to the repayment of mortgage recovery... does not change the terms of the loan note guarantee. (4) Special servicing options shall be used in...

42 CFR § 414.1440 - Qualifying APM participant determination: All-payer combination option.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1440 Qualifying APM participant determination: All-payer combination option. (a) Payments excluded...

Management for adaptation

Treesearch

John Innes; Linda A. Joyce; Seppo Kellomaki; Bastiaan Louman; Aynslie Ogden; Ian Thompson; Matthew Ayres; Chin Ong; Heru Santoso; Brent Sohngen; Anita Wreford

2009-01-01

This chapter develops a framework to explore examples of adaptation options that could be used to ensure that the ecosystem services provided by forests are maintained under future climates. The services are divided into broad areas within which managers can identify specific management goals for individual forests or landscapes. Adaptation options exist for the major...

78 FR 8060 - Treatment of Grantor of an Option on a Partnership Interest

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... Treatment of Grantor of an Option on a Partnership Interest AGENCY: Internal Revenue Service (IRS), Treasury... the tax treatment of noncompensatory options and convertible instruments issued by a partnership... with respect to, or a lapse of, an option on a partnership interest. The proposed regulations will...

38 CFR 8.25 - Options.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Options. 8.25 Section 8.25 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Optional Settlements § 8.25 Options. Insurance will be paid in a lump sum only when selected by...

75 FR 29680 - Importation of Mexican Hass Avocados; Additional Shipping Options

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... Avocados; Additional Shipping Options AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... originating in Michoacan, Mexico, into the United States by adding the option to ship avocados to the United... additional options for shipping Hass avocados from Mexico to the United States and allow Mexican exporters to...

42 CFR 436.201 - Individuals included in optional groups.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Individuals included in optional groups. 436.201... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options for Coverage as Categorically Needy § 436.201 Individuals included in optional groups. (a) The...

Corporate Child Care Options. A Position Paper by Catalyst. RR#1.

ERIC Educational Resources Information Center

Catalyst, New York, NY.

Described are principal options through which employers may address the child care concerns of their employees. Options fall into four general categories: financial assistance, time availability, direct care services, and provision of information. The principal options in the category of financial assistance are dependent care assistance plans and…

Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

PubMed

Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

2010-01-01

The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS).

PubMed

Phair, Glenn; Agus, Ashley; Normand, Charles; Brazil, Kevin; Burns, Aine; Roderick, Paul; Maxwell, Alexander P; Thompson, Colin; Yaqoob, Magdi; Noble, Helen

2018-05-01

Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease. Health service use was recorded up to 12 months after making the decision to receive conservative management. Mean costs were calculated for each 3-month time period. The annual cost was calculated in two ways: by using only patients with complete cost data and by using all available data weighted by the number of patients at each time point. In total, 42 patients who opted for conservative management over dialysis were recruited. Mean costs were £1622 (0-3 months), £1008 (3-6 months), £554 (6-9 months) and £2626 (9-12 months). Mean annual cost based on complete data ( n = 8) was £5511, and the weighted mean annual cost was £5620. The importance of this study is twofold. First, it provides substantive new information for health and social care planning of conservative management by demonstrating where demand exists for services, in both the United Kingdom and other countries with a comparable health service structure. Second, methodologically, it indicates that it is feasible to collect service use data directly from this patient population.

Aortic Valve Disease

MedlinePlus

... factors, a physical exam, and with results from tests and procedures. Diagnosis and Treatment Options Diagnosis and Treatment Options There is no one test that can diagnose aortic valve disease, so your ...

Space Station Systems Analysis Study. Volume 2: Program options, book 1, parts 1 and 2

NASA Technical Reports Server (NTRS)

1977-01-01

Program options are defined and requirements are determined for integrating crew, mass, volume, and electrical power for a space construction base which incorporates the space shuttle external tanks. Orbits, stabilization, flight control hardware, as well as modules and aids for orbital assembly and servicing are considered. The effectiveness of various program options for life science and radio astronomy missions, for the solar terrestrial observatory, and for public service platforms is assessed. Technology development items are identified and costs are estimated.

Retirement Options to Offer College Faculty.

ERIC Educational Resources Information Center

Felicetti, Daniel A.

1982-01-01

Retirement options available to institutions are outlined, including early retirement incentives, phased retirement, facilitating consulting opportunities, travel and outplacement services, maintaining community involvement, annuities, and pensions. Suggestions are made for increasing cost-effectiveness and fitting the options to local…

The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service.

PubMed

Baynam, Gareth; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharon; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Walker, Caroline E; Molster, Caron; Blackwell, Jenefer M; Jamieson, Sarra; Tang, Dave; Lassmann, Timo; Mina, Kym; Beilby, John; Davis, Mark; Laing, Nigel; Murphy, Lesley; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

2016-06-11

The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.

Opportunities for disease state management in prostate cancer.

PubMed

Pickard, A Simon; Hung, Shih-Ying; McKoy, June M; Witt, Whitney P; Arseven, Adnan; Sharifi, Roohollah; Wu, Zhigang; Knight, Sara J; McWilliams, Norene; Schumock, Glen T; Bennett, Charles L

2005-08-01

In this paper, we examine how the management of prostate cancer lends itself to a disease state management (DSM)-based approach, and propose a framework that emphasizes the patient-provider-caregiver triad in managing the long-term implications of the condition. There is often no clearly superior approach to the management of patients with prostate cancer (eg, watchful waiting and hormonal therapy), and each option entails different trade-offs in quality of life. Ideally, the physician and patient discuss the options, issues, and patient preferences for treatment through the shared decision-making process. A family caregiver such as the spouse of the patient is often involved in the treatment decision and in the long-term management of the cancer experience. In order to develop a DSM program supporting both patient and caregiver, educational, psychosocial, and health care system support needs should be tailored to each phase of cancer treatment/management. To embrace the unique aspects of prostate cancer management, the proposed framework emphasizes communication among the patient-caregiver-provider triad, inclusion of family caregivers in the program, cancer phase-specific support, and psychosocial services as a basis for implementation and evaluation of a DSM program in prostate cancer.

Addressing Trauma in Schools: Multitiered Service Delivery Options for Practitioners

ERIC Educational Resources Information Center

Reinbergs, Erik J.; Fefer, Sarah A.

2018-01-01

Hundreds of thousands of children are confronted with traumatic experiences each year in the United States. As trauma-informed care begins to take hold in schools, school mental health providers (e.g., school psychologists, counselors, and social workers) desire concrete service-delivery options for students affected by trauma. This article…

31 CFR 203.7 - Termination of agreement or change of election or option.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Termination of agreement or change of election or option. 203.7 Section 203.7 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF...

42 CFR 436.217 - Individuals receiving home and community-based services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE VIRGIN ISLANDS Options for Coverage as Categorically Needy Options for Coverage of Families and... receiving home and community-based services. The agency may provide Medicaid to any group or groups of individuals in the community who meet the following requirements: (a) The group would be eligible for Medicaid...

75 FR 69477 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...-Based Professional Subscriber Fees Charged by OPRA for its Basic Service November 8, 2010. Pursuant to... Options Last Sale Reports and Quotation Information (``OPRA Plan'').\\3\\ The proposed amendment would revise the device-based professional subscriber fees charged by OPRA in respect of its Basic Service. A...

14 CFR § 1214.104 - Reimbursement for optional services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... FLIGHT General Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government... will be escalated in accordance with the provisions of § 1214.103(d). (c) Schedules of payments. NASA... launch agreement at the time a particular optional service is agreed to between the customer and NASA. (d...

Industry-Related Day Care: Trends and Options.

ERIC Educational Resources Information Center

Verzaro-Lawrence, Marce; And Others

1982-01-01

Examines current needs and trends of child care options in the United States, and discusses industrial responses to providing day care services. The advantages and disadvantages of industry-related day care and options available are also discussed. (Author/DB)

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

A Delphi study and ranking exercise to support commissioning services: future delivery of Thrombectomy services in England.

PubMed

Halvorsrud, Kristoffer; Flynn, Darren; Ford, Gary A; McMeekin, Peter; Bhalla, Ajay; Balami, Joyce; Craig, Dawn; White, Phil

2018-02-22

Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets. One approach to elucidate the implementation preferences and considerations of key experts is a Delphi survey. In order to support commissioning decisions, we aimed using an electronic Delphi survey to establish consensus on the options for future organisation of thrombectomy services among physicians with clinical experience in managing large artery occlusive stroke. A Delphi survey was developed with 12 options for future organisation of thrombectomy services in England. A purposive sampling strategy established an expert panel of stroke physicians from the British Association of Stroke Physicians (BASP) Clinical Standards and/or Executive Membership that deliver 24/7 intravenous thrombolysis. Options with aggregate scores falling within the lowest quartile were removed from the subsequent Delphi round. Options reaching consensus following the two Delphi rounds were then ranked in a final exercise by both the wider BASP membership and the British Society of Neuroradiologists (BSNR). Eleven stroke physicians from BASP completed the initial two Delphi rounds. Three options achieved consensus, with subsequently wider BASP (97%, n = 43) and BSNR members (86%, n = 21) assigning the highest approval rankings in the final exercise for transferring large artery occlusive stroke patients to nearest neuroscience centre for thrombectomy based on local CT/CT Angiography. The initial Delphi rounds ensured optimal reduction of options by an expert panel of stroke physicians, while subsequent ranking exercises allowed remaining options to be ranked by a wider group of experts within stroke to reach consensus. The preferred implementation option for thrombectomy is investigating suspected acute stroke patients by CT/CT Angiography and secondary transfer of large artery occlusive stroke patients to the nearest neuroscience (thrombectomy) centre.

A group arrival retrial G - queue with multi optional stages of service, orbital search and server breakdown

NASA Astrophysics Data System (ADS)

Radha, J.; Indhira, K.; Chandrasekaran, V. M.

2017-11-01

A group arrival feedback retrial queue with k optional stages of service and orbital search policy is studied. Any arriving group of customer finds the server free, one from the group enters into the first stage of service and the rest of the group join into the orbit. After completion of the i th stage of service, the customer under service may have the option to choose (i+1)th stage of service with θi probability, with pI probability may join into orbit as feedback customer or may leave the system with {q}i=≤ft\\{\\begin{array}{l}1-{p}i-{θ }i,i=1,2,\\cdots k-1\\ 1-{p}i,i=k\\end{array}\\right\\} probability. Busy server may get to breakdown due to the arrival of negative customers and the service channel will fail for a short interval of time. At the completion of service or repair, the server searches for the customer in the orbit (if any) with probability α or remains idle with probability 1-α. By using the supplementary variable method, steady state probability generating function for system size, some system performance measures are discussed.

Advances in mobile mental health: opportunities and implications for the spectrum of e-mental health services

PubMed Central

Chan, Steven; Hwang, Tiffany; Wong, Alice; Bauer, Amy M.

2017-01-01

Mobile health (mHealth), telemedicine and other technology-based services facilitate mental health service delivery and may be considered part of an e-mental health (eMH) spectrum of care. Web- and Internet-based resources provide a great opportunity for the public, patients, healthcare providers and others to improve wellness, practice prevention and reduce suffering from illnesses. Mobile apps offer portability for access anytime/anywhere, are inexpensive versus traditional desktop computers, and have additional features (e.g., context-aware interventions and sensors with real-time feedback. This paper discusses mobile mental health (mMH) options, as part of a broader framework of eMH options. The evidence-based literature shows that many people have an openness to technology as a way to help themselves, change behaviors and engage additional clinical services. Studies show that traditional video-based synchronous telepsychiatry (TP) is as good as in-person service, but mHealth outcomes have been rarely, directly compared to in-person and other eMH care options. Similarly, technology options added to in-person care or combined with others have not been evaluated nor linked with specific goals and desired outcomes. Skills and competencies for clinicians are needed for mHealth, social media and other new technologies in the eMH spectrum, in addition to research by randomized trials and study of health service delivery models with an emphasis on effectiveness. PMID:28894744

What Motivates Pre-Service Teachers to Become Teachers and Their Perspectives of English Teaching as a Career Option

ERIC Educational Resources Information Center

Tustiawati, I. A. Mela

2017-01-01

Teaching motivation issues are well-researched in several countries. However, these issues have been rarely investigated in the Indonesian context. This study investigated motivational factors that influence pre-service teachers to enter English teacher training and their perspectives of English teaching as a career option. It comprised a survey…

Defense Health Care: Additional Analysis of Costs and Benefits of Potential Governance Structures Is Needed

DTIC Science & Technology

2012-09-01

options, (2) a business case analysis and strategy for implementing its shared services concept, and (3) more complete analyses of the options’ strengths...and weaknesses. DoD concurred with developing a business case analysis for its shared services concept. DoD did not concur with the other two

Choice, perceived control, and customer satisfaction: the psychology of online service recovery.

PubMed

Chang, Chia-Chi

2008-06-01

Service failures and consequent recoveries have been identified as critical determinants of customer retention. Therefore, effective service recovery programs warrant further exploration, particularly in the online shopping environment, where consumers can receive immediate and tangible service recovery. The results of the present study suggest that by providing a choice of recovery options, customers' sense of control is increased, as is their satisfaction with the particular recovery efforts and their overall satisfaction with the entire service experience. Also, service importance accentuated the impact of choice on perceived control. Specifically, when the service was of greater importance, giving customers a choice of recovery options augmented customers' sense of control more than when the service was of lesser importance. The implications of the findings are also discussed.

Modelling the affordability and distributional implications of future health care financing options in South Africa.

PubMed

McIntyre, Di; Ataguba, John E

2012-03-01

South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but needs careful design to ensure its long-term sustainability.

Service contract with periodic preventive maintenance for a dump truck sold with a two-dimensional warranty

NASA Astrophysics Data System (ADS)

Nasrum, A.; Pasaribu, U. S.; Husniah, H.

2016-02-01

This paper deals with maintenance service contract for a dump truck sold with a two-dimensional warranties. We consider a situation where an agent offers two maintenance contract options and the owner of the equipment has to select the optimal option either the OEM carried out all repairs and preventive maintenance activities (option one) or the OEM only carries out failure while the costumer undertakes preventive maintenance action in-house (option two). As the number of preventive maintenance and corrective maintenance that occurs in the area of servicing contracts is very influential in determining the value of the contract, we have to determine the optimal time between preventive maintenance that can minimize the cost of repair in the contract area. Moreover, we also study the maintenance service contract considering reduction of the intensity function after preventive maintenance from both the owner and OEM point of views. In this paper, we use a Weibull intensity function to consider a product with increasing failure intensity. We use a non-cooperative game formulation to determine the optimal price structure (i.e., the contract price and repair cost) for the OEM and the owner. A numerical example derived from the model has shown that if the owner choose option one then the owner obtain a higher profit compared with the profit resulted from option two. The result agree with earlier work which uses the accelerated failure time (AFT) for the failure modeling, while here we model the failure of the dump truck without the use of the AFT.

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia

PubMed Central

Nguyen, Kim-Huong; Smith, Anthony C.; Armfield, Nigel R.; Bensink, Mark; Scuffham, Paul A.

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013–14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia’s health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited. PMID:26406592

Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

PubMed

Nguyen, Kim-Huong; Smith, Anthony C; Armfield, Nigel R; Bensink, Mark; Scuffham, Paul A

2015-01-01

Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited.

Designing climate change mitigation plans that add up.

PubMed

Bajželj, Bojana; Allwood, Julian M; Cullen, Jonathan M

2013-07-16

Mitigation plans to combat climate change depend on the combined implementation of many abatement options, but the options interact. Published anthropogenic emissions inventories are disaggregated by gas, sector, country, or final energy form. This allows the assessment of novel energy supply options, but is insufficient for understanding how options for efficiency and demand reduction interact. A consistent framework for understanding the drivers of emissions is therefore developed, with a set of seven complete inventories reflecting all technical options for mitigation connected through lossless allocation matrices. The required data set is compiled and calculated from a wide range of industry, government, and academic reports. The framework is used to create a global Sankey diagram to relate human demand for services to anthropogenic emissions. The application of this framework is demonstrated through a prediction of per-capita emissions based on service demand in different countries, and through an example showing how the "technical potentials" of a set of separate mitigation options should be combined.

Energy efficiency business options for industrial end users in Latin American competitive energy markets: The case of Colombia

NASA Astrophysics Data System (ADS)

Botero, Sergio

2002-01-01

Energy markets today in Latin America and worldwide are being restructured from monopolies, either state-owned or privately-owned, to be more openly competitive and incorporate more participation from the private sector. Thus, the schemes that were formerly developed to foster end use energy efficiency are no longer applicable because they were based on mandatory regulations made with political decisions, without sufficiently considering economic feasibility. A consensus exists that the only way energy efficiency could survive in this new paradigm is by being market oriented, giving better services, and additional options to users. However; there is very little information on what end users prefer, and which options would most satisfy customers. Using Colombia as a case study, this research determines and categorizes the energy efficiency business options for large energy end users that can freely participate in the competitive energy market. The energy efficiency market is understood as a market of services aiming to increase efficiency in energy use. These services can be grouped into seven business options. A survey, following the descriptive method, was sent to energy end users in order to determine their preferences for specific energy efficiency business options, as well as the decision-making criteria taken into account for such options. This data was categorized in ten industry groups. As a conclusion, energy efficiency providers should adapt not only to the economic activity or processes of each customer, but also to the potential business options. It was also found that not all industries consider performance contracting as their most preferred option, as a matter of fact, some industries show much higher preference for conventional business options. Among end users, the divergence in option preferences contrasted with the convergence in decision-making criteria. The decision-making criteria "cost-benefit ratio" overwhelmed all other criterion. End users appear to chose a specific energy efficiency option based mostly on obtaining better economic returns, giving low consideration to other criterion that feature differences among the energy efficiency options.

20 CFR 411.355 - What payment options does a State VR agency have?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What payment options does a State VR agency... Ticket to Work Program § 411.355 What payment options does a State VR agency have? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services...

20 CFR 411.355 - What payment options does a State VR agency have?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What payment options does a State VR agency... Ticket to Work Program § 411.355 What payment options does a State VR agency have? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services...

20 CFR 411.355 - What payment options does a State VR agency have?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false What payment options does a State VR agency... Ticket to Work Program § 411.355 What payment options does a State VR agency have? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services...

20 CFR 411.355 - What payment options does a State VR agency have?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false What payment options does a State VR agency... Ticket to Work Program § 411.355 What payment options does a State VR agency have? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services...

20 CFR 411.355 - What payment options does a State VR agency have?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false What payment options does a State VR agency... Ticket to Work Program § 411.355 What payment options does a State VR agency have? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services...

Options for the Development of a Voluntary Network of Participants in the National Environmental Data Referral Service. Final Report.

ERIC Educational Resources Information Center

MAXIMA Corp., Silver Spring, MD.

Building on the findings of a survey of potential users and a descriptive review of five existing information networks, the present study represents an attempt to characterize several options for a voluntary confederation of participants in operating the National Environmental Data Referral Services (NEDRES) being developed by the Assessment and…

5 CFR 870.603 - Conversion of Basic and Optional insurance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Conversion of Basic and Optional... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Termination and Conversion § 870.603 Conversion of Basic and Optional insurance. (a)(1) When group coverage terminates for any...

Freight Transportation Energy Use : Volume 4. Analysis of Selected Energy Conservation Options.

DOT National Transportation Integrated Search

1978-07-01

The TSC Freight Energy Model is applied to a preliminary analysis of two energy conservation options: (1) increased use of Run-Through TOFC rail service; and (2) use of double 40-foot trailers on all divided highways. These options are examined prima...

Review of Saccharomyces boulardii as a treatment option in IBD.

PubMed

Sivananthan, Kavitha; Petersen, Andreas Munk

2018-05-17

Review of the yeast Saccharomyces boulardii as a treatment option for the inflammatory bowel diseases (IBD) ulcerative colitis and Crohn's disease. IBD is caused by an inappropriate immune response to gut microbiota. Treatment options could therefore be prebiotics, probiotics, antibiotics and/or fecal transplant. In this review, we have looked at the evidence for the yeast S. boulardii as a treatment option. Searches in PubMed and the Cochrane Library with the MeSH words 'Saccharomyces boulardii AND IBD', 'Saccharomyces boulardii AND Inflammatory Bowel Disease', 'Saccharomyces boulardii AND ulcerative colitis' and 'Saccharomyces boulardii AND Crohn's disease' gave total a total of 80 articles. After exclusions because of irrelevance, articles in other languages and some articles that were not available, 16 articles were included in this review. Three of the clinical trials showed a positive effect of S. boulardii in IBD patients (two Crohn's disease, one ulcerative colitis), while there was one trial that didn't prove any effect (Crohn's disease). Included Animal trials and cell assays describes different anti-inflammatory mechanisms of S. boulardii supporting a possible effect when treating IBD patients. The number of studies of S. boulardii as treatment for IBD is limited. Furthermore, the existing trials have small populations and short duration. We do not have enough evidence to prove the effect of S. boulardii in IBD. Saccharomyces boulardii is, however, a plausible treatment option in the future, but more placebo-controlled clinical studies on both patients with ulcerative colitis and Crohn's disease are needed.

Management of stage IV rectal cancer: Palliative options

PubMed Central

Ronnekleiv-Kelly, Sean M; Kennedy, Gregory D

2011-01-01

Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease. PMID:21412493

Humanistic burden of disease for patients with advanced melanoma in Canada.

PubMed

Cheung, Winson Y; Bayliss, Martha S; White, Michelle K; Stroupe, Angela; Lovley, Andrew; King-Kallimanis, Bellinda L; Lasch, Kathryn

2018-06-01

Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach. Many patients' journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients' overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers. Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.

Health-enabling technologies for pervasive health care: on services and ICT architecture paradigms.

PubMed

Haux, Reinhold; Howe, Jurgen; Marschollek, Michael; Plischke, Maik; Wolf, Klaus-Hendrik

2008-06-01

Progress in information and communication technologies (ICT) is providing new opportunities for pervasive health care services in aging societies. To identify starting points of health-enabling technologies for pervasive health care. To describe typical services of and contemporary ICT architecture paradigms for pervasive health care. Summarizing outcomes of literature analyses and results from own research projects in this field. Basic functions for pervasive health care with respect to home care comprise emergency detection and alarm, disease management, as well as health status feedback and advice. These functions are complemented by optional (non-health care) functions. Four major paradigms for contemporary ICT architectures are person-centered ICT architectures, home-centered ICT architectures, telehealth service-centered ICT architectures and health care institution-centered ICT architectures. Health-enabling technologies may lead to both new ways of living and new ways of health care. Both ways are interwoven. This has to be considered for appropriate ICT architectures of sensor-enhanced health information systems. IMIA, the International Medical Informatics Association, may be an appropriate forum for interdisciplinary research exchange on health-enabling technologies for pervasive health care.

Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State.

PubMed

Friedberg, Mark W; Martsolf, Grant R; White, Chapin; Auerbach, David I; Kandrack, Ryan; Reid, Rachel O; Butcher, Emily; Yu, Hao; Hollands, Simon; Nie, Xiaoyu

2017-01-01

The Washington State legislature has recently considered several policy options to address a perceived shortage of primary care physicians in rural Washington. These policy options include opening the new Elson S. Floyd College of Medicine at Washington State University in 2017; increasing the number of primary care residency positions in the state; expanding educational loan-repayment incentives to encourage primary care physicians to practice in rural Washington; increasing Medicaid payment rates for primary care physicians in rural Washington; and encouraging the adoption of alternative models of primary care, such as medical homes and nurse-managed health centers, that reallocate work from physicians to nurse practitioners (NPs) and physician assistants (PAs). RAND Corporation researchers projected the effects that these and other policy options could have on the state's rural primary care workforce through 2025. They project a 7-percent decrease in the number of rural primary care physicians and a 5-percent decrease in the number of urban ones. None of the policy options modeled in this study, on its own, will offset this expected decrease by relying on physicians alone. However, combinations of these strategies or partial reallocation of rural primary care services to NPs and PAs via such new practice models as medical homes and nurse-managed health centers are plausible options for preserving the overall availability of primary care services in rural Washington through 2025.

78 FR 54970 - Cotton Futures Classification: Optional Classification Procedure

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-09

... Service 7 CFR Part 27 [AMS-CN-13-0043] RIN 0581-AD33 Cotton Futures Classification: Optional... optional cotton futures classification procedure--identified and known as ``registration'' by the U.S. cotton industry and the Intercontinental Exchange (ICE). In response to requests from the U.S. cotton...

77 FR 16879 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Granting Approval of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... financial information for investment advisory services, fund administration, portfolio management, financial... the Exchange will be European-style exercise.\\17\\ Upon exercise, holders of options contracts would... Corporation (``OCC'').\\19\\ \\17\\ Unlike American style options, European style options may be exercised only on...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

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

PubMed

Brauer, Paula; Dietrich, Linda; Davidson, Bridget

2006-01-01

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

Seroprevalence of Trypanosoma cruzi in blood donors at the National Blood Transfusion Services--Guyana.

PubMed

Bwititi, P T; Browne, J

2012-09-01

Blood transfusion is an important transmission route of Trypanosoma cruzi (T cruzi), a major parasitic infection in Central and South America. The limited treatment options are most effective in acute Chagas' infection. At present, there is no current data on the prevalence of T cruzi in the blood donor population of Guyana. This information is necessary to protect the supply of the blood donation programme. This study sought to determine the prevalence of T cruzi in the blood supply at the National Blood Transfusion Services of Guyana with the hope of providing knowledge to the on-going surveillance for Chagas' disease worldwide and therefore address the risk of its spread by blood transfusion. Two commercialized ELISAs utilizing crude or recombinant T cruzi antigens were used to study 2000 blood samples voluntarily donated for the purpose of altruistic or family replacement donation retrospectively. The results showed that approximately 1 in 286 donations tested positive for antibodies to T cruzi. These results indicate that T cruzi continues to be a risk in Guyana and there is a need to continue screening donated blood. Trypanosoma cruzi is a life-long infection and infected persons may be asymptomatic chronic carriers of the disease. Education, housing improvement, and controlled use of insecticides should be introduced to contain Chagas' disease.

Attitudes of GPs towards Older Adults Psychology Services in the Scottish Highlands.

PubMed

Todman, Jonathan P F; Law, Jim; MacDougall, Andrew

2011-01-01

The mental health of older adults is of increasing concern in an aging population and GPs are frequently the gatekeepers to specialist mental health services. Psychotherapy, social interventions and bibliotherapy all have an evidence-base for treating depression and anxiety in the elderly, as does pharmacological treatment. However, the referral rate from GPs for an Older Adults Clinical Psychology service in the Scottish Highlands in the months prior to the study had been very low and the reasons for this were not clear. General practitioners may have felt that depression and anxiety are 'understandable' in older adults and are therefore unsuitable for treatment, or they may have felt that psycho-pharmacotherapy treatments are more effective than the psychotherapy treatment options. Alternatively, local issues associated with the remote location of many NHS Highland GP practices and patients may have prevented them referring. Therefore, the current study aimed to elicit the therapeutic preferences of Highland GPs, the perceived availability of these options and an estimate of the prevalence of older adults in the area suffering from mild or moderate mental health problems. Questionnaires including brief quantitative and qualitative questions were sent to all 284 GPs in the area with 119 (46%) were completed and returned. Responses from GPs suggested that many patients with depression or anxiety may not be referred. The GPs indicated that social therapeutic options are seen to be as effective as pharmacological options and more effective than other psychological and bibliotherapy options. However, GPs indicated that they were substantially more likely to prescribe pharmacological options than other forms of therapy. The GPs suggested that lower waiting times and a more localised service would increase the likelihood of a referral being made. The current study suggests that low awareness of psychological service provision among GPs may have resulted in fewer referrals, rather than low confidence in psychotherapies for this population. The GPs' preference for social interventions may reflect the particular risk of isolation of the elderly in remote communities and may be worthy of consideration when developing services in these areas.

Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study.

PubMed

Sanchez, Katherine; Eghaneyan, Brittany H; Trivedi, Madhukar H

2016-07-29

Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications. Stigma is primarily perpetuated due to inadequate disease literacy and cultural factors. Common concerns about depression treatments among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. The current manuscript presents the study protocol for the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) study funded by the Center for Medicare and Medicaid Services (CMS) Grants to Support the Hispanic Health Services Research Grant Program. DESEO will implement universal screening with a self-report depression screening tool (the 9-item Patient Health Questionnaire (PHQ-9)) that is presented through a customized web application and a Depression Education Intervention (DEI) designed to increase disease literacy, and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. This project will be conducted at one community health center whose patient population is majority Hispanic. The target enrollment for recruitment is 350 patients over the 24-month study period. A one-group, pretest-posttest design will be used to asses knowledge of depression and its treatment and related stigma before, immediately after, and one month post intervention. Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment options, participate in shared decision-making with their provider, and increase engagement in treatment of depression which might lead to improved overall health. It is also expected that implementation of the iPad Depression Screening application will increase provider awareness of the incidence and prevalence of depression in their own practice and improve the performance and care the clinic provides. The study was registered with: NCT02491034 July 2, 2015.

Rehabilitation or Compensation: Time for a Fresh Perspective on Speech and Language Therapy for Dysphagia and Parkinson's Disease?

ERIC Educational Resources Information Center

Smith, Sarah K.; Roddam, Hazel; Sheldrick, Heulwen

2012-01-01

Background: Dysphagia is a common symptom of Parkinson's disease and can have negative consequences for physical health and quality of life. A variety of treatment options are available to clinicians working with people who have dysphagia and Parkinson's disease. These options can be broadly categorized as being compensatory or rehabilitative in…

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities.

PubMed

Laar, Amos Kankponang

2013-03-15

Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women's right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client's right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines.

Sodium in Store and Restaurant Food Environments - Guam, 2015.

PubMed

Jackson, Sandra L; VanFrank, Brenna K; Lundeen, Elizabeth; Uncangco, Alyssa; Alam, Lawrence; King, Sallyann M Coleman; Cogswell, Mary E

2016-05-27

Compared with the United States overall, Guam has higher mortality rates from cardiovascular disease and stroke (1). Excess sodium intake can increase blood pressure and risk for cardiovascular disease (2,3). To determine the availability and promotion of lower-sodium options in the nutrition environment, the Guam Department of Public Health and Social Services (DPHSS) conducted an assessment in September 2015 using previously validated tools adapted to include sodium measures. Stores (N = 114) and restaurants (N = 63) were randomly sampled by region (north, central, and south). Data from 100 stores and 62 restaurants were analyzed and weighted to account for the sampling design. Across the nine product types assessed, lower-sodium products were offered less frequently than regular-sodium products (p<0.001) with <50% of stores offering lower-sodium canned vegetables, tuna, salad dressing, soy sauce, and hot dogs. Lower-sodium products were also less frequently offered in small stores than large (two or more cash registers) stores. Reduced-sodium soy sauce cost more than regular soy sauce (p<0.001) in stores offering both options in the same size bottle. Few restaurants engaged in promotion practices such as posting sodium information (3%) or identifying lower-sodium entrées (1%). Improving the availability and promotion of lower-sodium foods in stores and restaurants could help support healthier eating in Guam.

7 CFR Exhibit F to Subpart I of... - Site Option Loan to Technical Assistance Grantees

Code of Federal Regulations, 2010 CFR

2010-01-01

...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... decision reviewed following the procedure established in subpart B of part 1900 of this chapter. (2) Review...

42 CFR 441.575 - Development and Implementation Council.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and implementing a State plan amendment to provide Community First Choice services and supports. ... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice...

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Waiver options for Medicaid agency. 456.506 Section 456.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

26 CFR 1.1402(a)-16 - Exercise of option.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 12 2014-04-01 2014-04-01 false Exercise of option. 1.1402(a)-16 Section 1.1402(a)-16 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Tax on Self-Employment Income § 1.1402(a)-16 Exercise of option. A...

26 CFR 1.1402(a)-16 - Exercise of option.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 12 2011-04-01 2011-04-01 false Exercise of option. 1.1402(a)-16 Section 1.1402(a)-16 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Tax on Self-Employment Income § 1.1402(a)-16 Exercise of option. A...

26 CFR 1.1402(a)-16 - Exercise of option.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 12 2012-04-01 2012-04-01 false Exercise of option. 1.1402(a)-16 Section 1.1402(a)-16 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Tax on Self-Employment Income § 1.1402(a)-16 Exercise of option. A...

26 CFR 1.1402(a)-16 - Exercise of option.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 12 2013-04-01 2013-04-01 false Exercise of option. 1.1402(a)-16 Section 1.1402(a)-16 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Tax on Self-Employment Income § 1.1402(a)-16 Exercise of option. A...

An Employer's Guide to Child Care Consultants.

ERIC Educational Resources Information Center

Eichman, Caroline

This guide is designed to help employers hire a qualified child care consultant who will evaluate child care options in light of employees' needs and help develop and implement appropriate child care options. These options include: (1) establishment of a child care facility; (2) financial assistance; (3) a resource and referral service; (4)…

Helping Working Parents: Child Care Options for Business.

ERIC Educational Resources Information Center

North Carolina State Dept. of Administration, Raleigh.

Seven models representing the existing range of options of employer involvement in day care are described in this paper. The range of options are grouped into two categories: (1) company owned, operated, or subsidized child day care; and (2) employee assistance services, benefits, and policies. The models included in the first category are the…

On Ramps: Options and Issues in Accessing the Internet.

ERIC Educational Resources Information Center

Bocher, Bob

1995-01-01

Outlines the basic options that schools and libraries have for accessing the Internet, focusing on four models: direct connection; dial access using SLIP/PPP (Serial Line Internet Protocol/Point-to-Point Protocol); dial-up using terminal emulation mode; and dial access through commercial online services. Discusses access option issues such as…

42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on health status... this selection, lose their eligibility for free-standing dental, optical, or prescription drug benefits... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...

78 FR 36005 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... Clear Over-the-Counter Index Options on Underlying Indices Published by Standard & Poor's Financial... publishing this notice to solicit comments on the proposed rule change from interested persons. \\1\\ 15 U.S.C...-counter (``OTC'') index options on underlying indices published by Standard & Poor's Financial Services...

26 CFR 1.1402(a)-16 - Exercise of option.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 12 2010-04-01 2010-04-01 false Exercise of option. 1.1402(a)-16 Section 1.1402(a)-16 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Tax on Self-Employment Income § 1.1402(a)-16 Exercise of option. A taxpayer shall...

Interest in internet lung cancer support among rural cardiothoracic patients.

PubMed

Quin, Jacquelyn; Stams, Victor; Phelps, Beth; Boley, Theresa; Hazelrigg, Stephen

2010-05-01

The Internet may provide an alternative option for rural lung cancer patients who lack access to on-site cancer support; however, Internet access and use among rural patients is unknown. An anonymous waiting-room survey was administered to all outpatient cardiothoracic surgery patients over 3 mo. Survey questions included age, gender, and diagnosis, possession of a home computer and Internet service, estimated Internet use, and use of the Internet for health information. Patients with known or suspected lung cancer were asked to indicate their interest in on-site and Internet cancer support. There were 597 returned surveys (response rate 96%). The mean age was 64.6 y (SE 0.55), and 58% were men. Diagnoses included known or possible lung cancer (15.4%), lung disease (9.5%), heart disease (30.4%), other diagnoses (13.9%), and undetermined (30.6%). There were 343 patients (57.4%) with a home computer and 299 (50.1%) with home Internet service. Average Internet use was 8.5 h per wk (n = 298), and 225 patients used the Internet for health information. Of the 92 patients with lung cancer, 10 indicated interest in on-site support services while 37 expressed interest in Internet-based support. Based on survey results, a slight majority of rural patients have a home computer and Internet access. Internet use for health information appears relatively common. Overall interest for support services among lung cancer patients appears modest with a greater interest in Internet-based services compared with on-site support. Copyright 2010 Elsevier Inc. All rights reserved.

42 CFR 62.76 - How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be required to be repaid? 62.76 Section 62.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING...

42 CFR 62.76 - How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be required to be repaid? 62.76 Section 62.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING...

42 CFR 62.76 - How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be required to be repaid? 62.76 Section 62.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING...

42 CFR 62.76 - How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be required to be repaid? 62.76 Section 62.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING...

42 CFR 62.76 - How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false How will amounts of money due under the option under section 204(c)(1) of Public Law 100-177 be required to be repaid? 62.76 Section 62.76 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING...

Management Options for Biochemically Recurrent Prostate Cancer.

PubMed

Fakhrejahani, Farhad; Madan, Ravi A; Dahut, William L

2017-05-01

Prostate cancer is the most common solid tumor malignancy in men worldwide. Treatment with surgery and radiation can be curative in organ-confined disease. Unfortunately, about one third of men develop biochemically recurrent disease based only on rising prostate-specific antigen (PSA) in the absence of visible disease on conventional imaging. For these patients with biochemical recurrent prostate cancer, there is no uniform guideline for subsequent management. Based on available data, it seems prudent that biochemical recurrent prostate cancer should initially be evaluated for salvage radiation or prostatectomy, with curative intent. In selected cases, high-intensity focused ultrasound and cryotherapy may be considered in patients that meet very narrow criteria as defined by non-randomized trials. If salvage options are not practical or unsuccessful, androgen deprivation therapy (ADT) is a standard option for disease control. While some patients prefer ADT to manage the disease immediately, others defer treatment because of the associated toxicity. In the absence of definitive randomized data, patients may be followed using PSA doubling time as a trigger to initiate ADT. Based on retrospective data, a PSA doubling time of less than 3-6 months has been associated with near-term development of metastasis and thus could be used signal to initiate ADT. Once treatment is begun, patients and their providers can choose between an intermittent and continuous ADT strategy. The intermittent approach may limit side effects but in patients with metastatic disease studies could not exclude a 20% greater risk of death. In men with biochemical recurrence, large studies have shown that intermittent therapy is non-inferior to continuous therapy, thus making this a reasonable option. Since biochemically recurrent prostate cancer is defined by technological limitations of radiographic detection, as new imaging (i.e., PSMA) strategies are developed, it may alter how the disease is monitored and perhaps managed. Furthermore, patients have no symptoms related to their disease and thus many prefer options that minimize toxicity. For this reason, herbal agents and immunotherapy are under investigation as potential alternatives to ADT and its accompanying side effects. New therapeutic options combined with improved imaging to evaluate the disease may markedly change how biochemically recurrent prostate cancer is managed in the future.

24 CFR 700.130 - Service coordinator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... AND PUBLIC AND INDIAN HOUSING PROGRAMS) CONGREGATE HOUSING SERVICES PROGRAM § 700.130 Service...; (10) Educate grant recipient's program participants on such issues as benefits application procedures (e.g. SSI, food stamps, Medicaid), service availability, and program participant options and...

A novel approach for mental health disease management: the Air Force Medical Service's interdisciplinary model.

PubMed

Runyan, Christine N; Fonseca, Vincent P; Meyer, John G; Oordt, Mark S; Talcott, G Wayne

2003-01-01

Mental health disorders are one of the most substantial public health problems affecting society today, accounting for roughly 15% of the overall burden of disease from all causes in the United States. Although primary care (PC) has the potential to be the frontline for recognition and management of behavioral health conditions, this has been a challenge historically. In order to more effectively address the broad scope of behavioral health needs, the Air Force Medical Service (AFMS) established a new model of behavioral health care. Through a series of coordinated steps, the AFMS ultimately placed trained behavioral health providers into PC clinics to serve as consultants to PC providers (PCPs). Behavioral Health Consultants (BHCs) provide focused assessments, present healthcare options to patients, and deliver brief collaborative interventions in the PC setting. BHCs see patients at the request of the PCP, in 15-30-min appointments. In the pilot study, patients averaged 1.6 visits to the BHC. Over 70% of patients fell into six categories of presenting problems: situational reactions, depressive disorders, adjustment disorders, anxiety disorders, health promotion, and obesity. Patient data (n = 76) suggest 97% of patients seen were either "satisfied" or "very satisfied" with BHC services, and 100% of the PCPs (n = 23, 68% response rate) were highly satisfied and indicated they would "definitely recommend" others use BHC services for their patients. Both the implications and the limitations of this pilot study are discussed.

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

Indications and interventional options for non-resectable tracheal stenosis

PubMed Central

Bacon, Jenny Louise; Patterson, Caroline Marie

2014-01-01

Non-specific presentation and normal examination findings in early disease often result in tracheal obstruction being overlooked as a diagnosis until patients present acutely. Once diagnosed, surgical options should be considered, but often patient co-morbidity necessitates other interventional options. Non-resectable tracheal stenosis can be successfully managed by interventional bronchoscopy, with therapeutic options including airway dilatation, local tissue destruction and airway stenting. There are common aspects to the management of tracheal obstruction, tracheomalacia and tracheal fistulae. This paper reviews the pathogenesis, presentation, investigation and management of tracheal disease, with a focus on tracheal obstruction and the role of endotracheal intervention in management. PMID:24624290

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

Voice and choice by delegation.

PubMed

van de Bovenkamp, Hester; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

2013-02-01

In many Western countries, options for citizens to influence public services are increased to improve the quality of services and democratize decision making. Possibilities to influence are often cast into Albert Hirschman's taxonomy of exit (choice), voice, and loyalty. In this article we identify delegation as an important addition to this framework. Delegation gives individuals the chance to practice exit/choice or voice without all the hard work that is usually involved in these options. Empirical research shows that not many people use their individual options of exit and voice, which could lead to inequality between users and nonusers. We identify delegation as a possible solution to this problem, using Dutch health care as a case study to explore this option. Notwithstanding various advantages, we show that voice and choice by delegation also entail problems of inequality and representativeness.

77 FR 65698 - Prospective Grant of Exclusive Evaluation Option License: Pre-clinical Evaluation of Human...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... diseases. Upon expiration or termination of the exclusive evaluation option license, MEDICENNA will have...-death related consequences of various diseases and injuries. This technology could be used to minimize or prevent apoptotic damage that can be caused by neurodegenerative disorders, e.g., Alzheimer's...

Help Preferences Among Employees Who Wish to Change Health Behaviors.

PubMed

Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L

2014-08-01

To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e., wellness service). Respondents to an electronic questionnaire who acknowledged wishing to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4,431), and physical activity (n = 5,179) were asked to choose up to three help alternatives on a predefined list. In descending order, smokers preferred help from nicotine gum, no help, and help and support from family and friends. Alcohol consumers preferred no help or help and support from family and friends or "other" forms. Employees who wanted to change eating habits preferred a free fruit bowl, free nutritional guidance, and healthy food at work. Employees who wanted to change physical activity patterns preferred exercise at work, offers of free exercise, and exercise in a social/collegial context. Wishing to change health behaviors is not always accompanied by perceiving a need for assistance. The no-help option was selected fairly frequently and mostly in relation to alcohol and smoking. A fruit bowl was the most preferred option for help, followed by exercise at work and free exercise. Help from traditional health services was ranked low, possibly reflecting that they are primarily viewed as a solution for stopping disease rather than promoting health. © 2013 Society for Public Health Education.

14 CFR 1214.105 - Apportionment and/or assignment of services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and/or assignment of Shuttle services may take place outside the payload. (b) Integration of... assistance in such integration will be provided as an optional service. (c) Customers intending to apportion...

42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...

42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...

42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... enrollment in the HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on..., because of this selection, lose their eligibility for free-standing dental, optical, or prescription drug... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...

How will climate change pathways and mitigation options alter incidence of vector-borne diseases? A framework for leishmaniasis in South and Meso-America

PubMed Central

Masante, Dario; Golding, Nicholas; Pigott, David; Day, John C.; Ibañez-Bernal, Sergio; Kolb, Melanie; Jones, Laurence

2017-01-01

The enormous global burden of vector-borne diseases disproportionately affects poor people in tropical, developing countries. Changes in vector-borne disease impacts are often linked to human modification of ecosystems as well as climate change. For tropical ecosystems, the health impacts of future environmental and developmental policy depend on how vector-borne disease risks trade off against other ecosystem services across heterogeneous landscapes. By linking future socio-economic and climate change pathways to dynamic land use models, this study is amongst the first to analyse and project impacts of both land use and climate change on continental-scale patterns in vector-borne diseases. Models were developed for cutaneous and visceral leishmaniasis in the Americas—ecologically complex sand fly borne infections linked to tropical forests and diverse wild and domestic mammal hosts. Both diseases were hypothesised to increase with available interface habitat between forest and agricultural or domestic habitats and with mammal biodiversity. However, landscape edge metrics were not important as predictors of leishmaniasis. Models including mammal richness were similar in accuracy and predicted disease extent to models containing only climate and land use predictors. Overall, climatic factors explained 80% and land use factors only 20% of the variance in past disease patterns. Both diseases, but especially cutaneous leishmaniasis, were associated with low seasonality in temperature and precipitation. Since such seasonality increases under future climate change, particularly under strong climate forcing, both diseases were predicted to contract in geographical extent to 2050, with cutaneous leishmaniasis contracting by between 35% and 50%. Whilst visceral leishmaniasis contracted slightly more under strong than weak management for carbon, biodiversity and ecosystem services, future cutaneous leishmaniasis extent was relatively insensitive to future alternative socio-economic pathways. Models parameterised at narrower geographical scales may be more sensitive to land use pattern and project more substantial changes in disease extent under future alternative socio-economic pathways. PMID:29020041

How will climate change pathways and mitigation options alter incidence of vector-borne diseases? A framework for leishmaniasis in South and Meso-America.

PubMed

Purse, Bethan V; Masante, Dario; Golding, Nicholas; Pigott, David; Day, John C; Ibañez-Bernal, Sergio; Kolb, Melanie; Jones, Laurence

2017-01-01

The enormous global burden of vector-borne diseases disproportionately affects poor people in tropical, developing countries. Changes in vector-borne disease impacts are often linked to human modification of ecosystems as well as climate change. For tropical ecosystems, the health impacts of future environmental and developmental policy depend on how vector-borne disease risks trade off against other ecosystem services across heterogeneous landscapes. By linking future socio-economic and climate change pathways to dynamic land use models, this study is amongst the first to analyse and project impacts of both land use and climate change on continental-scale patterns in vector-borne diseases. Models were developed for cutaneous and visceral leishmaniasis in the Americas-ecologically complex sand fly borne infections linked to tropical forests and diverse wild and domestic mammal hosts. Both diseases were hypothesised to increase with available interface habitat between forest and agricultural or domestic habitats and with mammal biodiversity. However, landscape edge metrics were not important as predictors of leishmaniasis. Models including mammal richness were similar in accuracy and predicted disease extent to models containing only climate and land use predictors. Overall, climatic factors explained 80% and land use factors only 20% of the variance in past disease patterns. Both diseases, but especially cutaneous leishmaniasis, were associated with low seasonality in temperature and precipitation. Since such seasonality increases under future climate change, particularly under strong climate forcing, both diseases were predicted to contract in geographical extent to 2050, with cutaneous leishmaniasis contracting by between 35% and 50%. Whilst visceral leishmaniasis contracted slightly more under strong than weak management for carbon, biodiversity and ecosystem services, future cutaneous leishmaniasis extent was relatively insensitive to future alternative socio-economic pathways. Models parameterised at narrower geographical scales may be more sensitive to land use pattern and project more substantial changes in disease extent under future alternative socio-economic pathways.

[Independent medical processing enterprises as innovative organizational model for market of medical services].

PubMed

Shevchenko, Iu L; Matveev, S A; Makhnev, D A; Korsun, K Iu

2006-01-01

In Russia, current stage of health care development is characterized by occurrence of various problems. Most of them are related to cooperation between participators of market of medical services. Different options are proposed to resolve cooperation problems embedded into medical services market with emphasis on development of ultimately different medical processing enterprise with brand-new organizational and functional structure. Its functioning is based on process management logistics. The company broad professional experience allows to implement above-mentioned managerial structure and make it function as well as claims positive perspectives of described option.

DNA vaccines in veterinary use

PubMed Central

Redding, Laurel; Werner, David B

2015-01-01

DNA vaccines represent a new frontier in vaccine technology. One important application of this technology is in the veterinary arena. DNA vaccines have already gained a foothold in certain fields of veterinary medicine. However, several important questions must be addressed when developing DNA vaccines for animals, including whether or not the vaccine is efficacious and cost effective compared with currently available options. Another important question to consider is how to apply this developing technology in a wide range of different situations, from the domestic pet to individual fish in fisheries with several thousand animals, to wildlife programs for disease control. In some cases, DNA vaccines represent an interesting option for vaccination, while in others, currently available options are sufficient. This review will examine a number of diseases of veterinary importance and the progress being made in DNA vaccine technology relevant to these diseases, and we compare these with the conventional treatment options available. PMID:19722897

Technology-aided leisure and communication: Opportunities for persons with advanced Parkinson's disease.

PubMed

Lancioni, Giulio; Singh, Nirbhay; O'Reilly, Mark; Sigafoos, Jeff; D'Amico, Fiora; Sasanelli, Giovanni; Denitto, Floriana; Lang, Russell

2016-12-01

This study investigated whether simple technology-aided programs could be used to promote leisure and communication engagement in three persons with advanced Parkinson's disease. The programs included music and video options, which were combined with (a) text messaging and telephone calls for the first participant, (b) verbal statements/requests, text messaging, and reading for the second participant, and (c) verbal statements/requests and prayers for the third participant. The participants could activate those options via hand movement or vocal emission and specific microswitches. All three participants were successful in activating the options available. The mean cumulative frequencies of option activations were about five per 15-min session for the first two participants and about four per 10-min session for the third participant. The results were considered encouraging and relevant given the limited amount of evidence available on helping persons with advanced Parkinson's disease with leisure and communication.

ChemProt-2.0: visual navigation in a disease chemical biology database

PubMed Central

Kim Kjærulff, Sonny; Wich, Louis; Kringelum, Jens; Jacobsen, Ulrik P.; Kouskoumvekaki, Irene; Audouze, Karine; Lund, Ole; Brunak, Søren; Oprea, Tudor I.; Taboureau, Olivier

2013-01-01

ChemProt-2.0 (http://www.cbs.dtu.dk/services/ChemProt-2.0) is a public available compilation of multiple chemical–protein annotation resources integrated with diseases and clinical outcomes information. The database has been updated to >1.15 million compounds with 5.32 millions bioactivity measurements for 15 290 proteins. Each protein is linked to quality-scored human protein–protein interactions data based on more than half a million interactions, for studying diseases and biological outcomes (diseases, pathways and GO terms) through protein complexes. In ChemProt-2.0, therapeutic effects as well as adverse drug reactions have been integrated allowing for suggesting proteins associated to clinical outcomes. New chemical structure fingerprints were computed based on the similarity ensemble approach. Protein sequence similarity search was also integrated to evaluate the promiscuity of proteins, which can help in the prediction of off-target effects. Finally, the database was integrated into a visual interface that enables navigation of the pharmacological space for small molecules. Filtering options were included in order to facilitate and to guide dynamic search of specific queries. PMID:23185041

Reproductive rights and options available to women infected with HIV in Ghana: perspectives of service providers from three Ghanaian health facilities

PubMed Central

2013-01-01

Background Owing to improved management of HIV and its associated opportunistic infections, many HIV-positive persons of reproductive age are choosing to exercise their right of parenthood. This study explored the knowledge of health workers from two Ghanaian districts on the reproductive rights and options available to HIV-positive women who wish to conceive. Methods Facility-based cross-sectional in design, the study involved the entire population of nurse counselors (32) and medical officers (3) who provide counseling and testing services to clients infected with HIV. Both structured and in-depth interviews were conducted after informed consent. Results Two main perspectives were revealed. There was an overwhelmingly high level of approbation by the providers on HIV-positive women’s right to reproduction (94.3%). At the same time, the providers demonstrated a lack of knowledge regarding the various reproductive options available to women infected with HIV. Site of facility, and being younger were associated with practices that violated client’s right to contraceptive counseling (p < 0.05) in each case. Some of the providers openly expressed their inability to give qualified guidance to HIV-positive women on the various reproductive options. Conclusions Taken together, these findings suggest that many HIV-positive clients do not receive comprehensive information about their reproductive options. These findings highlight some of the problems that service providers face as HIV counselors. Both service providers and policy makers need to recognize these realities and incorporate reproductive health issues of HIV-persons into the existing guidelines. PMID:23496943

Trade study comparing specimen chamber servicing methods for the Space Station Centrifuge Facility

NASA Technical Reports Server (NTRS)

Calvisi, Michael L.; Sun, Sidney C.

1991-01-01

The Specimen Chamber Service Unit, a component of the Space Station Centrifuge Facility, must provide a clean enclosure on a continuing basis for the facility's plant, rodent and primate specimens. The specimen chambers can become soiled and can require periodic servicing to maintain a clean environment for the specimens. Two methods of servicing the specimen chambers are discussed: washing the chambers with an on-board washer, or disposing of the soiled chambers and replacing them with clean ones. Many of these issues are addressed by developing several servicing options, using either cleaning or replacement as the method of providing clean specimen chambers, and then evaluating each option according to a set of established quantitative and qualitative criteria. Disposing and replacing the Specimen Chambers is preferable to washing them.

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Service budget elements. 441.470 Section 441.470... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service budget must be developed and approved by the State based on the assessment of need and service plan and...

Satellite services system analysis study. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1981-01-01

Service requirements are considered. Topics include development of on-orbit operations scenarios, service equipment summary, crew interaction, and satellite features facilitating servicing. Service equipment concepts are considered. Topics include payload deployment, close proximity retrieval, on-orbit servicing, backup/contingency, delivery/retrieval of high energy payloads, Earth return, optional service, and advanced capabilities. Program requirements are assessed.

42 CFR 417.576 - Final settlement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... capita costs incurred in furnishing covered services to its Medicare enrollees, determined in accordance... January 1, 1996, the costs of hospital and SNF services paid by Medicare's intermediaries under the option...

42 CFR 482.52 - Condition of participation: Anesthesia services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Anesthesia services... Optional Hospital Services § 482.52 Condition of participation: Anesthesia services. If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a...

42 CFR 482.52 - Condition of participation: Anesthesia services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Anesthesia services... Optional Hospital Services § 482.52 Condition of participation: Anesthesia services. If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a...

42 CFR 482.53 - Condition of participation: Nuclear medicine services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients in...

42 CFR 482.53 - Condition of participation: Nuclear medicine services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients in...

42 CFR 482.53 - Condition of participation: Nuclear medicine services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients in...

42 CFR 482.53 - Condition of participation: Nuclear medicine services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients in...

42 CFR 482.53 - Condition of participation: Nuclear medicine services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Nuclear medicine... HOSPITALS Optional Hospital Services § 482.53 Condition of participation: Nuclear medicine services. If the hospital provides nuclear medicine services, those services must meet the needs of the patients in...

76 FR 14284 - Domestic Shipping Services Product Launch of Parcel Select Regional Ground

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... POSTAL SERVICE 39 CFR Part 111 Domestic Shipping Services Product Launch of Parcel Select Regional... competitive shipping option, Parcel Select Regional Ground \\TM\\ service. DATES: Effective Date: April 17, 2011... classification changes outlined by USPS[supreg] on the introduction of Parcel Select Regional Ground service...

42 CFR 482.52 - Condition of participation: Anesthesia services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Anesthesia services... Optional Hospital Services § 482.52 Condition of participation: Anesthesia services. If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a...

42 CFR 482.52 - Condition of participation: Anesthesia services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Anesthesia services... Optional Hospital Services § 482.52 Condition of participation: Anesthesia services. If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a...

42 CFR 482.52 - Condition of participation: Anesthesia services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Anesthesia services... Optional Hospital Services § 482.52 Condition of participation: Anesthesia services. If the hospital furnishes anesthesia services, they must be provided in a well-organized manner under the direction of a...

Economic Evaluation of Low-Vision Rehabilitation for Veterans With Macular Diseases in the US Department of Veterans Affairs.

PubMed

Stroupe, Kevin T; Stelmack, Joan A; Tang, X Charlene; Wei, Yongliang; Sayers, Scott; Reda, Domenic J; Kwon, Ellen; Massof, Robert W

2018-05-01

Examining costs and consequences of different low-vision (LV) programs provides important information about resources needed to expand treatment options efficiently. To examine the costs and consequences of LV rehabilitation or basic LV services. The US Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) II was conducted from September 27, 2010, to July 31, 2014, at 9 VA facilities and included 323 veterans with macular diseases and a best-corrected distance visual acuity of 20/50 to 20/200. Veterans were randomized to receive basic LV services that provided LV devices without therapy, or LV rehabilitation that added a therapist to LV services who provided instruction and homework on using LV devices, eccentric viewing, and environmental modification. We compared costs and consequences between these groups. Low-vision devices without therapy and LV devices with therapy. Costs of providing basic LV services or LV rehabilitation were assessed. We measured consequences as changes in functional visual ability from baseline to follow-up 4 months after randomization using the VA Low Vision Visual Functioning Questionnaire. Visual ability was measured in dimensionless log odds units (logits). Of 323 randomized patients, the mean (SD) age was 80 (10.5) years, 314 (97.2%) were men, and 292 (90.4%) were white. One hundred sixty (49.5%) received basic LV services and 163 (50.1%) received LV rehabilitation. The mean (SD) total direct health care costs per patient were similar between patients who were randomized to receive basic LV services ($1662 [$671]) or LV rehabilitation ($1788 [$864]) (basic LV services, $126 lower; 95% CI, $299 lower to $35 higher; P = .15). However, basic LV services required less time and had lower transportation costs. Patients receiving LV rehabilitation had greater improvements in overall visual ability, reading ability, visual information processing, and visual motor skill scores.

"Advice to the medical students in my service": the rediscovery of a golden book by Jean Hamburger, father of nephrology and of medical humanities.

PubMed

Barbara, Piccoli Giorgina

2013-03-15

Jean Hamburger (1909-1992) is considered the founder of the concept of medical intensive care (réanimation médicale) and the first to propose the name Nephrology for the branch of medicine dealing with kidney diseases. One of the first kidney grafts in the world (with short-term success), in 1953, and the first dialysis session in France, in 1955, were performed under his guidance. His achievements as a writer were at least comparable: Hamburger was awarded several important literary prizes, including prix Femina, prix Balzac and the Cino del Duca prize (1979), awarded, among others, to Jorge Luis Borges and Konrad Lorenz.Here we would like to offer a selected reading of a "golden" book, "Conseils aux étudiants en medicine de mon service" ("Advice to the Medical Students in my Service"), the first book dedicated to patient-physician relationship in Nephrology, written when dialysis and transplantation were becoming clinical options (1963). The themes include: the central role of the patient, who should be known by name, profession, life style, and not by disease; the importance of the setting of the care; the need for truth-telling and for leaving hope; the role of research not only in the progression of science, but also in the daily clinical practice.

Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti

PubMed Central

Domercant, Jean Wysler; Puttkammer, Nancy; Young, Paul; Yuhas, Krista; François, Kesner; Grand’Pierre, Reynold; Lowrance, David; Adler, Michelle

2017-01-01

ABSTRACT Background: Access to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+. Objective: To assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti. Methods: Longitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan–Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition. Results: Among 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9–37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6–52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001). Conclusions: ART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help reduce ART attrition. PMID:28640661

Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti.

PubMed

Domercant, Jean Wysler; Puttkammer, Nancy; Young, Paul; Yuhas, Krista; François, Kesner; Grand'Pierre, Reynold; Lowrance, David; Adler, Michelle

2017-01-01

Access to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+. To assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti. Longitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan-Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition. Among 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9-37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6-52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001). ART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help reduce ART attrition.

The use of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes & chronic kidney disease

PubMed Central

Bittle, Polly A.

2017-01-01

Abstract: There is a need for treatment options in patients with type 2 diabetes mellitus and kidney disease to achieve glucose targets without risk of hypoglycemia. This article describes management options for these patients using glucose-lowering therapies, in particular dipeptidyl peptidase-4 inhibitors. PMID:28225432

Options for change in the NHS consultant contract.

PubMed

Clarke, R W; Gray, C

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.

Options for change in the NHS consultant contract.

PubMed Central

Clarke, R. W.; Gray, C.

1994-01-01

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers. PMID:8086915

42 CFR 23.23 - Who is eligible to receive a private practice option loan?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Who is eligible to receive a private practice option loan? 23.23 Section 23.23 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... § 23.23 Who is eligible to receive a private practice option loan? (a) Eligibility for loans is limited...

42 CFR 23.23 - Who is eligible to receive a private practice option loan?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Who is eligible to receive a private practice option loan? 23.23 Section 23.23 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... § 23.23 Who is eligible to receive a private practice option loan? (a) Eligibility for loans is limited...

42 CFR 23.23 - Who is eligible to receive a private practice option loan?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Who is eligible to receive a private practice option loan? 23.23 Section 23.23 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... § 23.23 Who is eligible to receive a private practice option loan? (a) Eligibility for loans is limited...

42 CFR 23.23 - Who is eligible to receive a private practice option loan?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Who is eligible to receive a private practice option loan? 23.23 Section 23.23 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... § 23.23 Who is eligible to receive a private practice option loan? (a) Eligibility for loans is limited...

42 CFR 23.23 - Who is eligible to receive a private practice option loan?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Who is eligible to receive a private practice option loan? 23.23 Section 23.23 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... § 23.23 Who is eligible to receive a private practice option loan? (a) Eligibility for loans is limited...

5 CFR 894.507 - After I'm enrolled, may I change from one dental or vision plan or plan option to another?

Code of Federal Regulations, 2013 CFR

2013-01-01

... dental or vision plan or plan option to another? 894.507 Section 894.507 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL... change from one dental or vision plan or plan option to another? (a) You may change from one dental and...

5 CFR 894.507 - After I'm enrolled, may I change from one dental or vision plan or plan option to another?

Code of Federal Regulations, 2014 CFR

2014-01-01

... dental or vision plan or plan option to another? 894.507 Section 894.507 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL... change from one dental or vision plan or plan option to another? (a) You may change from one dental and...

5 CFR 894.507 - After I'm enrolled, may I change from one dental or vision plan or plan option to another?

Code of Federal Regulations, 2012 CFR

2012-01-01

... dental or vision plan or plan option to another? 894.507 Section 894.507 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL... change from one dental or vision plan or plan option to another? (a) You may change from one dental and...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

42 CFR 482.57 - Condition of participation: Respiratory care services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Respiratory care... HOSPITALS Optional Hospital Services § 482.57 Condition of participation: Respiratory care services. The... following requirements apply if the hospital provides respiratory care service. (a) Standard: Organization...

NHS Dentistry: Options for Change in context--a personal overview of a landmark document and what it could mean for the future of dental services.

PubMed

Pitts, N B

2003-12-06

The aims of this paper are to provide an impartial overview of the proposals and agenda for the future brought together in the NHS Dentistry: Options for Change document in the context of previous dental service delivery in primary care, and to start to explore what Options for Change could mean for the future of NHS dental services. Options has been described as perhaps the most radical and ground breaking opportunity for NHS dentistry to finally move forward after prolonged periods of stagnation and disharmony. The Options agenda has the potential to bring in a new style of NHS practice for dentistry, providing a way to finally get off the current 'treadmill' and to develop new NHS dental services where prevention is a priority and providing high quality dental treatment, tailored to the long term needs of the 21st century patient, is the driving aim. However, the difficulties on all sides of leaving behind decades of disputes and overcoming real access, workforce and funding issues must not be underestimated or dismissed. The report was prepared by a working group comprising representatives from the profession, of patient groups and various sections of the Department of Health in England which was brought together by the then Chief Dental Officer. The key themes and priorities for action identified in Options include: local commissioning and funding, methods of remuneration for general dental practitioners, prevention and an oral health assessment for patients, clinical pathways, information and communication technology, practice structure, development of the dental team and the patient experience. The document also contains comprehensive reports of the three Options for Change task groups making recommendations for: 1) a new deal for patients - national standards, 2) systems of delivery of dental care and 3) education, training and development of the dental team. Ways forward for delivering improved, modern, effective, preventive, patient-centred dental care have been identified. This potential can, however, only be realised if viable and sustainable agreements can be achieved to operationalise the best choices.

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

ERIC Educational Resources Information Center

Coston, Caroline A., Ed.

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

Document Delivery: Evaluating the Options.

ERIC Educational Resources Information Center

Ward, Suzanne M.

1997-01-01

Discusses options available to libraries for document delivery. Topics include users' needs; cost; copyright compliance; traditional interlibrary loan; types of suppliers; selection criteria, including customer service; new developments in interlibrary loan, including outsourcing arrangements; and the need to evaluate suppliers. (LRW)

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2013-10-01 2013-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2012-10-01 2012-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2011-10-01 2011-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2010-10-01 2010-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2014-10-01 2014-10-01 false Optional disclosure of nonconfidential information...

Paratransit Integration Symposium Proceedings, October 14, 1977

DOT National Transportation Integrated Search

1978-06-01

Paratransit innovation is considered by DOT/UMTA to be an essential part of the provision of public transportation. A variety of service options, ranging from many-to-many dial-a-ride to subscription ridership, offer cost effective options to convent...

14 CFR 1215.101 - Scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (TDRSS) Use and Reimbursement Policy for Non-U.S. Government Users § 1215.101 Scope. This subpart sets forth the policy governing TDRSS services provided to non-U.S. government users and the reimbursement for rendering such services. It excludes TDRSS services provided as standard or optional services to...

How to buy a medical home? Policy options and practical questions.

PubMed

Berenson, Robert A; Rich, Eugene C

2010-06-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for "new" PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations.

How to Buy a Medical Home? Policy Options and Practical Questions

PubMed Central

Berenson, Robert A.

2010-01-01

In this paper, we describe a range of payment options to support the PCMH, identifying their conceptual strengths and weaknesses. These include enhanced FFS payment for office visits to the PCMH; paying additional FFS for “new” PCMH services; variations of traditional FFS combined with new PCMH-oriented per patient per month capitation; and combined capitation payments for traditional primary care medical services as well as new medical home services. In discussing options for PCMH payment reform we consider issues in patient severity adjustment, performance payment, and the role of payments to community service organizations to collaborate with the PCMH. We also highlight some of the practical challenges that can complicate reimbursement reform for primary care and the PCMH. Through this discussion we identify key dimensions to provider payment reform relevant to promoting enhanced primary care through the patient centered medical home. These consist of paying for the basic medical home services, rewarding excellent performance of medical homes, incentivizing medical home connections to other community health care resources, and overcoming implementation challenges to medical home payments. Each of these overarching policy issues invokes a substantial subset of policy relevant research questions that collectively comprise a robust research agenda. We conclude that the conceptual strengths and weaknesses of available payment models for medical home functions invoke a complex array of options with varying levels of real-world feasibility. The different needs of patients and communities, and varying characteristics of practices must also be factors guiding PCMH payment reform. Indeed, it may be that different circumstances will require different payment approaches in various combinations. PMID:20467911

Lung transplantation and interstitial lung disease.

PubMed

Alalawi, Raed; Whelan, Timothy; Bajwa, Ravinder S; Hodges, Tony N

2005-09-01

Interstitial lung disease includes a heterogeneous group of disorders that leads to respiratory insufficiency and death in a significant number of patients. Lung transplantation is a therapeutic option in select candidates. The indications, transplant procedure options, and outcomes continue to evolve. Various recipient comorbidities influence the choice of procedure in patients with interstitial lung disease. Single lung transplants are used as the procedure of choice and bilateral transplants are reserved for patients with suppurative lung disease and patients with pulmonary hypertension. Issues unique to patients with interstitial lung disease affect the morbidity, mortality and recurrence of the disease. Lung transplantation is an effective therapy for respiratory failure in interstitial lung disease with survival following transplant being similar to that achieved in transplant recipients with other diseases.

Options for basing Dietary Reference Intakes (DRIs) on chronic disease endpoints: report from a joint US-/Canadian-sponsored working group123

PubMed Central

Yetley, Elizabeth A; MacFarlane, Amanda J; Greene-Finestone, Linda S; Garza, Cutberto; Ard, Jamy D; Atkinson, Stephanie A; Bier, Dennis M; Carriquiry, Alicia L; Harlan, William R; Hattis, Dale; King, Janet C; Krewski, Daniel; O’Connor, Deborah L; Prentice, Ross L; Rodricks, Joseph V; Wells, George A

2017-01-01

Dietary Reference Intakes (DRIs) are used in Canada and the United States in planning and assessing diets of apparently healthy individuals and population groups. The approaches used to establish DRIs on the basis of classical nutrient deficiencies and/or toxicities have worked well. However, it has proved to be more challenging to base DRI values on chronic disease endpoints; deviations from the traditional framework were often required, and in some cases, DRI values were not established for intakes that affected chronic disease outcomes despite evidence that supported a relation. The increasing proportions of elderly citizens, the growing prevalence of chronic diseases, and the persistently high prevalence of overweight and obesity, which predispose to chronic disease, highlight the importance of understanding the impact of nutrition on chronic disease prevention and control. A multidisciplinary working group sponsored by the Canadian and US government DRI steering committees met from November 2014 to April 2016 to identify options for addressing key scientific challenges encountered in the use of chronic disease endpoints to establish reference values. The working group focused on 3 key questions: 1) What are the important evidentiary challenges for selecting and using chronic disease endpoints in future DRI reviews, 2) what intake-response models can future DRI committees consider when using chronic disease endpoints, and 3) what are the arguments for and against continuing to include chronic disease endpoints in future DRI reviews? This report outlines the range of options identified by the working group for answering these key questions, as well as the strengths and weaknesses of each option. PMID:27927637

The Cost of Universal Health Care in India: A Model Based Estimate

PubMed Central

Prinja, Shankar; Bahuguna, Pankaj; Pinto, Andrew D.; Sharma, Atul; Bharaj, Gursimer; Kumar, Vishal; Tripathy, Jaya Prasad; Kaur, Manmeet; Kumar, Rajesh

2012-01-01

Introduction As high out-of-pocket healthcare expenses pose heavy financial burden on the families, Government of India is considering a variety of financing and delivery options to universalize health care services. Hence, an estimate of the cost of delivering universal health care services is needed. Methods We developed a model to estimate recurrent and annual costs for providing health services through a mix of public and private providers in Chandigarh located in northern India. Necessary health services required to deliver good quality care were defined by the Indian Public Health Standards. National Sample Survey data was utilized to estimate disease burden. In addition, morbidity and treatment data was collected from two secondary and two tertiary care hospitals. The unit cost of treatment was estimated from the published literature. For diseases where data on treatment cost was not available, we collected data on standard treatment protocols and cost of care from local health providers. Results We estimate that the cost of universal health care delivery through the existing mix of public and private health institutions would be INR 1713 (USD 38, 95%CI USD 18–73) per person per annum in India. This cost would be 24% higher, if branded drugs are used. Extrapolation of these costs to entire country indicates that Indian government needs to spend 3.8% (2.1%–6.8%) of the GDP for universalizing health care services. Conclusion The cost of universal health care delivered through a combination of public and private providers is estimated to be INR 1713 per capita per year in India. Important issues such as delivery strategy for ensuring quality, reducing inequities in access, and managing the growth of health care demand need be explored. PMID:22299038

Nonmalignant Diseases and Treatments Associated with Primary Ovarian Failure: An Expanded Role for Fertility Preservation

PubMed Central

Hirshfeld-Cytron, Jennifer; Gracia, Clarisa

2011-01-01

Abstract Cancer treatments can be detrimental to fertility; recent literature has focused on the efforts of fertility preservation for this patient population. It should be recognized, however, that several nonmalignant medical conditions and therapeutic interventions could be similarly hazardous to fertility. Some of these nonmalignant diseases and their treatments that can adversely impact the reproductive axis are gastrointestinal diseases, rheumatologic disorders, nonmalignant hematologic conditions, neurologic disorders, renal disorders, gynecologic conditions, and metabolic diseases. Their negative effects on reproductive function are only now being appreciated and include impaired ovarian function, endocrine function, or sexual function and inability to carry a pregnancy to term. Complications and comorbidities associated with certain diseases may limit the success of established fertility preservation options. Recent advances in fertility preservation techniques may provide these patients with new options for childbearing. Here, we review several fertility-threatening conditions and treatments, describe current established and experimental fertility preservation options, and present three initiatives that may help minimize the adverse reproductive effects of these medical conditions and treatments by raising awareness of the issues and options: (1) increase awareness among practitioners about the reproductive consequences of specific diseases and treatments, (2) facilitate referral of patients to fertility-sparing or restorative programs, and (3) provide patient education about the risk of infertility at the time of diagnosis before initiation of treatment. PMID:21827325

Nonmalignant diseases and treatments associated with primary ovarian failure: an expanded role for fertility preservation.

PubMed

Hirshfeld-Cytron, Jennifer; Gracia, Clarisa; Woodruff, Teresa K

2011-10-01

Cancer treatments can be detrimental to fertility; recent literature has focused on the efforts of fertility preservation for this patient population. It should be recognized, however, that several nonmalignant medical conditions and therapeutic interventions could be similarly hazardous to fertility. Some of these nonmalignant diseases and their treatments that can adversely impact the reproductive axis are gastrointestinal diseases, rheumatologic disorders, nonmalignant hematologic conditions, neurologic disorders, renal disorders, gynecologic conditions, and metabolic diseases. Their negative effects on reproductive function are only now being appreciated and include impaired ovarian function, endocrine function, or sexual function and inability to carry a pregnancy to term. Complications and comorbidities associated with certain diseases may limit the success of established fertility preservation options. Recent advances in fertility preservation techniques may provide these patients with new options for childbearing. Here, we review several fertility-threatening conditions and treatments, describe current established and experimental fertility preservation options, and present three initiatives that may help minimize the adverse reproductive effects of these medical conditions and treatments by raising awareness of the issues and options: (1) increase awareness among practitioners about the reproductive consequences of specific diseases and treatments, (2) facilitate referral of patients to fertility-sparing or restorative programs, and (3) provide patient education about the risk of infertility at the time of diagnosis before initiation of treatment.

Re-Evaluating Progression in an Era of Progress: A Review of First- and Second-Line Treatment Options in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer.

PubMed

Castellanos, Emily H; Horn, Leora

2016-06-01

: The advent of crizotinib, the first small molecule inhibitor against anaplastic lymphoma kinase (ALK), has led to impressive advances in the care of patients with advanced ALK-rearranged non-small cell lung cancer. The development of second-generation ALK inhibitors, starting with the recent U.S. Food and Drug Administration approval of ceritinib, promises to expand the therapeutic landscape for this cohort of patients. With increasing use of molecularly targeted therapy options, it has been observed that disease progression in patients receiving targeted agents has a heterogeneous biology, manifesting as either oligoprogressive or widely progressive disease, which may require development of innovative treatment strategies. This review discusses the first- and second-generation ALK inhibitors approved or in clinical development, as well as the novel challenges and approaches to disease progression in patients on targeted agents. The identification of driver mutations in non-small cell lung cancer (NSCLC), most prominently epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), has expanded treatment options for a significant cohort of patients. However, the success of targeted agents has brought new challenges, particularly regarding management of progression. Progression manifests heterogeneously, and management of oligoprogression may differ from diffusely progressive disease. Multiple options for treatment at progression exist, and it is becoming evident that selecting the best avenue of care requires understanding the biology and potential drivers of disease progression. This review discusses the array of treatment options available for patients with ALK-positive NSCLC, as well as evaluation and treatment of progressive disease. ©AlphaMed Press.

Re-Evaluating Progression in an Era of Progress: A Review of First- and Second-Line Treatment Options in Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer

PubMed Central

Castellanos, Emily H.

2016-01-01

The advent of crizotinib, the first small molecule inhibitor against anaplastic lymphoma kinase (ALK), has led to impressive advances in the care of patients with advanced ALK-rearranged non-small cell lung cancer. The development of second-generation ALK inhibitors, starting with the recent U.S. Food and Drug Administration approval of ceritinib, promises to expand the therapeutic landscape for this cohort of patients. With increasing use of molecularly targeted therapy options, it has been observed that disease progression in patients receiving targeted agents has a heterogeneous biology, manifesting as either oligoprogressive or widely progressive disease, which may require development of innovative treatment strategies. This review discusses the first- and second-generation ALK inhibitors approved or in clinical development, as well as the novel challenges and approaches to disease progression in patients on targeted agents. Implications for Practice: The identification of driver mutations in non-small cell lung cancer (NSCLC), most prominently epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), has expanded treatment options for a significant cohort of patients. However, the success of targeted agents has brought new challenges, particularly regarding management of progression. Progression manifests heterogeneously, and management of oligoprogression may differ from diffusely progressive disease. Multiple options for treatment at progression exist, and it is becoming evident that selecting the best avenue of care requires understanding the biology and potential drivers of disease progression. This review discusses the array of treatment options available for patients with ALK-positive NSCLC, as well as evaluation and treatment of progressive disease. PMID:27053502

Modulation of Microglial Activity by Rho-Kinase (ROCK) Inhibition as Therapeutic Strategy in Parkinson's Disease and Amyotrophic Lateral Sclerosis.

PubMed

Roser, Anna-Elisa; Tönges, Lars; Lingor, Paul

2017-01-01

Neurodegenerative diseases are characterized by the progressive degeneration of neurons in the central and peripheral nervous system (CNS, PNS), resulting in a reduced innervation of target structures and a loss of function. A shared characteristic of many neurodegenerative diseases is the infiltration of microglial cells into affected brain regions. During early disease stages microglial cells often display a rather neuroprotective phenotype, but switch to a more pro-inflammatory neurotoxic phenotype in later stages of the disease, contributing to the neurodegeneration. Activation of the Rho kinase (ROCK) pathway appears to be instrumental for the modulation of the microglial phenotype: increased ROCK activity in microglia mediates mechanisms of the inflammatory response and is associated with improved motility, increased production of reactive oxygen species (ROS) and release of inflammatory cytokines. Recently, several studies suggested inhibition of ROCK signaling as a promising treatment option for neurodegenerative diseases. In this review article, we discuss the contribution of microglial activity and phenotype switch to the pathophysiology of Parkinson's disease (PD) and Amyotrophic lateral sclerosis (ALS), two devastating neurodegenerative diseases without disease-modifying treatment options. Furthermore, we describe how ROCK inhibition can influence the microglial phenotype in disease models and explore ROCK inhibition as a future treatment option for PD and ALS.

Expanding contraceptive options for PMTCT clients: a mixed methods implementation study in Cape Town, South Africa

PubMed Central

2014-01-01

Background Clients of prevention of mother-to-child transmission (PMTCT) services in South Africa who use contraception following childbirth rely primarily on short-acting methods like condoms, pills, and injectables, even when they desire no future pregnancies. Evidence is needed on strategies for expanding contraceptive options for postpartum PMTCT clients to include long-acting and permanent methods. Methods We examined the process of expanding contraceptive options in five health centers in Cape Town providing services to HIV-positive women. Maternal/child health service providers received training and coaching to strengthen contraceptive counseling for postpartum women, including PMTCT clients. Training and supplies were introduced to strengthen intrauterine device (IUD) services, and referral mechanisms for female sterilization were reinforced. We conducted interviews with separate samples of postpartum PMTCT clients (265 pre-intervention and 266 post-intervention) to assess knowledge and behaviors regarding postpartum contraception. The process of implementing the intervention was evaluated through systematic documentation and interpretation using an intervention tracking tool. In-depth interviews with providers who participated in study-sponsored training were conducted to assess their attitudes toward and experiences with promoting voluntary contraceptive services to HIV-positive clients. Results Following the intervention, 6% of interviewed PMTCT clients had the desired knowledge about the IUD and 23% had the desired knowledge about female sterilization. At both pre- and post-intervention, 7% of clients were sterilized and IUD use was negligible; by comparison, 75% of clients used injectables. Intervention tracking and in-depth interviews with providers revealed intervention shortcomings and health system constraints explaining the failure to produce intended effects. Conclusions The intervention failed to improve PMTCT clients’ knowledge about the IUD and sterilization or to increase use of those methods. To address the family planning needs of postpartum PMTCT clients in a way that is consistent with their fertility desires, services must expand the range of contraceptive options to include long-acting and permanent methods. In turn, to ensure consistent access to high quality family planning services that are effectively linked to HIV services, attention must also be focused on resolving underlying health system constraints weakening health service delivery more generally. PMID:24410922

Cost analysis of the Hemodialysis Reliable Outflow (HeRO) Graft compared to the tunneled dialysis catheter.

PubMed

Al Shakarchi, Julien; Inston, Nicholas; Jones, Robert G; Maclaine, Grant; Hollinworth, David

2016-04-01

In end-stage renal disease patients with central venous obstruction, who have limited vascular access options, the Hemodialysis Reliable Outflow (HeRO) Graft is a new alternative with a lower incidence of complications and longer effective device life compared to tunneled dialysis catheters (TDCs). We undertook an economic analysis of introducing the HeRO Graft in the UK. A 1-year cost-consequence decision analytic model was developed comparing management with the HeRO Graft to TDCs from the perspective of the National Health Service in England. The model comprises four 3-month cycles during which the vascular access option either remains functional for hemodialysis or fails, patients can experience access-related infection and device thrombosis, and they can also accrue associated costs. Clinical input data were sourced from published studies and unit cost data from National Health Service 2014-15 Reference Costs. In the base case, a 100-patient cohort managed with the HeRO Graft experienced 6 fewer failed devices, 53 fewer access-related infections, and 67 fewer device thromboses compared to patients managed with TDCs. Although the initial device and placement costs for the HeRO Graft are greater than those for TDCs, savings from the lower incidence of device complications and longer effective device patency reduces these costs. Overall net annual costs are £2600 for each HeRO Graft-managed patient compared to TDC-managed patients. If the National Health Service were to reimburse hemodialysis at a uniform rate regardless of the type of vascular access, net 1-year savings of £1200 per patient are estimated for individuals managed with the HeRO Graft. The base case results showed a marginal net positive cost associated with vascular access with the HeRO Graft compared with TDCs for the incremental clinical benefit of reductions in patency failures, device-related thrombosis, and access-related infection events in a patient population with limited options for dialysis vascular access. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study.

PubMed

Jones, Ray; Young, Kim; Munro, James; Miller, Heather; Brelsford, Stephanie; Aronsson, Jennie; Goodman, Benny; Peters, Jane

2017-10-01

Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments. To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum. Five case studies using mixed data collection methods. British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media. Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum. We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum. Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services. Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the nursing curriculum. Copyright © 2017 Elsevier Ltd. All rights reserved.

42 CFR 447.52 - Cost sharing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... State option, cost sharing imposed for any service (other than for drugs and non-emergency services... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

Circuit Riding: A Method for Providing Reference Services.

ERIC Educational Resources Information Center

Plunket, Linda; And Others

1983-01-01

Discussion of the design and implementation of the Circuit Rider Librarian Program, a shared services project for delivering reference services to eight hospitals in Maine, includes a cost analysis of services and description of user evaluation survey. Five references, composite results of the survey, and postgrant options proposal are appended.…

20 CFR 404.1210 - Optionally excluded services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 404.1210 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... selectively by coverage groups. They are: (a) Services in any class or classes of elective positions; (b) Services in any class or classes of part-time positions; (c) Services in any class or classes of positions...

42 CFR 436.222 - Individuals under age 21 who meet the income and resource requirements of AFDC.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options for Coverage as Categorically Needy Options for... nursing facility services are provided under the plan to individuals within the age group selected under...

47 CFR 32.5002 - Optional extended area revenue.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Optional extended area revenue. 32.5002 Section 32.5002 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5002...

Carbon tax and greenhouse gas control : options and considerations for Congress

DOT National Transportation Integrated Search

2009-02-23

This report prepared by the Congressional Research Service discusses the current policy tools available for use in bridging the gap between a carbon tax and a cap-and-trade program, implementation issues and options for revenue distribution.

Transdermal rivastigmine in the treatment of Alzheimer's disease: current and future directions.

PubMed

Amanatkar, Hamid Reza; Grossberg, George Thomas

2014-10-01

Despite the fact that the prevalence of Alzheimer's disease (AD) is exponentially increasing, we have not yet been able to develop a new treatment to modify the course of the disease. This vacuum makes the traditional cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonist the only accessible pharmacotherapy options for the treatment of this disease. Among these medications, the only available transdermal patch at this time is the rivastigmine patch. This patch provides significantly lower gastrointestinal adverse effects. A higher tolerability rate provides the option for physicians to continue treatment with higher doses of rivastigmine in advanced stages of AD. Moreover, ease of use, easy-to-follow schedule, less administration time spent by the caregiver result in greater adherent to the treatment. This article aims to provide a comprehensive drug profile for transdermal rivastigmine, to review currently available treatment options, and to try to anticipate future treatment directions for AD.

Kawasaki Disease: Etiopathogenesis and Novel Treatment Strategies

PubMed Central

Agarwal, Shreya; Agrawal, Devendra K.

2017-01-01

Introduction Kawasaki disease is an acute febrile systemic vasculitis that predominantly occurs in children below five years of age. Its etiopathogenesis is still not clear, but it is thought to be a complex interplay of genetic factors, infections and immunity. Areas covered This review article discusses in detail Kawasaki disease, with particular emphasis on the recent updates on its pathogenesis and upcoming alternate treatment options. Though self-limiting in many cases, it can lead to severe complications like coronary artery aneurysms and thrombo-embolic occlusions, and hence requires early diagnosis and urgent attention to avoid them. Intravenous immunoglobulin (IVIG) with or without aspirin has remained the sole treatment option for these cases, but 10-15% cases develop resistance to this treatment. Expert Commentary There is a need to develop additional treatment strategies for children with Kawasaki disease. Targeting different steps of pathogenesis could provide us with alternate therapeutic options. PMID:27590181

Financing reforms of public health services in China: lessons for other nations.

PubMed

Liu, Xingzhu; Mills, Anne

2002-06-01

Financing reforms of China's public health services are characterised by a reduction in government budgetary support and the introduction of charges. These reforms have changed the financing structure of public health institutions. Before the financing reforms, in 1980, government budgetary support covered the full costs of public health institutions, while after the reforms by the middle of the 1990s, the government's contribution to the institutions' revenue had fallen to 30-50%, barely covering the salaries of health workers, and the share of revenue generated from charges had increased to 50-70%. These market-oriented financing reforms improved the productivity of public health institutions, but several unintended consequences became evident. The economic incentives that were built into the financing system led to over-provision of unnecessary services, and under-provision of socially desirable services. User fees reduced the take-up of preventive services with positive externalities. The lack of government funds resulted in under-provision of services with public goods' characteristics. The Chinese experience has generated important lessons for other nations. Firstly, a decline in the role of government in financing public health services is likely to result in decreased overall efficiency of the health sector. Secondly, levying charges for public health services can reduce demand for these services and increase the risk of disease transmission. Thirdly, market-oriented financing reforms of public health services should not be considered as a policy option. Once this step is made, the unintended consequences may outweigh the intended ones. Chinese experience strongly suggests that the government should take a very active role in financing public health services.

Proposed DoD (Department of Defense) Internet Protocol Standard.

DTIC Science & Technology

1982-07-06

parameters fall into two categories: service quality parameters and service options. Service quality parameters influence the transmission service provided...Corporation 6 July 1982 -7- TM-7172/481/OO o Service Quality Parameters - Precedence : attempts preferential treatment for high importance datagrams...select the transmission quality. IP passes the type of service (TOS) command set for service quality to the SNP where it is mapped into subnetwork

42 CFR 441.590 - Increased Federal financial participation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

42 CFR 441.590 - Increased Federal financial participation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

Medicare: Comparison of Catastropic Health Insurance Proposals--an Update.

DTIC Science & Technology

1987-10-01

Accounting Office ICF intermediate care facility SNF skilled nursing facility VA Veterans Administration d4 ....... ’. - --- MEDICARE: COMPARISON OF...optional woe services, such as home and community-based services; services in an intermediate care facility (ICF); and prescribed drugs, dentures

[Preservation of ability to work and securing vocational participation : non-pharmaceutical support options for rheumatologists].

PubMed

Drambyan, Y; Parthier, K

2014-02-01

For patients of working age with chronic rheumatic diseases preservation of the ability to work and therefore for equal participation in professional life is of particular importance. Significant supporting actions by rheumatologists include non-pharmaceutical and non-medical interventions in addition to drug therapy. Measures aiming at sustained working capacity such as physiotherapy, occupational therapy, medical rehabilitation and stepwise return to work have to be utilized. This support can include referral to a counseling service and assistance with the application for medical or vocational rehabilitation programs. In order to ensure sustainable success of the initiated measures it is essential that follow-up care and function-related interventions are supervised by a rheumatologist.

Common Misconceptions About Service-Oriented Architecture

DTIC Science & Technology

2007-11-01

addition, the architect(s) must make decisions on how services are implemented. Service implementations may involve developing new software , wrapping a...legacy software system, incor- porating services provided by third par- ties, or a combination of these options. Information about the quality attrib...temperature. However, there 28 CROSSTALK The Journal of Defense Software Engineering November 2007 Common Misconceptions About Service -Oriented

Evidence-Based Medicine: Options for Dupuytren's Contracture: Incise, Excise, and Dissolve.

PubMed

Denkler, Keith A; Vaughn, Carolyn J; Dolan, Estelle L; Hansen, Scott L

2017-01-01

After studying this article, the participant should be able to: 1. Understand updates in the basic science, epidemiology, and treatment of Dupuytren's disease. 2. Understand treatment with needle aponeurotomy, collagenase, and fasciectomy. 3. Understand advanced needle techniques for Dupuytren's contracture. 4. Understand the safety and effectiveness of a new treatment, collagenase. The literature on Dupuytren's disease encompasses many specialties. Its treatment is generally by perforating, excising, or dissolving the affected tissues. This article reviews the changing understanding of this disease and treatment options.

Improving access to optometry services for people at risk of preventable sight loss: a qualitative study in five UK locations.

PubMed

Leamon, S; Hayden, C; Lee, H; Trudinger, D; Appelbee, E; Hurrell, D-L; Richardson, I

2014-12-01

Reducing preventable sight loss is an increasing priority for public health and health care providers. We examined the factors affecting people's use of optometry services in population groups at increased risk of sight loss. This is a qualitative study in five UK locations. In England, participants were from the Pakistani and Black Caribbean communities; in Scotland from the Pakistani community; and in Northern Ireland and Wales from white socio-economically deprived communities. Thirty-four focus groups were conducted (n = 289). The study included people who attend optometry services and people not engaged with services. Barriers to access included limited awareness of eye health and eye disease, concern about the cost of spectacles and the appropriateness of optometry in a commercial setting. Attendance at the optometrist was primarily symptom led. A positive previous experience or continuing relationship with the optometrist helped to alleviate the barriers and promote attendance. Addressing the disparity between the broader messages about eye health and the current perception of the function of optometry could help improve access to services. Uptake may be improved through the co-production of interventions that better resonate with local communities. Non-retail service delivery options should be explored. © The Author 2014, Published by Oxford University Press on behalf of Faculty of Public Health.

Recent surgical options for vestibular vertigo

PubMed Central

Volkenstein, Stefan; Dazert, Stefan

2017-01-01

Vertigo is not a well-defined disease but a symptom that can occur in heterogeneous entities diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine, and primary care physicians. Most vertigo syndromes have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe and discuss different surgical therapy options for hydropic inner ear diseases, Menière’s disease, dehiscence syndromes, perilymph fistulas, and benign paroxysmal positional vertigo. At the end, we shortly introduce the most recent developments in regard to vestibular implants. Surgical therapy is still indicated for vestibular disease in selected patients nowadays when conservative options did not reduce symptoms and patients are still suffering. Success depends on the correct diagnosis and choosing among different procedures the ones going along with an adequate patient selection. With regard to the invasiveness and the possible risks due to surgery, in depth individual counseling is absolutely necessary. Ablative and destructive surgical procedures usually achieve a successful vertigo control, but are associated with a high risk for hearing loss. Therefore, residual hearing has to be included in the decision making process for surgical therapy. PMID:29279721

7 CFR 1781.14 - Planning, options, and appraisals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Planning, options, and appraisals. 1781.14 Section 1781.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) RESOURCE CONSERVATION AND DEVELOPMENT (RCD) LOANS AND WATERSHED (WS...

7 CFR 1781.14 - Planning, options, and appraisals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Planning, options, and appraisals. 1781.14 Section 1781.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) RESOURCE CONSERVATION AND DEVELOPMENT (RCD) LOANS AND WATERSHED (WS...

7 CFR 1781.14 - Planning, options, and appraisals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Planning, options, and appraisals. 1781.14 Section 1781.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) RESOURCE CONSERVATION AND DEVELOPMENT (RCD) LOANS AND WATERSHED (WS...

7 CFR 1781.14 - Planning, options, and appraisals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Planning, options, and appraisals. 1781.14 Section 1781.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) RESOURCE CONSERVATION AND DEVELOPMENT (RCD) LOANS AND WATERSHED (WS...

Facilitated IEP Meetings. PHP-c90

ERIC Educational Resources Information Center

PACER Center, 2004

2004-01-01

To help special education planning teams reach agreements, the Minnesota Department of Education and the Minnesota Special Education Mediation Service (MNSEMS) provide the option of facilitated IEP meetings. This option is available for IEP (Individualized Education Program), IIIP (Individual Interagency Intervention Plan), and IFSP (Individual…

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

48 CFR 36.702 - Forms for use in contracting for architect-engineer services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contracting for architect-engineer services. 36.702 Section 36.702 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Standard and Optional Forms for Contracting for Construction, Architect-Engineer Services, and...

Calling for help. Using outside parties for equipment servicing.

PubMed

2011-03-01

You may be thinking about having your equipment servicing done by the device manufacturer, or contracting with an independent servicing organization. Each choice presents its own set of issues to consider. Here's what you need to know when weighing the options.

Injury and Compensation Claims Module Maintenance Manual

DTIC Science & Technology

1989-01-01

DUTY* 15. IF INTERRUPTED, SHOW DATES RESUMED HEALTH BENEFIT OPTIONAL INSURANCE 16. IF HEALTH BENEFITS 6oPTION HAS CHANGED FEHB NUMBER DATE 17. *Press...INCLUSIVE DATES OF COP, FROM: .......... TO: 24. HEALTH BENEFIT (HBS) CODE, IF ENROLLED 25. SHOW DATE THROUGH WHICH HBS LAST MADE 26. ATTENDING...TO INJURY? 24. DUTY AFFORDED 11 MONTHS WORK? 25. TOTAL LENGTH FEDERAL CIVIL SERVICE, YRS. MOS. HEALTH BENEFITS AND OPTIONAL LIFE INSURANCE 26

Opinion and Special Articles: Loan forgiveness options for young neurologists: Current landscape and practice implications.

PubMed

George, Benjamin P; Dorsey, E Ray; Grischkan, Justin A

2017-04-11

Increasing education debt has led to the availability of a variety of loan forgiveness options including the Department of Education's Public Service Loan Forgiveness (PSLF) program. This article discusses the current landscape of loan forgiveness options including trends in PSLF for rising neurology trainees, and implications for choices in specialization, employment, practice location, and the pursuit of an academic career. We further provide guidance on how to navigate the various loan forgiveness options that neurology residents and fellows may consider. © 2017 American Academy of Neurology.

Metastasis to the Glans Penis: An Unusual Site of Rectal Cancer Recurrence.

PubMed

Nunes, Beatriz; Matias, Margarida; Alves, António; Jorge, Marília

2015-01-01

Secondary malignancy of the penis is a rare clinical condition, often associated with disseminated genitourinary malignancies. The prognosis is poor and the treatment options include penectomy, local surgical excision, radiation therapy, chemotherapy and supportive therapy. Neither of these therapeutic options lead to superior treatment outcomes in the literature. The authors report the case of a 66 year-old man with a metastasis to the glans penis from a rectal adenocarcinoma, diagnosed two years after radical treatment for primary disease. The patient underwent palliative treatment with radiotherapy and chemotherapy, remaining asymptomatic and disease-free at one year follow-up. Close follow-up of patients with history of rectal adenocarcinoma is very important. Radiochemotherapy is a feasible and effective therapeutic option for penile metastasis, addressing both disease control and symptomatic improvement.

Knowledge of Advocacy Options within Services for People with Learning Disabilities

ERIC Educational Resources Information Center

Martins, Claudia Da Silva; Willner, Paul; Brown, Amanda; Jenkins, Rosemary

2011-01-01

Background: The aim of this study was to evaluate the extent to which care managers in learning disability services understand the role of the Independent Mental Capacity Advocate (IMCA) service, and the difference between the newly created statutory IMCA and existing general advocacy (GA) services. Method: There were 22 participants from three…

42 CFR 447.52 - Minimum and maximum income-related charges.

Code of Federal Regulations, 2013 CFR

2013-10-01

... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... option, cost sharing imposed for any service (other than for drugs and non-emergency services furnished... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

PubMed

Farrell, Alexander E; Corbett, James J; Winebrake, James J

2002-12-01

Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

Comparing the Life Cycle Energy Consumption, Global ...

EPA Pesticide Factsheets

Managing the water-energy-nutrient nexus for the built environment requires, in part, a full system analysis of energy consumption, global warming and eutrophication potentials of municipal water services. As an example, we evaluated the life cycle energy use, greenhouse gas (GHG) emissions and aqueous nutrient releases of the whole anthropogenic municipal water cycle starting from raw water extraction to wastewater treatment and reuse/discharge for five municipal water and wastewater systems. The assessed options included conventional centralized services and four alternative options following the principles of source-separation and water fit-for-purpose. The comparative life cycle assessment identified that centralized drinking water supply coupled with blackwater energy recovery and on-site greywater treatment and reuse was the most energyand carbon-efficient water service system evaluated, while the conventional (drinking water and sewerage) centralized system ranked as the most energy- and carbon-intensive system. The electricity generated from blackwater and food residuals co-digestion was estimated to offset at least 40% of life cycle energy consumption for water/waste services. The dry composting toilet option demonstrated the lowest life cycle eutrophication potential. The nutrients in wastewater effluent are the dominating contributors for the eutrophication potential for the assessed system configurations. Among the parameters for which variability

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association.

PubMed

Braun, Lynne T; Grady, Kathleen L; Kutner, Jean S; Adler, Eric; Berlinger, Nancy; Boss, Renee; Butler, Javed; Enguidanos, Susan; Friebert, Sarah; Gardner, Timothy J; Higgins, Phil; Holloway, Robert; Konig, Madeleine; Meier, Diane; Morrissey, Mary Beth; Quest, Tammie E; Wiegand, Debra L; Coombs-Lee, Barbara; Fitchett, George; Gupta, Charu; Roach, William H

2016-09-13

The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions. Palliative care, defined as patient- and family-centered care that optimizes health-related quality of life by anticipating, preventing, and treating suffering, should be integrated into the care of all patients with advanced cardiovascular disease and stroke early in the disease trajectory. Palliative care focuses on communication, shared decision making about treatment options, advance care planning, and attention to physical, emotional, spiritual, and psychological distress with inclusion of the patient's family and care system. Our policy recommendations address the following: reimbursement for comprehensive delivery of palliative care services for patients with advanced cardiovascular disease and stroke; strong payer-provider relationships that involve data sharing to identify patients in need of palliative care, identification of better care and payment models, and establishment of quality standards and outcome measurements; healthcare system policies for the provision of comprehensive palliative care services during hospitalization, including goals of care, treatment decisions, needs of family caregivers, and transition to other care settings; and health professional education in palliative care as part of licensure requirements. © 2016 American Heart Association, Inc.

Music Education Suites

ERIC Educational Resources Information Center

Kemp, Wayne

2009-01-01

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

Housing Options for Older Adults: A Guide for Making Housing Decisions

MedlinePlus

... from house sharing may have on eligibility for public benefits. ■ The effect of receiving Medicaid services on the ... facilities and whether the facility accepts individuals whose costs are paid by Medicaid. Benefits: Group housing options offer a wide range of ...

34 CFR 300.110 - Program options.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Program options. 300.110 Section 300.110 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

Insights in Public Health

PubMed Central

Donohoe Mather, Carolyn M; McGurk, Meghan D

2014-01-01

Over half of the adults in Hawai‘i are overweight or obese, exposing them to increased risk for chronic diseases and resulting in higher health care expenses. Poor dietary habits and physical inactivity are important contributors to obesity and overweight. Because adults spend most of their waking hours at work, the workplace is an important setting for interventions to solve this growing problem. Changing the nutrition environment to support healthy eating is a recommended practice for worksite wellness interventions. Following this recommendation, the Hawai‘i State Department of Health (DOH) launched the Choose Healthy Now! Healthy Vending Pilot Project to increase access to healthy options in worksites. Choose Healthy Now! utilized an education campaign and a traffic light nutrition coding system (green = go, yellow = slow, red = uh-oh), based on federal nutrition guidelines, to help employees identify the healthier options in their worksite snack shops. Inventory of healthy items was increased and product placement techniques were used to help make the healthy choice the easy choice. DOH partnered with the Department of Human Services' Ho‘opono Vending Program to pilot the project in six government buildings on O‘ahu between May and September of 2014. Vendors added new green (healthy) and yellow (intermediate) options to their snack shop and cafeteria inventories, and labeled their snacks and beverages with green and yellow point-of-decision stickers. The following article outlines background and preliminary findings from the Choose Healthy Now! pilot. PMID:25414808

JUVENILE SCLERODERMA-what has changed in the meantime?

PubMed

Adrovic, Amra; Sahin, Sezgin; Barut, Kenan; Kasapcopur, Ozgur

2018-04-22

Juvenile scleroderma is a rarely seen chronic connective tissue disorder characterized by stiffening of the skin. The frequency of the disease was reported as one per million. According to organ involvement, the disease is divided into two main forms: systemic and localized scleroderma. Since it is uncommon in children, many aspects of the disease remain discussable. With this review, we aimed to revise recent findings and new developments in this rare condition. Skin manifestations are most prominent feature of the systemic form, followed by musculoskeletal and vascular involvement. Cardiovascular, gastrointestinal and renal disorders are rare in childhood. Combination of disease modifying antirheumatic drugs (methotrexate, mycophenolate-mofetil, cyclosporine) and steroid reprents the first line therapy. Bosentan is used for cases with pulmonary hypertension and for extensive digital ulcerations. Biological treatment emerges as a useful treatment option in most severe form of the disease. Localized scleroderma is characterized with sclerodermatosis of the skin. Internal organ involvement is not expected. Classification of the local scleroderma is made according to the size and localization of the skin changes. There are few different therapeutical options but there is no specific therapy for the localized scleroderma. Many data regarding disease features and treatment options in juvenile scleroderma are based on studies among adults. There is a striking need for multicentric, prospective studies among children with juvenile scleroderma.Emerging biological agents and new treatment options are showing promising results. Anyhow, juvenile scleroderma remains a mystery with many aspects of the disease waiting to be solved. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

University Child Care Proposal.

ERIC Educational Resources Information Center

Eastern Michigan Univ., Ypsilanti.

Options for expanding child care services to Eastern Michigan University students, staff, and faculty are presented by the special assistant to the university vice president for university marketing and student affairs. The university's policy statement concerning child care services is considered, along with the relationship of these services to…

[Endometriosis Update 2016].

PubMed

Imesch, Patrick; Fink, Daniel

2016-03-02

Endometriosis is a common gynecologic benign disease, affecting 6–10% of women of reproductive age. The disease is often associated with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The exact mechanism of the pathogenesis of endometriosis has not yet been fully elucidated, therefore, current medical therapeutic options are more symptom-oriented than causal. The aim of the present work is to summarize the current diagnostic and therapeutic options.

A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

PubMed

Mohan, Vinuta; Lind, Robert

2016-01-01

Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

24 CFR 908.108 - Cost.

Code of Federal Regulations, 2010 CFR

2010-04-01

... computer hardware or software, or both, the cost of contracting for those services, or the cost of... operating budget. At the HA's option, the cost of the computer software may include service contracts to...

New Options for AV in Telecommunications

ERIC Educational Resources Information Center

Gelman, Morrie

1974-01-01

A discussion of MDS, a multi-point distribution service which is a recently evolved supplementary telecommunications service that suggests new possibilities for improving the reach, impact and effectiveness of audio-visual communications. (Author)

Gastroesophageal Reflux Management with the LINX® System for Gastroesophageal Reflux Disease Following Laparoscopic Sleeve Gastrectomy.

PubMed

Desart, Kenneth; Rossidis, Georgios; Michel, Michael; Lux, Tamara; Ben-David, Kfir

2015-10-01

Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy. This study was conducted at the University Medical Center. This is a retrospective review of seven consecutive patients who had a laparoscopic LINX® magnetic sphincter device placement for patients with refractory gastroesophageal reflux disease after laparoscopic sleeve gastrectomy between July 2014 and April 2015. All patients were noted to have self-reported greatly improved gastroesophageal reflux symptoms 2-4 weeks after their procedure. They were all noted to have statistically significant improved severity and frequency of their reflux, regurgitation, epigastric pain, sensation of fullness, dysphagia, and cough symptoms in their postoperative GERD symptoms compared with their preoperative evaluation. This is the first reported pilot case series, illustrating that the LINX® device is a safe and effective option in patients with de novo refractory gastroesophageal reflux disease after a laparoscopic sleeve gastrectomy despite appropriate weight loss.

[Prescription of temporal disability certificates in workers attending to IMSS from the perspective of health economy].

PubMed

Constantino-Casas, Patricia; del Pilar Torres-Arreola, Laura; Posadas-García, Jorge Luis; Nevárez-Sida, Armando; García-Contreras, Fernando

2007-01-01

The repercussion of health-disease state on social life or individual includes his/her work performance. In many countries, social security is one of the options for diffusing and buffering the impact of the disease. This paper is focused on the analysis of the unjustified prescription of temporary sick leave certificates (CITT), which combines the social security medical components and economic benefits (subsidies). The objective is to analyze the mechanism of prescription of CITT from the perspective of health economics and health care services. The detailed flow of CITT at the Mexican Institute of Social Security is described, as are some concepts of the health economics perspective that contribute to explain the prescription of CITT. Statistical data of sick leaves due to work-related and non-work-related diseases are presented from the institutional perspective. Finally, it is emphasized that although CITT are a medical prescription, it is advisable to take into account the economic perspective and its concepts in order to achieve an efficient use of resources.

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study

PubMed Central

Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-01-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes. PMID:28207061

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

PubMed

Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-03-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

Screening for coronary heart disease risk factors in retail pharmacies in Sheffield, 1992.

PubMed Central

Allison, C; Page, H; George, S

1994-01-01

OBJECTIVE--To investigate the current and likely future provision of screening services for risk factors for coronary heart disease in retail pharmacies in Sheffield. DESIGN--This was a questionnaire survey asking about screening tests currently offered, price charged per test, likely future provision of screening tests, the action respondents would take upon finding an abnormal test result, whether the pharmacy was owner-run, franchised, or part of a commercial chain, and inviting open comments from respondents. SETTING--All retail pharmacy premises on the Sheffield Family Health Services Authority list. RESULTS--Seventy seven responses were obtained to 102 questionnaires distributed. Only nine of these currently offered any screening test other than pregnancy testing, although 37 indicated that they might offer tests in the future. Thirty nine were not offering screening and had no plans to do so. Pharmacies offering or likely to offer screening tests were mainly owner-run. All pharmacists who replied to the question asking about their action upon finding abnormal result (33) reported that they would advise the patient to see a doctor. The most frequent comments made by pharmacists were about the commercial viability of screening in pharmacies and the lack of space available to ensure patient privacy and confidentiality during screening. CONCLUSIONS--Screening in retail pharmacies would probably be a commercial failure unless doctors were able to contract for screening services from pharmacies. Evidence from this study and others, however, leads us to question the desirability of this option. PMID:8189175

Entrepreneurship Education. OPTIONS. Expanding Educational Services for Adults.

ERIC Educational Resources Information Center

Belcher, James O.; Warmbrod, Catharine P.

This monograph is part of OPTIONS, a packaged set of materials developed to provide postsecondary administrators, program planners, curriculum developers, counselors, and instructors with up-to-date, reliable information. This volume and two other monographs are intended to enable counselors and instructors to establish and conduct special…

Distance Travelled: Outcomes and Evidence in Flexible Learning Options

ERIC Educational Resources Information Center

Thomas, Joseph; McGinty, Sue; te Riele, Kitty; Wilson, Kimberley

2017-01-01

Flexible learning options (FLOs) provide individualised learning pathways for disengaged young people with strong emphasis on inclusivity and wellbeing support. Amidst a rapid expansion of Australia's flexible learning sector, service providers are under increasing pressure to substantiate participant outcomes. This paper stems from a national…

Placement of Students with Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Mathur, Sarup R.; Jolivette, Kristine

2012-01-01

Students with emotional and behavioral disorders (E/BD) receive educational and related services within a continuum of placement options per the Individual with Disabilities Education Act. The continuum of placement options ranges from fully included general education type classrooms to more restrictive environments such as alternative education…

Assessing Sustainability of Coral Reef Ecosystem Services using a Spatially-Explicit Decision Support Tool

EPA Science Inventory

Forecasting and communicating the potential outcomes of decision options requires support tools that aid in evaluating alternative scenarios in a user-friendly context and that highlight variables relevant to the decision options and valuable stakeholders. Envision is a GIS-base...

Facilitated IEP Meetings. PACER Center ACTion Information Sheets: PHP-c90

ERIC Educational Resources Information Center

PACER Center, 2014

2014-01-01

To help special education planning teams reach agreements, the Minnesota Department of Education, Compliance and Assistance, Alternative Dispute Resolution Services provide the option of facilitated IEP (Individualized Education Program) meetings. This option is available for IEP, IIIP (Individual Interagency Intervention Plan), and IFSP…

MedlinePlus Connect: Technical Information

MedlinePlus

... Service Technical Information Page MedlinePlus Connect Implementation Options Web Application How does it work? Responds to requests ... examples of MedlinePlus Connect Web Application response pages. Web Service How does it work? Responds to requests ...

Treatment Option Overview (Childhood Rhabdomyosarcoma)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options for Childhood Craniopharyngioma

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options for Wilms Tumor

MedlinePlus

... to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Option Overview (Kaposi Sarcoma)

MedlinePlus

... to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Option Overview (Vulvar Cancer)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Option Overview (Bladder Cancer)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options for Childhood Rhabdomyosarcoma

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options by Stage (Melanoma)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options for Kaposi Sarcoma

MedlinePlus

... to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

The business concept of leader pricing as applied to heart failure disease management.

PubMed

Hauptman, Paul J; Bednarek, Heather L

2004-01-01

The implementation of a disease management approach for patients with heart failure has been promoted as a way to improve outcomes, including a decrease in hospitalizations. However, in the absence of rigorous cost analyses and with revenues limited by professional fees, heart failure disease management programs may appear to operate at a loss. The literature outlining the importance of disease management for patients with heart failure is summarized. We review the limitations of current cost analyses and outline the economic concepts of leader pricing, vertical integration and transaction costs to argue that heart failure disease management programs may provide significant "downstream" revenue for an integrated system of health care delivery in a fee-for-service payment structure, while reducing overall costs of care. Pilot data from a university-based program are used in support of this argument. In addition, the favorable impact on patient satisfaction and loyalty can enhance market share, a vital consideration for all health systems. Options for improving the reputation of heart failure disease management within a health system are suggested. Viewed as a loss leader, disease management provides not only quality care for patients with heart failure but also appears to provide financial benefits to the health system that funds the infrastructure and administration of the program. The actual magnitude of this benefit and the degree to which it mitigates overall administration costs requires further study.

Governance Options to Enhance Ecosystem Services in Cocoa, Soy, Tropical Timber and Palm Oil Value Chains.

PubMed

Ingram, Verina; van den Berg, Jolanda; van Oorschot, Mark; Arets, Eric; Judge, Lucas

2018-02-06

Dutch policies have advocated sustainable commodity value chains, which have implications for the landscapes from which these commodities originate. This study examines governance and policy options for sustainability in terms of how ecosystem services are addressed in cocoa, soy, tropical timber and palm oil value chains with Dutch links. A range of policies addressing ecosystem services were identified, from market governance (certification, payments for ecosystem services) to multi-actor platforms (roundtables) and public governance (policies and regulations). An analysis of policy narratives and interviews identified if and how ecosystem services are addressed within value chains and policies; how the concept has been incorporated into value chain governance; and which governance options are available. The Dutch government was found to take a steering but indirect role in all the cases, primarily through supporting, financing, facilitating and partnering policies. Interventions mainly from end-of-chain stakeholders located in processing and consumption countries resulted in new market governance, notably voluntary sustainability standards. These have been successful in creating awareness of some ecosystem services and bringing stakeholders together. However, they have not fully addressed all ecosystem services or stakeholders, thus failing to increase the sustainability of value chains or of the landscapes of origin. We argue that chains sourced in tropical landscapes may be governed more effectively for sustainability if voluntary, market policy tools and governance arrangements have more integrated goals that take account of sourcing landscapes and impacts along the entire value chain. Given the international nature of these commodities. These findings have significance for debates on public-private approaches to value chain and landscape governance.

42 CFR 441.482 - Permissible purchases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Permissible purchases. 441.482 Section 441.482... Optional Self-Directed Personal Assistance Services Program § 441.482 Permissible purchases. (a... assistance. (b) The services, supports and items that are purchased with a service budget must be linked to...

76 FR 80903 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... Enhanced Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department...

78 FR 78342 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... (the Department) Enhanced Access to Autism Services Demonstration Project (Autism Demonstration) under the Extended Care Health Option (ECHO) for beneficiaries diagnosed with an Autism Spectrum Disorder...

Protecting our life support systems: US federal research and policy on ecosystem services

EPA Science Inventory

In the United States, a broad range of federal entities are conducting research related to ecosystem services, and government agencies at all levels are increasingly interested in measuring the outcomes of proposed policy options in terms of ecosystem service benefits. However, ...

78 FR 40060 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... identified in this AD, Boeing Commercial Airplanes, Attention: Data & Services Management, P.O. Box 3707, MC... Attention Service Bulletin 777-78-0064, Revision 1, dated November 30, 2006. That AD requires repetitive... flight operation, on airplanes on which the optional terminating action (Boeing Special Attention Service...

Outsourcing in Higher Education. ERIC Digest.

ERIC Educational Resources Information Center

Wood, Patricia A.

Higher education has increasingly turned to outsourcing to improve service in the face of declining resources. Outsourcing has traditionally been used to operate campus bookstores and dining services and has more recently become a legitimate option for additional campus functions, such as facilities operation, computer services, security, child…

45 CFR 1306.30 - Provisions of comprehensive child development services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

45 CFR 1306.30 - Provisions of comprehensive child development services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

45 CFR 1306.30 - Provisions of comprehensive child development services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

45 CFR 1306.30 - Provisions of comprehensive child development services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Provisions of comprehensive child development... Start Program Options § 1306.30 Provisions of comprehensive child development services. (a) All Head Start grantees must provide comprehensive child development services, as defined in the Head Start...

77 FR 18707 - USPS Package Intercept-New Product Offerings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... service that replaced the former recall of mail process. Plans were announced to implement new features.... Additionally, customers using the electronic process will have the option of adding selected extra services to... POSTAL SERVICE 39 CFR Part 111 USPS Package Intercept--New Product Offerings AGENCY: Postal...

Schools and Programs in Canada: Programs and Services Chart.

ERIC Educational Resources Information Center

American Annals of the Deaf, 2003

2003-01-01

This chart provides detailed information on the programs and services provided by Canadian schools for preschool, elementary, and secondary children who are deaf or hard of hearing. Schools are listed by province and information is provided on enrollment, age range, educational services, and communication options. (CR)

Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease.

PubMed

Ahmed, Kamran A; Torres-Roca, Javier F

2016-01-01

The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is now a primary management option for patients with oligometastatic disease. The properties of SBRT are summarized and the results of retrospective and prospective studies of SBRT use in the management of oligometastases are reviewed. Future directions of SBRT, including optimizing dose and fractionation schedules, are also discussed. SBRT can deliver highly conformal, dosed radiation treatments for ablative tumors in a few treatment sessions. Phase 1/2 trials and retrospective institutional results support use of SBRT as a treatment option for oligometastatic disease metastasized to the lung, liver, and spine, and SBRT offers adequate toxicity profiles with good rates of local control. Future directions will involve optimizing dose and fractionation schedules for select histologies to improve rates of local control while limiting toxicity to normal structures. SBRT offers an excellent management option for patients with oligometastases. However, additional research is still needed to optimize dose and fractionation schedules.

Cost, energy, global warming, eutrophication and local human health impacts of community water and sanitation service options.

PubMed

Schoen, Mary E; Xue, Xiaobo; Wood, Alison; Hawkins, Troy R; Garland, Jay; Ashbolt, Nicholas J

2017-02-01

We compared water and sanitation system options for a coastal community across selected sustainability metrics, including environmental impact (i.e., life cycle eutrophication potential, energy consumption, and global warming potential), equivalent annual cost, and local human health impact. We computed normalized metric scores, which we used to discuss the options' strengths and weaknesses, and conducted sensitivity analysis of the scores to changes in variable and uncertain input parameters. The alternative systems, which combined centralized drinking water with sanitation services based on the concepts of energy and nutrient recovery as well as on-site water reuse, had reduced environmental and local human health impacts and costs than the conventional, centralized option. Of the selected sustainability metrics, the greatest advantages of the alternative community water systems (compared to the conventional system) were in terms of local human health impact and eutrophication potential, despite large, outstanding uncertainties. Of the alternative options, the systems with on-site water reuse and energy recovery technologies had the least local human health impact; however, the cost of these options was highly variable and the energy consumption was comparable to on-site alternatives without water reuse or energy recovery, due to on-site reuse treatment. Future work should aim to reduce the uncertainty in the energy recovery process and explore the health risks associated with less costly, on-site water treatment options. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stricturoplasty-a bowel-sparing option for long segment small bowel Crohn's disease.

PubMed

Limmer, Alexandra M; Koh, Hoey C; Gilmore, Andrew

2017-08-01

Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures.

Prevalence and treatment of depression in Parkinson's disease.

PubMed

Veazey, Connie; Aki, Sahinde Ozlem Erden; Cook, Karon F; Lai, Eugene C; Kunik, Mark E

2005-01-01

Parkinson's disease (PD) is a progressive neurological condition with debilitating symptoms, and depression is a common comorbid condition of this disease. The authors review existing literature on the prevalence and treatment of depression in PD. Prevalence estimates of depression vary widely, ranging from 7%-76%. This variation is due to inconsistent methodology. Treatment options for depression in PD include medication therapy, electroconvulsive therapy (ECT), and psychotherapy. There are few randomized controlled trials of these treatment options. The authors argue for more systematic and controlled research examining both the prevalence and treatment of depression in PD.

Commercial aviation : programs and options for providing air service to small communities : testimony before the Subcommittee on Aviation, Committee on Transportation and Infrastructure, U.S. House of Representatives

DOT National Transportation Integrated Search

2007-04-25

Congress established two key programs to help support air service to small communities the Essential Air Service (EAS) providing about $100 million in subsidies per year and the Small Community Air Service Development Program (SCASDP) that provide...

Security Services Discovery by ATM Endsystems

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

Sholander, Peter; Tarman, Thomas

This contribution proposes strawman techniques for Security Service Discovery by ATM endsystems in ATM networks. Candidate techniques include ILMI extensions, ANS extensions and new ATM anycast addresses. Another option is a new protocol based on an IETF service discovery protocol, such as Service Location Protocol (SLP). Finally, this contribution provides strawman requirements for Security-Based Routing in ATM networks.

34 CFR 303.211 - State option to make services under this part available to children ages three and older.

Code of Federal Regulations, 2013 CFR

2013-07-01

... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...

34 CFR 303.211 - State option to make services under this part available to children ages three and older.

Code of Federal Regulations, 2014 CFR

2014-07-01

... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...

34 CFR 303.211 - State option to make services under this part available to children ages three and older.

Code of Federal Regulations, 2012 CFR

2012-07-01

... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...

The Market for Community Services for Older People.

ERIC Educational Resources Information Center

Hereford, Russell W.

The Supportive Services Program for Older Persons is designed to demonstrate that a private market for home and community-based health related services can be developed in response to the demand expressed by older people and their families. The objective of the program is to expand the service options available to older people by letting market…

['Pharmacologic interventions in drug addiction': an advisory report from the Health Council of the Netherlands].

PubMed

Goppel, M A; van den Brink, W; van Ree, J M

2003-08-23

Addiction is a relapsing brain disease with a tendency towards chronicity. Biological, psychological and socio-cultural factors play a role in the onset and course of this disease. The Health Council of the Netherlands has issued a report on pharmacotherapeutic interventions. The treatment of addiction should be regarded as a medical intervention. A growing number of effective pharmacotherapies are becoming available for the treatment of heroin addiction, although not all of those are available in the Netherlands. Currently, no effective pharmacotherapies are available for the treatment of cocaine addiction. In polydrug addicts, pharmacotherapeutic interventions should be directed at the various separate addictions. In the majority of cases pharmacotherapy is part of an integrated treatment approach in which supportive psychosocial interventions are also important. The long-term continuation of treatment is usually indicated. The Health Council recommends that addiction physicians be put in charge of the multidisciplinary treatment. Medical schools should pay attention to the practical aspects of the treatment and management of addicts. The organisation and workforce of addiction treatment services should comply with the demands that are placed upon healthcare services. Public information campaigns about addiction and the treatment options for addicts can contribute to the destigmatisation of this patient category.

Behavioral Interventions for Enhancing Life Participation in behavioral variant Frontotemporal Dementia and Primary Progressive Aphasia

PubMed Central

Kortte, Kathleen B.; Rogalski, Emily J.

2013-01-01

Primary progressive aphasia (PPA) and behavioral-variant frontotemporal dementia (bvFTD) are clinical syndromes under the umbrella term “frontotemporal dementia (FTD)” and are caused by a neurodegenerative disease with an onset most typically in the productive years of adulthood. The cognitive and behavioral impairments associated with FTD interfere with the successful engagement in typical life roles, such as parenting, working, and maintenance of interpersonal relationships. There are currently no treatments to stop or slow the degenerative process and there are only very limited medication options for the management of the cognitive-behavioral symptoms. However, alternative, non-pharmacological interventions may offer significant benefit to the quality of life of the diagnosed individual. The goal of this paper is to provide an overview of the approaches available through neurorehabilitation and community-based services that facilitate successful engagement in life activities and promote optimal quality of life for the individuals and families living with FTD. It is hoped that as medical providers become more familiar with behavioral interventions, referrals for services will increase thereby allowing individuals with FTD and their caregivers to learn ways to adapt, adjust, and participate in life to the fullest despite the impairments from this progressive disease. PMID:23611353

Hematopoietic stem cell transplantation for myelofibrosis: where are we now?

PubMed

Fleischman, Angela G; Maziarz, Richard T

2013-03-01

A succinct yet comprehensive review of the biology of myeloproliferative neoplasms and therapeutic options with a focus on rational decision making for hematopoietic stem cell transplantation. The introduction of Janus kinase inhibitors for myelofibrosis have ushered in a new era for treatment of constitutional symptoms and splenomegaly in myelofibrosis, but the effect of these agents on the natural history of the disease has yet to be clearly defined. Reduced intensity transplants have emerged as the preferred option with recent evidence suggesting fludarabine and melphalan as the optimal conditioning regimen. Myelofibrosis is a rare hematologic malignancy with limited curative therapeutic options. Significant advances in our understanding of disease pathogenesis have led to new targets and new therapeutic options are forthcoming. Hematopoietic stem cell transplantation is at present the only treatment with curative intent; however, the selection of patients who are likely to be best served by this procedure is difficult. As myelofibrosis is an extremely rare disease, randomized clinical trials specifically investigating the role of transplantation in myelofibrosis are unlikely to occur, thus current decision making processes are best guided by retrospective analyses from registry databases and single institution experiences.

Customer concerns regarding satellite servicing

NASA Technical Reports Server (NTRS)

Rysavy, Gordon

1987-01-01

The organization of orbital servicing of satellites is discussed. Provision of servicing equipment; design interfaces between the satellite and the servicing equipment; and the economic viability of the concept are discussed. The proposed solution for satisfying customer concerns is for the servicing organizations to baseline an adequate inventory of servicing equipment with standard interfaces and established servicing costs. With this knowledge, the customer can conduct tradeoff studies and make programmatic decisions regarding servicing options. A dialog procedure between customers and servicing specialists is outlined.

Poverty and stroke in India: a time to act.

PubMed

Pandian, Jeyaraj D; Srikanth, Velandai; Read, Stephen J; Thrift, Amanda G

2007-11-01

In developed countries, the predominant health problems are those lifestyle-related illnesses associated with increased wealth. In contrast, diseases occurring in developing countries can largely be attributed to poverty, poor healthcare infrastructure, and limited access to care. However, many developing countries such as India have undergone economic and demographic growth in recent years resulting in a transition from diseases caused by poverty toward chronic, noncommunicable, lifestyle-related diseases. Despite this recent rapid economic growth, a large proportion of the Indian population lives in poverty. Although risk factors for stroke in urban Indian populations are similar to developed nations, it is likely that they may be quite different among those afflicted by poverty. Furthermore, treatment options for stroke are fewer in developing countries like India. Well-organized stroke services and emergency transport services are lacking, many treatments are unaffordable, and sociocultural factors may influence access to medical care for many stroke victims. Most stroke centers are currently in the private sector and establishing such centers in the public sector will require enormous capital investment. Given the limited resources available for hospital treatments, it would be logical to place a greater emphasis on effective populationwide interventions to control or reduce exposure to leading stroke risk factors. There also needs to be a concerted effort to ensure access to stroke care programs that are tailored to suit Indian communities and are accessible to the large majority of the population, namely the poor.

[Information needs of the health and diseases in users of healthcare services in Primary Care at Salamanca, Spain].

PubMed

Bernad Vallés, Mercedes; Maderuelo Fernández, José Ángel; Moreno González, Pilar

2016-01-01

To learn, interpret and understand the information needs of health and disease in users of the healthcare services of the urban Primary Care of Salamanca. Qualitative research corresponding an exploratory qualitative/structural perspective. Primary Care. Urban area, Salamanca in 2007. Ten discussion groups, 2 composed of members of health-related associations and 8 primary care users, involved a total of 83 people. The structural variables considered are: gender, age, educational level and membership or not associations. Generate information to achieve information saturation in the discussion groups. Upon obtaining their informed consent, all subjects in the study participated in videotaped conversations, which were transcribed verbatim. Four researchers categorized the content, intentionality of discourse and developed the concept map. After categorization, triangulation and coding, content obtained was analysed with the NudistQ6 program. Informative content suggest four information needs: health and prevention, early diagnosis, first aid and disease. Different intentions (information needs, watching, claim and improvement) and needs profiles are detected as structural variables. Major information needs are relate to diagnosis, prognosis and therapeutic options. There is agreement between the groups that the information transmitted to the patient must be intelligible, updated and coordinated among the different professionals and care levels. Participants require information of a clinical nature to exercise their right to autonomy translating tendency to empower users as part of the social change. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

78 FR 19100 - Noncompensatory Partnership Options

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [TD 9612] RIN 1545-BA53 Noncompensatory Partnership Options Correction In rule document 2013-2259 appearing on pages 7997-8016 in the issue of Tuesday, February 5, 2013, make the following correction: Sec. 1.704-1 [Corrected] In Sec. 1...

Modeling Incorrect Responses to Multiple-Choice Items with Multilinear Formula Score Theory.

ERIC Educational Resources Information Center

Drasgow, Fritz; And Others

This paper addresses the information revealed in incorrect option selection on multiple choice items. Multilinear Formula Scoring (MFS), a theory providing methods for solving psychological measurement problems of long standing, is first used to estimate option characteristic curves for the Armed Services Vocational Aptitude Battery Arithmetic…

Work and Family Resource Kit.

ERIC Educational Resources Information Center

Women's Bureau (DOL), Washington, DC.

This kit is designed to help employers understand the range of family needs emerging in the workplace and the numerous options for a company response. An introduction discusses the need for child care services, dependent care problems, and how employers respond and benefit. Sections address the following: selecting the right option in relation to…

Solar Energy Innovation Network | Solar Research | NREL

Science.gov Websites

Coordinated Control Algorithms for Distributed Battery Energy Storage Systems to Provide Grid Support Services local governments, nonprofits, innovative companies, and system operators-with analytical support from a Affordability of Renewable Energy through Options Analysis and Systems Design (or "Options Analysis"

The Traveler's Guide to E-mail Access.

ERIC Educational Resources Information Center

Clyde, Anne

1999-01-01

Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)

Students with Intellectual Disability in Higher Education: Adult Service Provider Perspectives

ERIC Educational Resources Information Center

Sheppard-Jones, Kathleen; Kleinert, Harold Lawrence; Druckemiller, Wendy; Ray, Megan Kovacevich

2015-01-01

Postsecondary education (PSE) is increasingly becoming an option for students with intellectual disability (ID; Grigal & Hart, 2012). Postsecondary education offers the promise of pursuing a valued social role (that of college student), enhanced social networks, and, most significantly, increased employment options. To date, research and…

Prognostication: Do the Services See the Same Future of Warfare?

DTIC Science & Technology

2008-05-01

conduct of war, warfare. 24 Dana Johnson, Scott Pace, C. Bryan Gabbard , Space: Emerging Options for National Power, (RAND, 1998), 10. 25 Creveld, 145...Bryan Gabbard . Space: Emerging Options for National Power, RAND http://www.rand.org/pubs/monograph_reports/MR517/, 1998. (Accessed 5 January 2008

77 FR 14321 - Modifications to Minimum Present Value Requirements for Partial Annuity Distribution Options...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-110980-10] RIN 1545-BJ55 Modifications to Minimum Present Value Requirements for Partial Annuity Distribution Options Under Defined... FR 5454), providing guidance relating to the minimum present value requirements applicable to certain...

75 FR 15757 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-61716; File No. SR-CBOE-2010-008] Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a Proposed Rule Change Relating to Co- location Service Fees March 16, 2010. Correction In notice document 2010-6184...

Expanding Educational Services for Adults. OPTIONS. Publicity Kit.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This publicity kit is intended to provide adult educators with materials for promoting and recruiting students into an adult education program designed according to the OPTIONS model (i.e., programs geared toward teaching the literacy, technical, and entrepreneurship skills that are necessary to adapt to changing labor market conditions resulting…

75 FR 8927 - Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended Care Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...

41 CFR 302-15.8 - When my agency authorizes payment for me under this part, am I obligated to use such services, or...

Code of Federal Regulations, 2010 CFR

2010-07-01

... management services allowance. You have the option of choosing to sell your residence at Government expense...-ALLOWANCE FOR PROPERTY MANAGEMENT SERVICES General Rules for the Employee § 302-15.8 When my agency...

77 FR 69903 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

..., a Participant may also elect to have CBOE perform certain additional marketing services on its behalf. These services consist of including the Participant's functionality in the general marketing activities of CBOE's marketing staff. CBOE permits a Participant electing to have CBOE perform these services...

7 CFR 1951.711 - Servicing options in lieu of liquidation or legal action to collect.

Code of Federal Regulations, 2010 CFR

2010-01-01

... COLLECTIONS Servicing Cases Where Unauthorized Loan(s) or Other Financial Assistance Was Received-Community... financial capabilities, the case will be serviced according to one of the following, as appropriate. (1... the present market interest rate, whichever is greater, for the respective Community and Business...

National transportation system : options and analytical tools to strengthen DOT's approach to supporting communities' access to the system.

DOT National Transportation Integrated Search

2009-07-01

Since 1978, the Essential Air : Service (EAS) program has : subsidized air service to eligible : communities that would otherwise : not have scheduled service. The : cost of this program has risen as : the number of communities being : served and sub...

48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options. 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options. 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

48 CFR 3017.204-90 - Detention Facilities and Services (ICE).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Detention Facilities and Services (ICE). 3017.204-90 Section 3017.204-90 Federal Acquisition Regulations System DEPARTMENT OF... SPECIAL CONTRACTING METHODS Options 3017.204-90 Detention Facilities and Services (ICE). The ICE Head of...

42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...

42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...

42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...

42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...

Schools and Programs in the U.S.: Programs and Services Chart.

ERIC Educational Resources Information Center

American Annals of the Deaf, 2003

2003-01-01

This chart provides detailed information on the programs and services provided by U.S. schools for preschool, elementary, and secondary children who are deaf or hard of hearing. Schools are listed by state and information is provided on enrollment, age range, educational services, and communication options. (CR)

Fuzzy usage pattern in customizing public transport fleet and its maintenance options

NASA Astrophysics Data System (ADS)

Husniah, H.; Herdiani, L.; Kusmaya; Supriatna, A. K.

2018-05-01

In this paper we study a two-dimensional maintenance contract for a fleet of public transport, such as buses, shuttle etc. The buses are sold with a two-dimensional warranty. The warranty and the maintenance contract are characterized by two parameters – age and usage – which define a two-dimensional region. However, we use one dimensional approach to model these age and usage of the buses. The under-laying maintenance service contracts is the one which offers policy limit cost to protect a service provider (an agent) from over claim and to pursue the owner to do maintenance under specified cost in house. This in turn gives benefit for both the owner of the buses and the agent of service contract. The decision problem for an agent is to determine the optimal price for each option offered, and for the owner is to select the best contract option. We use a Nash game theory formulation in order to obtain a win-win solution – i.e. the optimal price for the agent and the optimal option for the owner. We further assume that there will be three different usage pattern of the buses, i.e. low, medium, and high pattern of the usage rate. In many situations it is often that we face a blur boundary between the adjacent patterns. In this paper we look for the optimal price for the agent and the optimal option for the owner, which minimizes the expected total cost while considering the fuzziness of the usage rate pattern.

Conventional Prompt Global Strike and Long-Range Ballistic Missiles: Background and Issues

DTIC Science & Technology

2012-07-06

Missiles Congressional Research Service Forward-Based Global Strike ( FBGS ...Congressional Research Service 36 Forward-Based Global Strike ( FBGS ) Analysts have also explored the option of deploying long-range land-based

Treatment Options by Stage (Bladder Cancer)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

Treatment Options by Stage (Vulvar Cancer)

MedlinePlus

... to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is ... Security Reuse & Copyright Syndication Services Website Linking U.S. Department of Health and Human Services National Institutes of ...

User-experience surveys with maternity services: a randomized comparison of two data collection models.

PubMed

Bjertnaes, Oyvind Andresen; Iversen, Hilde Hestad

2012-08-01

To compare two ways of combining postal and electronic data collection for a maternity services user-experience survey. Cross-sectional survey. Maternity services in Norway. All women who gave birth at a university hospital in Norway between 1 June and 27 July 2010. Patients were randomized into the following groups (n= 752): Group A, who were posted questionnaires with both electronic and paper response options for both the initial and reminder postal requests; and Group B, who were posted questionnaires with an electronic response option for the initial request, and both electronic and paper response options for the reminder postal request. Response rate, the amount of difference in background variables between respondents and non-respondents, main study results and estimated cost-effectiveness. The final response rate was significantly higher in Group A (51.9%) than Group B (41.1%). None of the background variables differed significantly between the respondents and non-respondents in Group A, while two variables differed significantly between the respondents and non-respondents in Group B. None of the 11 user-experience scales differed significantly between Groups A and B. The estimated costs per response for the forthcoming national survey was €11.7 for data collection Model A and €9.0 for Model B. The model with electronic-only response option in the first request had lowest response rate. However, this model performed equal to the other model on non-response bias and better on estimated cost-effectiveness, and is the better of the two models in large-scale user experiences surveys with maternity services.

Teleconsultation in vascular surgery: a 13 year single centre experience.

PubMed

Schmidt, Christian A P; Schmidt-Weitmann, Sabine H; Lachat, Mario L; Brockes, Christiane M

2014-01-01

The University Hospital of Zurich has provided an email-based medical consultation service for the general public since 1999. We examined the enquiries in a 13-year period to identify those related to vascular surgery (based on 22 ICD-10 codes specific for vascular surgery). There were 40,062 questions, of which 643 (2%) were selected by ICD-10 codes. After exclusion of diagnoses not relevant to vascular surgery, 139 questions remained, i.e. an average rate of about one per month. The mean age of the users was 43 years (range 19-88). Most users (61%) were women. The majority of users asked questions about their own health problems (79%) with varicose veins and spider veins accounting for 63% of all questions. Arterial diseases accounted for 30%. The patient's intention in contacting the service was to obtain advice on treatment options (37%), information about a diagnosis or symptoms (27%), or a second opinion (15%). The online service responded with detailed information and advice (87%) and suggested a referral to the family doctor or a specialist in 75%. Most patients (82%) rated the service overall as good or very good. It appears likely that telemedicine and in particular email teleconsultations will increase in vascular surgery in the future.

Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project.

PubMed

Bailie, Ross; Si, Damin; Connors, Christine; Weeramanthri, Tarun; Clark, Louise; Dowden, Michelle; O'Donohue, Lynette; Condon, John; Thompson, Sandra; Clelland, Nikki; Nagel, Tricia; Gardner, Karen; Brown, Alex

2008-09-17

A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities. The study will be conducted in 40-50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental health care and health promotion. The project will be carried out in a form of collaborative characterised by a sequence of annual learning cycles with action periods for CQI activities between each learning cycle. Key outcome measures include uptake and integration of CQI activities into routine service activity, state of system development, delivery of evidence-based services, intermediate patient outcomes (e.g. blood pressure and glucose control), and health outcomes (complications, hospitalisations and mortality). The ABCD Extension project will contribute directly to the evidence base on effectiveness of collaborative CQI approaches on prevention and management of chronic disease in Australia's Indigenous communities, and to inform the operational and policy environments that are required to incorporate CQI activities into routine practice.

Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project

PubMed Central

Bailie, Ross; Si, Damin; Connors, Christine; Weeramanthri, Tarun; Clark, Louise; Dowden, Michelle; O'Donohue, Lynette; Condon, John; Thompson, Sandra; Clelland, Nikki; Nagel, Tricia; Gardner, Karen; Brown, Alex

2008-01-01

Background A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities. Methods/design The study will be conducted in 40–50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental health care and health promotion. The project will be carried out in a form of collaborative characterised by a sequence of annual learning cycles with action periods for CQI activities between each learning cycle. Key outcome measures include uptake and integration of CQI activities into routine service activity, state of system development, delivery of evidence-based services, intermediate patient outcomes (e.g. blood pressure and glucose control), and health outcomes (complications, hospitalisations and mortality). Conclusion The ABCD Extension project will contribute directly to the evidence base on effectiveness of collaborative CQI approaches on prevention and management of chronic disease in Australia's Indigenous communities, and to inform the operational and policy environments that are required to incorporate CQI activities into routine practice. PMID:18799011

Infectious Disease Information Collection System at the Scene of Disaster Relief Based on a Personal Digital Assistant.

PubMed

Li, Ya-Pin; Gao, Hong-Wei; Fan, Hao-Jun; Wei, Wei; Xu, Bo; Dong, Wen-Long; Li, Qing-Feng; Song, Wen-Jing; Hou, Shi-Ke

2017-12-01

The objective of this study was to build a database to collect infectious disease information at the scene of a disaster through the use of 128 epidemiological questionnaires and 47 types of options, with rapid acquisition of information regarding infectious disease and rapid questionnaire customization at the scene of disaster relief by use of a personal digital assistant (PDA). SQL Server 2005 (Microsoft Corp, Redmond, WA) was used to create the option database for the infectious disease investigation, to develop a client application for the PDA, and to deploy the application on the server side. The users accessed the server for data collection and questionnaire customization with the PDA. A database with a set of comprehensive options was created and an application system was developed for the Android operating system (Google Inc, Mountain View, CA). On this basis, an infectious disease information collection system was built for use at the scene of disaster relief. The creation of an infectious disease information collection system and rapid questionnaire customization through the use of a PDA was achieved. This system integrated computer technology and mobile communication technology to develop an infectious disease information collection system and to allow for rapid questionnaire customization at the scene of disaster relief. (Disaster Med Public Health Preparedness. 2017;11:668-673).

Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending.

PubMed

Favreault, Melissa M; Gleckman, Howard; Johnson, Richard W

2015-12-01

About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high costs and uncertainty, relatively few people purchase private long-term care insurance or save sufficiently to fully finance LTSS; many will eventually turn to Medicaid for help. To show how policy changes could expand insurance's role in financing these needs, we modeled several new insurance options. Specifically, we looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. We identified important differences among the alternatives, highlighting relevant trade-offs that policy makers can consider in evaluating proposals. If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial. Project HOPE—The People-to-People Health Foundation, Inc.

Preparing the workforce for healthy aging programs: the Skills for Healthy Aging Resources and Programs (SHARP) model.

PubMed

Frank, Janet C; Altpeter, Mary; Damron-Rodriguez, JoAnn; Driggers, Joann; Lachenmayr, Susan; Manning, Colleen; Martinez, Dana M; Price, Rachel M; Robinson, Patricia

2014-10-01

Current public health and aging service agency personnel have little training in gerontology, and virtually no training in evidence-based health promotion and disease management programs for older adults. These programs are rapidly becoming the future of our community-based long-term care support system. The purpose of this project was to develop and test a model community college career technical education program, Skills for Healthy Aging Resources and Programs (SHARP), for undergraduate college students, current personnel in aging service and community organizations, and others interested in retraining. A multidisciplinary cross-sector team from disciplines of public health, sociology, gerontology and nursing developed four competency-based courses that focus on healthy aging, behavior change strategies, program management, an internship, and an option for leader training in the Chronic Disease Self-Management Program. To enhance implementation and fidelity, intensive faculty development training was provided to all instructors and community agency partners. Baseline and postprogram evaluation of competencies for faculty and students was conducted. Process evaluation for both groups focused on satisfaction with the curricula and suggestions for program improvement. SHARP has been piloted five times at two community colleges. Trainees (n = 113) were primarily community college students (n = 108) and current aging service personnel (n = 5). Statistically significant improvements in all competencies were found for both faculty and students. Process evaluation outcomes identified the needed logical and component adaptations to enhance the feasibility of program implementation, dissemination, and student satisfaction. The SHARP program provides a well-tested, evidence-based effective model for addressing workforce preparation in support of healthy aging service program expansion and delivery. © 2014 Society for Public Health Education.

New Therapies Offer Valuable Options for Patients with Melanoma

Cancer.gov

Two phase III clinical trials of new therapies for patients with metastatic melanoma presented in June at the 2011 ASCO conference confirmed that vemurafenib and ipilimumab (Yervoy™) offer valuable new options for the disease.

Development of a community-sensitive strategy to increase availability of fresh fruits and vegetables in Nashville's urban food deserts, 2010-2012.

PubMed

Larson, Celia; Haushalter, Alisa; Buck, Tracy; Campbell, David; Henderson, Trevor; Schlundt, David

2013-07-25

Food deserts, areas that lack full-service grocery stores, may contribute to rising rates of obesity and chronic diseases among low-income and racial/ethnic minority residents. Our corner store project, part of the Centers for Disease Control and Prevention's Communities Putting Prevention to Work initiative, aimed to increase availability of healthful foods in food deserts in Nashville, Tennessee. We identified 4 food deserts in which most residents are low-income and racially and ethnically diverse. Our objectives were to develop an approach to increase availability of fresh fruits and vegetables, low-fat or nonfat milk, and 100% whole-wheat bread in Nashville's food deserts and to engage community members to inform our strategy. Five corner stores located in food deserts met inclusion criteria for our intervention. We then conducted community listening sessions, proprietor surveys, store audits, and customer-intercept surveys to identify needs, challenges to retailing the products, and potential intervention strategies. Few stores offered fresh fruits, fresh vegetables, low-fat or nonfat milk, or 100% whole-wheat bread, and none stocked items from all 4 categories. Major barriers to retailing healthful options identified by community members are mistrust of store owners, history of poor-quality produce, and limited familiarity with healthful options. Store owners identified neighborhood crime as the major barrier. We used community input to develop strategies. Engaging community residents and understanding neighborhood context is critical to developing strategies that increase access to healthful foods in corner stores.

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

77 FR 16574 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... ``customer'' is any person who is or may be required to pay for goods or services through telemarketing. A... Permit Holder to inquire about a product or service offered by the Trading Permit Holder within the three... or provide any goods or services, a provision under which a customer receives a product or service...

The Effect of Tailored Web-Based Feedback and Optional Telephone Coaching on Health Improvements: A Randomized Intervention Among Employees in the Transport Service Industry.

PubMed

Solenhill, Madeleine; Grotta, Alessandra; Pasquali, Elena; Bakkman, Linda; Bellocco, Rino; Trolle Lagerros, Ylva

2016-08-11

Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index-BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants' reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m(2)) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47.8%, and 165 of 324 participants, 50.9%, for groups B and C, respectively) and physical activity habits (181 of 301 participants, 60.1%, and 207 of 324 participants, 63.9%, for B and C, respectively) compared with the control group A (122 of 356 participants, 34.3%, for diet and 177 of 356 participants, 49.7%, for physical activity). At follow-up, the intervention groups had significantly decreased motivation (group B: P<.001 for change in diet; P<.001 for change in physical activity; group C: P=.007 for change in diet; P<.001 for change in physical activity), whereas the control group reported significantly increased motivation to change diet and physical activity (P<.001 for change in diet; P<.001 for change in physical activity). Tailored Web-based health feedback and the offering of optional telephone coaching did not have a positive health effect on employees in the transport services. However, our findings suggest an increased short-term motivation to change health behaviors related to diet and physical activity among those receiving tailored Web-based health feedback.

Statistical Policy Working Paper 24. Electronic Dissemination of Statistical Data

DOT National Transportation Integrated Search

1995-11-01

The report, Statistical Policy Working Paper 24, Electronic Dissemination of Statistical Data, includes several topics, such as Options and Best Uses for Different Media Operation of Electronic Dissemination Service, Customer Service Programs, Cost a...

Health Care Delivery.

ERIC Educational Resources Information Center

Starfield, Barbara

1987-01-01

The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)

CIDR

Science.gov Websites

Initiation Application Schedule Service Information and Pricing Services Sample Requirements Pricing SNP Genotyping General Information Genome Wide Association Custom FFPE Sample Options Methylation Linkage Consortium Developed Mouse Whole Genome Sequencing General Information Whole Genome Whole Exome Custom

Merritt Island National Wildlife Refuge : transit planning study

DOT National Transportation Integrated Search

2015-07-07

This study for the Fish and Wildlife Service (FWS) identifies and analyzes options for enhancing existing transit service at Merritt Island National Wildlife Refuge (the Refuge), a regional destination in Floridas Space Coast which serves approxim...

Infinite capacity multi-server queue with second optional service channel

NASA Astrophysics Data System (ADS)

Ke, Jau-Chuan; Wu, Chia-Huang; Pearn, Wen Lea

2013-02-01

This paper deals with an infinite-capacity multi-server queueing system with a second optional service (SOS) channel. The inter-arrival times of arriving customers, the service times of the first essential service (FES) and the SOS channel are all exponentially distributed. A customer may leave the system after the FES channel with probability (1-θ), or at the completion of the FES may immediately require a SOS with probability θ (0 <= θ <= 1). The formulae for computing the rate matrix and stationary probabilities are derived by means of a matrix analytical approach. A cost model is developed to determine the optimal values of the number of servers and the two service rates, simultaneously, at the minimal total expected cost per unit time. Quasi-Newton method are employed to deal with the optimization problem. Under optimal operating conditions, numerical results are provided in which several system performance measures are calculated based on assumed numerical values of the system parameters.

Lessons Learned From Option B+ in the Evolution Toward "Test and Start" From Malawi, Cameroon, and the United Republic of Tanzania.

PubMed

Kalua, Thokozani; Tippett Barr, Beth A; van Oosterhout, Joep J; Mbori-Ngacha, Dorothy; Schouten, Erik J; Gupta, Sundeep; Sande, Amakobe; Zomba, Gerald; Tweya, Hannock; Lungu, Edgar; Kajoka, Deborah; Tih, Pius; Jahn, Andreas

2017-05-01

The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania. Malawi's HIV program started in 2002, but by 2009, the PMTCT program was lagging far behind the antiretroviral therapy (ART) program because of numerous health system challenges. When WHO recommended Option A and Option B for PMTCT in 2010, it was clear that Malawi's HIV program would not be able to successfully implement either option without increasing existing barriers to PMTCT services and potentially decreasing women's access to care. Subsequent stakeholder discussions led to the development of Option B+. Operationalizing Option B+ required several critical considerations, including the complete integration of ART and PMTCT programs, systematic reduction of barriers to facilitate doubling the number of ART sites in less than a year, building consensus with stakeholders, and securing additional resources for the new program. During the planning and implementation process, several lessons were learned which are considerations for countries transitioning to "treat-all": Comprehensive change requires effective government leadership and coordination; national clinical guidelines must accommodate health system limitations; ART services and commodities should be decentralized within facilities; the general public should be well informed about major changes in the national HIV program; and patients should be educated on clinic processes to improve program monitoring.

Alopecia areata update: part II. Treatment.

PubMed

Alkhalifah, Abdullah; Alsantali, Adel; Wang, Eddy; McElwee, Kevin J; Shapiro, Jerry

2010-02-01

Various therapeutic agents have been described for the treatment of alopecia areata (AA), but none are curative or preventive. The aim of AA treatment is to suppress the activity of the disease. The high rate of spontaneous remission and the paucity of randomized, double-blind, placebo-controlled studies make the evidence-based assessment of these therapies difficult. The second part of this two-part series on AA discusses treatment options in detail and suggests treatment plans according to specific disease presentation. It also reviews recently reported experimental treatment options and potential directions for future disease management. After completing this learning activity, participants should be able to compare the efficacy and safety of various treatment options, formulate a treatment plan tailored to individual patients, and recognize recently described treatments and potential therapeutic approaches. Copyright (c) 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes.

PubMed

Sangkum, P; Levy, J; Yafi, F A; Hellstrom, W J G

2015-05-01

Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized. © 2015 American Society of Andrology and European Academy of Andrology.

78 FR 42532 - Prospective Grant of Start-Up Exclusive Evaluation Option License: Methods of Treating Giardiasis...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Prospective Grant of Start-Up Exclusive Evaluation Option License: Methods of Treating Giardiasis Using Available Compounds.../2013 filed April 22, 2013 (E-211- 2010/2-IN-05); each entitled ``Methods of Treating Giardiasis'' by...

78 FR 63265 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

..., Incorporated (the ``Exchange'' or ``CBOE'') proposes to: (i) Make available historical Customized Option Pricing Service (``COPS'') data and (ii) revise the description of COPS. The text of the proposed rule.... The text of these statements may be examined at the places specified in Item IV below. The Exchange...

Current Challenges Facing Secondary Education and Transition Services: What Research Tells Us.

ERIC Educational Resources Information Center

Johnson, David R.; Stodden, Robert A.; Emanuel, Ellen J.; Luecking, Richard; Mack, Mary

2002-01-01

The transition challenges discussed are to ensure that (1) students have access to the full range of curriculum options and learning experiences; (2) high school graduation decisions are based on meaningful indicators of learning; (3) students have access to postsecondary education, employment, and independent living options; (4) student and…

Do School Boards Still Have Options? The Erosion of Management Authority.

ERIC Educational Resources Information Center

Lieberman, Myron

1997-01-01

School boards are woefully unprepared to deal with "make or buy" issues, due to massive union efforts to eliminate or restrict board freedom to contract for services. Teachers neither understand nor support a market economy. School boards' contracting out ability will not be secure until favorable legislative options are considered and…

76 FR 17485 - Meeting Notice Correction-Federal Interagency Committee on Emergency Medical Services; Correction...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... (FICEMS) to be held as a stakeholder input call-in session to receive input regarding the current and... options for establishing or designating a Federal lead office or agency for EMS. The National Security Staff Resilience Directorate has requested that FICEMS engage with stakeholders and develop an options...

26 CFR 1.83-7 - Taxation of nonqualified stock options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Taxation of nonqualified stock options. 1.83-7 Section 1.83-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Included in Gross Income § 1.83-7 Taxation...

42 CFR 441.580 - Data collection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Data collection. 441.580 Section 441.580 Public... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.580 Data... under sections 1115, 1915(c) and (i) of the Act, or the personal care State plan option. (e) Data...

42 CFR 441.580 - Data collection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Data collection. 441.580 Section 441.580 Public... Community-Based Attendant Services and Supports State Plan Option (Community First Choice) § 441.580 Data... under sections 1115, 1915(c) and (i) of the Act, or the personal care State plan option. (e) Data...

Preretirement Work Options: Evaluation Report. Volume 2.

ERIC Educational Resources Information Center

Holden, Karen C.; And Others

Pre-Retirement Work Options is a demonstration project designed to develop and test alternative employment patterns for older workers in the Wisconsin Civil Service System. The program ws evaluated to determine the interest of older state workers in reducing their work hours prior to retirement as well as the impact of that reduction for those who…

78 FR 68888 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... Options Clearing Corporation and NYSE Liffe US LLC in Connection With NYSE Liffe US LLC's Transition to... Services Agreement (``Clearing Agreement'') between OCC and NYSE Liffe US LLC (``NYSE Liffe US'') to make changes to the Clearing Agreement in connection with NYSE Liffe US' transition to electronic vault...

26 CFR 1.83-7 - Taxation of nonqualified stock options.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Taxation of nonqualified stock options. 1.83-7 Section 1.83-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Items Specifically Included in Gross Income § 1.83-7 Taxation...

Improving Injectable Medicines Prescription in Outpatient Services: A Path Towards Rational Use of Medicines in Iran

PubMed Central

Bairami, Firoozeh; Soleymani, Fatemeh; Rashidian, Arash

2016-01-01

Injection is one of the most common medical procedures in the health sector. Annually up to 16 billion injections are prescribed in low- and middle-income countries (LMICs), many of them are not necessary for the patients, increase the healthcare costs and may result in side effects. Currently over 40% of outpatient prescriptions in Iran contain at least one injectable medicine. To address the issue, a working group was established (August 2014 to April 2015) to provide a comprehensive policy brief to be used by national decision-makers. This report is the extract of methods that were followed and the main policy options for improving injectable medicines prescribing in outpatient services. Thirty-three potential policy options were developed focusing on different stakeholders. The panel reached consensus on seven policy options, noting effectiveness, cost, durability, and feasibility of each policy. The recommended policy options are targeted at patients and public (2 policies), insurers (2), physicians (1), pharmacies (1), and the Ministry of Health and Medical Education (MoHME) (1). PMID:27239881

One health approach to influenza: assessment of critical issues and options.

PubMed

Powdrill, Thomas F; Nipp, Terry L; Rinderknecht, Jennifer L

2010-08-01

A task force of experts on influenza, public health, and animal health met at the conference One Health Approach to Influenza: Assessment of Critical Issues and Options in Washington, DC, on December 1-2, 2009. These experts discussed the role of the One Health approach in preparing for and responding to an influenza pandemic or other emerging zoonotic disease by using pandemic (H1N1) 2009 as a case study. The meeting was convened by the US Department of Homeland Security National Center for Foreign Animal and Zoonotic Disease Defense, and the National Institute of Allergy and Infectious Diseases/National Institutes of Health Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases.

Inner ear symptoms and disease: Pathophysiological understanding and therapeutic options

PubMed Central

Ciuman, Raphael R.

2013-01-01

In recent years, huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss, tinnitus, and vertigo. Advances in understanding comprise biochemical and physiological research of stimulus perception and conduction, inner ear homeostasis, and hereditary diseases with underlying genetics. This review describes and tabulates the various causes of inner ear disease and defines inner ear and non-inner ear causes of hearing loss, tinnitus, and vertigo. The aim of this review was to comprehensively breakdown this field of otorhinolaryngology for specialists and non-specialists and to discuss current therapeutic options in distinct diseases and promising research for future therapies, especially pharmaceutic, genetic, or stem cell therapy. PMID:24362017

[Successful endoscopic dilatation of a stenosis in relation to an ileorectal anastomosis by acute ileus].

PubMed

Kjærgaard, Jane Christensen; Hendel, Jakob; Gügenur, Ismail

2014-02-17

Endoscopic dilatation is a treatment option for patients with Crohns disease suffering from stenosis in relation to an ileorectal anastomosis. We present a case of a patient with Crohns disease who was admitted with acute obstructive symptoms due to a stensosis of the ileorectal anastomosis. The patient was septic. We performed a successful endoscopic dilatation in the acute phase and the patient was discharged few days after an uneventful recovery. Endoscopic dilatation of an ileorectal anastomsis in patients with Crohns disease is a treatment option in the acute setting when performed by experienced endoscopists.

Stricturoplasty—a bowel-sparing option for long segment small bowel Crohn's disease

PubMed Central

Koh, Hoey C.; Gilmore, Andrew

2017-01-01

Abstract Stricturoplasty is a surgical option for management of severe stricturing Crohn's disease of the small bowel. It avoids the need for small bowel resection and the associated metabolic complications. This report contrasts the indications and technical aspects of two different stricturoplasty techniques. Case 1 describes an extensive Michelassi (side-to-side isoperistaltic) stricturoplasty performed for a 100 cm segment of diseased small bowel in a 45-year-old patient. Case 2 describes the performance of 12 Heineke-Mikulicz stricturoplasties in a 23-year-old patient with multiple short fibrotic strictures. PMID:29423160

The treatment of Dupuytren disease.

PubMed

Desai, Shaunak S; Hentz, Vincent R

2011-05-01

The treatment of progressive Dupuytren contractures has historically been and continues to be largely surgical. Although a number of surgical interventions do exist, limited palmar fasciectomy continues to be the most common and widely accepted treatment option. Until recently, nonsurgical options were limited and clinically ineffective. However, the commercial availability and recent approval of collagenase clostridium histolyticum now provides practitioners with a nonsurgical approach to this disease. This article presents a comprehensive review of the surgical and nonsurgical treatments of Dupuytren disease, with a focus on collagenase. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Novel Therapeutic Options for the Treatment of Mineral Metabolism Abnormalities in End Stage Renal Disease

PubMed Central

Kendrick, Jessica; Chonchol, Michel

2015-01-01

Abnormalities in mineral metabolism are a universal complication in dialysis patients and are associated with an increased risk of cardiovascular disease and mortality. Hyperphosphatemia, increased fibroblast growth factor 23 levels and secondary hyperparathyroidism are all strongly associated with adverse outcomes in end stage renal disease (ESRD) and most treatment strategies target these parameters. Over the past few years, new therapies have emerged for the treatment of abnormalities of mineral metabolism in ESRD and many are promising. This article will review these new therapeutic options including the potential advantages and disadvantages compared to existing therapies. PMID:26278462

The Impact of In-Class Service-Learning Projects

ERIC Educational Resources Information Center

Jenkins, Shannon

2011-01-01

Service-learning has been shown to have many benefits, but it is often difficult to coordinate such projects due to increased outside demands on students' time. One option is to make arrangements for students to fulfill their service obligations during regularly scheduled class time. This article examines whether the decrease in face time…

Wilderness Education Association Affiliates and Service-Learning: Where Do They Stand?

ERIC Educational Resources Information Center

Poff, Raymond; Harris, Matthew; Spencer, Steve

2005-01-01

The purpose of this article is to report the findings of a study, conducted among Wilderness Education Association Affiliates, aimed at understanding the service-learning options provided. Several definitions and viewpoints regarding service-learning can be found throughout the literature; only a few are presented to introduce the topic. E-mails…

A Longitudinal Sociological Monitoring of Customers' Satisfaction with the Quality of Educational Services

ERIC Educational Resources Information Center

Gaidukova, G. N.

2014-01-01

Research data on levels of satisfaction with educational services in a Russian university show room for improvement in such areas as vocational guidance work; range of opportunities in the choice of specialization and optional disciplines; availability of academic and methodological literature; the quality of food services; and amount of practical…

Social Service Aide Project. Summary Reports and Proposals.

ERIC Educational Resources Information Center

YMCA of Metropolitan Chicago, IL. Career Options Research and Development (CORD).

The Social Service Aide Project for the training and education of paraprofessionals is a part of the Career Options Research and Development Project of the Young Men's Christian Association of Chicago. These materials include: (1) "A Report of Pilot A Social Service Aide Program: Phase I and II (September 1969-August 1970)," (2)…

75 FR 13625 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

..., Incorporated; Order Approving a Proposed Rule Change Relating to Co- Location Service Fees I. Introduction On... to co-location services and related fees. The proposed rule change was published for comment in the... of the equipment to the Exchange's servers, at no additional charge. This ``co-location service...

The N-policy for an unreliable server with delaying repair and two phases of service

NASA Astrophysics Data System (ADS)

Choudhury, Gautam; Ke, Jau-Chuan; Tadj, Lotfi

2009-09-01

This paper deals with an MX/G/1 with an additional second phase of optional service and unreliable server, which consist of a breakdown period and a delay period under N-policy. While the server is working with any phase of service, it may break down at any instant and the service channel will fail for a short interval of time. Further concept of the delay time is also introduced. If no customer arrives during the breakdown period, the server becomes idle in the system until the queue size builds up to a threshold value . As soon as the queue size becomes at least N, the server immediately begins to serve the first phase of regular service to all the waiting customers. After the completion of which, only some of them receive the second phase of the optional service. We derive the queue size distribution at a random epoch and departure epoch as well as various system performance measures. Finally we derive a simple procedure to obtain optimal stationary policy under a suitable linear cost structure.

Mapping ecosystem services for land use planning, the case of Central Kalimantan.

PubMed

Sumarga, Elham; Hein, Lars

2014-07-01

Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been proposed as a concept that would facilitate the identification of sustainable land management options, however, the scale of land conversion and its spatial diversity pose particular challenges in Indonesia. The objective of this paper is to analyze how ecosystem services can be mapped at the provincial scale, focusing on Central Kalimantan, and to examine how ecosystem services maps can be used for a land use planning. Central Kalimantan is subject to rapid deforestation including the loss of peatland forests and the provincial still lacks a comprehensive land use plan. We examine how seven key ecosystem services can be mapped and modeled at the provincial scale, using a variety of models, and how large scale ecosystem services maps can support the identification of options for sustainable expansion of palm oil production.

Study of the Cherokee Nuclear Station: projected impacts, monitoring plan, and mitigation options for Cherokee County, South Carolina

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

Peelle, E.; Schweitzer, M.; Scharre, P.

1979-07-01

This report inventories Cherokee County's capabilities and CNS project characteristics, projects expected impacts from the interaction of the two defines four options for Cherokee County decision makers, and presents a range of possible mitigation and monitoring plans for dealing with the problems identified. The four options and general implementation guidelines for each are presented after reviewing pertinent features of other mitigation and monitoring plans. The four options include (1) no action, (2) preventing impacts by preventing growth, (3) selective growth in designated areas as services can be supplied, and (4) maximum growth designed to attract as many in-movers as possiblemore » through a major program of capital investiments in public and private services. With the exception of the no action option, all plans deal with impacts according to some strategy determined by how the County wishes to manage growth. Solutions for impact problems depend on which growth strategy is selected and what additional resources are secured during the impact period. A monitoring program deals with the problems of data and projections uncertainty, while direct action is proposed to deal with the institutional problems of delay of the needed access road, timeing and location problems from the tax base mismatch, and lack of local planning capability.« less

48 CFR 307.7101 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services available from only one source. (4) Proposals under the Small Business Innovative Research (SBIR) and Small Business Technology Transfer (STTR) programs. (5) Acquisition of commercial items/services... under HHS-wide strategic sourcing vehicles. (8) Contract/order modifications that— (i) Exercise options...