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

PubMed

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

2005-10-01

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

A framework to assess welfare mix and service provision models in health care and social welfare: case studies of two prominent Italian regions.

PubMed

Longo, Francesco; Notarnicola, Elisabetta; Tasselli, Stefano

2015-04-09

The mechanisms through which the relationships among public institutions, private providers and families affect care and service provision systems are puzzling. How can we understand the mechanisms in these contexts? Which elements should we explore to capture the complexity of care provision? The aim of our study is to provide a framework that can help read and reframe these puzzling care provision mechanisms in a welfare mix context. First, we develop a theoretical framework for understanding how service provision occurs in care systems that are characterised by a variety of relationships between multiple actors, using an evidence-based approach that looks at both public and private expenditures and the number of users relative to the level of needs coverage and compared with declared values and political rhetoric. Second, we test this framework in two case studies built on data from two prominent Italian regions, Lombardy and Emilia-Romagna. We argue that service provision models depend on the interplay among six conceptual elements: policy values, governance rules, resources, nature of the providers, service standards and eligibility criteria. Our empirical study shows that beneath the relevant differences in values and political rhetoric between the case studies of the two Italian regions, there is a surprising isomorphism in service standards and the levels of covering the population's needs. The suggested framework appears to be effective and feasible; it fosters interdisciplinary approaches and supports policy-making discussions. This study may contribute to deepening knowledge about public care service provision and institutional arrangements, which can be used to promote more effective reforms and may advance future research. Although the framework was tested on the Italian welfare system, it can be used to assess many different systems.

An Integrated Approach to Forest Ecosystem Services

Treesearch

José Joaquin Campos; Francisco Alpizar; Bastiaan Louman; John A. Parrotta

2005-01-01

Forest ecosystem services (FES) are fundamental for the Earth’s life support systems. This chapter discusses the different services provided by forest ecosystems and the effects that land use and forest management practices have on their provision. It also discusses the role of markets in providing an enabling environment for a sustainable and equitable provision of...

31 CFR 281.9 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

....9 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE FOREIGN EXCHANGE OPERATIONS § 281.9 General provisions. (a) Nothing contained in this part shall be construed as having the effect of superseding or...

Reducing health care costs--potential and limitations of local authority health services.

PubMed

Ijsselmuiden, C B; De Beer, C

1990-08-04

Local authorities (LAs) currently provide preventive and promotive services. It is argued that, by extending the role of the LA to the provision of comprehensive services, including ambulatory and hospital curative care, both the quality and the cost-effectiveness of health care would be improved. Making health care the responsibility of the LA would minimise fragmentation, allow for the provision of a number of services that currently are neglected because they fall through the gap that exists between preventive and curative services, and result in the more effective use of personnel currently restricted to providing preventive care only. LAs offer an appropriate structure for effective community control over the health services, and are more likely to be sensitive to local needs and demands. In addition, their administrative proximity to other LA departments responsible for housing, town planning and parks and recreation allows for an effective multisectoral approach to health. The positive aspects of LA care can only be achieved in the context of racially integrated services provided by an LA elected by universal adult franchise. Smaller LAs may need to be grouped together in larger units for the purpose of achieving satisfactory economies of scale in the provision of health care.

Enhancement of biodiversity and ecosystem services by ecological restoration: a meta-analysis.

PubMed

Rey Benayas, José M; Newton, Adrian C; Diaz, Anita; Bullock, James M

2009-08-28

Ecological restoration is widely used to reverse the environmental degradation caused by human activities. However, the effectiveness of restoration actions in increasing provision of both biodiversity and ecosystem services has not been evaluated systematically. A meta-analysis of 89 restoration assessments in a wide range of ecosystem types across the globe indicates that ecological restoration increased provision of biodiversity and ecosystem services by 44 and 25%, respectively. However, values of both remained lower in restored versus intact reference ecosystems. Increases in biodiversity and ecosystem service measures after restoration were positively correlated. Results indicate that restoration actions focused on enhancing biodiversity should support increased provision of ecosystem services, particularly in tropical terrestrial biomes.

Selecting cost-effective areas for restoration of ecosystem services.

PubMed

Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

2015-04-01

Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.

Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

ERIC Educational Resources Information Center

Franks, Myfanwy; Goswami, Haridhan

2010-01-01

This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

45 CFR 1203.5 - Assurances required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for another purpose involving the provision of similar services or benefits, or for as long as the... Government, the instrument effecting or recording the transfer shall contain a covenant running with the land... the provision of similar services or benefits. When no transfer of property of interest therein from...

Differentiated protection services with failure probability guarantee for workflow-based applications

NASA Astrophysics Data System (ADS)

Zhong, Yaoquan; Guo, Wei; Jin, Yaohui; Sun, Weiqiang; Hu, Weisheng

2010-12-01

A cost-effective and service-differentiated provisioning strategy is very desirable to service providers so that they can offer users satisfactory services, while optimizing network resource allocation. Providing differentiated protection services to connections for surviving link failure has been extensively studied in recent years. However, the differentiated protection services for workflow-based applications, which consist of many interdependent tasks, have scarcely been studied. This paper investigates the problem of providing differentiated services for workflow-based applications in optical grid. In this paper, we develop three differentiated protection services provisioning strategies which can provide security level guarantee and network-resource optimization for workflow-based applications. The simulation demonstrates that these heuristic algorithms provide protection cost-effectively while satisfying the applications' failure probability requirements.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations.

PubMed

Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; van Delden, Otto; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

2016-04-01

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

PubMed

Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

2016-02-06

Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

The effects of competition on medical service provision.

PubMed

Brosig-Koch, Jeannette; Hehenkamp, Burkhard; Kokot, Johanna

2017-12-01

We explore how competition between physicians affects medical service provision. Previous research has shown that, without competition, physicians deviate from patient-optimal treatment under payment systems like capitation and fee-for-service. Although competition might reduce these distortions, physicians usually interact with each other repeatedly over time and only a fraction of patients switches providers at all. Both patterns might prevent competition to work in the desired direction. To analyze the behavioral effects of competition, we develop a theoretical benchmark that is then tested in a controlled laboratory experiment. Experimental conditions vary physician payment and patient characteristics. Real patients benefit from provision decisions made in the experiment. Our results reveal that, in line with the theoretical prediction, introducing competition can reduce overprovision and underprovision, respectively. The observed effects depend on patient characteristics and the payment system, though. Tacit collusion is observed and particularly pronounced with fee-for-service payment, but it appears to be less frequent than in related experimental research on price competition. Copyright © 2017 John Wiley & Sons, Ltd.

Estimating the value of non-use benefits from small changes in the provision of ecosystem services.

PubMed

Dutton, Adam; Edwards-Jones, Gareth; Macdonald, David W

2010-12-01

The unit of trade in ecosystem services is usually the use of a proportion of the parcels of land associated with a given service. Valuing small changes in the provision of an ecosystem service presents obstacles, particularly when the service provides non-use benefits, as is the case with conservation of most plants and animals. Quantifying non-use values requires stated-preference valuations. Stated-preference valuations can provide estimates of the public's willingness to pay for a broad conservation goal. Nevertheless, stated-preference valuations can be expensive and do not produce consistent measures for varying levels of provision of a service. Additionally, the unit of trade, land use, is not always linearly related to the level of ecosystem services the land might provide. To overcome these obstacles, we developed a method to estimate the value of a marginal change in the provision of a non-use ecosystem service--in this case conservation of plants or animals associated with a given land-cover type. Our method serves as a tool for calculating transferable valuations of small changes in the provision of ecosystem services relative to the existing provision. Valuation is achieved through stated-preference investigations, calculation of a unit value for a parcel of land, and the weighting of this parcel by its ability to provide the desired ecosystem service and its effect on the ability of the surrounding land parcels to provide the desired service. We used the water vole (Arvicola terrestris) as a case study to illustrate the method. The average present value of a meter of water vole habitat was estimated at UK £ 12, but the marginal value of a meter (based on our methods) could range between £ 0 and £ 40 or more. © 2010 Society for Conservation Biology.

Assessing the effects of pharmacists' perceived organizational support, organizational commitment and turnover intention on provision of medication information at community pharmacies in Lithuania: a structural equation modeling approach.

PubMed

Urbonas, Gvidas; Kubilienė, Loreta; Kubilius, Raimondas; Urbonienė, Aušra

2015-03-01

As a member of a pharmacy organization, a pharmacist is not only bound to fulfill his/her professional obligations but is also affected by different personal and organizational factors that may influence his/her behavior and, consequently, the quality of the services he/she provides to patients. The main purpose of the research was to test a hypothesized model of the relationships among several organizational variables, and to investigate whether any of these variables affects the service of provision of medication information at community pharmacies. During the survey, pharmacists working at community pharmacies in Lithuania were asked to express their opinions on the community pharmacies at which they worked and to reflect on their actions when providing information on medicines to their patients. The statistical data were analyzed by applying a structural equation modeling technique to test the hypothesized model of the relationships among the variables of Perceived Organizational Support, Organizational Commitment, Turnover Intention, and Provision of Medication Information. The final model revealed that Organizational Commitment had a positive direct effect on Provision of Medication Information (standardized estimate = 0.27) and a negative direct effect (standardized estimate = -0.66) on Turnover Intention. Organizational Commitment mediated the indirect effects of Perceived Organizational Support on Turnover Intention (standardized estimate = -0.48) and on Provision of Medication Information (standardized estimate = 0.20). Pharmacists' Turnover Intention had no significant effect on Provision of Medication Information. Community pharmacies may be viewed as encouraging, to some extent, the service of provision of medication information. Pharmacists who felt higher levels of support from their organizations also expressed, to a certain extent, higher commitment to their organizations by providing more consistent medication information to patients. However, the effect of organizational variables on the variable of Provision of Medication Information appeared to be limited.

Autonomous Information Fading and Provision to Achieve High Response Time in Distributed Information Systems

NASA Astrophysics Data System (ADS)

Lu, Xiaodong; Arfaoui, Helene; Mori, Kinji

In highly dynamic electronic commerce environment, the need for adaptability and rapid response time to information service systems has become increasingly important. In order to cope with the continuously changing conditions of service provision and utilization, Faded Information Field (FIF) has been proposed. FIF is a distributed information service system architecture, sustained by push/pull mobile agents to bring high-assurance of services through a recursive demand-oriented provision of the most popular information closer to the users to make a tradeoff between the cost of information service allocation and access. In this paper, based on the analysis of the relationship that exists among the users distribution, information provision and access time, we propose the technology for FIF design to resolve the competing requirements of users and providers to improve users' access time. In addition, to achieve dynamic load balancing with changing users preference, the autonomous information reallocation technology is proposed. We proved the effectiveness of the proposed technology through the simulation and comparison with the conventional system.

Medicare and Medicaid programs; rural hospitals: provision of long-term care services (swing-bed provision); flexibility in application of standards--Health Care Financing Administration. Interim final rule with comment period.

PubMed

1982-07-20

These regulations implement sections 904 and 949 of Pub. L. 96-499, the Omnibus Reconciliation Act of 1980. Under section 904 (the swing-bed provision), certain small, rural hospitals may use their inpatient facilities to furnish skilled nursing facility (SNF) services to Medicare and Medicaid beneficiaries, and intermediate care facility (ICF) services to Medicaid beneficiaries. These hospitals will be reimbursed at rates appropriate for those services, which are generally lower than hospital rates. This statutory provision is intended to encourage the most efficient and effective use of inpatient hospital beds for delivery of either hospital or SNF and ICF services. Under section 949, rural hospitals of 50 or fewer beds may be exempted from certain personnel standards in the conditions of participation for hospitals. This exemption applies only to the extent that it does not jeopardize or adversely affect the health and safety of patients.

14 CFR 272.11 - Effective date of provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Effective date of provisions. 272.11 Section 272.11 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.11 Effective...

Compositional diversity of rehabilitated tropical lands supports multiple ecosystem services and buffers uncertainties

PubMed Central

Knoke, Thomas; Paul, Carola; Hildebrandt, Patrick; Calvas, Baltazar; Castro, Luz Maria; Härtl, Fabian; Döllerer, Martin; Hamer, Ute; Windhorst, David; Wiersma, Yolanda F.; Curatola Fernández, Giulia F.; Obermeier, Wolfgang A.; Adams, Julia; Breuer, Lutz; Mosandl, Reinhard; Beck, Erwin; Weber, Michael; Stimm, Bernd; Haber, Wolfgang; Fürst, Christine; Bendix, Jörg

2016-01-01

High landscape diversity is assumed to increase the number and level of ecosystem services. However, the interactions between ecosystem service provision, disturbance and landscape composition are poorly understood. Here we present a novel approach to include uncertainty in the optimization of land allocation for improving the provision of multiple ecosystem services. We refer to the rehabilitation of abandoned agricultural lands in Ecuador including two types of both afforestation and pasture rehabilitation, together with a succession option. Our results show that high compositional landscape diversity supports multiple ecosystem services (multifunction effect). This implicitly provides a buffer against uncertainty. Our work shows that active integration of uncertainty is only important when optimizing single or highly correlated ecosystem services and that the multifunction effect on landscape diversity is stronger than the uncertainty effect. This is an important insight to support a land-use planning based on ecosystem services. PMID:27292766

Compositional diversity of rehabilitated tropical lands supports multiple ecosystem services and buffers uncertainties.

PubMed

Knoke, Thomas; Paul, Carola; Hildebrandt, Patrick; Calvas, Baltazar; Castro, Luz Maria; Härtl, Fabian; Döllerer, Martin; Hamer, Ute; Windhorst, David; Wiersma, Yolanda F; Curatola Fernández, Giulia F; Obermeier, Wolfgang A; Adams, Julia; Breuer, Lutz; Mosandl, Reinhard; Beck, Erwin; Weber, Michael; Stimm, Bernd; Haber, Wolfgang; Fürst, Christine; Bendix, Jörg

2016-06-13

High landscape diversity is assumed to increase the number and level of ecosystem services. However, the interactions between ecosystem service provision, disturbance and landscape composition are poorly understood. Here we present a novel approach to include uncertainty in the optimization of land allocation for improving the provision of multiple ecosystem services. We refer to the rehabilitation of abandoned agricultural lands in Ecuador including two types of both afforestation and pasture rehabilitation, together with a succession option. Our results show that high compositional landscape diversity supports multiple ecosystem services (multifunction effect). This implicitly provides a buffer against uncertainty. Our work shows that active integration of uncertainty is only important when optimizing single or highly correlated ecosystem services and that the multifunction effect on landscape diversity is stronger than the uncertainty effect. This is an important insight to support a land-use planning based on ecosystem services.

Management to Insulate Ecosystem Services from the Effects of Catchment Development

NASA Astrophysics Data System (ADS)

Gell, Peter

2018-02-01

Natural ecosystems provide amenity to human populations in the form of ecosystem services. These services are grouped into four broad categories: provisioning - food and water production; regulating - control of climate and disease; supporting - crop pollination; and cultural - spiritual and recreational benefits. Aquatic systems provide considerable service through the provision of potable water, fisheries and aquaculture production, nutrient mitigation and the psychological benefits that accrue from the aesthetic amenity provided from lakes, rivers and other wetlands. Further, littoral and riparian ecosystems, and aquifers, protect human communities from sea level encroachment, and tidal and river flooding. Catchment and water development provides critical resources for human consumption. Where these provisioning services are prioritized over others, the level and quality of production may be impacted. Further, the benefits from these provisioning services comes with the opportunity cost of diminishing regulating, supporting and cultural services. This imbalance flags concerns for humanity as it exceeds recognised safe operating spaces. These concepts are explored by reference to long term records of change in some of the world's largest river catchments and lessons are drawn that may enable other communities to consider the balance of ecosystems services in natural resource management.

Assessment of economic viability of solid waste service provision in small settlements in developing countries: case study Rosetta, Egypt.

PubMed

Abdrabo, Mohamed Abdel-Karim

2008-12-01

Problems associated with solid waste management (SWM) service provision in developing countries are reaching an ever increasing magnitude, leading to considerable adverse impacts on the environment and quality of life of the inhabitants. Such problems are usually associated with limited managerial, technical and financial capabilities of municipal authorities. Municipal authorities in Egypt that are responsible for SWM services have always been accused of providing a less than satisfactory service, leading to huge quantities of solid waste being uncollected. This study assesses the potential for the provision of an effective and sustainable service, by estimating willingness of the residents to pay for such a service and the cost involved in its provision. The study covered the Rosetta urban centre and its adjacent areas, which are located in the northwestern part of the Nile Delta. It was found that, from an economic perspective, a viable SWM service could be provided in the study area using local funds. In order to increase the likelihood of success of such a service, it may be provided by a local firm or a cooperative to be established for that purpose.

A conceptual framework to assess effectiveness in wheelchair provision.

PubMed

Kamaraj, Deepan C; Bray, Nathan; Rispin, Karen; Kankipati, Padmaja; Pearlman, Jonathan; Borg, Johan

2017-01-01

Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. The three iterations of the conceptual framework are described in this manuscript. We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.

The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

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

Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr; Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk; Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it

2016-04-15

Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continuedmore » development of safe and high-quality IR services in Europe and beyond.« less

42 CFR 137.3 - Effect on existing Tribal rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Effect on existing Tribal rights. 137.3 Section 137.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE General Provisions § 137.3 Effect on existing...

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

PubMed

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

2017-03-01

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

Quality of service provision assessment in the healthcare information and telecommunications infrastructures.

PubMed

Babulak, Eduard

2006-01-01

The continuous increase in the complexity and the heterogeneity of corporate and healthcare telecommunications infrastructures will require new assessment methods of quality of service (QoS) provision that are capable of addressing all engineering and social issues with much faster speeds. Speed and accessibility to any information at any time from anywhere will create global communications infrastructures with great performance bottlenecks that may put in danger human lives, power supplies, national economy and security. Regardless of the technology supporting the information flows, the final verdict on the QoS is made by the end user. The users' perception of telecommunications' network infrastructure QoS provision is critical to the successful business management operation of any organization. As a result, it is essential to assess the QoS Provision in the light of user's perception. This article presents a cost effective methodology to assess the user's perception of quality of service provision utilizing the existing Staffordshire University Network (SUN) by adding a component of measurement to the existing model presented by Walker. This paper presents the real examples of CISCO Networking Solutions for Health Care givers and offers a cost effective approach to assess the QoS provision within the campus network, which could be easily adapted to any health care organization or campus network in the world.

Mental health economics, health service provision, and the practice of geriatric psychiatry.

PubMed

Suh, Guk-Hee; Han, Changsu

2008-11-01

Economic evaluation is becoming more and more important as a means to assist policy makers in choosing the best intervention or treatment against a pervasive scarcity of resources relative to the demands. Health service provision and the practice of geriatric psychiatry are closely associated with costs and outcomes of health economics. Recently published literature raising unanswered questions in these areas is reviewed. Some studies on the costs, outcomes, and cost-effectiveness of certain interventions or treatments (e.g. respite care, home-visiting community service) compared with usual strategies show that these are not optimal in terms of health economics. The updated guidance by the National Institute for Health and Clinical Excellence that cholinesterase inhibitors should be used only for moderate severity dementia on the grounds of cost-effectiveness has been heavily criticized. Mental health provision for older people varies across 'developed' and 'developing' countries. Updated findings provide better understanding of recent progress and issues on mental health economics, health service provision, and the practice of geriatric psychiatry. The application of health economics to the field of mental health should make complicated issues simple and explicit. Constructive criticisms and scientific debates will hasten the development of better tools or methodologies to evaluate the cost-effectiveness of current and new interventions or treatments.

76 FR 34886 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... information technology (IT) supplies, services and systems with security requirements. DATES: Effective Date... effective date that include information technology (IT) supplies, services and systems with security...

A study on strategic provisioning of cloud computing services.

PubMed

Whaiduzzaman, Md; Haque, Mohammad Nazmul; Rejaul Karim Chowdhury, Md; Gani, Abdullah

2014-01-01

Cloud computing is currently emerging as an ever-changing, growing paradigm that models "everything-as-a-service." Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified.

A Study on Strategic Provisioning of Cloud Computing Services

PubMed Central

Rejaul Karim Chowdhury, Md

2014-01-01

Cloud computing is currently emerging as an ever-changing, growing paradigm that models “everything-as-a-service.” Virtualised physical resources, infrastructure, and applications are supplied by service provisioning in the cloud. The evolution in the adoption of cloud computing is driven by clear and distinct promising features for both cloud users and cloud providers. However, the increasing number of cloud providers and the variety of service offerings have made it difficult for the customers to choose the best services. By employing successful service provisioning, the essential services required by customers, such as agility and availability, pricing, security and trust, and user metrics can be guaranteed by service provisioning. Hence, continuous service provisioning that satisfies the user requirements is a mandatory feature for the cloud user and vitally important in cloud computing service offerings. Therefore, we aim to review the state-of-the-art service provisioning objectives, essential services, topologies, user requirements, necessary metrics, and pricing mechanisms. We synthesize and summarize different provision techniques, approaches, and models through a comprehensive literature review. A thematic taxonomy of cloud service provisioning is presented after the systematic review. Finally, future research directions and open research issues are identified. PMID:25032243

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

USGS Publications Warehouse

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

2014-01-01

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

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

PubMed Central

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda.

PubMed

Lu, Chunling; Cook, Benjamin; Desmond, Chris

2017-01-01

Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities.

Equitable service provision for inclusive education and effective early intervention.

PubMed

Wicks, K M

1998-01-01

This paper illustrates one model of providing an integrated paediatric speech and language therapy service which attempts to meet the demands of both inclusive education and effective early intervention. A move has been made from location-oriented therapy provision to offering children and their families equal opportunities to have appropriate intervention according to need. The model incorporates the philosophy of inclusive education and supports the development of current specialist educational establishments into resource bases of expertise for children with special needs in mainstream schools.

Plural provision of primary medical care in England, 2002-2012.

PubMed

Sheaff, Rod

2013-10-01

Health care reforms often include provider diversification, including privatization, to increase competition and thereby health care quality and efficiency. Donabedian's organizational theory implies that the consequences will vary according to the providers' ownership. The aim was to examine how far that theory applies to changes in English NHS primary medical care (general practice) since 1998, and the consequences for patterns of service provision. Framework analysis whose categories and structure reflected Donabedian's theory and its implications, populated with data from a systematic review, administrative sources and press rapportage. Two patterns of provider diversification occurred: 'native' diversification among existing providers and plural provision as providers with different types of ownership were introduced. Native diversification occurred through: extensive recruitment of salaried GPs; extending the range of services provided by general practices; introducing limited liability partnerships; establishing GPs with special clinical interests; and introducing a wider range of services for GPs to refer to. All of these had little apparent effect on competition between general practices. Plural provision involved: increased primary care provision by corporations; introducing GP-owned firms; establishing social enterprises (initially mostly out-of-hours cooperatives); and Primary Care Trusts taking over general practices. Plural provision was on a smaller scale than native diversification and appeared to go into reverse in 2011. Although the available data confirm the implications of Donabedian's theory, there are exceptions. Native diversification and plural provision policies differ in their implications for service development.

A conceptual framework to assess effectiveness in wheelchair provision

PubMed Central

Kankipati, Padmaja

2017-01-01

Background Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. Objectives In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. Method The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. Results The three iterations of the conceptual framework are described in this manuscript. Conclusion We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe. PMID:28936421

Hospital ownership and medical services: market mix, spillover effects, and nonprofit objectives.

PubMed

Horwitz, Jill R; Nichols, Austin

2009-09-01

Hospitals operate in markets with varied demographic, competitive, and ownership characteristics, yet research on ownership tends to examine hospitals in isolation. Here we examine three hospital ownership types -- nonprofit, for-profit, and government -- and their spillover effects. We estimate the effects of for-profit market share in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals' medical service provision systematically varies by market mix. We find no significant effect of market mix on the operating margins of nonprofit hospitals, but find that for-profit hospitals have higher margins in markets with more for-profits. These results fit best with theories in which hospitals maximize their own output.

Ecosystem services capacity across heterogeneous forest types: understanding the interactions and suggesting pathways for sustaining multiple ecosystem services.

PubMed

Alamgir, Mohammed; Turton, Stephen M; Macgregor, Colin J; Pert, Petina L

2016-10-01

As ecosystem services supply from tropical forests is declining due to deforestation and forest degradation, much effort is essential to sustain ecosystem services supply from tropical forested landscapes, because tropical forests provide the largest flow of multiple ecosystem services among the terrestrial ecosystems. In order to sustain multiple ecosystem services, understanding ecosystem services capacity across heterogeneous forest types and identifying certain ecosystem services that could be managed to leverage positive effects across the wider bundle of ecosystem services are required. We sampled three forest types, tropical rainforests, sclerophyll forests, and rehabilitated plantation forests, over an area of 32,000m(2) from Wet Tropics bioregion, Australia, aiming to compare supply and evaluate interactions and patterns of eight ecosystem services (global climate regulation, air quality regulation, erosion regulation, nutrient regulation, cyclone protection, habitat provision, energy provision, and timber provision). On average, multiple ecosystem services were highest in the rainforests, lowest in sclerophyll forests, and intermediate in rehabilitated plantation forests. However, a wide variation was apparent among the plots across the three forest types. Global climate regulation service had a synergistic impact on the supply of multiple ecosystem services, while nutrient regulation service was found to have a trade-off impact. Considering multiple ecosystem services, most of the rehabilitated plantation forest plots shared the same ordination space with rainforest plots in the ordination analysis, indicating that rehabilitated plantation forests may supply certain ecosystem services nearly equivalent to rainforests. Two synergy groups and one trade-off group were identified. Apart from conserving rainforests and sclerophyll forests, our findings suggest two additional integrated pathways to sustain the supply of multiple ecosystem services from a heterogeneous tropical forest landscape: (i) rehabilitation of degraded forests aiming to provide global climate regulation and habitat provision ecosystem services and (ii) management intervention to sustain global climate regulation and habitat provision ecosystem services. Copyright © 2016 Elsevier B.V. All rights reserved.

Trade-offs across space, time, and ecosystem services

USGS Publications Warehouse

Rodriguez, J.P.; Beard, T.D.; Bennett, E.M.; Cumming, Graeme S.; Cork, S.J.; Agard, J.; Dobson, A.P.; Peterson, G.D.

2006-01-01

Ecosystem service (ES) trade-offs arise from management choices made by humans, which can change the type, magnitude, and relative mix of services provided by ecosystems. Trade-offs occur when the provision of one ES is reduced as a consequence of increased use of another ES. In some cases, a trade-off may be an explicit choice; but in others, trade-offs arise without premeditation or even awareness that they are taking place. Trade-offs in ES can be classified along three axes: spatial scale, temporal scale, and reversibility. Spatial scale refers to whether the effects of the trade-off are felt locally or at a distant location. Temporal scale refers to whether the effects take place relatively rapidly or slowly. Reversibility expresses the likelihood that the perturbed ES may return to its original state if the perturbation ceases. Across all four Millennium Ecosystem Assessment scenarios and selected case study examples, trade-off decisions show a preference for provisioning, regulating, or cultural services (in that order). Supporting services are more likely to be "taken for granted." Cultural ES are almost entirely unquantified in scenario modeling; therefore, the calculated model results do not fully capture losses of these services that occur in the scenarios. The quantitative scenario models primarily capture the services that are perceived by society as more important - provisioning and regulating ecosystem services - and thus do not fully capture trade-offs of cultural and supporting services. Successful management policies will be those that incorporate lessons learned from prior decisions into future management actions. Managers should complement their actions with monitoring programs that, in addition to monitoring the short-term provisions of services, also monitor the long-term evolution of slowly changing variables. Policies can then be developed to take into account ES trade-offs at multiple spatial and temporal scales. Successful strategies will recognize the inherent complexities of ecosystem management and will work to develop policies that minimize the effects of ES trade-offs. Copyright ?? 2006 by the author(s).

The Relevance of the Affordable Care Act for Improving Mental Health Care.

PubMed

Mechanic, David; Olfson, Mark

2016-01-01

Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.

A Study of Policy, Organisation and Provision in Community Education and Leisure and Recreation in Three Scottish Regions.

ERIC Educational Resources Information Center

Alexander, D. J.; And Others

This document describes a study conducted to examine the effectiveness and efficiency of the provision of leisure and recreation services and community education services in selected areas of the Tayside, Central, and Fife Regions of Scotland. The 18-month-long study gathered 826 responses from 1,060 questionnaires issued in order to study the…

26 CFR 1.527-8 - Effective date; filing requirements; and miscellaneous provisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Effective date; filing requirements; and miscellaneous provisions. 1.527-8 Section 1.527-8 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Farmers' Cooperatives § 1.527-8...

Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia.

PubMed

Hewett, Paul C; Nalubamba, Mutinta; Bozzani, Fiammetta; Digitale, Jean; Vu, Lung; Yam, Eileen; Nambao, Mary

2016-08-12

Provision of HIV prevention and sexual and reproductive health services in Zambia is largely characterized by discrete service provision with weak client referral and linkage. The literature reveals gaps in the continuity of care for HIV and sexual and reproductive health. This study assessed whether improved service delivery models increased the uptake and cost-effectiveness of HIV and sexual and reproductive health services. Adult clients 18+ years of age accessing family planning (females), HIV testing and counseling (females and males), and male circumcision services (males) were recruited, enrolled and individually randomized to one of three study arms: 1) the standard model of service provision at the entry point (N = 1319); 2) an enhanced counseling and referral to add-on service with follow-up (N = 1323); and 3) the components of study arm two, with the additional offer of an escort (N = 1321). Interviews were conducted with the same clients at baseline, six weeks and six months. Uptake of services for HIV, family planning, male circumcision, and cervical cancer screening at six weeks and six months were the primary endpoints. Pairwise chi-square and multivariable logistic regression statistical tests assessed differences across study arms, which were also assessed for incremental cost-efficiency and cost-effectiveness. A total of 3963 clients, 1920 males and 2043 females, were enrolled; 82 % of participants at six weeks were tracked and 81 % at six months; follow-up rates did not vary significantly by study arm. The odds of clients accessing HIV testing and counseling, cervical cancer screening services among females, and circumcision services among males varied significantly by study arm at six weeks and six months; less consistent findings were observed for HIV care and treatment. Client uptake of family planning services did not vary significantly by study arm. Integrated services were found to be more efficiently provided than vertical service provision; the cost-effectiveness for HIV/AIDS and cervical cancer was high in the enhanced service models. Study results provide evidence for increasing the linkages and integration of a selection of HIV and sexual and reproductive health services. The study provided cost-effective service delivery models that enhanced the likelihood of clients accessing some additional needed health services. ISRCTN84228514 Retrospectively registered. The study was retrospectively registered in the ISRCTN clinical trials registry on 06 October 2015. The first recruitment of participants occurred on 17 December 2013.

Dentist age, period and cohort effects on provision of dental services in Australia: 1983-84 to 2009-10.

PubMed

Ju, Xiangqun; Spencer, A John; Brennan, David S

2017-06-01

To examine age, period and cohort factors of dentists in relation to diagnostic, preventive and total dental services over time in Australia. The Longitudinal Study of Dentists' Practice Activity (LSDPA) was designed to monitor dental practice activity and service provision in Australia. Participating dentists were sampled randomly from the dental registers in Australia from 1983 to 1984, and dental services provision was collected by mailed questionnaire with a log of dental services provided over one or two typical days. The data collection has been repeated every 5 years until 2009-2010. Sample supplementation of newly registered dentists occurred at successive waves. This study focused on diagnostic, preventive and total services. The time trends in the mean rates of the services were described using a standard cohort table, and negative binomial regression was applied to estimate age, period and cohort effects. The response rates were 73%, 75%, 74%, 71%, 76% and 67% in 1983, 1988, 1993, 1998, 2003 and 2009, respectively. The mean rates of diagnostic, preventive and total services increased between 1983 and 2009 across all age groups. The period effect showed a higher rate of diagnostic (rate ratios [RR]: 1.21 in 1993 to 1.80 in 2009), preventive (RR: 1.19 in 1988 to 1.85 in 2009) and the total service (RR: 1.08 in 1988 to 1.39 in 2009) over time, compared with the reference group of 1983. Older cohorts had a lower rate, and the younger cohorts had a higher rate of diagnostic, preventive and the total number of services over the study period. The highest rate of diagnostic (RR=2.53), preventive (RR=2.44) and the total service (RR=1.52) was in those aged 25-29 years in 1983 compared with the reference group of 30-34 years in 1983. Trends in dental services provision can be associated with age, period and cohort effects. The study found the rate of diagnostic, preventive and total services increased over time. Meanwhile, an increasing rate of diagnostic, preventive and the total services was observed when moving from older cohorts to younger cohorts among Australian dentists suggesting a sustained shift towards these services into the future. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Regional Correlates of Psychiatric Inpatient Treatment.

PubMed

Ala-Nikkola, Taina; Pirkola, Sami; Kaila, Minna; Saarni, Samuli I; Joffe, Grigori; Kontio, Raija; Oranta, Olli; Sadeniemi, Minna; Wahlbeck, Kristian

2016-12-05

Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.

78 FR 60453 - Application of the Fair Labor Standards Act to Domestic Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

...In 1974, Congress extended the protections of the Fair Labor Standards Act (FLSA or the Act) to ``domestic service'' employees, but it exempted from the Act's minimum wage and overtime provisions domestic service employees who provide ``companionship services'' to elderly people or people with illnesses, injuries, or disabilities who require assistance in caring for themselves, and it exempted from the Act's overtime provision domestic service employees who reside in the household in which they provide services. This Final Rule revises the Department's 1975 regulations implementing these amendments to the Act to better reflect Congressional intent given the changes to the home care industry and workforce since that time. Most significantly, the Department is revising the definition of ``companionship services'' to clarify and narrow the duties that fall within the term; in addition third party employers, such as home care agencies, will not be able to claim either of the exemptions. The major effect of this Final Rule is that more domestic service workers will be protected by the FLSA's minimum wage, overtime, and recordkeeping provisions.

Valuing ecosystem services in terms of ecological risks and returns.

PubMed

Abson, David J; Termansen, Mette

2011-04-01

The economic valuation of ecosystem services is a key policy tool in stemming losses of biological diversity. It is proposed that the loss of ecosystem function and the biological resources within ecosystems is due in part to the failure of markets to recognize the benefits humans derive from ecosystems. Placing monetary values on ecosystem services is often suggested as a necessary step in correcting such market failures. We consider the effects of valuing different types of ecosystem services within an economic framework. We argue that provisioning and regulating ecosystem services are generally produced and consumed in ways that make them amenable to economic valuation. The values associated with cultural ecosystem services lie outside the domain of economic valuation, but their worth may be expressed through noneconomic, deliberative forms of valuation. We argue that supporting ecosystem services are not of direct value and that the losses of such services can be expressed in terms of the effects of their loss on the risk to the provision of the directly valued ecosystem services they support. We propose a heuristic framework that considers the relations between ecological risks and returns in the provision of ecosystem services. The proposed ecosystem-service valuation framework, which allows the expression of the value of all types of ecosystem services, calls for a shift from static, purely monetary valuation toward the consideration of trade-offs between the current flow of benefits from ecosystems and the ability of those ecosystems to provide future flows. ©2010 Society for Conservation Biology.

Implementing the optimal provision of ecosystem services

PubMed Central

Polasky, Stephen; Lewis, David J.; Plantinga, Andrew J.; Nelson, Erik

2014-01-01

Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners’ costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information. PMID:24722635

Implementing the optimal provision of ecosystem services.

PubMed

Polasky, Stephen; Lewis, David J; Plantinga, Andrew J; Nelson, Erik

2014-04-29

Many ecosystem services are public goods whose provision depends on the spatial pattern of land use. The pattern of land use is often determined by the decisions of multiple private landowners. Increasing the provision of ecosystem services, though beneficial for society as a whole, may be costly to private landowners. A regulator interested in providing incentives to landowners for increased provision of ecosystem services often lacks complete information on landowners' costs. The combination of spatially dependent benefits and asymmetric cost information means that the optimal provision of ecosystem services cannot be achieved using standard regulatory or payment for ecosystem services approaches. Here we show that an auction that sets payments between landowners and the regulator for the increased value of ecosystem services with conservation provides incentives for landowners to truthfully reveal cost information, and allows the regulator to implement the optimal provision of ecosystem services, even in the case with spatially dependent benefits and asymmetric information.

20 CFR 653.101 - Provision of services to migrant and seasonal farmworkers (MSFWs).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Provision of services to migrant and seasonal..., DEPARTMENT OF LABOR SERVICES OF THE EMPLOYMENT SERVICE SYSTEM Services for Migrant and Seasonal Farmworkers (MSFWs) § 653.101 Provision of services to migrant and seasonal farmworkers (MSFWs). (a) Each State...

Place and provision: mapping mental health advocacy services in London.

PubMed

Foley, Ronan; Platzer, Hazel

2007-02-01

The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

42 CFR 457.1015 - Cost-effectiveness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart...

RESNA Wheelchair Service Provision Guide

ERIC Educational Resources Information Center

Arledge, Stan; Armstrong, William; Babinec, Mike; Dicianno, Brad E.; Digiovine, Carmen; Dyson-Hudson, Trevor; Pederson, Jessica; Piriano, Julie; Plummer, Teresa; Rosen, Lauren; Schmeler, Mark; Shea, Mary; Stogner, Jody

2011-01-01

The purpose of the Wheelchair Service Provision Guide is to provide an appropriate framework for identifying the essential steps in the provision of a wheelchair. It is designed for use by all participants in the provision process including consumers, family members, caregivers, social service and health care professionals, suppliers,…

45 CFR 400.147 - Priority in provision of services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

45 CFR 400.147 - Priority in provision of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

45 CFR 400.147 - Priority in provision of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

45 CFR 400.147 - Priority in provision of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

45 CFR 400.147 - Priority in provision of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Priority in provision of services. 400.147 Section 400.147 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Funding and Service Priorities § 400.147 Priority in provision of services. A...

Freshwater Ecosystem Service Flow Model To Evaluate Regional Water Security: A Case Study In Beijing-Tianjin-Hebei Region, China

NASA Astrophysics Data System (ADS)

Li, D.; Li, S.

2016-12-01

Freshwater service, as the most important support ecosystem service, is essential to human survival and development. Many studies have evidenced the spatial differences in the supply and demand of ecosystem services and raised the concept of ecosystem service flow. However, rather few studies quantitatively characterize the freshwater service flow. This paper aims to quantify the effect of freshwater ecosystem service flow on downstream areas in Beijing-Tianjin-Hebei (BTH) region, China over 2000, 2005 and 2010. We computed the freshwater ecosystem service provision with InVEST model. We calculated freshwater ecosystem service consumption with water quota method. We simulated the freshwater ecosystem service flow using our simplified flow model and assessed the regional water security with the improved freshwater security index. The freshwater provision service mainly depends on climatic factors that cannot be influenced by management, while the freshwater consumption service is constrained by human activities. Furthermore, the decrease of water quota for agricultural, domestic and industrial water counteracts the impact of increasing freshwater demand. The analysis of freshwater ecosystem service flow reveals that the majority area of the BTH (69.2%) is affected by upstream freshwater. If freshwater ecosystem service flow is considered, the water safety areas of the whole BTH account for 66.9%, 66.1%, 71.3%, which increase 6.4%, 6.8% and 5.7% in 2000, 2005 and 2010, respectively. These results highlight the need to understand the teleconnections between distant freshwater ecosystem service provision and local freshwater ecosystem service use. This approach therefore helps managers choose specific management and investment strategies for critical upstream freshwater provisions across different regions.

22 CFR 92.92 - Service of legal process under provisions of State law.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of legal process under provisions of... AND RELATED SERVICES Quasi-Legal Services § 92.92 Service of legal process under provisions of State law. It may be found that a State statue purporting to regulate the service of process in foreign...

Soil management shapes ecosystem service provision and trade-offs in agricultural landscapes.

PubMed

Tamburini, Giovanni; De Simone, Serena; Sigura, Maurizia; Boscutti, Francesco; Marini, Lorenzo

2016-08-31

Agroecosystems are principally managed to maximize food provisioning even if they receive a large array of supporting and regulating ecosystem services (ESs). Hence, comprehensive studies investigating the effects of local management and landscape composition on the provision of and trade-offs between multiple ESs are urgently needed. We explored the effects of conservation tillage, nitrogen fertilization and landscape composition on six ESs (crop production, disease control, soil fertility, water quality regulation, weed and pest control) in winter cereals. Conservation tillage enhanced soil fertility and pest control, decreased water quality regulation and weed control, without affecting crop production and disease control. Fertilization only influenced crop production by increasing grain yield. Landscape intensification reduced the provision of disease and pest control. We also found tillage and landscape composition to interactively affect water quality regulation and weed control. Under N fertilization, conventional tillage resulted in more trade-offs between ESs than conservation tillage. Our results demonstrate that soil management and landscape composition affect the provision of several ESs and that soil management potentially shapes the trade-offs between them. © 2016 The Author(s).

Dynamic Hop Service Differentiation Model for End-to-End QoS Provisioning in Multi-Hop Wireless Networks

NASA Astrophysics Data System (ADS)

Youn, Joo-Sang; Seok, Seung-Joon; Kang, Chul-Hee

This paper presents a new QoS model for end-to-end service provisioning in multi-hop wireless networks. In legacy IEEE 802.11e based multi-hop wireless networks, the fixed assignment of service classes according to flow's priority at every node causes priority inversion problem when performing end-to-end service differentiation. Thus, this paper proposes a new QoS provisioning model called Dynamic Hop Service Differentiation (DHSD) to alleviate the problem and support effective service differentiation between end-to-end nodes. Many previous works for QoS model through the 802.11e based service differentiation focus on packet scheduling on several service queues with different service rate and service priority. Our model, however, concentrates on a dynamic class selection scheme, called Per Hop Class Assignment (PHCA), in the node's MAC layer, which selects a proper service class for each packet, in accordance with queue states and service requirement, in every node along the end-to-end route of the packet. The proposed QoS solution is evaluated using the OPNET simulator. The simulation results show that the proposed model outperforms both best-effort and 802.11e based strict priority service models in mobile ad hoc environments.

14 CFR 1214.114 - Provision of services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

14 CFR 1214.114 - Provision of services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

14 CFR 1214.114 - Provision of services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

14 CFR 1214.114 - Provision of services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

29 CFR 4.143 - Effects of changes or extensions of contracts, generally.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Application of the McNamara-O'Hara Service Contract Act Changes in Contract Coverage § 4.143 Effects of... purposes of the application of the Act's provisions. The general rule with respect to such contracts is... provisions of the Act and the regulations thereunder will apply to the changed contract in the same manner...

10 CFR 35.80 - Provision of mobile medical service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Provision of mobile medical service. 35.80 Section 35.80... § 35.80 Provision of mobile medical service. (a) A licensee providing mobile medical service shall— (1... to ensure compliance with the requirements in Part 20 of this chapter. (b) A mobile medical service...

14 CFR § 1214.114 - Provision of services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Provisions Regarding Space Shuttle Flights of Payloads for Non-U.S. Government, Reimbursable Customers § 1214.114 Provision of services. NASA will provide, solely at its discretion, services to the extent...

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

NASA Astrophysics Data System (ADS)

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-07-01

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-07-28

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes.

Experimental demonstration of multi-dimensional resources integration for service provisioning in cloud radio over fiber network

PubMed Central

Yang, Hui; Zhang, Jie; Ji, Yuefeng; He, Yongqi; Lee, Young

2016-01-01

Cloud radio access network (C-RAN) becomes a promising scenario to accommodate high-performance services with ubiquitous user coverage and real-time cloud computing in 5G area. However, the radio network, optical network and processing unit cloud have been decoupled from each other, so that their resources are controlled independently. Traditional architecture cannot implement the resource optimization and scheduling for the high-level service guarantee due to the communication obstacle among them with the growing number of mobile internet users. In this paper, we report a study on multi-dimensional resources integration (MDRI) for service provisioning in cloud radio over fiber network (C-RoFN). A resources integrated provisioning (RIP) scheme using an auxiliary graph is introduced based on the proposed architecture. The MDRI can enhance the responsiveness to dynamic end-to-end user demands and globally optimize radio frequency, optical network and processing resources effectively to maximize radio coverage. The feasibility of the proposed architecture is experimentally verified on OpenFlow-based enhanced SDN testbed. The performance of RIP scheme under heavy traffic load scenario is also quantitatively evaluated to demonstrate the efficiency of the proposal based on MDRI architecture in terms of resource utilization, path blocking probability, network cost and path provisioning latency, compared with other provisioning schemes. PMID:27465296

42 CFR 137.48 - What is the effect of incorporating a Title I provision into a compact or funding agreement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SELF-GOVERNANCE Funding Agreements Terms in A Funding Agreement § 137.48 What is the effect of... 42 Public Health 1 2010-10-01 2010-10-01 false What is the effect of incorporating a Title I provision into a compact or funding agreement? 137.48 Section 137.48 Public Health PUBLIC HEALTH SERVICE...

42 CFR 137.48 - What is the effect of incorporating a Title I provision into a compact or funding agreement?

Code of Federal Regulations, 2011 CFR

2011-10-01

... SELF-GOVERNANCE Funding Agreements Terms in A Funding Agreement § 137.48 What is the effect of... 42 Public Health 1 2011-10-01 2011-10-01 false What is the effect of incorporating a Title I provision into a compact or funding agreement? 137.48 Section 137.48 Public Health PUBLIC HEALTH SERVICE...

42 CFR 137.48 - What is the effect of incorporating a Title I provision into a compact or funding agreement?

Code of Federal Regulations, 2013 CFR

2013-10-01

... SELF-GOVERNANCE Funding Agreements Terms in A Funding Agreement § 137.48 What is the effect of... 42 Public Health 1 2013-10-01 2013-10-01 false What is the effect of incorporating a Title I provision into a compact or funding agreement? 137.48 Section 137.48 Public Health PUBLIC HEALTH SERVICE...

42 CFR 137.48 - What is the effect of incorporating a Title I provision into a compact or funding agreement?

Code of Federal Regulations, 2014 CFR

2014-10-01

... SELF-GOVERNANCE Funding Agreements Terms in A Funding Agreement § 137.48 What is the effect of... 42 Public Health 1 2014-10-01 2014-10-01 false What is the effect of incorporating a Title I provision into a compact or funding agreement? 137.48 Section 137.48 Public Health PUBLIC HEALTH SERVICE...

42 CFR 137.48 - What is the effect of incorporating a Title I provision into a compact or funding agreement?

Code of Federal Regulations, 2012 CFR

2012-10-01

... SELF-GOVERNANCE Funding Agreements Terms in A Funding Agreement § 137.48 What is the effect of... 42 Public Health 1 2012-10-01 2012-10-01 false What is the effect of incorporating a Title I provision into a compact or funding agreement? 137.48 Section 137.48 Public Health PUBLIC HEALTH SERVICE...

26 CFR 1.42-11 - Provision of services.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

26 CFR 1.42-11 - Provision of services.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

26 CFR 1.42-11 - Provision of services.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Provision of services. 1.42-11 Section 1.42-11 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Credits Against Tax § 1.42-11 Provision of services. (a) General rule. The furnishing to tenants of services other than housing (whether or not the services...

Web-Based Self-Service Systems for Managed IT Support: Service Provider Perspectives of Stakeholder-Based Issues

NASA Astrophysics Data System (ADS)

Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross

This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.

77 FR 749 - General Services Administration Acquisition Regulation; Implementation of Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... Acquisition Regulation; Implementation of Information Technology Security Provision AGENCY: Office of... orders that include information technology (IT) supplies, services and systems. DATES: Effective Date... 6, 2012 that include information technology (IT) supplies, services and systems with security...

Best practices in transit service planning : final report, March 2009.

DOT National Transportation Integrated Search

2009-03-01

The provision of cost efficient and effective bus transit service is the basic premise upon which transit service is developed and the goal that all public transportations agencies strive to achieve. To attain this goal, public transit agencies must ...

Nitrogen Cycling from Increased Soil Organic Carbon Contributes Both Positively and Negatively to Ecosystem Services in Wheat Agro-Ecosystems

PubMed Central

Palmer, Jeda; Thorburn, Peter J.; Biggs, Jody S.; Dominati, Estelle J.; Probert, Merv E.; Meier, Elizabeth A.; Huth, Neil I.; Dodd, Mike; Snow, Val; Larsen, Joshua R.; Parton, William J.

2017-01-01

Soil organic carbon (SOC) is an important and manageable property of soils that impacts on multiple ecosystem services through its effect on soil processes such as nitrogen (N) cycling and soil physical properties. There is considerable interest in increasing SOC concentration in agro-ecosystems worldwide. In some agro-ecosystems, increased SOC has been found to enhance the provision of ecosystem services such as the provision of food. However, increased SOC may increase the environmental footprint of some agro-ecosystems, for example by increasing nitrous oxide emissions. Given this uncertainty, progress is needed in quantifying the impact of increased SOC concentration on agro-ecosystems. Increased SOC concentration affects both N cycling and soil physical properties (i.e., water holding capacity). Thus, the aim of this study was to quantify the contribution, both positive and negative, of increased SOC concentration on ecosystem services provided by wheat agro-ecosystems. We used the Agricultural Production Systems sIMulator (APSIM) to represent the effect of increased SOC concentration on N cycling and soil physical properties, and used model outputs as proxies for multiple ecosystem services from wheat production agro-ecosystems at seven locations around the world. Under increased SOC, we found that N cycling had a larger effect on a range of ecosystem services (food provision, filtering of N, and nitrous oxide regulation) than soil physical properties. We predicted that food provision in these agro-ecosystems could be significantly increased by increased SOC concentration when N supply is limiting. Conversely, we predicted no significant benefit to food production from increasing SOC when soil N supply (from fertiliser and soil N stocks) is not limiting. The effect of increasing SOC on N cycling also led to significantly higher nitrous oxide emissions, although the relative increase was small. We also found that N losses via deep drainage were minimally affected by increased SOC in the dryland agro-ecosystems studied, but increased in the irrigated agro-ecosystem. Therefore, we show that under increased SOC concentration, N cycling contributes both positively and negatively to ecosystem services depending on supply, while the effects on soil physical properties are negligible. PMID:28539929

Nitrogen Cycling from Increased Soil Organic Carbon Contributes Both Positively and Negatively to Ecosystem Services in Wheat Agro-Ecosystems.

PubMed

Palmer, Jeda; Thorburn, Peter J; Biggs, Jody S; Dominati, Estelle J; Probert, Merv E; Meier, Elizabeth A; Huth, Neil I; Dodd, Mike; Snow, Val; Larsen, Joshua R; Parton, William J

2017-01-01

Soil organic carbon (SOC) is an important and manageable property of soils that impacts on multiple ecosystem services through its effect on soil processes such as nitrogen (N) cycling and soil physical properties. There is considerable interest in increasing SOC concentration in agro-ecosystems worldwide. In some agro-ecosystems, increased SOC has been found to enhance the provision of ecosystem services such as the provision of food. However, increased SOC may increase the environmental footprint of some agro-ecosystems, for example by increasing nitrous oxide emissions. Given this uncertainty, progress is needed in quantifying the impact of increased SOC concentration on agro-ecosystems. Increased SOC concentration affects both N cycling and soil physical properties (i.e., water holding capacity). Thus, the aim of this study was to quantify the contribution, both positive and negative, of increased SOC concentration on ecosystem services provided by wheat agro-ecosystems. We used the Agricultural Production Systems sIMulator (APSIM) to represent the effect of increased SOC concentration on N cycling and soil physical properties, and used model outputs as proxies for multiple ecosystem services from wheat production agro-ecosystems at seven locations around the world. Under increased SOC, we found that N cycling had a larger effect on a range of ecosystem services (food provision, filtering of N, and nitrous oxide regulation) than soil physical properties. We predicted that food provision in these agro-ecosystems could be significantly increased by increased SOC concentration when N supply is limiting. Conversely, we predicted no significant benefit to food production from increasing SOC when soil N supply (from fertiliser and soil N stocks) is not limiting. The effect of increasing SOC on N cycling also led to significantly higher nitrous oxide emissions, although the relative increase was small. We also found that N losses via deep drainage were minimally affected by increased SOC in the dryland agro-ecosystems studied, but increased in the irrigated agro-ecosystem. Therefore, we show that under increased SOC concentration, N cycling contributes both positively and negatively to ecosystem services depending on supply, while the effects on soil physical properties are negligible.

Enhancing the metalinguistic abilities of pre-service teachers via coursework targeting language structure knowledge.

PubMed

Purvis, Caralyn J; McNeill, Brigid C; Everatt, John

2016-04-01

Low metalinguistic knowledge of pre-service and in-service teachers is likely to restrict the provision of evidence-based literacy instruction in the classroom. Despite such concerns, relatively few studies have examined the effects of teacher preparation coursework in building pre-service teachers' language structure knowledge. This study examined the effects of 7 h of language structure coursework, delivered over 7 weeks, on 121 New Zealand pre-service teachers in their initial year of study. Changes in participants' phonological awareness, morphological awareness, and orthographic knowledge were tracked across the teaching period. The impact of the coursework for participants who presented with strong spelling (n = 24) and poor spelling (n = 24) ability was also compared. The cohort demonstrated significant gains across all measures. Strong spellers responded more favourably to the teaching than poor spellers, even when accounting for initial levels of meta-linguistic knowledge. Implications for the development of teacher preparation programmes that enhance the provision of effective literacy instruction are discussed.

45 CFR 400.117 - Provision of care and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Provision of care and services. 400.117 Section... Child Welfare Services § 400.117 Provision of care and services. (a) A State may provide care and... agency approved or licensed under State law. (b) If a State arranges for the care and services through a...

Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector of Mexico: a case study.

PubMed

Díaz de León-Castañeda, Christian; Gutiérrez-Godínez, Jéssica; Colado-Velázquez, Juventino Iii; Toledano-Jaimes, Cairo

2018-04-22

In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision. Copyright © 2018 Elsevier Inc. All rights reserved.

31 CFR 598.406 - Provision of services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

31 CFR 598.406 - Provision of services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

31 CFR 598.406 - Provision of services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

31 CFR 598.406 - Provision of services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Provision of services. 598.406 Section 598.406 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.406 Provision of services. (a) The prohibitions contained in § 598.203 apply to services...

Has recommended preventive service use increased after elimination of cost-sharing as part of the Affordable Care Act in the United States?

PubMed

Han, Xuesong; Robin Yabroff, K; Guy, Gery P; Zheng, Zhiyuan; Jemal, Ahmedin

2015-09-01

An early provision of the Affordable Care Act (ACA) eliminated cost-sharing for a range of recommended preventive services. This provision took effect in September 2010, but little is known about its effect on preventive service use. We evaluated changes in the use of recommended preventive services from 2009 (before the implementation of ACA cost-sharing provision) to 2011/2012 (after the implementation) in the Medical Expenditure Panel Survey, a nationally representative household interview survey in the US. Specifically, we examined: blood pressure check, cholesterol check, flu vaccination, and cervical, breast, and colorectal cancer screening, controlling for demographic characteristics and stratifying by insurance type. There were 64,280 (21,310 before and 42,970 after the implementation of ACA cost-sharing provision) adults included in the analyses. Receipt of recent blood pressure check, cholesterol check and flu vaccination increased significantly from 2009 to 2011/2012, primarily in the privately insured population aged 18-64years, with adjusted prevalence ratios (95% confidence intervals) 1.03 (1.01-1.05) for blood pressure check, 1.13 (1.09-1.18) for cholesterol check and 1.04 (1.00-1.08) for flu vaccination (all p-values<0.05). However, few changes were observed for cancer screening. We observed little change in the uninsured population. These early observations suggest positive benefits from the ACA policy of eliminating cost-sharing for some preventive services. Future research is warranted to monitor and evaluate longer term effects of the ACA on access to care and health outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

7 CFR 1789.158 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the services to be provided and applicable time frames for the provision of such services. (2) The... Borrower to enter into the agreements and to take such other action as is necessary to effect the purposes...

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

Did Project Liberty displace community-based medicaid services in New York?

PubMed

Gomes, Carla; McGuire, Thomas G; Foster, M Jameson; Donahue, Sheila A; Felton, Chip J; Essock, Susan M

2006-09-01

This study analyzed how the introduction of Project Liberty services after the September 11, 2001, terrorist attacks affected agencies' provision of community-based Medicaid mental health services in the New York metropolitan area. Provision of Medicaid mental health services was tracked between January 2000 and June 2003 for provider agencies participating in Project Liberty (N=164) and for a comparison group of mental health provider agencies that did not participate in this program (N=94). Overall, participation in Project Liberty did not significantly affect the volume of Medicaid services provided. However, for agencies with one site, a statistically significant difference was seen; compared with agencies in the comparison group, agencies that participated in Project Liberty claimed a mean+/-SE decrease of $4.66+/-3.57 less in Medicaid services per month per Project Liberty visit. Project Liberty permitted rapid expansion of the total volume of services provided by community-based organizations without interfering with the provision of traditional services, although a modest effect was seen for smaller agencies. Although the results do not imply that "supply side" planning for disaster needs would not improve system response, they do imply that implementation of flexible "demand side" financing can call forth a large volume of new services rapidly and without interfering with other community services.

Evaluation of a primary care adult mental health service: Year 2

PubMed Central

2013-01-01

Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery. Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs). Results A total of 43 individuals attended for an initial appointment, of whom 19 (44.2%) completed brief CBT treatment. Of the 13 service users who were in the clinical range pre-treatment, 11 (84.6%) achieved clinical and reliably significant improvement. Of the six service users who were in the non-clinical range pre-treatment, three (50%) achieved reliably significant improvement. Both service users and GPs indicated high levels of satisfaction with the service, although service accessibility was highlighted as needing improvement. Conclusion The service was effective in treating mild to moderate mental health problems in primary care. Stricter adherence to a stepped care model through the provision of low-intensity, high-throughput interventions would be desirable for future service provision. PMID:24381655

The outer limits of the welfare state: discrimination, racism and their effect on human services.

PubMed

Wershow, H J

The European social democracies have been more generous than the United States in social provision, including services to aged. The momentum of provision has slowed down in recent years. We suggest that prosperity which has led to use of foreign laborers in menial jobs has caused this slow down. The dynamics are similar to the historical U.S. use of "non-100% Americans" as our menial workers. Changes in social policy strategies are needed: 1) universal provision, rather than programs aimed at minorities, is needed to enlist support of stable working and middle classes; 2) tax reforms, which lower progressive income-tax structures for middle incomes, and value-added tax, may be necessary to overcome anti-tax ideologies; 3) clear priorities as to most necessary services must be established by the gerontological community.

What factors influence physiotherapy service provision in rural communities? A pilot study.

PubMed

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

Epilepsy services in Ireland: 'A survey of people with epilepsy in relation to satisfaction, preferences and information provision'.

PubMed

Bennett, Louise; Bergin, Michael; Gooney, Martina; Doherty, Colin P; Synnott, Cara; Wells, John S G

2015-07-01

A challenge facing modern health care systems is to develop and implement new models of service that deliver increased capacity while providing a higher-quality, more cost-effective service within resource constraints. Incorporating the experience of people with epilepsy must be seen as central to the effectiveness of service design and delivery. This paper, therefore, reports the views of people with epilepsy with regards to health service delivery in Ireland. A cross-sectional descriptive survey design involving both quantitative and qualitative items was administered to a convenience sample of one hundred and two people with epilepsy (n=102) attending an epilepsy specialist centre. Despite high levels of satisfaction with hospital and primary care, participants offered several suggestions to improve healthcare delivery, such as: less delay in accessing specialist care and hospital appointments; better communication; and easier access to investigatory services. Findings demonstrate that for people with epilepsy the burden of the disorder is substantial and complex encompassing social, psychological and structural difficulties. Poor information provision particularly among women is reported. Furthermore, a lack of empowerment in people with epilepsy is highlighted. This study has implications for the reform and development of epilepsy services in relation to practice, education and research. It provides a basis for an evaluation of current practice and identifies opportunities for future service reorganization to improve the quality and efficiency of healthcare provision. Copyright © 2015 Elsevier B.V. All rights reserved.

A Survey of Mental Health Service Provision in New York State Residential Treatment Centers

ERIC Educational Resources Information Center

Baker, Amy J. L.; Fulmore, Darren; Collins, Julie

2008-01-01

Thirty-seven of 43 (86%) agencies operating child welfare residential treatment centers in New York State responded to a survey about the provision of mental health services. Questions were asked about provision of services, satisfaction with services, and suggestions for improvement in five domains: therapeutic milieu, individual therapy, group…

The Use of Ecological Indicators as a Basis for Operationalizing a PES Scheme on Forest Conservation in Northern Argentina

NASA Astrophysics Data System (ADS)

Gobbi, José; Deguillon, Marie

2017-04-01

Payments for ecosystem services (PES) aim to improve the supply of ecosystem services (ES) by making payments to service providers, which are conditional on the provision of those services. Payments cannot be conditional unless the service can be effectively monitored. Direct monitoring of ES to assess conditionality could be methodologically complex and operatively expensive. To overcome such constraints, the pilot "GEF-PES Project" of Northern Argentina has developed a set of five indicators on forest conservation status (CS) as a basis for estimating the amount of ES provided -considering a positive correlation between the CS of a forest and its level of provision of ecosystem services -and for operationalizing the PES. Field data indicate that selected indicators: (i) exhibit strong correlation with the amount of carbon and biodiversity provided by forests according to their CS, ii) are cost-effective to monitor ES conditionality and (iii) allow easy application of payment levels.

42 CFR 2a.7 - Effect of Confidentiality Certificate.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Effect of Confidentiality Certificate. 2a.7 Section 2a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.7 Effect of Confidentiality Certificate. (a) A Confidentiality...

42 CFR 2a.7 - Effect of Confidentiality Certificate.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Effect of Confidentiality Certificate. 2a.7 Section 2a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.7 Effect of Confidentiality Certificate. (a) A Confidentiality...

42 CFR 2a.7 - Effect of Confidentiality Certificate.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Effect of Confidentiality Certificate. 2a.7 Section 2a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.7 Effect of Confidentiality Certificate. (a) A Confidentiality...

42 CFR 2a.7 - Effect of Confidentiality Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Effect of Confidentiality Certificate. 2a.7 Section 2a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.7 Effect of Confidentiality Certificate. (a) A Confidentiality...

42 CFR 2a.7 - Effect of Confidentiality Certificate.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Effect of Confidentiality Certificate. 2a.7 Section 2a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.7 Effect of Confidentiality Certificate. (a) A Confidentiality...

Relationships, Expertise, Incentives, and Governance: Supporting Care Home Residents' Access to Health Care. An Interview Study From England

PubMed Central

Goodman, Claire; Davies, Sue L.; Gordon, Adam L.; Meyer, Julienne; Dening, Tom; Gladman, John R.F.; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C.

2015-01-01

Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. PMID:25687930

Enhancing the Metalinguistic Abilities of Pre-Service Teachers via Coursework Targeting Language Structure Knowledge

ERIC Educational Resources Information Center

Purvis, Caralyn J.; McNeill, Brigid C.; Everatt, John

2016-01-01

Low metalinguistic knowledge of pre-service and in-service teachers is likely to restrict the provision of evidence-based literacy instruction in the classroom. Despite such concerns, relatively few studies have examined the effects of teacher preparation coursework in building pre-service teachers' language structure knowledge. This study…

Effectiveness of Asynchronous Reference Services for Distance Learning Students within Florida's Community College System

ERIC Educational Resources Information Center

Profeta, Patricia C.

2007-01-01

The provision of equitable library services to distance learning students emerged as a critical area during the 1990s. Library services available to distance learning students included digital reference and instructional services, remote access to online research tools, database and research tutorials, interlibrary loan, and document delivery.…

Building an Agricultural Extension Services System Supported by ICTs in Tanzania: Progress Made, Challenges Remain

ERIC Educational Resources Information Center

Sanga, C.; Kalungwizi, V. J.; Msuya, C. P.

2013-01-01

The conventional agricultural extension service in Tanzania is mainly provided by extension officers visiting farmers to provide agricultural advisory service. This system of extension service provision faces a number of challenges including the few number of extension officers and limited resources. This article assesses the effectiveness of an…

47 CFR 22.711 - Provision of information to applicants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

47 CFR 22.711 - Provision of information to applicants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

47 CFR 22.711 - Provision of information to applicants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

47 CFR 22.711 - Provision of information to applicants.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Provision of information to applicants. 22.711 Section 22.711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.711 Provision of information to applicants...

Utilising a collective case study system theory mixed methods approach: a rural health example

PubMed Central

2014-01-01

Background Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research. PMID:25066241

Utilising a collective case study system theory mixed methods approach: a rural health example.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2014-07-28

Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.

Predicting effects of climate and land use change on human well-being via changes in ecosystem services

EPA Science Inventory

Landuse and climate change have affected biological systems in many parts of the world, and are projected to further adversely affect associated ecosystem goods and services, including provisioning of clean air, clean water, food, and biodiversity. Such adverse effects on ecosyst...

42 CFR 2.61 - Legal effect of order.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Legal effect of order. 2.61 Section 2.61 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.61 Legal...

42 CFR 2.61 - Legal effect of order.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Legal effect of order. 2.61 Section 2.61 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.61 Legal...

42 CFR 2.61 - Legal effect of order.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Legal effect of order. 2.61 Section 2.61 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.61 Legal...

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...

47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

47 CFR 64.401 - Policies and procedures for provisioning and restoring certain telecommunications services in...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Policies and procedures for provisioning and restoring certain telecommunications services in emergencies. 64.401 Section 64.401 Telecommunication... procedures for provisioning and restoring certain telecommunications services in emergencies. The...

Supporting the scientific lifecycle through cloud services

NASA Astrophysics Data System (ADS)

Gensch, S.; Klump, J. F.; Bertelmann, R.; Braune, C.

2014-12-01

Cloud computing has made resources and applications available for numerous use cases ranging from business processes in the private sector to scientific applications. Developers have created tools for data management, collaborative writing, social networking, data access and visualization, project management and many more; either for free or as paid premium services with additional or extended features. Scientists have begun to incorporate tools that fit their needs into their daily work. To satisfy specialized needs, some cloud applications specifically address the needs of scientists for sharing research data, literature search, laboratory documentation, or data visualization. Cloud services may vary in extent, user coverage, and inter-service integration and are also at risk of being abandonend or changed by the service providers making changes to their business model, or leaving the field entirely.Within the project Academic Enterprise Cloud we examine cloud based services that support the research lifecycle, using feature models to describe key properties in the areas of infrastructure and service provision, compliance to legal regulations, and data curation. Emphasis is put on the term Enterprise as to establish an academic cloud service provider infrastructure that satisfies demands of the research community through continious provision across the whole cloud stack. This could enable the research community to be independent from service providers regarding changes to terms of service and ensuring full control of its extent and usage. This shift towards a self-empowered scientific cloud provider infrastructure and its community raises implications about feasability of provision and overall costs. Legal aspects and licensing issues have to be considered, when moving data into cloud services, especially when personal data is involved.Educating researchers about cloud based tools is important to help in the transition towards effective and safe use. Scientists can benefit from the provision of standard services, like weblog and website creation, virtual machine deployments, and groupware provision using cloud based app store-like portals. And, other than in an industrial environment, researchers will want to keep their existing user profile when moving from one institution to another.

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

PubMed

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

2005-12-01

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

System considerations, projected requirements and applications for aeronautical mobile satellite communications for air traffic services

NASA Technical Reports Server (NTRS)

Mcdonald, K. D.; Miller, C. M.; Scales, W. C.; Dement, D. K.

1990-01-01

The projected application and requirements in the near term (to 1995) and far term (to 2010) for aeronautical mobile services supporting air traffic control operations are addressed. The implications of these requirements on spectrum needs, and the resulting effects on the satellite design and operation are discussed. The U.S. is working with international standards and regulatory organizations to develop the necessary aviation standards, signalling protocols, and implementation methods. In the provision of aeronautical safety services, a number of critical issues were identified, including system reliability and availability, access time, channel restoration time, interoperability, pre-emption techniques, and the system network interfaces. Means for accomplishing these critical services in the aeronautical mobile satellite service (AMSS), and the various activities relating to the future provision of aeronautical safety services are addressed.

System considerations, projected requirements and applications for aeronautical mobile satellite communications for air traffic services

NASA Astrophysics Data System (ADS)

McDonald, K. D.; Miller, C. M.; Scales, W. C.; Dement, D. K.

The projected application and requirements in the near term (to 1995) and far term (to 2010) for aeronautical mobile services supporting air traffic control operations are addressed. The implications of these requirements on spectrum needs, and the resulting effects on the satellite design and operation are discussed. The U.S. is working with international standards and regulatory organizations to develop the necessary aviation standards, signalling protocols, and implementation methods. In the provision of aeronautical safety services, a number of critical issues were identified, including system reliability and availability, access time, channel restoration time, interoperability, pre-emption techniques, and the system network interfaces. Means for accomplishing these critical services in the aeronautical mobile satellite service (AMSS), and the various activities relating to the future provision of aeronautical safety services are addressed.

Inequalities in healthcare provision for people with severe mental illness.

PubMed

Lawrence, David; Kisely, Stephen

2010-11-01

There are many factors that contribute to the poor physical health of people with severe mental illness (SMI), including lifestyle factors and medication side effects. However, there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes. These inequalities have been attributed to a combination of factors including systemic issues, such as the separation of mental health services from other medical services, healthcare provider issues including the pervasive stigma associated with mental illness, and consequences of mental illness and side effects of its treatment. A number of solutions have been proposed. To tackle systemic barriers to healthcare provision integrated care models could be employed including co-location of physical and mental health services or the use of case managers or other staff to undertake a co-ordination or liaison role between services. The health care sector could be targeted for programmes aimed at reducing the stigma of mental illness. The cognitive deficits and other consequences of SMI could be addressed through the provision of healthcare skills training to people with SMI or by the use of peer supporters. Population health and health promotion approaches could be developed and targeted at this population, by integrating health promotion activities across domains of interest. To date there have only been small-scale trials to evaluate these ideas suggesting that a range of models may have benefit. More work is needed to build the evidence base in this area.

Locating provisioning ecosystem services in urban forests: Forageable woody species in New York City, USA

Treesearch

Patrick T. Hurley; Marla R. Emery

2017-01-01

Scholarship on the ecosystem services provided by urban forests has focused on regulating and supporting services, with a growing body of research examining provisioning and cultural ecosystem services from farms and gardens in metropolitan areas. Using the case of New York, New York, USA, we propose a method to assess the supply of potential provisioning ecosystem...

Learners' perspectives on the provision of condoms in South African public schools.

PubMed

de Bruin, W E; Panday-Soobrayan, S

2017-12-01

A stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE's policy by exploring learners' perspectives on the provision of condoms and SRHR-services in schools. Sixteen focus group discussions were conducted with learners (n = 116) from 33 public schools, to assess their attitudes, social influences, and needs and desires regarding condom provision and SRHR-services in schools. The majority of learners did not support condom provision in schools as they feared that it may increase sexual activity. Contrarily, they supported the provision of other SRHR-services as clinics fail to offer youth-friendly services. Learners' sexual behaviour and access to SRHR-services are strongly determined by their social environment, including traditional norms and values, and social-pressure from peers and adults. Learners' most pressing needs and desires to access condoms and SRHR-services in school concerned respect, privacy and confidentiality of such service provision. Implementation of DBE's policy must be preceded by an evidence-informed advocacy campaign to debunk myths about the risk of increased sexual activity, to advocate for why such services are needed, to shift societal norms towards open discussion of adolescent SRHR and to grapple with the juxtaposition of being legally empowered but socially inhibited to protect oneself from HIV, STIs and early pregnancy. Provision of condoms and other SRHR-services in schools must be sensitive to learners' privacy and confidentiality to minimise stigma and discrimination.

78 FR 75997 - Provision of Early Intervention and Special Education Services to Eligible DoD Dependents

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-13

... individuals with disabilities; selecting, designing, fitting, customizing, adapting, applying, maintaining... specially designed services for an infant or toddler with a disability and the family of such infant or... impartial mediator who is trained in effective mediation techniques. Medical services. Those evaluative...

Library Services in Hospitals.

ERIC Educational Resources Information Center

Department of Health and Social Security, London (England).

The memorandum gives guidance to the provision and organization of library services at hospitals both for staff and for patients. It also draws attention to the assistance available from outside sources towards the development and maintenance of these services so hospital authorities may make the most effective use of the available facilities.…

Information analytics for healthcare service discovery.

PubMed

Sun, Lily; Yamin, Mohammad; Mushi, Cleopa; Liu, Kecheng; Alsaigh, Mohammed; Chen, Fabian

2014-01-01

The concept of being 'patient-centric' is a challenge to many existing healthcare service provision practices. This paper focuses on the issue of referrals, where multiple stakeholders, such as General Practitioners (GPs) and patients, are encouraged to make a consensual decision based on patients' needs. In this paper, we present an ontology-enabled healthcare service provision, which facilitates both patients and GPs in jointly deciding upon the referral decision. In the healthcare service provision model, we define three types of profiles which represent different stakeholders' requirements. This model also comprises a set of healthcare service discovery processes: articulating a service need, matching the need with the healthcare service offerings, and deciding on a best-fit service for acceptance. As a result, the healthcare service provision can carry out coherent analysis using personalised information and iterative processes that deal with requirements which change over time.

Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.

PubMed

Watt, Nicola; Yupar, Aye; Sender, Paul; Campbell, Fiona; Legido-Quigley, Helena; Howard, Natasha

2016-12-09

To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar. A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding. Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants. Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning. 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/.

Projecting global land-use change and its effect on ecosystem service provision and biodiversity with simple models.

PubMed

Nelson, Erik; Sander, Heather; Hawthorne, Peter; Conte, Marc; Ennaanay, Driss; Wolny, Stacie; Manson, Steven; Polasky, Stephen

2010-12-15

As the global human population grows and its consumption patterns change, additional land will be needed for living space and agricultural production. A critical question facing global society is how to meet growing human demands for living space, food, fuel, and other materials while sustaining ecosystem services and biodiversity [1]. We spatially allocate two scenarios of 2000 to 2015 global areal change in urban land and cropland at the grid cell-level and measure the impact of this change on the provision of ecosystem services and biodiversity. The models and techniques used to spatially allocate land-use/land-cover (LULC) change and evaluate its impact on ecosystems are relatively simple and transparent [2]. The difference in the magnitude and pattern of cropland expansion across the two scenarios engenders different tradeoffs among crop production, provision of species habitat, and other important ecosystem services such as biomass carbon storage. For example, in one scenario, 5.2 grams of carbon stored in biomass is released for every additional calorie of crop produced across the globe; under the other scenario this tradeoff rate is 13.7. By comparing scenarios and their impacts we can begin to identify the global pattern of cropland and irrigation development that is significant enough to meet future food needs but has less of an impact on ecosystem service and habitat provision. Urban area and croplands will expand in the future to meet human needs for living space, livelihoods, and food. In order to jointly provide desired levels of urban land, food production, and ecosystem service and species habitat provision the global society will have to become much more strategic in its allocation of intensively managed land uses. Here we illustrate a method for quickly and transparently evaluating the performance of potential global futures.

Ecosystem service provision in a changing Europe: adapting to the impacts of combined climate and socio-economic change.

PubMed

Dunford, Robert W; Smith, Alison C; Harrison, Paula A; Hanganu, Diana

Future patterns of European ecosystem services provision are likely to vary significantly as a result of climatic and socio-economic change and the implementation of adaptation strategies. However, there is little research in mapping future ecosystem services and no integrated assessment approach to map the combined impacts of these drivers. Map changing patterns in ecosystem services for different European futures and (a) identify the role of driving forces; (b) explore the potential influence of different adaptation options. The CLIMSAVE integrated assessment platform is used to map spatial patterns in services (food, water and timber provision, atmospheric regulation, biodiversity existence/bequest, landscape experience and land use diversity) for a number of combined climatic and socio-economic scenarios. Eight adaptation strategies are explored within each scenario. Future service provision (particularly water provision) will be significantly impacted by climate change. Socio-economic changes shift patterns of service provision: more dystopian societies focus on food provision at the expense of other services. Adaptation options offer significant opportunities, but may necessitate trade-offs between services, particularly between agriculture- and forestry-related services. Unavoidable trade-offs between regions (particularly South-North) are also identified in some scenarios. Coordinating adaptation across regions and sectors will be essential to ensure that all needs are met: a factor that will become increasingly pressing under dystopian futures where inter-regional cooperation breaks down. Integrated assessment enables exploration of interactions and trade-offs between ecosystem services, highlighting the importance of taking account of complex cross-sectoral interactions under different future scenarios of planning adaptation responses.

76 FR 61245 - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

...--Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International... of September 28, 2011 Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Memorandum for the Secretary of Transportation By the authority...

49 CFR 37.191 - Special provision for small mixed-service operators.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION SERVICES FOR INDIVIDUALS WITH DISABILITIES (ADA) Over-the-Road Buses (OTRBs) § 37.191 Special provision for...

Habitat Fragmentation Intensifies Trade-Offs between Biodiversity and Ecosystem Services in a Heathland Ecosystem in Southern England.

PubMed

Cordingley, Justine E; Newton, Adrian C; Rose, Robert J; Clarke, Ralph T; Bullock, James M

2015-01-01

While habitat fragmentation represents a major threat to global biodiversity, its impacts on provision of ecosystem services are largely unknown. We analysed biodiversity value and provision of multiple ecosystem services in 110 fragments of lowland heathland ecosystems in southern England, in which vegetation dynamics have been monitored for over 30 years. Decreasing fragment size was found to be associated with a decrease in biodiversity and recreational values, but an increase in relative carbon storage, aesthetic value and timber value. The trade-off between either biodiversity or recreational values with the other ecosystem services therefore became more pronounced as heathland size decreased. This was attributed to a higher rate of woody succession in smaller heathland fragments over the past three decades, and contrasting values of different successional vegetation types for biodiversity and provision of ecosystem services. These results suggest that habitat fragmentation can reduce the potential for developing "win win" solutions that contribute to biodiversity conservation while also supporting socio-economic development. Approaches to multi-purpose management of fragmented landscapes should therefore consider the potential trade-offs in ecosystem services and biodiversity associated with fragmentation, in order to make an effective contribution to sustainable development.

Habitat Fragmentation Intensifies Trade-Offs between Biodiversity and Ecosystem Services in a Heathland Ecosystem in Southern England

PubMed Central

Cordingley, Justine E.; Newton, Adrian C.; Rose, Robert J.; Clarke, Ralph T.; Bullock, James M.

2015-01-01

While habitat fragmentation represents a major threat to global biodiversity, its impacts on provision of ecosystem services are largely unknown. We analysed biodiversity value and provision of multiple ecosystem services in 110 fragments of lowland heathland ecosystems in southern England, in which vegetation dynamics have been monitored for over 30 years. Decreasing fragment size was found to be associated with a decrease in biodiversity and recreational values, but an increase in relative carbon storage, aesthetic value and timber value. The trade-off between either biodiversity or recreational values with the other ecosystem services therefore became more pronounced as heathland size decreased. This was attributed to a higher rate of woody succession in smaller heathland fragments over the past three decades, and contrasting values of different successional vegetation types for biodiversity and provision of ecosystem services. These results suggest that habitat fragmentation can reduce the potential for developing “win win” solutions that contribute to biodiversity conservation while also supporting socio-economic development. Approaches to multi-purpose management of fragmented landscapes should therefore consider the potential trade-offs in ecosystem services and biodiversity associated with fragmentation, in order to make an effective contribution to sustainable development. PMID:26114753

Service provision in the wake of a new funding model for community pharmacy.

PubMed

Smith, Alesha J; Scahill, Shane L; Harrison, Jeff; Carroll, Tilley; Medlicott, Natalie J

2018-05-02

Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community pharmacies since introduction of the new funding model, what the barriers are to providing these services. A survey of all community pharmacies were undertaken between August, 2014 and February, 2015. Basic descriptive statistics were completed and group comparisons were made using the chi squared test with significance set at p < 0.05. 528 responses were received. Education and advice on prescription and non-prescription medicines were the two top listed services provided. There were no significant differences in service provision between rural and metro based pharmacies. Many pharmacies were considering introducing new patient centred services. Four of the top ten frequently provided services have no public funding attached. Costs and staff availability are the most common barriers to undertake services, more predominantly in patient centred services. This study was the first to provide an evaluation of service provision in response to a new funding model for New Zealand Community Pharmacies. A broad range of services are being undertaken in New Zealand community pharmacies including patient-centred services. A number of barriers to service provision were identified. This study provides a baseline for the current levels of service provision upon which future studies can compare to and evaluate any changes in service provision with differing funding models going forward.

[Evaluation of ecosystem provisioning service and its economic value].

PubMed

Wu, Nan; Gao, Ji-Xi; Sudebilige; Ricketts, Taylor H; Olwero, Nasser; Luo, Zun-Lan

2010-02-01

Aiming at the fact that the current approaches of evaluating the efficacy of ecosystem provisioning service were lack of spatial information and did not take the accessibility of products into account, this paper established an evaluation model to simulate the spatial distribution of ecosystem provisioning service and its economic value, based on ArcGIS 9. 2 and taking the supply and demand factors of ecosystem products into account. The provision of timber product in Laojunshan in 2000 was analyzed with the model. In 2000, the total physical quantity of the timber' s provisioning service in Laojunshan was 11.12 x 10(4) m3 x a(-1), occupying 3.2% of the total increment of timber stock volume. The total provisioning service value of timber was 6669.27 x 10(4) yuan, among which, coniferous forest contributed most (90.41%). Due to the denser distribution of populations and roads in the eastern area of Laojunshan, some parts of the area being located outside of conservancy district, and forests being in scattered distribution, the spatial distribution pattern of the physical quantity of timber's provisioning service was higher in the eastern than in the western area.

Defense Transportation Regulation, Part III: Mobility.

DTIC Science & Technology

1997-04-11

servicing agreements are in effect . This Regulation is effective immediately. To ensure uniformity, there is no provision for supplemental or unilateral...accounting. 2. Accessorial Service. A service performed by a carrier in addition to the line-haul. 3. Acquired Dependent. A military member’s dependent...affiliation training program. Classroom and hands-on instruction provide a forum for exchange of information in an informal, working -level environment. The

The Provision of Psychological Therapy to People with Intellectual Disabilities: An Investigation into Some of the Relevant Factors

ERIC Educational Resources Information Center

Mason, J.

2007-01-01

Background: Five factors are proposed as important in influencing the provision of psychological therapy to people with intellectual disabilities (IDs): the perceived effectiveness of psychological therapy, individual clinician competence, service resources (number of trained clinicians), the level of the clients disability and the diagnostic…

The Current Status and Factors Associated With Implanon Service Provision by the Health Extension Workers at the Health Post Level, Wolaita Zone, Southern Ethiopia: A Cross-Sectional Study

PubMed Central

Desalegn, Ketsela; Loha, Eskindir; Meskele, Mengistu

2017-01-01

Objective: Family Planning is often taken as one of the “Magic Bullet” interventions owing to its high impact and wide reaching nature in achieving multiple goals. This study aimed to assess the current status and the factors associated with health post level Implanon service provision through trained health extension workers in Wolaita zone, southern Ethiopia. Materials and methods: A cross sectional study was conducted among trained health extension workers in Wolaita zone in February 2013. A simple random sampling technique was used to identify a total of 285 trained HEWs. First bivariate, then multivariate logistic regression model along with 95% confidence interval was used to see the independent effect of factors associated with current Implanon service provision by the health extension workers. Results: Currently, the number of Implaon providing trained health extension workers in Wolaita was 264(45.8%). Distance of health post from district health offices and health center, turnover of trained health extension workers in the health post, interest of trained health extension workers in providing Implanon and their job satisfaction to serve as a health extension workers and availability of service delivery guidelines and teaching aids were associated with the current provision of Implanon by health extension workers. Conclusion: Implanon provision among trained health extension workers was affected by different factors. Hence, improving the working conditions of trained health extension workers, regular and periodic facilitative supervision, availing service delivery guidelines and improvement of health management information system are recommended. PMID:29114263

The "empty void" is a crowded space: health service provision at the margins of fragile and conflict affected states.

PubMed

Hill, Peter S; Pavignani, Enrico; Michael, Markus; Murru, Maurizio; Beesley, Mark E

2014-01-01

Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. THE STUDY EXAMINED SIX DIVERSE CASE STUDIES: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011-2012 and interviews with key informants. Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a "void", waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring conventional health system analyses, when applied to these contexts. The third distortion reflects the failure of the global development community to recognise-or engage-the emergent networks of health providers. To effectively harness the service provision currently available in this crowded space, development actors need to adapt their current approaches, engage non-state providers, and support local capacity and governance, particularly grassroots social institutions with a public-good orientation.

Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol.

PubMed

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wolfenden, Luke; Regan, Timothy; Dray, Julia; Bailey, Jacqueline; Bowman, Jenny

2018-04-30

People with a mental illness experience a higher morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of risk behaviours, including tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity, is a substantial contributor to this health inequity. Clinical practice guidelines recommend that mental health services routinely provide care to their clients to address these risk behaviours. Such care may include the following elements: ask, assess, advise, assist and arrange (the '5As'), which has been demonstrated to be effective in reducing risk behaviours. Despite this potential, the provision of such care is reported to be low internationally and in Australia, and there is a need to identify effective strategies to increase care provision. The proposed review will examine the effectiveness of interventions which aimed to increase care provision (i.e. increase the proportion of clients receiving or clinicians providing the 5As) for the chronic disease risk behaviours of clients within the context of mental health service delivery. Eligible studies will be any quantitative study designs with a comparison group and which report on the effectiveness of an intervention strategy (including delivery arrangements, financial arrangements, governance arrangements and implementation strategies) to increase care provision specifically for chronic disease risk behaviours (tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity). Screening for studies will be conducted across seven electronic databases: PsycINFO, MEDLINE, Excerpta Medica database (EMBASE), Psychology and Behavioural Sciences Collection, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors will independently screen studies for eligibility and extract data from included studies. Where studies are sufficiently homogenous, meta-analysis will be performed. Where considerable heterogeneity exists (I 2  ≥ 75), narrative synthesis will be used. This review will be the first to synthesise evidence for the effectiveness of intervention approaches to facilitate care provision for chronic disease risk behaviours in the context of mental health service delivery. The results have the potential to inform the development of evidenced-based approaches to address the health inequities experienced by this population group. PROSPERO CRD42017074360 .

Aftercare Services for Child Victims of Sex Trafficking: A Systematic Review of Policy and Practice.

PubMed

Muraya, Dorothy Neriah; Fry, Deborah

2016-04-01

To explore aftercare services provided to child victims of sex trafficking globally based on the results of a systematic review of published and unpublished research, organizational policy, and current practice. This systematic review serves as a first step toward developing best practices for aftercare service providers. A systematic search was conducted of four English language databases, two human trafficking resource libraries, and one Internet search engine for journal articles and "grey" literature published between January 2000 and May 2013 on the services offered to child sex trafficking victims globally. The search yielded 15 documents for inclusion in the review. The 15 documents emphasized the need for aftercare service provision to be founded on children's rights and trauma-informed service provision. They recommended delivery practices such as case management and multidisciplinary, multiagency and multinational coordination to ensure the child victims benefit fully from the services. The systematic review revealed that there are three phases to aftercare service provision: rescue, recover, and reintegration. Each of these phases is characterized by different needs and types of services provided. The recovery phase received the most attention compared to recovery and reintegration phases. The literature highlighted that aftercare service provision for child sex trafficking victims is a new area that needs an evidence base from which policy and practice can be formed. There is great need for further research and better documentation of service provision. While this research provides insight into this area, the gap in literature remains wide. The area of aftercare service provision for children who have been trafficked has experienced phenomenal growth within the last 10 years, and with more research and resources being directed to the area, the achievement of international minimum standards of care provision is possible. © The Author(s) 2015.

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

PubMed

Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2015-01-01

To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the predictors of and barriers to rehabilitation services for older adults in the Ontario Home Care System. Barriers of PT included dementia diagnosis and French as a first language. Barriers to OT included dementia diagnosis. Policies and practices related to service provision for older adults should be reconsidered if we are going to meet the demands of aging populations and increasing rates of functional and cognitive impairments.

Mitigating Provider Uncertainty in Service Provision Contracts

NASA Astrophysics Data System (ADS)

Smith, Chris; van Moorsel, Aad

Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

The provision of assistive technology products and services for people with dementia in the United Kingdom.

PubMed

Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise

2016-07-01

In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources. © The Author(s) 2014.

77 FR 28797 - Redundancy of Communications Systems: Backup Power Private Land Mobile Radio Services: Selection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... Systems: Backup Power Private Land Mobile Radio Services: Selection and Assignment of Frequencies, and... certain rule provisions that are without current legal effect and obsolete. These nonsubstantive revisions... current legal effect and is deleted as obsolete. 2. This Order also deletes a rule providing that UHF...

75 FR 10289 - Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... provisions concerning payments for home health services comply with the requirements of the Social Security... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Notice of Opportunity for a Hearing on Compliance of Missouri State Plan Provisions Concerning Payments for Home Health...

25 CFR 23.49 - Fair and uniform provision of services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Fair and uniform provision of services. 23.49 Section 23.49 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT General and Uniform Grant Administration Provisions and Requirements § 23.49 Fair and uniform...

47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary Mobile-Satellite Service.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary Mobile-Satellite Service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

47 CFR 25.142 - Licensing provisions for the non-voice, non-geostationary mobile-satellite service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Licensing provisions for the non-voice, non... Stations § 25.142 Licensing provisions for the non-voice, non-geostationary mobile-satellite service. (a... the non-voice, non-geostationary mobile-satellite service shall describe in detail the proposed non...

A decade of experience with a clinical pharmacokinetics service.

PubMed

Ambrose, P J; Smith, W E; Palarea, E R

1988-09-01

The development, operation, and functions of the pharmacokinetics service at Memorial Medical Center of Long Beach (MMCLB) are described, and the data used to determine the quality and cost-effectiveness of the service are presented. Current functions of the pharmacokinetics service at MMCLB include making brief written comments about the interpretations of serum drug concentrations (SDCs) and oral recommendations to physicians on dosage adjustment; provision of written consultations with dosage recommendations; provision of drug information, education, and research; and development of drug dosing guidelines for the pharmacy and medical staff. During the 10-year existence of this service, costs have been justified on the basis of not only revenue generated by the service (in the form of "drug concentration scheduling" and "drug concentration evaluation" fees charged to patients) but also by cost savings resulting from the prevention of inappropriate, misleading, and potentially dangerous SDCs. An audit conducted in 1986 showed that the policy of having pharmacists schedule the sampling times for SDCs saves about $500,000 annually. Quality assurance has been documented by auditing compliance with and therapeutic effectiveness of dosing guidelines and by working with laboratory personnel to identify and prevent spurious SDC results and assay errors. The methods used by the pharmacokinetics service at MMCLB to document the benefits of the service have been vital in proving both its cost-effectiveness and its positive effect on patient care.

From home, to market, to headquarters, to home. Relocating health services planning and purchasing in New Zealand.

PubMed

Gauld, Robin

2002-01-01

Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand's four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989-1991) with planning and purchasing located at "home" in local areas and closely aligned with service provision; a competitive internal market system (1993-1996) which separated planning and purchasing from service provision; a centralised system with a "headquarters" controlling planning and purchasing (1997-1999) while maintaining the distance from provision; and the district health board system currently under development (1999-) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand's experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.

Utilization of Mental Health Services and Mental Health Status Among Children Placed in Out-of-Home Care: A Parallel Process Latent Growth Modeling Approach.

PubMed

Yampolskaya, Svetlana; Sharrock, Patty J; Clark, Colleen; Hanson, Ardis

2017-10-01

This longitudinal study examined the parallel trajectories of mental health service use and mental health status among children placed in Florida out-of-home care. The results of growth curve modeling suggested that children with greater mental health problems initially received more mental health services. Initial child mental health status, however, had no effect on subsequent service provision when all outpatient mental health services were included. When specific types of mental health services, such as basic outpatient, targeted case management, and intensive mental health services were examined, results suggested that children with compromised functioning during the baseline period received more intensive mental health services over time. However, this increased provision of intensive mental health services did not improve mental health status, rather it was significantly associated with progressively worse mental health functioning. These findings underscore the need for regular comprehensive mental health assessments focusing on specific needs of the child.

42 CFR 90.1 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND... of 1986, and section 3019 of the Resource Conservation and Recovery Act. These provisions apply to...

31 CFR 538.505 - Provision of certain legal services to the Government of Sudan, persons in Sudan, or benefitting...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Licensing Policy § 538.505 Provision of certain legal services to the Government of Sudan, persons in Sudan... for the following legal services by U.S. persons to the Government of Sudan or to a person in Sudan... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Provision of certain legal services to...

34 CFR 303.345 - Provision of services before evaluation and assessment are completed.

Code of Federal Regulations, 2010 CFR

2010-07-01

... System of Early Intervention Services Individualized Family Service Plans (ifsps) § 303.345 Provision of services before evaluation and assessment are completed. Early intervention services for an eligible child... Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY...

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

PubMed Central

2011-01-01

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

77 FR 26417 - Roth Feature to the Thrift Savings Plan and Miscellaneous Uniformed Services Account Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... 1690 Roth Feature to the Thrift Savings Plan and Miscellaneous Uniformed Services Account Amendments... Plan. This final rule also reorganizes regulatory provisions pertaining to uniformed services accounts. DATES: This rule is effective May 7, 2012. FOR FURTHER INFORMATION CONTACT: Laurissa Stokes at (202) 942...

School-Based Mental Health Services: Definitions and Models of Effective Practice

ERIC Educational Resources Information Center

Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.

2017-01-01

School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…

Provision of NHS generalist and specialist services to care homes in England: review of surveys.

PubMed

Iliffe, Steve; Davies, Susan L; Gordon, Adam L; Schneider, Justine; Dening, Tom; Bowman, Clive; Gage, Heather; Martin, Finbarr C; Gladman, John R F; Victor, Christina; Meyer, Julienne; Goodman, Claire

2016-03-01

The number of beds in care homes (with and without nurses) in the United Kingdom is three times greater than the number of beds in National Health Service (NHS) hospitals. Care homes are predominantly owned by a range of commercial, not-for-profit or charitable providers and their residents have high levels of disability, frailty and co-morbidity. NHS support for care home residents is very variable, and it is unclear what models of clinical support work and are cost-effective. To critically evaluate how the NHS works with care homes. A review of surveys of NHS services provided to care homes that had been completed since 2008. It included published national surveys, local surveys commissioned by Primary Care organisations, studies from charities and academic centres, grey literature identified across the nine government regions, and information from care home, primary care and other research networks. Data extraction captured forms of NHS service provision for care homes in England in terms of frequency, location, focus and purpose. Five surveys focused primarily on general practitioner services, and 10 on specialist services to care home. Working relationships between the NHS and care homes lack structure and purpose and have generally evolved locally. There are wide variations in provision of both generalist and specialist healthcare services to care homes. Larger care home chains may take a systematic approach to both organising access to NHS generalist and specialist services, and to supplementing gaps with in-house provision. Access to dental care for care home residents appears to be particularly deficient. Historical differences in innovation and provision of NHS services, the complexities of collaborating across different sectors (private and public, health and social care, general and mental health), and variable levels of organisation of care homes, all lead to persistent and embedded inequity in the distribution of NHS resources to this population. Clinical commissioners seeking to improve the quality of care of care home residents need to consider how best to provide fair access to health care for older people living in a care home, and to establish a specification for service delivery to this vulnerable population.

Ecosystem service bundles for analyzing tradeoffs in diverse landscapes

PubMed Central

Raudsepp-Hearne, C.; Peterson, G. D.; Bennett, E. M.

2010-01-01

A key challenge of ecosystem management is determining how to manage multiple ecosystem services across landscapes. Enhancing important provisioning ecosystem services, such as food and timber, often leads to tradeoffs between regulating and cultural ecosystem services, such as nutrient cycling, flood protection, and tourism. We developed a framework for analyzing the provision of multiple ecosystem services across landscapes and present an empirical demonstration of ecosystem service bundles, sets of services that appear together repeatedly. Ecosystem service bundles were identified by analyzing the spatial patterns of 12 ecosystem services in a mixed-use landscape consisting of 137 municipalities in Quebec, Canada. We identified six types of ecosystem service bundles and were able to link these bundles to areas on the landscape characterized by distinct social–ecological dynamics. Our results show landscape-scale tradeoffs between provisioning and almost all regulating and cultural ecosystem services, and they show that a greater diversity of ecosystem services is positively correlated with the provision of regulating ecosystem services. Ecosystem service-bundle analysis can identify areas on a landscape where ecosystem management has produced exceptionally desirable or undesirable sets of ecosystem services. PMID:20194739

Mental Health Services for Children and Adolescents with Learning Disabilities: A Review of Research on Experiences of Service Users and Providers

ERIC Educational Resources Information Center

Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig

2016-01-01

Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…

42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

42 CFR 24.8 - Applicability of provisions of Title 5, U.S. Code.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Applicability of provisions of Title 5, U.S. Code. 24.8 Section 24.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL SENIOR BIOMEDICAL RESEARCH SERVICE § 24.8 Applicability of provisions of Title 5, U.S. Code. (a...

A Review of Healthcare Service and Education Provision of Autism Spectrum Condition in Mainland China

ERIC Educational Resources Information Center

Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Baron-Cohen, Simon; Brayne, Carol

2013-01-01

Little is known about the current situation regarding Autism Spectrum Conditions in mainland China. Electronic databases and bibliographies were searched to identify literature on service provision for ASC in both English and Chinese databases. 14 studies and 6 reports were reviewed. The findings of identified papers on service provision were…

The Provision of Services to Students with Special Needs in Canadian Academic Libraries.

ERIC Educational Resources Information Center

Goltz, Eileen

1991-01-01

Describes results of a survey of Canadian academic libraries that was conducted to determine the provision of services to the disabled, i.e., students with visual, hearing, or motor deficiencies. External resources are described, the role of library staff is emphasized, and library policy statements concerning the provision of special services are…

47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

Code of Federal Regulations, 2014 CFR

2014-10-01

... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

Code of Federal Regulations, 2010 CFR

2010-10-01

... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

Code of Federal Regulations, 2013 CFR

2013-10-01

... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

47 CFR 27.1213 - Designated entity provisions for BRS in Commission auctions commencing prior to January 1, 2004.

Code of Federal Regulations, 2011 CFR

2011-10-01

... COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Broadband Radio Service and Educational Broadband Service § 27.1213 Designated entity provisions for BRS in...

Public long-term care insurance for the elderly in Korea: design, characteristics, and tasks.

PubMed

Seok, Jae Eun

2010-03-01

This paper examines the design and issues of the long-term care scheme in Korea: coverage, eligibility, benefit types, financing, delivery system, and role sharing of state, family, and market in long-term care. It also aims to examine the radical change and impacts on service financing, provision, and governance from the introduction of the long-term care insurance for the elderly in Korea. The first noteworthy change is that the long-term care service has transformed from the very selective service applicable only to low-income groups to a universal service for all income groups. The second notable change is that the service provision method has been changed from the provision by nonprofit organizations entrusted by the state under a monopolistic commission arrangement in the past to a new open-service provision arrangement in which free competition among service providers in service market and consumers' choice will be emphasized.

Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

PubMed

Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

2015-11-01

Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more useful frame than generalizable outcomes of effectiveness. Copyright © 2015 Elsevier Ltd. All rights reserved.

Attitudes of Scottish abortion care providers towards provision of abortion after 16 weeks' gestation within Scotland.

PubMed

Cochrane, Rosemary A; Cameron, Sharon T

2013-06-01

In Scotland, in contrast to the rest of Great Britain, abortion at gestations over 20 weeks is not provided, and provision of procedures above 16 weeks varies considerably between regions. Women at varying gestations above 16 weeks must travel outside Scotland, usually to England, for the procedure. To determine the views of professionals working within Scottish abortion care about a Scottish late abortion service. Delegates at a meeting for abortion providers in Scotland completed a questionnaire about their views on abortion provision over 16 weeks and their perceived barriers to service provision. Of 95 distributed questionnaires, 70 (76%) were analysed. Fifty-six respondents (80%) supported a Scottish late abortion service, ten (14%) would maintain current service arrangements, and five (7%) were undecided. Forty (57%) of the supporters of a Scottish service would prefer a single national service, and 16 (22%) several regional services. Perceived barriers included lack of trained staff (n = 39; 56%), accommodation for the service (n = 34; 48%), and perception of lack of support among senior management (n = 28; 40%). The majority of health professionals surveyed who work in Scottish abortion services support provision of abortion beyond 16 weeks within Scotland, and most favour a single national service. Further work on the feasibility of providing this service is required.

Predicting effects of environmental change on river inflows to Tillamook Bay, Oregon

EPA Science Inventory

Estuarine river watersheds provide valued ecosystem services to their surrounding communities including drinking water, fish habitat, and regulation of estuarine water quality. However, the provisioning of these services can be affected by changes in the quantity and quality of ...

5 CFR 850.101 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Employees' Retirement System (FERS) by using contemporary, automated business processes and supporting... employing more efficient and effective business systems to respond to increased customer demand for higher levels of customer service and online self-service tools. (b) The provisions of this part authorize...

42 CFR 93.508 - Filing, forms, and service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative... nondocumentary materials such as videotapes, computer disks, or physical evidence. This provision does not apply...

42 CFR 93.508 - Filing, forms, and service.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative... nondocumentary materials such as videotapes, computer disks, or physical evidence. This provision does not apply...

42 CFR 93.508 - Filing, forms, and service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative... nondocumentary materials such as videotapes, computer disks, or physical evidence. This provision does not apply...

42 CFR 93.508 - Filing, forms, and service.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative... nondocumentary materials such as videotapes, computer disks, or physical evidence. This provision does not apply...

42 CFR 93.508 - Filing, forms, and service.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative... nondocumentary materials such as videotapes, computer disks, or physical evidence. This provision does not apply...

Regulating danger on the highways: hours of service regulations.

PubMed

Mansfield, Daniel; Kryger, Meir

2015-12-01

Current hours of service regulations governing commercial truck drivers in place in the United States, Canada, Australia, and the European Union are summarized and compared to facilitate the assessment of the effectiveness of such provisions in preventing fatigue and drowsiness among truck drivers. Current hours of service provisions governing commercial truck drivers were derived from governmental sources. The commercial truck driver hours of service provisions in the United States, Canada, and the European Union permit drivers to work 14 hours and those of Australia permit drivers to work 12 hours a day on a regular basis. The regulations do not state what a driver may do with time off. They are consistent with a driver being able to drive after 24 hours without sleep. They do not take into account circadian rhythm by linking driving or rest to time of day. Current hours of service regulations governing commercial truck drivers leave gaps--permitting drivers to work long hours on a regular basis, permitting driving after no sleep for 24 hours, and failing to take into account the importance of circadian rhythm, endangering the public safety and the truck drivers themselves. Copyright © 2015 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Rapid Assessment of Ecosystem Services Provided by Two Mineral Extraction Sites Restored for Nature Conservation in an Agricultural Landscape in Eastern England

PubMed Central

Blaen, Phillip J.; Jia, Li; Peh, Kelvin S.-H.; Field, Rob H.; Balmford, Andrew; MacDonald, Michael A.; Bradbury, Richard B.

2015-01-01

Despite growing recognition that mineral sites restored for nature conservation can enhance local biodiversity, the wider societal benefits provided by this type of restoration relative to alternative options are not well understood. This study addresses this research gap by quantifying differences in ecosystem services provision under two common mineral site after-uses: nature conservation and agriculture. Using a combination of site-specific primary field data, benefits transfer and modelling, we show that for our sites restoration for nature conservation provides a more diverse array of ecosystem services than would be delivered under an agricultural restoration scenario. We also explore the effects of addressing different conservation targets, which we find alter the provision of ecosystem services on a service-specific basis. Highly species-focused intervention areas are associated with increased carbon storage and livestock grazing provision, whereas non-intervention areas are important for carbon sequestration, fishing, recreation and flood risk mitigation. The results of this study highlight the wider societal importance of restored mineral sites and may help conservation managers and planners to develop future restoration strategies that provide benefits for both biodiversity and human well-being. PMID:25894293

Rapid assessment of ecosystem services provided by two mineral extraction sites restored for nature conservation in an agricultural landscape in eastern England.

PubMed

Blaen, Phillip J; Jia, Li; Peh, Kelvin S-H; Field, Rob H; Balmford, Andrew; MacDonald, Michael A; Bradbury, Richard B

2015-01-01

Despite growing recognition that mineral sites restored for nature conservation can enhance local biodiversity, the wider societal benefits provided by this type of restoration relative to alternative options are not well understood. This study addresses this research gap by quantifying differences in ecosystem services provision under two common mineral site after-uses: nature conservation and agriculture. Using a combination of site-specific primary field data, benefits transfer and modelling, we show that for our sites restoration for nature conservation provides a more diverse array of ecosystem services than would be delivered under an agricultural restoration scenario. We also explore the effects of addressing different conservation targets, which we find alter the provision of ecosystem services on a service-specific basis. Highly species-focused intervention areas are associated with increased carbon storage and livestock grazing provision, whereas non-intervention areas are important for carbon sequestration, fishing, recreation and flood risk mitigation. The results of this study highlight the wider societal importance of restored mineral sites and may help conservation managers and planners to develop future restoration strategies that provide benefits for both biodiversity and human well-being.

42 CFR 55a.106 - Provision for waiver by the Secretary.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Provision for waiver by the Secretary. 55a.106 Section 55a.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.106 Provision for waiver by the Secretary...

42 CFR 55a.106 - Provision for waiver by the Secretary.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Provision for waiver by the Secretary. 55a.106 Section 55a.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS PROGRAM GRANTS FOR BLACK LUNG CLINICS General Provisions § 55a.106 Provision for waiver by the Secretary...

Relationships, expertise, incentives, and governance: supporting care home residents' access to health care. An interview study from England.

PubMed

Goodman, Claire; Davies, Sue L; Gordon, Adam L; Meyer, Julienne; Dening, Tom; Gladman, John R F; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C

2015-05-01

To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

3 CFR - Provision of Defense Articles and Services to Vetted Members of the Syrian Opposition for Use in...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Provision of Defense Articles and Services to Vetted... and Related Materials, Organizations Implementing U.S. Department of State or U.S. Agency for... Determination No. 2013-15 of September 16, 2013 Provision of Defense Articles and Services to Vetted Members of...

49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

Code of Federal Regulations, 2013 CFR

2013-10-01

...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

Code of Federal Regulations, 2014 CFR

2014-10-01

...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

Code of Federal Regulations, 2011 CFR

2011-10-01

...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

49 CFR 39.51 - What is the general requirement for PVOs' provision of auxiliary aids and services to passengers?

Code of Federal Regulations, 2012 CFR

2012-10-01

...' provision of auxiliary aids and services to passengers? 39.51 Section 39.51 Transportation Office of the... for Passengers § 39.51 What is the general requirement for PVOs' provision of auxiliary aids and... auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity...

Cross-Cultural Considerations regarding Inclusion and Service Provision for Children with Disabilities in India

ERIC Educational Resources Information Center

Browning, Ellen R.; Caro, Patricia; Shastry, Sunita P.

2011-01-01

Providing services for children with disabilities has been a part of the culture of India for generations. However service provision has been within the context of family and community rather than in the public sector and thus has been inclusive by its very nature. This article describes current educational provisions and practices in India for…

47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

Code of Federal Regulations, 2010 CFR

2010-10-01

... priority access service by commercial mobile radio service providers. 64.402 Section 64.402... RULES RELATING TO COMMON CARRIERS Procedures for Handling Priority Services in Emergencies § 64.402 Policies and procedures for the provision of priority access service by commercial mobile radio service...

Feasibility of sustainable provision of intradermal post exposure prophylaxis against rabies at primary care level –evidence from rural Haryana

PubMed Central

2014-01-01

Background Rabies is the most severe and neglected public health problem in India. Management of animal bite with post exposure prophylaxis is the only existent strategy to prevent rabies related deaths. Cost-effective and sustainable programme for provision of post exposure prophylaxis (PEP) is needed in India. Methods In this study, we have documented the experience of implementation of intra-dermal anti rabies vaccination in Animal Bite Management (ABM) clinic at Primary Health Centre (PHC). This study facility belonged to Comprehensive Rural Health Services Project, Ballabgarh in Faridabad district of Haryana. Hospital service record of ABM clinic was analyzed and various feasibility issues such as costing of services, vaccine wastage and other operational issues in providing PEP services at PHC level were documented. Results A total of 619 patients were treated in the ABM clinic. Service utilization of ABM clinic was increased by 38% in the second year of implementation. Mean age of the patients was 23.9 years (SD: 18.8) and majority (70.4%) were males. Majority (86%) of the patients received the first dose of anti-rabies vaccine within the recommended 48 hours. A total 446 vaccine vials (1 ml) were consumed of which 20.8% was contributed in vaccine wastage. User-fee (350 Indian Rupees) collected from the patients. User-fee was re-used to purchase vaccines, intradermal (ID) syringes and other consumables required to ensure regular availability of ARV services at the PHC. Conclusions This study demonstrated the cost-effective and sustainable model of provision of PEP against rabies at primary care level. ID PEP provision at primary care level not only address the unmet need of animal bite management in the community also reduces the out of pocket expenditure of the patients. PMID:24965875

Is Telephone Review Feasible and Potentially Effective in Low Vision Services?

ERIC Educational Resources Information Center

Parkes, Claire; Lennon, Julie; Harper, Robert

2013-01-01

Purpose: Demographic transformations within the UK population combine to contribute to a substantial increase in demand for low vision (LV) services, creating a pressing need to reconsider the appropriate methods for service provision. In this study, we evaluate the feasibility of using telephone triage to assess the need for, and timing of, LV…

77 FR 43892 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... or service offered by the Member within the three months immediately preceding the date of an... conversion'' means, in an offer or agreement to sell or provide any goods or services, a provision under which a customer receives a product or service for free for an initial period and will incur an...

77 FR 26348 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-03

... or service offered by the Member within the three months immediately preceding the date of an... conversion'' means, in an offer or agreement to sell or provide any goods or services, a provision under which a customer receives a product or service for free for an initial period and will incur an...

77 FR 26343 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-03

... or service offered by the Member within the three months immediately preceding the date of an... conversion'' means, in an offer or agreement to sell or provide any goods or services, a provision under which a customer receives a product or service for free for an initial period and will incur an...

Trust Management and Accountability for Internet Security

ERIC Educational Resources Information Center

Liu, Wayne W.

2011-01-01

Adversarial yet interacting interdependent relationships in information sharing and service provisioning have been a pressing issue of the Internet. Such relationships exist among autonomous software agents, in networking system peers, as well as between "service users and providers." Traditional "ad hoc" security approaches effective in…

42 CFR 3.106 - Security requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Security management. A PSO must address: (i) Maintenance and effective implementation of written policies... 42 Public Health 1 2010-10-01 2010-10-01 false Security requirements. 3.106 Section 3.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PATIENT SAFETY...

42 CFR 3.106 - Security requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Security management. A PSO must address: (i) Maintenance and effective implementation of written policies... 42 Public Health 1 2011-10-01 2011-10-01 false Security requirements. 3.106 Section 3.106 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PATIENT SAFETY...

Service Provision for Autism in Mainland China: A Service Providers' Perspective

ERIC Educational Resources Information Center

Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Murray, Stuart; Baron-Cohen, Simon; Brayne, Carol

2013-01-01

Qualitative semi-structured interviews were conducted with service providers regarding the current healthcare provision and education services for children with Autism Spectrum Conditions (ASC) and their families in mainland China. 10 service providers described the current policy and identified unmet needs within current practice. Providers…

Provision of Rehabilitation Services in Residential Care Facilities: Evidence From a National Survey.

PubMed

Bhuyan, Soumitra S; Chandak, Aastha; Gupta, Niodita; Wyant, David K; Kim, Jungyoon; Bhatt, Jay; Singh, Ayesha; Gilmore, Sean; Ahn, SangNam; Chang, Cyril F

2017-06-01

To examine the association between organizational factors and provision of rehabilitation services that include physical therapy (PT) and occupational therapy (OT) in residential care facilities (RCFs) in the United States. A cross-sectional, observational study conducted using a national sample from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. U.S. RCFs. RCFs (N=2302; weighted sample, 31,134 RCFs). Not applicable. The association between characteristics of the facilities, director and staff, and residents, and provision of PT and OT services was assessed using multivariate logistic regression analyses. Among all RCFs in the United States, 43.9% provided PT and 40.0% provided OT. Medicaid-certified RCFs, larger-sized RCFs, RCFs with a licensed director, RCFs that used volunteers, and RCFs with higher personal care aide hours per patient per day were more likely to provide both PT and OT, while private, for-profit RCFs were less likely to provide PT and OT. RCFs with a higher percentage of white residents were more likely to provide PT, while RCFs with chain affiliation were more likely to provide OT. Less than half of the RCFs in the United States provide PT and OT, and this provision of therapy services is associated with organizational characteristics of the facilities. Future research should explore the effectiveness of rehabilitation services in RCFs on residents' health outcomes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

Code of Federal Regulations, 2014 CFR

2014-01-01

... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

Code of Federal Regulations, 2012 CFR

2012-01-01

... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

Code of Federal Regulations, 2013 CFR

2013-01-01

... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

5 CFR 875.203 - Am I eligible if I separated under the FERS MRA+10 provision?

Code of Federal Regulations, 2011 CFR

2011-01-01

... FERS MRA+10 provision? 875.203 Section 875.203 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT....203 Am I eligible if I separated under the FERS MRA+10 provision? If you have separated from service under the FERS Minimum Retirement Age and 10 years of service (MRA+10) provision of 5 U.S.C. 8412(g...

Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

PubMed Central

Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

2017-01-01

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved. PMID:29386978

Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia.

PubMed

Arifin, Nooranida; Hasbollah, Hasif Rafidee; Hanafi, Muhammad Hafiz; Ibrahim, Al Hafiz; Rahman, Wan Afezah Wan Abdul; Aziz, Roslizawati Che

2017-10-01

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.

77 FR 42513 - Sunshine Act Meetings Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

... LEGAL SERVICES CORPORATION Sunshine Act Meetings Notice DATE AND TIME: The Legal Services... Committee 5. Promotion & Provision for the Delivery of Legal Services Committee. 6. Operations & Regulations....C. Sec. 552b(c)(9) and (10), and the corresponding provision of the Legal Services Corporation's...

Rural district hospitals - essential cogs in the district health system - and primary healthcare re-engineering.

PubMed

le Roux, K W D P; Couper, I

2015-06-01

The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

Information technologies in optimization process of monitoring of software and hardware status

NASA Astrophysics Data System (ADS)

Nikitin, P. V.; Savinov, A. N.; Bazhenov, R. I.; Ryabov, I. V.

2018-05-01

The article describes a model of a hardware and software monitoring system for a large company that provides customers with software as a service (SaaS solution) using information technology. The main functions of the monitoring system are: provision of up-todate data for analyzing the state of the IT infrastructure, rapid detection of the fault and its effective elimination. The main risks associated with the provision of these services are described; the comparative characteristics of the software are given; author's methods of monitoring the status of software and hardware are proposed.

42 CFR 403.756 - Sunset provision.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.752 - Payment provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.756 - Sunset provision.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.756 - Sunset provision.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.752 - Payment provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.752 - Payment provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.752 - Payment provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.756 - Sunset provision.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.752 - Payment provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Payment provisions. 403.752 Section 403.752 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

42 CFR 403.756 - Sunset provision.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Sunset provision. 403.756 Section 403.756 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...

Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

PubMed

Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

2015-03-01

Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so. © British Journal of General Practice 2015.

Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

PubMed Central

Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

2015-01-01

Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups. Professional concerns about privacy were unrealised and those about workload were only partly so. PMID:25733435

40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Standards: Valves in gas/vapor service...

40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Standards: Valves in gas/vapor service...

40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

Code of Federal Regulations, 2013 CFR

2013-07-01

... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Standards: Valves in gas/vapor service...

40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

Code of Federal Regulations, 2014 CFR

2014-07-01

... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2014-07-01 2014-07-01 false Standards: Valves in gas/vapor service...

40 CFR 63.168 - Standards: Valves in gas/vapor service and in light liquid service.

Code of Federal Regulations, 2012 CFR

2012-07-01

... § 63.168 Standards: Valves in gas/vapor service and in light liquid service. (a) The provisions of this section apply to valves that are either in gas service or in light liquid service. (1) The provisions are... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Standards: Valves in gas/vapor service...

A national survey of pain clinics within the United Kingdom and Ireland focusing on the multidisciplinary team and the incorporation of the extended nursing role.

PubMed

Kailainathan, Pungavi; Humble, Stephen; Dawson, Helen; Cameron, Fiona; Gokani, Shyam; Lidder, Gursimren

2018-02-01

Inconsistencies in the availability and quality of pain service provision have been noted nationally, as have lengthy waiting times for appointments and lack of awareness of the Pain Clinic role. The 2013 NHS England report stated that specialist pain services must offer multispecialty and multidisciplinary pain clinics. This national survey of multidisciplinary pain service provision in the United Kingdom and Ireland provides a snapshot of pain service provision in order to review and highlight what variations exist in multidisciplinary team (MDT) provision and working patterns. A common perception among clinicians is that financial pressures have led to alternate ways of staff utilisation with variable degrees of success. The survey included 143 pain clinics, focusing principally on MDT working patterns, MDT composition and adoption of the extended role. The results identified that the majority of Pain Clinics utilise the MDT approach. However, provision of critical components such as regular MDT meetings is highly variable as is the composition of the MDT itself and also working patterns of the individual clinicians. The survey reports the successful use of the extended roles for specialist nurses in follow up clinics. In contrast, the survey highlights that a large proportion of clinicians surveyed have reservations about both the effectiveness and the safety of utilising specialist nurses in the extended role to see new referrals of complex pain patients to pain clinics. This survey underlines the essential requirement for incorporation of greater MDT working locally and nationally and allocation of appropriate resources to facilitate this.

Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments.

PubMed

Roesch-McNally, Gabrielle E; Rabotyagov, Sergey S

2016-03-01

The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at $217.59 per household/year under a mandatory tax mechanism and $160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

Paying for Forest Ecosystem Services: Voluntary Versus Mandatory Payments

NASA Astrophysics Data System (ADS)

Roesch-McNally, Gabrielle E.; Rabotyagov, Sergey S.

2016-03-01

The emergence of new markets for forest ecosystem services can be a compelling opportunity for market diversification for private forest landowners, while increasing the provision of public goods from private lands. However, there is limited information available on the willingness-to-pay (WTP) for specific forest ecosystem services, particularly across different ecosystem market mechanisms. We utilize survey data from Oregon and Washington households to compare marginal WTP for forest ecosystem services and the total WTP for cost-effective bundles of forest ecosystem services obtained from a typical Pacific Northwest forest across two value elicitation formats representing two different ecosystem market mechanisms: an incentive-compatible choice experiment involving mandatory tax payments and a hypothetical private provision scenario modeled as eliciting contributions to the preferred forest management alternative via a provision point mechanism with a refund. A representative household's total WTP for the average forest management program was estimated at 217.59 per household/year under a mandatory tax mechanism and 160.44 per household/per year under a voluntary, crowdfunding-style, contribution mechanism; however, these estimates are not statistically different. Marginal WTP estimates were assessed for particular forest ecosystem service attributes including water quality, carbon storage, mature forest habitat, and public recreational access. This study finds that survey respondents place significant economic value on forest ecosystem services in both elicitation formats and that the distributions of the marginal WTP are not statistically significantly different.

Genetic service delivery: infrastructure, assessment and information.

PubMed

Kaye, C I

2012-01-01

Identification of genomic determinants of complex disorders such as cancer, diabetes and cardiovascular disease has prompted public health systems to focus on genetic service delivery for prevention of these disorders, adding to their previous efforts in birth defects prevention and newborn screening. This focus is consistent with previously identified obligations of the public health system as well as the core functions of public health identified by the Institute of Medicine. Models of service delivery include provision of services by the primary care provider in conjunction with subspecialists, provision of services through the medical home with co-management by genetics providers, provision of services in conjunction with disorder-specific treatment centers, and provision of services through a network of genetics clinics linked to medical homes. Whatever the model for provision of genetic services, tools to assist providers include facilities for outreach and telemedicine, information technology, just-in-time management plans, and emergency management tools. Assessment tools to determine which care is best are critical for quality improvement and development of best practices. Because the workforce of genetics providers is not keeping pace with the need for services, an understanding of the factors contributing to this lag is important, as is the development of an improved knowledge base in genomics for primary care providers. Copyright © 2012 S. Karger AG, Basel.

The “empty void” is a crowded space: health service provision at the margins of fragile and conflict affected states

PubMed Central

2014-01-01

Background Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. Methods The study examined six diverse case studies: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011–2012 and interviews with key informants. Results Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. Conclusions We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a “void”, waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring conventional health system analyses, when applied to these contexts. The third distortion reflects the failure of the global development community to recognise—or engage—the emergent networks of health providers. To effectively harness the service provision currently available in this crowded space, development actors need to adapt their current approaches, engage non-state providers, and support local capacity and governance, particularly grassroots social institutions with a public-good orientation. PMID:25349625

76 FR 20050 - Sunshine Act Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... LEGAL SERVICES CORPORATION Sunshine Act Meetings Notice DATE AND TIME: The Legal Services.... Promotion & Provision for the Delivery 9 a.m. of Legal Services Committee. 2. Operations & Regulations... provisions of the Legal Services Corporation's implementing regulation, 45 CFR 1622.5(a) and (h), will not be...

42 CFR 417.520 - Effect on HMO and CMP contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 417.520 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS, AND... these provisions, references to “M+C organizations” must be read as references to “HMOs and CMPs”. (c...

Effects of user fee exemptions on the provision and use of maternal health services: a review of literature.

PubMed

Hatt, Laurel E; Makinen, Marty; Madhavan, Supriya; Conlon, Claudia M

2013-12-01

User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects of user fee exemptions on maternal health service utilization, service provision, and outcomes, including both supply-side and demand-side effects. We reviewed 19 peer-reviewed research articles addressing user fee exemptions and maternal health services or outcomes published since 1990. Studies were identified through a USAID-commissioned call for evidence, key word search, and screening process. Teams of reviewers assigned criteria-based quality scores to each paper and prepared structured narrative reviews. The grade of the evidence was found to be relatively weak, mainly from short-term, non-controlled studies. The introduction of user fee exemptions appears to have resulted in increased rates of facility-based deliveries and caesarean sections in some contexts. Impacts on maternal and neonatal mortality have not been conclusively demonstrated; exemptions for delivery care may contribute to modest reductions in institutional maternal mortality but the evidence is very weak. User fee exemptions were found to have negative, neutral, or inconclusive effects on availability of inputs, provider motivation, and quality of services. The extent to which user fee revenue lost by facilities is replaced can directly affect service provision and may have unintended consequences for provider motivation. Few studies have looked at the equity effects of fee removal, despite clear evidence that fees disproportionately burden the poor. This review highlights potential and documented benefits (increased use of maternity services) as well as risks (decreased provider motivation and quality) of user fee exemption policies for maternal health services. Governments should link user fee exemption policies with the replacement of lost revenue for facilities as well as broader health system improvements, including facility upgrades, ensured supply of needed inputs, and improved human resources for health. Removing user fees may increase uptake but will not reduce mortality proportionally if the quality of facility-based care is poor. More rigorous evaluations of both demand- and supply-side effects of mature fee exemption programmes are needed.

Anticipating the potential for positive uptake and adaptation in the implementation of a publicly funded online STBBI testing service: a qualitative analysis.

PubMed

Chabot, Cathy; Gilbert, Mark; Haag, Devon; Ogilvie, Gina; Hawe, Penelope; Bungay, Vicky; Shoveller, Jean A

2018-01-30

Online health services are a rapidly growing aspect of public health provision, including testing for sexually transmitted and other blood-borne infections (STBBI). Generally, healthcare providers, policymakers, and clients imbue online approaches with great positive potential (e.g., encouraging clients' agency; providing cost-effective services to more clients). However, the promise of online health services may vary across contexts and be perceived in negative or ambiguous ways (e.g., risks to 'gold standard' care provision; loss of provider control over an intervention; uncertainty related to budget implications). This study examines attitudes and perceptions regarding the development of a novel online STBBI testing service in Vancouver, Canada. We examine the perceptions about the intervention's potential by interviewing practitioners and planners who were engaged in the development and initial implementation of this testing service. We conducted in-depth interviews with 37 healthcare providers, administrators, policymakers, and community-based service providers engaged in the design and launch of the new online STBBI testing service. We also conducted observations during planning and implementation meetings for the new service. Thematic analysis techniques were employed to identify codes and broader discursive themes across the interview transcripts and observation notes. Some study participants expressed concern that the potential popularity of the new testing service might increase demand on existing sexual health services or become fiscally unsustainable. However, most participants regarded the new service as having the potential to improve STBBI testing in several ways, including reducing waiting times, enhancing privacy and confidentiality, appealing to more tech-savvy sub-populations, optimizing the redistribution of demands on face-to-face service provision, and providing patient-centred technology to empower clients to seek testing. Participants perceived this online STBBI testing service to have the potential to improve sexual health care provision. But, they also anticipated actions-and-reactions, revealing a need to monitor ongoing implementation dynamics. They also identified the larger, potentially system-transforming dimension of the new technology, which enables new system drivers (consumers) and reduces the amount of control health care providers have over online STBBI testing compared to conventional in-person testing.

The just provision of health care: a reply to Elizabeth Telfer.

PubMed Central

Steiner, H

1976-01-01

Dr Hillel Steiner in this reply to Elizabeth Telfer takes each of her arguments for different arrangements of a health service and examines them--'four positions which can be located on a linear ideological spectrum'--and adds a fifth which could have the effect of 'turning the alleged linear spectrum into a circle'. Underlying both Elizabeth Telfer's article and Dr Steiner's reply, the base is inescapably a 'political' one, but cannot be abandoned in favour of purely philosophical concepts. Whatever the attitude of mind of the reader of these two papers to the provision of a health service, the stimulus to more careful assessments of our own National Health Service and its problems can only be good. PMID:1003436

Cost analysis for the implementation of a medication review with follow-up service in Spain.

PubMed

Noain, Aranzazu; Garcia-Cardenas, Victoria; Gastelurrutia, Miguel Angel; Malet-Larrea, Amaia; Martinez-Martinez, Fernando; Sabater-Hernandez, Daniel; Benrimoj, Shalom I

2017-08-01

Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

Utility, economic rationalism and the circumscription of agency.

PubMed

Dirita, P A; Parmenter, T R; Stancliffe, R J

2008-07-01

Great strides have been achieved over the past few decades in service provision for people with intellectual disability (ID). However, there has also been a growth in the use of economic rationalism and a related rise in managerialism in forming service provision outcomes. An account of the focus on process and means of provision directed within the managerialist agenda to determine how individual authority has become subsumed within patterns of dependence. An underlying influence of utilitarianism has led to a focus on servicing the average through service provision trajectories which in turn have weakened the pace for social change and perpetuated a vulnerable conception of people with ID. There has been a qualification of the idealised intent of providing individualised support, choice and recognition of the moral worth of people with ID into relative features of equality. There remains an overriding static conception of the person with ID within funding frameworks and service provision which relies on economic and rationalist depictions of the individual.

Modeling the effects of urban expansion on natural capital stocks and ecosystem service flows: A case study in the Puget Sound, Washington, USA

USGS Publications Warehouse

Zank, Ben; Bagstad, Kenneth J.; Voigt, Brian; Villa, Ferdinando

2016-01-01

Urban expansion and its associated landscape modifications are important drivers of changes in ecosystem service (ES). This study examined the effects of two alternative land use-change development scenarios in the Puget Sound region of Washington State on natural capital stocks and ES flows. Land-use change model outputs served as inputs to five ES models developed using the Artificial Intelligence for Ecosystem Services (ARIES) platform. While natural capital stocks declined under managed (1.3–5.8%) and unmanaged (2.8–11.8%) development scenarios, ES flows increased by 18.5–56% and 23.2–55.7%, respectively. Human development of natural landscapes reduced their capacity for service provision, while simultaneously adding beneficiaries, particularly along the urban fringe. Using global and local Moran’s I, we identified three distinct patterns of change in ES due to projected landuse change. For services with location-dependent beneficiaries – open space proximity, viewsheds, and flood regulation – urbanization led to increased clustering and hot-spot intensities. ES flows were greatest in the managed land-use change scenario for open space proximity and flood regulation, and in the unmanaged land-use change scenario for viewsheds—a consequence of the differing ES flow mechanisms underpinning these services. We observed a third pattern – general declines in service provision – for carbon storage and sediment retention, where beneficiaries in our analysis were not location dependent. Contrary to past authors’ finding of ES declines under urbanization, a more nuanced analysis that maps and quantifies ES provision, beneficiaries, and flows better identifies gains and losses for specific ES beneficiaries as urban areas expand.

1 CFR 3.1 - Information services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

1 CFR 3.1 - Information services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

1 CFR 3.1 - Information services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

1 CFR 3.1 - Information services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

1 CFR 3.1 - Information services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Information services. 3.1 Section 3.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER GENERAL SERVICES TO THE PUBLIC § 3.1 Information services. Except in cases where the time required would be excessive, information concerning the...

42 CFR 71.31 - General provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

42 CFR 71.41 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

42 CFR 71.31 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

42 CFR 71.31 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false General provisions. 71.31 Section 71.31 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Health Measures at U.S. Ports: Communicable Diseases § 71.31 General provisions. (a...

42 CFR 71.41 - General provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

42 CFR 71.41 - General provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false General provisions. 71.41 Section 71.41 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Requirements Upon Arrival at U.S. Ports: Sanitary Inspection § 71.41 General provisions...

Changes in abortion service provision in Bihar and Jharkhand states, India between 2004 and 2013

PubMed Central

Singh, Kaushalendra K.; Li, Qingfeng; Fruhauf, Timothee; Tsui, Amy O.

2018-01-01

Background The Medical Termination of Pregnancy (MTP) Act of 1971 liberalized abortion laws in India. This study examines changes in abortion service provision and characteristics of abortion providers in Bihar and Jharkhand states, India between 2004 and 2013. Methods We used state-representative data from cross-sectional surveys of reproductive health service providers we conducted in 2004 (N = 1,323) and 2012/2013 (N = 1,020). We employed chi-squared tests to examine and compare abortion providers’ characteristics, and fitted separate multivariate logistic regression models for provision of surgical, medical, and any abortion services, respectively, adjusting for potential confounders to identify factors associated with abortion service provision at the two survey time points. Results Of providers interviewed in 2004 and 2012/2013, 63.7% and 84.5%, respectively, offered abortion services. Among abortion providers, 21.1% offered surgical and 10.7% offered medical abortions in 2004; 15.8% and 94.1% did so, respectively, in 2012/2013. Private providers were more likely than public providers to offer abortion services at both time points. Compared to female providers, male providers were significantly less likely to provide both surgical and medical abortions in 2004, and significantly less likely to provide surgical abortions in 2012/2013. Pharmacists and community health workers played increasingly important roles in abortion service provision, especially medical abortion, during the period. Conclusion This study documents important changes in abortion provision in the two Indian states during 2004–2013. PMID:29879132

Variation in outpatient mental health service utilization under capitation.

PubMed

Chou, Ann F; Wallace, Neal; Bloom, Joan R; Hu, Teh-Wei

2005-03-01

To improve the financing of Colorado's public mental health system, the state designed, implemented, and evaluated a pilot program that consisted of three reimbursement models for the provision of outpatient services. Community mental health centers (CMHCs), the primary providers of comprehensive mental health services to Medicaid recipients in Colorado, had to search for innovative ways to provide cost-effective services. This study assessed outpatient service delivery to Medicaid-eligible consumers under this program. This paper is among the first to study variations in the delivery of specific types of outpatient mental health services under capitated financing systems. This study uses claims data (1994-1997) from Colorado's Medicaid and Mental Health Services Agency. The fee-for-service (FFS) model served as the comparison model. Two capitated models under evaluation are: (i) direct capitation (DC), where the state contracts with a non-profit entity to provide both the services and administers the capitated financing, and (ii) managed behavioral health organization (MBHO), which is a joint venture between a for-profit company who manages the capitated financing and a number of non-profit entities who deliver the services. A sample of severely mentally ill patients who reported at least one inpatient visit was included in the analysis. Types of outpatient services of interest are: day-treatment visits, group therapy, individual therapy, medication monitoring, case management, testing, and all other services. Comparisons were set up to examine differences in service utilization and cost between FFS and each of the two capitated models, using a two-part model across three time periods. Results showed differences in service delivery among reimbursement models over time. Capitated providers had higher initial utilization in most outpatient service categories than their FFS counterparts and as a result of capitation, outpatient services delivered under these providers decreased to converge to the FFS pattern. Findings also suggest substitution between group therapy and individual psychotherapy. Overall, more service integration was observed and less complex service packages were provided post capitation. IMPLICATION FOR HEALTH CARE PROVISION AND POLICIES: Financing models and organizational arrangements have an impact on mental health service delivery. Changes in utilization and costs of specific types of outpatient services reflect the effects of capitation. Understanding the mechanism for these changes may lead to more streamlined service delivery allowing extra funding for expanding the range of cost-effective treatment alternatives. These changes pose implications for improving the financing of public mental health systems, coordination of mental health services with other healthcare and human services, and provision of services through a more efficient financing system.

Hindering Health? The Influence of Health Service Organization on the Delivery of Care for Eating Disorders in a University Setting.

ERIC Educational Resources Information Center

McKinney, Kristen J.

A case study is presented which seeks to understand the provision of health services to university students, specifically in situations that require an integration of treatment. The relationship of the effects of traditional bureaucratic structures on quality of services provided for students is explored by looking at the relationship between…

Ghana's National Health Insurance Scheme: a national level investigation of members' perceptions of service provision.

PubMed

Dixon, Jenna; Tenkorang, Eric Y; Luginaah, Isaac

2013-08-23

Ghana's National Health Insurance Scheme (NHIS), established into law in 2003 and implemented in 2005 as a 'pro-poor' method of health financing, has made great progress in enrolling members of the general population. While many studies have focused on predictors of enrolment this study offers a novel analysis of NHIS members' perceptions of service provision at the national level. Using data from the 2008 Ghana Demographic Health Survey we analyzed the perceptions of service provision as indicated by members enrolled in the NHIS at the time of the survey (n = 3468; m = 1422; f = 2046). Ordinal Logistic Regression was applied to examine the relationship between perceptions of service provision and theoretically relevant socioeconomic and demographic variables. Results demonstrate that wealth, gender and ethnicity all play a role in influencing members' perceptions of NHIS service provision, distinctive from its influence on enrolment. Notably, although wealth predicted enrolment in other studies, our study found that compared to the poorest men and uneducated women, wealthy men and educated women were less likely to perceive their service provision as better/same (more likely to report it was worse). Wealth was not an important factor for women, suggesting that household gender dynamics supersede household wealth status in influencing perceptions. As well, when compared to Akan women, women from all other ethnic groups were about half as likely to perceive the service provision to be better/same. Findings of this study suggest there is an important difference between originally enrolling in the NHIS because one believes it is potentially beneficial, and using the NHIS and perceiving it to be of benefit. We conclude that understanding the nature of this relationship is essential for Ghana's NHIS to ensure its longevity and meet its pro-poor mandate. As national health insurance systems are a relatively new phenomenon in sub-Saharan Africa little is known about their long term viability; understanding user perceptions of service provision is an important piece of that puzzle.

The Effect of Bilingualism on Self-Perceived Multicultural Counseling Competence

ERIC Educational Resources Information Center

Ivers, Nathaniel N.; Villalba, José A.

2015-01-01

Ethnic and linguistic minorities continue to underutilize and prematurely terminate counseling services at higher rates than their ethnic majority counterparts. To improve the provision of counseling services to culturally diverse clients, new avenues supported by theory and research need to be uncovered. One factor that has received little…

Overcoming Common Misunderstandings about Students with Disabilities Who Are English Language Learners

ERIC Educational Resources Information Center

Cheatham, Gregory A.; Hart Barnett, Juliet E.

2017-01-01

Special education programs are increasingly serving students with disabilities who are English language learners and their families. Facilitating bilingualism is an effective practice and aligns with culturally responsive special education service provision. It is critical for special educators and service providers to learn about bilingualism,…

Staff Training in Positive Behaviour Support: Impact on Attitudes and Knowledge

ERIC Educational Resources Information Center

Lowe, Kathy; Jones, Edwin; Allen, David; Davies, Dee; James, Wendy; Doyle, Tony; Andrew, Jock; Kaye, Neil; Jones, Sian; Brophy, Sam; Moore, Kate

2007-01-01

Background: Positive behavioural support is increasingly viewed as the preferred service approach for people who challenge, but skills are insufficiently widespread. The need for effective staff training has been highlighted as a key factor in high quality service provision, with investigators recommending a multidimensional approach to increase…

Web 2.0 and Nigerian Academic Librarians

ERIC Educational Resources Information Center

Adekunmisi, Sowemimo Ronke; Odunewu, Abiodun Olusegun

2016-01-01

Web 2.0 applications to library services are aimed at enhancing the provision of relevant and cost-effective information resources for quality education and research. Despite the richness of these web applications and their enormous impact on library and information services as recorded in the developed world, Nigerian academic libraries are yet…

34 CFR 110.23 - Assurances required.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provision of similar services or benefits. (2) In the case of Federal financial assistance extended to..., the instrument effecting or recording this transfer must contain a covenant running with the land to... services or benefits. (2) If no transfer of property is involved but property is purchased or improved with...

An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

PubMed

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

2011-12-01

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Relationship Between the Provision of Injection Services in Ambulatory Physician Offices and Prescribing Injectable Medicines.

PubMed

Yousefi, Naeimeh; Rashidian, Arash; Soleymani, Fatemeh; Kebriaeezade, Abbas

2017-01-01

Overuse of injections is a common problem in many low-income and middle income countries. While cultural factors and attitudes of both physicians and patients are important factors, physicians› financial intensives may play an important role in overprescribing of injections. This study was designed to assess the effects of providing injection- services in physicians› ambulatory offices on prescribing injectable medicines. This cross-sectional study was conducted in Tehran in 2012 -2013and included a random sample of general physicians, pediatricians and infectious disease specialists. We collected data on the provision of injection services in or in proximity of physician offices, and obtained data from physicians› prescriptions in the previous three-month period. We analyzed the data using ANOVA, Student›s t-test and linear regression methods. We obtained complete data from 465 of 600 sampled physicians. Overall 41.9% of prescriptions contained injectable medicines. 75% of physicians offered injection services in their offices. Male physicians and general physicians were more likely to offer the services, and more likely to prescribe injectables. We observed a clear linear relationship between the injection service working hours and the proportion of prescriptions containing injectables (p-value<0.001). Providing injection service in the office was directly linked with the proportion of prescriptions containing injectables. While provision of injection services may provide a direct financial benefit to physicians, it is unlikely to be able to substantially reduce injectable medicines› prescription without addressing the issue.

49 CFR 37.191 - Special provision for small mixed-service operators.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

49 CFR 37.191 - Special provision for small mixed-service operators.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

49 CFR 37.191 - Special provision for small mixed-service operators.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

49 CFR 37.191 - Special provision for small mixed-service operators.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Special provision for small mixed-service operators. 37.191 Section 37.191 Transportation Office of the Secretary of Transportation TRANSPORTATION... small mixed-service operators. (a) For purposes of this section, a small mixed-service operator is a...

75 FR 35989 - Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

...] Facilitating the Provision of Fixed and Mobile Broadband Access, Educational and Other Advanced Services in the...), clarifying the requirements necessary for Broadband Radio Service (BRS) and Educational Broadband Service (EBS) licensees to demonstrate substantial service and ensure that BRS licensees of new initial...

Nondiscrimination on the basis of handicap in the provision of health care to handicapped infants--Office of the Secretary, HHS. Notice of court order declaring rule invalid.

PubMed

1983-04-25

This notice is to advise that the interim final rule issued by the Department of Health and Human Services on March 7, 1983, 48 FR 9630, concerning discrimination in the provision of health care to handicapped infants, has been declared invalid and has no further force and effect.

Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs.

PubMed

Giannetti, Vincent; Caley, Charles F; Kamal, Khalid M; Covvey, Jordan R; McKee, Jerry; Wells, Barbara G; Najarian, Dean M; Dunn, Tyler J; Vadagam, Pratyusha

2018-06-04

Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, service provision, stigma, attitudes and beliefs of a national sample of community pharmacists towards individuals with mental illness. Setting National random sample of 3008 community pharmacists in the USA. Method 101-item cross-sectional mailed survey questionnaire on: (1) demographics, (2) knowledge and practice characteristics, (3) provision of clinical pharmacy services, and (4) comparative opinions. Main outcome measure Scaled measures of service provision (comfort, confidence, willingness and interest) and comparative opinions (stigma, attitudes and beliefs) of mental illness, four linear regression models to predict service provision. Results A total of 239 responses were received (response rate 7.95%). Across pharmacy services, ratings for willingness/interest were higher than those for comfort/confidence. Pharmacists who reported providing medication therapy management (MTM) services for patients reported higher comfort (18.36 vs. 17.46, p < 0.05), confidence (17.73 vs. 16.01, p < 0.05), willingness (20.0 vs. 18.62, p < 0.05) and interest (19.13 vs. 17.66, p < 0.05). Pharmacists with personal experience with mental illness also resulted in higher scores across all four domains of service provision, lower levels of stigma (18.28 vs. 20.76, p < 0.05) and more positive attitudes (52.24 vs. 50.53, p < 0.01). Regression analyses demonstrated increased frequency of MTM service delivery and more positive attitudes as significantly predictive across all four models for comfort, confidence, willingness and interest. Increased delivery of pharmacy services was significantly associated with both willingness and interest to provide mental illness-specific services. Conclusion Despite willingness/interest to provide services to patients with mental illness, decreased levels of comfort/confidence remain service-related barriers for community pharmacists.

3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of December 27, 2013 Provision of Aviation Insurance Coverage for Commercial...

3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 3 The President 1 2011-01-01 2011-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 29, 2010 Provision of Aviation Insurance Coverage for Commercial...

3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 28, 2011 Provision of Aviation Insurance Coverage for Commercial...

3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of September 27, 2012 Provision of Aviation Insurance Coverage for Commercial...

3 CFR - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations Presidential Documents Other Presidential Documents Memorandum of August 21, 2009 Provision of Aviation Insurance Coverage for Commercial...

78 FR 19797 - Designation & Determination Pursuant to the Foreign Missions Act; Concerning the Provision of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... DEPARTMENT OF STATE [Public Notice 8266] Designation & Determination Pursuant to the Foreign Missions Act; Concerning the Provision of Application Services for Visas, Passports and Similar Documents... designate the provision of application services with respect to visas, passports and similar documents by...

29 CFR 552.108 - Child labor provisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

29 CFR 552.108 - Child labor provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

29 CFR 552.108 - Child labor provisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

29 CFR 552.108 - Child labor provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

29 CFR 552.108 - Child labor provisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Child labor provisions. 552.108 Section 552.108 Labor... OF THE FAIR LABOR STANDARDS ACT TO DOMESTIC SERVICE Interpretations § 552.108 Child labor provisions. Congress made no change in section 12 as regards domestic service employees. Accordingly, the child labor...

The relationship between context, structure, and processes with outcomes of 6 regional diabetes networks in Europe.

PubMed

Mahdavi, Mahdi; Vissers, Jan; Elkhuizen, Sylvia; van Dijk, Mattees; Vanhala, Antero; Karampli, Eleftheria; Faubel, Raquel; Forte, Paul; Coroian, Elena; van de Klundert, Joris

2018-01-01

While health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian's Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK. Data collection consisted of: a) systematic modelling of provider network's structures and processes, and b) a cross-sectional survey of patient reported outcomes and other information. The survey resulted in data from 1459 T2D patients, during 2011-2012. Stepwise linear regression models were used to identify how independent cumulative proportion of variance in quality of life and service satisfaction are related to differences in context, structure and process. The selected context, structure and process variables are based on Donabedian's SPO model, a service quality research instrument (SERVQUAL), and previous organization and professional level evidence. Additional analysis deepens the possible bidirectional relation between outcomes and processes. The regression models explain 44% of variance in service satisfaction, mostly by structure and process variables (such as human resource use and the SERVQUAL dimensions). The models explained 23% of variance in quality of life between the networks, much of which is related to contextual variables. Our results suggest that effectiveness of A1c control is negatively correlated with process variables such as total hours of care provided per year and cost of services per year. While the selected structure and process variables explain much of the variance in service satisfaction, this is less the case for quality of life. Moreover, it appears that the effect of the clinical outcome A1c control on processes is stronger than the other way around, as poorer control seems to relate to more service use, and higher cost. The standardized operational models used in this research prove to form a basis for expanding the network level evidence base for effective T2D service provisioning.

The relationship between context, structure, and processes with outcomes of 6 regional diabetes networks in Europe

PubMed Central

Elkhuizen, Sylvia; van Dijk, Mattees; Vanhala, Antero; Karampli, Eleftheria; Faubel, Raquel; Forte, Paul; Coroian, Elena

2018-01-01

Background While health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian’s Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK. Methods Data collection consisted of: a) systematic modelling of provider network’s structures and processes, and b) a cross-sectional survey of patient reported outcomes and other information. The survey resulted in data from 1459 T2D patients, during 2011–2012. Stepwise linear regression models were used to identify how independent cumulative proportion of variance in quality of life and service satisfaction are related to differences in context, structure and process. The selected context, structure and process variables are based on Donabedian’s SPO model, a service quality research instrument (SERVQUAL), and previous organization and professional level evidence. Additional analysis deepens the possible bidirectional relation between outcomes and processes. Results The regression models explain 44% of variance in service satisfaction, mostly by structure and process variables (such as human resource use and the SERVQUAL dimensions). The models explained 23% of variance in quality of life between the networks, much of which is related to contextual variables. Our results suggest that effectiveness of A1c control is negatively correlated with process variables such as total hours of care provided per year and cost of services per year. Conclusions While the selected structure and process variables explain much of the variance in service satisfaction, this is less the case for quality of life. Moreover, it appears that the effect of the clinical outcome A1c control on processes is stronger than the other way around, as poorer control seems to relate to more service use, and higher cost. The standardized operational models used in this research prove to form a basis for expanding the network level evidence base for effective T2D service provisioning. PMID:29447220

76 FR 19792 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-08

... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Clients in Louisiana (Service Area LA- 1) Beginning June 2011 AGENCY: Legal...: The Legal Services Corporation (LSC) hereby announces its intention to award grants and contracts to...

Provision of QoS for Multimedia Services in IEEE 802.11 Wireless Network

DTIC Science & Technology

2006-10-01

Provision of QoS for Multimedia Services in IEEE 802.11 Wireless Network. In Dynamic Communications Management (pp. 10-1 – 10-16). Meeting Proceedings...mechanisms have been used for managing a limited bandwidth link within the IPv6 military narrowband network. The detailed description of these...confirms that implemented video rate adaptation mechanism enables improvement of qaulity of video transfer. Provision of QoS for Multimedia Services in

Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

PubMed

Austin, Anne; Gulema, Hanna; Belizan, Maria; Colaci, Daniela S; Kendall, Tamil; Tebeka, Mahlet; Hailemariam, Mengistu; Bekele, Delayehu; Tadesse, Lia; Berhane, Yemane; Langer, Ana

2015-03-29

Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision. A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network. Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care. Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

Capacity, pressure, demand, and flow: A conceptual framework for analyzing ecosystem service provision and delivery

USGS Publications Warehouse

Villamagna, Amy M.; Angermeier, Paul L.; Bennett, Elena M.

2013-01-01

Ecosystem services provide an instinctive way to understand the trade-offs associated with natural resource management. However, despite their apparent usefulness, several hurdles have prevented ecosystem services from becoming deeply embedded in environmental decision-making. Ecosystem service studies vary widely in focal services, geographic extent, and in methods for defining and measuring services. Dissent among scientists on basic terminology and approaches to evaluating ecosystem services create difficulties for those trying to incorporate ecosystem services into decision-making. To facilitate clearer comparison among recent studies, we provide a synthesis of common terminology and explain a rationale and framework for distinguishing among the components of ecosystem service delivery, including: an ecosystem's capacity to produce services; ecological pressures that interfere with an ecosystem's ability to provide the service; societal demand for the service; and flow of the service to people. We discuss how interpretation and measurement of these four components can differ among provisioning, regulating, and cultural services. Our flexible framework treats service capacity, ecological pressure, demand, and flow as separate but interactive entities to improve our ability to evaluate the sustainability of service provision and to help guide management decisions. We consider ecosystem service provision to be sustainable when demand is met without decreasing capacity for future provision of that service or causing undesirable declines in other services. When ecosystem service demand exceeds ecosystem capacity to provide services, society can choose to enhance natural capacity, decrease demand and/or ecological pressure, or invest in a technological substitute. Because regulating services are frequently overlooked in environmental assessments, we provide a more detailed examination of regulating services and propose a novel method for quantifying the flow of regulating services based on estimates of ecological work. We anticipate that our synthesis and framework will reduce inconsistency and facilitate coherence across analyses of ecosystem services, thereby increasing their utility in environmental decision-making.

Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia.

PubMed

Dawson, Angela; Bateson, Deborah; Estoesta, Jane; Sullivan, Elizabeth

2016-10-22

Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical abortion. However, to implement such directives leadership is required from Australian medical, nursing, midwifery and pharmacy practitioners, academic faculties and their associated professional associations. In addition, political will is needed to nationally decriminalise abortion and ensure dedicated public provision that is based on comprehensive models tailored for all populations.

5 CFR 1201.191 - Savings provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

....191 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES PRACTICES AND... in effect prior to the effective date of the Civil Service Reform Act shall continue in effect and be... President, Office of Personnel Management, the Merit Systems Protection Board, the Equal Employment...

7 CFR 905.82 - Effective time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Effective time. 905.82 Section 905.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.82 Effective time. The...

7 CFR 905.82 - Effective time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Effective time. 905.82 Section 905.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.82 Effective time. The...

7 CFR 905.82 - Effective time.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Effective time. 905.82 Section 905.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.82 Effective time. The...

7 CFR 905.82 - Effective time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Effective time. 905.82 Section 905.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.82 Effective time. The...

7 CFR 905.82 - Effective time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Effective time. 905.82 Section 905.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... TANGELOS GROWN IN FLORIDA Order Regulating Handling Miscellaneous Provisions § 905.82 Effective time. The...

Use of fees to fund local public health services in Western Massachusetts.

PubMed

Shila Waritu, A; Bulzacchelli, Maria T; Begay, Michael E

2015-01-01

Recent budget cuts have forced many local health departments (LHDs) to cut staff and services. Setting fees that cover the cost of service provision is one option for continuing to fund certain activities. To describe the use of fees by LHDs in Western Massachusetts and determine whether fees charged cover the cost of providing selected services. A cross-sectional descriptive analysis was used to identify the types of services for which fees are charged and the fee amounts charged. A comparative cost analysis was conducted to compare fees charged with estimated costs of service provision. Fifty-nine LHDs in Western Massachusetts. Number of towns charging fees for selected types of services; minimum, maximum, and mean fee amounts; estimated cost of service provision; number of towns experiencing a surplus or deficit for each service; and average size of deficits experienced. Enormous variation exists both in the types of services for which fees are charged and fee amounts charged. Fees set by most health departments did not cover the cost of service provision. Some fees were set as much as $600 below estimated costs. These results suggest that considerations other than costs of service provision factor into the setting of fees by LHDs in Western Massachusetts. Given their limited and often uncertain funding, LHDs could benefit from examining their fee schedules to ensure that the fee amounts charged cover the costs of providing the services. Cost estimates should include at least the health agent's wage and time spent performing inspections and completing paperwork, travel expenses, and cost of necessary materials.

Recovery-oriented service provision and clinical outcomes in assertive community treatment.

PubMed

Kidd, Sean A; George, Lindsey; O'Connell, Maria; Sylvestre, John; Kirkpatrick, Helen; Browne, Gina; Odueyungbo, Adefowope O; Davidson, Larry

2011-01-01

While the term "recovery" is routinely referenced in clinical services and health policy, few studies have examined the relationship between recovery-oriented service provision and client outcomes. The present study was designed to examine the relationship between recovery-orientation of service provision for persons with severe mental illnesses and outcomes in Assertive Community Treatment (ACT). Client, family, staff, and manager ratings of service recovery-orientation and outcomes across a range of service utilization and community functioning indicators were examined among 67 ACT teams in Ontario, Canada. Significant associations were found between ratings of recovery-oriented service provision and better outcomes in the domains of legal involvement, hospitalization days, education involvement, and employment. Results were not uniformly positive or consistent, however, across stakeholder Recovery Self-Assessment (RSA) ratings or outcomes. These findings provide some preliminary support for an association between recovery-oriented service delivery for persons with severe mental illnesses and better outcomes. In line with the current practice commentary, this association would suggest the importance of evaluating and cultivating recovery-oriented values and practices in ACT contexts. This is a particularly salient point given that ACT standards minimally address key domains of recovery-oriented service provision. Further study is required, however, to determine if these findings apply to the implementation of ACT in other jurisdictions or generalize to other community support programs.

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

PubMed

Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A

2015-01-01

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations.

The Effects of Introducing Mixed Payment Systems for Physicians: Experimental Evidence.

PubMed

Brosig-Koch, Jeannette; Hennig-Schmidt, Heike; Kairies-Schwarz, Nadja; Wiesen, Daniel

2017-02-01

Mixed payment systems have become a prominent alternative to paying physicians through fee-for-service and capitation. While theory shows mixed payment systems to be superior, causal effects on physicians' behavior when introducing mixed systems are not well understood empirically. We systematically analyze the influence of fee-for-service, capitation, and mixed payment systems on physicians' service provision. In a controlled laboratory setting, we implement an exogenous variation of the payment method. Medical and non-medical students in the role of physicians in the lab (N = 213) choose quantities of medical services affecting patients' health outside the lab. Behavioral data reveal significant overprovision of medical services under fee-for-service and significant underprovision under capitation, although less than predicted when assuming profit maximization. Introducing mixed payment systems significantly reduces deviations from patient-optimal treatment. Although medical students tend to be more patient regarding, our results hold for both medical and non-medical students. Responses to incentive systems can be explained by a behavioral model capturing individual altruism. In particular, we find support that altruism plays a role in service provision and can partially mitigate agency problems, but altruism is heterogeneous in the population. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

PubMed

Webb, Lucy

2012-07-01

This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

7 CFR 945.82 - Effective time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Effective time. 945.82 Section 945.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.82 Effective time. The provisions of this subpart shall become effective at such time as the...

7 CFR 945.82 - Effective time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Effective time. 945.82 Section 945.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.82 Effective time. The provisions of this subpart shall become effective at such time as the...

7 CFR 945.82 - Effective time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Effective time. 945.82 Section 945.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... § 945.82 Effective time. The provisions of this subpart shall become effective at such time as the...

7 CFR 945.82 - Effective time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Effective time. 945.82 Section 945.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... § 945.82 Effective time. The provisions of this subpart shall become effective at such time as the...

7 CFR 945.82 - Effective time.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Effective time. 945.82 Section 945.82 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... § 945.82 Effective time. The provisions of this subpart shall become effective at such time as the...

42 CFR 483.118 - Residents and applicants determined not to require NF level of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provision of specialized services for the mental illness or mental retardation. (2) Short term residents... provision of, specialized services for the mental illness or mental retardation. (3) For the purpose of...) Applicants who do not require NF services. If the State mental health or mental retardation authority...

Providing Written Language Services in the Schools: The Time Is Now

ERIC Educational Resources Information Center

Fallon, Karen A.; Katz, Lauren A.

2011-01-01

Purpose: The current study was conducted to investigate the provision of written language services by school-based speech-language pathologists (SLPs). Specifically, the study examined SLPs' knowledge, attitudes, and collaborative practices in the area of written language services as well as the variables that impact provision of these services.…

Service Provision to Students: Where the Gown Best Fits

ERIC Educational Resources Information Center

Schulz, Lucy; Szekeres, Judy

2008-01-01

One of the challenges facing those responsible for service provision in universities is ensuring that service is provided at the right point in the organisation. Service delivery points can exist at the school/department level, faculty/division level or central unit/university wide level. This does not always follow organisational logic, common…

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

47 CFR 22.950 - Provision of service in the Gulf of Mexico Service Area (GMSA)

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Provision of service in the Gulf of Mexico... service in the Gulf of Mexico Service Area (GMSA) The GMSA has been divided into two areas for licensing purposes, the Gulf of Mexico Exclusive Zone (GMEZ) and the Gulf of Mexico Coastal Zone (GMCZ). This section...

31 CFR 560.416 - Brokering services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

31 CFR 560.416 - Brokering services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

31 CFR 560.416 - Brokering services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provision of goods, services or technology, from whatever source, to or from Iran or the Government of Iran... the Government of Iran; (3) Act as broker for the provision of financing, a financial guarantee or an extension of credit by any person to Iran or the Government of Iran; (4) Act as a broker for the provision...

76 FR 36400 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-22

...-000 and AD10-13-000] Third-Party Provision of Ancillary Services; Accounting and Financial Reporting... current accounting and reporting requirements as applied to electric storage. As such, the Commission... the technologies used for such provision; and the adequacy of current accounting and reporting...

Integrating the provision of ecosystem services and trawl fisheries for the management of the marine environment.

PubMed

Muntadas, Alba; de Juan, Silvia; Demestre, Montserrat

2015-02-15

The species interaction and their biological traits (BT) determine the function of benthic communities and, hence, the delivery of ecosystem services. Therefore, disturbance of benthic communities by trawling may compromise ecosystem service delivery, including fisheries' catches. In this work, we explore 1) the impact of trawling activities on benthic functional components (after the BTA approach) and 2) how trawling impact may affect the ecosystem services delivered by benthic communities. To this aim, we assessed the provision of ecosystem services by adopting the concept of Ecosystem Service Providers (ESP), i.e. ecological units that perform ecosystem functions that will ultimately deliver ecosystem services. We studied thirteen sites subjected to different levels of fishing effort in the Mediterranean. From a range of environmental variables included in the study, we found ESPs to be mainly affected by fishing effort and grain size. Our results suggested that habitat type has significant effects on the distribution of ESPs and this natural variability influences ESP response to trawling at a specific site. In order to summarize the complex relationships between human uses, ecosystem components and the demand for ecosystem services in trawling grounds, we adapted a DPSIR (Drivers-Pressures-State Change-Impact-Response) framework to the study area, emphasizing the role of society as Drivers of change and actors demanding management Responses. This integrative framework aims to inform managers about the interactions between all the elements involved in the management of trawling grounds, highlighting the need for an integrated approach in order to ensure ecosystem service provision. Copyright © 2014 Elsevier B.V. All rights reserved.

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

PubMed Central

2011-01-01

Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations. PMID:21575159

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: a case study.

PubMed

Pieper, Hans-Olaf; Clerkin, Pauline; MacFarlane, Anne

2011-05-15

Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

47 CFR 90.363 - Grandfathering provisions for existing AVM licensees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Grandfathering provisions for existing AVM licensees. 90.363 Section 90.363 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Intelligent Transportation Systems Radio Service...

Implicit spiritual assessment: an alternative approach for assessing client spirituality.

PubMed

Hodge, David R

2013-07-01

To provide optimal services, a spiritual assessment is often administered to understand the intersection between clients' spirituality and service provision. Traditional assessment approaches, however, may be ineffective with clients who are uncomfortable with spiritual language or who are otherwise hesitant to discuss spirituality overtly. This article orients readers to an implicit spiritual assessment, an alternative approach that may be more valid with such clients. The process of administering an implicit assessment is discussed, sample questions are provided to help operationalize this approach, and suggestions are offered to integrate an implicit assessment with more traditional assessment approaches. By using terminology that is implicitly spiritual in nature, an implicit assessment enables practitioners to identify and operationalize dimensions of clients' experience that may be critical to effective service provision but would otherwise be overlooked.

Determinants of efficiency in the provision of municipal street-cleaning and refuse collection services

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

Benito-Lopez, Bernardino, E-mail: benitobl@um.es; Rocio Moreno-Enguix, Maria del, E-mail: mrmoreno@um.es; Solana-Ibanez, Jose, E-mail: jsolana@um.es

Effective waste management systems can make critical contributions to public health, environmental sustainability and economic development. The challenge affects every person and institution in society, and measures cannot be undertaken without data collection and a quantitative analysis approach. In this paper, the two-stage double bootstrap procedure of is used to estimate the efficiency determinants of Spanish local entities in the provision of public street-cleaning and refuse collection services. The purpose is to identify factors that influence efficiency. The final sample comprised 1072 municipalities. In the first stage, robust efficiency estimates are obtained with Data Envelopment Analysis (DEA). We apply themore » second stage, based on a truncated-regression, to estimate the effect of a group of environmental factors on DEA estimates. The results show the existence of a significant relation between efficiency and all the variables analysed (per capita income, urban population density, the comparative index of the importance of tourism and that of the whole economic activity). We have also considered the influence of a dummy categorical variable - the political sign of the governing party - on the efficient provision of the services under study. The results from the methodology proposed show that municipalities governed by progressive parties are more efficient.« less

Determinants of efficiency in the provision of municipal street-cleaning and refuse collection services.

PubMed

Benito-López, Bernardino; Moreno-Enguix, María del Rocio; Solana-Ibañez, José

2011-06-01

Effective waste management systems can make critical contributions to public health, environmental sustainability and economic development. The challenge affects every person and institution in society, and measures cannot be undertaken without data collection and a quantitative analysis approach. In this paper, the two-stage double bootstrap procedure of Simar and Wilson (2007) is used to estimate the efficiency determinants of Spanish local entities in the provision of public street-cleaning and refuse collection services. The purpose is to identify factors that influence efficiency. The final sample comprised 1072 municipalities. In the first stage, robust efficiency estimates are obtained with Data Envelopment Analysis (DEA). We apply the second stage, based on a truncated-regression, to estimate the effect of a group of environmental factors on DEA estimates. The results show the existence of a significant relation between efficiency and all the variables analysed (per capita income, urban population density, the comparative index of the importance of tourism and that of the whole economic activity). We have also considered the influence of a dummy categorical variable - the political sign of the governing party - on the efficient provision of the services under study. The results from the methodology proposed show that municipalities governed by progressive parties are more efficient. Copyright © 2011 Elsevier Ltd. All rights reserved.

National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study).

PubMed

Connolly, Martin J; Kenealy, Timothy; Barber, P Alan; Carswell, Peter; Clinton, Janet; Dyall, Lorna; Devlin, Gerard; Doughty, Robert N; Kerse, Ngaire; Kolbe, John; Lawrenson, Ross; Moffitt, Allan; Sheridan, Nicolette

2011-10-14

Chronic illness is the leading cause of morbidity, mortality, and inequitable health outcomes in New Zealand. The ABCCNZ Stocktake aimed to identify extent of long-term conditions management evidence-based practices in stroke, cardiovascular disease, chronic obstructive pulmonary disease and congestive heart failure in New Zealand's District Health Boards (DHBs). Eleven 'dimensions' of care for long-term conditions, identified by literature review and confirmed at workshops with long-term conditions professionals, formed the basis of the Stocktake of all 21 DHBs. It comprised two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing service provision. Fifteen DHBs completed all or parts of the questionnaires. Data accrual was completed in July 2008. Although most DHBs had developed long-term conditions management strategies to a moderate degree, there was considerable variability of practice between DHBs. DHBs thought their PHOs had developed strategies in some areas to a low to moderate level, though cardiovascular disease provision rated more highly. Regarding disease-specific services, larger DHBs had greater long-term conditions management provision not only of tertiary services, but of standard care, leadership, self-management, case-management, and audit. There is considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual disease-specific service provision appears to relate to DHB size.

Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study.

PubMed

Saronga, Happiness P; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell A; Savadogo, Germain; Tonchev, Pencho; Dong, Hengjin; Sauerborn, Rainer; Loukanova, Svetla

2014-02-28

Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives.

42 CFR 488.12 - Effect of survey agency certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Effect of survey agency certification. 488.12... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General Provisions § 488.12 Effect of survey agency certification. Certifications by the State survey agency...

45 CFR 92.5 - Effect on other issuances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Effect on other issuances. 92.5 Section 92.5 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION UNIFORM ADMINISTRATIVE... Effect on other issuances. All other grants administration provisions of codified program regulations...

Balancing the balanced scorecard for a New Zealand mental health service.

PubMed

Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

Podiatry: an illustration of surgery provided by allied health professionals.

PubMed

Maher, Anthony

2013-10-01

As with the prescribing of medicines, the provision of surgery continues to evolve and this is particularly true in the delivery of foot surgery which, until the 1960s, in the United Kingdom was practiced exclusively by medically qualified surgeons. Over the last 40 years however podiatric surgery performed by podiatrists has become established as a viable, safe and cost effective alternative to traditional models of service provision.

Family-centered services for children with complex communication needs: the practices and beliefs of school-based speech-language pathologists.

PubMed

Mandak, Kelsey; Light, Janice

2018-06-01

This study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists (SLPs) who served children with complex communication needs regarding their provision of family-centered services. Participants revealed that despite their desire for family involvement and reported beliefs in the importance of family-centered services, there were barriers in place that often limited family-centered service provision. Across the SLPs, many were dissatisfied with their current provision of family-centered services. The SLPs varied in their reported practices, with some reporting family-centered services and others, professional-centered services. Future research is recommended in order to investigate which factors contribute to the variation among SLPs and how the variation impacts children who require augmentative and alternative communication (AAC) and their families. Potential clinical implications for in-service and pre-service SLPs are discussed to improve future family-centered AAC services.

Physiotherapy in Bangladesh: Inequality Begets Inequality.

PubMed

Mamin, Firoz Ahmed; Hayes, Rieke

2018-01-01

The demand for health services in developing countries often outweighs provision. This article describes the present condition of physiotherapy in Bangladesh. Physiotherapy is not recognized as a profession by the government. There is no single registration and regulation body. The health-related and economic benefits of physiotherapy are not felt by the majority of Bangladeshi citizens. The burden of disease is changing, and Bangladesh needs a profession that specializes in physical rehabilitation to face these challenges. This article outlines the benefits to patients and the wider economy from a broad physiotherapy regime for all Bangladeshi citizens. It describes the many barriers the profession faces. Physiotherapy is efficacious in many post-trauma situations and long-term conditions. Economic evidence supports the provision physiotherapy as a cost-effective treatment which should be considered as part of the provision of a universal health-care service. Official recognition of the protected "physiotherapist" title and a single registration and regulation agency are recommended.

42 CFR 6.5 - Deeming process for eligible entities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Deeming process for eligible entities. 6.5 Section 6.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS... entities. Eligible entities will be covered by this part only on and after the effective date of a...

42 CFR 6.5 - Deeming process for eligible entities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Deeming process for eligible entities. 6.5 Section 6.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS... entities. Eligible entities will be covered by this part only on and after the effective date of a...

42 CFR 4.5 - Use of materials from the collections.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Use of materials from the collections. 4.5 Section 4.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS... prescribe additional reasonable rules to assure the most effective use of the Library's resources by health...

42 CFR 4.5 - Use of materials from the collections.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Use of materials from the collections. 4.5 Section 4.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS... prescribe additional reasonable rules to assure the most effective use of the Library's resources by health...

42 CFR 2a.8 - Termination.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Termination. 2a.8 Section 2a.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.8 Termination. (a) A Confidentiality Certificate is in effect from the date of its...

42 CFR 2a.8 - Termination.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Termination. 2a.8 Section 2a.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.8 Termination. (a) A Confidentiality Certificate is in effect from the date of its...

42 CFR 2a.8 - Termination.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Termination. 2a.8 Section 2a.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.8 Termination. (a) A Confidentiality Certificate is in effect from the date of its...

42 CFR 4.5 - Use of materials from the collections.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Use of materials from the collections. 4.5 Section 4.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS... prescribe additional reasonable rules to assure the most effective use of the Library's resources by health...

Moments of Truth: An Unexplored Dimension to Communicate Effectiveness

ERIC Educational Resources Information Center

Ramirez, Ricardo

2008-01-01

The settings for this article are rural and remote communities in the province of Ontario, Canada, where the advent of high-speed Internet has brought about new opportunities for the provision of public health and information services. This article proposes that public funding agencies and service providers will gain planning and evaluation…

47 CFR 97.19 - Application for a vanity call sign.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES AMATEUR RADIO SERVICE General Provisions § 97.19 Application for a vanity call sign. (a) The person named in an operator/primary station license grant or in a club station license grant is eligible... sign selected by the vanity call sign system. Effective February 14, 2011, the person named in a club...

47 CFR 97.19 - Application for a vanity call sign.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES AMATEUR RADIO SERVICE General Provisions § 97.19 Application for a vanity call sign. (a) The person named in an operator/primary station license grant or in a club station license grant is eligible... sign selected by the vanity call sign system. Effective February 14, 2011, the person named in a club...

47 CFR 97.19 - Application for a vanity call sign.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES AMATEUR RADIO SERVICE General Provisions § 97.19 Application for a vanity call sign. (a) The person named in an operator/primary station license grant or in a club station license grant is eligible... sign selected by the vanity call sign system. Effective February 14, 2011, the person named in a club...

47 CFR 97.19 - Application for a vanity call sign.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES AMATEUR RADIO SERVICE General Provisions § 97.19 Application for a vanity call sign. (a) The person named in an operator/primary station license grant or in a club station license grant is eligible... sign selected by the vanity call sign system. Effective February 14, 2011, the person named in a club...

Elder Abuse and Neglect: Assessment Tools, Interventions, and Recommendations for Effective Service Provision

ERIC Educational Resources Information Center

Imbody, Bethany; Vandsburger, Etty

2011-01-01

With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…

Case Management in Community Corrections: Current Status and Future Directions

ERIC Educational Resources Information Center

Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

2012-01-01

Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

42 CFR 2a.8 - Termination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Termination. 2a.8 Section 2a.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.8 Termination. (a) A Confidentiality Certificate is in effect from the date of its...

42 CFR 2a.8 - Termination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Termination. 2a.8 Section 2a.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS PROTECTION OF IDENTITY-RESEARCH SUBJECTS § 2a.8 Termination. (a) A Confidentiality Certificate is in effect from the date of its...

31 CFR 588.405 - Provision of services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of services. 588.405 Section 588.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE..., accounting, financial, brokering, freight forwarding, transportation, public relations, or other services to...

Service mix in the hospital outpatient department: implications for Medicare payment reform.

PubMed Central

Miller, M E; Sulvetta, M B; Englert, E

1995-01-01

OBJECTIVE. To determine if implementation of a PPS for Medicare hospital outpatient department (HOPD) services will have distributional consequences across hospital types and regions, this analysis assesses variation in service mix and the provision of high-technology services in the HOPD. DATA. HCFA's 1990 claims file for a 5 percent random sample of Medicare beneficiaries using the HOPD was merged, by hospital provider number, with various HCFA hospital characteristic files. STUDY DESIGN. Hospital characteristics examined are urban/rural location, teaching status, disproportionate-share status, and bed size. Two analyses of HOPD services are presented: mix of services provided and the provision of high-technology services. The mix of services is measured by the percentage of services in each of 14 type-of-service categories (e.g., medical visits, advanced imaging services, diagnostic testing services). Technology provision is measured by the percentage of hospitals providing selected high-technology services. FINDINGS/CONCLUSIONS. The findings suggest that the role hospital types play in providing HOPD services warrants consideration in establishing a PPS. HOPDs in major teaching hospitals and hospitals serving a disproportionate share of the poor play an important role in providing routine visits. HOPDs in both major and minor teaching hospitals are important providers of high-technology services. Other findings have implications for the structure of an HOPD PPS as well. First, over half of the services provided in the HOPD are laboratory tests and HOPDs may have limited control over these services since they are often for patients referred from local physician offices. Second, service mix and technology provision vary markedly among regions, suggesting the need for a transition to prospective payment. Third, the organization of service supply in a region may affect service provision in the HOPD suggesting that an HOPD PPS needs to be coordinated with payment policies in competing sites of care (e.g., ambulatory surgical centers). PMID:7721585

7 CFR 4288.131 - Payment provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General Provisions Payment Provisions § 4288.131 Payment provisions. Payments to advanced biofuel producers for eligible advanced biofuel production will be determined in accordance with the provisions of...

31 CFR 226.7 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Effective date. 226.7 Section 226.7 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE... LOAN DEPOSITARIES § 226.7 Effective date. The provisions of this part become effective November 2, 1978...

Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

PubMed

Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

2018-02-01

To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright © 2017 Elsevier Inc. All rights reserved.

Re-examining Responsibilities: Health Educators as Researchers.

ERIC Educational Resources Information Center

Drolet, Judy C.

1991-01-01

Discusses seven areas of responsibility for entry-level health educators which can be demonstrated through research: assessing individual and community needs for health education; planning effective health education programs; implementing programs; evaluating program effectiveness; coordinating service provision; acting as a resource; and…

25 CFR 900.196 - Do covered services include the conduct of clinical studies and investigations and the provision...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Do covered services include the conduct of clinical studies and investigations and the provision of emergency services, including the operation of emergency... Claims § 900.196 Do covered services include the conduct of clinical studies and investigations and the...

78 FR 64249 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2014 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2014 Competitive Grant Awards. SUMMARY: The Legal...

77 FR 64551 - Notice of Intent to Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... LEGAL SERVICES CORPORATION Notice of Intent to Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2013 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2013 Competitive Grant Awards. SUMMARY: The Legal...

76 FR 68221 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... LEGAL SERVICES CORPORATION Notice of Intent To Award--Grant Awards for the Provision of Civil Legal Services to Eligible Low-Income Clients Beginning January 1, 2012 AGENCY: Legal Services Corporation. ACTION: Announcement of intention to make FY 2012 Competitive Grant Awards. SUMMARY: The Legal...

Business Model Evaluation for an Advanced Multimedia Service Portfolio

NASA Astrophysics Data System (ADS)

Pisciella, Paolo; Zoric, Josip; Gaivoronski, Alexei A.

In this paper we analyze quantitatively a business model for the collaborative provision of an advanced mobile data service portfolio composed of three multimedia services: Video on Demand, Internet Protocol Television and User Generated Content. We provide a description of the provision system considering the relation occurring between tecnical aspects and business aspects for each agent providing the basic multimedia service. Such a techno-business analysis is then projected into a mathematical model dealing with the problem of the definition of incentives between the different agents involved in a collaborative service provision. Through the implementation of this model we aim at shaping the behaviour of each of the contributing agents modifying the level of profitability that the Service Portfolio yields to each of them.

Not Nearly Enough Geography! University Provision for England's Pre-Service Primary Teachers

ERIC Educational Resources Information Center

Catling, Simon

2017-01-01

Research into geography provision in primary initial teacher education [ITE] courses in the United Kingdom and worldwide is very limited. England educates pre-service primary teachers of 5-11 year olds to be "generalists" who teach the full range of curriculum subjects, including geography. This article identifies that the provision of…

Inequalities in the Provision of Paediatric Speech and Language Therapy Services across London Boroughs

ERIC Educational Resources Information Center

Pring, Tim

2016-01-01

Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest. Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs. Methods & Procedures: Information on the…

Collaboration or chaos: a consumer perspective.

PubMed

Connor, H

1999-09-01

Consumer participation in all levels of mental health service provision is now government policy throughout Australia. However, effective participation by consumers requires collaboration between mental health nurses and consumers. Effective collaboration and the partnership between those who provide and receive services requires trust and respect on both sides. Accompanying consumers on their 'journey' of wellness and recovery is likely to also provide mental health nurses with opportunities for personal and professional growth.

45 CFR 400.314 - Priority in provision of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Priority in provision of services. 400.314 Section 400.314 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

45 CFR 303.7 - Provision of services in interstate IV-D cases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.7 Provision of services in interstate IV... central registry responsible for receiving, distributing and responding to inquiries on all incoming...

47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

Code of Federal Regulations, 2014 CFR

2014-10-01

... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

Code of Federal Regulations, 2010 CFR

2010-10-01

... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum. Licensees in the Educational...

47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

Code of Federal Regulations, 2011 CFR

2011-10-01

... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum. Licensees in the Educational...

47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

Code of Federal Regulations, 2013 CFR

2013-10-01

... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

47 CFR 1.9047 - Special provisions relating to leases of educational broadband service spectrum.

Code of Federal Regulations, 2012 CFR

2012-10-01

... educational broadband service spectrum. 1.9047 Section 1.9047 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Spectrum Leasing General Policies and Procedures § 1.9047 Special provisions relating to leases of educational broadband service spectrum...

Challenges of user-centred assistive technology provision in Australia: shopping without a prescription.

PubMed

Steel, Emily J; Layton, Natasha Ann; Foster, Michele M; Bennett, Sally

2016-01-01

People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision. User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia. There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices. Ensuring access and equity in the public provision of AT is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision. Implications for Rehabilitation Variations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers. An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services. Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.

5 CFR 731.601 - Savings provision.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Savings provision. 731.601 Section 731.601 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Savings Provision § 731.601 Savings provision. No provision of the regulations in...

5 CFR 731.601 - Savings provision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Savings provision. 731.601 Section 731.601 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) SUITABILITY Savings Provision § 731.601 Savings provision. No provision of the regulations in...

Strengthening rehabilitation services in Indonesia: A brief situation analysis.

PubMed

Nugraha, Boya; Setyono, Garry Rahardian; Defi, Irma Ruslina; Gutenbrunner, Christoph

2018-04-18

People with disability (PWD) in Indonesia are often neglected by society. Improving their life situation towards full participation in society is crucial. As a health strategy, rehabilitation can improve func-tioning, quality of life and participation in society. However, rehabilitation services in Indonesia need improvement. Making a situation analysis of rehabilitation services and their provision in the country is a pre-requisite to taking any action towards improvement. This paper compiles available data related to disability and rehabilitation services in Indonesia, using the Rehabilitation Services Assessment Tool (RSAT) as a framework. Gaps in provision were analysed, resulting in the compilation of a list of generic recommendations to improve rehabilitation services in the country. Indonesia faces many challenges in rehabilitation services, including the health workforce and the provision of services. This situation analysis and list of generic recommendations may be used in further discussions with relevant stakeholders in the country to develop a national strategy to strengthen rehabilitation services.

Services for children with developmental co-ordination disorder: an evaluation against best practice principles.

PubMed

Pentland, Jacqueline; Maciver, Donald; Owen, Christine; Forsyth, Kirsty; Irvine, Linda; Walsh, Mike; Crowe, Miriam

2016-01-01

The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation. There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

How integrated are neurology and palliative care services? Results of a multicentre mapping exercise.

PubMed

van Vliet, Liesbeth M; Gao, Wei; DiFrancesco, Daniel; Crosby, Vincent; Wilcock, Andrew; Byrne, Anthony; Al-Chalabi, Ammar; Chaudhuri, K Ray; Evans, Catherine; Silber, Eli; Young, Carolyn; Malik, Farida; Quibell, Rachel; Higginson, Irene J

2016-05-10

Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and integration between these services. The mapping exercise was conducted in eight centres with neurology and palliative care services in the United Kingdom. The data were provided by the respective neurology and specialist palliative care teams. Questions focused on: i) catchment and population served; ii) service provision and staffing; iii) integration and relationships. Centres varied in size of catchment areas (39-5,840 square miles) and population served (142,000-3,500,000). Neurology and specialist palliative care were often not co-terminus. Service provisions for neurology and specialist palliative care were also varied. For example, neurology services varied in the number and type of provided clinics and palliative care services in the settings they work in. Integration was most developed in Motor Neuron Disease (MND), e.g., joint meetings were often held, followed by Parkinsonism (made up of Parkinson's Disease (PD), Multiple-System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP), with integration being more developed for MSA and PSP) and least in Multiple Sclerosis (MS), e.g., most sites had no formal links. The number of neurology patients per annum receiving specialist palliative care reflected these differences in integration (range: 9-88 MND, 3-25 Parkinsonism, and 0-5 MS). This mapping exercise showed heterogeneity in service provision and integration between neurology and specialist palliative care services, which varied not only between sites but also between diseases. This highlights the need and opportunities for improved models of integration, which should be rigorously tested for effectiveness.

7 CFR 915.66 - Effect of termination or amendment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Effect of termination or amendment. 915.66 Section 915... SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE AVOCADOS GROWN IN SOUTH FLORIDA Order Regulating Handling Miscellaneous Provisions § 915.66 Effect of termination...

7 CFR 996.75 - Effective time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Effective time. 996.75 Section 996.75 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Effective time. The provisions of this part, as well as any amendments, shall apply to 2003-04 and...

7 CFR 996.75 - Effective time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Effective time. 996.75 Section 996.75 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Effective time. The provisions of this part, as well as any amendments, shall apply to 2003-04 and...

7 CFR 996.75 - Effective time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Effective time. 996.75 Section 996.75 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Effective time. The provisions of this part, as well as any amendments, shall apply to 2003-04 and...

7 CFR 996.75 - Effective time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Effective time. 996.75 Section 996.75 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Effective time. The provisions of this part, as well as any amendments, shall apply to 2003-04 and...

Ghana’s National Health Insurance Scheme: a national level investigation of members’ perceptions of service provision

PubMed Central

2013-01-01

Background Ghana’s National Health Insurance Scheme (NHIS), established into law in 2003 and implemented in 2005 as a ‘pro-poor’ method of health financing, has made great progress in enrolling members of the general population. While many studies have focused on predictors of enrolment this study offers a novel analysis of NHIS members’ perceptions of service provision at the national level. Methods Using data from the 2008 Ghana Demographic Health Survey we analyzed the perceptions of service provision as indicated by members enrolled in the NHIS at the time of the survey (n = 3468; m = 1422; f = 2046). Ordinal Logistic Regression was applied to examine the relationship between perceptions of service provision and theoretically relevant socioeconomic and demographic variables. Results Results demonstrate that wealth, gender and ethnicity all play a role in influencing members’ perceptions of NHIS service provision, distinctive from its influence on enrolment. Notably, although wealth predicted enrolment in other studies, our study found that compared to the poorest men and uneducated women, wealthy men and educated women were less likely to perceive their service provision as better/same (more likely to report it was worse). Wealth was not an important factor for women, suggesting that household gender dynamics supersede household wealth status in influencing perceptions. As well, when compared to Akan women, women from all other ethnic groups were about half as likely to perceive the service provision to be better/same. Conclusions Findings of this study suggest there is an important difference between originally enrolling in the NHIS because one believes it is potentially beneficial, and using the NHIS and perceiving it to be of benefit. We conclude that understanding the nature of this relationship is essential for Ghana’s NHIS to ensure its longevity and meet its pro-poor mandate. As national health insurance systems are a relatively new phenomenon in sub-Saharan Africa little is known about their long term viability; understanding user perceptions of service provision is an important piece of that puzzle. PMID:23968385

Treating first episode psychosis--the service users' perspective: a focus group evaluation.

PubMed

O'Toole, M S; Ohlsen, R I; Taylor, T M; Purvis, R; Walters, J; Pilowsky, L S

2004-06-01

UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users' experiences of a first episode intervention designed along evidence-based 'best practice' guidelines and to establish specific elements seen as effective to help inform future service planning and provision. Twelve users of a specialist first episode service participated in focus groups. These were then analyzed using Interpretative Phenomenological Analysis, a specialized form of content analysis. Key elements identified by the service users included the 'human' approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users' experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users' and caregivers' perspective.

Alternative management structures for municipal waste collection services: The influence of economic and political factors

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

Plata-Díaz, Ana María, E-mail: amplata@ugr.es; Zafra-Gómez, José Luis, E-mail: jlzafra@ugr.es; Pérez-López, Gemma, E-mail: gemmapl@ugr.es

2014-11-15

Highlights: • We analyzed the factors that influence on the restructuring of MSW services. • We evaluated five different alternatives for public and private service. • Our analysis covers a broad time horizon, 2002–2010. • We used a conditional fixed-effects logistic regression as the evaluation method. • Municipalities tend to contract out the MSW service in the presence of high costs and fiscal stress. - Abstract: Identifying and characterising the factors that determine why a local authority opts for a particular way of managing its waste collection service is an important issue, warranting research interest in the field of municipalmore » solid waste (MSW) management. This paper presents empirical evidence spanning a broad time horizon (2002–2010) showing that economic and political factors impact in different ways on the provision of waste management services. We examine five alternatives in this area, including public and private service delivery formulas and, within each field, individual and joint options. Our findings highlight the importance of the service cost and that of the various indicators of fiscal stress as determinant factors of management decisions regarding the provision of MSW management services.« less

A comparison of two coaching approaches to enhance implementation of a recovery-oriented service model.

PubMed

Deane, Frank P; Andresen, Retta; Crowe, Trevor P; Oades, Lindsay G; Ciarrochi, Joseph; Williams, Virginia

2014-09-01

Moving to recovery-oriented service provision in mental health may entail retraining existing staff, as well as training new staff. This represents a substantial burden on organisations, particularly since transfer of training into practice is often poor. Follow-up supervision and/or coaching have been found to improve the implementation and sustainment of new approaches. We compared the effect of two coaching conditions, skills-based and transformational coaching, on the implementation of a recovery-oriented model following training. Training followed by coaching led to significant sustained improvements in the quality of care planning in accordance with the new model over the 12-month study period. No interaction effect was observed between the two conditions. However, post hoc analyses suggest that transformational coaching warrants further exploration. The results support the provision of supervision in the form of coaching in the implementation of a recovery-oriented service model, and suggest the need to better elucidate the mechanisms within different coaching approaches that might contribute to improved care.

Cultural diversity and the mistreatment of older people in black and minority ethnic communities: some implications for service provision.

PubMed

Bowes, Alison; Avan, Ghizala; Macintosh, Sherry Bien

2012-07-01

Previous research on mistreatment of older people in black and minority ethnic communities has identified limited service responses and the need to consider mistreatment as an issue not only for individuals but also for families, communities, and institutions. The impact of cultural factors on understandings, experiences, and remedies for mistreatment has been debated. Drawing on empirical research in the United Kingdom involving service providers and ethnically-diverse community members, the article explores implications of cultural variation for service provision. Clear gaps exist between service provision and people experiencing mistreatment due to structural and contextual factors; cultural factors have a relatively minor impact.

The Effectiveness of Peer-Delivered Services in the Management of Mental Health Conditions: A Meta-Analysis of Studies from Low- and Middle-Income Countries

ERIC Educational Resources Information Center

Vally, Zahir; Abrahams, Lameze

2016-01-01

It has been suggested that peers, or lay persons, should be more readily utilized in the provision of some mental health services, particularly in poor contexts where limited resources invariably result in many clients not receiving suitable and timely services. A systematic review and meta-analysis was conducted of all studies where peers were…

Balancing workload, motivation and job satisfaction in Rwanda: assessing the effect of adding family planning service provision to community health worker duties.

PubMed

Chin-Quee, Dawn; Mugeni, Cathy; Nkunda, Denis; Uwizeye, Marie Rose; Stockton, Laurie L; Wesson, Jennifer

2016-01-06

Task shifting from higher cadre providers to CHWs has been widely adopted to address healthcare provider shortages, but the addition of any service can potentially add to an already considerable workload for CHWs. Objective measures of workload alone, such as work-related time and travel may not reflect howCHWs actually perceive and react to their circumstances. This study combined perception and objectivemeasures of workload to examine their effect on quality of services, worker performance, and job and clientsatisfaction. Three hundred eighty-three CHWs from control and intervention districts, where the intervention group was trained to provide contraceptive resupply, completed diaries of work-related activities for one month. Interviews were also conducted with a subset of CHWs and their clients. CHW diaries did not reveal significant differences between intervention and control groups in time spent on service provision or travel. Over 90% of CHWs reported workload manageability, job satisfaction, and motivation to perform their jobs. Clients were highly satisfied with CHW services and most stated preference for future services from CHWs. The study demonstrated that adding resupply of hormonal contraceptives to CHWs' tasks would not place undue burden on them. Accordingly, the initiative was scaled up in all 30 districts in the country.

The relationship between general population suicide rates and mental health funding, service provision and national policy: a cross-national study.

PubMed

Shah, Ajit; Bhandarkar, Ritesh; Bhatia, Gurleen

2010-07-01

The main aims were to examine the relationship between general population suicide rates and the presence of national policies on mental health, funding for mental health, and measures of mental health service provision. Data on general population suicide rates for both genders were obtained from the World Health Organization (WHO) databank available on the WHO website. Data on the presence of national policies on mental health, funding for mental health and measures of mental health service provision were obtained from the Mental Health Atlas 2005, also available on the WHO website. The main findings were: (i) there was no relationship between suicide rates in both genders and different measures of mental health policy, except they were increased in countries with mental health legislation; (ii) there was a significant positive correlation between suicide rates in both genders and the percentage of the total health budget spent on mental health; and (iii) suicide rates in both genders were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists and psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on suicide rates requires further examination in longitudinal within-country studies.

A family-centered, community-based system of services for children and youth with special health care needs.

PubMed

Perrin, James M; Romm, Diane; Bloom, Sheila R; Homer, Charles J; Kuhlthau, Karen A; Cooley, Carl; Duncan, Paula; Roberts, Richard; Sloyer, Phyllis; Wells, Nora; Newacheck, Paul

2007-10-01

To present a conceptual definition of a family-centered system of services for children and youth with special health care needs (CYSHCN). Previous work by the Maternal and Child Health Bureau to define CYSHCN has had widespread program effects. This article similarly seeks to provide a definition of a system of services. Comprehensive literature review of systems of services and consensus panel organized to review and refine the definition. Policy research group and advisors at multiple sites. Policy researchers, content experts on CYSHCN, family representatives, and state program directors. Definition of a system of services for CYSHCN. This article defines a system of services for CYSHCN as a family-centered network of community-based services designed to promote the healthy development and well-being of these children and their families. The definition can guide discussion among policy makers, practitioners, state programs, researchers, and families for implementing the "community-based systems of services" contained in Title V of the Social Security Act. Critical characteristics of a system include coordination of child and family services, effective communication among providers and the family, family partnership in care provision, and flexibility. This definition provides a conceptual model that can help measurement development and assessment of how well systems work and achieve their goals. Currently available performance objectives for the provision of care for CYSHCN and national surveys of child health could be modified to assess systems of services in general.

A Retrospective Evaluation of Critical Care Blood Culture Yield - Do Support Services Contribute to the "Weekend Effect"?

PubMed

Morton, Ben; Nagaraja, Shankara; Collins, Andrea; Pennington, Shaun H; Blakey, John D

2015-01-01

The "weekend effect" describes an increase in adverse outcomes for patients admitted at the weekend. Critical care units have moved to higher intensity working patterns to address this with some improved outcomes. However, support services have persisted with traditional working patterns. Blood cultures are an essential diagnostic tool for patients with sepsis but yield is dependent on sampling technique and processing. We therefore used blood culture yield as a surrogate for the quality of support service provision. We hypothesized that blood culture yields would be lower over the weekend as a consequence of reduced support services. We performed a retrospective observational study examining 1575 blood culture samples in a university hospital critical care unit over a one-year period. Patients with positive cultures had, on average, higher APACHE II scores (p = 0.015), longer durations of stay (p = 0.03), required more renal replacement therapy (p<0.001) and had higher mortality (p = 0.024). Blood culture yield decreased with repeated sampling with an increased proportion of contaminants. Blood cultures were 26.7% less likely to be positive if taken at the weekend (p = 0.0402). This effect size is the equivalent to the impact of sampling before and after antibiotic administration. Our study demonstrates that blood culture yield is lower at the weekend. This is likely caused by delays or errors in incubation and processing, reflecting the reduced provision of support services at the weekend. Reorganization of services to address the "weekend effect" should acknowledge the interdependent nature of healthcare service delivery.

47 CFR 64.1502 - Limitations on the provision of pay-per-call services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on the provision of pay-per-call services. 64.1502 Section 64.1502 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and...

47 CFR 64.705 - Restrictions on charges related to the provision of operator services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provision of operator services. 64.705 Section 64.705 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... operator services shall: (1) Not bill for unanswered telephone calls in areas where equal access is available; (2) Not knowingly bill for unanswered telephone calls where equal access is not available; (3...

Service Provision for Preschool Children Who Are Deaf: Parents' Perspectives.

ERIC Educational Resources Information Center

Robinshaw, Helen; Evans, Roy

2001-01-01

Reports on data from national review of preschool service provision for deaf children and their families in the United Kingdom. Presents families' responses to early identification; information available after identification; perceptions of partnerships with professionals; and value of family-centered services for themselves, for their children,…

12 CFR 611.1125 - Treatment of associations not approving districtwide mergers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... in a districtwide merger or consolidation: (1) Discriminate in the provision of any financial service... provision of any related services that are offered by the district bank to associations and their member... to, charging different rates of interest or different prices for services, or declining to provide...

45 CFR 303.7 - Provision of services in intergovernmental IV-D cases.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.7 Provision of services in intergovernmental IV-D cases. (a) General responsibilities. A State IV-D agency must: (1) Establish and use...

47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for the provision of... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS... National Security and Emergency Preparedness personnel shall provide priority access service in accordance...

42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

42 CFR 412.87 - Additional payment for new medical services and technologies: General provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... technologies: General provisions. 412.87 Section 412.87 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... SERVICES Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices Additional Special Payment for Certain New Technology § 412.87 Additional...

32 CFR 154.55 - Requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... commander of the duty organization shall insure that the parent Component of the individual concerned is... separated from the Service under provisions of this part if removal or separation can be effected under OPM...

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…

29 CFR 4.151 - Employees covered by provisions of section 2(a).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 4.151 Labor Office of the Secretary of Labor LABOR STANDARDS FOR FEDERAL SERVICE CONTRACTS Application of the McNamara-O'Hara Service Contract Act Employees Covered by the Act § 4.151 Employees covered by provisions of section 2(a). The provisions of sections 2(a) and 4(c) of the Act prescribe labor...

12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE... Branches and Offices § 303.46 Financial education programs that include the provision of bank products and...

12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE... Branches and Offices § 303.46 Financial education programs that include the provision of bank products and...

Do family-planning workers in China support provision of sexual and reproductive health services to unmarried young people?

PubMed

Tu, Xiaowen; Cui, Nian; Lou, Chaohua; Gao, Ersheng

2004-04-01

To ascertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. Data were drawn from a survey of 1927 family-planning workers and 16 focus group discussions conducted in eight sites in China in 1998-99. Family-planning workers recognized the need to protect the sexual health of unmarried young people and were unambiguous about the need for government agencies to provide information and education on sexual and reproductive health to unmarried young people; however, perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools. Family-planning workers in China are ambivalent about the provision of sexual and reproductive health services to unmarried young people, which potentially poses a significant obstacle to the adoption of safe sex behaviours by young people, as well as to the provision of sexual and reproductive health information and services to young unmarried people in China. Training programmes for family-planning workers are urgently needed to address this issue.

Dynamics of ecosystem services provided by subtropical ...

EPA Pesticide Factsheets

The trends in the provision of ecosystem services during restoration and succession of subtropical forests and plantations were quantified, in terms of both receiver and donor values, based on a case study of a 3-step secondary succession series that included a 400-year-old subtropical forest and a 23-year history of growth on 3 subtropical forest plantations in Southeastern China. The ‘People's Republic of China Forestry Standard: Forest Ecosystem Service Valuation Norms’ was revised and applied to quantify the receiver values of ecosystem services, which were then compared with the emergy-based, donor values of the services. The results revealed that the efficiencies of subtropical forests and plantations in providing ecosystem services were 2 orders of magnitude higher than similar services provided by the current China economic system, and these efficiencieskept increasing over the course of succession. As a result, we conclude that afforestation is an efficient way to accelerate both the ability and efficiency of subtropical forests to provide ecosystem services. This paper is significant because it examines the dynamics of the provision of ecosystem services by forests over a succession series that spans 400 years. The paper also examines the rate of increase of services during forest restoration over a period of 23 years. The emergy used in ecosystem services provision is compared to the provision of similar services by economic means in the Chinese e

26 CFR 514.10 - Effective date.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Effective date. 514.10 Section 514.10 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS FRANCE Withholding of Tax § 514.10 Effective date. The provisions of §§ 514.1 through 517.9 shall be...

26 CFR 514.10 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Effective date. 514.10 Section 514.10 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS FRANCE Withholding of Tax § 514.10 Effective date. The provisions of §§ 514.1 through 517.9 shall be...

Denmark's National Family Guidance Program: A Preventive Mental Health Program for Children and Families.

ERIC Educational Resources Information Center

Wagner, Marsden

This document describes Denmark's 10-year (1965-75) program of cost-effective provision of social services to crisis families with children under the Danish 1964 Child and Youth Welfare Act. The program, voluntary and open to all families, provided preventive psychosocial services for children based on a family support system. The background to…

Supporting the Transition to Inclusive Education: Teachers' Attitudes to Inclusion in the Seychelles

ERIC Educational Resources Information Center

Main, Susan; Chambers, Dianne J.; Sarah, Paulette

2016-01-01

The inclusion of children with disability in regular classroom settings has been identified worldwide as crucial to the provision of effective education for all children and to the creation of more inclusive societies. To this end there has been significant focus on pre-service and in-service teacher education to ensure that teachers are…

31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine, medical...

31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine, medical...

31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine, medical...

31 CFR 597.511 - In-kind donations of medicine, medical devices, and medical services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false In-kind donations of medicine, medical... § 597.511 In-kind donations of medicine, medical devices, and medical services. (a) Effective July 6... provision by nongovernmental organizations that are U.S. persons of in-kind donations of medicine, medical...

38 CFR 8.11 - Cash value and policy loan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... become effective at the completion of the first policy year on any plan of National Service Life Insurance other than the 5-year level premium term plan. The cash value at the end of the first policy year... SERVICE LIFE INSURANCE Cash Value and Policy Loan § 8.11 Cash value and policy loan. (a) Provisions for...

Health Promotion in Pre-Service Teacher Education: Effects of a Pilot Inter-Professional Curriculum Change

ERIC Educational Resources Information Center

Byrne, Jenny; Speller, Viv; Dewhirst, Sue; Roderick, Paul; Almond, Palo; Grace, Marcus; Memon, Anjum

2012-01-01

Purpose: The purpose of this paper is to discuss a curriculum change in the provision of health promotion in pre-service teacher education in a one-year postgraduate certificate in education (PGCE) secondary course in one Higher Education Institution (HEI) in England. Design/methodology/approach: The paper describes the iterative development…

Exploring the Experiences of People with Intellectual Disabilities when Service Users Die

ERIC Educational Resources Information Center

Ryan, Karen; Guerin, Suzanne; Dodd, Philip; McEvoy, John

2011-01-01

Research is lacking on the effect of the deaths of fellow service users on people with intellectual disabilities. This qualitative study formed part of a project which aimed to describe the provision of palliative care to people with intellectual disabilities in Ireland and to assess the population's palliative care needs. We report on findings…

Trace saver: A tool for network service improvement and personalised analysis of user centric statistics

NASA Astrophysics Data System (ADS)

Bilal, Muhammad; Asfand-e-Yar, Mockford, Steve; Khan, Wasiq; Awan, Irfan

2012-11-01

Mobile technology is among the fastest growing technologies in today's world with low cost and highly effective benefits. Most important and entertaining areas in mobile technology development and usage are location based services, user friendly networked applications and gaming applications. However, concern towards network operator service provision and improvement has been very low. The portable applications available for a range of mobile operating systems which help improve the network operator services are desirable by the mobile operators. This paper proposes a state of the art mobile application Tracesaver, which provides a great achievement over the barriers in gathering device and network related information, for network operators to improve their network service provision. Tracesaver is available for a broad range of mobile devices with different mobile operating systems and computational capabilities. The availability of Tracesaver in market has proliferated over the last year since it was published. The survey and results show that Tracesaver is being used by millions of mobile users and provides novel ways of network service improvement with its highly user friendly interface.

The Impact of Local Environmental Health Capacity on Foodborne Illness Morbidity in Maryland

PubMed Central

Resnick, Beth A.; Fox, Mary A.; McGready, John; Yager, James P.; Burke, Thomas A.

2011-01-01

Objectives. We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. Methods. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Results. Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Conclusions. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness. PMID:21750282

42 CFR 67.101 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

42 CFR 67.101 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

42 CFR 67.101 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

42 CFR 67.101 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... services and procedures; projects to improve methods and data bases for outcomes and effectiveness research... regulations of this subpart also contain provisions respecting confidentiality of research data, control of data, and availability of information. ...

Autism spectrum disorder in adults: diagnosis, management, and health services development

PubMed Central

Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

2016-01-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

Medicaid program; modification of the Medicaid upper payment limit transition period for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. Final rule.

PubMed

2001-09-05

This final rule modifies the Medicaid upper payment (UPL) limit provisions by establishing a new transition period for States that submitted plan amendments before March 13, 2001 that do not comply with the new UPLs effective on that date (but do comply with the prior UPLs) and were approved on or after January 22, 2001. This new transition period applies to payments for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services.

Wildfires, Ecosystem Services, and Biodiversity in Tropical Dry Forest in India.

PubMed

Schmerbeck, Joachim; Fiener, Peter

2015-08-01

This review is intended to contribute to the understanding of the interlinkage between wildfire in India's tropical dry forest (TDF) and selected ecosystem services (ES), namely forest provisioning and water regulating services, as well as biodiversity. TDF covers approximately 146,000 km(2) (4.4%) of India, whereas according to the MODIS fire product about 2200 km(2) (1.4%) burns per year. As studies on wildfire effects upon ESs and biodiversity in Indian TDFs are rare we partly transferred findings from other (dry) forest areas to the environmental situation in India. In India (intentionally lit) wildfires have a very important connection to local livelihoods and the availability of non-wood forest products. Very important adverse long-term effects are the deterioration of forest ecosystems and soil degradation. The potential for TDF to regulate hydrological cycles is expected to be greater in the absence of fire than with it. A general judgment on the effect of fire on biodiversity is difficult as it depends on the community and species involved but a loss of biodiversity under regular burnings is apparent. Consequently, forest managers need sound knowledge regarding the interplay of wildfires and ecosystem behavior in general and more specific knowledge regarding the effects on taxa being considered for conservation efforts. Generally, much more research is needed to understand the trade-offs between the short-term benefits gained from forest provisioning services and long-term adverse effects.

Wildfires, Ecosystem Services, and Biodiversity in Tropical Dry Forest in India

NASA Astrophysics Data System (ADS)

Schmerbeck, Joachim; Fiener, Peter

2015-08-01

This review is intended to contribute to the understanding of the interlinkage between wildfire in India's tropical dry forest (TDF) and selected ecosystem services (ES), namely forest provisioning and water regulating services, as well as biodiversity. TDF covers approximately 146,000 km2 (4.4 %) of India, whereas according to the MODIS fire product about 2200 km2 (1.4 %) burns per year. As studies on wildfire effects upon ESs and biodiversity in Indian TDFs are rare we partly transferred findings from other (dry) forest areas to the environmental situation in India. In India (intentionally lit) wildfires have a very important connection to local livelihoods and the availability of non-wood forest products. Very important adverse long-term effects are the deterioration of forest ecosystems and soil degradation. The potential for TDF to regulate hydrological cycles is expected to be greater in the absence of fire than with it. A general judgment on the effect of fire on biodiversity is difficult as it depends on the community and species involved but a loss of biodiversity under regular burnings is apparent. Consequently, forest managers need sound knowledge regarding the interplay of wildfires and ecosystem behavior in general and more specific knowledge regarding the effects on taxa being considered for conservation efforts. Generally, much more research is needed to understand the trade-offs between the short-term benefits gained from forest provisioning services and long-term adverse effects.

76 FR 77053 - Proposed Collection; Income, Excise, and Estate and Gift Taxes Effective Dates, etc.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... Estate and Gift Taxes Effective Dates, etc. AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... gift taxes; effective dates and other issues arising under the employee benefit provisions of the tax..., Excise, and Estate and Gift Taxes Effective Dates and Other Issues Arising Under the Employee Benefit...

18 CFR 358.4 - Non-discrimination requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provisions relating to the sale or purchase of open access transmission service, if the tariff provisions do... relating to the sale or purchase of open access transmission service in a fair and impartial manner that...

Study protocol for two randomized controlled trials examining the effectiveness and safety of current weekend allied health services and a new stakeholder-driven model for acute medical/surgical patients versus no weekend allied health services.

PubMed

Haines, Terry P; O'Brien, Lisa; Mitchell, Deb; Bowles, Kelly-Ann; Haas, Romi; Markham, Donna; Plumb, Samantha; Chiu, Timothy; May, Kerry; Philip, Kathleen; Lescai, David; McDermott, Fiona; Sarkies, Mitchell; Ghaly, Marcelle; Shaw, Leonie; Juj, Genevieve; Skinner, Elizabeth H

2015-04-02

Disinvestment from inefficient or ineffective health services is a growing priority for health care systems. Provision of allied health services over the weekend is now commonplace despite a relative paucity of evidence supporting their provision. The relatively high cost of providing this service combined with the paucity of evidence supporting its provision makes this a potential candidate for disinvestment so that resources consumed can be used in other areas. This study aims to determine the effectiveness, cost-effectiveness and safety of the current model of weekend allied health service and a new stakeholder-driven model of weekend allied health service delivery on acute medical and surgical wards compared to having no weekend allied health service. Two stepped wedge, cluster randomised trials of weekend allied health services will be conducted in six acute medical/surgical wards across two public metropolitan hospitals in Melbourne (Australia). Wards have been chosen to participate by management teams at each hospital. The allied health services to be investigated will include physiotherapy, occupational therapy, speech therapy, dietetics, social work and allied health assistants. At baseline, all wards will be receiving weekend allied health services. Study 1 intervention will be the sequential disinvestment (roll-in) of the current weekend allied health service model from each participating ward in monthly intervals and study 2 will be the roll-out of a new stakeholder-driven model of weekend allied health service delivery. The order in which weekend allied health services will be rolled in and out amongst participating wards will be determined randomly. This trial will be conducted in each of the two participating hospitals at a different time interval. Primary outcomes will be length of stay, rate of unplanned hospital readmission within 28 days and rate of adverse events. Secondary outcomes will be number of complaints and compliments, staff absenteeism, and patient discharge destination, satisfaction, and functional independence at discharge. This is the world's first application of the recently described non-inferiority (roll-in) stepped wedge trial design, and the largest investigation of the effectiveness of weekend allied health services on acute medical surgical wards to date. Australian New Zealand Clinical Trials Registry. ACTRN12613001231730 (first study) and ACTRN12613001361796 (second study). Was this trial prospectively registered?: Yes. Date registered: 8 November 2013 (first study), 12 December 2013 (second study). Anticipated completion: June 2015. Protocol version: 1. Role of trial sponsor: KP and DL are directly employed by one of the trial sponsors, their roles were: KP assisted with overall development of research design and assisted with overall project management; DL contributed to project management, administration and communications strategy.

Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study)

PubMed Central

Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

2014-01-01

Objective To explore views of service providers caring for injured people on: the extent to which services meet patients’ needs and their perspectives on factors contributing to any identified gaps in service provision. Design Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers’ views were elicited through semistructured interviews. Data were analysed using thematic analysis. Setting Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. Participants 40 service providers from a range of disciplines. Results Service providers described two distinct models of trauma care: an ‘ideal’ model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a ‘real’ model based on the realities of National Health Service (NHS) practice. Participants’ ‘ideal’ model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, ‘real’ care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients’ needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Conclusions Service providers envisage an ‘ideal’ model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between ‘real’ and ‘ideal’ care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. PMID:25005598

Palliative care needs of terminally ill people living alone: a service provider perspective.

PubMed

Aoun, Samar M; Wall, David; Kristjanson, Linda J; Shahid, Shaouli

2013-01-01

Community-based palliative care services face challenges in meeting the needs of terminally ill clients who live alone without a primary caregiver. Yet, there is a dearth of literature on the perceptions of health service providers (HSPs) regarding the care needs and possible management options to assist this growing group to remain at home. This paper investigated the support needs of people living alone with a terminal illness from a service provider perspective. In depth semi-structured interviews were conducted with nine HSPs from community based services in three Australian states. Four main themes emerged: care challenges, differences in care provision, appropriate approaches to care and essentials for an effective service such as 24 h care, cost-free provision of personal alarm systems, supported and coordinated housekeeping services, funded respite care and financial care packages. HSPs expressed a respect for the autonomy and independence of the clients, yet felt pressured to ensure that safe and attentive care was possible. HSPs recognised the central importance of maintaining the independence and autonomy of palliative care clients living alone. This study is the first in-depth account of what HSPs perceive they need to effectively look after home alone dying clients. The study provided directions to inform service planning for this growing and challenging population group regarding adequate and timely services that will lead to more complying with the clients' wishes, more care being delivered at home, a reduction in hospitalisations, a better quality of life and a capacity to die at home.

[The roles and functions of volunteer counselors to the elderly].

PubMed

Chen, Chun-Yu

2004-06-01

In Taiwan's current counseling centers for the elderly, large numbers of volunteers are supervised by only a few social workers or nurses, so the roles and functions of these volunteers are very important. A neat summary of the services provided by the volunteers would include: (1) Direct services: telephone counseling, telephone interviewing, case handling, mail counseling, resource provision. (2) Indirect services: fundraising, supervision. (3) Administration: administrative assistance, management of institutional web sites. (4) Strategic consultancy: consultancy, provision of expertise. (5) Advocacy: service as educators and spokespersons; public relations and marketing. (6) MANAGEMENT: team leadership, plan implementation. To sum up, their functions are, by means of telephone and face-to-face contact, to provide information to the elderly about finances, medical services, housing, citizenship, the dignity of life and death, and related issues, as well as to serve as advocates for the provision of resources--such as educational courses--and to facilitate such provision. Indeed, the roles and functions of volunteer counselors become more diverse and more comprehensive by the day.

Employment relationships in Victorian public hospitals: the Kennett years.

PubMed

Stanton, P

2000-01-01

From 1992 to 1999, the Kennett government in Victoria moved to competitive market models of service delivery and the measurement of service provision through casemix funding. Public hospital managers were given greater accountability for the costs and provision of service delivery and a new range of service providers, many from the private sector, entered the public health market. The decentralisation of the industrial relations system led to new developments in bargaining that brought both opportunities and problems. In the Victorian public health system there was an increasing emphasis on decentralisation in both service provision and employment relations. In this paper I suggest that there were contradictions in these developments for government, and new challenges and difficulties for employers, employees and trade unions.

The research of service provision based on service-oriented architecture for NGN

NASA Astrophysics Data System (ADS)

Jie, Yin; Nian, Zhou; Qian, Mao

2007-11-01

Service convergence is an important characteristic of NGN(Next Generation Networking). How to integrate the service capabilities of telecommunication network and Internet. At first, this article puts forward the concepts and characteristics of SOA (Service-Oriented Architecture) and Web Service, then discusses relationship between them. Secondly, combined with five kinds of Service Provision in NGN, A service platform architecture design of NGN and a service development mode based on SOA are brought up. At last, a specific example is analyzed with BPEL (Business Process Execution Language) in order to describe service development flow based on SOA for NGN.

20 CFR 658.601 - State agency responsibility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and accuracy of documents prepared in the course of service delivery; and (E) Effectiveness of JS... deficiencies has been effective. (7)(a) The provisions of the JS regulations which require numerical and... carry out JS regulations, including regulations on performance standards and program emphases, and any...

75 FR 27322 - Capacity Building Program for Traditionally Underserved Populations-Technical Assistance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... improve the provision of vocational rehabilitation (VR) services to, and the employment outcomes of... foundation of the VR process and service provision; (2) the application of Federal rules, regulations, and... AIVRS grantees are among the many State VR agency partners eligible to receive services from the TACE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 2 2013-07-01 2013-07-01 false Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 2 2014-07-01 2013-07-01 true Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 361.50 - Written policies governing the provision of services for individuals with disabilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Written policies governing the provision of services for individuals with disabilities. 361.50 Section 361.50 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF...

34 CFR 364.43 - What requirements apply to the provision of State IL services?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true What requirements apply to the provision of State IL services? 364.43 Section 364.43 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 364.43 - What requirements apply to the provision of State IL services?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What requirements apply to the provision of State IL services? 364.43 Section 364.43 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

42 CFR 5a.1 - Statutory basis and purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Statutory basis and purpose. 5a.1 Section 5a.1 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS RURAL... the Public Health Service Act. These provisions define “underserved rural community” for purposes of...

Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

ERIC Educational Resources Information Center

Myers, Bronwyn; Fakier, Nuraan

2009-01-01

To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

18 CFR 367.1110 - Account 111, Accumulated provision for amortization of service company property.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT UNIFORM SYSTEM OF ACCOUNTS FOR CENTRALIZED SERVICE COMPANIES SUBJECT TO THE PROVISIONS OF THE PUBLIC UTILITY HOLDING... (§ 367.4040), for the current amortization of limited-term service company property investments. (2...

36 CFR 1501.1 - Cross reference to National Park Service regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Cross reference to National... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I...

36 CFR 1501.1 - Cross reference to National Park Service regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Cross reference to National... NATIONAL MEMORIAL TRUST GENERAL PROVISIONS § 1501.1 Cross reference to National Park Service regulations... (the Trust) adopts by cross reference the provisions of the National Park Service in 36 CFR chapter I...

31 CFR 515.572 - Authorization of transactions incident to the provision of travel services, carrier services, and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... who use their services information showing compliance with the relevant remittance provisions of this.... Note to paragraph (a)(3): A suggested form for the collection of information showing compliance with... state of applicant's organization, if a juridical entity, the address of its principal place of business...

14 CFR 93.30 - Assignment provisions for domestic and U.S./Canada transborder service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Assignment provisions for domestic and U.S./Canada transborder service. 93.30 Section 93.30 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... domestic and U.S./Canada transborder service. (a) Whenever the FAA has determined that sufficient Arrival...

20 CFR 203.1 - Statutory provisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... property used in the employer's operations, other personal services the rendition of which is integrated... THE ACT § 203.1 Statutory provisions. The term “employee” means (1) any individual in the service of... local lodge or division defined as an employer in sub-section (a) only if he was in the service of or in...

20 CFR 203.1 - Statutory provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... property used in the employer's operations, other personal services the rendition of which is integrated... THE ACT § 203.1 Statutory provisions. The term “employee” means (1) any individual in the service of... local lodge or division defined as an employer in sub-section (a) only if he was in the service of or in...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2013 CFR

2013-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2014 CFR

2014-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2012 CFR

2012-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2010 CFR

2010-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...

15 CFR 270.204 - Provision of additional resources and services needed by a Team.

Code of Federal Regulations, 2011 CFR

2011-01-01

... services needed by a Team. 270.204 Section 270.204 Commerce and Foreign Trade Regulations Relating to... CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Investigations § 270.204 Provision of additional resources and services needed by a Team. The Director will determine the appropriate resources that a Team...