14 CFR 221.52 - Airport to airport application, accessorial services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Airport to airport application, accessorial... Charges § 221.52 Airport to airport application, accessorial services. Tariffs shall specify whether or not the fares therein include services in addition to airport-to-airport transportation. ...

14 CFR 221.52 - Airport to airport application, accessorial services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Airport to airport application, accessorial... Charges § 221.52 Airport to airport application, accessorial services. Tariffs shall specify whether or not the fares therein include services in addition to airport-to-airport transportation. ...

14 CFR 221.52 - Airport to airport application, accessorial services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Airport to airport application, accessorial... Charges § 221.52 Airport to airport application, accessorial services. Tariffs shall specify whether or not the fares therein include services in addition to airport-to-airport transportation. ...

14 CFR 221.52 - Airport to airport application, accessorial services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Airport to airport application, accessorial... Charges § 221.52 Airport to airport application, accessorial services. Tariffs shall specify whether or not the fares therein include services in addition to airport-to-airport transportation. ...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2012 CFR

2012-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2014 CFR

2014-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2011 CFR

2011-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2013 CFR

2013-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

Managing the Services Supply Chain in the Department of Defense: Opportunities and Challenges

DTIC Science & Technology

2006-04-30

and Russell (1990), Heskett, Sasser and Hart (1990), Lovelock (1992b), Fitzsimmons and Fitzsimmons (2006), and in casebooks including Sasser, Hart...managers of service businesses. Lovelock (1983) proposes five schemes for classifying services that offer insight for marketing and operations...managers in different service businesses. Additional suggestions for managing service business are given by Lovelock (1992a), Schmenner (1986), and Quinn

An acoustic energy framework for predicting combustion-driven acoustic instabilities in premixed gas-turbines

NASA Astrophysics Data System (ADS)

Ibrahim, Zuhair M. A.

The purpose of this study was to discover and assess student financial services delivered to students enrolled at East Tennessee State University. The research was undertaken for institutional self-improvement. The research explored changes that have occurred in student financial services in the dynamic higher education market. The research revealed universities pursued best practices for the delivery of student financial services through expanded employee knowledge, restructured organizations, and integrated information technologies. The research was conducted during October and November, 2006. The data were gathered from an online student survey of student financial services. The areas researched included: the Bursar office, the Financial Aid office, and online services. The results of the data analysis revealed problems with the students' perceived quality of existing financial services and the additional services students desire. The research focused on student perceptions of the quality of financial services by age and gender classifications and response categories. Although no statistically significant difference was found between the age-gender classifications on the perception of the quality of the financial services studied, the research adds to our understanding of student financial services at East Tennessee State University. Recommendation for continued research included annual surveys of segmented student populations that include ethnicity, age, gender, and educational level. The research would be used for continuous improvement efforts and student relationship management. Also additional research was recommended for employee learning in relation to the institution's mission, goals, and values.

47 CFR 15.713 - TV bands database.

Code of Federal Regulations, 2011 CFR

2011-10-01

... authorized services operating in the TV bands. In addition, a TV bands database must also verify that the FCC identifier (FCC ID) of a device seeking access to its services is valid; under this requirement the TV bands... information will come from the official Commission database. These services include: (i) Digital television...

7 CFR 1962.6 - Liens and assignments on chattel property.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF..., including FSA Farm Programs (formerly ASCS) payments. (2) When a current loan is not being made to a... taken as additional security for Farm Ownership (FO), Rural Housing (RH), Labor Housing (LH), and Soil...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

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

Center for Research Libraries Study, Concordia University. Final Report.

ERIC Educational Resources Information Center

Tallon, J.

This discussion of the implementation of services related to the Center for Research Libraries (CRL) if Concordia University Libraries were to join CRL includes policies and procedures designed to assist Concordia in making effective use of CRL's services without sacrificing regular services or incurring large expenses in addition to the…

Special Educators' Perspectives on the Services and Benefits of Educational Audiologists

ERIC Educational Resources Information Center

Knickelbein, Becky A.; Richburg, Cynthia M.

2012-01-01

A 36-item survey was used to determine whether special educators have access to the services of an audiologist and whether they obtained benefit from the audiologist's services. Additional goals included gathering information about special educators' understanding of basic audiological concepts related to a school setting, added job…

38 CFR 17.40 - Additional services for indigents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... services, including haircutting and shaving necessary for hygienic reasons. [33 FR 5299, Apr. 3, 1968, as amended at 47 FR 58247, Dec. 30, 1982. Redesignated at 61 FR 21965, May 13, 1996] Examinations and...

Views From the Pacific--Military Base Hospital Libraries in Hawaii and Guam.

PubMed

Stephenson, Priscilla L; Trafford, Mabel A; Hadley, Alice E

2016-01-01

Hospital libraries serving military bases offer a different perspective on library services. Two libraries located on islands in the Pacific Ocean provide services to active duty service men and women, including those deployed to other regions of the world. In addition, these hospital libraries serve service members' families living on the base, and often citizens from the surrounding communities.

78 FR 27184 - Notice of Reopening of Public Comment Period-Proposed Directives for Forest Service Land...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... Period--Proposed Directives for Forest Service Land Management Planning AGENCY: Forest Service, USDA... comment period for the proposed directive regarding land management planning for an additional 15 days... identify your comments by including ``RIN 0596-AD06'' or ``planning directives'' on the cover sheet or the...

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

PubMed

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

2006-01-01

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

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

PubMed

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

2013-03-01

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

RX for School Nursing.

ERIC Educational Resources Information Center

Smolkin, Rachel

2003-01-01

Describes how some districts are coping with nursing shortages and tight budgets by employing several approaches to providing health services to students, including requesting additional services from existing staff, establishing partnerships with local health agencies and hospitals, and obtaining information about school-health programs from…

The Database Business: Managing Today--Planning for Tomorrow. Profiting with New Products and Services.

ERIC Educational Resources Information Center

Berger, Mary C.; Bourne, Charles P.

1988-01-01

The first paper discusses the factors involved in a decision to provide document delivery services, including user needs, competitive climate, business potential, fit with current business, and logistics of providing the service. The second reviews the kinds of additional products that can be developed as a byproduct of conventional database…

Agile Integration of Complex Systems

DTIC Science & Technology

2010-11-01

touch screens for dismounted warfighters or first responders Laptops for mounted warfighters or first responders Multitouch would be useful for all...Messaging Service provides basic distribution support for the other SOAF services, as shown in Figure 3. This support includes interacting with the...entered with the details necessary to accomplish the respective interactions of consuming and providing services. The combination of additional

8 CFR 286.8 - Establishment of pilot programs for the charging of a land border fee for inspection services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS IMMIGRATION USER FEE § 286.8 Establishment of pilot... charge fees for immigration inspection services to be collected by the Commissioner. Individual ports-of... inspection services and to recover the cost of: (a) Hiring additional immigration inspectors, including all...

Rapid Building Assessment Project

DTIC Science & Technology

2014-05-01

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

Enhancements to the NASA Astrophysics Science Information and Abstract Service

NASA Astrophysics Data System (ADS)

Kurtz, M. J.; Eichhorn, G.; Accomazzi, A.; Grant, C. S.; Murray, S. S.

1995-05-01

The NASA Astrophysics Data System Astrophysics Science Information and Abstract Service, the extension of the ADS Abstract Service continues rapidly to expand in both use and capabilities. Each month the service is used by about 4,000 different people, and returns about 1,000,000 pieces of bibliographic information. Among the recent additions to the system are: 1. Whole Text Access. In addition to the ApJ Letters we now have whole text for the ApJ on-line, soon we will have AJ and Rev. Mexicana. Discussions with other publishers are in progress. 2. Space Instrumentation Database. We now provide a second abstract service, covering papers related to space instruments. This is larger than the astronomy and astrophysics database in terms of total abstracts. 3. Reference Books and Historical Journals. We have begun putting the SAO Annals and the HCO Annals on-line. We have put the Handbook of Space Astronomy and Astrophysics by M.V. Zombeck (Cambridge U.P.) on-line. 4. Author Abstracts. We can now include original abstracts in addition to those we get from the NASA STI Abstracts Database. We have included abstracts for A&A in collaboration with the CDS in Strasbourg, and are collaborating with the AAS and the ASP on others. We invite publishers and editors of journals and conference proceedings to include their original abstracts in our service; send inquiries via e-mail to ads@cfa.harvard.edu. 5. Author Notes. We now accept notes and comments from authors of articles in our database. These are arbitrary html files and may contain pointers to other WWW documents, they are listed along with the abstracts, whole text, and data available in the index listing for every reference. The ASIAS is available at: http://adswww.harvard.edu/

Navigation Architecture For A Space Mobile Network

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

36 CFR 51.76 - May the Director include in a concession contract or otherwise grant a concessioner a...

Code of Federal Regulations, 2010 CFR

2010-07-01

... concession contract or otherwise grant a concessioner a preferential right to provide new or additional... include in a concession contract or otherwise grant a concessioner a preferential right to provide new or... grant a concessioner a preferential right to provide new or additional visitor services under the terms...

75 FR 66176 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

... Change To Codify Prices for Co-Location Services October 21, 2010. Pursuant to Section 19(b)(1) of the... (``Commission'') a proposed rule change to codify pricing for co- location services. The text of the proposed... for the Exchange's co-location services.\\3\\ This filing seeks to codify additional fees not included...

Safeguarding biodiversity and ecosystem services in the Little Karoo, South Africa.

PubMed

Egoh, Benis N; Reyers, Belinda; Carwardine, Josie; Bode, Michael; O'Farrell, Patrick J; Wilson, Kerrie A; Possingham, Hugh P; Rouget, Mathieu; de Lange, Willem; Richardson, David M; Cowling, Richard M

2010-08-01

Global declines in biodiversity and the widespread degradation of ecosystem services have led to urgent calls to safeguard both. Responses to this urgency include calls to integrate the needs of ecosystem services and biodiversity into the design of conservation interventions. The benefits of such integration are purported to include improvements in the justification and resources available for these interventions. Nevertheless, additional costs and potential trade-offs remain poorly understood in the design of interventions that seek to conserve biodiversity and ecosystem services. We sought to investigate the synergies and trade-offs in safeguarding ecosystem services and biodiversity in South Africa's Little Karoo. We used data on three ecosystem services--carbon storage, water recharge, and fodder provision--and data on biodiversity to examine several conservation planning scenarios. First, we investigated the amount of each ecosystem service captured incidentally by a conservation plan to meet targets for biodiversity only while minimizing opportunity costs. We then examined the costs of adding targets for ecosystem services into this conservation plan. Finally, we explored trade-offs between biodiversity and ecosystem service targets at a fixed cost. At least 30% of each ecosystem service was captured incidentally when all of biodiversity targets were met. By including data on ecosystem services, we increased the amount of services captured by at least 20% for all three services without additional costs. When biodiversity targets were reduced by 8%, an extra 40% of fodder provision and water recharge were obtained and 58% of carbon could be captured for the same cost. The opportunity cost (in terms of forgone production) of safeguarding 100% of the biodiversity targets was about US$500 million. Our results showed that with a small decrease in biodiversity target achievement, substantial gains for the conservation of ecosystem services can be achieved within our biodiversity priority areas for no extra cost.

21 CFR 74.101 - FD&C Blue No. 1.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.101 FD&C Blue No. 1. (a) Identity. (1) The color additive FD&C...] (o-sulfobenzyl) ammonium hydroxide inner salt. (2) Color additive mixtures for food use (including...

21 CFR 74.101 - FD&C Blue No. 1.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.101 FD&C Blue No. 1. (a) Identity. (1) The color additive FD&C...] (o-sulfobenzyl) ammonium hydroxide inner salt. (2) Color additive mixtures for food use (including...

21 CFR 74.101 - FD&C Blue No. 1.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.101 FD&C Blue No. 1. (a) Identity. (1) The color additive FD&C...] (o-sulfobenzyl) ammonium hydroxide inner salt. (2) Color additive mixtures for food use (including...

Manpower Mix for Health Services

PubMed Central

Shuman, Larry J.; Young, John P.; Naddor, Eliezer

1971-01-01

A model is formulated to determine the mix of manpower and technology needed to provide health services of acceptable quality at a minimum total cost to the community. Total costs include both the direct costs associated with providing the services and with developing additional manpower and the indirect costs (shortage costs) resulting from not providing needed services. The model is applied to a hypothetical neighborhood health center, and its sensitivity to alternative policies is investigated by cost-benefit analyses. Possible extensions of the model to include dynamic elements in health delivery systems are discussed, as is its adaptation for use in hospital planning, with a changed objective function. PMID:5095652

Redesigning a home oxygen assessment and review service.

PubMed

Wrench, Christine; Darwin, Ruth; Lawson, Rod

2015-03-01

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

7 CFR Appendix E to Subpart B of... - Feasibility Study Content

Code of Federal Regulations, 2014 CFR

2014-01-01

... project including any additional markets created (e.g., for agricultural and forestry products and agricultural waste material) and potential for rural economic development. Provide feasibility/plans of project...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for...

7 CFR Appendix E to Subpart B of... - Feasibility Study Content

Code of Federal Regulations, 2013 CFR

2013-01-01

... project including any additional markets created (e.g., for agricultural and forestry products and agricultural waste material) and potential for rural economic development. Provide feasibility/plans of project...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for...

7 CFR Appendix E to Subpart B of... - Feasibility Study Content

Code of Federal Regulations, 2012 CFR

2012-01-01

... project including any additional markets created (e.g., for agricultural and forestry products and agricultural waste material) and potential for rural economic development. Provide feasibility/plans of project...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for...

39 CFR 447.42 - Additional prohibited political activities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 447.42 Postal Service UNITED STATES POSTAL SERVICE PERSONNEL RULES OF CONDUCT FOR POSTAL EMPLOYEES... restrictions on political activities mentioned in § 447.51, an employee may not: (1) Display a political... paragraph, however, from displaying a picture, including a personally autographed picture of a political...

A Model-Driven, Science Data Product Registration Service

NASA Astrophysics Data System (ADS)

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

2011-12-01

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

The Homeland Security Enterprise: Where Do We Fit?

DTIC Science & Technology

2009-09-01

information, including suggestions for reducing this burden, to Washington headquarters Services , Directorate for Information Operations and Reports, 1215...emphasized federalism as the nation’s guiding principle (Clovis, 2006, p. 1). Additionally, Keith Bea, Congressional Research Service , (2005, p. 5...governance, in which each jurisdiction provides the necessary goods and services for its citizens (Clovis, 2006, pp. 3–4). The power for this arrangement

21 CFR 74.340 - FD&C Red No. 40.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.340 FD&C Red No. 40. (a) Identity. (1) The color additive FD&C...-naphthalenesulfonic acid. (2) Color additive mixtures for food use (including dietary supplements) made with FD&C Red...

21 CFR 74.340 - FD&C Red No. 40.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.340 FD&C Red No. 40. (a) Identity. (1) The color additive FD&C...-naphthalenesulfonic acid. (2) Color additive mixtures for food use (including dietary supplements) made with FD&C Red...

21 CFR 74.340 - FD&C Red No. 40.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION Foods § 74.340 FD&C Red No. 40. (a) Identity. (1) The color additive FD&C...-naphthalenesulfonic acid. (2) Color additive mixtures for food use (including dietary supplements) made with FD&C Red...

78 FR 57105 - Wm. Wrigley Jr. Company; Filing of Color Additive Petition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 73 [Docket No. FDA-2013-C-1008] Wm. Wrigley Jr. Company; Filing of Color Additive Petition AGENCY: Food and Drug... additive regulations be amended to expand the use of synthetic iron oxide to include soft and hard candy...

Kentucky's Statewide Early Childhood Professional Development System

ERIC Educational Resources Information Center

Rous, Beth; Grove, Jaime; Townley, Kim

2007-01-01

Public school systems have recently become major players in providing services for children in their early years. In addition, a number of other services are available to young children including child care, Head Start, and Early Head Start programs. The link between program quality and professional development of early care and education…

Farm Tractor Tune-Up and Service Specifications.

ERIC Educational Resources Information Center

Bryant, J. G.; And Others

Tune-up and service specifications for 10 major tractor manufacturers are presented in the handbook. In addition, the following tables are included: (1) spark plug heat-range comparisons, (2) freezing protection, (3) pressures for farm tractor tires, (4) use of calcium chloride for liquid weighting, (5) comparisons of American Petroleum Institute…

Agricultural Supplies and Services. Program Planning Guide: Volume 2.

ERIC Educational Resources Information Center

Welton, Richard; Marks, Michael

The program planning guide for agricultural supplies and services was written to assist Applied Biological and Agricultural Occupations (ABAO) teachers in enriching existing programs and/or to provide the basis for expansion of offerings to include additional materials for the cluster areas of agricultural chemicals, feeds, seeds, fertilizers, and…

10 CFR 430.35 - Petitions with respect to general service lamps.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Section 430.35 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Energy and Water Conservation Standards § 430.35 Petitions with respect to general service lamps... exemption for a product under this paragraph, the Secretary shall include, as an additional criterion, that...

10 CFR 430.35 - Petitions with respect to general service lamps.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 430.35 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Energy and Water Conservation Standards § 430.35 Petitions with respect to general service lamps... exemption for a product under this paragraph, the Secretary shall include, as an additional criterion, that...

10 CFR 430.35 - Petitions with respect to general service lamps.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Section 430.35 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Energy and Water Conservation Standards § 430.35 Petitions with respect to general service lamps... exemption for a product under this paragraph, the Secretary shall include, as an additional criterion, that...

10 CFR 430.35 - Petitions with respect to general service lamps.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 430.35 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Energy and Water Conservation Standards § 430.35 Petitions with respect to general service lamps... exemption for a product under this paragraph, the Secretary shall include, as an additional criterion, that...

76 FR 29264 - Minor Boundary Revision at Rocky Mountain National Park

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... DEPARTMENT OF THE INTERIOR National Park Service Minor Boundary Revision at Rocky Mountain National Park AGENCY: National Park Service, Interior. ACTION: Notification of park boundary revision... National Park is modified to include an additional 0.13 acres of land identified as Tract 03-137, tax...

Autonomous Motivation of Omani Early Childhood Pre-Service Teachers for Teaching

ERIC Educational Resources Information Center

Tekin, Ali Kemal

2016-01-01

This study investigated the Omani early childhood pre-service teachers' motivation for teaching. Specific attention was given to the levels of their autonomous motivation, including: (1) intrinsic motivation and (2) extrinsic motivation comprised of identified, introjected, and external motivations. In addition, the effects of age, cohort (grade…

Semantic Web Data Discovery of Earth Science Data at NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

NASA Technical Reports Server (NTRS)

Hegde, Mahabaleshwara; Strub, Richard F.; Lynnes, Christopher S.; Fang, Hongliang; Teng, William

2008-01-01

Mirador is a web interface for searching Earth Science data archived at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). Mirador provides keyword-based search and guided navigation for providing efficient search and access to Earth Science data. Mirador employs the power of Google's universal search technology for fast metadata keyword searches, augmented by additional capabilities such as event searches (e.g., hurricanes), searches based on location gazetteer, and data services like format converters and data sub-setters. The objective of guided data navigation is to present users with multiple guided navigation in Mirador is an ontology based on the Global Change Master directory (GCMD) Directory Interchange Format (DIF). Current implementation includes the project ontology covering various instruments and model data. Additional capabilities in the pipeline include Earth Science parameter and applications ontologies.

University-Community-Hospice Partnership to Address Organizational Barriers to Cultural Competence.

PubMed

Reese, Dona J; Buila, Sarah; Cox, Sarah; Davis, Jessica; Olsen, Meaghan; Jurkowski, Elaine

2017-02-01

Research documents a lack of access to, utilization of, and satisfaction with hospice care for African Americans. Models for culturally competent hospice services have been developed but are not in general use. Major organizational barriers include (1) lack of funding/budgeting for additional staff for community outreach, (2) lack of applications from culturally diverse professionals, (3) lack of funding/budgeting for additional staff for development of culturally competent services, (4) lack of knowledge about diverse cultures, and (5) lack of awareness of which cultural groups are not being served. A participatory action research project addressed these organizational barriers through a multicultural social work student field placement in 1 rural hospice. The effectiveness of the student interventions was evaluated, including addressing organizational barriers, cultural competence training of staff, and community outreach. Results indicated that students can provide a valuable service in addressing organizational barriers through a hospice field placement.

Satellite Communications for ATM

NASA Technical Reports Server (NTRS)

Shamma, Mohammed A.

2003-01-01

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

Medication therapy management: its relationship to patient counseling, disease management, and pharmaceutical care.

PubMed

McGivney, Melissa Somma; Meyer, Susan M; Duncan-Hewitt, Wendy; Hall, Deanne L; Goode, Jean-Venable R; Smith, Randall B

2007-01-01

To delineate the relationship, including similarities and differences, between medication therapy management (MTM) and contemporary pharmacist-provided services, including patient counseling, disease management, and pharmaceutical care, to facilitate the continued evolution of commonly used language and a standard of practice across geographic areas and practice environments. Incorporation of MTM services into the array of Medicare-funded services affords an opportunity for pharmacists to develop direct patient care services in the community. Defining the role of MTM within the scope of pharmacist-provided patient care activities, including patient counseling, disease management, and all currently provided pharmacy services is essential to the delineation of a viable and sustainable practice model for pharmacists. The definitions of each of these services are offered, as well as comparisons and contrasts of the individual services. In addition to Medicare-eligible patients, MTM services are appropriate for anyone with medication-related needs. MTM is offered as an all-encompassing model that incorporates the philosophy of pharmaceutical care, techniques of patient counseling, and disease management in an environment that facilitates the direct collaboration of patients, pharmacists, and other health professionals. Defining the role of MTM within the current patient care models, including patient counseling, disease management, and all who provide pharmacy services, is essential in delineating a viable and sustainable practice model for pharmacists.

Information Technology Research Services: Powerful Tools to Keep Up with a Rapidly Moving Field

NASA Technical Reports Server (NTRS)

Hunter, Paul

2010-01-01

Marty firms offer Information Technology Research reports, analyst calls, conferences, seminars, tools, leadership development, etc. These entities include Gartner, Forrester Research, IDC, The Burton Group, Society for Information Management, 1nfoTech Research, The Corporate Executive Board, and so on. This talk will cover how a number of such services are being used at the Goddard Space Flight Center to improve our IT management practices, workforce skills, approach to innovation, and service delivery. These tools and services are used across the workforce, from the executive leadership to the IT worker. The presentation will cover the types of services each vendor provides and their primary engagement model. The use of these services at other NASA Centers and Headquarters will be included. In addition, I will explain how two of these services are available now to the entire NASA IT workforce through enterprise-wide subscriptions.

bioGUID: resolving, discovering, and minting identifiers for biodiversity informatics

PubMed Central

Page, Roderic DM

2009-01-01

Background Linking together the data of interest to biodiversity researchers (including specimen records, images, taxonomic names, and DNA sequences) requires services that can mint, resolve, and discover globally unique identifiers (including, but not limited to, DOIs, HTTP URIs, and LSIDs). Results bioGUID implements a range of services, the core ones being an OpenURL resolver for bibliographic resources, and a LSID resolver. The LSID resolver supports Linked Data-friendly resolution using HTTP 303 redirects and content negotiation. Additional services include journal ISSN look-up, author name matching, and a tool to monitor the status of biodiversity data providers. Conclusion bioGUID is available at . Source code is available from . PMID:19900301

Exclusive queueing model including the choice of service windows

NASA Astrophysics Data System (ADS)

Tanaka, Masahiro; Yanagisawa, Daichi; Nishinari, Katsuhiro

2018-01-01

In a queueing system involving multiple service windows, choice behavior is a significant concern. This paper incorporates the choice of service windows into a queueing model with a floor represented by discrete cells. We contrived a logit-based choice algorithm for agents considering the numbers of agents and the distances to all service windows. Simulations were conducted with various parameters of agent choice preference for these two elements and for different floor configurations, including the floor length and the number of service windows. We investigated the model from the viewpoint of transit times and entrance block rates. The influences of the parameters on these factors were surveyed in detail and we determined that there are optimum floor lengths that minimize the transit times. In addition, we observed that the transit times were determined almost entirely by the entrance block rates. The results of the presented model are relevant to understanding queueing systems including the choice of service windows and can be employed to optimize facility design and floor management.

45 CFR 156.285 - Additional standards specific to SHOP.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 156.285 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Minimum Certification Standards § 156.285 Additional standards...

45 CFR 156.285 - Additional standards specific to SHOP.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 156.285 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Minimum Certification Standards § 156.285 Additional standards...

45 CFR 156.285 - Additional standards specific to SHOP.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 156.285 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Minimum Certification Standards § 156.285 Additional standards...

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

PubMed Central

Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M.

2015-01-01

Objective The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines. PMID:26048860

A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service.

PubMed

Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M

2015-01-01

The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the 'Guidelines on prevention & management of foot problems in Type 2 Diabetes' by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.

A Strategy for Computing Disease and Non-Battle Injury Rates

DTIC Science & Technology

1989-12-12

information on outpatient visits, monthly morbidity reports, service history data, environment data, and deployment information. In addition, more outpatient...information from available service history records. 2 A STRATEGY FOR coKptnfl DISEASE AND N-BATTLE INJURY RATES William M. Pugh Medical planners need an...between 1968 and 1979. The population information was acquired from service history files. These data included information on the patients’ age, sex

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

PubMed Central

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

2014-01-01

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

Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

PubMed

Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

2018-02-01

To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups ( P < 0.001). A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

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

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

78 FR 55135 - Request for Comments on Additional Participants in Trade in Services Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-09

... Congress of the Administration's intention to enter into negotiations for a Trade in Services Agreement... negotiating TISA ``will expand as negotiations progress to include others who share our ambitious goals. This... consensus to allow these new participants to join the negotiations. The Office of the United States Trade...

75 FR 72773 - Empowering Consumers to Avoid Bill Shock; Consumer Information and Disclosure

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... require mobile service providers to provide usage alerts and information that will assist consumers in... proposes rules that would require mobile service providers to provide usage alerts, such as voice or text... consumers, including methods such as providing voice or text alerts. In addition, the Commission seeks...

Best Practices for Artifact Versioning in Service-Oriented Systems

DTIC Science & Technology

2012-01-01

and endpoint [OASIS 2004]. But as Peltz and Anagol- Subbarao warn, “[I]t can be appealing to version down to the very lowest levels in accordance...Schemes There are multiple sources for typical naming schemes in SOA environments: • Anagol- Subbarao and Peltz provide service naming schemes, including...service versioning. 3. Extensions must not use the targetNamespace value. Peltz and Anagol- Subbarao provide additional guidance on how to implement

75 FR 47141 - Review of Personal Radio Services Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

...In this document, the Commission proposes to update, reorganize, simplify and streamline its Personal Radio Services rules to reflect technological advances and other changes in the way the American public uses the Personal Radio Services. In addition to improving the clarity of the rules, this document includes proposals intended to reduce unnecessary regulatory burdens on users, improve spectrum use, provide for enhanced equipment operating features, and promote the safety and consumer interests of operators. The document also proposes to reclassify one of the existing Personal Radio Services, specifically the 218-219 MHz service, as a Miscellaneous Wireless Communications Service, and accordingly move its rules from one part to another.

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

PubMed

Singer, Judy; Adams, Jon

2014-05-22

Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services.

Public-Private Ventures for Morale, Welfare, and Recreation Activities. A Solution to the Loss of Appropriated Funds. Volume 3. Appendix F

DTIC Science & Technology

1990-07-01

Plans included the addition of 18 lanes and two multipurpose rooms, an expansion of the snack bar/lounge facilities, and renovations of other areas... snack bar prices, and pro shop merchandise. Such price flexibility should enable the Concessioner to provide a full-service operation and still remain...pricing for services and merchandise not related to bowling fees. This includes bowling lessons, snack bar prices, amusements, and pro shop merchandise

17 CFR 201.160 - Time computation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... act, event, or default from which the designated period of time begins to run shall not be included... legal holiday (as defined in § 201.104), in which event the period runs until the end of the next day...) Additional time for service by mail. If service is made by mail, three days shall be added to the prescribed...

17 CFR 201.160 - Time computation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... act, event, or default from which the designated period of time begins to run shall not be included... legal holiday (as defined in § 201.104), in which event the period runs until the end of the next day...) Additional time for service by mail. If service is made by mail, three days shall be added to the prescribed...

17 CFR 201.160 - Time computation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... act, event, or default from which the designated period of time begins to run shall not be included... legal holiday (as defined in § 201.104), in which event the period runs until the end of the next day...) Additional time for service by mail. If service is made by mail, three days shall be added to the prescribed...

17 CFR 201.160 - Time computation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... act, event, or default from which the designated period of time begins to run shall not be included... legal holiday (as defined in § 201.104), in which event the period runs until the end of the next day...) Additional time for service by mail. If service is made by mail, three days shall be added to the prescribed...

17 CFR 201.160 - Time computation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... act, event, or default from which the designated period of time begins to run shall not be included... legal holiday (as defined in § 201.104), in which event the period runs until the end of the next day...) Additional time for service by mail. If service is made by mail, three days shall be added to the prescribed...

Educational Audiologists: Their Access, Benefit, and Collaborative Assistance to Speech-Language Pathologists in Schools

ERIC Educational Resources Information Center

Richburg, Cynthia McCormick; Knickelbein, Becky A.

2011-01-01

Purpose: The main goals of this study were to determine if school-based speech-language pathologists (SLPs) have access to the services of an audiologist and if those SLPs felt they obtained benefit from the audiologist's services. Additional goals included gathering information about SLPs' (a) understanding of basic audiological concepts typical…

Prices and Values: A Perspective on Adult and Community Education

ERIC Educational Resources Information Center

Wells, Graeme

2007-01-01

Government-provided services are caught in the jaws of a "cost-tax vice". On the cost side, the long-term trend of rising relative prices of services, including education, seems set to continue. The other jaw of the vice is the high efficiency cost of raising additional taxes. Recent research making the case for public provision of…

Innovations in Protective Services. Final Evaluation Report, September 1, 1982 through August 31, 1983.

ERIC Educational Resources Information Center

Texas State Dept. of Human Resources, Austin.

This evaluation report describes programs funded by the Texas Department of Human Resources to develop and implement child abuse and neglect services. Yearly evaluation reports and other related information are included for each of the seven programs funded. In addition to this basic information, the evaluation of the Special Investigative…

Easy access to geophysical data sets at the IRIS Data Management Center

NASA Astrophysics Data System (ADS)

Trabant, C.; Ahern, T.; Suleiman, Y.; Karstens, R.; Weertman, B.

2012-04-01

At the IRIS Data Management Center (DMC) we primarily manage seismological data but also have other geophysical data sets for related fields including atmospheric pressure and gravity measurements and higher level data products derived from raw data. With a few exceptions all data managed by the IRIS DMC are openly available and we serve an international research audience. These data are available via a number of different mechanisms from batch requests submitted through email, web interfaces, near real time streams and more recently web services. Our initial suite of web services offer access to almost all of the raw data and associated metadata managed at the DMC. In addition, we offer services that apply processing to the data before it is sent to the user. Web service technologies are ubiquitous with support available in nearly every programming language and operating system. By their nature web services are programmatic interfaces, but by choosing a simple subset of web service methods we make our data available to a very broad user base. These interfaces will be usable by professional developers as well as non-programmers. Whenever possible we chose open and recognized standards. The data returned to the user is in a variety of formats depending on type, including FDSN SEED, QuakeML, StationXML, ASCII, PNG images and in some cases where no appropriate standard could be found a customized XML format. To promote easy access to seismological data for all researchers we are coordinating with international partners to define web service interfaces standards. Additionally we are working with key partners in Europe to complete the initial implementation of these services. Once a standard has been adopted and implemented at multiple data centers researchers will be able to use the same request tools to access data across multiple data centers. The web services that apply on-demand processing to requested data include the capability to apply instrument corrections and format translations which ultimately allows more researchers to use the data without knowledge of specific data and metadata formats. In addition to serving as a new platform on top of which research scientists will build advanced processing tools we anticipate that they will result in more data being accessible by more users.

Miami urban partnership agreement (UPA) Pines Boulevard transit signal priority evaluation .report.

DOT National Transportation Integrated Search

2011-09-01

The Miami Urban Partnership Agreement included the conversion of high occupancy vehicle (HOV) lanes on I-95 to high occupancy toll : (HOT) lanes and additional express bus service. It also included funding for the installation of transit signal prior...

Cool Apps: Building Cryospheric Data Applications with Standards-Based Service Oriented Architecture

NASA Astrophysics Data System (ADS)

Oldenburg, J.; Truslove, I.; Collins, J. A.; Liu, M.; Lewis, S.; Brodzik, M.

2012-12-01

The National Snow and Ice Data Center (NSIDC) holds a large collection of cryospheric data, and is involved in a number of informatics research and development projects aimed at improving the discoverability and accessibility of these data. To develop high- quality software in a timely manner, we have adopted a Service- Oriented Architecture (SOA) approach for our core technical infrastructure development. Data services at NSIDC are internally exposed to other tools and applications through standards-based service interfaces. These standards include OAI-PMH (Open Archives Initiative Protocol for Metadata Harvesting), various OGC (Open Geospatial Consortium) standards including WMS (Web Map Service) and WFS (Web Feature Service), ESIP (Federation of Earth Sciences Information Partners) OpenSearch, and NSIDC-defined service endpoints which follow a RESTful architecture. By taking a standards-based approach, we are able to use off-the-shelf tools and libraries to consume, translate and broker these data services, and thus develop applications faster. Additionally, by exposing public interfaces to these services we provide valuable data services to technical collaborators; for example, NASA Reverb (http://reverb.echo.nasa.gov) uses NSIDC's WMS services. Our latest generation of web applications consume these data services directly. The most complete example of this is the Operation IceBridge Data Portal (http://nsidc.org/icebridge/ portal) which depends on many of the aforementioned services, retrieving data in several ways. The maps it displays are obtained through the use of WMS and WFS protocols from a MapServer instance hosted at NSIDC. Links to the scientific data collected on Operation IceBridge campaigns are obtained through ESIP OpenSearch requests service providers that encapsulate our metadata databases. These standards-based web services are also developed at NSIDC and are designed to be used independently of the Portal. This poster provides a visual representation of the relationships described above, with additional details and examples, and more generally outlines the benefits and challenges of this SOA approach.

Homeless youth: Barriers and facilitators for service referrals.

PubMed

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

2018-06-01

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

Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD’s Plans and Enhance Accountability

DTIC Science & Technology

2013-11-01

on timelines; and was not required to include information on shared services because the reporting time frame was not applicable. GAO also assessed...implementation costs and aggregated cost-savings estimates for the consolidation of four shared services . However, some key details of a sound business...case were missing, such as the basis for the savings. DOD’s business cases aggregated the separate business lines of its shared services , which

Enhancing UCSF Chimera through web services

PubMed Central

Huang, Conrad C.; Meng, Elaine C.; Morris, John H.; Pettersen, Eric F.; Ferrin, Thomas E.

2014-01-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. PMID:24861624

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

PubMed

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

2014-12-01

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

Mental health services costs within the Alberta criminal justice system.

PubMed

Jacobs, Philip; Moffatt, Jessica; Dewa, Carolyn S; Nguyen, Thanh; Zhang, Ting; Lesage, Alain

2016-01-01

Mental illness has been widely cited as a driver of costs in the criminal justice system. The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta. We set up a model of the flow of all persons through the criminal justice system, including police, court, and corrections components, and for mental health diversion, review, and forensic services. We estimate the transitional probabilities and costs that accrue as persons who have been charged move through the system. Costs are estimated for the Alberta criminal justice system as a whole, and for the mental illness component. Public expenditures for each person diverted or charged in Alberta in the criminal justice system, including mental health costs, were $16,138. The 95% range of this estimate was from $14,530 to $19,580. Of these costs, 87% were for criminal justice services and 13% were for mental illness-related services. Hospitalization for people with mental illness who were reviewed represented the greatest additional cost associated with mental illnesses. Treatment costs stemming from mental illnesses directly add about 13% onto those in the criminal justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.

An academic-health service partnership in nursing: lessons from the field.

PubMed

Granger, Bradi B; Prvu-Bettger, Janet; Aucoin, Julia; Fuchs, Mary Ann; Mitchell, Pamela H; Holditch-Davis, Diane; Roth, Deborah; Califf, Robert M; Gilliss, Catherine L

2012-03-01

To describe the development of an academic-health services partnership undertaken to improve use of evidence in clinical practice. Academic health science schools and health service settings share common elements of their missions: to educate, participate in research, and excel in healthcare delivery, but differences in the business models, incentives, and approaches to problem solving can lead to differences in priorities. Thus, academic and health service settings do not naturally align their leadership structures or work processes. We established a common commitment to accelerate the appropriate use of evidence in clinical practice and created an organizational structure to optimize opportunities for partnering that would leverage shared resources to achieve our goal. A jointly governed and funded institute integrated existing activities from the academic and service sectors. Additional resources included clinical staff and student training and mentoring, a pilot research grant-funding program, and support to access existing data. Emergent developments include an appreciation for a wider range of investigative methodologies and cross-disciplinary teams with skills to integrate research in daily practice and improve patient outcomes. By developing an integrated leadership structure and commitment to shared goals, we developed a framework for integrating academic and health service resources, leveraging additional resources, and forming a mutually beneficial partnership to improve clinical outcomes for patients. Structurally integrated academic-health service partnerships result in improved evidence-based patient care delivery and in a stronger foundation for generating new clinical knowledge, thus improving patient outcomes. © 2012 Sigma Theta Tau International.

Self-referral of imaging and increased utilization: some practical perspectives on tackling the dilemma.

PubMed

Romano, Donald H

2009-11-01

Health care costs are higher in the United States than in any other country in the world, and imaging services have been growing much more rapidly than other services. Studies have shown a tendency for increased utilization of services, including imaging services, when referring physicians have ownership interest in the services. In recent years, the CMS has taken some action with respect to how it pays for imaging, including reducing physician payments when multiple images are taken on contiguous body parts during the same visit, establishing a cap on payments for certain imaging services, and imposing an antimarkup rule on diagnostic tests. In addition, CMS has made some changes to the Stark rules, which included adding nuclear medicine to the list of designated health services, prohibiting certain per-service or per-click leasing arrangements, and prohibiting physicians from owning entities that sell services to providers that then bill for them under arrangements. Because it is unclear whether these policy changes will have much effect on imaging utilization, CMS will continue to seek new ways to rein in utilization. In the near future, CMS and the US Department of Health and Human Services are likely to attempt to curb utilization not only through postpayment review and education but also through its various initiatives on improving the quality of services furnished to Medicare benificiaries.

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

PubMed

Hammersmith, Kimberly J; Lee, Jessica Y

2009-01-01

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

Music Education Suites

ERIC Educational Resources Information Center

Kemp, Wayne

2009-01-01

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

Evaluation of bull fertility in dairy and beef cattle using cow field data.

PubMed

Berry, D P; Evans, R D; Mc Parland, S

2011-01-01

A successful outcome to a given service is a combination of both male and female fertility. Despite this, most national evaluations for fertility are generally confined to female fertility with evaluations for male fertility commonly undertaken by individual breeding organisations and generally not made public. The objective of this study was to define a pertinent male fertility trait for seasonal calving production systems, and to develop a multiple regression mixed model that may be used to evaluate male fertility at a national level. The data included in the study after editing consisted of 361,412 artificial inseminations from 206,683 cow-lactations (134,911 cows) in 2,843 commercial dairy and beef herds. Fixed effects associated with whether a successful pregnancy ensued (pregnant = 1) or not (pregnant = 0) from a given service were year by month of service, day of the week, days since calving, cow parity, level of calving difficulty experienced, whether or not the previous calving was associated with perinatal mortality, and age of the service bull at the date of insemination. Non-additive genetic effects such as heterosis and recombination loss as well as inbreeding level of the service bull, dam or mating were not associated with a successful pregnancy; there was no difference in pregnancy rate between fresh or frozen semen. Random effects included in the model were the additive genetic effect of the cow, as well as a within lactation and across lactation permanent environmental effect of the cow; pedigree group effects based on cow breed were also included via the relationship matrix. Temporal differences in the AI technician and service bull were also included as random effects. A difference in five percentage units in male fertility was evident between the average effects of different dairy and beef breeds. The correlation between raw pregnancy rates for bulls with more than 100 services (n = 431) and service bull solutions from the mixed model analysis was 0.66. The correlation between the raw pregnancy rates of 288 technicians with more than 100 services and their respective solutions from the mixed model was 0.35. These low to moderate correlations suggest considerable re-ranking among both service bulls and technicians and suggest possibly a benefit of using a statistical model to better estimate the performance of both service bulls and technicians. Copyright © 2011 Elsevier Inc. All rights reserved.

47 CFR 54.503 - Other supported special services.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Schools.

PubMed

Rose, India D; Friedman, Daniela B

2017-04-01

Sexual and gender minority (SGM) youth are at disproportionate risk for HIV. Schools play an integral role in educating young people about sexual health in addition to providing sexual health services. This qualitative study examined SGM youths' perception of school sexual health education and services. A total of 42 self-identified African American SGM males participated in focus groups or in an in-depth interview. Qualitative findings revealed that schools are missing the opportunity to educate SGM youth about sexual health. Youth participants noted several barriers to accessing sexual health education and services at schools including limited, targeted health information and school nurses not being knowledgeable of health issues that impact SGM youth. Participants noted that school sexual health services are not adequately marketed to students and sometimes do not include testing for HIV and other sexually transmitted diseases. Suggestions for future research and implications for school nurses and sexual health services are discussed.

ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG HIV-INFECTED ADULTS IN THE UNITED STATES

PubMed Central

Beer, Linda; Skarbinski, Jacek

2015-01-01

National estimates of antiretroviral therapy (ART) adherence and adherence support services utilization are needed to inform efforts to improve the health of HIV-infected persons in the United States. In a nationally representative sample of HIV-infected adults receiving medical care, 86% self-reported taking all ART doses in the past 72 hours. Overall, 20% reported using adherence support services and 2% reported an unmet need for services. If all nonadherent persons not receiving adherence support and all persons with a self-perceived unmet need for adherence support accessed services, resources to support ~42,673 additional persons would be needed. Factors associated with lower adherence included younger age, female gender, depression, stimulant use, binge alcohol use, greater than once-daily dosing, longer time since HIV diagnosis, and patient beliefs. Predictors of adherence are multifactorial so multiple targeted strategies to improve adherence are warranted. Providing adherence support services to all those in need may require additional resources. PMID:25490733

Learning by Doing: Service Learning as a Means of Personal Growth in the Middle Grades

ERIC Educational Resources Information Center

Farber, Katherine A.

2017-01-01

Does service learning impact the personal growth of middle grades students in grades 4-8? If so, in what ways? A review of the literature indicates that it does, in terms of the development of empathy, responsibility, civic engagement, and self-efficacy. In addition, findings include growth in students' communication with parents and teachers. In…

Medical Services: Veterinary Health Services

DTIC Science & Technology

1994-08-16

each dog will be immunized against rabies, canine distemper , canine adenovirus (type 1 or type 2), canine parvovirus, and leptospirosis, if it has...vaccination laws and regulations of States and foreign countries is mandatory. b. Other immunizations. Annual immunizations will include ca- nine distemper ...adenovirus (type 2), canine parvovirus, and lep- tospirosis. Additional immunizations may be given when needed to prevent an epizootic, or when

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

PubMed

Runte, Rebecca; Müller, Rolf

2016-12-01

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

Negotiation and Monitoring of Service Level Agreements

NASA Astrophysics Data System (ADS)

Quillinan, Thomas B.; Clark, Kassidy P.; Warnier, Martijn; Brazier, Frances M. T.; Rana, Omer

Service level agreements (SLAs) provide a means to define specific Quality of Service (QoS) guarantees between providers and consumers of services. Negotiation and definition of these QoS characteristics is an area of significant research. However, defining the actions that take place when an agreement is violated is a topic of more recent focus. This paper discusses recent advances in this field and propose some additional features that can help both consumers and producers during the enactment of services. These features include the ability to (re)negotiate penalties in an agreement, and specifically focuses on the renegotiation of penalties during enactment to reflect ongoing violations.

78 FR 24190 - Transcontinental Gas Pipe Line Company, LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... Northeast Connector Project (Project) in New York. The Project is an expansion of Transco's existing... Rockaway Delivery Lateral. The Project will include compressor unit modifications and the net addition of... required. In addition to the firm service to be provided by the Project, National Grid NY can use its...

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

ERIC Educational Resources Information Center

Baker, Peter; Appleton, Philippa; Williams, Rosie

2017-01-01

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

Pacific Southwest Media Center

EPA Pesticide Factsheets

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

49 CFR 365.107 - Types of applications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (i.e., natural disasters or national emergencies) when evidence of immediate service need can be..., including Mexico- or non-North America-domiciled carrier applicants. In addition to meeting the fitness...

49 CFR 365.107 - Types of applications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (i.e., natural disasters or national emergencies) when evidence of immediate service need can be..., including Mexico- or non-North America-domiciled carrier applicants. In addition to meeting the fitness...

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

NASA Astrophysics Data System (ADS)

Richardson, M.; Kumar, P.

2016-12-01

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

FDSN and EarthCube: Coordinating Global Infrastructures within Seismology and Across Other Geophysical Domains

NASA Astrophysics Data System (ADS)

Ahern, T. K.; Ekstrom, G.; Grobbelaer, M.; Trabant, C. M.; Van Fossen, M.; Stults, M.; Tsuboi, S.; Beaudoin, B. C.; Bondar, I.

2016-12-01

Seismology, by its very nature, requires sharing information across international boundaries and as such seismology evolved as a science that promotes free and open access to data. The International Federation of Digital Seismograph Networks (FDSN) has commission status within IASPEI and as such is the international standards body in our community. In the late 1980s a domain standard for exchanging seismological information was created and the SEED format is still the dominant domain standard. More recently the FDSN standardized web-service interfaces for key services used in our community. The standardization of these services also enabled the development of a federation of data centers. These federated centers, can be accessed through standard FDSN service calls. Client software exists that currently allows seamless and transparent access to all data managed at 14 globally distributed data centers on three continents with plans to expand this more broadly. IRIS is also involved in the EarthCube project funded by the US National Science Foundation. The GEOphysical Web Services (GeoWS) project extended the style of web services endorsed by the FDSN to interdisciplinary domains. IRIS worked with five data centers in other domains (Caltech, UCSD, Columbia University, UNAVCO and Unidata) to develop `similar' service-based interfaces to their data systems that were drawn from the oceanographic, atmospheric, and solid earth divisions within the NSF's geosciences directorate. Additionally IRIS developed GeoWS style web services for six additional data collections that included magnetic observations, field gravity measurements, superconducting gravimetry data, volcano monitoring data, tidal data, and oceanographic observations including those from cabled arrays in the ocean. This presentation will highlight the success the FDSN and GeoWS services have demonstrated within and beyond seismology as well as identifying some next steps being considered.

"I just answer 'yes' to everything they say": access to health care for deaf people in Worcester, South Africa and the politics of exclusion.

PubMed

Kritzinger, Janis; Schneider, Marguerite; Swartz, Leslie; Braathen, Stine Hellum

2014-03-01

To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A systematic review of the unit costs of allied health and community services used by older people in Australia.

PubMed

Farag, Inez; Sherrington, Cathie; Ferreira, Manuela; Howard, Kirsten

2013-02-20

An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.

Ecosystem services and economic theory: integration for policy-relevant research.

PubMed

Fisher, Brendan; Turner, Kerry; Zylstra, Matthew; Brouwer, Roy; de Groot, Rudolf; Farber, Stephen; Ferraro, Paul; Green, Rhys; Hadley, David; Harlow, Julian; Jefferiss, Paul; Kirkby, Chris; Morling, Paul; Mowatt, Shaun; Naidoo, Robin; Paavola, Jouni; Strassburg, Bernardo; Yu, Doug; Balmford, Andrew

2008-12-01

It has become essential in policy and decision-making circles to think about the economic benefits (in addition to moral and scientific motivations) humans derive from well-functioning ecosystems. The concept of ecosystem services has been developed to address this link between ecosystems and human welfare. Since policy decisions are often evaluated through cost-benefit assessments, an economic analysis can help make ecosystem service research operational. In this paper we provide some simple economic analyses to discuss key concepts involved in formalizing ecosystem service research. These include the distinction between services and benefits, understanding the importance of marginal ecosystem changes, formalizing the idea of a safe minimum standard for ecosystem service provision, and discussing how to capture the public benefits of ecosystem services. We discuss how the integration of economic concepts and ecosystem services can provide policy and decision makers with a fuller spectrum of information for making conservation-conversion trade-offs. We include the results from a survey of the literature and a questionnaire of researchers regarding how ecosystem service research can be integrated into the policy process. We feel this discussion of economic concepts will be a practical aid for ecosystem service research to become more immediately policy relevant.

Expanding Suicide Crisis Services to Text and Chat.

PubMed

Predmore, Zachary; Ramchand, Rajeev; Ayer, Lynsay; Kotzias, Virginia; Engel, Charles; Ebener, Patricia; Kemp, Janet E; Karras, Elizabeth; Haas, Gretchen L

2017-07-01

Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging. To better understand differences in the use of phone and chat/text services. We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis. Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services. We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited. While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

PubMed Central

2014-01-01

Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. Conclusions From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services. PMID:24885066

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

21 CFR 1.328 - What definitions apply to this subpart?

Code of Federal Regulations, 2011 CFR

2011-04-01

... Section 1.328 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL.... Farm means a facility in one general physical location devoted to the growing and harvesting of crops...; animal feed, including pet food; food and feed ingredients and additives, including substances that...

21 CFR 1.328 - What definitions apply to this subpart?

Code of Federal Regulations, 2012 CFR

2012-04-01

... Section 1.328 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL.... Farm means a facility in one general physical location devoted to the growing and harvesting of crops...; animal feed, including pet food; food and feed ingredients and additives, including substances that...

21 CFR 1.328 - What definitions apply to this subpart?

Code of Federal Regulations, 2014 CFR

2014-04-01

... Section 1.328 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL.... Farm means a facility in one general physical location devoted to the growing and harvesting of crops...; animal feed, including pet food; food and feed ingredients and additives, including substances that...

21 CFR 1.328 - What definitions apply to this subpart?

Code of Federal Regulations, 2013 CFR

2013-04-01

... Section 1.328 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL.... Farm means a facility in one general physical location devoted to the growing and harvesting of crops...; animal feed, including pet food; food and feed ingredients and additives, including substances that...

26 CFR 145.4052-1 - Special rules and definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... registration number ____. I understand that the fraudulent use of this certificate to secure exemption will... for the article whether that consideration is paid in money, services, or other forms. In addition... fair market value (including any tax imposed by section 4071) at retail of any tires (not including any...

75 FR 52629 - Medicare Program; Establishing Additional Medicare Durable Medical Equipment, Prosthetics...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... wheelchairs. Prosthetic devices are included in the definition of ``medical and other health services'' under section 1861(s)(8) of the Act. Prosthetic devices are defined in this section of the Act as ``devices... insertion of an intraocular lens.'' Other examples of prosthetic devices include cardiac pacemakers...

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

32 CFR 230.4 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical..., including cardiovascular surgery. It may be undyed or dyed with an approved color additive and may be...

21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical..., including cardiovascular surgery. It may be undyed or dyed with an approved color additive and may be...

21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.

Code of Federal Regulations, 2012 CFR

2012-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical..., including cardiovascular surgery. It may be undyed or dyed with an approved color additive and may be...

21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical..., including cardiovascular surgery. It may be undyed or dyed with an approved color additive and may be...

Service Modeling for Service Engineering

NASA Astrophysics Data System (ADS)

Shimomura, Yoshiki; Tomiyama, Tetsuo

Intensification of service and knowledge contents within product life cycles is considered crucial for dematerialization, in particular, to design optimal product-service systems from the viewpoint of environmentally conscious design and manufacturing in advanced post industrial societies. In addition to the environmental limitations, we are facing social limitations which include limitations of markets to accept increasing numbers of mass-produced artifacts and such environmental and social limitations are restraining economic growth. To attack and remove these problems, we need to reconsider the current mass production paradigm and to make products have more added values largely from knowledge and service contents to compensate volume reduction under the concept of dematerialization. Namely, dematerialization of products needs to enrich service contents. However, service was mainly discussed within marketing and has been mostly neglected within traditional engineering. Therefore, we need new engineering methods to look at services, rather than just functions, called "Service Engineering." To establish service engineering, this paper proposes a modeling technique of service.

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

NASA Astrophysics Data System (ADS)

Tsontos, V. M.; Vazquez, J.

2017-12-01

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

Twelve month use of mental health services in a nationally representative, active military sample.

PubMed

Fikretoglu, Deniz; Guay, Stéphane; Pedlar, David; Brunet, Alain

2008-02-01

Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations. The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use. A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses. Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services. Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.

JABAWS 2.2 distributed web services for Bioinformatics: protein disorder, conservation and RNA secondary structure.

PubMed

Troshin, Peter V; Procter, James B; Sherstnev, Alexander; Barton, Daniel L; Madeira, Fábio; Barton, Geoffrey J

2018-06-01

JABAWS 2.2 is a computational framework that simplifies the deployment of web services for Bioinformatics. In addition to the five multiple sequence alignment (MSA) algorithms in JABAWS 1.0, JABAWS 2.2 includes three additional MSA programs (Clustal Omega, MSAprobs, GLprobs), four protein disorder prediction methods (DisEMBL, IUPred, Ronn, GlobPlot), 18 measures of protein conservation as implemented in AACon, and RNA secondary structure prediction by the RNAalifold program. JABAWS 2.2 can be deployed on a variety of in-house or hosted systems. JABAWS 2.2 web services may be accessed from the Jalview multiple sequence analysis workbench (Version 2.8 and later), as well as directly via the JABAWS command line interface (CLI) client. JABAWS 2.2 can be deployed on a local virtual server as a Virtual Appliance (VA) or simply as a Web Application Archive (WAR) for private use. Improvements in JABAWS 2.2 also include simplified installation and a range of utility tools for usage statistics collection, and web services querying and monitoring. The JABAWS CLI client has been updated to support all the new services and allow integration of JABAWS 2.2 services into conventional scripts. A public JABAWS 2 server has been in production since December 2011 and served over 800 000 analyses for users worldwide. JABAWS 2.2 is made freely available under the Apache 2 license and can be obtained from: http://www.compbio.dundee.ac.uk/jabaws. g.j.barton@dundee.ac.uk.

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

USGS Publications Warehouse

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

2013-01-01

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

Training Cyber Warriors: What Can Be Learned from Defense Language Training?

DTIC Science & Technology

2015-01-01

other agencies. In addition, the National Cryp- tologic School , Foreign Service Institute, and CIA University, among others, each train students for...They provide a variety of services, including group instruction , distance learning , and one-on-one tutoring. Pipeline-Building Programs The Language...commonly monolingual English speakers,1 (2) the U.S. education system provides limited opportunities for students to learn other languages in

DDC 10 Year Requirements and Planning Study. Interagency Survey Report

DTIC Science & Technology

1975-12-12

RDT&E Management Information Services Traditional bibliographic information storage and retrieval techniques are insufficienL for satisfaction of...a private source. 3.3 Economics and Marketing ERDA’s tradition of absorbing costs for information 1rocessing shows no indication of changing...Libraries. Its products, in addition to traditional library services, include three prime data bases: 0 MEDLINE - journal citations and subject

Media Libraries in Action for Administrators, Teachers, Media Librarians, Library Technicians/Aides, and Volunteer Parents (Helping Programs Grow).

ERIC Educational Resources Information Center

Franklin, Esther, Ed.

Suggestions for improving school library and media services are offered by elementary school media staff in the Sacramento (California) area. This manual consists of one-page reference sheets for each school that responded to a request to share helpful ideas on media services. In addition to a helpful idea or ideas, each sheet includes the name of…

77 FR 1526 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-10

... other public sources, or on-line information services such as Bloomberg or Reuters. Each Benchmark and..., on the Web site of ICE Futures ( www.theice.com ). In addition, various data vendors and news... major market data vendors worldwide, including Bloomberg and Reuters. In addition, the Exchange further...

21 CFR 74.1340 - FD&C Red No. 40.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false FD&C Red No. 40. 74.1340 Section 74.1340 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR... additive mixtures for coloring drugs. (3) The listing of this color additive includes lakes prepared as...

FASTQ quality control dashboard

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

2016-07-25

FQCDB builds up existing open source software, FastQC, implementing a modern web interface for across parsed output of FastQC. In addition, FQCDB is extensible as a web service to include additional plots of type line, boxplot, or heatmap, across data formatted according to guidelines. The interface is also configurable via more readable JSON format, enabling customization by non-web programmers.

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

42 CFR 447.45 - Timely claims payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... implement an automated claims processing and information retrieval system. (2) The agency's request for a... additional information from the provider of the service or from a third party. It includes a claim with...

Consider long-term care as service alternative.

PubMed

Loria, L S

1987-04-01

The increasing demand for elderly care services, pressures on inpatient average length of stay and payment levels, and potential financial rewards from providing additional services, makes long-term care look attractive to hospitals. Long-term care, however, is not for every hospital. Before deciding to establish long-term care services, management should examine how the service fits within the hospital's strategic plan. The action plan below provides guidance in evaluating a decision to use hospital facilities for long-term care. Examine how long-term care services fit within the hospital's strategic plan. Study area demographics and competitors to assess the need and supply of long-term care services. Survey the medical staff, consumers and payers to determine attitudes, perceptions and interests regarding long-term care services. Develop a facility plan that identifies areas of excess capacity that can be most easily converted into long-term care with minimal effects on hospital operations. Prepare a financial feasibility analysis of the contribution margin and return on investment attributable to long-term care services. Include an impact analysis on hospital operations. Establish a management task force to develop a detailed implementation plan including assigned individual responsibilities and related timetable. Develop an effective marketing plan designed to generate increased patient market share.

Enhancing UCSF Chimera through web services.

PubMed

Huang, Conrad C; Meng, Elaine C; Morris, John H; Pettersen, Eric F; Ferrin, Thomas E

2014-07-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Developing Federal Clinical Care Recommendations for Women.

PubMed

Godfrey, Emily M; Tepper, Naomi K; Curtis, Kathryn M; Moskosky, Susan B; Gavin, Loretta E

2015-08-01

The provision of family planning services has important health benefits for the U.S. Approximately 25 million women in the U.S. receive contraceptive services annually and 44 million make at least one family planning-related clinical visit each year. These services are provided by private clinicians, as well as publicly funded clinics, including specialty family planning clinics, health departments, Planned Parenthoods, community health centers, and primary care clinics. Recommendations for providing quality family planning services have been published by CDC and the Office of Population Affairs of the DHHS. This paper describes the process used to develop the women's clinical services portion of the new recommendations and the rationale underpinning them. The recommendations define family planning services as contraceptive care, pregnancy testing and counseling, achieving pregnancy, basic infertility care, sexually transmitted disease services, and preconception health. Because many women who seek family planning services have no other source of care, the recommendations also include additional screening services related to women's health, such as cervical cancer screening. These clinical guidelines are aimed at providing the highest-quality care and are designed to establish a national standard for family planning in the U.S. Published by Elsevier Inc.

Gearing service quality into public and private hospitals in small islands: empirical evidence from Cyprus.

PubMed

Arasli, Huseyin; Ekiz, Erdogan Haktan; Katircioglu, Salih Turan

2008-01-01

The purpose of this research is to develop and compare some determinants of service quality in both the public and private hospitals of Northern Cyprus. There is considerable lack of literature with respect to service quality in public and private hospitals. Randomly, 454 respondents, who have recently benefited from hospital services in Famagusta, were selected to answer a modified version of the SERVQUAL Instrument. The instrument contained both service expectations and perceptions questions. This study identifies six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals. These are: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment. Research results revealed that the various expectations of inpatients have not been met in either the public or the private hospitals At the micro level, the lack of management commitment to service quality in both hospital settings leads doctors and nurses to expend less effort increasing or improving inpatient satisfaction. Hospital managers should also satisfy their employees, since job satisfaction leads to customer satisfaction and loyalty. Additionally, hospital administrations need to gather systematic feedback from their inpatients, establish visible and transparent complaint procedures so that inpatients' complaints can be addressed effectively and efficiently. The hospitals need to organize training sessions based on the critical importance of service quality and the crucial role of inpatient satisfaction in the health care industry. Future studies should include the remaining regions in Cyprus in order to increase research findings' generalizability. Additionally, including other dimensions such as hospital processes and discharge management and co-ordination may provide further insights into understanding inpatients' perceptions and intentions.

The Carle Clinic.

PubMed

Schraeder, C; Britt, T

1997-03-01

Confronting the challenge of effective, efficient health care for the elderly has led to many variations in service delivery modalities. The approach employed by the Community Nursing Organization (CNO) is based on nurse coordinated care. Nurses are integrally involved in the authorization, coordination, evaluation and payment of services. The nursing role encompasses case management, including coordination of non-CNO covered services as well as those provided through the capitated payment schedule. Thus, in addition to authorizing CNO services, the nurse also may coordinate services such as physician visits, home repair, transportation, respite services and home-delivered meals, even though they are not covered financially under the auspices of the CNO. Preliminary findings indicate that this model may be successful clinically and financially by determining and utilizing an appropriate mix, intensity and duration of services.

A comprehensive review of available epidemiologic and HIV service data for female sex workers, men who have sex with men, and people who inject drugs in select West and Central African countries.

PubMed

MacAllister, Jack; Sherwood, Jennifer; Galjour, Joshua; Robbins, Sarah; Zhao, Jinkou; Dam, Kim; Grosso, Ashley; Baral, Stefan D

2015-03-01

To identify gaps in epidemiologic and HIV service coverage data for key populations (KP), including men who have sex with men (MSM), female sex workers (FSW), people who inject drugs (PWID), and transgender persons, in 8 West and Central Africa countries: Cameroon, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ghana, Guinea-Bissau, Niger, and Nigeria. A comprehensive search of peer-reviewed literature was conducted using PubMed and MEDLINE. This search was supplemented by an additional search of relevant non-peer-reviewed, or gray, literature. Available data on HIV prevalence, KP size estimates, HIV prevention service targets, and HIV prevention service coverage, including the availability of population-specific minimum packages of services, were included in the review. No data for transgender persons were found. HIV prevalence data and size estimates were more frequently available for FSW, followed by MSM. Only 2 countries (Ghana and Nigeria) had both KP size estimates and HIV prevalence data for PWID. The degree to which HIV prevention service targets were adopted was highly variable across the selected countries, and the collection of relevant HIV prevention service coverage data for those targets that were identified was inconsistent. Population-specific minimum packages of services were identified in 3 countries (Cote d'Ivoire, Ghana, and Nigeria), although only Ghana and Nigeria included services for PWID. Epidemiologic and HIV prevention service data for FSW, MSM, PWID, and transgender persons remain sparse, and these KP are inconsistently accounted for in-service delivery and nationally endorsed minimum packages of HIV services in West and Central Africa. The strengthening of data collection and reporting to consistently include KP and the inclusion of that data in national planning is imperative for effectively addressing the HIV epidemic.

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

PubMed Central

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2017-01-01

Background: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design: Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants: In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results: In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion: Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people. PMID:28502218

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

PubMed

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2018-01-01

Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Semi-structured in-depth qualitative interviews analysed using thematic analysis. In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

5 CFR 537.109 - Employee reimbursements to the Government.

Code of Federal Regulations, 2013 CFR

2013-01-01

... existing service agreement to provide additional student loan repayment benefits for additional service (as... initial service period but fails to complete the additional service period, he or she is required to... additional service period. (d) If an employee fails to reimburse the paying agency for the amount owed under...

Cool Apps: Building Cryospheric Data Applications With Standards-Based Service Oriented Architecture

NASA Astrophysics Data System (ADS)

Collins, J. A.; Truslove, I.; Billingsley, B. W.; Oldenburg, J.; Brodzik, M.; Lewis, S.; Liu, M.

2012-12-01

The National Snow and Ice Data Center (NSIDC) holds a large collection of cryospheric data, and is involved in a number of informatics research and development projects aimed at improving the discoverability and accessibility of these data. To develop high-quality software in a timely manner, we have adopted a Service-Oriented Architecture (SOA) approach for our core technical infrastructure development. Data services at NSIDC are internally exposed to other tools and applications through standards-based service interfaces. These standards include OAI-PMH (Open Archives Initiative Protocol for Metadata Harvesting), various OGC (Open Geospatial Consortium) standards including WMS (Web Map Service) and WFS (Web Feature Service), ESIP (Federation of Earth Sciences Information Partners) OpenSearch, and NSIDC-specific RESTful services. By taking a standards-based approach, we are able to use off-the-shelf tools and libraries to consume, translate and broker these data services, and thus develop applications faster. Additionally, by exposing public interfaces to these services we provide valuable data services to technical collaborators; for example, NASA Reverb (http://reverb.echo.nasa.gov) uses NSIDC's WMS services. Our latest generation of web applications consume these data services directly. The most complete example of this is the Operation IceBridge Data Portal (http://nsidc.org/icebridge/portal) which depends on many of the aforementioned services, and clearly exhibits many of the advantages of building applications atop a service-oriented architecture. This presentation outlines the architectural approach and components and open standards and protocols adopted at NSIDC, demonstrates the interactions and uses of public and internal service interfaces currently powering applications including the IceBridge Data Portal, and outlines the benefits and challenges of this approach.

Integrating telemedicine and telehealth: putting it all together.

PubMed

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care organizations. Telemedicine programs should perform ongoing assessments of activities, ranging from service usage to quality of service assessments, to ongoing analyses of financial performance. The financial assessments should include evaluations of costs and benefits, coding issues, reimbursement, account receivables, bad debt and network utilization. Long-range strategic planning for a telemedicine and telehealth program should be carried out on an on-going basis and should include the program's governing board. This planning process should include goal setting and the periodic updating of the program's vision and mission statements. There can be additional special issues for multi-organization telemedicine and telehealth programs. For example, authority management can require the use of innovative approaches tailored to the realities of the organizational structures of the participating members. Inter-institutional relations may introduce additional issues when competing health care organizations are utilizing shared resources. Branding issues are preferably addressed during the initial planning of a multi-organizational telemedicine and telehealth program. Ideally, public policy regarding telemedicine and telehealth within a service region will complement the objectives of telemedicine and telehealth programs within that service area.

STS-117 Rotating Service Structure move

NASA Image and Video Library

2007-01-30

The rotating service structure on Launch Pad 39A has moved for the first time in more than a year due to maintenance and upgrades on the pad. Some of the work included sandblasting the structure to remove rust and repainting. In addition, the RSS was jacked up and a new upper-bearing race assembly installed where the RSS pivots against the fixed service structure and a half-inch steel plate added. Pad 39A is being made ready for its first launch in four years, the upcoming STS-117 on March 15.

STS-117 Rotating Service Structure move

NASA Image and Video Library

2007-01-30

The rotating service structure on Launch Pad 39A is being moved for the first time in more than a year due to maintenance and upgrades on the pad. Some of the work included sandblasting the structure to remove rust and repainting. In addition, the RSS was jacked up and a new upper-bearing race assembly installed where the RSS pivots against the fixed service structure and a half-inch steel plate added. Pad 39A is being made ready for its first launch in four years, the upcoming STS-117 on March 15.

Evaluation of DUII Sentencing Practices in Oregon.

DOT National Transportation Integrated Search

1997-10-01

Oregon law requires motorists driving under the influence of intoxicants (DUII) to be sentenced with some sanctions, and allows judges the use of additional sanctions. Sanctions including drug/alcohol treatment, jail time, community service, etc., ar...

ME/CFS in Children: Fact Sheet for Parents/Guardians

MedlinePlus

... Additional services could include an Individualized Education Plan (IEP) or a 504 Plan. A 504 plan lists ... disability and how the school can help. An IEP is a legal document that tells the school ...

20 CFR 669.500 - What performance measures and standards apply to the NFJP?

Code of Federal Regulations, 2010 CFR

2010-04-01

... must be included in the approved plan. (b) We may develop additional performance indicators with... service area economy and local demographics of eligible MSFW's. The levels of performance for these...

76 FR 38382 - Public Service Company of Colorado; Notice of Filing

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... entities into PSCo. Additionally, PSCo requested a waiver of the Commission's accounting regulations to allow it to include the fair value of the acquired Calpine facilities in Account 101, Electric Plant in...

47 CFR 5.85 - Frequencies and policy governing frequency assignment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (including the radio astronomy service). Stations authorized under subparts E and F are subject to additional... flux density assuming a free space characteristic impedance of 120π ohms) at the reference coordinates...

47 CFR 5.85 - Frequencies and policy governing frequency assignment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (including the radio astronomy service). Stations authorized under subparts E and F are subject to additional... flux density assuming a free space characteristic impedance of 120π ohms) at the reference coordinates...

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Adhikari, Kishor; Shankar, Pathiyil Ravi; K C, Vikash Kumar; Basnet, Suyog

2014-04-28

Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections.

Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States

PubMed Central

Fortuna, Lisa R.; Porche, Michelle V.; Alegria, Margarita

2009-01-01

Objectives We present the prevalence of political violence (PV) of immigrant Latinos in the US, and perceived need for and correlates of mental health services use among this population. Methods We use the National Latino and Asian American Study (NLAAS), a nationally representative epidemiological survey of US Latinos, including a probability sample of 1630 immigrant Latinos. We use a conceptual framework that assumes a strong role of social and cultural factors in understanding the risk for psychopathology and mental health service use. Results Eleven percent of all immigrant Latinos reported PV exposure and 76% described additional lifetime traumas. Among those with a history of PV, an increased likelihood of using mental health services was associated with female gender, English language proficiency, experiencing personal assaults, higher perceived discrimination, and having an anxiety or substance disorder. Specific subgroups of Latinos, including men and Mexican immigrants, were less likely to access mental health services after experiencing PV. Perceived need for mental health services use is the strongest correlate of any lifetime and last 12 months service use. Conclusions The strong consequences of PV suggest the need for systematic screening and referral strategies. Specific outreach interventions focused on perceptions of need could be helpful for subgroups of Latinos including men who are particularly underrepresented in mental health services but who exhibit significant trauma histories. PMID:18850369

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Discrimination and Mental Health–Related Service Use in a National Study of Asian Americans

PubMed Central

Chen, Juan; Gee, Gilbert C.; Fabian, Cathryn G.; Takeuchi, David T.

2010-01-01

Objectives. We examined the association between perceived discrimination and use of mental health services among a national sample of Asian Americans. Methods. Our data came from the National Latino and Asian American Study, the first national survey of Asian Americans. Our sample included 600 Chinese, 508 Filipinos, 520 Vietnamese, and 467 other Asians (n=2095). We used logistic regression to examine the association between discrimination and formal and informal service use and the interactive effect of discrimination and English language proficiency. Results. Perceived discrimination was associated with more use of informal services, but not with less use of formal services. Additionally, higher levels of perceived discrimination combined with lower English proficiency were associated with more use of informal services. Conclusions. The effect of perceived discrimination and language proficiency on service use indicates a need for more bilingual services and more collaborations between formal service systems and community resources. PMID:20299649

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

PubMed

Scharlach, Andrew E

2015-01-01

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

Latest Trends in Home Networking Technologies

NASA Astrophysics Data System (ADS)

Tsutsui, Akihiro

Broadband access service, including FTTH, is now in widespread use in Japan. More than half of the households that have broadband Internet access construct local area networks (home networks) in their homes. In addition, information appliances such as personal computers, networked audio, and visual devices and game machines are connected to home networks, and many novel service applications are provided via the Internet. However, it is still difficult to install and incorporate these devices and services because networked devices have been developed in different communities. I briefly explain the current status of information appliances and home networking technologies and services and discuss some of the problems in this and their solutions.

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

DTIC Science & Technology

1993-06-01

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

Military and Security Developments Involving the People’s Republic of China 2013

DTIC Science & Technology

2013-01-01

discussions have stalled over pricing differences. China’s Top Crude Suppliers 2011 Country Volume (1,000 barrels per day) Percentage of...the transfer or disclosure of U.S.-origin defense articles, defense services, technical data, and/or technology to China. Additionally, Public Law... transfer or export of defense articles (including technical data) and defense services. Beijing primarily conducts arms sales to enhance foreign

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

PubMed

1996-01-01

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

Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-02-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

What are true community benefits?

PubMed

Trocchio, J

1996-01-01

Not-for-profit healthcare organizations have increasingly recognized the need to document their community benefit services, but not all healthcare services should be included in a community benefits report. Some services are reasonably expected of any high-quality healthcare organization, regardless of its tax status. Others are provided as part of a commitment to the community, but they cannot or should not be quantified. A third group of services, however, can be counted and reported in an inventory of benefits. To qualify as a true community benefit, an activity must respond to a particular health problem in the community, especially one involving special populations. In addition, it must be financed through philanthropic contributions, volunteer efforts, or an endowment; generate a low or negative margin; or be a service that would be discontinued if the decision were made on a purely financial basis. Once an organization has determined that an activity is a community benefit and not a basic service or promotional program, organizational leaders must decide whether to include the service in a quantitative inventory or in a more general narrative without assignment of specific financial benefit. The community benefit services might be further broken down according to the intended recipient, whether it is the poor or the broader community.

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

PubMed

Schauffler, H H

1993-01-01

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

Social and economic value of Portuguese community pharmacies in health care.

PubMed

Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício

2017-08-29

Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

Improve services project -- Republic of the Marshall Islands.

PubMed

Langidrik, J

1995-01-01

The Republic of the Marshall Islands has 60 dispensary sites, each staffed by 1 health assistant, to cover 80-800 people/site on 34 atolls. Until the spring of 1994, only curative services were available on a regular basis, and preventive services were provided by traveling health teams from the urban centers. In 1994, the health assistants in selected outer islands were trained to administer immunizations from vaccines which are sent regularly by air. Additional project sites are being selected. In 1993, 2 dispensaries initiated a project to 1) increase the number of women with access to prenatal care during the first trimester, 2) increase immunization levels, 3) improve access to preventive services, and 4) improve reporting and record-keeping systems. This project includes an important training component for the health assistant, the wife of the health assistant, the traditional birth attendant, the youth peer educator, community leaders, and a member of the local council. By 1994, this project was expanded to 13 dispensaries on 2 atolls. In 1995, 18 more dispensaries on 4 more atolls will be able to offer these additional services.

Occupational health services for shift and night workers.

PubMed

Koller, M

1996-02-01

It is important for an occupational health service to plan health supervision and measures for shift and night workers considering the biorhythmic and psychosocial desynchronisation, as well as the frequent prevalence of combined effects of adverse environmental and working conditions. The measures taken should be preventive to reduce the expected health risks rather than being rehabilitative. Both a medical surveillance and a counselling service are recommended before and during engagement in shift and night work. Sleep, digestive, metabolic and cardiovascular troubles should be noted and followed up. Medical counselling is especially necessary in the first months of shift and night work exposure and then after long-term exposure. The postulate for timed surveillance and intervention is supported by data of our epidemiologic investigations. The importance of the single health measures is underlined by direct reference to the relevant literature. Recommendations that should be applied in all countries and enterprises are in accordance with the ILO Night Work Convention 1990a and include: (1) appropriate occupational health services provided for night and shift workers, including counselling; (2) first aid facilities during all shift hours; (3) the option of transfer to day work when certified unfit for night work for reasons of health; and (4) measures for women on night shifts, in particular special maternity protection (transfer to day work, social security benefits or an extension of maternity leave). Examples of occupational health services already installed in some states for shift and night workers, and information on future developments are given. Up to now the medical service has been implemented mostly on the basis of collective agreements rather than on the basis of legal provisions. The Austrian Night Shift/Heavy Work Law Regulations of 1981, revised 1993, are cited: workers exposed to night shifts under defined single or combined additional heavy workloads are entitled to a special health assessment, additional rest pauses, additional free time and early retirement depending on years of exposure.

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.

9. Photocopy of 1940 architectural drawing titled: 'Alternations & Additions ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopy of 1940 architectural drawing titled: 'Alternations & Additions to (4290) Hosital, Sections' includes section and elevation views. Dated 4-12-40. HABS film is a high-contrast 8x10' negative made from original drawing in the collection of Housing and Engineering Services, Fort Lewis, WA. - Fort Lewis, Post Hospital, Near Ninth Division Drive & Idaho Avenue, DuPont, Pierce County, WA

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

PubMed

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

2016-01-01

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

47 CFR 90.201 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirements for use of frequencies and equipment in the radio services governed by this part. Such requirements include standards for acceptability of equipment, frequency tolerance, modulation, emissions, power, and bandwidths. Special additional technical standards applicable to certain frequency bands and...

78 FR 8101 - Codex Alimentarius Commission: Meeting of the Codex Committee on Food Additives

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... the building and its parking area. If you require parking, please include the vehicle make and tag... offers an electronic mail subscription service which provides automatic and customized access to selected...

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

USGS Publications Warehouse

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

2008-01-01

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

Behavioral medicine as a part of a comprehensive small animal medical program.

PubMed

Burghardt, W F

1991-03-01

The rationale of incorporating behavioral medicine into veterinary practice is that it can expand the range of medical services offered, help obtain happier, more acceptable pets, and lead to longer pet ownership. In doing so, veterinarians should be able to increase their business both through an actual increase in pet ownership and retention and through increased services for individual pets. The range of services offered can differ from practice to practice but may include preventive, interventive, and ancillary services, as with other areas in contemporary veterinary medical practice. Each area of behavioral practice can be an economically feasible addition to veterinary practice from the perspective of medical services rendered, as a method of practice promotion, or as an area of public service. The choice depends on the level of competence of the practitioner, the practice philosophy, and the need for the services in a given service area.

Current challenges and future achievements of blood transfusion service in Afghanistan.

PubMed

Cheraghali, A M; Sanei Moghaddam, E; Masoud, A; Faisal, H

2012-10-01

Afghanistan is a country with population of over 28 million. The long term conflicts have devastated country's qualified resources including human resources. ANBSTS was established by MoPH as the country national blood service. Currently in addition to central and regional blood centers of ANBSTS many other hospitals have their own transfusion services. Blood donation in Afghanistan mainly depends on replacement donors. Donor selection and donor interview are not very efficient. Most of the blood in Afghanistan is administered as fresh whole blood. Although blood transfusion services in Afghanistan require more efforts to be fully efficient, based on recent improvements in working procedures of ANBSTS a promising future for blood transfusion services in Afghanistan is predicted. Copyright © 2012 Elsevier Ltd. All rights reserved.

45 CFR 400.106 - Additional services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.106 Additional services. If a State or local jurisdiction provides additional medical services beyond the scope of the State's Medicaid program to destitute residents of the...

Other Defense Organizations and Defense Finance and Accounting Service Controls Over High-Risk Transactions Were Not Effective

DTIC Science & Technology

2016-03-28

Management (DHA- CRM ), agreed with Recommendations 1 and 2. The Chief stated that the service-level agreements should be updated to provide...descriptive language on the defined roles and responsibilities. In some instances, DHA- CRM personnel find it difficult to identify responsible parties at...that it maintains a universe of all accounting transactions processed daily to include disbursements. Additionally, DHA- CRM personnel perform a

Data Migration Strategy and Information Assurance for the Business Enterprise Information Services

DTIC Science & Technology

2009-07-30

direct questions to me at (703) 601-5868 (DSN 329-5868). t ~a/J1~ Patricia A. Marsh, CPA Assistant Inspector General Defense Business Operations ...incrcment. Additionally, a Managemen t Control Matrix has been ~ubmillcd tor the BEIS FllrTlily o( System!! on an annual basis 6ince 2006. POg< l of4...including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215

Rationale for a Threshold Limit Value (TLV)R for JP-4/Jet B Wide Cut Aviation Turbine Fuel.

DTIC Science & Technology

1983-04-01

Additional copies may be purchased from: National Technical Information Service 5285 Port Royal Road Springfield, Virginia 22161 Government agencies...Cameron Station Alexandria, Virginia 22314 This report has been reviewed by the Public Affairs Office and is releasable to the National Technical...Information Service (NTIS). At NTIS, it will be available to the general public, including foreign nations . This technical report has been reviewed and is

Legal considerations for document delivery services.

PubMed

Bunting, A

1994-04-01

Health sciences libraries that provide fee-based information services must consider and develop policies and procedures for complying with legal requirements. This paper reviews the provisions of copyright law that pertain to document delivery, including two court decisions concerning copyright. Also discussed are recent actions by publishers to reinforce their view of libraries' responsibilities for royalty fees for articles copied and their use of licenses to impose additional restrictions on the use of and reproduction of materials.

FINANCIAL PRIVACY: Status of State Actions on Gramm-Leach-Bliley Act’s Privacy Provisions

DTIC Science & Technology

2002-04-01

initial notice) to the consumer . In addition, for consumers who become customers of a financial institution, the institution must furnish the privacy...a financial product or service that is to be used primarily for personal, family, or household purposes. A customer is a consumer who has established...service customer accounts. The other set of exceptions includes disclosures authorized by the consumer , disclosures to the consumer’s authorized

Directory of Special Programs for Minority Group Members: Career Information Services, Employment Skill Banks, Financial Aid Sources. Second Edition, With an Additional Section on Employment Assistance Services for Women.

ERIC Educational Resources Information Center

Johnson, Willis L., Ed.

Although planned as a comprehensive listing of special programs for minority group members several decisions were made which significantly expanded its scope, and hopefully, makes it even more useful to candidates, counselors, and employers. A number of programs for "disadvantaged" persons were included. Some general programs, open to all persons,…

Navigation Architecture for a Space Mobile Network

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

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

PubMed

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

2011-05-01

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

20 CFR 641.210 - What services, in addition to the applicable core services, must SCSEP grantees and sub...

Code of Federal Regulations, 2011 CFR

2011-04-01

... core services, must SCSEP grantees and sub-recipients provide through the One-Stop delivery system? 641... Investment Act § 641.210 What services, in addition to the applicable core services, must SCSEP grantees and sub-recipients provide through the One-Stop delivery system? In addition to providing core services...

20 CFR 641.210 - What services, in addition to the applicable core services, must SCSEP grantees provide through...

Code of Federal Regulations, 2010 CFR

2010-04-01

... core services, must SCSEP grantees provide through the One-Stop Delivery System? 641.210 Section 641... § 641.210 What services, in addition to the applicable core services, must SCSEP grantees provide through the One-Stop Delivery System? In addition to providing core services, SCSEP grantees must make...

Prototyping an online wetland ecosystem services model using open model sharing standards

USGS Publications Warehouse

Feng, M.; Liu, S.; Euliss, N.H.; Young, Caitlin; Mushet, D.M.

2011-01-01

Great interest currently exists for developing ecosystem models to forecast how ecosystem services may change under alternative land use and climate futures. Ecosystem services are diverse and include supporting services or functions (e.g., primary production, nutrient cycling), provisioning services (e.g., wildlife, groundwater), regulating services (e.g., water purification, floodwater retention), and even cultural services (e.g., ecotourism, cultural heritage). Hence, the knowledge base necessary to quantify ecosystem services is broad and derived from many diverse scientific disciplines. Building the required interdisciplinary models is especially challenging as modelers from different locations and times may develop the disciplinary models needed for ecosystem simulations, and these models must be identified and made accessible to the interdisciplinary simulation. Additional difficulties include inconsistent data structures, formats, and metadata required by geospatial models as well as limitations on computing, storage, and connectivity. Traditional standalone and closed network systems cannot fully support sharing and integrating interdisciplinary geospatial models from variant sources. To address this need, we developed an approach to openly share and access geospatial computational models using distributed Geographic Information System (GIS) techniques and open geospatial standards. We included a means to share computational models compliant with Open Geospatial Consortium (OGC) Web Processing Services (WPS) standard to ensure modelers have an efficient and simplified means to publish new models. To demonstrate our approach, we developed five disciplinary models that can be integrated and shared to simulate a few of the ecosystem services (e.g., water storage, waterfowl breeding) that are provided by wetlands in the Prairie Pothole Region (PPR) of North America.

77 FR 5483 - Codex Alimentarius Commission: Meeting of the Codex Committee on Food Additives

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... building and its parking area. If you require parking, please include the vehicle make and tag number when..., FSIS offers an electronic mail subscription service which provides automatic and customized access to...

The ESA Space Weather Applications Pilot Project

NASA Astrophysics Data System (ADS)

Glover, A.; Hilgers, A.; Daly, E.

Following the completion in 2001 of two parallel studies to consider the feasibility of a European Space Weather Programme ESA embarked upon a space weather pilot study with the goal of prototyping European space weather services and assessing the overall market for such within Europe This pilot project centred on a number of targeted service development activities supported by a common infrastructure and making use of only existing space weather assets Each service activity included clear participation from at least one identified service user who was requested to provide initial requirements and regular feedback during the operational phase of the service These service activities are now reaching the end of their 2-year development and testing phase and are now accessible each with an element of the service in the public domain see http www esa-spaceweathet net swenet An additional crucial element of the study was the inclusion of a comprehensive and independent analysis of the benefits both economic and strategic of embarking on a programme which would include the deployment of an infrastructure with space-based elements The results of this study will be reported together with their implication for future coordinated European activities in this field

10. Photocopy of 1940 architectural drawing titled: 'Alterations & Additions ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopy of 1940 architectural drawing titled: 'Alterations & Additions to (4290) Hosital, Schedules' includes 'Typical Door Elevations' and 'Metal Door Frames.' Dated 4-12-40. HABS film is a high-contrast 8x10' negative made from original drawing in the collection of Housing and Engineering Services, Fort Lewis, WA. - Fort Lewis, Post Hospital, Near Ninth Division Drive & Idaho Avenue, DuPont, Pierce County, WA

Government Contracting Under the Javits-Wagner-O’Day Act

DTIC Science & Technology

1991-12-01

to manufacture its commodities, or provide its services. Likewise, a qualified work center for the severely disabled must employ personnel with... manufacture (CAD/CAM) systems. Additionally, it studies a unique and innovative business arrangement that serves as a model of contract efficiency and...Additional research areas include the types of commodities currently manufactured in the workshops, tha barriers to enlarging the commodity 3 base, the

Incremental analysis of the reengineering of an outpatient billing process: an empirical study in a public hospital

PubMed Central

2013-01-01

Background A smartcard is an integrated circuit card that provides identification, authentication, data storage, and application processing. Among other functions, smartcards can serve as credit and ATM cards and can be used to pay various invoices using a ‘reader’. This study looks at the unit cost and activity time of both a traditional cash billing service and a newly introduced smartcard billing service in an outpatient department in a hospital in Taipei, Taiwan. Methods The activity time required in using the cash billing service was determined via a time and motion study. A cost analysis was used to compare the unit costs of the two services. A sensitivity analysis was also performed to determine the effect of smartcard use and number of cashier windows on incremental cost and waiting time. Results Overall, the smartcard system had a higher unit cost because of the additional service fees and business tax, but it reduced patient waiting time by at least 8 minutes. Thus, it is a convenient service for patients. In addition, if half of all outpatients used smartcards to pay their invoices, along with four cashier windows for cash payments, then the waiting time of cash service users could be reduced by approximately 3 minutes and the incremental cost would be close to breaking even (even though it has a higher overall unit cost that the traditional service). Conclusions Traditional cash billing services are time consuming and require patients to carry large sums of money. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience. The idle time of nurses could also be reduced as they help to process smartcard payments. A reduction in idle time reduces hospital costs. However, the cost of the smartcard service is higher than the cash service and, as such, hospital administrators must weigh the costs and benefits of introducing a smartcard service. In addition to the obvious benefits of the smartcard service, there is also scope to extend its use in a hospital setting to include the notification of patient arrival and use in other departments. PMID:23763904

Incremental analysis of the reengineering of an outpatient billing process: an empirical study in a public hospital.

PubMed

Chu, Kuan-Yu; Huang, Chunmin

2013-06-13

A smartcard is an integrated circuit card that provides identification, authentication, data storage, and application processing. Among other functions, smartcards can serve as credit and ATM cards and can be used to pay various invoices using a 'reader'. This study looks at the unit cost and activity time of both a traditional cash billing service and a newly introduced smartcard billing service in an outpatient department in a hospital in Taipei, Taiwan. The activity time required in using the cash billing service was determined via a time and motion study. A cost analysis was used to compare the unit costs of the two services. A sensitivity analysis was also performed to determine the effect of smartcard use and number of cashier windows on incremental cost and waiting time. Overall, the smartcard system had a higher unit cost because of the additional service fees and business tax, but it reduced patient waiting time by at least 8 minutes. Thus, it is a convenient service for patients. In addition, if half of all outpatients used smartcards to pay their invoices, along with four cashier windows for cash payments, then the waiting time of cash service users could be reduced by approximately 3 minutes and the incremental cost would be close to breaking even (even though it has a higher overall unit cost that the traditional service). Traditional cash billing services are time consuming and require patients to carry large sums of money. Smartcard services enable patients to pay their bill immediately in the outpatient clinic and offer greater security and convenience. The idle time of nurses could also be reduced as they help to process smartcard payments. A reduction in idle time reduces hospital costs. However, the cost of the smartcard service is higher than the cash service and, as such, hospital administrators must weigh the costs and benefits of introducing a smartcard service. In addition to the obvious benefits of the smartcard service, there is also scope to extend its use in a hospital setting to include the notification of patient arrival and use in other departments.

Scalable web services for the PSIPRED Protein Analysis Workbench.

PubMed

Buchan, Daniel W A; Minneci, Federico; Nugent, Tim C O; Bryson, Kevin; Jones, David T

2013-07-01

Here, we present the new UCL Bioinformatics Group's PSIPRED Protein Analysis Workbench. The Workbench unites all of our previously available analysis methods into a single web-based framework. The new web portal provides a greatly streamlined user interface with a number of new features to allow users to better explore their results. We offer a number of additional services to enable computationally scalable execution of our prediction methods; these include SOAP and XML-RPC web server access and new HADOOP packages. All software and services are available via the UCL Bioinformatics Group website at http://bioinf.cs.ucl.ac.uk/.

[Mobile autonomous robots-Possibilities and limits].

PubMed

Maehle, E; Brockmann, W; Walthelm, A

2002-02-01

Besides industrial robots, which today are firmly established in production processes, service robots are becoming more and more important. They shall provide services for humans in different areas of their professional and everyday environment including medicine. Most of these service robots are mobile which requires an intelligent autonomous behaviour. After characterising the different kinds of robots the relevant paradigms of intelligent autonomous behaviour for mobile robots are critically discussed in this paper and illustrated by three concrete examples of robots realized in Lübeck. In addition a short survey of actual kinds of surgical robots as well as an outlook to future developments is given.

Space Station flight telerobotic servicer functional requirements development

NASA Technical Reports Server (NTRS)

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

1987-01-01

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

Demonstration of an SOA-assisted open metro-access infrastructure for heterogeneous services.

PubMed

Schmuck, H; Bonk, R; Poehlmann, W; Haslach, C; Kuebart, W; Karnick, D; Meyer, J; Fritzsche, D; Weis, E; Becker, J; Freude, W; Pfeiffer, T

2014-01-13

An open converged metro-access network approach allows for sharing optical layer resources like fibers and optical spectrum among different services and operators. We demonstrated experimentally the feasibility of such a concept by the simultaneous operation of multiple services showing different modulation formats and multiplexing techniques. Flexible access nodes are implemented including semiconductor optical amplifiers to create a transparent and reconfigurable optical ring network. The impact of cascaded optical amplifiers on the signal quality is studied along the ring. In addition, the influence of high power rival signals in the same waveband and in the same fiber is analyzed.

Social impact analysis: monetary valuation

USGS Publications Warehouse

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

2014-01-01

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

STS-117 Rotating Service Structure move

NASA Image and Video Library

2007-01-30

The rotating service structure on Launch Pad 39A has been fully opened for the first time in more than a year due to maintenance and upgrades on the pad. Some of the work included sandblasting the structure to remove rust and repainting. In addition, the RSS was jacked up and a new upper-bearing race assembly installed where the RSS pivots against the fixed service structure and a half-inch steel plate added. Pad 39A is being made ready for its first launch in four years, the upcoming STS-117 on March 15. Photo credit: NASA/George Shelton

STS-117 Rotating Service Structure move

NASA Image and Video Library

2007-01-30

Workers on Launch Pad 39A get ready to begin the movement of the rotating service structure above them. The RSS has not been rotated for more than a year during the maintenance and upgrades on the pad. Some of the work included sandblasting the structure to remove rust and repainting. In addition, the RSS was jacked up and a new upper-bearing race assembly installed where the RSS pivots against the fixed service structure and a half-inch steel plate added. Pad 39A is being made ready for its first launch in four years, the upcoming STS-117 on March 15.

Health system preparedness for integration of mental health services in rural Liberia.

PubMed

Gwaikolo, Wilfred S; Kohrt, Brandon A; Cooper, Janice L

2017-07-27

There are increasing efforts and attention focused on the delivery of mental health services in primary care in low resource settings (e.g., mental health Gap Action Programme, mhGAP). However, less attention is devoted to systematic approaches that identify and address barriers to the development and uptake of mental health services within primary care in low-resource settings. Our objective was to prepare for optimal uptake by identifying barriers in rural Liberia. The country's need for mental health services is compounded by a 14-year history of political violence and the largest Ebola virus disease outbreak in history. Both events have immediate and lasting mental health effects. A mixed-methods approach was employed, consisting of qualitative interviews with 22 key informants and six focus group discussions. Additional qualitative data as well as quantitative data were collected through semi-structured assessments of 19 rural primary care health facilities. Data were collected from March 2013 to March 2014. Potential barriers to development and uptake of mental health services included lack of mental health knowledge among primary health care staff; high workload for primary health care workers precluding addition of mental health responsibilities; lack of mental health drugs; poor physical infrastructure of health facilities including lack of space for confidential consultation; poor communication support including lack of electricity and mobile phone networks that prevent referrals and phone consultation with supervisors; absence of transportation for patients to facilitate referrals; negative attitudes and stigma towards people with severe mental disorders and their family members; and stigma against mental health workers. To develop and facilitate effective primary care mental health services in a post-conflict, low resource setting will require (1) addressing the knowledge and clinical skills gap in the primary care workforce; (2) improving physical infrastructure of health facilities at care delivery points; and (3) implementing concurrent interventions designed to improve attitudes towards people with mental illness, their family members and mental health care providers.

How a North Carolina program boosted preventive oral health services for low-income children.

PubMed

Rozier, R Gary; Stearns, Sally C; Pahel, Bhavna T; Quinonez, Rocio B; Park, Jeongyoung

2010-12-01

Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than age three. Analysis of physician and dentist Medicaid claims from the period 2000-2006 shows that the program greatly increased preventive oral health services. By 2006 approximately 30 percent of well-child visits for children ages six months up to three years included these services. However, additional strategies are needed to ensure preventive oral health care for more low-income children.

[Research progress of ecosystem service flow.

PubMed

Liu, Hui Min; Fan, Yu Long; Ding, Sheng Yan

2016-07-01

With the development of social economy, human disturbance has resulted in a variety of ecosystem service degradation or disappearance. Ecosystem services flow plays an important role in delivery, transformation and maintenance of ecosystem services, and becomes one of the new research directions. In this paper, based on the classification of ecosystem services flow, we analyzed ecosystem service delivery carrier, and investigated the mechanism of ecosystem service flow, including the information, property, scale features, quantification and cartography. Moreover, a tentative analysis on cost-effective of ecosystem services flow (such as transportation costs, conversion costs, usage costs and cost of relativity) was made to analyze the consumption cost in ecosystem services flow process. It aimed to analyze dissipation cost in ecosystem services flow process. To a certain extent, the study of ecosystem service flow solved the problem of "double counting" in ecosystem services valuation, which could make a contribution for the sake of recognizing hot supply and consumption spots of ecosystem services. In addition, it would be conducive to maximizing the ecosystem service benefits in the transmission process and putting forward scientific and reasonable ecological compensation.

Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.

PubMed

Kline, Ronald M; Muldoon, L Daniel; Schumacher, Heidi K; Strawbridge, Larisa M; York, Andrew W; Mortimer, Laura K; Falb, Alison F; Cox, Katherine J; Bazell, Carol; Lukens, Ellen W; Kapp, Mary C; Rajkumar, Rahul; Bassano, Amy; Conway, Patrick H

2017-07-01

The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations. Policy and technical decisions include the definition of the episode, including its initiation, duration, and included services; the identification of beneficiaries included in the model; and beneficiary attribution to practitioners with overall responsibility for managing their care. In addition, the calculation and risk adjustment of benchmark episode prices for the bundle of services must reflect geographic cost variations and diverse patient populations, including varying disease subtypes, medical comorbidities, changes in standards of care over time, the adoption of expensive new drugs (especially in oncology), as well as diverse practice patterns. Other steps include timely monitoring and intervention as needed to avoid shifting the attribution of beneficiaries on the basis of their expected episode expenditures as well as to ensure the provision of necessary medical services and the development of a meaningful link to quality measurement and improvement through the episode-based payment methodology. The complex and diverse nature of oncology business relationships and the specific rules and requirements of Medicare payment systems for different types of providers intensify these issues. The Centers for Medicare & Medicaid Services believes that by sharing its approach to addressing these decisions and challenges, it may facilitate greater understanding of the model within the oncology community and provide insight to others considering the development of episode-based payment models in the commercial or government sectors.

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

7 CFR 210.18 - Administrative reviews.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NATIONAL SCHOOL LUNCH PROGRAM Requirements for State Agency Participation... payments and fiscal action, including recoveries made. Additionally, the State agency must have on file: (1...

47 CFR 1.1703 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Cable Operations and Licensing... requests to assign rights granted by the authorization or to transfer control of entities holding... specified period, a station in the Cable Television Relay Service. In addition, this term includes authority...

ESA SSA Space Weather Services Supporting Space Surveillance and Tracking

NASA Astrophysics Data System (ADS)

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

2012-07-01

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

Sustaining and improving an international service-learning partnership: Evaluation of an evidence-based service delivery model.

PubMed

Hayward, Lorna M; Li, Li

2017-06-01

International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic-community partnership. Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics. Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills. As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits.

Smart Location Database - Service

EPA Pesticide Factsheets

The Smart Location Database (SLD) summarizes over 80 demographic, built environment, transit service, and destination accessibility attributes for every census block group in the United States. Future updates to the SLD will include additional attributes which summarize the relative location efficiency of a block group when compared to other block groups within the same metropolitan region. EPA also plans to periodically update attributes and add new attributes to reflect latest available data. A log of SLD updates is included in the SLD User Guide. See the user guide for a full description of data sources, data currency, and known limitations: https://edg.epa.gov/data/Public/OP/SLD/SLD_userguide.pdf

Legal considerations for document delivery services.

PubMed Central

Bunting, A

1994-01-01

Health sciences libraries that provide fee-based information services must consider and develop policies and procedures for complying with legal requirements. This paper reviews the provisions of copyright law that pertain to document delivery, including two court decisions concerning copyright. Also discussed are recent actions by publishers to reinforce their view of libraries' responsibilities for royalty fees for articles copied and their use of licenses to impose additional restrictions on the use of and reproduction of materials. PMID:8004023

A new ambulatory classification and funding model for radiation oncology: non-admitted patients in Victorian hospitals.

PubMed

Antioch, K M; Walsh, M K; Anderson, D; Wilson, R; Chambers, C; Willmer, P

1998-01-01

The Victorian Department of Human Services has developed a classification and funding model for non-admitted radiation oncology patients. Agencies were previously funded on an historical cost input basis. For 1996-97, payments were made according to the new Non-admitted Radiation Oncology Classification System and include four key components. Fixed grants are based on Weighted Radiation Therapy Services targets for megavoltage courses, planning procedures (dosimetry and simulation) and consultations. The additional throughput pool covers additional Weighted Radiation Therapy Services once targets are reached, with access conditional on the utilisation of a minimum number of megavoltage fields by each hospital. Block grants cover specialised treatments, such as brachytherapy, allied health payments and other support services. Compensation grants were available to bring payments up to the level of the previous year. There is potential to provide incentives to promote best practice in Australia through linking appropriate practice to funding models. Key Australian and international developments should be monitored, including economic evaluation studies, classification and funding models, and the deliberations of the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Trans-Tasman Radiation Oncology Group and the Council of Oncology Societies of Australia. National impact on clinical practice guidelines in Australia can be achieved through the Quality of Care and Health Outcomes Committee of the National Health and Medical Research Council.

Access to primary health care services for Indigenous peoples: A framework synthesis.

PubMed

Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

2016-09-30

Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

Effects and mechanisms of an allied health research position in a Queensland regional and rural health service: a descriptive case study.

PubMed

Wenke, Rachel J; Tynan, Anna; Scott, Annette; Mickan, Sharon

2017-10-30

The aim of the present case study is to illustrate the outcomes of a dedicated allied health (AH) research position within a large Queensland regional and rural health service. The secondary aim of the case study is to describe the enabling and hindering mechanisms to the success of the role. Semistructured interviews were conducted with the Executive Director of Allied Health and the current AH research fellow incumbent within the health service. A focus group was also undertaken with six stakeholders (e.g. clinicians, team leaders) who had engaged with the research position. Outcomes of the AH research fellow included clinical and service improvements, enhanced research culture and staff up-skilling, development of research infrastructure and the formation of strategic research collaborations. Despite being a sole position in a geographically expansive health service with constrained resources, key enabling mechanisms to the success of the role were identified, including strong advocacy and regular communication with the Executive. In conclusion, the case study highlights the potential value of an AH research position in building research capacity within a large non-metropolitan health service. Factors to facilitate ongoing success could include additional research and administrative funding, as well as increased use of technology and team-based research. What is known about the topic? Dedicated research positions embedded within health care settings are a well cited strategy to increase research capacity building of allied health professionals (AHPs). However the majority of these positions are within metropolitan health settings and unique challenges exist for these roles in regional and rural areas. Few studies have described the impact of dedicated AH research positions within regional health centres or the factors which facilitate or hinder their role. What does this paper add? Dedicated research positions within a non-metropolitan Australian health service may have a positive impact on AH clinical services, research culture, staff upskilling, research infrastructure and research collaborations. Key enabling mechanisms to support the role may include advocacy from higher level management, strong networks and communication channels. Additional research and administrative funding, the use of technology and team based research may enhance sustainability of such roles. What are the implications for practitioners? AH research positions have potential value in building research capacity within a large non-metropolitan health service. Health managers and researchers should be aware of the unique challenges to these roles and consider mechanisms that may best enhance and sustain outcomes of the positions including: the development of infrastructure (i.e. technology, website of resources), networks, and communication strategies (i.e. regular meetings with leadership and promotion internally).

78 FR 2398 - Motorola Mobility LLC and Google Inc.; Analysis of Proposed Consent Order to Aid Public Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... responsible for making sure that your comment does not include any sensitive health information, like medical records or other individually identifiable health information. In addition, do not include any ``[t]rade... overnight service. Visit the Commission Web site at http://www.ftc.gov to read this Notice and the news...

Transitioning home: comprehensive case management for America's heroes.

PubMed

Perla, Lisa Y; Jackson, Patricia D; Hopkins, Sherry L; Daggett, Margaret C; Van Horn, Linda J

2013-01-01

The conflicts in Afghanistan and Iraq, also known as Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, have created unique challenges for rehabilitation teams, including nurse and social work case managers. Active duty service members, National Guard and Reservists have deployed in large numbers and as many as 20% have been exposed to blast injury, which can result in polytrauma and traumatic brain injury, the "signature injury" of the war, as well as psychological trauma, and painful musculoskeletal injuries. In addition, there are also documented emotional injuries associated with the constant stress of war and the frequency of exposure to the graphic scenes of war. The Departments of Defense and Veterans Affairs work closely to provide comprehensive care coordination and case management for service members and veterans who have honorably served our country. This article describes the case management collaborative between Veterans Affairs and the Department of Defense that ensures service members and veterans receive their entitled healthcare services. The complex care needs of these returning service members require astute case management in addition to clinical care. This collaboration ensures the best life-long outcomes and will be discussed in detail in this article. © 2013 Association of Rehabilitation Nurses.

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

PubMed

Akl, Elie A; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field.

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

PubMed Central

Akl, Elie A.; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

2015-01-01

Background Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. Methods We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Results Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. Conclusion This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field. PMID:26332670

Childhood bereavement services: a survey of UK provision.

PubMed

Rolls, L; Payne, S

2003-07-01

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

Preventing skin cancer: findings of the Task Force on Community Preventive Services On reducing Exposure to Ultraviolet Light.

PubMed

Saraiya, Mona; Glanz, Karen; Briss, Peter; Nichols, Phyllis; White, Cornelia; Das, Debjani

2003-10-17

Rates of skin cancer, the most common cancer in the United States, are increasing. The most preventable risk factor for skin cancer is unprotected ultraviolet (UV) exposure. Seeking to identify effective approaches to reducing the incidence of skin cancer by improving individual and community efforts to reduce unprotected UV exposure, the Task Force on Community Preventive Services conducted systematic reviews of community interventions to reduce exposure to ultraviolet light and increase protective behaviors. The Task Force found sufficient evidence to recommend two interventions that are based on improvements in sun protective or "covering-up" behavior (wearing protective clothing including long-sleeved clothing or hats): educational and policy approaches in two settings--primary schools and recreational or tourism sites. They found insufficient evidence to determine the effectiveness of a range of other population-based interventions and recommended additional research in these areas: educational and policy approaches in child care centers, secondary schools and colleges, recreational or tourism sites for children, and workplaces; interventions conducted in health-care settings and targeted to both providers and children's parents or caregivers; media campaigns alone; and community wide multicomponent interventions. This report also presents additional information regarding the recommended community interventions, briefly describes how the reviews were conducted, provides resources for further information, and provides information that can help in applying the interventions locally. The U.S. Preventive Services Task Force conducted a systematic review of counseling by primary care clinicians to prevent skin cancer (CDC. Counseling to prevent skin cancer: recommendation and rationale of the U.S. Preventive Services Task Force. MMWR 2003;52[No. RR-15]:13-17), which is also included in this issue, the first jointly released findings from the Task Force on Community Preventive Services and the U.S. Preventive Services Task Force.

Providing comprehensive health services for young key populations: needs, barriers and gaps

PubMed Central

Delany-Moretlwe, Sinead; Cowan, Frances M; Busza, Joanna; Bolton-Moore, Carolyn; Kelley, Karen; Fairlie, Lee

2015-01-01

Introduction Adolescence is a time of physical, emotional and social transitions that have implications for health. In addition to being at high risk for HIV, young key populations (YKP) may experience other health problems attributable to high-risk behaviour or their developmental stage, or a combination of both. Discussion We reviewed the needs, barriers and gaps for other non-HIV health services for YKP. We searched PubMed and Google Scholar for articles that provided specific age-related data on sexual and reproductive health; mental health; violence; and substance use problems for adolescent, youth or young sex workers, men who have sex with men, transgender people, and people who inject drugs. Results YKP experience more unprotected sex, sexually transmitted infections including HIV, unintended pregnancy, violence, mental health disorders and substance use compared to older members of key populations and youth among the general population. YKP experience significant barriers to accessing care; coverage of services is low, largely because of stigma and discrimination experienced at both the health system and policy levels. Discussion YKP require comprehensive, integrated services that respond to their specific developmental needs, including health, educational and social services within the context of a human rights-based approach. The recent WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations are an important first step for a more comprehensive approach to HIV programming for YKP, but there are limited data on the effective delivery of combined interventions for YKP. Significant investments in research and implementation will be required to ensure adequate provision and coverage of services for YKP. In addition, greater commitments to harm reduction and rights-based approaches are needed to address structural barriers to access to care. PMID:25724511

77 FR 16568 - International Mail Contract

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

...-filed Postal Service request to enter into an additional International Business Reply Service contract... additional International Business Reply Service (IBRS) contract.\\1\\ The Postal Service asserts that the... Service Filing of a Functionally Equivalent International Business Reply Service Competitive Contract 3...

77 FR 10577 - International Mail Contract

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

...-filed Postal Service request to enter into an additional International Business Reply Service contract... additional International Business Reply Service (IBRS) contract.\\1\\ The Postal Service asserts that the... United States Postal Service Filing of a Functionally Equivalent International Business Reply Service...

Collaboration, facilities and communities in day care services for older people.

PubMed

Adams, John

2001-05-01

Similarities and differences between day hospitals, run by the NHS, and day centres, run by local authorities or charitable organisations, have been widely discussed in the literature of gerontology for many years. The authors of this paper have undertaken a single blind, randomised-controlled trial to compare rehabilitation outcomes in the two settings, which was published in 1999. This research project involved augmenting the staff of day centres by visiting therapists. In addition to quantitative findings, their project also generated much qualitative data from interviews with health service and social service staff which provides the thought-provoking content. The themes identified included the reluctance of some patients to accept referral to a day centre, and the difficulties associated with discharging patients. Positive aspects included the opportunity to share skills, knowledge and resources. 29 references.

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal

PubMed Central

2014-01-01

Background Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. Methods A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Results Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The ‘Current Index of Medical Specialties’ was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Conclusions Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections. PMID:24774195

Whole-genome scan reveals significant non-additive effects for sire conception rate in Holstein cattle.

PubMed

Nicolini, Paula; Amorín, Rocío; Han, Yi; Peñagaricano, Francisco

2018-02-27

Service sire has a considerable impact on reproductive success in dairy cattle. Most gene mapping studies for bull fertility have focused on additive effects, while non-additive effects have been largely ignored. The main goal of this study was to assess the relevance of non-additive effects on Sire Conception Rate (SCR) in Holstein dairy cattle. The analysis included 7.5 k Holstein bulls with both SCR records and 57.8 k single nucleotide polymorphism (SNP) markers spanning the entire genome. The importance of non-additive effects was evaluated using an efficient two-step mixed model-based approach. Four genomic regions located on chromosomes BTA8, BTA9, BTA13 and BTA17 showed marked dominance and/or recessive effects. Most of these regions harbor genes, such as ADAM28, DNAJA1, TBC1D20, SPO11, PIWIL3 and TMEM119, that are directly implicated in testis development, male germ line maintenance, and sperm maturation. This study provides further evidence for the relevance of non-additive effects in fitness-related traits, such as male fertility. In addition, these findings may point out new strategies for improving service sire fertility in dairy cattle via marker-assisted selection.

IMPACT: Investigating the impact of Models of Practice for Allied health Care in subacuTe settings. A protocol for a quasi-experimental mixed methods study of cost effectiveness and outcomes for patients exposed to different models of allied health care.

PubMed

Coker, Freya; Williams, Cylie M; Taylor, Nicholas F; Caspers, Kirsten; McAlinden, Fiona; Wilton, Anita; Shields, Nora; Haines, Terry P

2018-05-10

This protocol considers three allied health staffing models across public health subacute hospitals. This quasi-experimental mixed-methods study, including qualitative process evaluation, aims to evaluate the impact of additional allied health services in subacute care, in rehabilitation and geriatric evaluation management settings, on patient, health service and societal outcomes. This health services research will analyse outcomes of patients exposed to different allied health models of care at three health services. Each health service will have a control ward (routine care) and an intervention ward (additional allied health). This project has two parts. Part 1: a whole of site data extraction for included wards. Outcome measures will include: length of stay, rate of readmissions, discharge destinations, community referrals, patient feedback and staff perspectives. Part 2: Functional Independence Measure scores will be collected every 2-3 days for the duration of 60 patient admissions.Data from part 1 will be analysed by linear regression analysis for continuous outcomes using patient-level data and logistic regression analysis for binary outcomes. Qualitative data will be analysed using a deductive thematic approach. For part 2, a linear mixed model analysis will be conducted using therapy service delivery and days since admission to subacute care as fixed factors in the model and individual participant as a random factor. Graphical analysis will be used to examine the growth curve of the model and transformations. The days since admission factor will be used to examine non-linear growth trajectories to determine if they lead to better model fit. Findings will be disseminated through local reports and to the Department of Health and Human Services Victoria. Results will be presented at conferences and submitted to peer-reviewed journals. The Monash Health Human Research Ethics committee approved this multisite research (HREC/17/MonH/144 and HREC/17/MonH/547). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

21 CFR 900.5 - Evaluation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MAMMOGRAPHY QUALITY... each accreditation body. Such evaluation shall include an assessment of the reports of FDA or State inspections of facilities accredited by the body as well as any additional information deemed relevant by FDA...

21 CFR 900.5 - Evaluation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MAMMOGRAPHY QUALITY... each accreditation body. Such evaluation shall include an assessment of the reports of FDA or State inspections of facilities accredited by the body as well as any additional information deemed relevant by FDA...

Polychannel Systems for Mass Digital Communication

DTIC Science & Technology

1988-07-01

years additional systems similar to ours have become operational, including X*Press, Main- stream Data, and Stargate . X*Press Information Services...cities in the United States, and Stargate uses the satellite TV station WTBS to transmit electronic bulletin boards to remote com- puter sites

Gender Imputation

ERIC Educational Resources Information Center

National Student Clearinghouse, 2013

2013-01-01

In late 2007, the National Student Clearinghouse (NSC) expanded its Enrollment Reporting service to include several additional data elements (commonly referred to as the "A2" or "expanded" data elements). One of these expanded data elements is student gender. Although gender is potentially important to a number of research…

Queensland Youth Cancer Service: A Partnership Model to Facilitate Access to Quality Care for Young People Diagnosed with Cancer.

PubMed

Bradford, Natalie K; Henney, Roslyn; Walker, Rick; Walpole, Euan; Kennedy, Glen; Nicholls, Wayne; Pinkerton, Ross

2018-06-01

Global recognition of the need to improve outcomes for adolescents and young adults (AYA) with cancer has led to the development of specific oncology programs and services. In Australia, Youth Cancer Services (YCS) are now established across the country. While each service has been shaped by nationally agreed principles, program development has been influenced by local policy and geographic differences. Queensland is a vast state with a widely dispersed population; coordination of cancer services for young people across this landscape presents unique challenges. The Queensland YCS (QYCS) work in a consultative partnership model with primary treating teams, across both pediatric and adult tertiary cancer services. Understanding how cancer services approach challenges and service development can provide guidance for other developing services. In this article, we describe the goals and development of QYCS and review the outcomes achieved in the service to date. We reviewed referral data and retrieved statewide clinical activity from the web-based data system. We compared these data with cancer registry data to identify disparities and areas for service development. While the service has achieved notable outcomes, challenges remain. These include recruitment of appropriately skilled and trained health professionals for this newly developing area of oncology. In addition, there is an ongoing need to advocate for this relatively small patient group, and to promote awareness and understanding of the need for AYA-specific services. With the dispersed population and concentration of services in metropolitan Brisbane, identifying and testing new innovative models, including telehealth, to reach all AYA diagnosed with cancer regardless of location of care are priorities.

A framework for m-health service development and success evaluation.

PubMed

Sadegh, S Saeedeh; Khakshour Saadat, Parisa; Sepehri, Mohammad Mehdi; Assadi, Vahid

2018-04-01

The emergence of mobile technology has influenced many service industries including health care. Mobile health (m-Health) applications have been used widely, and many services have been developed that have changed delivery systems and have improved effectiveness of health care services. Stakeholders of m-Health services have various resources and rights that lends to a complexity in service delivery. In addition, abundance of different m-Health services makes it difficult to choose an appropriate service for these stakeholders that include customers, patients, users or even providers. Moreover, a comprehensive framework is not yet provided in the literature that would help manage and evaluate m-health services, considering various stakeholder's benefits. In this paper, a comprehensive literature review has been done on famous frameworks and models in the field of Information Technology and electronic health with the aim of finding different aspects of developing and managing m-health services. Using the results of literature review and conducting a stakeholder analysis, we have proposed an m-health evaluation framework which evaluates the success of a given m-health service through a three-stage life cycle: (1) Service Requirement Analysis, (2) Service Development, and (3) Service Delivery. Key factors of m-health evaluation in each step are introduced in the proposed framework considering m-health key stakeholder's benefits. The proposed framework is validated via expert interviews, and key factors in each evaluation step is validated using PLS model. Results show that path coefficients are higher than their threshold which supports the validity of proposed framework. Copyright © 2018 Elsevier B.V. All rights reserved.

The Role of Nonphysician Clinicians in the Rapid Expansion of HIV Care in Mozambique

PubMed Central

Sherr, Kenneth; Pfeiffer, James; Mussa, Antonio; Vio, Ferruccio; Gimbel, Sarah; Micek, Mark; Gloyd, Stephen

2017-01-01

The shortage of health workers impedes universal coverage of quality HIV services, especially in those countries hardest hit by the epidemic. The dramatic increase in international aid to scale-up HIV services, including antiretroviral therapy (ART), has highlighted workforce deficiencies and provided an opportunity to strengthen health systems capacity. In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing non-physician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. As a result of responsible task shifting, the number of facilities providing ART tripled during a 6-month period, and patients from disadvantaged areas have access to quality ART services. Because the NPC-driven ART approach is integrated into primary health care, the addition of new clinical staff also promises to improve general health services. PMID:19858931

Chiropractic practice in military and veterans health care: The state of the literature

PubMed Central

Green, Bart N.; Johnson, Claire D.; Lisi, Anthony J.; Tucker, John

2009-01-01

Objective To summarize scholarly literature that describes practice, utilization, and/or policy of chiropractic services within international active duty and/or veteran health care environments. Data Sources PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Index to Chiropractic Literature were searched from their starting dates through June 2009. Review Methods All authors independently reviewed each of the articles to verify that each met the inclusion criteria. Citations of included papers and other pertinent findings were logged in a summary table. Results Thirteen articles were included in this study. Integration of chiropractic care into military or veteran health care systems has been described in 3 systems: the United States Department of Defense, the United States Department of Veterans Affairs, and the Canadian Forces. Conclusion Chiropractic services seem to be included successfully within military and veteran health care facilities. However, there is a great need for additional written evaluation of the processes, policies, practices, and effectiveness of chiropractic services in these environments. PMID:19714234

Quality of life for chronic psychiatric illnesses and home care

PubMed Central

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

2016-01-01

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

Customer-oriented Data Formats and Services for Global Land Data Assimilation System (GLDAS) Products at the NASA GES DISC

NASA Astrophysics Data System (ADS)

Fang, H.; Kato, H.; Rodell, M.; Teng, W. L.; Vollmer, B. E.

2008-12-01

The Global Land Data Assimilation System (GLDAS) has been generating a series of land surface state (e.g., soil moisture and surface temperature) and flux (e.g., evaporation and sensible heat flux) products, simulated by four land surface models (CLM, Mosaic, Noah and VIC). These products are now accessible at the Hydrology Data and Information Services Center (HDISC), a component of the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). Current GLDAS data hosted at HDISC include a set of 1.0° data products, covering 1979 to the present, from the four models and a 0.25° data product, covering 2000 to the present, from the Noah model. In addition to the basic anonymous ftp data downloading, users can avail themselves of several advanced data search and downloading services, such as Mirador and OPeNDAP. Mirador is a Google-based search tool that provides keywords searching, on-the-fly spatial and parameter subsetting of selected data. OPeNDAP (Open-source Project for a Network Data Access Protocol) enables remote OPeNDAP clients to access OPeNDAP served data regardless of local storage format. Additional data services to be available in the near future from HDISC include (1) on-the-fly converter of GLDAS to NetCDF and binary data formats; (2) temporal aggregation of GLDAS files; and (3) Giovanni, an online visualization and analysis tool that provides a simple way to visualize, analyze, and access vast amounts of data without having to download the data.

42 CFR 59.12 - Additional conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Additional conditions. 59.12 Section 59.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.12 Additional conditions. The Secretary may, with...

42 CFR 59.12 - Additional conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Additional conditions. 59.12 Section 59.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.12 Additional conditions. The Secretary may, with...

42 CFR 59.214 - Additional conditions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Additional conditions. 59.214 Section 59.214 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.214 Additional conditions. The Secretary may with...

42 CFR 59.12 - Additional conditions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Additional conditions. 59.12 Section 59.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.12 Additional conditions. The Secretary may, with...

42 CFR 59.12 - Additional conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Additional conditions. 59.12 Section 59.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.12 Additional conditions. The Secretary may, with...

42 CFR 59.12 - Additional conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Additional conditions. 59.12 Section 59.12 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.12 Additional conditions. The Secretary may, with...

42 CFR 59.214 - Additional conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Additional conditions. 59.214 Section 59.214 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.214 Additional conditions. The Secretary may with...

42 CFR 59.214 - Additional conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Additional conditions. 59.214 Section 59.214 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.214 Additional conditions. The Secretary may with...

42 CFR 59.214 - Additional conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Additional conditions. 59.214 Section 59.214 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.214 Additional conditions. The Secretary may with...

42 CFR 59.214 - Additional conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Additional conditions. 59.214 Section 59.214 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR FAMILY PLANNING SERVICES Grants for Family Planning Service Training § 59.214 Additional conditions. The Secretary may with...

22 CFR 1429.22 - Additional time after service by mail.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Additional time after service by mail. 1429.22 Section 1429.22 Foreign Relations FOREIGN SERVICE LABOR RELATIONS BOARD; FEDERAL LABOR RELATIONS AUTHORITY... MISCELLANEOUS AND GENERAL REQUIREMENTS General Requirements § 1429.22 Additional time after service by mail...

22 CFR 1429.22 - Additional time after service by mail.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Additional time after service by mail. 1429.22 Section 1429.22 Foreign Relations FOREIGN SERVICE LABOR RELATIONS BOARD; FEDERAL LABOR RELATIONS AUTHORITY... MISCELLANEOUS AND GENERAL REQUIREMENTS General Requirements § 1429.22 Additional time after service by mail...

22 CFR 1429.22 - Additional time after service by mail.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Additional time after service by mail. 1429.22 Section 1429.22 Foreign Relations FOREIGN SERVICE LABOR RELATIONS BOARD; FEDERAL LABOR RELATIONS AUTHORITY... MISCELLANEOUS AND GENERAL REQUIREMENTS General Requirements § 1429.22 Additional time after service by mail...

22 CFR 1429.22 - Additional time after service by mail.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Additional time after service by mail. 1429.22 Section 1429.22 Foreign Relations FOREIGN SERVICE LABOR RELATIONS BOARD; FEDERAL LABOR RELATIONS AUTHORITY... MISCELLANEOUS AND GENERAL REQUIREMENTS General Requirements § 1429.22 Additional time after service by mail...

22 CFR 1429.22 - Additional time after service by mail.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Additional time after service by mail. 1429.22 Section 1429.22 Foreign Relations FOREIGN SERVICE LABOR RELATIONS BOARD; FEDERAL LABOR RELATIONS AUTHORITY... MISCELLANEOUS AND GENERAL REQUIREMENTS General Requirements § 1429.22 Additional time after service by mail...

42 CFR 414.46 - Additional rules for payment of anesthesia services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Additional rules for payment of anesthesia services... SERVICES Physicians and Other Practitioners § 414.46 Additional rules for payment of anesthesia services... the value for each anesthesia code that reflects all activities other than anesthesia time. These...

Effectiveness of a Social Marketing Campaign Promoting Use of a Sexual Health Text Service by Teens.

PubMed

Willoughby, Jessica Fitts

2015-01-01

Sexual health text message services are becoming an increasingly popular way to provide adolescents with accurate sexual health information, but promotion of such services is often limited. This study uses three quantitative methods (service use data, a text message-based questionnaire, and an in-school online survey) to assess the effectiveness of an in-school social marketing campaign promoting a sexual health text message service that connects teens directly with a health educator. The 3-month campaign was associated with increased service use, but use was still relatively low. Follow-up qualitative work that included focus groups and interviews found a number of barriers to use. Teens indicated they did not have sexual health questions, did not think of the service, or were unsure how to use it. Teens also brought up additional barriers such as concern over parents seeing the messages. Implications for text message service providers and health educators are discussed.

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

NASA Astrophysics Data System (ADS)

Pennella, John J.; Smith, Douglas E.

2001-02-01

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

Predicting Positive Education Outcomes for Emerging Adults in Mental Health Systems of Care.

PubMed

Brennan, Eileen M; Nygren, Peggy; Stephens, Robert L; Croskey, Adrienne

2016-10-01

Emerging adults who receive services based on positive youth development models have shown an ability to shape their own life course to achieve positive goals. This paper reports secondary data analysis from the Longitudinal Child and Family Outcome Study including 248 culturally diverse youth ages 17 through 22 receiving mental health services in systems of care. After 12 months of services, school performance was positively related to youth ratings of school functioning and service participation and satisfaction. Regression analysis revealed ratings of young peoples' perceptions of school functioning, and their experience in services added to the significant prediction of satisfactory school performance, even controlling for sex and attendance. Finally, in addition to expected predictors, participation in planning their own services significantly predicted enrollment in higher education for those who finished high school. Findings suggest that programs and practices based on positive youth development approaches can improve educational outcomes for emerging adults.

Barriers to Male Involvement in Antenatal Care in Rural Mozambique

PubMed Central

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

2015-01-01

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

Integrating primary care with occupational health services: a success story.

PubMed

Griffith, Karen; Strasser, Patricia B

2010-12-01

This article describes the process used by a large U.S. manufacturing company to successfully integrate full-service primary care centers at two locations. The company believed that by providing employees with health promotion and disease prevention services, including screening, early diagnosis, and uncomplicated illness treatment, its health care costs could be significantly reduced while saving employees money. To accurately demonstrate the cost-effectiveness of adding primary care to existing occupational health services, a thorough financial analysis projected the return on investment (ROI) of the program. Decisions were made about center size, the scope of services, and staffing. A critical part of the ROI analysis involved evaluating employee health claim data to identify the actual cost of health care services for each center and the projected costs if the services were provided on-site. The pilot initiative included constructing two on-site health center facilities staffed with primary care physicians, nurse practitioners, physical therapists, and other health care professionals. Key outcome metrics from the pilot clinics exceeded goals in three of four categories. In addition, clinic use after 12 months far exceeded benchmarks for similar clinics. Most importantly, the pilot clinics were operating with a positive cash flow within the first year and demonstrated an increasingly positive ROI. Copyright 2010, SLACK Incorporated.

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

PubMed

Brauer, Paula; Dietrich, Linda; Davidson, Bridget

2006-01-01

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

Operations analysis (study 2.1): Shuttle upper stage software requirements

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

An investigation of software costs related to space shuttle upper stage operations with emphasis on the additional costs attributable to space servicing was conducted. The questions and problem areas include the following: (1) the key parameters involved with software costs; (2) historical data for extrapolation of future costs; (3) elements of the basic software development effort that are applicable to servicing functions; (4) effect of multiple servicing on complexity of the operation; and (5) are recurring software costs significant. The results address these questions and provide a foundation for estimating software costs based on the costs of similar programs and a series of empirical factors.

The first and second generation Aussat systems

NASA Astrophysics Data System (ADS)

Hope, W.

1988-12-01

The present three-spacecraft Aussat satellite communication system is described and illustrated with extensive drawings, diagrams, and photographs; and plans for the second-generation system (Aussat-B, to begin replacing the current spacecraft in 1992) are discussed. Consideration is given to the legal status, structure, and staff of the Aussat organization; the first-generation space segment; satellite launch and orbital transfer procedures; the Aussat communication payload; the ground segment; and the current market for satellite services in Australia. For the second-generation system, topics addressed include additional and improved services, the Aussat-B procurement program, mobile satellite services, and the impact on the Australian space industry.

20 CFR 662.260 - What services, in addition to the applicable core services, are to be provided by One-Stop...

Code of Federal Regulations, 2011 CFR

2011-04-01

... core services, are to be provided by One-Stop partners through the One-Stop delivery system? 662.260... Responsibilities of Partners § 662.260 What services, in addition to the applicable core services, are to be provided by One-Stop partners through the One-Stop delivery system? In addition to the provision of core...

20 CFR 662.260 - What services, in addition to the applicable core services, are to be provided by One-Stop...

Code of Federal Regulations, 2010 CFR

2010-04-01

... core services, are to be provided by One-Stop partners through the One-Stop delivery system? 662.260... Responsibilities of Partners § 662.260 What services, in addition to the applicable core services, are to be provided by One-Stop partners through the One-Stop delivery system? In addition to the provision of core...

75 FR 23807 - Submission for OMB Review: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... one-year retention of information on work applications and job orders. For additional information, see... collection. Title of Collection: Work Application/Job Order Recordkeeping. OMB Control Number: 1205-0001..., work experience, and desired pay. They also include services provided to applicants, such as job...

Becoming Responsible Learners: Community Matters

ERIC Educational Resources Information Center

Wiersema, Janice A.; Licklider, Barbara L.; Ebbers, Larry

2013-01-01

Students at Iowa State University had the opportunity to enroll in a two-year National Science Foundation (NFS) Scholarship for Service (SFS) leadership development program, in addition to their work within their majors. This interdisciplinary program included faculty and students in computer engineering, computer science, mathematics, political…

29 CFR 1470.40 - Monitoring and reporting program performance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Monitoring and reporting program performance. 1470.40 Section 1470.40 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE... not met. (iii) Additional pertinent information including, when appropriate, analysis and explanation...

Adverse Childhood Experiences and the Mental Health of Veterans.

PubMed

McGuinness, Teena M; Waldrop, Jessica R

2015-06-01

Many U.S. Veterans have experienced the burdens of mental illness and suicide. The current article focuses on Veterans who served from 2001-2015. Although combat exposure and suicidal ideation are linked, approximately one half of all suicides among Active Duty service members (who have served since 2001) occurred among those who never deployed. Researchers who sought additional risks for suicide found that Veterans have greater odds of adversities in childhood than the general population. Adverse childhood experiences are stressful and traumatic experiences, including abuse and neglect, as well as witnessing household dysfunction, or growing up with individuals with mental illness or substance abuse. Further, childhood physical abuse has been shown to be a significant predictor for posttraumatic stress disorder and suicide. Adverse childhood experiences confer additional risk for the mental health of service members. Psychiatric nursing implications include the importance of assessing early childhood adversity during psychosocial assessments. Providing trauma-informed strategies for treatment is an essential element of psychiatric nursing care. Copyright 2015, SLACK Incorporated.

Stakeholder survey results for Lake Umbagog National Wildlife Refuge: Completion report

USGS Publications Warehouse

Sexton, Natalie R.; Stewart, Susan C.; Koontz, Lynne; Wundrock, Katherine D.

2005-01-01

Lake Umbagog is a newly established Refuge (in 1993) with an increasing visitation. Current visitation numbers are around 55,000 visits/year. Though limited visitor services are currently offered, additional services will be proposed in the CCP. The purpose of this survey is to assess interested publics' and stakeholders' satisfaction with existing visitor conditions and experiences on the Refuge and the preferences for proposed changes to the Refuge affecting visitation. An additional purpose is to gauge customers' understanding and knowledge regarding the Refuge so that future communications with stakeholders regarding proposed changes can be most effective. Appendix A of this report includes the survey instrument. Appendix B includes the summary data for all of the questions in the survey, in the order that they appear in the survey. For the most part, that information is not repeated in the body of the report, which focuses on the meaning of more in-depth analyses of the survey data.

Batching System for Superior Service

NASA Technical Reports Server (NTRS)

2001-01-01

Veridian's Portable Batch System (PBS) was the recipient of the 1997 NASA Space Act Award for outstanding software. A batch system is a set of processes for managing queues and jobs. Without a batch system, it is difficult to manage the workload of a computer system. By bundling the enterprise's computing resources, the PBS technology offers users a single coherent interface, resulting in efficient management of the batch services. Users choose which information to package into "containers" for system-wide use. PBS also provides detailed system usage data, a procedure not easily executed without this software. PBS operates on networked, multi-platform UNIX environments. Veridian's new version, PBS Pro,TM has additional features and enhancements, including support for additional operating systems. Veridian distributes the original version of PBS as Open Source software via the PBS website. Customers can register and download the software at no cost. PBS Pro is also available via the web and offers additional features such as increased stability, reliability, and fault tolerance.A company using PBS can expect a significant increase in the effective management of its computing resources. Tangible benefits include increased utilization of costly resources and enhanced understanding of computational requirements and user needs.

[Supplementary services used as marketing tools in the competition among private practice doctors].

PubMed

Meurers, Horst

2009-01-01

What is the relation between additional healthcare services, marketing and competition among office-based physicians? The best and truly effective marketing strategy is a satisfied patient recommending his doctor's services to others. Hence, good marketing starts with a convincing service concept, not just with advertising. More and more frequently patients ask for supplementary health service offerings. Additional services tailored to individual practices--e.g., in the field of nutrition, sports, fitness, wellness, aesthetics--meet the patients' demands, but at the same time they provide a competitive advantage over the ordinary medical practice. And what is more, these additional healthcare services have a nice side effect: they earn an additional income which is not unwelcome in times of decreasing revenues from the public healthcare system. The much sought-after potential for additional services and income can be achieved by offering commercial medical services, e.g., the sale of healthcare products. The coexistence of the doctor's commercial and non-commercial medical services is admissible as long as certain rules of professional conduct and tax laws are followed.

The impact of contracting out on health outcomes and use of health services in low and middle-income countries.

PubMed

Lagarde, Mylene; Palmer, Natasha

2009-10-07

Recent literature on the lack of efficiency and acceptability of publicly provided health services has led to an interest in the use of partnerships with the private sector to deliver public services. To assess the effectiveness of contracting out healthcare services in improving access to care in low and middle-income countries and, where possible, health outcomes. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, in addition to development studies and economic databases. We also searched the websites and online resources of numerous international agencies, organisations and universities to find relevant grey literature. The original searches were conducted between November 2005 and April 2006. An updated search in MEDLINE was carried out in May 2009. Contracting out health services is defined as the provision of healthcare services on behalf of the government by non-state providers. Studies had to include an objective measure of at least one of the following outcomes: health care utilisation, health expenditure, health outcomes or equity outcomes. Studies also needed to use one of the following study designs: randomised controlled trial, non-randomised controlled trial, interrupted time series analysis or controlled before and after study. We made an attempt to present results from the different studies in a systematic way, however due to the diversity of sources, contexts and methods used, we undertook a narrative synthesis. Three studies met our inclusion criteria (one after re-analysis of data). These studies suggest that contracting out services to non-state providers can increase access and utilisation of health services. One study found a reduction in out-of-pocket expenditures and improvement in some health outcomes. However, methodological weaknesses and particularities of the reported programme settings limit the strength and generalisability of their conclusions. Three studies suggest that contracting out may be an appropriate response to scale up service delivery in particular settings, such as post-conflict or fragile states. Evidence was not presented on whether this approach was more effective than making a similar investment in the public sector, as there was not an exact control available in any of the settings. In addition, the introduction of non-state providers into some settings and not others also brings many potentially confounding variables, such as the presence of additional management expertise or expatriate doctors, which may improve drug supply or increase utilisation.

A Methodology for the Development of RESTful Semantic Web Services for Gene Expression Analysis

PubMed Central

Guardia, Gabriela D. A.; Pires, Luís Ferreira; Vêncio, Ricardo Z. N.; Malmegrim, Kelen C. R.; de Farias, Cléver R. G.

2015-01-01

Gene expression studies are generally performed through multi-step analysis processes, which require the integrated use of a number of analysis tools. In order to facilitate tool/data integration, an increasing number of analysis tools have been developed as or adapted to semantic web services. In recent years, some approaches have been defined for the development and semantic annotation of web services created from legacy software tools, but these approaches still present many limitations. In addition, to the best of our knowledge, no suitable approach has been defined for the functional genomics domain. Therefore, this paper aims at defining an integrated methodology for the implementation of RESTful semantic web services created from gene expression analysis tools and the semantic annotation of such services. We have applied our methodology to the development of a number of services to support the analysis of different types of gene expression data, including microarray and RNASeq. All developed services are publicly available in the Gene Expression Analysis Services (GEAS) Repository at http://dcm.ffclrp.usp.br/lssb/geas. Additionally, we have used a number of the developed services to create different integrated analysis scenarios to reproduce parts of two gene expression studies documented in the literature. The first study involves the analysis of one-color microarray data obtained from multiple sclerosis patients and healthy donors. The second study comprises the analysis of RNA-Seq data obtained from melanoma cells to investigate the role of the remodeller BRG1 in the proliferation and morphology of these cells. Our methodology provides concrete guidelines and technical details in order to facilitate the systematic development of semantic web services. Moreover, it encourages the development and reuse of these services for the creation of semantically integrated solutions for gene expression analysis. PMID:26207740

A Methodology for the Development of RESTful Semantic Web Services for Gene Expression Analysis.

PubMed

Guardia, Gabriela D A; Pires, Luís Ferreira; Vêncio, Ricardo Z N; Malmegrim, Kelen C R; de Farias, Cléver R G

2015-01-01

Gene expression studies are generally performed through multi-step analysis processes, which require the integrated use of a number of analysis tools. In order to facilitate tool/data integration, an increasing number of analysis tools have been developed as or adapted to semantic web services. In recent years, some approaches have been defined for the development and semantic annotation of web services created from legacy software tools, but these approaches still present many limitations. In addition, to the best of our knowledge, no suitable approach has been defined for the functional genomics domain. Therefore, this paper aims at defining an integrated methodology for the implementation of RESTful semantic web services created from gene expression analysis tools and the semantic annotation of such services. We have applied our methodology to the development of a number of services to support the analysis of different types of gene expression data, including microarray and RNASeq. All developed services are publicly available in the Gene Expression Analysis Services (GEAS) Repository at http://dcm.ffclrp.usp.br/lssb/geas. Additionally, we have used a number of the developed services to create different integrated analysis scenarios to reproduce parts of two gene expression studies documented in the literature. The first study involves the analysis of one-color microarray data obtained from multiple sclerosis patients and healthy donors. The second study comprises the analysis of RNA-Seq data obtained from melanoma cells to investigate the role of the remodeller BRG1 in the proliferation and morphology of these cells. Our methodology provides concrete guidelines and technical details in order to facilitate the systematic development of semantic web services. Moreover, it encourages the development and reuse of these services for the creation of semantically integrated solutions for gene expression analysis.

Command and Service Module Communications

NASA Technical Reports Server (NTRS)

Interbartolo, Michael

2009-01-01

This viewgraph presentation examines Command and Service Module (CSM) Communications. The communication system's capabilities are defined, including CSM-Earth, CSM-Lunar Module and CSM-Extravehicular crewman communications. An overview is provided for S-band communications, including data transmission and receiving rates, operating frequencies and major system components (pre-modulation processors, unified S-band electronics, S-band power amplifier and S-band antennas). Additionally, data transmission rates, operating frequencies and the capabilities of VHF communications are described. Major VHF components, including transmitters and receivers, and the VHF multiplexer and antennas are also highlighted. Finally, communications during pre-launch, ascent, in-flight and entry are discussed. Overall, the CSM communication system was rated highly by flight controllers and crew. The system was mostly autonomous for both crew and flight controllers and no major issues were encountered during flight.

EnviroAtlas National Layers Master Web Service

EPA Pesticide Factsheets

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

Using internal marketing to improve organizational commitment and service quality.

PubMed

Tsai, Yafang; Wu, Shih-Wang

2011-12-01

The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

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

A study of an adaptive replication framework for orchestrated composite web services.

PubMed

Mohamed, Marwa F; Elyamany, Hany F; Nassar, Hamed M

2013-01-01

Replication is considered one of the most important techniques to improve the Quality of Services (QoS) of published Web Services. It has achieved impressive success in managing resource sharing and usage in order to moderate the energy consumed in IT environments. For a robust and successful replication process, attention should be paid to suitable time as well as the constraints and capabilities in which the process runs. The replication process is time-consuming since outsourcing some new replicas into other hosts is lengthy. Furthermore, nowadays, most of the business processes that might be implemented over the Web are composed of multiple Web services working together in two main styles: Orchestration and Choreography. Accomplishing a replication over such business processes is another challenge due to the complexity and flexibility involved. In this paper, we present an adaptive replication framework for regular and orchestrated composite Web services. The suggested framework includes a number of components for detecting unexpected and unhappy events that might occur when consuming the original published web services including failure or overloading. It also includes a specific replication controller to manage the replication process and select the best host that would encapsulate a new replica. In addition, it includes a component for predicting the incoming load in order to decrease the time needed for outsourcing new replicas, enhancing the performance greatly. A simulation environment has been created to measure the performance of the suggested framework. The results indicate that adaptive replication with prediction scenario is the best option for enhancing the performance of the replication process in an online business environment.

Qualification of Life Extension Schemes for Engine Components (Homologation des Programmes de Prolongation du cycle de vie des Organes Moteur)

DTIC Science & Technology

1999-03-01

cycle managers include (1) improving the durability of components through material substitution, or the addition of protective coatings, (2) returning... including in service trials, is required to demonstrate that the repaired and/or modified component is safe to use and remains so once returned to...Better Turbine Materials and Technology Including 5 Predicted Life Improvements by T.J. Williams Repair Developments to Fit Customer Needs (Presented

Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

PubMed Central

2013-01-01

Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF > 60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial registration Clinical Trials NCT00378248 PMID:24268099

Public Willingness to Pay to Improve Services for Individuals With Serious Mental Illness.

PubMed

Stone, Elizabeth M; McGinty, Emma E

2018-05-08

This study measured Americans' willingness to pay an additional $50 in taxes to improve health care and social services for individuals with serious mental illness. A nationally representative online survey was conducted with 1,010 respondents. Analysis examined how respondents' demographic characteristics and attitudes toward individuals with serious mental illness correlated with their willingness to pay additional taxes to improve health care and social services for this vulnerable population. A majority of respondents expressed willingness to pay $50 in additional taxes to improve health care services (60%) and social services (58%) for individuals with serious mental illness. Those with more negative attitudes toward individuals with serious mental illness were less willing to pay additional taxes to improve either service type. Many Americans are willing to pay additional taxes to improve health care and social services for individuals with serious mental illness.

Medical equipment libraries: implementation, experience and user satisfaction.

PubMed

Keay, S; McCarthy, J P; Carey-Smith, B E

2015-01-01

The hospital-wide pooling and sharing of certain types of medical equipment can lead to both significant improvements in patient safety and financial advantages when compared with a department or ward-level equipment ownership system. In September 2003, a Medical Equipment Loan Service (MELS) was established, focusing initially on infusion pumps. The aims and expected benefits included; improving availability of equipment for both patients and clinical users, managing and reducing clinical risk, reducing equipment diversity, improving equipment management and reducing the overall cost of equipment provision. A user survey was carried out in 2005 and repeated in 2011. The results showed wide and continued satisfaction with the service. The process and difficulties of establishing the service and its development to include additional types of equipment are described. The benefits of managing medical equipment which is in widespread general use, through a MELS as part of a Clinical Engineering Department, are presented.

Soft optics in intelligent optical networks

NASA Astrophysics Data System (ADS)

Shue, Chikong; Cao, Yang

2001-10-01

In addition to the recent advances in Hard-optics that pushes the optical transmission speed, distance, wave density and optical switching capacity, Soft-optics provides the necessary intelligence and control software that reduces operational costs, increase efficiency, and enhances revenue generating services by automating optimal optical circuit placement and restoration, and enabling value-added new services like Optical VPN. This paper describes the advances in 1) Overall Hard-optics and Soft-optics 2) Layered hierarchy of Soft-optics 3) Component of Soft-optics, including hard-optics drivers, Management Soft-optics, Routing Soft-optics and System Soft-optics 4) Key component of Routing and System Soft-optics, namely optical routing and signaling (including UNI/NNI and GMPLS signaling). In summary, the soft-optics on a new generation of OXC's enables Intelligent Optical Networks to provide just-in-time service delivery and fast restoration, and real-time capacity management that eliminates stranded bandwidth. It reduces operational costs and provides new revenue opportunities.

Hawaii's public mental health system.

PubMed

VanderVoort, Debra J

2005-03-01

The following article addresses the nature of and problems with the public mental health system in Hawaii. It includes a brief history of Hawaii's public mental health system, a description and analysis of this system, economic factors affecting mental health, as well as a needs assessment of the elderly, individuals with severe mental illness, children and adolescents, and ethnically diverse individuals. In addition to having the potential to increase suicide rates and unnecessarily prolong personal suffering, problems in the public mental health system such as inadequate services contribute to an increase in social problems including, but not limited to, an increase in crime rates (e.g., domestic violence, child abuse), divorce rates, school failure, and behavioral problems in children. The population in need of mental health services in Hawaii is under served, with this inadequacy of services due to economic limitations and a variety of other factors.

Disability and access to health care - a community based descriptive study.

PubMed

Maart, Soraya; Jelsma, Jennifer

2014-01-01

The World Disability Report highlighted the need for adequate access to health and medical rehabilitation services for those with disability. Participants in a large community based survey in a low-income area were asked questions relating to their use of health related services. Using random, cluster sampling a representative sample of 1083 households in a deprived area of Cape Town were approached and 152 people with disability were interviewed. Those with disability were more likely to be male (χ² = 4.24, p = 0.03) and unemployed (χ² = 66.89, p > 0.001) compared to those without disability. The percentages reporting unmet needs were respectively: 54% for home-based care; 34.5% for assistive devices, 28.9% for medical rehabilitation services; and 2.5% for health services. Those over 65 years of age were less likely to have had the medical rehabilitation that they required (χ² = 8.00, p = 0.018). There were fewer respondents with sensory and language disorders but these groups reported proportionately more unmet needs. The main problems with accessing services included inadequate finances (71%) and transport problems (72%). It is recommended that all efforts be expended to extend appropriate rehabilitation services, including home based-care and appliances to those identified as having disability, particularly to those older than 65 years. In addition, the services need to be affordable and accessible in terms of suitable transport, particularly in the light of the high unemployment rate and the large number of respondents with mobility problems. Implications for Rehabilitation People with disability may be the most in need of additional health related care and the least able to access it. Transport and financial considerations were found to limit the ability to access appropriate care. Rehabilitation and health services need to reach out through home-based care and appropriate forms of rehabilitation delivery to ensure that those who are most in need of care, such as the elderly and those with more neglected forms of disability, are provided with the services that they require.

36 CFR 223.229 - Contents of prospectus.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The amount of performance bond required; and (k) Such additional information about the sale as the....229 Section 223.229 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE... Contents of prospectus. The prospectus for the sale of special forest products shall include the following...

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

18 CFR 157.16 - Exhibits relating to acquisitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., including engineering, financial accounting, legal, or other services, and the compensation, fees, or other....14(a)(4). (c) Exhibit S—Accounting. A statement showing: (1) The amounts recorded upon the books of... a clear description of such property, the additional costs to be incurred, and the accounting...

Soil and water quality with tall fescue management in the Southern Piedmont

USDA-ARS?s Scientific Manuscript database

Pasture management not only affects plant and animal productivity, but also soil quality, carbon sequestration, and water quality. These additional ecosystem services need to be evaluated under a diversity of management approaches, including how nutrients are supplied (i.e. inorganic or broiler litt...

Commercial and Industrial Wiring.

ERIC Educational Resources Information Center

Kaltwasser, Stan; Flowers, Gary

This module is the third in a series of three wiring publications, includes additional technical knowledge and applications required for job entry in the commercial and industrial wiring trade. The module contains 15 instructional units that cover the following topics: blueprint reading and load calculations; tools and equipment; service;…

42 CFR 416.51 - Conditions for coverage-Infection control.

Code of Federal Regulations, 2012 CFR

2012-10-01

... communicable diseases. In addition, the infection control and prevention program must include documentation... 42 Public Health 3 2012-10-01 2012-10-01 false Conditions for coverage-Infection control. 416.51 Section 416.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 416.51 - Conditions for coverage-Infection control.

Code of Federal Regulations, 2014 CFR

2014-10-01

... communicable diseases. In addition, the infection control and prevention program must include documentation... 42 Public Health 3 2014-10-01 2014-10-01 false Conditions for coverage-Infection control. 416.51 Section 416.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 416.51 - Conditions for coverage-Infection control.

Code of Federal Regulations, 2013 CFR

2013-10-01

... communicable diseases. In addition, the infection control and prevention program must include documentation... 42 Public Health 3 2013-10-01 2013-10-01 false Conditions for coverage-Infection control. 416.51 Section 416.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

42 CFR 409.33 - Examples of skilled nursing and rehabilitation services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... reaction. Patients who, in addition to their physical problems, exhibit acute psychological symptoms such... of a patient care plan, including tests and measurements of range of motion, strength, balance... neurological, muscular, or skeletal abnormality; (4) Range of motion exercises: Range of motion exercises which...

42 CFR 409.33 - Examples of skilled nursing and rehabilitation services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reaction. Patients who, in addition to their physical problems, exhibit acute psychological symptoms such... of a patient care plan, including tests and measurements of range of motion, strength, balance... neurological, muscular, or skeletal abnormality; (4) Range of motion exercises: Range of motion exercises which...

30 CFR 75.1433 - Examinations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... addition, visual examination for wear and broken wires shall be made at stress points, including the area... SAFETY STANDARDS-UNDERGROUND COAL MINES Hoisting and Mantrips Wire Ropes § 75.1433 Examinations. (a) At least once every fourteen calendar days, each wire rope in service shall be visually examined along its...

30 CFR 75.1433 - Examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... addition, visual examination for wear and broken wires shall be made at stress points, including the area... SAFETY STANDARDS-UNDERGROUND COAL MINES Hoisting and Mantrips Wire Ropes § 75.1433 Examinations. (a) At least once every fourteen calendar days, each wire rope in service shall be visually examined along its...

30 CFR 75.1433 - Examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... addition, visual examination for wear and broken wires shall be made at stress points, including the area... SAFETY STANDARDS-UNDERGROUND COAL MINES Hoisting and Mantrips Wire Ropes § 75.1433 Examinations. (a) At least once every fourteen calendar days, each wire rope in service shall be visually examined along its...

30 CFR 75.1433 - Examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... addition, visual examination for wear and broken wires shall be made at stress points, including the area... SAFETY STANDARDS-UNDERGROUND COAL MINES Hoisting and Mantrips Wire Ropes § 75.1433 Examinations. (a) At least once every fourteen calendar days, each wire rope in service shall be visually examined along its...

Elderly Alcoholism: Implications for Human Service Education

ERIC Educational Resources Information Center

Beechem, Michael

2004-01-01

Incumbent upon those faculty who teach substance abuse courses is the need to integrate elderly alcoholism-related course content to encourage and adequately prepare university students to serve this "hidden" population. Course content would ideally include theories specific to loss-grief, aging, and alcoholism. In addition, field placement…

78 FR 4872 - Minor Boundary Revision at Governors Island National Monument

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... INFORMATION CONTACT: Superintendent Patti Reilly, Governors Island National Monument, 10 South Street--Slip 7... Revision at Governors Island National Monument AGENCY: National Park Service, Interior. ACTION...), the boundary of Governors Island National Monument is modified to include an additional 0.13-acre of...

34 CFR 645.15 - What additional services may Veterans Upward Bound projects provide?

Code of Federal Regulations, 2013 CFR

2013-07-01

... projects provide? 645.15 Section 645.15 Education Regulations of the Offices of the Department of Education... Projects and Services Does the Secretary Assist Under This Program? § 645.15 What additional services may Veterans Upward Bound projects provide? In addition to the services that must be provided under § 645.11, a...

34 CFR 645.15 - What additional services may Veterans Upward Bound projects provide?

Code of Federal Regulations, 2014 CFR

2014-07-01

... projects provide? 645.15 Section 645.15 Education Regulations of the Offices of the Department of Education... Projects and Services Does the Secretary Assist Under This Program? § 645.15 What additional services may Veterans Upward Bound projects provide? In addition to the services that must be provided under § 645.11, a...

34 CFR 645.15 - What additional services may Veterans Upward Bound projects provide?

Code of Federal Regulations, 2012 CFR

2012-07-01

... projects provide? 645.15 Section 645.15 Education Regulations of the Offices of the Department of Education... Projects and Services Does the Secretary Assist Under This Program? § 645.15 What additional services may Veterans Upward Bound projects provide? In addition to the services that must be provided under § 645.11, a...

34 CFR 645.15 - What additional services may Veterans Upward Bound projects provide?

Code of Federal Regulations, 2011 CFR

2011-07-01

... projects provide? 645.15 Section 645.15 Education Regulations of the Offices of the Department of Education... Projects and Services Does the Secretary Assist Under This Program? § 645.15 What additional services may Veterans Upward Bound projects provide? In addition to the services that must be provided under § 645.11, a...

Asset management in theory and practice.

PubMed

Mace, J D

1998-01-01

Managing capital-intensive imaging environments continues to be a challenge for nearly all administrators. Asset management, the strategic management of equipment inventory, must include planning, assessment, procurement, utilization review, maintenance, repair and disposal of equipment to reduce costs and improve efficiency. It must involve some shared risk between the facility and the provider, whether an original equipment manufacturer (OEM) or independent service organization (ISO). An absence of risk in the arrangement implies the provider is offering service management or consulting. A case study reports on three hospitals in the OhioHealth system. Their immediate goal, as they began to investigate asset management: cut costs immediately. A cross-functional team from the three hospitals began its investigation of various options, including working with ISOs, OEMs and development of inhouse clinical engineering. After developing a process to evaluate vendors, the team was able to score each against their cost-reduction potential, quality and implementation skills. The team narrowed its selection quickly to two multivendor service providers. An initial contract guaranteed savings of 20 percent of the annual budget, with a projected two to five percent additional savings. OEM relationships were moved to a time-and-materials basis, and ISOs were used in selected areas. In addition, the internal inhouse clinical engineering services group was moved into a "first call" approach in some areas. That expanded role resulted in savings and improved response time. The process, although not without its problems, was viewed favorably overall.

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.

Pilot study: incorporation of pharmacogenetic testing in medication therapy management services.

PubMed

Haga, Susanne B; Allen LaPointe, Nancy M; Moaddeb, Jivan; Mills, Rachel; Patel, Mahesh; Kraus, William E

2014-11-01

Aim: To describe the rationale and design of a pilot study evaluating the integration of pharmacogenetic (PGx) testing into pharmacist-delivered medication therapy management (MTM). Study rationale: Clinical delivery approaches of PGx testing involving pharmacists may overcome barriers of limited physician knowledge about and experience with testing. Study design: We will assess the addition of PGx testing to MTM services for cardiology patients taking three or more medications including simvastatin or clopidogrel. We will measure the impact of MTM plus PGx testing on drug/dose adjustment and clinical outcomes. Factors associated with delivery, such as time to prepare and conduct MTM and consult with physicians will be recorded. Additionally, patient interest and satisfaction will be measured. Anticipated results: We anticipate that PGx testing can be practically integrated into standard a MTM service, providing a viable delivery model for testing. Conclusion: Given the lack of evidence of an effective PGx delivery models, this study will provide preliminary evidence regarding a pharmacist-delivered approach.

Towards a definition of orphaned and vulnerable children.

PubMed

Skinner, Donald; Tsheko, N; Mtero-Munyati, S; Segwabe, M; Chibatamoto, P; Mfecane, S; Chandiwana, B; Nkomo, N; Tlou, S; Chitiyo, G

2006-11-01

The HIV epidemic presents challenges including orphans and a large mass of children rendered vulnerable by the epidemic and other societal forces. Focus on orphaned and vulnerable children (OVC) is important, but needs accurate definition. Twelve focus group interviews of service providers, leaders in these communities, OVC and their caretakers were conducted at six project sites across Botswana, South Africa and Zimbabwe to extend this definition. The loss of a parent through death or desertion is an important aspect of vulnerability. Additional factors leading to vulnerability included severe chronic illness of a parent or caregiver, poverty, hunger, lack of access to services, inadequate clothing or shelter, overcrowding, deficient caretakers, and factors specific to the child, including disability, direct experience of physical or sexual violence, or severe chronic illness. Important questions raised in this research include the long-term implications for the child and community, and the contribution of culture systems.

Utilization of counseling services at one medical school.

PubMed

Chang, Elaine; Eddins-Folensbee, Florence; Porter, Ben; Coverdale, John

2013-08-01

The purpose of this study was to assess the usage of mental health counseling services by medical students. Medical students experience high rates of burnout, depression, and suicidal ideation. Our medical school (Baylor) provides free professional counseling services. The authors administered a survey that included a burnout scale; a depression screen; and questions about demographics, usage of counseling services, and helpful coping mechanisms for 526 first-through third-year students (336 respondents) at one school. Approximately 24% of students with high rates of burnout and 24% of students with depressive symptoms took advantage of counseling services at least once. Of the students who had not used counseling services, approximately 49% were found to have high rates of burnout in the domain of emotional exhaustion. Similarly, of the students who had not accessed counseling services, 56% had depressive symptoms. A large percentage of medical students across three classes did not use mental health counseling services provided by the school. Students should be clearly informed about the availability of counseling services and their potential utility. In addition, specific barriers to attendance should be identified and reduced.

75 FR 49481 - Procurement List; Additions and Deletion

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... added to the Procurement List: Services Service Type/Locations: Laundry Service, Atlanta VA Medical...: Additions to and deletion from the Procurement List. SUMMARY: This action adds services to the Procurement... disabilities and deletes a service from the Procurement List previously furnished by such agency. DATES...

Using AER to Improve Teacher Education

NASA Astrophysics Data System (ADS)

Ludwig, Randi R.

2013-06-01

In many ways, the astronomy education community is uniquely poised to influence pre-service and in-service teacher preparation. Astro101 courses are among those most commonly taken to satisfy general education requirements for non-science majors, including 9-25% education majors (Deming & Hufnagel, 2001; Rudolph et al. 2010). In addition, the astronomy community's numerous observatories and NASA centers engage in many efforts to satisfy demand for in-service teacher professional development (PD). These efforts represent a great laboratory in which we can apply conclusions from astronomy education research (AER) studies in particular and science education research (SER) in general. Foremost, we can work to align typical Astro101 and teacher PD content coverage to heavily hit topics in the Next Generation Science Standards (http://www.nextgenscience.org/) and utilize methods of teaching those topics that have been identified as successful in AER studies. Additionally, we can work to present teacher education using methodology that has been identified by the SER community as effective for lasting learning. In this presentation, I will highlight some of the big ideas from AER and SER that may be most useful in teacher education, many of which we implement at UT Austin in the Hands-on-Science program for pre-service teacher education and in-service teacher PD.

Engaging military parents in a home-based reintegration program: a consideration of strategies.

PubMed

Ross, Abigail M; DeVoe, Ellen R

2014-02-01

For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

Integration of antenatal care services with health programmes in low- and middle-income countries: systematic review.

PubMed

de Jongh, Thyra E; Gurol-Urganci, Ipek; Allen, Elizabeth; Zhu, Nina Jiayue; Atun, Rifat

2016-06-01

Antenatal care (ANC) presents a potentially valuable platform for integrated delivery of additional health services for pregnant women-services that are vital to reduce the persistently high rates of maternal and neonatal mortality in low- and middle-income countries (LMICs). However, there is limited evidence on the impact of integrating health services with ANC to guide policy. This review assesses the impact of integration of postnatal and other health services with ANC on health services uptake and utilisation, health outcomes and user experience of care in LMICs. Cochrane Library, MEDLINE, Embase, CINAHL Plus, POPLINE and Global Health were searched for studies that compared integrated models for delivery of postnatal and other health services with ANC to non-integrated models. Risk of bias of included studies was assessed using the Cochrane Effective Practice and Organisation of Care (EPOC) criteria and the Newcastle-Ottawa Scale, depending on the study design. Due to high heterogeneity no meta-analysis could be conducted. Results are presented narratively. 12 studies were included in the review. Limited evidence, with moderate- to high-risk of bias, suggests that integrated service delivery results in improved uptake of essential health services for women, earlier initiation of treatment, and better health outcomes. Women also reported improved satisfaction with integrated services. The reported evidence is largely based on non-randomised studies with poor generalizability, and therefore offers very limited policy guidance. More rigorously conducted and geographically diverse studies are needed to better ascertain and quantify the health and economic benefits of integrating health services with ANC.

Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service.

PubMed

Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee; Yoo, Sooyoung

2015-04-01

To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.

Korean American women's perceptions about physical examinations and cancer screening services offered in Korea: the influences of medical tourism on Korean Americans.

PubMed

Oh, Kyeung Mi; Jun, Jungmi; Zhou, Qiuping; Kreps, Gary

2014-04-01

Cancer is the leading cause of death for Korean-Americans (KAs), while cancer screening rates among KAs have been consistently low. Seven semi-structured focus group interviews with 34 KA women aged 40 or older in the Washington, DC metropolitan area were conducted to explore the perceptions of KA women about seeking physical examinations and cancer screening services in Korea. Data were analyzed using a framework approach. Informants positively perceived the use of health screening services in Korea in comparison to seeking such services in the US. Decision-making factors included cost benefits, high quality services, and more convenient screening procedures in Korea. These benefits outweighed the risks of delaying health care and travelling a vast distance with incurring additional travel costs. Motivations to seek these services in Korea included opportunities to visit their homeland and to enjoy comfortable communication with their native language. The increase of available information about Korean medical services due to the industry's aggressive marketing/PR was identified as a facilitator. Most informants did not recognize possible negative health outcomes of obtaining services in Korea such as inappropriate follow up care if having abnormal findings. Educational programs are needed to educate KAs about the benefits and risks of getting the services in Korea and proper follow up care in the US. Health care providers need to know the different cancer risks and screening needs for this population.

Next Generation Highly Conducting Organic Films Using Novel Donor-Acceptor Molecules for Opto-electronic Applications

DTIC Science & Technology

2010-06-01

addition, a new class of donor molecules was invented in the course of the DRI program. 2.1 Polymer Based Donor-acceptor Material The following work by...average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information

Effective/efficient mental health programs for school-age children: a synthesis of reviews.

PubMed

Browne, Gina; Gafni, Amiram; Roberts, Jacqueline; Byrne, Carolyn; Majumdar, Basanti

2004-04-01

The prevalence of mental health problems, some of which seem to be occurring among younger cohorts, leads researchers and policy-makers to search for practical solutions to reduce the burden of suffering on children and their families, and the costs to society both immediate and long term. Numerous programs are in place to reduce or alleviate problem behaviour or disorders and/or assist positive youth development. Evaluated results are dispersed throughout the literature. To assess findings and determine common elements of effective children's services, a literature search was undertaken for evidence-based evaluations of non-clinical programs for school-age children. Prescriptive comments aim to inform service-providers, policy-makers and families about best practices for effective services such as: early, long-term intervention including reinforcement, follow-up and an ecological focus with family and community sector involvement; consistent adult staffing; and interactive, non-didactic programming adapted to gender, age and cultural needs. Gaps are identified in our understanding of efficiencies that result from effective programs. Policy implications include the need to develop strategies for intersectoral interventions, including: new financing arrangements to encourage (not penalize) interagency cooperation and, to ensure services reach appropriate segments of the population; replication of best practices; and publicizing information about benefits and cost savings. In many jurisdictions legislative changes could create incentives for services to collaborate on service delivery. Joint decision-making would require intersectoral governance, pooling of some funding, and policy changes to retain savings at the local level. Savings could finance expansion of services for additional youth.

Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

PubMed Central

Mold, Freda; de Lusignan, Simon

2015-01-01

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

PubMed

Mold, Freda; de Lusignan, Simon

2015-12-04

Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

Evaluating a Special Education Training Programme in Nicaragua

ERIC Educational Resources Information Center

Delkamiller, Julie; Swain, Kristine D.; Ritzman, Mitzi J.; Leader-Janssen, Elizabeth M.

2016-01-01

This study examined a two-year special education and inclusive practices in-service training programme with a university in Nicaragua. Participants included 14 teachers from nine schools in Nicaragua. Participants' knowledge of special education concepts were evaluated as part of assessing the training modules. In addition, programme evaluation…

34 CFR 412.30 - What additional activities must be carried out by Curriculum Coordination Centers?

Code of Federal Regulations, 2010 CFR

2010-07-01

... activities: (a) Assist States in the development, adaptation, adoption, dissemination, and use of curriculum materials and services and other information resulting from research and development activities carried out under the Act, including performing these activities during at least two regional meetings involving...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2012 CFR

2012-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2014 CFR

2014-01-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

36 CFR 1290.3 - Sources of assassination records and additional records and information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... service with a government agency, office, or entity; (f) Persons, including individuals and corporations... Government; (b) Agencies, offices, and entities of the executive, legislative, and judicial branches of state and local governments; (c) Record repositories and archives of Federal, state, and local governments...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

76 FR 18737 - Defense Transportation Regulation, Part IV

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... III business rules include the elimination of the Domestic and International Local Move (dLM and iLM) and Intra-Country Move (iCM) Tender of Service. Requirements for Domestic Local Moves (dLM) can be met...'' and the 400NG solicitation. In addition, Phase III development efforts will incorporate International...

Cuba: U.S. Restrictions on Travel and Remittances

DTIC Science & Technology

2008-07-30

Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one of the largest licensed travel agencies, booking some 300 to 500 passengers...Cuba.20 In addition to La Estrella de Cuba, OFAC suspended the service activities of several other companies in 2006, including Baby Envios Travel

Cuba: U.S. Restrictions on Travel and Remittances

DTIC Science & Technology

2008-09-28

travel agency, La Estrella de Cuba, from booking travel to Cuba. The agency reportedly was one of the largest licensed travel agencies, booking some...that do business with Cuba.20 In addition to La Estrella de Cuba, OFAC suspended the service activities of several other companies in 2006, including

An Empirical Examination of Toddler Development in Inclusive Childcare

ERIC Educational Resources Information Center

Stahmer, Aubyn C.; Carter, Cynthia

2005-01-01

An increasing number of families are enrolling their children in out-of-home early childcare services. In addition, a growing number of community childcare programs are including children with developmental disabilities. While some studies have explored the effects of inclusion for preschool children with disabilities, there is little knowledge…

75 FR 42460 - Minor Boundary Revision at Lewis and Clark National Historical Park

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... DEPARTMENT OF THE INTERIOR National Park Service Minor Boundary Revision at Lewis and Clark... Clark National Historical Park is modified to include an additional 106.74+/- acres of land identified..., Oregon, immediately adjacent to the southern boundary of the Sunset Beach portion of Lewis and Clark...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

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

7 CFR 226.16 - Sponsoring organization provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

....16 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... regulations. In addition to the information required in §§ 226.6(b) and 226.6(f), the application must include... applying for initial participation on or after June 20, 2000, if required by State law, regulation, or...

7 CFR 226.16 - Sponsoring organization provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

....16 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... regulations. In addition to the information required in §§ 226.6(b) and 226.6(f), the application must include... applying for initial participation on or after June 20, 2000, if required by State law, regulation, or...

7 CFR 226.16 - Sponsoring organization provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

....16 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE... regulations. In addition to the information required in §§ 226.6(b) and 226.6(f), the application must include... applying for initial participation on or after June 20, 2000, if required by State law, regulation, or...

41 CFR 102-85.115 - How is the Rent determined?

Code of Federal Regulations, 2010 CFR

2010-07-01

... owned space provided by GSA is based on market appraisals of fully serviced rental values for the..., and security charges are calculated separately and added to the appraised shell Rent to establish the... addition to the shell Rent, the Rent includes amortization of TI allowances used, real estate taxes...

41 CFR 102-85.115 - How is the Rent determined?

Code of Federal Regulations, 2013 CFR

2013-07-01

... owned space provided by GSA is based on market appraisals of fully serviced rental values for the..., and security charges are calculated separately and added to the appraised shell Rent to establish the... addition to the shell Rent, the Rent includes amortization of TI allowances used, real estate taxes...

41 CFR 102-85.115 - How is the Rent determined?

Code of Federal Regulations, 2014 CFR

2014-01-01

... owned space provided by GSA is based on market appraisals of fully serviced rental values for the..., and security charges are calculated separately and added to the appraised shell Rent to establish the... addition to the shell Rent, the Rent includes amortization of TI allowances used, real estate taxes...

Survey of State Library Agencies, 1977.

ERIC Educational Resources Information Center

Wilkins, Barratt

This report is a collection of statistical tables whose data were derived from a survey of state library agencies about activities during fiscal year 1977. Subject matter of the tables includes (1) location of state library agencies within state government departments; (2) services administered; library material collections, and additions to these…

Incorporating SAT® Writing into Admission and Placement Decisions

ERIC Educational Resources Information Center

Shaw, Emily

2010-01-01

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

41 CFR 102-85.55 - What are the terms and conditions included in an OA?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING... used; (d) Operating costs and escalations; (e) One time charges; e.g., lump sum payments by the customer; (f) Real estate tax and escalations; (g) Parking and escalations; (h) Additional/reduced services...

Assessing Young Children in Inclusive Settings: The Blended Practices Approach

ERIC Educational Resources Information Center

Grisham-Brown, Jennifer; Pretti-Frontczak, Kristie

2011-01-01

To ensure the best possible outcomes for young children with and without disabilities, early childhood educators must enter the classroom ready to conduct all types of early childhood assessment--including determining if children need additional services, planning and monitoring instruction, and determining program effectiveness. They'll get the…

76 FR 34676 - Applications for New Awards; Gaining Early Awareness and Readiness for Undergraduate Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... participating in programs, such as GEAR UP, that offer additional services designed to increase student success... warning indicator systems designed to prevent students from dropping out. Competitive Preference Priority... low-income students, including students with disabilities, need to enable them to obtain a secondary...

The Continental Margins Program in Georgia

USGS Publications Warehouse

Cocker, M.D.; Shapiro, E.A.

1999-01-01

From 1984 to 1993, the Georgia Geologic Survey (GGS) participated in the Minerals Management Service-funded Continental Margins Program. Geological and geophysical data acquisition focused on offshore stratigraphic framework studies, phosphate-bearing Miocene-age strata, distribution of heavy minerals, near-surface alternative sources of groundwater, and development of a PC-based Coastal Geographic Information System (GIS). Seven GGS publications document results of those investigations. In addition to those publications, direct benefits of the GGS's participation include an impetus to the GGS's investigations of economic minerals on the Georgia coast, establishment of a GIS that includes computer hardware and software, and seeds for additional investigations through the information and training acquired as a result of the Continental Margins Program. These addtional investigations are quite varied in scope, and many were made possible because of GIS expertise gained as a result of the Continental Margins Program. Future investigations will also reap the benefits of the Continental Margins Program.From 1984 to 1993, the Georgia Geologic Survey (GGS) participated in the Minerals Management Service-funded Continental Margins Program. Geological and geophysical data acquisition focused on offshore stratigraphic framework studies, phosphate-bearing Miocene-age strata, distribution of heavy minerals, near-surface alternative sources of groundwater, and development of a PC-based Coastal Geographic Information System (GIS). Seven GGS publications document results of those investigations. In addition to those publications, direct benefits of the GGS's participation include an impetus to the GGS's investigations of economic minerals on the Georgia coast, establishment of a GIS that includes computer hardware and software, and seeds for additional investigations through the information and training acquired as a result of the Continental Margins Program. These additional investigations are quite varied in scope, and many were made possible because of GIS expertise gained as a result of the Continental Margins Program. Future investigations will also reap the benefits of the Continental Margins Program.

Advancing the role of the pharmacy technician: A systematic review.

PubMed

Mattingly, Ashlee N; Mattingly, T Joseph

To summarize the findings of a literature search on advancing the role of pharmacy technicians, including the types of training identified and the potential costs and benefits to both the technician and the pharmacy. A literature search of Scopus, Embase, and Medline was conducted on January 11, 2017. Original research, research reports, case studies, or association reports were included for review. Articles were considered to be relevant based on identification of an advanced pharmacy technician role or addressing additional training/education for technician functions. A standard data extraction form was used to collect study authors, article title, year published, journal title, study design, brief description of methods, primary outcome measures, advanced technician roles identified, additional education or training addressed, and additional costs and benefits identified in each article. A total of 33 articles were included for full review and data extraction. Study design varied, with 17 (52%) quantitative, 1 (3%) qualitative, 5 (15%) mixed-method, and 10 (30%) case study designs. Seventeen (52%) of the studies included were published after 2006. The mechanism of training was primarily through supervised on-the-job training, allowing technicians to assume administrative-based positions that facilitated a pharmacist-led clinical service, with either the pharmacist or the pharmacy receiving the greatest benefits. Although the literature supports technicians performing advanced roles in the pharmacy, resulting in either improved patient outcomes or opportunities for pharmacists to engage in additional clinical services, the benefits to the technician were primarily indirect, such as an increase in job satisfaction or a more desirable work schedule. If a technician is to take on additional roles that require completion of a formalized training or educational program, benefits that are more tangible may help to inspire technicians to pursue these roles. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

75 FR 7634 - New Postal Product

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-22

... public that the Postal Service has filed a request to add International Business Reply Service... entered into two additional International Business Reply Service (IBRS) Contracts.\\1\\ Additionally, the... to Establish Successor Instruments as Baseline International Business Reply Service Competitive...

Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: economic outcomes.

PubMed

Barrett, Barbara; Waheed, Waquas; Farrelly, Simone; Birchwood, Max; Dunn, Graham; Flach, Clare; Henderson, Claire; Leese, Morven; Lester, Helen; Marshall, Max; Rose, Diana; Sutherby, Kim; Szmukler, George; Thornicroft, Graham; Byford, Sarah

2013-01-01

Compulsory admission to psychiatric hospitals may be distressing, disruptive to patients and families, and associated with considerable cost to the health service. Improved patient experience and cost reductions could be realised by providing cost-effective crisis planning services. Economic evaluation within a multi-centre randomised controlled trial comparing Joint Crisis Plans (JCP) plus treatment as usual (TAU) to TAU alone for patients aged over 16, with at least one psychiatric hospital admission in the previous two years and on the Enhanced Care Programme Approach register. JCPs, containing the patient's treatment preferences for any future psychiatric emergency, are a form of crisis intervention that aim to mitigate the negative consequences of relapse, including hospital admission and use of coercion. Data were collected at baseline and 18-months after randomisation. The primary outcome was admission to hospital under the Mental Health Act. The economic evaluation took a service perspective (health, social care and criminal justice services) and a societal perspective (additionally including criminal activity and productivity losses). The addition of JCPs to TAU had no significant effect on compulsory admissions or total societal cost per participant over 18-months follow-up. From the service cost perspective, however, evidence suggests a higher probability (80%) of JCPs being the more cost-effective option. Exploration by ethnic group highlights distinct patterns of costs and effects. Whilst the evidence does not support the cost-effectiveness of JCPs for White or Asian ethnic groups, there is at least a 90% probability of the JCP intervention being the more cost-effective option in the Black ethnic group. The results by ethnic group are sufficiently striking to warrant further investigation into the potential for patient gain from JCPs among black patient groups. Current Controlled Trials ISRCTN11501328.

Intelligent device management in the selfcare marketplace.

PubMed

Biniaris, Christos G; Marsh, Andrew J

2008-01-01

Over the last ten years the Internet has emerged as a key infrastructure for service innovation, enabling IP (Internet Protocol) to become the wide area network communication protocol of choice. The natural result of this choice is that service providers and their customers are looking for ways to optimise costs by migrating existing services and applications onto IP as well. A good example is the medical industry, which is transitioning to Internet-based communications as the field of telemedicine broadens to preventative and self healthcare. However, technology is changing quickly and consumers face an array of choices to satisfy their healthcare needs with numerous devices from different vendors. Seamless healthcare device networking can play a major role in automating and safeguarding the process of collecting and transferring medical data, remote patient monitoring and reducing costs through remote equipment monitoring. In this scope, we describe an approach augmenting the Session Initiation Protocol (SIP) with healthcare services in order to form a framework for efficient collection and storage of measurements, aiming to address the issues of the lack of a standardised data interface for consumer healthcare technologies (including hardware and protocols) and the lack of a standardised format for self-collected healthcare data (including the storage medium). In this framework, measurements can be seamlessly collected and stored as XML notes located virtually anywhere, such as the user's home or mobile device. Additionally, these notes can be accessed locally or remotely by doctors and specialists. Also, we discuss how this approach supports user mobility by proxying and redirecting requests to the user's current location and how it can remove the complexity of using consumer healthcare technologies from different vendors connected to different devices and the opportunities for Independent Software Vendors to develop additional services.

Age Cohort and Health Service Utilization Among Gay Men.

PubMed

Green, Daniel C; Goldbach, Jeremy T; Raymond, Henry F

2018-05-01

Gay men report unique health disparities and service utilization trends compared to their heterosexual peers including a lack of health-care participation which may lead to chronic health conditions. Limited research has been conducted analyzing group differences among gay men such as the influence of one's age cohort on disparities. The aim of this study was to examine the association age cohort has on health service utilization among gay men. A sample of 383 self-identified gay men was collected by the San Francisco Department of Public Health. Older men were less likely to have visited a medical provider in the past 12 months compared to middle-aged men (OR = 0.10; 95% CI [2.47, 39.8]) and younger men (OR = 0.35; 95% CI [1.28, 10.42]). However, older men were more likely to have a usual source of medical care compared to younger men (OR = 4.0; 95% CI [.05, .84]). Age cohort differences in health-care service utilization appear to exist among gay men. This study highlights additional areas for exploration including the impact HIV and socioeconomic status have on health-seeking behavior and health service utilization.

Pregnant adolescents living with HIV: what we know, what we need to know, where we need to go.

PubMed

Callahan, Tegan; Modi, Surbhi; Swanson, Jennifer; Ng'eno, Bernadette; Broyles, Laura N

2017-08-04

HIV-infected pregnant and breastfeeding adolescents are a particularly vulnerable group that require special attention and enhanced support to achieve optimal maternal and infant outcomes. The objective of this paper is to review published evidence about antenatal care (ANC) service delivery and outcomes for HIV-infected pregnant adolescents in low-income country settings, identify gaps in knowledge and programme services and highlight the way forward to improve clinical outcomes of this vulnerable group. Emerging data from programmes in sub-Saharan Africa highlight that HIV-infected pregnant adolescents have poorer prevention of mother-to-child HIV transmission (PMTCT) service outcomes, including lower PMTCT service uptake, compared to HIV-infected pregnant adults. In addition, the limited evidence available suggests that there may be higher rates of mother-to-child HIV transmission among infants of HIV-infected pregnant adolescents. While the reasons for the inferior outcomes among adolescents in ANC need to be further explored and addressed, there is sufficient evidence that immediate operational changes are needed to address the unique needs of this population. Such changes could include integration of adolescent-friendly services into PMTCT settings or targeting HIV-infected pregnant adolescents with enhanced retention and follow-up activities.

Role of the employee assistance program in helping the troubled worker.

PubMed

Fitzgerald, S T; Hammond, S C; Harder, K A

1989-01-01

The worksite has been identified as the most logical setting for providing primary preventive health care efforts that will reduce health care costs. Hazeldon Research Services in their review entitled, "The Cost-Impact of Employee Assistance and Chemical Dependency Treatment Programs," concluded that a significant savings for organizations has been demonstrated by EAP treatment programs. This group also concluded that work remains for service providers, the community, industry, and government to identify the balance between reasonable costs and quality of care. Roman has found that EAPs are becoming more acceptable to management as a means of addressing a broad range of employee problems. In addition, Roman has found that there is recognition by management that many employees have problems that affect job performance. Such problems may include substance abuse, relationship difficulties, absenteeism, and burnout. EAP services have evolved from occupational alcoholism programs to include a broad array of services, and they can be scaled to fit the size and needs of a particular company. Even if only limited services are offered, the EAP must adhere to high standards. Competent employee evaluation and appropriate referrals are necessary in EAPs with even the smallest of scopes.

Inequalities in use of health services among Jews and Arabs in Israel.

PubMed

Baron-Epel, Orna; Garty, Noga; Green, Manfred S

2007-06-01

To compare the levels of utilization of health services in Jews and Arabs taking into account differences in levels of socioeconomic status (SES) in a country with a National Health Insurance Law (NHIL). A cross-sectional National Health Interview Survey was carried out in Israel based on a random sample of telephone numbers as part of the EUROHIS project (WHO European Health Interview Survey 2003-2004). A random telephone survey included 9,352 interviews. Questions included use of health care services, health status, and socioeconomic variables. After adjusting for sex, age, income, education, marital status, and self-reported chronic diseases, Arabs more often reported visiting a family physician (odds ratio [OR]=1.56, 95 percent confidence interval [CI]=1.35-1.81) and less often reported visiting a specialist (OR=0.73, 95 percent CI=0.60-0.89) compared with Jews. In addition, the odds ratio for hospitalization was similar among Arabs and Jews (OR=1.16, 95 percent CI=0.97-1.38). SES was associated with utilization of health care services only in the Jewish population. A different pattern of utilization of health care services was observed in Arabs and Jews. This was not explained by differences in socioeconomic levels. More research is needed regarding the distribution of services between Jews and Arabs.

Equity inthe use of dental services provided by the Brazilian Unified Health System (SUS) among the elderly: a population-based study.

PubMed

Oliveira, Renata Francine Rodrigues de; Souza, João Gabriel Silva; Haikal, Desireé Sant'Ana; Ferreira, Efigênia Ferreira E; Martins, Andréa Maria Eleutério de Barros Lima

2016-11-01

The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

Improving the interface between informal carers and formal health and social services: a qualitative study.

PubMed

McPherson, K M; Kayes, N K; Moloczij, N; Cummins, C

2014-03-01

Reports about the impact of caring vary widely, but a consistent finding is that the role is influenced (for better or worse) by how formal services respond to, and work with informal carers and of course the cared for person. We aimed to explore the connection between informal and formal cares and identify how a positive connection or interface might be developed and maintained. We undertook a qualitative descriptive study with focus groups and individual interviews with informal carers, formal care service providers and representatives from carer advocacy groups. Content analysis was used to identify key factors impacting on the interface between informal and formal carers and propose specific recommendations for service development. Community setting including urban and rural areas of New Zealand. Seventy participants (the majority informal carers) took part in 13 focus groups and 22 individual interviews. Four key themes were derived: Quality of care for the care recipient; Knowledge exchange (valuing carer perspectives); One size does not fit all (creating flexible services); and A constant struggle (reducing the burden services add). An optimum interface to address these key areas was proposed. In addition to ensuring quality care for the care recipient, specific structures and processes to support a more positive interface appear warranted if informal carers and services are to work well together. An approach recognising the caring context and carer expertise may decrease the additional burden services contribute, and reduce conflicting information and resultant confusion and/or frustration many carers experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

Motion Imagery and Robotics Application (MIRA)

NASA Technical Reports Server (NTRS)

Martinez, Lindolfo; Rich, Thomas

2011-01-01

Objectives include: I. Prototype a camera service leveraging the CCSDS Integrated protocol stack (MIRA/SM&C/AMS/DTN): a) CCSDS MIRA Service (New). b) Spacecraft Monitor and Control (SM&C). c) Asynchronous Messaging Service (AMS). d) Delay/Disruption Tolerant Networking (DTN). II. Additional MIRA Objectives: a) Demo of Camera Control through ISS using CCSDS protocol stack (Berlin, May 2011). b) Verify that the CCSDS standards stack can provide end-to-end space camera services across ground and space environments. c) Test interoperability of various CCSDS protocol standards. d) Identify overlaps in the design and implementations of the CCSDS protocol standards. e) Identify software incompatibilities in the CCSDS stack interfaces. f) Provide redlines to the SM&C, AMS, and DTN working groups. d) Enable the CCSDS MIRA service for potential use in ISS Kibo camera commanding. e) Assist in long-term evolution of this entire group of CCSDS standards to TRL 6 or greater.

An estimation of the cost per visit of nursing home care services.

PubMed

Ryu, Ho-Sihn

2009-01-01

Procedures used for analyzing the cost of providing home care nursing services through hospital-based home care agencies (HCAs) was the focus of this study. A cross-sectional descriptive study design was used to analyze the workload and caseload of 36 home care nurses from ten HCAs. In addition, information obtained from a national health insurance database, including 54,639 home care claim cases from a total of 185 HCAs during a 6-month period, were analyzed. The findings provide a foundation for improving the alternative home care billing and reimbursement system by using the actual amount of time invested in providing home care when calculating the cost of providing home care nursing services. Further, this study provides a procedure for calculating nursing service costs by analyzing actual data. The results have great potential for use in nursing service cost analysis methodology, which is an essential step in developing a policy for providing home care.

The Quality of Work in the Belgian Service Voucher System.

PubMed

Mousaid, Sarah; Huegaerts, Kelly; Bosmans, Kim; Julià, Mireia; Benach, Joan; Vanroelen, Christophe

2017-01-01

Several European countries implemented initiatives to boost the growth of the domestic cleaning sector. Few studies investigated the quality of work in these initiatives, although effects on workers' health and on social health inequalities can be expected. This study contributes to the scant research on this subject, by investigating the quality of work in the Belgian service voucher system - a subsidized system for domestic work. The applied research methodology includes a qualitative content analysis of parliamentary debates, legislation and previous research about the service voucher system and of 40 in-depth interviews with service voucher workers. The study shows that the legal framework that regulates the system must be further enhanced in order to improve the quality of work in the service voucher system. In addition, the actors involved must be better controlled, and sanctioned in case of non-compliance with legislation. © The Author(s) 2016.

Access to Health Care Services among Young People Exchanging Sex in Detroit.

PubMed

Knittel, Andrea K; Graham, Louis F; Peterson, Jerry; Lopez, William; Snow, Rachel C

2018-04-05

Within the related epidemics of sex exchange, drug use, and poverty, access to health care is shaped by intersecting identities, policy, and infrastructure. This study uses a unique survey sample of young adults in Detroit, who are exchanging sex on the street, in strip clubs, and at after-hours parties and other social clubs. Factors predicting access to free or affordable health care services, such as venue, patterns of sexual exchange influence, drug use and access to transportation, were examined using multivariable logistic regression and qualitative comparative analysis. The most significant predictors of low access to health care services were unstable housing and lack of access to reliable transportation. In addition, working on the street was associated with decreased access to services. Coordinated policy and programming changes are needed to increase health care access to this group, including improved access to transportation, housing, and employment, and integration of health care services.

EnviroAtlas - Recreation, Culture, and Aesthetics Metrics for Conterminous United States

EPA Pesticide Factsheets

This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). The Recreation, Culture, and Aesthetics category in this web service includes layers illustrating the ecosystems and natural resources that provide inherent cultural and aesthetic value or recreation opportunity, the need or demand for these amenities, the impacts associated with their presence and accessibility, and factors that place stress on the natural environment's capability to provide these benefits. EnviroAtlas allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the conterminous United States. Additional descriptive information about each attribute in this web service is located within each web service layer (see Full Metadata hyperlink) or can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

What is the role of e-technology in mental health services and psychiatric research?

PubMed

Cleary, Michelle; Walter, Garry; Matheson, Sandra

2008-04-01

In this article, the role of e-technology is explored, with an emphasis on the advantages and disadvantages of its use for health care and mental health research. E-technology is broadly understood to include the Internet and related information technologies, and in recent years, its use has grown rapidly. The Internet is a major source of health information, and there is potential to deliver enhanced services through this medium. In addition, e-technology's role in future mental health service delivery and research will continue to expand as increased numbers of consumers, caregivers, health professionals, and the general population go online, particularly as the technology is refined and made even more user friendly.

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

PubMed

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

2018-01-01

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

5 CFR 3101.111 - Additional rules for United States Secret Service employees. [Reserved

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...

5 CFR 3101.111 - Additional rules for United States Secret Service employees. [Reserved

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...

5 CFR 3101.111 - Additional rules for United States Secret Service employees. [Reserved

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...

5 CFR 3101.111 - Additional rules for United States Secret Service employees. [Reserved

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...

5 CFR 3101.111 - Additional rules for United States Secret Service employees. [Reserved

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Additional rules for United States Secret Service employees. [Reserved] 3101.111 Section 3101.111 Administrative Personnel DEPARTMENT OF THE....111 Additional rules for United States Secret Service employees. [Reserved] ...

47 CFR 22.719 - Additional channel policy for rural radiotelephone stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Additional channel policy for rural radiotelephone stations. 22.719 Section 22.719 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.719 Additional channel...

47 CFR 22.719 - Additional channel policy for rural radiotelephone stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Additional channel policy for rural radiotelephone stations. 22.719 Section 22.719 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.719 Additional channel...

47 CFR 22.719 - Additional channel policy for rural radiotelephone stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Additional channel policy for rural radiotelephone stations. 22.719 Section 22.719 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.719 Additional channel...

42 CFR 66.115 - Additional conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Additional conditions. 66.115 Section 66.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.115 Additional conditions. The Secretary may with...

42 CFR 66.115 - Additional conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Additional conditions. 66.115 Section 66.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.115 Additional conditions. The Secretary may with...

42 CFR 66.115 - Additional conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Additional conditions. 66.115 Section 66.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES FELLOWSHIPS, INTERNSHIPS, TRAINING NATIONAL RESEARCH SERVICE AWARDS Direct Awards § 66.115 Additional conditions. The Secretary may with...

OCLC for the hospital library: the justification plan for hospital administration.

PubMed

Allen, C W; Branson, J R

1982-07-01

This paper delineates the necessary steps to provide hospital administrators with the information needed to evaluate an automated system, OCLC, for addition to the medical library. Based on experience at the Norton-Children's Hospitals, included are: (1) cost analyses of present technical processing systems and cost comparisons with OCLC; (2) delineation of start-up costs for installing OCLC; (3) budgetary requirements for 1981; (4) the impact of automation on library systems, personnel, and services; (5) potential as a shared service; and (6) preparation of the proposal for administrative review.

OCLC for the hospital library: the justification plan for hospital administration.

PubMed Central

Allen, C W; Branson, J R

1982-01-01

This paper delineates the necessary steps to provide hospital administrators with the information needed to evaluate an automated system, OCLC, for addition to the medical library. Based on experience at the Norton-Children's Hospitals, included are: (1) cost analyses of present technical processing systems and cost comparisons with OCLC; (2) delineation of start-up costs for installing OCLC; (3) budgetary requirements for 1981; (4) the impact of automation on library systems, personnel, and services; (5) potential as a shared service; and (6) preparation of the proposal for administrative review. PMID:7116018

The Virtual Solar Observatory: Progress and Diversions

NASA Astrophysics Data System (ADS)

Gurman, Joseph B.; Bogart, R. S.; Amezcua, A.; Hill, Frank; Oien, Niles; Davey, Alisdair R.; Hourcle, Joseph; Mansky, E.; Spencer, Jennifer L.

2017-08-01

The Virtual Solar Observatory (VSO) is a known and useful method for identifying and accessing solar physics data online. We review current "behind the scenes" work on the VSO, including the addition of new data providers and the return of access to data sets to which service was temporarily interrupted. We also report on the effect on software development efforts when government IT “security” initiatives impinge on finite resoruces. As always, we invite SPD members to identify data sets, services, and interfaces they would like to see implemented in the VSO.

Responding to the health and rehabilitation needs of people with disabilities post-Haiyan

PubMed Central

Kleinitz, Pauline; Calina, Liezel; Alcido, Ma Rowena; Gohy, Bérengère; Hall, Julie Lyn

2015-01-01

Introduction It is estimated that 15% of the world’s population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. Method A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Results Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Discussion Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters. PMID:26767137

Responding to the health and rehabilitation needs of people with disabilities post-Haiyan.

PubMed

Benigno, Mylene Rose; Kleinitz, Pauline; Calina, Liezel; Alcido, Ma Rowena; Gohy, Bérengère; Hall, Julie Lyn

2015-01-01

It is estimated that 15% of the world's population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters.

A method for studying the development pattern of urban commercial service facilities based on customer reviews from social media

NASA Astrophysics Data System (ADS)

Wang, Y. D.; Jiang, B. T.; Ye, X. Y.

2016-06-01

Urbanization is one of the most important human social activities in the 21st century (Chaolin et al., 2012). With an increasing number of people visiting cities, the provision of adequate urban service facilities, including public and commercial service facilities, in locations where people live has become an important guarantee of the success of urbanization. Exploring the commercial service facilities in a specific area of a city can help us understand the progress and trends of urban renewal in the area, provide a quantitative basis for evaluating the rationality of planning implementation, and facilitate an analysis of the effects of different factors on the regional development of a city (Schor et al. 2003). In this paper, we proposed a data processing and analysis method for studying the distribution and development pattern of urban commercial facilities based on customer reviews. In addition, based on road network constraints, we explored the patterns contained in customer reviews data, including patterns for the spatial distribution and spatial-temporal evolution of facilities as well as the number of facilities and degree of satisfaction.

Assessing Service Delivery Systems for Assitive Technology in Brazil using HEART Study quality indicators.

PubMed

Maximo, Tulio; Clift, Laurence

2015-01-01

recently in Brazil, there have been investments and improvements in the service delivery system for assistive technology provision. However, there is little documentation of this process, or evidence that users are being involved appropriately. to understand how a ssistive technology service provision currently functions in Belo Horizonte city, Brazil, in order to provide context-specific interventions and recommendations to improve services. Qualitative research design, including visits to key institutions and semi-structured interviews with key stakeholders. Interview questions were divided with two purposes: 1) Exploratory, aiming to understand present service functioning; 2) Evaluative, aiming to assess staff difficulties in applying best existing best practices. Assistive Technology services in Belo Horizonte fall under the 'medical model' definition of service delivery developed by AAATE. It was also found that staff lack training and knowledge support to assess user requirements and involve them during the decision process. Additionally, there is no follow up stage after the device is delivered. The study clearly defines the service provision function and the staff difficulties at Belo Horizonte city, providing information for further studies.

75 FR 78939 - Senior Community Service Employment Program; Notice of Proposed Rulemaking, Additional Indicator...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

... Community Service Employment Program; Notice of Proposed Rulemaking, Additional Indicator on Volunteer Work... Senior Community Service Employment Program (SCSEP), Additional Indicator on Volunteer Work that was... number of exiting participants who enter volunteer work. The relevant Office of Management and Budget...

Australian nurses in general practice, enabling the provision of cervical screening and well women’s health care services: a qualitative study

PubMed Central

2012-01-01

Background The role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area. Methods A number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints. Results Four enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers. Conclusions The influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider’s role will be fundamental to comprehensive service delivery in the future. PMID:23145901

Free Legal Services - Attracting Legal Talent for Public Involvement Groups

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

Domby, A.H.

This paper reviews the public service responsibilities of lawyers, and how they can fulfill the annual goal of performing pro bono services by serving certain public involvement groups, including organization involved in Constitutional issues and environmental protection matters. Public involvement groups should consider their needs for legal services and consider soliciting lawyers to serve on their boards or to volunteer legal services which will assist those lawyers in fulfilling their professional obligations under Rules of Professional Conduct. The group should identify specific activities and tasks that require the skills and training of a lawyer, including corporate governance issues; conflict-of-interest questions;more » the statutory construction of laws, regulations and ordinances; or analysis of potential liability. The addition of a lawyer to advisory boards for governmental agencies and for non-profit boards of charitable, religious, civic, community, environmental and educational organizations may provide those boards with knowledge, analytical approaches and insights that complement the abilities of other board members. Rules of Professional Conduct applicable to lawyers include admonitions for lawyers to provide 'Public Service'. Representative of many rules, the American Bar Association Model Rule 6.1, entitled 'Voluntary Pro Bono Publico Service' addresses every lawyer's professional responsibility to provide legal services to those 'unable to pay'. This Model Rule exhorts each lawyer to provide fifty (50) hours of legal services without fee or expectation of fee to persons of limited means or charitable, religious or civic, community, governmental and educational organizations or to individuals, groups or organizations seeking 'to secure or protect civil rights, civil liberties, or public rights, or charitable, religious, civic, community, governmental and educational organizations in matters in furtherance of their purposes, where the payment of standard legal fees would significantly deplete the organisation's economic resources'. This Public Service rule sets forth a goal that lawyers should aspire to meet; the rule is without disciplinary penalties for its violation. (authors)« less

A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia.

PubMed

Psaila, Kim; Fowler, Cathrine; Kruske, Sue; Schmied, Virginia

2014-12-01

The transition of care (ToC) from maternity services, particularly from midwifery care to child and family health (CFH) nursing services, is a critical time in the support of women as they transition into early parenting. However significant issues in service provision exist, particularly meeting the needs of women with social and emotional health risk factors. These include insufficient resources, poor communication and information transfer, limited interface between private and public health systems and tension around role boundaries. In response some services are implementing strategies to improve the transition of care from maternity to CFH services. This paper describes a range of innovations developed to improve transition of care between maternity and child and family health services and identifies the characteristics common to all innovations. Data reported were collected in phase three of a mixed methods study investigating the feasibility of implementing a national approach to child and family health services in Australia (CHoRUS study). Data were collected from 33 professionals including midwives, child and family health nurses, allied health staff and managers, at seven sites across four Australian states. Data were analysed thematically, guided by Braun and Clarke's six-step process of thematic analysis. The range of innovations implemented included those which addressed; information sharing, the efficient use of funding and resources, development of new roles to improve co-ordination of care, the co-location of services and working together. Four of the seven sites implemented innovations that specifically targeted families with additional needs. Successful implementation was dependent on the preliminary work undertaken which required professionals and/or organisations to work collaboratively. Improving the transition of care requires co-ordination and collaboration to ensure families are adequately supported. Collaboration between professionals and services facilitated innovative practice and was core to successful change. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Higher levels of multiple ecosystem services are found in forests with more tree species

PubMed Central

Gamfeldt, Lars; Snäll, Tord; Bagchi, Robert; Jonsson, Micael; Gustafsson, Lena; Kjellander, Petter; Ruiz-Jaen, María C.; Fröberg, Mats; Stendahl, Johan; Philipson, Christopher D.; Mikusiński, Grzegorz; Andersson, Erik; Westerlund, Bertil; Andrén, Henrik; Moberg, Fredrik; Moen, Jon; Bengtsson, Jan

2013-01-01

Forests are of major importance to human society, contributing several crucial ecosystem services. Biodiversity is suggested to positively influence multiple services but evidence from natural systems at scales relevant to management is scarce. Here, across a scale of 400,000 km2, we report that tree species richness in production forests shows positive to positively hump-shaped relationships with multiple ecosystem services. These include production of tree biomass, soil carbon storage, berry production and game production potential. For example, biomass production was approximately 50% greater with five than with one tree species. In addition, we show positive relationships between tree species richness and proxies for other biodiversity components. Importantly, no single tree species was able to promote all services, and some services were negatively correlated to each other. Management of production forests will therefore benefit from considering multiple tree species to sustain the full range of benefits that the society obtains from forests. PMID:23299890

Financing nutrition services in a competitive market.

PubMed

Egan, M C; Kaufman, M

1985-02-01

Budget deficits and inflationary medical care costs threaten nutrition services, which until recently have been funded largely by federal, state, and local revenues. Nutritionists and dietitians responding to demands in the marketplace should develop innovative programs and pursue new sources for financing through the private sector, third-party payers, business/industry health promotion, and consumer fees for their services, as well as targeted federal, state, and locally funded food assistance, nutrition education, and health care programs. Trail-blazing dietitians are successfully offering their services in health maintenance organizations (HMOs), hospital or industry fitness programs, private practice, voluntary health agencies, and official agency programs. With the new federalism, nutritionists must articulate their role in comprehensive health care and market their services at the state and local levels in addition to the federal level. Nutrition services are defined to include assessment, planning, counseling, education, and referral to supportive agencies. Data management, managerial, and marketing skills must be developed for dietitians to compete effectively. Basic educational preparation and continuing education for practicing professionals must develop these competencies.

Food waste volume and origin: Case studies in the Finnish food service sector.

PubMed

Silvennoinen, Kirsi; Heikkilä, Lotta; Katajajuuri, Juha-Matti; Reinikainen, Anu

2015-12-01

We carried out a project to map the volume and composition of food waste in the Finnish food service sector. The amount, type and origin of avoidable food waste were investigated in 51 food service outlets, including schools, day-care centres, workplace canteens, petrol stations, restaurants and diners. Food service outlet personnel kept diaries and weighed the food produced and wasted during a one-week or one-day period. For weighing and sorting, the food waste was divided into two categories: originally edible (OE) food waste was separated from originally inedible (OIE) waste, such as vegetable peelings, bones and coffee grounds. In addition, food waste (OE) was divided into three categories in accordance with its origins: kitchen waste, service waste and customer leftovers. According to the results, about 20% of all food handled and prepared in the sector was wasted. The findings also suggest that the main drivers of wasted food are buffet services and overproduction. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Dog Is a Doctor's Best Friend: The Use of a Service Dog as a Perioperative Assistant.

PubMed

Tew, Shannon; Taicher, Brad M

2016-01-01

Service dogs are beneficial in providing assistance to people with multiple types of disabilities and medical disorders including visual impairment, physical disabilities, seizure disorders, diabetes, and mental illness. Some service animals have been trained as a screening tool for cancer. We review a case involving a 6-year-old female with a history of mast cell mediator release and immediate hypersensitivity due to the urticaria pigmentosa variant of cutaneous mastocytosis who underwent a cystourethroscopy. Her service dog, JJ, who would alert to mast cell mediator release, was used throughout the perioperative course as a means of anxiolysis and comfort and to monitor for mast cell mediator release. This case presents an example of a service dog used in a family-care model in the field of anesthesiology and provides a unique example of using a service dog as an additional monitor to alert the care team for impending mast cell mediator release.

A Dog Is a Doctor's Best Friend: The Use of a Service Dog as a Perioperative Assistant

PubMed Central

Tew, Shannon

2016-01-01

Service dogs are beneficial in providing assistance to people with multiple types of disabilities and medical disorders including visual impairment, physical disabilities, seizure disorders, diabetes, and mental illness. Some service animals have been trained as a screening tool for cancer. We review a case involving a 6-year-old female with a history of mast cell mediator release and immediate hypersensitivity due to the urticaria pigmentosa variant of cutaneous mastocytosis who underwent a cystourethroscopy. Her service dog, JJ, who would alert to mast cell mediator release, was used throughout the perioperative course as a means of anxiolysis and comfort and to monitor for mast cell mediator release. This case presents an example of a service dog used in a family-care model in the field of anesthesiology and provides a unique example of using a service dog as an additional monitor to alert the care team for impending mast cell mediator release. PMID:27843665

78 FR 22937 - 60-Day Notice of Proposed Information Collection: Application for Additional Visa Pages or...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

...: Application for Additional Visa Pages or Miscellaneous Passport Services ACTION: Notice of request for public... Information Collection: Application for Additional Visa Pages or Miscellaneous Passport Services. OMB Control...: Bureau of Consular Affairs, Passport Services, Office of Program Management and Operational Support...

75 FR 35119 - 60-Day Notice of Proposed Information Collection: Form DS-4085 Application for Additional Visa...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... DS-4085 Application for Additional Visa Pages or Miscellaneous Passport Services, OMB Control Number... of Information Collection: Application for Additional Visa Pages or Miscellaneous Passport Services.... Originating Office: Bureau of Consular Affairs, Passport Services CA/PPT. Form Number: DS-4085. Respondents...

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...

Distributive justice in American healthcare: institutions, power, and the equitable care of patients.

PubMed

Putsch, Robert W; Pololi, Linda

2004-09-01

The authors argue that the American healthcare system has developed in a fashion that permits and may support ongoing, widespread inequities based on poverty, race, gender, and ethnicity. Institutional structures also contribute to this problem. Analysis is based on (1) discussions of a group of experts convened by the Office of Minority Health, US Department of Health and Human Services at a conference to address healthcare disparities; and (2) review of documentation and scientific literature focused on health, health-related news, language, healthcare financing, and the law. Institutional factors contributing to inequity include the cost and financing of American healthcare, healthcare insurance principles such as mutual aid versus actuarial fairness, and institutional power. Additional causes for inequity are bias in decision making by healthcare practitioners, clinical training environments linked to abuse of patients and coworkers, healthcare provider ethnicity, and politics. Recommendations include establishment of core attributes of trust, relationship and advocacy in health systems; universal healthcare; and insurance systems based on mutual aid. In addition, monitoring of equity in health services and the development of a set of ethical principles to guide systems change and rule setting would provide a foundation for distributive justice in healthcare. Additionally, training centers should model the behaviors they seek to foster and be accountable to the communities they serve.

Service delivery in Kenyan district hospitals – what can we learn from literature on mid-level managers?

PubMed Central

2013-01-01

Background There is a growing emphasis on the need to tackle inadequate human resources for health (HRH) as an essential part of strengthening health systems; but the focus is mostly on macro-level issues, such as training, recruitment, skill mix and distribution. Few attempts have been made to understand the capability of health workers, their motivation and other structural and organizational aspects of systems that influence workforce performance. We have examined literature on the roles of mid-level managers to help us understand how they might influence service delivery quality in Kenyan hospitals. In the Kenyan hospital settings, these are roles that head of departments who are also clinical or nursing service providers might play. Methods A computerized search strategy was run in Pub Med, Cochrane Library, Directory of Open Access Journals Social Science Research Network, Eldis, Google Scholar and Human Resources for Health web site databases using both free-text and MeSH terms from 1980 to 2011. In addition, citation searching from excluded and included articles was used and relevant unpublished literature systematically identified. Results and discussion A total of 23 articles were finally included in the review from over 7000 titles and abstracts initially identified. The most widely documented roles of mid-level managers were decision-making or problem-solving, strategist or negotiator and communicator. Others included being a therapist or motivator, goal setting or articulation and mentoring or coaching. In addition to these roles, we identified important personal attributes of a good manager, which included interpersonal skills, delegation and accountability, and honesty. The majority of studies included in the review concerned the roles that mid-level managers are expected to play in times of organizational change. Conclusion This review highlights the possible significance of mid-level managers in achieving delivery of high-quality services in Kenyan public hospitals and strongly suggests that approaches to strengthen this level of management will be valuable. The findings from this review should also help inform empirical studies of the roles of mid-level managers in these settings. PMID:23442524

MALINA: a web service for visual analytics of human gut microbiota whole-genome metagenomic reads.

PubMed

Tyakht, Alexander V; Popenko, Anna S; Belenikin, Maxim S; Altukhov, Ilya A; Pavlenko, Alexander V; Kostryukova, Elena S; Selezneva, Oksana V; Larin, Andrei K; Karpova, Irina Y; Alexeev, Dmitry G

2012-12-07

MALINA is a web service for bioinformatic analysis of whole-genome metagenomic data obtained from human gut microbiota sequencing. As input data, it accepts metagenomic reads of various sequencing technologies, including long reads (such as Sanger and 454 sequencing) and next-generation (including SOLiD and Illumina). It is the first metagenomic web service that is capable of processing SOLiD color-space reads, to authors' knowledge. The web service allows phylogenetic and functional profiling of metagenomic samples using coverage depth resulting from the alignment of the reads to the catalogue of reference sequences which are built into the pipeline and contain prevalent microbial genomes and genes of human gut microbiota. The obtained metagenomic composition vectors are processed by the statistical analysis and visualization module containing methods for clustering, dimension reduction and group comparison. Additionally, the MALINA database includes vectors of bacterial and functional composition for human gut microbiota samples from a large number of existing studies allowing their comparative analysis together with user samples, namely datasets from Russian Metagenome project, MetaHIT and Human Microbiome Project (downloaded from http://hmpdacc.org). MALINA is made freely available on the web at http://malina.metagenome.ru. The website is implemented in JavaScript (using Ext JS), Microsoft .NET Framework, MS SQL, Python, with all major browsers supported.

77 FR 40344 - Procurement List; Proposed Additions and Deletion

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

... will not result in any additional reporting, recordkeeping or other compliance requirements for small.... If approved, the action will result in authorizing small entities to furnish the product and services...--Rock Island, Rock Island, IL. Services Service Type/Location: Contact Center Services, Defense Manpower...

Better Together: Co-Location of Dental and Primary Care Provides Opportunities to Improve Oral Health.

PubMed

Pourat, Nadereh; Martinez, Ana E; Crall, James J

2015-09-01

Community Health Centers (CHCs) are one of the principal safety-net providers of health care for low-income and uninsured populations. Co-locating dental services in primary care settings provides an opportunity to improve access to dental care. Yet this study of California CHCs that provide primary care services shows that only about one-third of them co-located primary and dental care services on-site. An additional one-third were members of multisite organizations in which at least one other site provided dental care. The remaining one-third of CHC sites had no dental care capacity. Policy options to promote co-location include requiring on-site availability of dental services, providing infrastructure funding to build and equip dental facilities, and offering financial incentives to provide dental care and recruit dental providers.

Tradeoff analysis of technology needs for public service helicopters

NASA Technical Reports Server (NTRS)

Bauchspies, J. S.; Bryant, W. R., Jr.; Simpson, W. E.

1985-01-01

The design requirements for a family or type of Public Service Helicopter (PSH) is examined which will satisfy the needs of municipal and state governments in the following mission areas: Emergency Medical Service--Airborne Rescue Squad; Law Enforcement; Search and Rescue; and Environmental Control (Fire Fighting, Pollution, Resource Management). The report compares both design and performance requirements as specified by the PSH user's group against current technological capabilities, RTOPS and US Army LHX design requirements. The study explores various design trade-offs and options available to the aircraft designer/manufacturer in order to meet the several criteria specified by the PSH user's group. In addition, the report includes a brief assessment of the feasibility of employing certain advanced rotorcraft designs to meet the stringent combination of operational capabilities desired by the Public Service Helicopter Users.

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

PubMed

Bradshaw, Catherine P; Haynes, Katherine Taylor

2012-07-01

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

Specialized Prisons and Services: Results From a National Survey

PubMed Central

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

2008-01-01

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

43 CFR 11.72 - Quantification phase-baseline services determination.

Code of Federal Regulations, 2012 CFR

2012-10-01

... for changes that have occurred as a result of causes other than the discharge or release. In addition... predictable that changes as a result of the discharge or release are likely to be detectable. (3) If... control area. Other factors, including climate, depth of ground water, vegetation type and area covered...

43 CFR 11.72 - Quantification phase-baseline services determination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for changes that have occurred as a result of causes other than the discharge or release. In addition... predictable that changes as a result of the discharge or release are likely to be detectable. (3) If... control area. Other factors, including climate, depth of ground water, vegetation type and area covered...

43 CFR 11.72 - Quantification phase-baseline services determination.

Code of Federal Regulations, 2014 CFR

2014-10-01

... for changes that have occurred as a result of causes other than the discharge or release. In addition... predictable that changes as a result of the discharge or release are likely to be detectable. (3) If... control area. Other factors, including climate, depth of ground water, vegetation type and area covered...

43 CFR 11.72 - Quantification phase-baseline services determination.

Code of Federal Regulations, 2013 CFR

2013-10-01

... for changes that have occurred as a result of causes other than the discharge or release. In addition... predictable that changes as a result of the discharge or release are likely to be detectable. (3) If... control area. Other factors, including climate, depth of ground water, vegetation type and area covered...

75 FR 22663 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

... information services such as Bloomberg or Reuters. The Benchmark will be disseminated by one or more major... news publications publish futures prices and data. The Exchange represents that quotation and last sale... vendors worldwide, including Bloomberg and Reuters. In addition, the Exchange further represents that...

Adult Training Centres--The Trainees and Their Instructors

ERIC Educational Resources Information Center

Howard, Mary

1975-01-01

The author outlines the general functions, aims, teaching services, and training requirements of adult training centers for the mentally handicapped. She then describes in detail the preparation and use of a skills analysis program, including the provision of additional back-up materials. A lesson in ice cream making is the illustration.…

Geospatial Perspective: Toward a Visual Political Literacy Project in Education, Health, and Human Services

ERIC Educational Resources Information Center

Hogrebe, Mark C.; Tate, William F., IV

2012-01-01

In this chapter, "geospatial" refers to geographic space that includes location, distance, and the relative position of things on the earth's surface. Geospatial perspective calls for the addition of a geographic lens that focuses on place and space as important contextual variables. A geospatial view increases one's understanding of…

21 CFR 74.340 - FD&C Red No. 40.

Code of Federal Regulations, 2011 CFR

2011-04-01

... more than 0.3 percent. 4-Amino-5-methoxy-o- toluenesulfonic acid, not more than 0.2 percent. Disodium... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR...-naphthalenesulfonic acid. (2) Color additive mixtures for food use (including dietary supplements) made with FD&C Red...

21 CFR 74.340 - FD&C Red No. 40.

Code of Federal Regulations, 2010 CFR

2010-04-01

... more than 0.3 percent. 4-Amino-5-methoxy-o- toluenesulfonic acid, not more than 0.2 percent. Disodium... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL LISTING OF COLOR...-naphthalenesulfonic acid. (2) Color additive mixtures for food use (including dietary supplements) made with FD&C Red...

77 FR 2077 - Intent To Request Renewal From OMB of One Current Public Collection of Information: Rail...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-13

... carriers, including each carrier operating light rail or heavy rail transit service on track that is part of the general railroad system of transportation and rail transit systems. Also, these persons are... any threat information. In addition, freight railroad carriers and the affected shippers and receivers...

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Plan well, plan often

Treesearch

Bill Block

2013-01-01

This issue includes an invited paper by Courtney Schultz and her colleagues commenting on the application of the newly adopted U.S. Forest Service Planning Rule (hereafter, the rule) for wildlife. The rule is basically implementing language to interpret the spirit and intent of the National Forest Management Act (NFMA) of 1976. Laws such as NFMA require additional...

78 FR 332 - Self-Regulatory Organizations; ICE Clear Europe Limited; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

..., the SPAN Arrays published by ICE Clear Europe include the Volatility Risk Credit Rate (the Offset Rate... Rule Change Related to SPAN Margin Methodology Enhancements to Inter-Contract Credits and Average..., the Proposed Rule Change In addition to providing clearing services for credit default swaps, ICE...

Financing Options for Home Care for Children with Chronic Illness and Severe Disability. Technical Assistance Manual.

ERIC Educational Resources Information Center

Ellison, Marsha Langer; And Others

This manual is intended to accompany technical assistance efforts aimed at improving selected states' home health care programs for children with chronic illness and severe disability. Summary descriptions of funding sources are presented, including purpose, eligibility guidelines, and services covered, as well as additional information as…

Cultural Speak: Culturally Relevant Pedagogy and Experiential Learning in a Public Speaking Classroom

ERIC Educational Resources Information Center

Colvin, Janet; Tobler, Nancy

2013-01-01

This study describes the efficacy of modifications made to a higher education Latina/o public speaking course to enhance student growth and understanding. The changes included the addition of a service-learning component and the incorporation of culturally relevant pedagogy. Selected research, particularly related to college students, on…

Relationships between Stressors and Parenting Attitudes in a Child Welfare Parenting Program

ERIC Educational Resources Information Center

Estefan, Lianne Fuino; Coulter, Martha L.; VandeWeerd, Carla L.; Armstrong, Mary; Gorski, Peter

2013-01-01

Families involved with child welfare services often experience a range of stressors in addition to maltreatment, including intimate partner violence, substance abuse, and mental health problems. Children in these families are at risk for developing a myriad of problems. Although parenting education programs are among the most routine interventions…

Effective Mental Health Interventions and Treatments for Young Children with Diverse Needs

ERIC Educational Resources Information Center

Osofsky, Joy; Wieder, Serena; Noroña, Carmen Rosa; Lowell, Darcy; Worthy, D'Lisa Ramsey

2018-01-01

Infant and early childhood mental health interventions and treatment take place in many different settings including clinics serving adults and children, primary care centers, pediatric clinics, private practice offices, homes, early intervention offices, and child care centers. In addition, the types of evaluations and services offered in these…

78 FR 52657 - Migratory Bird Hunting; Final Frameworks for Early-Season Migratory Bird Hunting Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... Working Group conducted this assessment work, which included a thorough assessment of the harvest... Potential Working Group indicated that additional opportunity could be provided for blue-winged teal and...; thus, a small technical group comprised of members from the Flyway Councils and Service should be...

78 FR 63915 - New Mailing Standards for Domestic Mailing Services Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... locations. In addition, preparing FSS scheme pallets allows for the creation of larger pallets, which...-digit FSS scheme pools when addressed for delivery to any FSS 5-digit scheme combination per labeling... into a separate pool for each individual 5-digit FSS-scheme combination. Mailings that include 10 or...

75 FR 4523 - Codex Alimentarius Commission: Meeting of the Codex Committee on Food Additives

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-28

... registration is encouraged because it will expedite entry into the building and its parking area. If you require parking, please include the vehicle make and tag number when you register. Because the meeting... provides automatic and customized access to selected food safety news and information. This service is...

Barriers to delivering mental health services in Georgia with an economic and financial focus: informing policy and acting on evidence.

PubMed

Sulaberidze, Lela; Green, Stuart; Chikovani, Ivdity; Uchaneishvili, Maia; Gotsadze, George

2018-02-13

Whilst there is recognition that the global burden of disease associated with mental health disorders is significant, the economic resources available, especially in Low and Middle Income Countries, are particularly scarce. Identifying the economic (system) and financial (individual) barriers to delivering mental health services and assessing the opportunities for reform can support the development of strategies for change. A mixed methods study was developed, which engaged with a range of stakeholders from mental health services, including key informants, service managers, healthcare professional and patients and their care-takers. Data generated from interviews and focus groups were analysed using an existing framework that outlines a range of economic and financial barriers to improving mental health practice. In addition, the study utilised health financing and programmatic data. The analysis identified a variety of local economic barriers, including: the inhibition of the diversification of the mental health workforce and services due to inflexible resources; the variable and limited provision of services across the country; and the absence of mechanisms to assess the delivery and quality of existing services. The main financial barriers identified were related to out-of pocket payments for purchasing high quality medications and transportation to access mental health services. Whilst scarcity of financial resources exists in Georgia, as in many other countries, there are clear opportunities to improve the effectiveness of the current mental health programme. Addressing system-wide barriers could enable the delivery of services that aim to meet the needs of patients. The use of existing data to assess the implementation of the mental health programme offers opportunities to benchmark and improve services and to support the appropriate commissioning and reconfiguration of services.

Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).

PubMed

Weller, Wendy E; Minkovitz, Cynthia S; Anderson, Gerard F

2003-09-01

To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children between 5 and 17 years were identified as chronically ill according to the Questionnaire for Identifying Children with Chronic Conditions (n = 3061). Independent variables included child and family characteristics categorized as predisposing, enabling, and need. Dependent variables included use of 4 medical or 7 health-related services. Most children (88.7%) had seen a physician; 23.9% had an emergency department visit, 11.4% had a mental health outpatient visit, and 6.4% were hospitalized. Health-related service use ranged from <5.0% (transportation and social work) to 65.1% (medical care coordination); 20% to 30% of children used the remaining services (therapeutic, assistive devices, nonmedical care coordination, housing modifications). In fully adjusted logistic models, children with public insurance were significantly more likely than privately insured children to use 2 of the 4 medical services and 5 of the 7 health-related services. Non-Hispanic black children and children from less educated families were significantly less likely to use many of the services examined. In 1994, factors in addition to need influenced medical and health-related service use by CSHCN. Differences in the scope of benefits covered by public insurance compared with private insurance may influence utilization of medical and especially health-related services. Attention is needed to ensure that CSHCN who are racial/ethnic minorities or are from less educated families have access to needed services. Future studies should determine whether these patterns have changed over time.

Incremental cost of increasing access to maternal health care services: perspectives from a demand and supply side intervention in Eastern Uganda.

PubMed

Mayora, Chrispus; Ekirapa-Kiracho, Elizabeth; Bishai, David; Peters, David H; Okui, Olico; Baine, Sebastian Olikira

2014-01-01

High maternal and infant mortality continue to be major challenges to the attainment of the Millennium Development Goals for many low and middle-income countries. There is now evidence that voucher initiatives can increase access to maternal health services. However, a dearth of knowledge exists on the cost implications of voucher schemes. This paper estimates the incremental costs of a demand and supply side intervention aimed at increasing access to maternal health care services. This costing study was part of a quasi-experimental voucher study conducted in two districts in Eastern Uganda to explore the impact of demand and supply - side incentives on increasing access to maternal health services. The provider's perspective was used and the ingredients approach to costing was employed. Costs were based on market prices as recorded in program records. Total, unit, and incremental costs were calculated. The estimated total financial cost of the intervention for the one year of implementation was US$525,472 (US$1 = 2200UgShs). The major cost drivers included costs for transport vouchers (35.3%), health system strengthening (29.2%) and vouchers for maternal health services (18.2%). The average cost of transport per woman to and from the health facility was US$4.6. The total incremental costs incurred on deliveries (excluding caesarean section) was US$317,157 and US$107,890 for post natal care (PNC). The incremental costs per additional delivery and PNC attendance were US$23.9 and US$7.6 respectively. Subsidizing maternal health care costs through demand and supply - side initiatives may not require significant amounts of resources contrary to what would be expected. With Uganda's Gross Domestic Product (GDP) per capita of US$55` (2012), the incremental cost per additional delivery (US$23.9) represents about 5% of GDP per capita to save a mother and probably her new born. For many low income countries, this may not be affordable, yet reliance on donor funding is often not sustainable. Alternative ways of raising additional resources for health must be explored. These include; encouraging private investments in critical sectors such as rural transport, health service provision; mobilizing households to save financial resources for preparedness, and financial targeting for the most vulnerable.

Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight

DTIC Science & Technology

2015-03-04

H 4 , 2 0 1 5 Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Report No. DODIG-2015...04 MAR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Naval...i Results in Brief Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Visit us at

40 CFR 86.436-78 - Additional service accumulation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... minimum test distance and at the useful life, and, (3) The results of the half life emission tests, when... Regulations for 1978 and Later New Motorcycles, General Provisions § 86.436-78 Additional service accumulation. (a) Additional service up to the useful life will be accumulated under the same conditions as the...

40 CFR 86.436-78 - Additional service accumulation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... minimum test distance and at the useful life, and, (3) The results of the half life emission tests, when... Regulations for 1978 and Later New Motorcycles, General Provisions § 86.436-78 Additional service accumulation. (a) Additional service up to the useful life will be accumulated under the same conditions as the...

Architecture Design of Healthcare Software-as-a-Service Platform for Cloud-Based Clinical Decision Support Service

PubMed Central

Oh, Sungyoung; Cha, Jieun; Ji, Myungkyu; Kang, Hyekyung; Kim, Seok; Heo, Eunyoung; Han, Jong Soo; Kang, Hyunggoo; Chae, Hoseok; Hwang, Hee

2015-01-01

Objectives To design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability. Methods We analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used. Results The functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services. Conclusions We expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs. PMID:25995962

Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

PubMed

Barnett, Jeffrey E

2011-06-01

Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

Pre-service mathematics teachers' attitudes towards learning English: A case study in Yogyakarta

NASA Astrophysics Data System (ADS)

Setyaningrum, Wahyu

2017-08-01

This study investigated attitudes of pre-service mathematics teachers towards English as one of the subject at the university. It is a qualitative study in which questionnaire and face-to-face interview were employed to collect the data. The participants of this study were sixty students of mathematics education department at one of the university in Yogyakarta. The main research question was concern with how pre-service mathematics teachers perceive the importance of learning English. This study found that most of the participants perceive English as an important language that should be acquired by mathematics teachers. Their beliefs about the importance of English were mostly due to instrumental orientation rather than integrative orientation, such as getting a good job, getting a scholarship and understanding learning sources that are written in English. The data also revealed some obstacles faced by pre-service mathematics teachers in learning English as an additional language for them. The main obstacles were related to the differences between English for mathematics and English in daily life including its vocabulary and structure. Most of the participants argued that several mathematics vocabularies had precise meaning and different from daily English. In addition, they found difficult to understand some sentences used in the paper journal due to its structure. This study therefore, provided an insight into the pre-service mathematics teachers' perception and obstacles when learning English that could be use in improving pre-service teachers' education.

Global Budgets and Technology-Intensive Medical Services.

PubMed

Song, Zirui; Fendrick, A Mark; Safran, Dana Gelb; Landon, Bruce; Chernew, Michael E

2013-06-01

In 2009-2010, Blue Cross Blue Shield of Massachusetts entered into global payment contracts (the Alternative Quality contract, AQC) with 11 provider organizations. We evaluated the impact of the AQC on spending and utilization of several categories of medical technologies, including one considered high value (colonoscopies) and three that include services that may be overused in some situations (cardiovascular, imaging, and orthopedic services). Approximately 420,000 unique enrollees in 2009 and 180,000 in 2010 were linked to primary care physicians whose organizations joined the AQC. Using three years of pre-intervention data and a large control group, we analyzed changes in utilization and spending associated with the AQC with a propensity-weighted difference-in-differences approach adjusting for enrollee demographics, health status, secular trends, and cost-sharing. In the 2009 AQC cohort, total volume of colonoscopies increased 5.2 percent (p=0.04) in the first two years of the contract relative to control. The contract was associated with varied changes in volume for cardiovascular and imaging services, but total spending on cardiovascular services in the first two years decreased by 7.4% (p=0.02) while total spending on imaging services decreased by 6.1% (p<0.001) relative to control. In addition to lower utilization of higher-priced services, these decreases were also attributable to shifting care to lower-priced providers. No effect was found in orthopedics. As one example of a large-scale global payment initiative, the AQC was associated with higher use of colonoscopies. Among several categories of services whose value may be controversial, the contract generally shifted volume to lower-priced facilities or services.

Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

PubMed

Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

2009-02-01

The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

PubMed

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

Development of a state-wide pediatric palliative care service in Australia: referral and outcomes over two years.

PubMed

Herbert, Anthony; Bradford, Natalie; Donovan, Leigh; Pedersen, Lee-Anne; Irving, Helen

2014-03-01

Pediatric palliative care is an evolving specialty that aims to improve the lives of children with a life-limiting condition. As an emerging specialty, there is much to be learned about service provision and the expected outcomes that can be achieved. Additionally, quantification of the needs for pediatric palliative care is complicated by the uncertainty of defining the population that requires care. Our aim was to define the characteristics of the population cared for by a newly formed state-wide service in Queensland, Australia, and describe the development of the service over a 24-month period. Data on all referrals and outcomes were collected. Descriptive statistics were used to describe patterns including the variation in outcomes between children with oncology and non-oncology diagnoses. Other factors influencing the development of the service including involved health professionals and the model of the Australian health care system are also described. Over a 24-month period, 150 patients were referred of whom 117 subsequently died. There was a wide range of diseases and ages, and significantly, 58% of children were from regional or rural locations where there are can be limited access to specialist pediatric services. The average length of service was 83 days. A variety of factors were identified as being important for providing optimal care including ensuring equity in access, timing of referral, and continuity of care. The importance of a population-based approach to pediatric palliative care in a state that is geographically large and diverse like Queensland is highlighted. This article may provide valuable information to other health care providers who care for children with life-limiting illnesses.

47 CFR 22.719 - Additional channel policy for rural radiotelephone stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Rural Radiotelephone Service § 22.719 Additional channel... spectrum-efficient technologies (i.e. BETRS) and by assigning the minimum number of channels necessary to..., two-way mobile and rural radiotelephone services. In the case of conventional rural radiotelephone...

76 FR 78248 - Procurement List; Addition and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

.... Service Type/Location: Laundry Service, Stratton Medical Center, 113 Holland Ave, Albany, NY. [[Page 78249...: Addition to and Deletions from the Procurement List. SUMMARY: This action adds a service to the Procurement... disabilities, and deletes products and services from the Procurement List previously furnished by such agencies...

Space-based Science Operations Grid Prototype

NASA Technical Reports Server (NTRS)

Bradford, Robert N.; Welch, Clara L.; Redman, Sandra

2004-01-01

Grid technology is the up and coming technology that is enabling widely disparate services to be offered to users that is very economical, easy to use and not available on a wide basis. Under the Grid concept disparate organizations generally defined as "virtual organizations" can share services i.e. sharing discipline specific computer applications, required to accomplish the specific scientific and engineering organizational goals and objectives. Grids are emerging as the new technology of the future. Grid technology has been enabled by the evolution of increasingly high speed networking. Without the evolution of high speed networking Grid technology would not have emerged. NASA/Marshall Space Flight Center's (MSFC) Flight Projects Directorate, Ground Systems Department is developing a Space-based Science Operations Grid prototype to provide to scientists and engineers the tools necessary to operate space-based science payloads/experiments and for scientists to conduct public and educational outreach. In addition Grid technology can provide new services not currently available to users. These services include mission voice and video, application sharing, telemetry management and display, payload and experiment commanding, data mining, high order data processing, discipline specific application sharing and data storage, all from a single grid portal. The Prototype will provide most of these services in a first step demonstration of integrated Grid and space-based science operations technologies. It will initially be based on the International Space Station science operational services located at the Payload Operations Integration Center at MSFC, but can be applied to many NASA projects including free flying satellites and future projects. The Prototype will use the Internet2 Abilene Research and Education Network that is currently a 10 Gb backbone network to reach the University of Alabama at Huntsville and several other, as yet unidentified, Space Station based science experimenters. There is an international aspect to the Grid involving the America's Pathway (AMPath) network, the Chilean REUNA Research and Education Network and the University of Chile in Santiago that will further demonstrate how extensive these services can be used. From the user's perspective, the Prototype will provide a single interface and logon to these varied services without the complexity of knowing the where's and how's of each service. There is a separate and deliberate emphasis on security. Security will be addressed by specifically outlining the different approaches and tools used. Grid technology, unlike the Internet, is being designed with security in mind. In addition we will show the locations, configurations and network paths associated with each service and virtual organization. We will discuss the separate virtual organizations that we define for the varied user communities. These will include certain, as yet undetermined, space-based science functions and/or processes and will include specific virtual organizations required for public and educational outreach and science and engineering collaboration. We will also discuss the Grid Prototype performance and the potential for further Grid applications both space-based and ground based projects and processes. In this paper and presentation we will detail each service and how they are integrated using Grid

Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives.

PubMed

Schultz, Nicole R; Martinez, Rociel; Cucciare, Michael A; Timko, Christine

2016-08-23

Because substance use disorder (SUD) treatment is expanding, and detoxification (detox) is often the entry point to SUD treatment, it is critical to provide ready access to detox services. The purpose of the current study was to examine patient, program, and system barriers or facilitators to detox access within an integrated health care system with variable rates of detox utilization across facilities. Inpatient and outpatient providers from 31 different U.S. Veterans Health Administration detox programs were interviewed. Qualitative analyses identified six facilitators and 11 barriers to detox access. Facilitators included program staff and program characteristics such as encouragement and immediate access, as well as systemic cooperation and patient circumstances. Barriers to detox included programmatic and systemic problems, including lack of available detox services, program rules or admission requirements, funding shortages, stigma related to a SUD diagnosis or receiving detox services, and a deficiency of education and training. Other major barriers pertained to patients' lack of motivation and competing responsibilities. To improve detox access, health care settings should consider enhancing supportive relationships by emphasizing outreach, engagement, and rapport-building with patients, improving systemic communication and teamwork, educating patients on available detox services and the detox process, and addressing patient centered barriers such as resistance to detox or competing responsibilities. In addition, programs should consider open-door and immediate-admission policies. These approaches may improve detox access, which is important for increasing the likelihood of transitioning patients to SUD treatment, thus improving outcomes and reducing utilization of high-cost services.

EnviroAtlas - Ecosystem Services Market-Based Programs Web Service, U.S., 2016, Forest Trends' Ecosystem Marketplace

EPA Pesticide Factsheets

This EnviroAtlas web service contains layers depicting market-based programs and projects addressing ecosystem services protection in the United States. Layers include data collected via surveys and desk research conducted by Forest Trends' Ecosystem Marketplace from 2008 to 2016 on biodiversity (i.e., imperiled species/habitats; wetlands and streams), carbon, and water markets and enabling conditions that facilitate, directly or indirectly, market-based approaches to protecting and investing in those ecosystem services. This dataset was produced by Forest Trends' Ecosystem Marketplace for EnviroAtlas in order to support public access to and use of information related to environmental markets. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Effects of physician-owned specialized facilities in health care: a systematic review.

PubMed

Trybou, Jeroen; De Regge, Melissa; Gemmel, Paul; Duyck, Philippe; Annemans, Lieven

2014-12-01

Multiple studies have investigated physician-owned specialized facilities (specialized hospitals and ambulatory surgery centres). However, the evidence is fragmented and the literature lacks cohesion. To provide a comprehensive overview of the effects of physician-owned specialized facilities by synthesizing the findings of published empirical studies. Two reviewers independently researched relevant studies using a standardized search strategy. The Institute of Medicine's quality framework (safe, effective, equitable, efficient, patient-centred, and accessible care) was applied in order to evaluate the performance of such facilities. In addition, the impact on the performance of full-service general hospitals was assessed. Forty-six studies were included in the systematic review. Overall, the quality of the included studies was satisfactory. Our results show that little evidence exists to confirm the advantages attributed to physician-owned specialized facilities, and their impact on full-service general hospitals remains limited. Although data is available on a wide variety of effects, the evidence base is surprisingly thin. There is no compelling evidence available demonstrating the added value of physician-owned specialized facilities in terms of quality or cost of the delivered care. More research is necessary on the relative merits of physician-owned specialized facilities. In addition, their corresponding impact on full-service general hospitals remains unclear. The development of physician-owned specialized facilities should thus be monitored carefully. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

PubMed Central

García-Valls, Marisol; Touahria, Imad Eddine

2017-01-01

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

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

PubMed

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

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

PubMed

García-Valls, Marisol; Touahria, Imad Eddine

2017-06-08

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

EnviroAtlas - Ecosystem Service Market and Project Areas, U.S., 2015, Forest Trends' Ecosystem Marketplace

EPA Pesticide Factsheets

This EnviroAtlas dataset contains polygons depicting the geographic areas of market-based programs, referred to herein as markets, and projects addressing ecosystem services protection in the United States. Depending upon the type of market or project and data availability, polygons reflect market coverage areas, project footprints, or project primary impact areas in which ecosystem service markets and projects operate. The data were collected via surveys and desk research conducted by Forest Trends' Ecosystem Marketplace from 2008 to 2016 on biodiversity (i.e., imperiled species/habitats; wetlands and streams), carbon, and water markets. Additional biodiversity data were obtained from the Regulatory In-lieu Fee and Bank Information Tracking System (RIBITS) database in 2015. Attribute data include information regarding the methodology, design, and development of biodiversity, carbon, and water markets and projects. This dataset was produced by Forest Trends' Ecosystem Marketplace for EnviroAtlas in order to support public access to and use of information related to environmental markets. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about thi

Role of a service corridor in ICU noise control, staff stress, and staff satisfaction: environmental research of an academic medical center.

PubMed

Wang, Zhe; Downs, Betsy; Farell, Ashley; Cook, Kimberly; Hourihan, Peter; McCreery, Shimby

2013-01-01

To investigate the role of a dedicated service corridor in intensive care unit (ICU) noise control and staff stress and satisfaction. Shared corridors immediately adjacent to patient rooms are generally noisy due to a variety of activities, including service deliveries and pickups. The strategy of providing a dedicated service corridor is thought to reduce noise for patient care, but the extent to which it actually contributes to noise reduction in the patient care environment and in turn improves staff performance has not been previously documented. A before-and-after comparison was conducted in an adult cardiac ICU. The ICU was relocated from a traditional hospital environment to a new addition with a dedicated service corridor. A total of 118 nursing staff participated in the surveys regarding pre-move and post-move environmental comfort, stress, and satisfaction in the previous and new units. Acoustical measures of noise within the new ICU and a control environment of the previous unit were collected during four work days, along with on-site observations of corridor traffic. Independent and paired sample t-tests of survey data showed that the perceived noise level was lower and staff reported less stress and more satisfaction in the new ICU (p < 0.01). Analyses of acoustical data confirmed that the new ICU was significantly quieter (p < 0.02). Observations revealed how the service corridor impacted patient care services and traffic. The addition of a dedicated service corridor works in the new unit for improving noise control and staff stress and satisfaction. Critical care/intensive care, noise, satisfaction, staff, work environment.

The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach.

PubMed

Ciemins, Elizabeth L; Blum, Linda; Nunley, Marsha; Lasher, Andrew; Newman, Jeffrey M

2007-12-01

While there has been a rapid increase of inpatient palliative care (PC) programs, the financial and clinical benefits have not been well established. Determine the effect of an inpatient PC consultation service on costs and clinical outcomes. Multifaceted study included: (1) interrupted time-series design utilizing mean daily costs preintervention and postintervention; (2) matched cohort analysis comparing PC to usual care patients; and (3) analysis of symptom control after consultation. Large private, not-for-profit, academic medical center in San Francisco, California, 2004-2006. Time series analysis included 282 PC patients; matched cohorts included 27 PC with 128 usual care patients; clinical outcome analysis of 48 PC patients. Mean daily patient costs and length of stay (LOS); pain, dyspnea, and secretions assessment scores. Mean daily costs were reduced 33% (p < 0.01) from preintervention to postintervention period. Mean length of stay (LOS) was reduced 30%. Mean daily costs for PC patients were 14.5% lower compared to usual care patients (p < 0.01). Pain, dyspnea, and secretions scores were reduced by 86%, 64%, and 87%, respectively. Over the study period, time to PC referral as well as overall ALOS were reduced by 50%. The large reduction in mean daily costs and LOS resulted in an estimated annual savings of $2.2 million in the study hospital. Our results extend the evidence base of financial and clinical benefits associated with inpatient PC programs. We recommend additional study of best practices for identifying patients and providing consultation services, in addition to progressive management support and reimbursement policy.

Engaging and Empowering the National Park Service to apply Earth Observations to Management Decisions

NASA Astrophysics Data System (ADS)

Clayton, A.; Ross, K. W.; Crepps, G.; Childs-Gleason, L. M.; Ruiz, M. L.; Rogers, L.; Allsbrook, K. N.

2017-12-01

Since 2015, the NASA DEVELOP National Program has partnered with the National Park Service (NPS) engaging more than 120 program participants, working on over 22 projects across approximately 27 unique park units. These projects examined a variety of cultural and environmental concerns facing the NPS including landscape disturbance, invasive species mapping, archaeological site preservation, and water resources monitoring. DEVELOP, part of NASA's Applied Sciences' Capacity Building program, conducts 10-week feasibility projects which demonstrate the utility of NASA's Earth observations as an additional tool for decision-making processes. This presentation will highlight several of these projects and discuss the progress of capacity building working with individual, regional, and institutional elements within the National Park Service.

Proceedings of the Third International Mobile Satellite Conference (IMSC 1993)

NASA Technical Reports Server (NTRS)

Kwan, Robert (Compiler); Rigley, Jack (Compiler); Cassingham, Randy (Editor)

1993-01-01

Satellite-based mobile communications systems provide voice and data communications to users over a vast geographic area. The users may communicate via mobile or hand-held terminals, which may also provide access to terrestrial cellular communications services. While the first and second International Mobile Satellite Conferences (IMSC) mostly concentrated on technical advances, this Third IMSC also focuses on the increasing worldwide commercial activities in Mobile Satellite Services. Because of the large service areas provided by such systems, it is important to consider political and regulatory issues in addition to technical and user requirements issues. Topics covered include: the direct broadcast of audio programming from satellites; spacecraft technology; regulatory and policy considerations; advanced system concepts and analysis; propagation; and user requirements and applications.

BANANAS: providing child care services to a multi-ethnic community.

PubMed

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

BANANAS, Inc. is a nonprofit organization that has provided child care resource and referral services for over 35 years. BANANAS emerged as a grassroots effort initiated by a group of female volunteers who sought to build a network of women with children who needed childcare. As the organization developed, its leaders recognized and responded to additional needs, including resource and information sharing, workshops and classes, and political advocacy. Beginning as a collective, BANANAS has grown into a multifaceted service delivery and advocacy nonprofit operating with an annual budget of $12 million. This history of the agency reflects the development of a unique community-based effort, its challenges and rewards, and the multiple successes that this pioneering nonprofit has experienced.

Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria.

PubMed

Napper, Genevieve; Fricke, Tim; Anjou, Mitchell D; Jackson, A Jonathan

2015-09-01

This report describes the implementation of and outcomes from a new spectacle subsidy scheme and de-centralised care options for Aboriginal and Torres Strait Islander peoples in Victoria, Australia. The Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) commenced in 2010, as an additional subsidy to the long-established Victorian Eyecare Service (VES). The Victorian Aboriginal Spectacle Subsidy Scheme aimed to improve access to and uptake of affordable spectacles and eye examinations by Indigenous Victorians. The scheme is overseen by a committee convened by the Victorian Government's Department of Health and Human Services and includes eye-health stakeholders from the Aboriginal community and government, not-for-profit, university and Aboriginal communities. Key features of the Victorian Aboriginal Spectacle Subsidy Scheme include reduced and certain patient co-payments of $10, expanded spectacle frame range, broadened eligibility and community participation in service design and implementation. We describe the services implemented by the Australian College of Optometry (ACO) in Victoria and their impact on access to eye-care services. In 2014, optometric services were available at 36 service sites across Victoria, including 21 Aboriginal Health Services (AHS) sites. Patient services have increased from 400 services per year in 2009, to 1,800 services provided in 2014. During the first three years of the Victorian Aboriginal Spectacle Subsidy Scheme program (2010 to 2013), 4,200 pairs of glasses (1,400 pairs per year) were provided. Further funding to 2016/17 will lift the number of glasses to be delivered to 6,600 pairs (1,650 per year). This compares to population projected needs of 2,400 pairs per year. Overcoming the barriers to using eye-care services by Indigenous people can be difficult and resource intensive; however the Victorian Aboriginal Spectacle Subsidy Scheme provides an example of positive outcomes achieved through carefully designed and targeted approaches that engender sector and stakeholder support. Sustained support for the Victorian Aboriginal Spectacle Subsidy Scheme at a level that meets population needs is an ongoing challenge. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Opportunistic Breast Cancer Education and Screening in Rural Honduras

PubMed Central

Kennedy, Linda S.; Bejarano, Suyapa A.; Onega, Tracy L.; Stenquist, Derek S.

2016-01-01

Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential. PMID:28717699

39 CFR 3050.13 - Additional documentation required in the Postal Service's section 3652 report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Service's section 3652 report. 3050.13 Section 3050.13 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.13 Additional documentation required in the Postal Service's section... recent Annual Compliance Determination was issued and the reasons that those changes were accepted. ...

The Integrated Landscape Modeling partnership - Current status and future directions

USGS Publications Warehouse

Mushet, David M.; Scherff, Eric J.

2016-01-28

The Integrated Landscape Modeling (ILM) partnership is an effort by the U.S. Geological Survey (USGS) and U.S. Department of Agriculture (USDA) to identify, evaluate, and develop models to quantify services derived from ecosystems, with a focus on wetland ecosystems and conservation effects. The ILM partnership uses the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) modeling platform to facilitate regional quantifications of ecosystem services under various scenarios of land-cover change that are representative of differing conservation program and practice implementation scenarios. To date, the ILM InVEST partnership has resulted in capabilities to quantify carbon stores, amphibian habitat, plant-community diversity, and pollination services. Work to include waterfowl and grassland bird habitat quality is in progress. Initial InVEST modeling has been focused on the Prairie Pothole Region (PPR) of the United States; future efforts might encompass other regions as data availability and knowledge increase as to how functions affecting ecosystem services differ among regions.The ILM partnership is also developing the capability for field-scale process-based modeling of depressional wetland ecosystems using the Agricultural Policy/Environmental Extender (APEX) model. Progress was made towards the development of techniques to use the APEX model for closed-basin depressional wetlands of the PPR, in addition to the open systems that the model was originally designed to simulate. The ILM partnership has matured to the stage where effects of conservation programs and practices on multiple ecosystem services can now be simulated in selected areas. Future work might include the continued development of modeling capabilities, as well as development and evaluation of differing conservation program and practice scenarios of interest to partner agencies including the USDA’s Farm Service Agency (FSA) and Natural Resources Conservation Service (NRCS). When combined, the ecosystem services modeling capabilities of InVEST and the process-based abilities of the APEX model should provide complementary information needed to meet USDA and the Department of the Interior information needs.

Joint Research Centre Copernicus Climate Change Service (C3S) Fitness-for-Purpose (F4P) Platform

NASA Astrophysics Data System (ADS)

Gobron, N.; Adams, J. S.; Cappucci, F.; Lanconelli, C.; Mota, B.; Melin, F.

2016-08-01

This paper presents the concept and first results of the Copernicus Climate Change Service Fitness-for-Purpose (C3S F4P) project. The main goal aims at evaluating the efficiency and overall performance of the service, mainly with regard to users information needs and high level requirements. This project will also assess the fitness- for-purpose of the C3S with a specific emphasis on the needs of European Union (EU) Policies and translate these recommendations into programmatic and technical requirements. The C3S Climate Data Records (CDS) include various Essential Climate Variables (ECVs) that are derived from space sensors, including from Copernicus Sentinels sensors. One module of the F4P platform focuses on the benchmarking of data sets and algorithms, in addition to radiative transfer models used towards understanding potential discrepancies between CDS records. Methods and preliminary results of the benchmark platform are presented in this contribution.

Evaluating the Impact of Immigration Policies on Health Status Among Undocumented Immigrants: A Systematic Review

PubMed Central

Martinez, Omar; Wu, Elwin; Sandfort, Theo; Dodge, Brian; Carballo-Dieguez, Alex; Pinto, Rogeiro; Rhodes, Scott D.; Moya, Eva; Chavez-Baray, Silvia

2014-01-01

Over the past two decades, new anti-immigration policies and laws have emerged to address the migration of undocumented immigrants. A systematic review of the literature was conducted to assess and understand how these immigration policies and laws may affect both access to health services and health outcomes among undocumented immigrants. Eight databases were used to conduct this review, which returned 325 papers that were assessed for validity based on specified inclusion criteria. Forty critically appraised articles were selected for analysis; thirty articles related to access to health services, and ten related to health outcomes. The articles showed a direct relationship between anti-immigration policies and their effects on access to health services. In addition, as a result of these policies, undocumented immigrants were impacted by mental health outcomes, including depression, anxiety, and post-traumatic stress disorder. Action items were presented, including the promotion of cultural diversity training and the development of innovative strategies to support safety-net health care facilities serving vulnerable populations. PMID:24375382

South African HIV self-testing policy and guidance considerations.

PubMed

Venter, Francois; Majam, Mohammed; Jankelowitz, Lauren; Adams, Siraaj; Moorhouse, Michelle; Carmona, Sergio; Stevens, Wendy; Msimanga, Busisiwe R; Allen, David; Balani, Pooja; Nevhutalu, Zwoitwaho; Rhagnath, Naleni; Shroufi, Amir; Devillé, Walter; Kazangarare, Victoria; van der Wiel, Renee; Templeman, Hugo; Puren, Adrian; Tucker, Tim; van Cutsem, Gilles; Conradie, Francesca; Dong, Krista; Chidarikire, Thato; Gray, Andy

2017-01-01

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017-2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

Public Health Service--health maintenance organizations: final regulations.

PubMed

1980-01-24

These rules amend the Public Health Service (PHS) regulations by implementing certain changes made by the HMO Amendments of 1978 with respect to grants and loan guarantees for planning and initial development costs (Subpart D) and to loans and loan guarantees for initial costs of operation (Subpart E). These regulations change Subpart D by including projects for the "expansion of services" of an HMO among the projects eligible for initial development assistance. In addition, they change the limits on the amount of assistance permitted for initial development projects. These regulations also change Subpart E by substituting the words "costs of operation" for the words "operating costs," thereby expanding the scope of assistance for initial operations (1) to include costs of certain small capital expenditures for equipment and alterations and renovations of facilities and (2) to incorporate into the regulations a longstanding policy which specifies the amount of preaward balance sheet liabilities which may be paid for with funds under operating loans (whether made directly or guaranteed by the Secretary).

Cost containment: the Middle East. Israel.

PubMed

Stern, Z; Altholz, J; Sprung, C L

1994-08-01

The Israeli Health Service was established with the intent of providing an equal standard of care to the entire Israeli population. The Health Service has dealt with changes over the years, including the governing of large populations of Judea, Samaria, and Gaza. In 1990, mass immigration brought 500,000 more individuals to Israel, putting an additional burden on medical services. ICUs in Israel began to emerge after the Six Day War in 1967. The government's Ministry of Health has approved a limited amount of ICU beds. Beyond this set amount, hospital directors decide whether to establish additional ICU beds, weighing departmental pressures from within the hospital to create beds against the knowledge that the hospital will not be reimbursed more than the per diem rate of an ordinary hospital bed ($US 265). Hospital directors and administrators, knowing that the average daily cost of an ICU bed is close to $US 800, turn to their supporting organization to finance the uncontrollable deficit, seek aid from the Ministry of Health to make the per diem rates or diagnosis-related group reimbursements more realistic, and/or implement hospital policies aimed at cutting costs and personnel.

Primary health care reform, dilemmatic space and risk of burnout among health workers.

PubMed

Freeman, Toby; Baum, Fran; Labonté, Ronald; Javanparast, Sara; Lawless, Angela

2018-05-01

Health system changes may increase primary health care workers' dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government-managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community-controlled service) during a period of change and examined workers' dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work 'under the radar', undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.

Inequalities in Use of Health Services among Jews and Arabs in Israel

PubMed Central

Baron-Epel, Orna; Garty, Noga; Green, Manfred S

2007-01-01

Objectives To compare the levels of utilization of health services in Jews and Arabs taking into account differences in levels of socioeconomic status (SES) in a country with a National Health Insurance Law (NHIL). Data Source/Study Setting A cross-sectional National Health Interview Survey was carried out in Israel based on a random sample of telephone numbers as part of the EUROHIS project (WHO European Health Interview Survey 2003–2004). Study Design A random telephone survey included 9,352 interviews. Questions included use of health care services, health status, and socioeconomic variables. Principal Findings After adjusting for sex, age, income, education, marital status, and self-reported chronic diseases, Arabs more often reported visiting a family physician (odds ratio [OR] = 1.56, 95 percent confidence interval [CI] = 1.35–1.81) and less often reported visiting a specialist (OR = 0.73, 95 percent CI = 0.60–0.89) compared with Jews. In addition, the odds ratio for hospitalization was similar among Arabs and Jews (OR = 1.16, 95 percent CI = 0.97–1.38). SES was associated with utilization of health care services only in the Jewish population. Conclusions A different pattern of utilization of health care services was observed in Arabs and Jews. This was not explained by differences in socioeconomic levels. More research is needed regarding the distribution of services between Jews and Arabs. PMID:17489901

The Impact of Comprehensive School Nursing Services on Students' Academic Performance.

PubMed

Kocoglu, Deniz; Emiroglu, Oya Nuran

2017-03-01

Introduction: School nursing services should be evaluated through health and academic outcomes of students; however, it is observed that the number of studies in this field is limited. The aim of this study is to evaluate the impact of comprehensive school nursing services provided to 4th grade primary school students on academic performance of students. Methods: The quasi-experimental study was conducted with 31 students attending a randomly selected school in economic disadvantaged area in Turky. Correlation analysis, repeated measures analyses of variance, multiple regression analysis were used to analyze the data with SPSS software. Results: At the end of school nursing practices, an increase was occurred in students' academic achievement grades whereas a decrease was occurred in absenteeism and academic procrastination behaviors. Whilst it was determined that nursing interventions including treatment/ procedure and surveillance was associated to the decrease of absenteeism, it also was discovered that the change in the health status of the student after nursing interventions was related to the increase of the academic achievement grade and the decrease of the academic procrastination behavior score. Conclusion: In this study, the conclusion that comprehensive school nursing services contributed positively to the academic performance of students has been reached. In addition, it can be suggested that effective school nursing services should include services such as acute-chronic disease treatment, first aid, health screening, health improvement-protection, health education, guidance and counseling and case management.