14 CFR 272.7 - Notice of discontinuance of service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.7 Notice of... of essential air service for such place, the level of service specified in Order 80-9-63; and (2) If the Department has made a determination of essential air service for such place, that level of...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

Introducing B2B Service Level Measures via a Poker-Card Activity

ERIC Educational Resources Information Center

Chen, Chun-Miin; Bailey, Matthew D.

2016-01-01

To determine the appropriate level of product availability, most operations management textbooks introduce and define service level measures in a Business-to-Customer context. In other words, a retailer that wants to measure product availability in their store calculates the fill rate (FR) or cycle service level over an infinite review horizon.…

Complexities in Subsetting Level 2 Data

NASA Technical Reports Server (NTRS)

Huwe, Paul; Wei, Jennifer; Meyer, David; Silberstein, David S.; Alfred, Jerome; Savtchenko, Andrey K.; Johnson, James E.; Albayrak, Arif; Hearty, Thomas

2017-01-01

Satellite Level 2 data presents unique challenges for tools and services. From nonlinear spatial geometry to inhomogeneous file data structure to inconsistent temporal variables to complex data variable dimensionality to multiple file formats, there are many difficulties in creating general tools for Level 2 data support. At NASA Goddard Earth Sciences Data and Information Services Center (GES DISC), we are implementing a general Level 2 Subsetting service for Level 2 data to a user-specified spatio-temporal region of interest (ROI). In this presentation, we will unravel some of the challenges faced in creating this service and the strategies we used to surmount them.

Long-term care-service use and increases in care-need level among home-based elderly people in a Japanese urban area.

PubMed

Koike, Soichi; Furui, Yuji

2013-04-01

The objective of this study was to examine the effects of home-based long-term care insurance services on an increase in care need levels and discuss its policy implications. We analyzed care need certification and long-term care service use data for 3006 non-institutionalized elderly persons in a Tokyo ward effective as of October 2009 and 2010. Individual care need assessment intervals and their corresponding changes in care need level were calculated from data at two data acquisition points of care need assessment. Those who had been certified but did not use any long-term care insurance service were defined as the control group. The Cox proportionate hazard model was used to determine whether the use of a long-term care insurance service is associated with increased care need level. After adjusting for sex, age, and care need level, the hazard ratio for the probability of increased care need level among service users was calculated as 0.75 (95% confidence interval, 0.64-0.88; p < 0.001). Home-based long-term care service use may prevent an increase in care need level. Administrative data on care need certification and services use could be an effective tool for evaluating the long-term care insurance system. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Using Attribution Theory to Examine Community Rehabilitation Provider Stigma

ERIC Educational Resources Information Center

Strauser, David R.; Ciftci, Ayse; O'Sullivan, Deirdre

2009-01-01

This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences…

Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

PubMed

Desombre, T; Eccles, G

1998-01-01

This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

Using attribution theory to examine community rehabilitation provider stigma.

PubMed

Strauser, David R; Ciftci, Ayse; O'Sullivan, Deirdre

2009-03-01

This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences in their stigmatizing tendencies on subscales of controllability and stability for different categories of disabilities. Specifically, service providers with a master's degree had more stigmatizing beliefs for psychosis and cocaine addiction, compared with service providers with a bachelor's degree. Service providers with either a bachelor's degree or master's degree reported lower levels of stigma overall for five of the six categories of disability compared with their community college student counterparts. No differences were found for length of time working with persons with psychiatric disabilities.

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Patient-level adjustments. 413.235 Section 413.235 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

Transforming Service Employees and Climate: A Multilevel, Multisource Examination of Transformational Leadership in Building Long-Term Service Relationships

ERIC Educational Resources Information Center

Liao, Hui; Chuang, Aichia

2007-01-01

This longitudinal field study integrates the theories of transformational leadership (TFL) and relationship marketing to examine how TFL influences employee service performance and customer relationship outcomes by transforming both (at the micro level) the service employees' attitudes and (at the macro level) the work unit's service climate.…

Assessing Transition Service for Handicapped Youth: A Cooperative Interagency Approach.

ERIC Educational Resources Information Center

Stodden, Robert A.; Boone, Rosalie

1987-01-01

The article presents a cooperative interagency approach for assessing effectiveness of programs and services to facilitate the transition of handicapped students from school to adult community living. Features of the model include cooperative planning at the policy level, implementation level, and direct service level; and collaboration by state…

Telecommunications Systems Career Ladder, AFSC 307XO.

DTIC Science & Technology

1981-01-01

standard test tone levels perform impulse noise tests make in-service or out-of- service quality check.s on composite signal transmission levels Even...service or out-of- service quality control (QC) reports maintain trouble and restoration record forms (DD Form 1443) direct circuit or system checks...include: perform fault isolation on analog circuits make in-service or out-of- service quality checks on voice frequency carrier telegraph (VFCT) terminals

Economic order quantity (EOQ) by game theory approach in probabilistic supply chain system under service level constraint for items with imperfect quality

NASA Astrophysics Data System (ADS)

Setiawan, R.

2018-03-01

In this paper, Economic Order Quantity (EOQ) of probabilistic two-level supply – chain system for items with imperfect quality has been analyzed under service level constraint. A firm applies an active service level constraint to avoid unpredictable shortage terms in the objective function. Mathematical analysis of optimal result is delivered using two equilibrium scheme concept in game theory approach. Stackelberg’s equilibrium for cooperative strategy and Stackelberg’s Equilibrium for noncooperative strategy. This is a new approach to game theory result in inventory system whether service level constraint is applied by a firm in his moves.

Wound center facility billing: A retrospective analysis of time, wound size, and acuity scoring for determining facility level of service.

PubMed

Fife, Caroline E; Walker, David; Farrow, Wade; Otto, Gordon

2007-01-01

Outpatient wound center facility reimbursement for Medicare beneficiaries can be a challenge to determine and obtain. To compare methods of calculating facility service levels for outpatient wound centers and to demonstrate the advantages of an acuity-based billing system (one that incorporates components of facility work that is non-reimbursable by procedure codes and that represents an activity-based costing approach to medical billing), a retrospective study of 5,098 patient encounters contained in a wound care-specific electronic medical record database was conducted. Approximately 500 patient visits to the outpatient wound center of a Texas regional hospital between April 2003 and November 2004 were categorized by service level in documentation and facility management software. Visits previously billed using a time-based system were compared to the Centers for Medicare and Medicaid Services' proposed three-tiered wound size-based system. The time-based system also was compared to an acuity-based scoring system. The Pearson correlation coefficient between billed level of service by time and estimated level of service by acuity was 0.442 and the majority of follow-up visits were billed as Level 3 and above (on a time level of 1 to 5) , confirming that time is not a surrogate for actual work performed. Wound size also was found to be unrelated to service level (Pearson correlation = 0.017) and 97% of wound areas were < 100 cm2. The acuity-based scoring system produced a near-normal distribution of results, producing more mid-range billings than extremes; no other method produced this distribution. Hospital-based outpatient wound centers should develop, review, and refine acuity score-based models on which to determine billed level of service.

Implementing oral chemotherapy services in community pharmacies: a qualitative study of chemotherapy nurses' and pharmacists' views.

PubMed

Butt, Farida; Ream, Emma

2016-05-01

Changes in health-care provision have led to cancer patients being offered oral chemotherapy in the community. Three levels of oral chemotherapy services have been proposed (levels 1, 2 and 3) with community pharmacies playing differing roles within them. This study aims to explore health-care professionals' views on oral chemotherapy services being delivered by community pharmacies and to gain insights into the barriers, facilitators and training/knowledge needs of community pharmacists with respect to providing them. Qualitative semi-structured interviews were conducted with a purposive sample of three chemotherapy nurses, five oncology pharmacists and five community pharmacists. Data were analysed thematically using Framework Analysis. Findings for level 1 and 2 services included uncertainty on community pharmacists' professional responsibilities, the expertise of GPs in prescribing oral chemotherapy and the training and competency of community pharmacists. The lack of patient information, care and support provision was emphasised for all the models. Although level 1 was achievable in current practice, level 2 was considered the safest option, while level 3 was ideal but risky option. For all levels, training and education for community pharmacists and inter-professional issues were facilitators to oral chemotherapy services. The service environment, dispensing process-related constraints (access to blood test results and protocols) were significant barriers for levels 2 and 3. Advanced communication skills, patient education and counselling were identified as key areas for education and training for community pharmacists. The study suggests there are significant concerns and challenges associated with community pharmacies implementing any of the proposed levels of oral chemotherapy services. Educational and training opportunities for community pharmacists and the careful development of safe infrastructures will be essential in the future planning and implementation of any community pharmacy oral chemotherapy service. © 2015 Royal Pharmaceutical Society.

Developmental and Behavioral Needs and Service Use for Young Children in Child Welfare

PubMed Central

Stahmer, Aubyn C.; Leslie, Laurel K.; Hurlburt, Michael; Barth, Richard P.; Webb, Mary Bruce; Landsverk, John; Zhang, Jinjin

2006-01-01

Objective To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States. Methods As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use. Results Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in out-of-home care but are less likely to use services. Children <3 years of age are least likely to use services. Conclusions Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention. PMID:16199698

Identification of Tasks in Home Economics Related Occupations: Food Service.

ERIC Educational Resources Information Center

Iowa State Univ. of Science and Technology, Ames. Dept. of Home Economics Education.

The study was made to obtain curriculum development data for food service education programs below the baccalaureate level. Tasks related to the job functions of service, production, sanitation/safety, menu planning, procurement, supervision, and management were studied for five job categories of full-time personnel: middle-level service,…

78 FR 21980 - Aging Management of Internal Surfaces, Service Level III and Other Coatings, Atmospheric Storage...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-12

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0068] Aging Management of Internal Surfaces, Service Level... Interim Staff Guidance (LR-ISG), LR-ISG-2012-02, ``Aging Management of Internal Surfaces, Service Level... proposes to revise NRC staff-recommended aging management programs (AMP) and aging management review (AMR...

Readiness of hospitals to provide Kangaroo Mother Care (KMC) and documentation of KMC service delivery: Analysis of Malawi 2014 Emergency Obstetric and Newborn Care (EmONC) survey data

PubMed Central

Chavula, Kondwani; Likomwa, Dyson; Valsangkar, Bina; Luhanga, Richard; Chimtembo, Lydia; Dube, Queen; Gobezie, Wasihun Andualem; Guenther, Tanya

2017-01-01

Background Malawi introduced Kangaroo Mother Care (KMC) in 1999 as part of its efforts to address newborn morbidity and mortality and has continued to expand KMC services across the country. Yet, data on availability of KMC services and routine service provision are limited. Methods Data from the 2014 Emergency Obstetric Newborn Care (EmONC) survey, which was a census of all 87 hospitals in Malawi, were analyzed. The WHO service availability and readiness domains were used to generate indicators for KMC service readiness and an additional domain for documentation of KMC services was included. Levels of KMC service delivery were quantified using data extracted from a 12–month register review and a KMC initiation rate was calculated for each facility by dividing the reported number of babies initiated on KMC by the number of live births at facility. We defined three levels of KMC readiness and two levels of KMC operational status. Results 79% of hospitals (69/87) reported providing inpatient KMC services. More than half of the hospitals (62%; 54/87) met the most basic definition of readiness (staff, space for KMC and functional weighing scale) and 35% (30/87) met an expanded definition of readiness (guidelines, staff, space, scale and register in use). Only 15% (13/87) of hospitals had all KMC tracer items. Less than half of the hospitals (43%; 37/87) met criteria for KMC operational status at minimum levels (≥1/100 live births), and just 16% (14/87) met criteria for KMC operational status at routine levels (≥5/100 live births). Conclusions Our study found large differences between reported levels of KMC services and documented levels of KMC readiness and service provision among hospitals in Malawi. It is recommended that facility assessments of services such as KMC include record reviews to better estimate service availability and delivery. Further efforts to strengthen the capacity of Malawian hospitals to deliver KMC are needed. PMID:29085623

County Context and Mental Health Service Utilization by Older Hispanics.

PubMed

Kim, Kyeongmo

2018-04-16

Although older Hispanics experience high rates of depression, they tend to underuse mental health services. The study examined the association between county characteristics and mental health service use among older Hispanics, controlling for individual characteristics. The study used the 2008-2012 Medical Expenditure Panel Study and linked county-level data from the 2013-2014 Area Health Resources Files and the 2008-2012 Chronic Conditions Data Warehouse, using the Federal Information Processing Standard county code. The sample includes 1,143 community-dwelling Hispanics ages 60 years or older (Level 1) and 156 counties (Level 2) where the sample resides. The single dichotomous measure of mental health service utilization was based on whether or not the respondent met one or more of three conditions: (1) the respondent received care from a mental health professional, (2) received a service including mental health counseling or psychotherapy, or (3) received a service that was related to the International Classification of Diseases. Multilevel logistic regression analysis was used to examine the role of county context. The proportion of older adults and the existence of community mental health centers at the county-level were associated with mental health services use among this population. At the individual-level, education and mental health status were also associated with using mental health services. The county context plays an important role in understanding mental health services use among older Hispanics, indicating the need for intervention strategies at the county level.

14 CFR 272.8 - Obligation to continue service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.8 Obligation to... eligible Freely Associated State place below the level of essential air service to such place, whether or not the Department has previously determined the level of essential air service to such place, the...

14 CFR 272.8 - Obligation to continue service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES § 272.8 Obligation to... eligible Freely Associated State place below the level of essential air service to such place, whether or not the Department has previously determined the level of essential air service to such place, the...

Frequent Participation in Service Learning: Examining Institutional Differences and Individual Benefits

ERIC Educational Resources Information Center

Bureau, Daniel A.; Cole, James S.; McCormick, Alexander C.

2014-01-01

This chapter examines the differences between institutions with high and low levels of involvement in service learning as well as the differences between students with high and low levels of involvement. The study shows a correlation between institutional organization and service-learning emphasis and describes, at the student level, correlations…

A Practical Guide for Managing Customer Service in Base Civil Engineering.

DTIC Science & Technology

1988-04-01

IMPROVING CUSTOMER SERVICE IN BASE CIVIL ENGINEERING Step One: Evaluate Present Service Quality .. ......... .11 Step Two: Develop and Clarify a...cross sectional viewpoint. In chapter three, specific steps will be presented for managers to evaluate and improve the present level of service quality in...customer service in base civil engineering or any other organization for that matter is to evaluate the present level of service quality (1:170). Data

Nursing Home Levels of Care: Problems and Alternatives

PubMed Central

Bishop, Christine E.; Plough, Alonzo L.; Willemain, Thomas R.

1980-01-01

Providers and recipients of nursing home care under Medicaid are currently classified into two levels of care to facilitate appropriate placement, care, and reimbursement. The inherent imprecision of the two level system leads to problems of increased cost to Medicaid, lowered quality of care, and inadequate access to care for Medicaid recipients. However, a more refined system is likely to encounter difficulties in carrying out the functions performed by the broad two-level system, including assessment of residents, prescription of needed services, and implementation of service plans. The service type-service intensity classification proposed here can work in combination with a three-part reimbursement rate to encourage more accurate matching of resident needs, services, and Medicaid payment, while avoiding disruption of care. PMID:10309329

Barriers and facilitators to intraorganizational collaboration in public health: Relational coordination across public health services targeting individuals and populations.

PubMed

McCullough, J Mac; Eisen-Cohen, Eileen; Lott, Breanne

2018-05-09

Modern public health emphasizes population-focused services, which may require collaborative work both across and within organizations. Studies have explored interorganizational collaborations, but there are little data regarding collaborations within public health organizations. We measured intraorganizational collaboration and identified barriers and facilitators to collaboration within a large public health department through a mixed-methods study. Our study occurred at the Maricopa County (Arizona) Department of Public Health, the third largest local public health jurisdiction in the United States. To measure collaboration, we surveyed staff using the relational coordination tool. To identify barriers and facilitators to collaboration, we performed key informant interviews with department personnel. Relational coordination scores varied according to the focus of the service; clinical services had significantly lower levels of relational coordination than population-focused services (p < .01). We found high levels of mutual respect and lower levels of shared knowledge across services. Facilitators to collaboration included purposive cross-program meetings around specific topics, the organization's structure and culture, and individuals' social identities. Barriers included raised expectations for collaboration, low slack resources, member's self-interest, and trust. The relational coordination of services varied significantly according to the focus of the service. Population-focused public health services had higher levels of relational coordination than individually focused services. Collaboration was facilitated and impeded by both well-known and potentially emergent factors, such as purposive cross-service meetings and organizational culture. Population-focused services possessed higher levels of collaboration than individually focused services. Intraorganizational collaboration for improved population health relies on deliberate support from senior management and structured activities to increase shared knowledge and mutual respect.

A Need Based In-Service Training Workshop for the Clerical Staff of the State of Florida Health and Rehabilitative Services.

ERIC Educational Resources Information Center

Ray, Barbara H.

The in-service training needs of first-level employees of the state health and rehabilitative clerical staff and the development and evaluation of an in-service training model workshop were investigated. Interviews were conducted with the first- and second-level supervisors to determine the needs of the clerical staff for in-service training, to…

Obtaining Life-Cycle Cost-Effective Facilities in the Department of Defense

DTIC Science & Technology

2013-01-01

8 Step 3: Regional, Service- Level , and OSD Project Ranking...13 2.3. Actors and Barriers to Life-Cycle Cost-Effective Facilities in the Regional, Service- Level , and OSD Project Ranking...Congressional authorization and appropriation OMB evaluation Regional, service- level , and OSD project ranking Economic analysis and DD form 1391 completed

Service user involvement for mental health system strengthening in India: a qualitative study.

PubMed

Samudre, Sandesh; Shidhaye, Rahul; Ahuja, Shalini; Nanda, Sharmishtha; Khan, Azaz; Evans-Lacko, Sara; Hanlon, Charlotte

2016-07-28

There is a wide recognition that involvement of service users and their caregivers in health system policy and planning processes can strengthen health systems; however, most evidence and experience has come from high-income countries. This study aimed to explore baseline experiences, barriers and facilitators to service user-caregiver involvement in the emerging mental health system in India, and stakeholders' perspectives on how greater involvement could be achieved. A qualitative study was conducted in Sehore district of Madhya Pradesh, India. In-depth interviews (n = 27) and a focus group discussion were conducted among service users, caregivers and their representatives at district, state and national levels and policy makers, service providers and mental health researchers. The topic guide explored the baseline situation in India, barriers and facilitators to service user and caregiver involvement in the following aspects of mental health systems: policy-making and planning, service development, monitoring and quality control, as well as research. Framework analysis was employed. Respondents spoke of the limited involvement of service users and caregivers in the current Indian mental health system. The major reported barriers to this involvement were (1) unmet treatment and economic needs arising from low access to mental health services coupled with the high burden of illness, (2) pervasive stigmatising attitudes operating at the level of service user, caregiver, community, healthcare provider and healthcare administrators, and (3) entrenched power differentials between service providers and service users. Respondents prioritised greater involvement of service users in the planning of their own individual-level mental health care before considering involvement at the mental health system level. A stepwise progression was endorsed, starting from needs assessment, through empowerment and organization of service users and caregivers, leading finally to meaningful involvement. Societal and system level barriers need to be addressed in order to facilitate the involvement of service users and caregivers to strengthen the Indian mental health system. Shifting from a largely 'provider-centric' to a more 'user-centric' model of mental health care may be a fundamental first step to sustainable user involvement at the system level.

The Effects of Organizational Culture on Mental Health Service Engagement of Transition Age Youth.

PubMed

Kim, HyunSoo; Tracy, Elizabeth M; Biegel, David E; Min, Meeyoung O; Munson, Michelle R

2015-10-01

Nationwide, there is a growing concern in understanding mental health service engagement among transition age youth. The ecological perspective suggests that there are multiple barriers to service engagement which exist on varying levels of the ecosystem. Based on the socio-technical theory and organizational culture theory, this study examined the impact of organization-level characteristics on perceived service engagement and the moderating role of organizational culture on practitioner-level characteristics affecting youth service engagement. A cross-sectional survey research design was used to address the research questions. The data were collected from 279 practitioners from 27 mental health service organizations representing three major metropolitan areas in Ohio. Hierarchical linear modeling was used to address a nested structure. Findings revealed that location of organization, service setting, and organizational culture had significant effects on the continuation of services. In addition, the relationship between service coordination and resource knowledge and service engagement was moderated by organizational culture.

Investigation of Global Citizenship Levels of Pre-Service Physical Education Teachers

ERIC Educational Resources Information Center

Kayisoglu, Numan Bahadir

2016-01-01

The purpose of the present research is to define global citizenship levels of pre-service physical education teachers and investigate whether their global citizenship levels vary by various variables. A total of 485 pre-service teachers, studying at 3rd and 4th grades of undergraduate programs of physical education teaching at thirteen different…

An Approach for Web Service Selection Based on Confidence Level of Decision Maker

PubMed Central

Khezrian, Mojtaba; Jahan, Ali; Wan Kadir, Wan Mohd Nasir; Ibrahim, Suhaimi

2014-01-01

Web services today are among the most widely used groups for Service Oriented Architecture (SOA). Service selection is one of the most significant current discussions in SOA, which evaluates discovered services and chooses the best candidate from them. Although a majority of service selection techniques apply Quality of Service (QoS), the behaviour of QoS-based service selection leads to service selection problems in Multi-Criteria Decision Making (MCDM). In the existing works, the confidence level of decision makers is neglected and does not consider their expertise in assessing Web services. In this paper, we employ the VIKOR (VIšekriterijumskoKOmpromisnoRangiranje) method, which is absent in the literature for service selection, but is well-known in other research. We propose a QoS-based approach that deals with service selection by applying VIKOR with improvement of features. This research determines the weights of criteria based on user preference and accounts for the confidence level of decision makers. The proposed approach is illustrated by an example in order to demonstrate and validate the model. The results of this research may facilitate service consumers to attain a more efficient decision when selecting the appropriate service. PMID:24897426

EFFECT OF INDIVIDUAL AND COMMUNITY FACTORS ON MATERNAL HEALTH CARE SERVICE USE IN INDIA: A MULTILEVEL APPROACH.

PubMed

Yadav, Awdhesh; Kesarwani, Ranjana

2016-01-01

This study aimed to assess empirically the influence of individual and community (neighbourhood) factors on the use of maternal health care services in India through three outcomes: utilization of full antenatal care (ANC) services, safe delivery and utilization of postnatal care services. Data were from the third round of the National Family Health Survey (2005-06). The study sample constituted ever-married women aged 15-49 from 29 Indian states. Multilevel logistic regression analysis was performed for the three outcomes of interest accounting for individual- and community-level factors associated with the use of maternal health care services. A substantial amount of variation was observed at the community level. About 45%, 51% and 62% of the total variance in the use of full ANC, safe delivery and postnatal care, respectively, could be attributed to differences across the community. There was significant variation in the use of maternal health care services at the individual level, with socioeconomic status and mother's education being the most prominent factors associated with the use of maternal health care services. At the community level, urban residence and poverty concentration were found to be significantly associated with maternal health care service use. The results suggest that an increased focus on community-level interventions could lead to an increase in the utilization of maternal health care services in India.

Characteristics of Human Brain Activity during the Evaluation of Service-to-Service Brand Extension

PubMed Central

Yang, Taeyang; Lee, Seungji; Seomoon, Eunbi; Kim, Sung-Phil

2018-01-01

Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs) in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG). A total of 56 text stimuli composed of service brand name (S1) followed by extended service name (S2) were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori. The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels (p < 0.05). The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods. PMID:29479313

Characteristics of Human Brain Activity during the Evaluation of Service-to-Service Brand Extension.

PubMed

Yang, Taeyang; Lee, Seungji; Seomoon, Eunbi; Kim, Sung-Phil

2018-01-01

Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs) in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG). A total of 56 text stimuli composed of service brand name (S1) followed by extended service name (S2) were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori . The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels ( p < 0.05). The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods.

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Individuals needing NF services. If the State mental health or intellectual disability authority determines... 42 Public Health 5 2014-10-01 2014-10-01 false Residents and applicants determined to require NF level of services. 483.116 Section 483.116 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Individuals needing NF services. If the State mental health or intellectual disability authority determines... 42 Public Health 5 2013-10-01 2013-10-01 false Residents and applicants determined to require NF level of services. 483.116 Section 483.116 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Individuals needing NF services. If the State mental health or intellectual disability authority determines... 42 Public Health 5 2012-10-01 2012-10-01 false Residents and applicants determined to require NF level of services. 483.116 Section 483.116 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

The Same Client: The Demographics of Education and Service Delivery Systems.

ERIC Educational Resources Information Center

Hodgkinson, Harold L.

In the United States, services (such as education, health care, housing, and transportation) are provided for citizens by a bewildering array of agencies at many government levels. Service organizations must learn to communicate across functional lines, and educators must become familiar with other service providers at various levels. This means…

Infertility service use among U.S. women: 1995 and 2002.

PubMed

Chandra, Anjani; Stephen, Elizabeth Hervey

2010-02-01

To examine trends in use of medical services for infertility, by individual characteristics of women. Pooled data from two cycles (1995 and 2002) of the National Survey of Family Growth, a periodically conducted, nationally representative, cross-sectional survey of women 15-44 years of age. The analysis sample was composed of 2,005 women 22-44 years of age with current fertility problems. None. Ever having used infertility services, and highest level of services used. Between 1995 and 2002, ever-use of infertility services by fertility-impaired women age 22-44 years continued to be closely associated with older age, nulliparity, formal marital status, and higher socioeconomic status (education, household income, and private health insurance). Net of these factors, race and Hispanic origin, showed no significant association with either the use of services overall or the highest level of services used. After controlling for compositional changes in these individual characteristics, a slight decline was seen in ever-use of services overall from 1995 to 2002. No effect of survey year was noted in the highest level of services. Infertility service use among fertility-impaired women remains closely tied with socioeconomic factors. The "threshold effect" of these factors has shifted upward to the receipt of more costly services such as assisted reproductive technologies. These higher level services remain a relatively small fraction of the services reported in a general population sample of fertility-impaired women. Published by Elsevier Inc.

[Perceptions of nursing service managers in the South African Military Health Service on their level of motivation].

PubMed

Fischer, A; Muller, M

2000-12-01

The process of transformation in the South African Military Health Services, has influenced the nursing service managers' level of motivation and the following research question is applicable: what are the perceptions of the nursing service managers within the South African Military Health Services on their level of motivation? The purpose with this study was to explore and describe the perceptions of nursing service managers on their level of motivation within these health services. A qualitative research design was utilized and four focus group interviews were conducted with 33 nursing service managers country wide. The transcribed interviews were exposed to a content analysis. The results confirm that the level of motivation amongst these nursing service managers is low. The demotivators relate mainly to the following: inadequate acknowledgement, job insecurity in relation to the future, problems with the process of integration, transformation and rationalization, problems with management, many labour related issues, poor/inadequate communication, inadequate support, increased work load, poor physical environment, negative publicity and poor self motivation. Although there were a few motivators identified, they were of less importance. These results were interpreted within Herzberg's motivation theory to identify the hygiene/maintenance factors and to assess whether the important motivators were in place. During any process of change, and/or when the level of motivation amongst employees is low, it is important to adequately manage the environment (hygiene/maintenance factors within the Herzberg theory). But it is even more important to ensure that the motivators are in place or to intensify them. It is therefore recommended that a motivation strategy, based on the Herzberg theory as well as the Hackman-Oldham job enrichment model, be developed, implemented and evaluated.

Mission-Related Execution and Planning Through Quality of Service Methods

DTIC Science & Technology

2010-06-01

which maximizes a mission effectiveness functions is the ideal driver of QoS mechanisms. Service Quality Quality of Service may also exist in other...However, service quality is the originating concept of QoS and is the level of performance which one entity expects from another, including non-IT SoSs... Service quality may also be reflected in the context of a system’s purpose or an organization’s mission. Putting level of service values and

49 CFR 192.375 - Service lines: Plastic.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Service lines: Plastic. 192.375 Section 192.375... § 192.375 Service lines: Plastic. (a) Each plastic service line outside a building must be installed... terminate above ground level and outside the building, if— (i) The above ground level part of the plastic...

49 CFR 192.375 - Service lines: Plastic.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Service lines: Plastic. 192.375 Section 192.375... § 192.375 Service lines: Plastic. (a) Each plastic service line outside a building must be installed... terminate above ground level and outside the building, if— (i) The above ground level part of the plastic...

49 CFR 192.375 - Service lines: Plastic.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Service lines: Plastic. 192.375 Section 192.375... § 192.375 Service lines: Plastic. (a) Each plastic service line outside a building must be installed... terminate above ground level and outside the building, if— (i) The above ground level part of the plastic...

49 CFR 192.375 - Service lines: Plastic.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Service lines: Plastic. 192.375 Section 192.375... § 192.375 Service lines: Plastic. (a) Each plastic service line outside a building must be installed... terminate above ground level and outside the building, if— (i) The above ground level part of the plastic...

49 CFR 192.375 - Service lines: Plastic.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Service lines: Plastic. 192.375 Section 192.375... § 192.375 Service lines: Plastic. (a) Each plastic service line outside a building must be installed... terminate above ground level and outside the building, if— (i) The above ground level part of the plastic...

An Evaluation of the Empathy Levels of Pre-Service Social Studies Teachers

ERIC Educational Resources Information Center

Kaya, Baris

2016-01-01

This study was conducted to determine the factors that affect the empathy levels of pre-service teachers studying in the Department of Social Studies Teaching. The research questions developed in this context aimed to determine the roles of gender, age and being a member of a school club in the empathy levels of pre-service teachers. The study…

Applying Quality Function Deployment Model in Burn Unit Service Improvement.

PubMed

Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi

2016-01-01

Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.

The Effect of Supply Disruptions on Customer Service Levels: a Case for Delivering Fertilizer Products using Maritime Transportation

NASA Astrophysics Data System (ADS)

Siswanto, N.; Kurniawati, U.; Wiratno, S. E.; Rusdiansyah, A.

2018-04-01

Delivering a product to customers can have a series of activities. It starts with the production of the product and then transporting it to the customers. However, uncontrollable and undesirable chance of disruption can occur during the delivery either at the production facility/supply side or in the process of transporting the product. Many researches has been conducting in the process of delivering the product. However not many considers these disruptions, although the disruptions has negative impacts on company such as reduce the profit, produce unbalanced inventory, and affect its reputation. This research will focus on the effect of supply disruption on customer service levels in the maritime transportation problem in order to maintain inventory level both in the supply and destination warehouses during predetermined planning horizon. The system considered consists of one loading port and two discharge ports for distributing one product. By using discrete event simulation, the result showed that supply disruption affects unbalanced inventory in the destination warehouses so that it will also influence company’s service level. The results show that there is a significant decreasing both in delivery service level, about 14%, and production service level, about 15% when the disruption occurs. A scenario to increase production rate is simulated to improved the service level.

Exploring the Impact of Reform Mathematics on Entry-Level Pre-Service Primary Teachers Attitudes towards Mathematics

ERIC Educational Resources Information Center

Leavy, Aisling; Hourigan, Mairead; Carroll, Claire

2017-01-01

This study reports entry-level mathematics attitudes of pre-service primary teachers entering an initial teacher education (ITE) program one decade apart. Attitudes of 360 pre-service primary teachers were compared to 419 pre-service teachers entering the same college of education almost one decade later. The latter experienced reform school…

Dental caries, contact with dental services and deprivation in young children: their relationship at a small area level.

PubMed

Tickle, M; Moulding, G; Milsom, K; Blinkhorn, A

2000-10-14

To measure the relationship between tooth decay, contact with dental services and deprivation at electoral ward level. The study was carried out in 1998 in Ellesmere Port in the North West of England. All children younger than six years resident in Ellesmere Port registered with GDS services and those using CDS services were matched against the HA population register to identify unregistered children. Rates for children aged 3-5 years 'in contact' with primary dental care services, whether CDS or GDS, were calculated at ward level. One calibrated examiner examined all 5-year-old children in Ellesmere Port and dmft scores were calculated at ward level. Ward deprivation was measured using the Jarman score. Bivariate linear regressions at ward level were performed in turn between: dmft and Jarman score; rates for 3-5-year-olds in contact with dental services and Jarman score; and dmft and rates for 3-5-year-olds in contact with dental services. A significant linear relationship was observed between dmft and Jarman score (P=0.02, R2 = 0.43). Significant inverse relationships were found between rates for 3-5-year-olds in contact with dental services and Jarman score (P=0.001, R2 = 0.67), and also between dmft and rates for 3-5-year-olds in contact with dental services (P=0.002, R2 = 0.65). A strong inverse relationship was found between dental caries and contact with primary dental care services at electoral ward level. This relationship needs to be explored over a wider geographical area to establish if it is consistent and independent of deprivation.

Event selection services in ATLAS

NASA Astrophysics Data System (ADS)

Cranshaw, J.; Cuhadar-Donszelmann, T.; Gallas, E.; Hrivnac, J.; Kenyon, M.; McGlone, H.; Malon, D.; Mambelli, M.; Nowak, M.; Viegas, F.; Vinek, E.; Zhang, Q.

2010-04-01

ATLAS has developed and deployed event-level selection services based upon event metadata records ("TAGS") and supporting file and database technology. These services allow physicists to extract events that satisfy their selection predicates from any stage of data processing and use them as input to later analyses. One component of these services is a web-based Event-Level Selection Service Interface (ELSSI). ELSSI supports event selection by integrating run-level metadata, luminosity-block-level metadata (e.g., detector status and quality information), and event-by-event information (e.g., triggers passed and physics content). The list of events that survive after some selection criterion is returned in a form that can be used directly as input to local or distributed analysis; indeed, it is possible to submit a skimming job directly from the ELSSI interface using grid proxy credential delegation. ELSSI allows physicists to explore ATLAS event metadata as a means to understand, qualitatively and quantitatively, the distributional characteristics of ATLAS data. In fact, the ELSSI service provides an easy interface to see the highest missing ET events or the events with the most leptons, to count how many events passed a given set of triggers, or to find events that failed a given trigger but nonetheless look relevant to an analysis based upon the results of offline reconstruction, and more. This work provides an overview of ATLAS event-level selection services, with an emphasis upon the interactive Event-Level Selection Service Interface.

Pre-Service Teachers' Ability to Identify and Implement Cognitive Levels in Mathematics Learning

ERIC Educational Resources Information Center

Ortiz, Enrique

2017-01-01

This study analyzed pre-service teachers' ability to identify and implement cognitive levels. The framework involved the use of the Concrete, Pictorial and Abstract (CPA) cognitive levels combined with the Virtual-level (CPVA-levels). The V-level involves applets and apps, and three digital-dynamic sublevels: virtual-Concrete, virtual-Pictorial…

Pre-Service Science Teachers' Written Argumentation Qualities: From the Perspectives of Socio- Scientific Issues, Epistemic Belief Levels and Online Discussion Environment

ERIC Educational Resources Information Center

Isbilir, Erdinc; Cakiroglu, Jale; Ertepinar, Hamide

2014-01-01

This study investigated the relationship between pre-service science teachers' written argumentation levels about socio-scientific issues and epistemic belief levels in an online discussion environment. A mixed-methods approach was used: 30 Turkish pre-service science teachers contributed with their written argumentations to four socio-scientific…

Research of three level match method about semantic web service based on ontology

NASA Astrophysics Data System (ADS)

Xiao, Jie; Cai, Fang

2011-10-01

An important step of Web service Application is the discovery of useful services. Keywords are used in service discovery in traditional technology like UDDI and WSDL, with the disadvantage of user intervention, lack of semantic description and low accuracy. To cope with these problems, OWL-S is introduced and extended with QoS attributes to describe the attribute and functions of Web Services. A three-level service matching algorithm based on ontology and QOS in proposed in this paper. Our algorithm can match web service by utilizing the service profile, QoS parameters together with input and output of the service. Simulation results shows that it greatly enhanced the speed of service matching while high accuracy is also guaranteed.

78 FR 76596 - Proposed Levels of Service at Locks and Dams on the J Bennett Johnston Waterway (Red River)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... DEPARTMENT OF DEFENSE Department of the Army; Corps of Engineers Proposed Levels of Service at Locks and Dams on the J Bennett Johnston Waterway (Red River) AGENCY: Department of the Army, U.S. Army... 1, 2014. Future level of service for each of the five locks and dams will be re-assessed following...

A spatial model to quantify the mortality impact of service delivery in Sub-Saharan Africa: an ecological design utilizing data from South Africa

PubMed Central

2013-01-01

Background Sub Saharan Africa is confronted with a wide range of interlinked health and economic problems that include high levels of mortality and poor service delivery. The objective of the paper is to develop a spatial model for Sub-Saharan Africa that can quantify the mortality impact of (poor) service delivery at sub-district level in order to integrate related health and local level policy interventions. In this regard, an expanded composite service delivery index was developed, and the data were analysed using a Bayesian Poisson spatial model. Results The results indicate significant differences in the risk of mortality and poor service delivery at sub-district level. In particular, the results indicate clusters of high mortality and poor service delivery in two of the bigger, poorer provinces with large rural communities. Conversely, two of the wealthier provinces have lower levels of mortality and higher levels of service delivery, but income inequality is more widespread. The bivariate and multivariate models, moreover, reflect significant positive linkages (p < 0.01) between increased mortality and poor service delivery after adjusting for HIV/AIDS, income inequality, population density and the protective influence of metropolitan areas. Finally, the hypothesized provision of a basket of services reduced the mortality rate in South Africa’s 248 sub-districts by an average of 5.3 (0.3-15.4) deaths per 1000. Conclusion The results indicate that the model can accurately plot mortality and service delivery “hotspots’ at sub-district level, as well as explain their associations and causality. A mortality reduction index shows that mortality in the highest risk sub-districts can be reduced by as much as 15.4 deaths per 1000 by providing a range of basic services. The ability to use the model in a wider SSA context and elsewhere is also feasible given the innovative use of available databases. Finally, the paper illustrates the importance of developing policy in SSA that can simultaneously solve both economic and health problems. PMID:23425437

A spatial model to quantify the mortality impact of service delivery in Sub-Saharan Africa: an ecological design utilizing data from South Africa.

PubMed

Sartorius, Kurt; Sartorius, Benn K D

2013-02-20

Sub Saharan Africa is confronted with a wide range of interlinked health and economic problems that include high levels of mortality and poor service delivery. The objective of the paper is to develop a spatial model for Sub-Saharan Africa that can quantify the mortality impact of (poor) service delivery at sub-district level in order to integrate related health and local level policy interventions. In this regard, an expanded composite service delivery index was developed, and the data were analysed using a Bayesian Poisson spatial model. The results indicate significant differences in the risk of mortality and poor service delivery at sub-district level. In particular, the results indicate clusters of high mortality and poor service delivery in two of the bigger, poorer provinces with large rural communities. Conversely, two of the wealthier provinces have lower levels of mortality and higher levels of service delivery, but income inequality is more widespread. The bivariate and multivariate models, moreover, reflect significant positive linkages (p < 0.01) between increased mortality and poor service delivery after adjusting for HIV/AIDS, income inequality, population density and the protective influence of metropolitan areas. Finally, the hypothesized provision of a basket of services reduced the mortality rate in South Africa's 248 sub-districts by an average of 5.3 (0.3-15.4) deaths per 1000. The results indicate that the model can accurately plot mortality and service delivery "hotspots' at sub-district level, as well as explain their associations and causality. A mortality reduction index shows that mortality in the highest risk sub-districts can be reduced by as much as 15.4 deaths per 1000 by providing a range of basic services. The ability to use the model in a wider SSA context and elsewhere is also feasible given the innovative use of available databases. Finally, the paper illustrates the importance of developing policy in SSA that can simultaneously solve both economic and health problems.

76 FR 13125 - Announcement of Grant Application Deadlines and Funding Levels; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Announcement of Grant Application Deadlines and Funding Levels; Correction AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Solicitation of Applications; correction. SUMMARY: The United States Department of Agriculture's (USDA) Rural Utilities Service...

76 FR 12017 - Announcement of Grant Application Deadlines and Funding Levels

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Announcement of Grant Application Deadlines and Funding Levels AGENCY: Rural Utilities Service, USDA. ACTION: Notice of solicitation of applications. SUMMARY: The United States Department of Agriculture's (USDA) Rural Utilities Service (RUS) announces the...

Human service delivery in a multi-tier system: the subtleties of collaboration among partners.

PubMed

Mayhew, Fred

2012-01-01

This article examines the nature of interorganizational relationships that are formed within a multi-tier human service delivery system. Taking into account the hierarchical structure of a statewide initiative to support early childhood education, the study investigates the differences in the relationships between organizations at the service and administrative levels of the system. Forty-nine administrative level and 146 service delivery level relationships are evaluated. Findings indicate that organizations involved in direct service delivery form more collaborative relationships. Thus, when government provides funding for human services, policymakers must seek to balance public accountability with the advantages believed to be inherent in devolved service delivery. Furthermore, practitioners who appreciate the importance and nuances of interorganizational relationships will be in a position to better manage their organizations in an environment of increased collaborative activity and joint delivery of services. Going forward, human service systems will continue to involve organizations from the public, nonprofit, and private sector. A better understanding of how these organizations work together is crucial to the effective delivery of these essential services.

Assessing Learners' Satisfication towards Support Services Delivery in National Open University Nigeria: Implications for Counselling Services

ERIC Educational Resources Information Center

Okopi, Fidel; Ofole, Ndidi

2013-01-01

This study aims at determining the level of students' satisfaction of learner support services in the study centres of NOUN--National Open University of Nigeria and whether the support services offered at the study centres have significant influence on the level of students' satisfaction. A descriptive survey of ex-post facto research design was…

Family Characteristics and Children's Receipt of Autism Services in Low-Resourced Families.

PubMed

Karp, Elizabeth A; Dudovitz, Rebecca; Nelson, Bergen B; Shih, Wendy; Gulsrud, Amanda; Orlich, Felice; Colombi, Costanza; Kuo, Alice A

2018-04-01

Parents of children with autism spectrum disorder (ASD) face competing demands when caring for their child and fulfilling family commitments. It remains unknown whether family obligations and parental stress might decrease the use of intervention services for young children with ASD. The current study is a secondary analysis of baseline date from a published randomized control trial with 147 low-resourced caregiver-child dyads. Demographic information, data on service use, maternal employment, parent's perception of their child's development, and parental stress were collected for primary caregivers of 2- to 5-year-old children with ASD from 5 sites. Multiple logistic regressions of accessing any intervention services or more than 1 services on familial characteristics were performed, controlling for demographic and contextual variables. Twenty-five percent of children were receiving no intervention service; 26% were receiving 1 service; and 49% were receiving 2 or more services. Perceived developmental delay and not having a sibling in the home were associated with higher odds of receiving intervention services. Children were more likely to receive more than 1 service if their parents had at least a college education and low levels of stress. Factors including perceived developmental level, parental stress, and caring for siblings may play a role in accessing services for children with ASD. Results reveal that competing family needs may be barriers to service use. Mothers of children with ASD with multiple children in the home, low levels of education, and high levels of stress may need additional supports or alternative service delivery models. Copyright © 2018 by the American Academy of Pediatrics.

Characteristics of Students Receiving Special Education Services in a Central Minnesota School District According to Setting, Classification, and Level of Service.

ERIC Educational Resources Information Center

Ittenbach, Richard F.; And Others

The records of 1,231 preschool, elementary, and secondary students receiving special education services in a central Minnesota school district were evaluated to provide information on differences according to setting, classification, and level of service. Data were analyzed within the context of four broad domains: demographics (age, race, gender,…

47 CFR 95.831 - Service requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... that it provides substantial service within the service area. Substantial service is defined as a service that is sound, favorable, and substantially above a level of service which might minimally warrant...

Wisconsin Fire Service Certification Program Procedures.

ERIC Educational Resources Information Center

Pribyl, Paul F.

These procedures for the Wisconsin Fire Service Certification Program provide professional qualification standards for three levels of fire fighter and four levels of fire service instructor. A section on program authority/operations covers program development, the credential review system, and revocation of certification. Requirements for…

Characteristics of school-based health services associated with students' mental health.

PubMed

Denny, Simon; Howie, Hamish; Grant, Sue; Galbreath, Ross; Utter, Jennifer; Fleming, Theresa; Clark, Terryann

2018-01-01

Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students' mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students' mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March-November 2012. Students' mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students' mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.

Accuracy testing of steel and electric groundwater-level measuring tapes: Test method and in-service tape accuracy

USGS Publications Warehouse

Fulford, Janice M.; Clayton, Christopher S.

2015-10-09

The calibration device and proposed method were used to calibrate a sample of in-service USGS steel and electric groundwater tapes. The sample of in-service groundwater steel tapes were in relatively good condition. All steel tapes, except one, were accurate to ±0.01 ft per 100 ft over their entire length. One steel tape, which had obvious damage in the first hundred feet, was marginally outside the accuracy of ±0.01 ft per 100 ft by 0.001 ft. The sample of in-service groundwater-level electric tapes were in a range of conditions—from like new, with cosmetic damage, to nonfunctional. The in-service electric tapes did not meet the USGS accuracy recommendation of ±0.01 ft. In-service electric tapes, except for the nonfunctional tape, were accurate to about ±0.03 ft per 100 ft. A comparison of new with in-service electric tapes found that steel-core electric tapes maintained their length and accuracy better than electric tapes without a steel core. The in-service steel tapes could be used as is and achieve USGS accuracy recommendations for groundwater-level measurements. The in-service electric tapes require tape corrections to achieve USGS accuracy recommendations for groundwater-level measurement.

Transition from manual to automatic rutting measurements : effect on pavement serviceability index values.

DOT National Transportation Integrated Search

2010-06-01

The Pavement Serviceability Index (pSn is used by New Mexico Department of Transportation : (NMDOT) to express the serviceability level of a pavement section at the network level. The PSI : is calculated with distress ratings (including rutting) and ...

Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.

PubMed

Halkitis, Perry N; Kupprat, Sandra A; Mukherjee, Preetika Pandey

2010-01-01

The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited. This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors. The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors. Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.

Association Between Helicopter vs Ground Emergency Medical Services and Survival for Adults With Major Trauma

PubMed Central

Galvagno, Samuel M.; Haut, Elliott R.; Zafar, S. Nabeel; Millin, Michael G.; Efron, David T.; Koenig, George J.; Baker, Susan P.; Bowman, Stephen M.; Pronovost, Peter J.; Haider, Adil H.

2012-01-01

Context Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007–2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score–matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14–1.17; P<.001; absolute risk reduction [ARR], 1.5%). For patients transported to level II trauma centers, helicopter transport was associated with an improved odds of survival (OR, 1.15; 95% CI, 1.13–1.17; P < .001; ARR, 1.4%). A greater proportion (18.2%) of those transported to level I trauma centers by helicopter were discharged to rehabilitation compared with 12.7% transported by ground services (P < .001), and 9.3% transported by helicopter were discharged to intermediate facilities compared with 6.5% by ground services (P < .001). Fewer patients transported by helicopter left level II trauma centers against medical advice (0.5% vs 1.0%, P < .001). Conclusion Among patients with major trauma admitted to level I or level II trauma centers, transport by helicopter compared with ground services was associated with improved survival to hospital discharge after controlling for multiple known confounders. PMID:22511688

42 CFR 137.143 - How is the funding level to which the Indian Tribe is entitled determined?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false How is the funding level to which the Indian Tribe is entitled determined? 137.143 Section 137.143 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF...

Factors affecting satisfaction level with the food services in a military hospital.

PubMed

Sahin, Bayram; Demir, Cesim; Celik, Yusuf; Teke, A Kadir

2006-10-01

To determine the factors affecting general satisfaction level of patients with the food services in a military hospital in Turkey. The study was carried out in a military hospital providing tertiary health care services with the capacity of 1000 hospital bed. A questionnaire was used as data collection tool on measuring satisfaction of the patients with the food services. The results showed that of 374 patients 51.3% evaluated food service quality adequate, 32.4% said that the food quality was inadequate, and 16.3% stated that they were uncertain. A logistic regression model was estimated in determining the most important and statistically significant factors affecting patient satisfaction with hospital foods and food services. The results showed that patient-specific demographic characteristics were insignificant in explaining satisfaction level with food services, but the variables of taste (OR = 9.853, p = 0.000) and appearance (OR = 2.687, p = 0.014) of the food were statistically significant and important determinants of patient satisfaction with the foods served at the hospital. The results of this study would be helpful in making decision on increasing the level of satisfaction of patients with the food services for hospital managers and the food (nutrition) departments. On the other hand, the results can also be used in benchmarking the hospital's food services quality with other hospitals, and in monitoring improvements in food services quality in the future.

General practitioner services in primary care groups in England: is there inequity between service availability and population need?

PubMed

Baker, D; Hann, M

2001-06-01

This study examined the coverage of minor surgery, child health surveillance and chronic disease management for asthma and diabetes in relation to population need and key organisational features of general practice in the 481 primary care groups (PCGs) in England. PCG-level summary scores were developed to estimate the relative availability of all four services and their relative importance in discriminating between high and low levels of service provision. The coverage of services was widespread and, in such circumstances, there was no systematic evidence of poorer service availability for PCGs with higher population need (the 'inverse care' law). Rather this relation was localised, being most predominant for PCGs covering London and its suburbs. In these PCGs, there was no association between indicators of lack of capacity, such as single-handed practice, and levels of service provision.

Semantic Repositories for eGovernment Initiatives: Integrating Knowledge and Services

NASA Astrophysics Data System (ADS)

Palmonari, Matteo; Viscusi, Gianluigi

In recent years, public sector investments in eGovernment initiatives have depended on making more reliable existing governmental ICT systems and infrastructures. Furthermore, we assist at a change in the focus of public sector management, from the disaggregation, competition and performance measurements typical of the New Public Management (NPM), to new models of governance, aiming for the reintegration of services under a new perspective in bureaucracy, namely a holistic approach to policy making which exploits the extensive digitalization of administrative operations. In this scenario, major challenges are related to support effective access to information both at the front-end level, by means of highly modular and customizable content provision, and at the back-end level, by means of information integration initiatives. Repositories of information about data and services that exploit semantic models and technologies can support these goals by bridging the gap between the data-level representations and the human-level knowledge involved in accessing information and in searching for services. Moreover, semantic repository technologies can reach a new level of automation for different tasks involved in interoperability programs, both related to data integration techniques and service-oriented computing approaches. In this chapter, we discuss the above topics by referring to techniques and experiences where repositories based on conceptual models and ontologies are used at different levels in eGovernment initiatives: at the back-end level to produce a comprehensive view of the information managed in the public administrations' (PA) information systems, and at the front-end level to support effective service delivery.

Perceived Service Need After Hurricane Sandy in a Representative Sample of Survivors: The Roles of Community-Level Damage and Individual-Level Stressors.

PubMed

Sampson, Laura; Lowe, Sarah R; Gruebner, Oliver; Cohen, Gregory H; Galea, Sandro

2016-06-01

We aimed to explore how individually experienced disaster-related stressors and collectively experienced community-level damage influenced perceived need for mental health services in the aftermath of Hurricane Sandy. In a cross-sectional study we analyzed 418 adults who lived in the most affected areas of New York City at the time of the storm. Participants indicated whether they perceived a need for mental health services since the storm and reported on their exposure to disaster-related stressors (eg, displacement, property damage). We located participants in communities (n=293 census tracts) and gathered community-level demographic data through the US Census and data on the number of damaged buildings in each community from the Federal Emergency Management Agency Modeling Task Force. A total of 7.9% of participants reported mental health service need since the hurricane. Through multilevel binomial logistic regression analysis, we found a cross-level interaction (P=0.04) between individual-level exposure to disaster-related stressors and community-level building damage. Individual-level stressors were significantly predictive of individual service needs in communities with building damage (adjusted odds ratio: 2.56; 95% confidence interval: 1.58-4.16) and not in communities without damage. Individuals who experienced individual stressors and who lived in more damaged communities were more likely to report need for services than were other persons after Hurricane Sandy. (Disaster Med Public Health Preparedness. 2016;10:428-435).

Sexual stigma, criminalization, investment, and access to HIV services among men who have sex with men worldwide.

PubMed

Arreola, Sonya; Santos, Glenn-Milo; Beck, Jack; Sundararaj, Mohan; Wilson, Patrick A; Hebert, Pato; Makofane, Keletso; Do, Tri D; Ayala, George

2015-02-01

Globally, HIV disproportionately affects men who have sex with men (MSM). This study explored associations between access to HIV services and (1) individual-level perceived sexual stigma; (2) country-level criminalization of homosexuality; and (3) country-level investment in HIV services for MSM. 3,340 MSM completed an online survey assessing access to HIV services. MSM from over 115 countries were categorized according to criminalization of homosexuality policy and investment in HIV services targeting MSM. Lower access to condoms, lubricants, and HIV testing were each associated with greater perceived sexual stigma, existence of homosexuality criminalization policies, and less investment in HIV services. Lower access to HIV treatment was associated with greater perceived sexual stigma and criminalization. Criminalization of homosexuality and low investment in HIV services were both associated with greater perceived sexual stigma. Efforts to prevent and treat HIV among MSM should be coupled with structural interventions to reduce stigma, overturn homosexuality criminalization policies, and increase investment in MSM-specific HIV services.

5 CFR 630.301 - Annual leave accrual and accumulation-Senior Executive Service, Senior-Level, and Scientific and...

Code of Federal Regulations, 2010 CFR

2010-01-01

...-Senior Executive Service, Senior-Level, and Scientific and Professional Employees. 630.301 Section 630... LEAVE Annual Leave § 630.301 Annual leave accrual and accumulation—Senior Executive Service, Senior... the full pay period, and who— (1) Holds a position in the Senior Executive Service (SES) which is...

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that target the disadvantaged household groups.

Managing for No Net Loss of Ecological Services: An Approach for Quantifying Loss of Coastal Wetlands due to Sea Level Rise

NASA Astrophysics Data System (ADS)

Kassakian, Jennifer; Jones, Ann; Martinich, Jeremy; Hudgens, Daniel

2017-05-01

Sea level rise has the potential to substantially alter the extent and nature of coastal wetlands and the critical ecological services they provide. In making choices about how to respond to rising sea level, planners are challenged with weighing easily quantified risks (e.g., loss of property value due to inundation) against those that are more difficult to quantify (e.g., loss of primary production or carbon sequestration services provided by wetlands due to inundation). Our goal was to develop a cost-effective, appropriately-scaled, model-based approach that allows planners to predict, under various sea level rise and response scenarios, the economic cost of wetland loss—with the estimates proxied by the costs of future restoration required to maintain the existing level of wetland habitat services. Our approach applies the Sea Level Affecting Marshes Model to predict changes in wetland habitats over the next century, and then applies Habitat Equivalency Analysis to predict the cost of restoration projects required to maintain ecological services at their present, pre-sea level rise level. We demonstrate the application of this approach in the Delaware Bay estuary and in the Indian River Lagoon (Florida), and discuss how this approach can support future coastal decision-making.

Managing for No Net Loss of Ecological Services: An Approach for Quantifying Loss of Coastal Wetlands due to Sea Level Rise.

PubMed

Kassakian, Jennifer; Jones, Ann; Martinich, Jeremy; Hudgens, Daniel

2017-05-01

Sea level rise has the potential to substantially alter the extent and nature of coastal wetlands and the critical ecological services they provide. In making choices about how to respond to rising sea level, planners are challenged with weighing easily quantified risks (e.g., loss of property value due to inundation) against those that are more difficult to quantify (e.g., loss of primary production or carbon sequestration services provided by wetlands due to inundation). Our goal was to develop a cost-effective, appropriately-scaled, model-based approach that allows planners to predict, under various sea level rise and response scenarios, the economic cost of wetland loss-with the estimates proxied by the costs of future restoration required to maintain the existing level of wetland habitat services. Our approach applies the Sea Level Affecting Marshes Model to predict changes in wetland habitats over the next century, and then applies Habitat Equivalency Analysis to predict the cost of restoration projects required to maintain ecological services at their present, pre-sea level rise level. We demonstrate the application of this approach in the Delaware Bay estuary and in the Indian River Lagoon (Florida), and discuss how this approach can support future coastal decision-making.

Assistive technology outcomes in post-secondary students with disabilities: the influence of diagnosis, gender, and class-level.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-01

This study investigated how outcomes of assistive technology (AT) services for college students with disabilities are influenced by diagnosis, gender and class-level (e.g., Freshman). Students' pre- and post-intervention ratings of their performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure, COPM) were analyzed, as well as students' responses on a survey about AT service provision, use, and preferences. Data from 455 students revealed "learning disability" to be the most prevalent diagnosis (38%), similar numbers of females and males served, and Freshmen (23.1%) as the largest class-level seeking AT services. For COPM data, each two-way analysis of variance (ANOVA) (grouping variable = diagnosis) revealed that pre-post change scores significantly improved for the entire sample, and that students with a mood disorder experienced the greatest changes compared to other diagnoses. COPM scores significantly and similarly improved for females and males, and across class levels. AT Survey ratings about timeliness of services and independent AT use were significantly lower for students with mobility deficits/pain and neurological damage, respectively. Gender and class-level variables did not significantly impact AT Survey ratings. The study results reveal that features of a college student's diagnosis may influence AT service outcomes, and student-perceptions of AT services ability to use AT. Implications for Rehabilitation College students who are Freshman and/or who have a learning disability are the most prevalent students referred for campus-based assistive technology services. While student ratings of academic task performance significantly increase across diagnostic groupings, these improvements were greatest for those with a mood disorder compared to other diagnostic groups. Service-providers should consider that features of certain diagnoses or disabilities may influence the student?s perception of AT service provision and their ability to use AT. A student's gender and class-level (e.g., Freshman) do not appear to influence the outcomes of AT services for college students with disabilities.

Use of SERVQUAL to assess clinicians' satisfaction with the blood transfusion service.

PubMed

Raspollini, E; Pappalettera, M; Riccardi, D; Parravicini, A; Sestili, S; Rebulla, P; Sirchia, G

1997-01-01

Limited information is available on the level of satisfaction of clinicians with services delivered by blood banks. The purpose of this study was to evaluate the satisfaction of clinicians with our blood transfusion service. We prepared a questionnaire based on SERVQUAL, a method used to measure customers' appreciation of quality of service, by assessing the gap between perceived and expected quality. The questionnaire consisted of 14 items grouped according to five dimensions of quality of service: assurance, empathy, responsiveness, reliability, tangibles. Clinicians were asked to give two scores on a scale from 1 to 7 for each item, score (e) representing what they expected from an 'excellent' service, score (r) how they graded the service received. We considered wide differences in scores of service expectation and receipt for a question to be indicative of either service above expected levels (r > e) or service below expectation (r < e); similar scores for both expected and received service (within 1 point on the grading scale) were taken to indicate that the service received was that which was expected. A total of 184 questionnaires (49%) were returned. For the 14 items considered, the proportion of clinicians expressing levels of satisfaction similar to or above expectation ranged from 67 to 96%. Three critical areas, which clinicians considered important (expectation scores 6-7) were associated with satisfaction below expectation in more than 20% of responders. They were: clarity of procedures, clarity of blood request forms, and convenience of blood request and issuing times, which were rated as important by 77, 80 and 72% of clinicians, respectively. SERVQUAL was useful to gather information on the level of clinicians' satisfaction with our transfusion service.

Contextual Predictors of Mental Health Service Use Among Children Open to Child Welfare

PubMed Central

Leslie, Laurel K.; Landsverk, John; Barth, Richard P.; Burns, Barbara J.; Gibbons, Robert D.; Slymen, Donald J.; Zhang, Jinjin

2006-01-01

Background Children involved with child welfare systems are at high risk for emotional and behavioral problems. Many children with identified mental health problems do not receive care, especially ethnic/minority children. Objective To examine how patterns of specialty mental health service use among children involved with child welfare vary as a function of the degree of coordination between local child welfare and mental health agencies. Design Specialty mental health service use for 1 year after contact with child welfare was examined in a nationally representative cohort of children aged 2 to 14 years. Predictors of service use were modeled at the child/family and agency/county levels. Child- and agency-level data were collected between October 15,1999, and April 30, 2001. Setting Ninety-seven US counties. Participants A total of 2823 child welfare cases (multiple informants) from the National Survey of Child and Adolescent Well-being and agency-level key informants from the participating counties. Main Outcome Measures Specialty mental health service use during the year after contact with the child welfare system. Results Only 28.3% of children received specialty mental health services during the year, although 42.4% had clinical-level Child Behavior Checklist scores. Out-of-home placement, age, and race/ethnicity were strong predictors of service use rates, even after controlling for Child Behavior Checklist scores. Increased coordination between local child welfare and mental health agencies was associated with stronger relationships between Child Behavior Checklist scores and service use and decreased differences in rates of service use between white and African American children. Conclusions Younger children and those remaining in their homes could benefit from increased specialty mental health services. They have disproportionately low rates of service use, despite high levels of need. Increases in interagency coordination may lead to more efficient allocation of service resources to children with the greatest need and to decreased racial/ethnic disparities. PMID:15583113

Talking about the institutional complexity of the integrated rehabilitation system-the importance of coordination.

PubMed

Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani

2013-01-01

Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services. The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy in Finland and how the policy has tried to overcome the negative effects of institutional complexity. In this study we used qualitative content analysis and frame analysis. As a result we identified four different welfare state frames with distinct features of policy problems, policy alternatives and institutional failure. The rehabilitation policy in Finland seems to be divided into different components which may cause problems at the level of service delivery and thus in the integration of services. Bringing these components together could at policy level enable a shared view of the rights of different population groups, effective management of integration at the level of service delivery and also an opportunity for change throughout the rehabilitation system.

Physical activity levels of older adults receiving a home care service.

PubMed

Burton, Elissa; Lewin, Gill; Boldy, Duncan

2013-04-01

The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.

Clients’ perception and satisfaction toward service provided by pharmacy professionals at a teaching hospital in Ethiopia

PubMed Central

Teshome Kefale, Adane; Hagos Atsebah, Gebru; Ayele Mega, Teshale

2016-01-01

Background Evaluation of client’s perception and satisfaction with pharmacy services is important to identify specific areas of the service that need improvement in achieving high-quality pharmacy services. It also helps to detect the gaps in the current pharmaceutical services provision. Objective To assess clients’ perception and satisfaction toward service provided by pharmacy professionals at Mizan-Tepi University Teaching Hospital. Methods A cross-sectional study design was employed from March 8 to 24, 2016. A semistructured questionnaire was used to assess clients’ perception and satisfaction toward service provided by pharmacy professionals. The data collected were entered into Epi data 3.1, cleaned, and transported into and analyzed using SPSS version 20. Logistic regression was employed to determine associated factors, and statistical significance was considered at p-value <0.05. Results Among 384 respondents, 53.1% were male. Of the total participants, 63.8% had good perception and 36.2% had poor perception toward pharmacy services. With regard to satisfaction, 52.6% of the respondents were satisfied and 47.4% were unsatisfied by the pharmaceutical services. Sociodemographic variables such as educational level (p=0.000), occupation (p=0.031), payment for service (p=0.002), and reasons the respondents seek service (p=0.001) showed statistically significant association with the level of perception. Clients’ satisfaction was found to be significantly associated with educational level (p=0.002) and reason for seeking service (p=0.016). Conclusion and recommendation This study showed that the overall mean perception and satisfaction of clients in Mizan-Tepi University Teaching Hospital was low, even though it was above the mean level of perception and satisfaction. Action has to be taken to improve the perception and satisfaction of clients with the services provided in the pharmacy section. PMID:29354544

Clients' perception and satisfaction toward service provided by pharmacy professionals at a teaching hospital in Ethiopia.

PubMed

Teshome Kefale, Adane; Hagos Atsebah, Gebru; Ayele Mega, Teshale

2016-01-01

Evaluation of client's perception and satisfaction with pharmacy services is important to identify specific areas of the service that need improvement in achieving high-quality pharmacy services. It also helps to detect the gaps in the current pharmaceutical services provision. To assess clients' perception and satisfaction toward service provided by pharmacy professionals at Mizan-Tepi University Teaching Hospital. A cross-sectional study design was employed from March 8 to 24, 2016. A semistructured questionnaire was used to assess clients' perception and satisfaction toward service provided by pharmacy professionals. The data collected were entered into Epi data 3.1, cleaned, and transported into and analyzed using SPSS version 20. Logistic regression was employed to determine associated factors, and statistical significance was considered at p -value <0.05. Among 384 respondents, 53.1% were male. Of the total participants, 63.8% had good perception and 36.2% had poor perception toward pharmacy services. With regard to satisfaction, 52.6% of the respondents were satisfied and 47.4% were unsatisfied by the pharmaceutical services. Sociodemographic variables such as educational level ( p =0.000), occupation ( p =0.031), payment for service ( p =0.002), and reasons the respondents seek service ( p =0.001) showed statistically significant association with the level of perception. Clients' satisfaction was found to be significantly associated with educational level ( p =0.002) and reason for seeking service ( p =0.016). This study showed that the overall mean perception and satisfaction of clients in Mizan-Tepi University Teaching Hospital was low, even though it was above the mean level of perception and satisfaction. Action has to be taken to improve the perception and satisfaction of clients with the services provided in the pharmacy section.

14 CFR 272.6 - Considerations in the determination of essential air service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS ESSENTIAL AIR SERVICE TO THE FREELY ASSOCIATED STATES... other factors, the following: (1) The demonstrated level of traffic demand; (2) The amount of compensation necessary to maintain a level of service sufficient to meet that demand; (3) The extent to which...

GreenIT Service Level Agreements

NASA Astrophysics Data System (ADS)

von Laszewski, Gregor; Wang, Lizhe

In this paper we are introducing a framework towards the inclusion of Green IT metrics as part of service level agreements for future Grids and Clouds. As part of this effort we need to revisit Green IT metrics and proxies that we consider optimizing against in order to develop GreenIT as a Services (GaaS) that can be reused as part of a Software as a Service (SaaS) and Infrastructure Infrastructureas a service (IaaS) framework. We report on some of our ongoing efforts and demonstrate how we already achieve impact on the environment with our services.

Reliable Change and Outcome Trajectories Across Levels of Care in a Mental Health System for Youth.

PubMed

Jackson, David S; Keir, Scott S; Sender, Max; Mueller, Charles W

2017-01-01

Knowledge of mental health treatment outcome trajectories across various service types can be valuable for both system- and client-level decision-making. Using longitudinal youth functional impairment scores across 2807 treatment episodes, this study examined outcome trajectories and estimated the number of months required for reliable change across nine major services (or levels of care). Results indicate logarithmic improvement trajectories for a majority of levels of care and significant differences in time until improvement ranging from 4 to 12 months. Findings can guide system-level policies on lengths of treatment and service authorizations and provide expected treatment response data for client-level treatment decisions.

Schools and Libraries Program: Update on State-Level Funding by Category of Service. Report to the Honorable John D. Rockefeller IV, U.S. Senate.

ERIC Educational Resources Information Center

Czerwinski, Stanley J.

This report provides state-level data on the amount of funds committed to the following three categories of eligible services for each of the first three years of the Federal Communications Commission's e-rate program for schools and libraries: (1) telecommunications service, such as local, long-distance, and international telephone service, as…

Technology Integration Support Levels for In-Service Teachers

ERIC Educational Resources Information Center

Williams, Mable Evans

2017-01-01

In-service teachers across the globe are expected to integrate technology in their respective instructional content area. The purpose of this qualitative study was to explore the perceptions of in-service teachers concerning building-level support for technology integration. Participants in the study were asked to participate in semi-structured…

The impact of autism services on mothers' psychological wellbeing.

PubMed

Hodgetts, S; McConnell, D; Zwaigenbaum, L; Nicholas, D

2017-01-01

Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. Mothers (n = 119) of children (mean child age 10.1 years; range 2-24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables. © 2016 John Wiley & Sons Ltd.

Identifying maternity services in public hospitals in rural and remote Australia.

PubMed

Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

2014-06-01

This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

Does long-term care insurance affect the length of stay in hospitals for the elderly in Korea?: a difference-in-difference method.

PubMed

Hyun, Kyung-Rae; Kang, Sungwook; Lee, Sunmi

2014-12-21

This study examines the effects of long-term care insurance (LTCI) on the length of stay (LoS) of senior citizens under the national health insurance of Korea. The subjects include 3,903,448 people aged 65 and over as of July 1, 2008 when the LTCI was introduced in Korea. This study uses their panel data which traced the records of medical services and LTCI services for the same people from 2007 to 2010, and applies a difference-in-difference approach on LTCI users from levels 1, 2, and 3 who are the treatment group and non-LTCI users who are the control group. We found that the LoS of LTCI users is 1.27 days greater than that of non-LTCI users, but the LoS of level 1 and level 2 beneficiaries decreases by 8.35 and 2.84 days, respectively, whereas the LTCI does not reduce the LoS of level 3 beneficiaries. The reason why there is an effect on the LoS of level 1 and 2 beneficiaries is that these groups could choose to utilize institutional care services provided by the LTCI, and out-of-pocket costs of institutions are lower than that of hospitals. However, the reason why there is no effect on the LoS of level 3 beneficiaries is that they are not permitted to use the institutional care services in the Korean LTCI policy. Therefore, we recommend a modification in the LTCI system that facilitates the use of long-term care institutional services by level 3 beneficiaries without conflicting Korea's LTCI principle to promote home-based care services instead of the institutional care services.

Factors Influencing Utilization of Primary Health Care Services in Patients with Chronic Respiratory Diseases.

PubMed

Kurpas, D; Bujnowska-Fedak, M M; Athanasiadou, A; Mroczek, B

2015-01-01

The purpose of our study was to determine the factors affecting the level of services provided in primary health care among patients with chronic respiratory diseases. The study group consisted of 299 adults (median age: 65, min-max: 18-92 years) with mixed chronic respiratory diseases, recruited from patients of 135 general practitioners. In the analysis, in addition to the assessment of the provided medical services, the following were used: Patient Satisfaction Questionnaire, Camberwell Assessment of Needs Short Appraisal Schedule, Acceptance of Illness Scale, and WHO Quality of Life Instrument Short Form. Variables that determined the level of services were the following: age, place of residence, marital status, number of chronic diseases, and level of disease acceptance, quality of life, and health behaviors. The level of provided services correlated with variables such as gender, severity of somatic symptoms, level of satisfied needs, and satisfaction with health care. We concluded that in patients with mixed chronic respiratory diseases a higher level of health care utilization should be expected in younger patients, those living in the countryside, those having a partner, with multimorbidity, a low level of disease acceptance, those satisfied with their current quality of life, with positive mental attitudes, and maintaining health practices.

Relation Between the Level of American Indian and Alaska Native Diabetes Education Program Services and Quality-of-Care Indicators

PubMed Central

Noonan, Carolyn; Goldberg, Jack H.; Valdez, S. Lorraine; Brown, Tammy L.; Manson, Spero M.; Acton, Kelly

2008-01-01

Objectives. We examined the relation between the level of diabetes education program services in the Indian Health Service (IHS) and indicators of the quality of diabetes care to determine if more-comprehensive diabetes services were associated with better quality of diabetes care. Methods. In this cross-sectional study, we used the IHS Integrated Diabetes Education Recognition Program to rank program services into 1 of 3 levels of comprehensiveness, ranging from lowest (developmental) to highest (integrated). We compared quality-of-care indicators among programs of differing levels with the 2001 IHS Diabetes Care and Outcomes Audit. Quality indicators included patients having recommended yearly examinations, education, and laboratory tests and achieving recommended levels of intermediate outcomes of care. Results. Most of the 86 participating programs were classified at or below the developmental level; only 9 programs (11%) were ranked at higher levels. After adjusting for patient characteristics, program factors, and correlation of patients within programs, we associated programs that were more comprehensive with higher completion rates of yearly lipid and hemoglobin A1C tests (P < .05). Conclusions. System-wide improvements in diabetes education are associated with better diabetes care. The results can help inform the development of diabetes education programs. PMID:18511737

[Inequality and inequity in the use of medical services in Chile, by age group, 2000-2011].

PubMed

Chovar Vera, Alejandra; Vásquez Lavín, Felipe; Paraje, Guillermo

2014-09-01

To calculate indices of inequality and inequity in the use of medical services for children, adults, and older adults in Chile from 2000 to 2011. Based on the CASEN survey (2000-2011), the concentration index (CI) was calculated to measure inequality and the horizontal inequity index (HI) was calculated to measure inequity in the use of medical services. Four groups were studied: children under 5, children aged 6-18 years, adults, and older adults. The results indicate higher levels of inequality in the use of specialized physician services in the child groups, and higher levels of inequity in the adult group. In the use of dental services, the greatest inequality and inequity is found among older adults. For visits to emergency services in the last two years for which data are available (2009 and 2011), the adult group shows a higher level of inequality. In terms of levels of inequity and inequality, there are differences among children, adults, and older adults over the years in at least three of the six variables studied.

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 impact of technological intensity of service provision on physician expenditures: an exploratory investigation.

PubMed

Roham, Mehrdad; Gabrielyan, Anait R; Archer, Norman P; Grignon, Michel L; Spencer, Byron G

2014-10-01

Advances in technology and subsequent changes in clinical practice can lead to increases in healthcare costs. Our objective is to assess the impact that changes in the technological intensity of physician-provided health services have had on the age pattern of both the volume of services provided and the average expenditures associated with them. We based our analysis on age-sex-specific patient-level administrative records of diagnoses and treatments. These records include virtually all physician services provided in the province of Ontario, Canada in a 10-year span ending in 2004 and their associated costs. An algorithm is developed to classify services and their costs into three levels of technological intensity. We find that while the overall age-standardized level and cost of services per capita have decreased, the volume and cost of high technologically intensive treatments have increased, especially among older patients. Copyright © 2013 John Wiley & Sons, Ltd.

Identifying priority areas for ecosystem service management in South African grasslands.

PubMed

Egoh, Benis N; Reyers, Belinda; Rouget, Mathieu; Richardson, David M

2011-06-01

Grasslands provide many ecosystem services required to support human well-being and are home to a diverse fauna and flora. Degradation of grasslands due to agriculture and other forms of land use threaten biodiversity and ecosystem services. Various efforts are underway around the world to stem these declines. The Grassland Programme in South Africa is one such initiative and is aimed at safeguarding both biodiversity and ecosystem services. As part of this developing programme, we identified spatial priority areas for ecosystem services, tested the effect of different target levels of ecosystem services used to identify priority areas, and evaluated whether biodiversity priority areas can be aligned with those for ecosystem services. We mapped five ecosystem services (below ground carbon storage, surface water supply, water flow regulation, soil accumulation and soil retention) and identified priority areas for individual ecosystem services and for all five services at the scale of quaternary catchments. Planning for individual ecosystem services showed that, depending on the ecosystem service of interest, between 4% and 13% of the grassland biome was required to conserve at least 40% of the soil and water services. Thirty-four percent of the biome was needed to conserve 40% of the carbon service in the grassland. Priority areas identified for five ecosystem services under three target levels (20%, 40%, 60% of the total amount) showed that between 17% and 56% of the grassland biome was needed to conserve these ecosystem services. There was moderate to high overlap between priority areas selected for ecosystem services and already-identified terrestrial and freshwater biodiversity priority areas. This level of overlap coupled with low irreplaceability values obtained when planning for individual ecosystem services makes it possible to combine biodiversity and ecosystem services in one plan using systematic conservation planning. Copyright © 2011 Elsevier Ltd. All rights reserved.

Family-centred service coordination in childhood health and disability services: the search for meaningful service outcome measures.

PubMed

Trute, B; Hiebert-Murphy, D; Wright, A

2008-05-01

Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.

Accessing disability services by people from culturally and linguistically diverse backgrounds in Australia.

PubMed

Zhou, Qingsheng

2016-01-01

To examine whether differences in access to specialist disability services by people from culturally and linguistically diverse (CALD) backgrounds when compared with those born in Australia represent a service gap or the healthy migrant effect. To use the latest disability statistics to measure the different rates of people with disability, and the rates of people with profound and severe disability, of people born in Australia and those born abroad; to compare the difference between those who mainly speak English with those who primarily speak a language other than English at home (LOTE); and examine the age-specific and standardised disability rates of these subgroups. The rate of access of specialist disability services by people with disability who were from CALD backgrounds is highly disproportionate to their presence in the community. As a whole, people from CALD backgrounds have a similar level of disability as Australia-born people. They have a greater rate of profound and severe disability and a higher level of need for assistance in undertaking core activities. For younger age cohorts targeted by specialist disability services, there is little difference in the level of need for assistance between people from CALD backgrounds and the rest of community. Those people who mainly speak LOTE at home have a relatively higher level of need for assistance than those who speak mainly English at home. The paper reveals a substantial gap in specialist disability services between people from CALD and the broader community. This cannot be explained by the difference in the level of need for assistance between Australia-born and overseas-born populations, therefore raises some policy questions as to the barriers to the use of such services and how to effectively narrow the service access gap and improve utilisation rates. The paper reveals a substantial accessibility gap in specialist disability services between people from culturally and linguistically diverse (CALD) backgrounds and the broader community in Australia. Rehabilitation is a large component of disability services. Therefore, understanding the gap, promoting the awareness of the services, developing appropriate and effective services to respond the need of people with disability from CALD backgrounds, are critically important to rehabilitation services and related research.

[Study on elasticity of medical service demand at the township level in China].

PubMed

Shi, Hong-xing; Lv, Jun; Xie, Yi-ping; Wang, Ying; Jia, Jin-zhong; Chang, Feng-shui; Duan, Lin; Sun, Mei; Wang, Zhi-feng; Hao, Mo

2010-06-18

To find out the economic laws regulating medical service demand in accordance with influencing factors at the township level, thus to provide references for further adjusting the medical service demand reasonably in the future. The model of medical service demand was established to measure the elasticity of demand in 49 township health clinics in 1995, 1999, 2003 and 2007. The price elasticity of outpatient and inpatient demand was stable during the four periods, and the average value was -0.029 and -0.132 respectively; the average value of income elasticity was 0.973 and 0.977, registering a downward trend in general. The medical service demand at the township level is price inelastic, indicating that it is a necessity for rural residents. The downward trend of income elasticity under the influence of some health policies illustrates a lightening in economic burden for medical service demand among rural residents in township health clinics.

Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

PubMed

Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

2014-09-01

We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

Customer Satisfaction Survey With Clinical Laboratory and Phlebotomy Services at a Tertiary Care Unit Level

PubMed Central

Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L.; Lee, Eun Yup; Son, Han Chul

2014-01-01

We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level. PMID:25187892

An Integrated Model of Patient and Staff Satisfaction Using Queuing Theory

PubMed Central

Mousavi, Ali; Clarkson, P. John; Young, Terry

2015-01-01

This paper investigates the connection between patient satisfaction, waiting time, staff satisfaction, and service time. It uses a variety of models to enable improvement against experiential and operational health service goals. Patient satisfaction levels are estimated using a model based on waiting (waiting times). Staff satisfaction levels are estimated using a model based on the time spent with patients (service time). An integrated model of patient and staff satisfaction, the effective satisfaction level model, is then proposed (using queuing theory). This links patient satisfaction, waiting time, staff satisfaction, and service time, connecting two important concepts, namely, experience and efficiency in care delivery and leading to a more holistic approach in designing and managing health services. The proposed model will enable healthcare systems analysts to objectively and directly relate elements of service quality to capacity planning. Moreover, as an instrument used jointly by healthcare commissioners and providers, it affords the prospect of better resource allocation. PMID:27170899

An Integrated Model of Patient and Staff Satisfaction Using Queuing Theory.

PubMed

Komashie, Alexander; Mousavi, Ali; Clarkson, P John; Young, Terry

2015-01-01

This paper investigates the connection between patient satisfaction, waiting time, staff satisfaction, and service time. It uses a variety of models to enable improvement against experiential and operational health service goals. Patient satisfaction levels are estimated using a model based on waiting (waiting times). Staff satisfaction levels are estimated using a model based on the time spent with patients (service time). An integrated model of patient and staff satisfaction, the effective satisfaction level model, is then proposed (using queuing theory). This links patient satisfaction, waiting time, staff satisfaction, and service time, connecting two important concepts, namely, experience and efficiency in care delivery and leading to a more holistic approach in designing and managing health services. The proposed model will enable healthcare systems analysts to objectively and directly relate elements of service quality to capacity planning. Moreover, as an instrument used jointly by healthcare commissioners and providers, it affords the prospect of better resource allocation.

Measuring e-Commerce service quality from online customer review using sentiment analysis

NASA Astrophysics Data System (ADS)

Kencana Sari, Puspita; Alamsyah, Andry; Wibowo, Sulistyo

2018-03-01

The biggest e-Commerce challenge to understand their market is to chart their level of service quality according to customer perception. The opportunities to collect user perception through online user review is considered faster methodology than conducting direct sampling methodology. To understand the service quality level, sentiment analysis methodology is used to classify the reviews into positive and negative sentiment for five dimensions of electronic service quality (e-Servqual). As case study in this research, we use Tokopedia, one of the biggest e-Commerce service in Indonesia. We obtain the online review comments about Tokopedia service quality during several month observations. The Naïve Bayes classification methodology is applied for the reason of its high-level accuracy and support large data processing. The result revealed that personalization and reliability dimension required more attention because have high negative sentiment. Meanwhile, trust and web design dimension have high positive sentiments that means it has very good services. The responsiveness dimension have balance sentiment positive and negative.

Penalty-rewards contrast analysis (PRCA) on the KL monorail services

NASA Astrophysics Data System (ADS)

Muda, Nora; Suradi, Nur Riza; Mat Roji, Noor Sulawati

2013-04-01

Changes in living standards, tastes, views and education has changed the lifestyles where people are more emphasizing on quality and satisfaction with public amenities provided. One of the services provided is the KL Monorail; a public transport service which is based on a single beam track in the city that connects the north and center of Kuala Lumpur. Therefore, this study measures the customer satisfaction on the KL Monorail services and to identify the factors that should be given priority in improving their service levels. There were seven attributes being studied, namely the informations, the situation at the station, the situation in the KL Monorail, customer service, safety, efficiency and other aspects. The analysis found that the overall customer satisfactionis mean is 4.86. Based on the measurement of Penalty-Reward Contrast Analysis (PRCA), most of the KL Monorail service attribute are at moderate level of satisfaction except for the attributes at the station that have lower level of satisfaction. Therefore, a remedial actions or planning is needed to improve the customer satisfaction on the KL Monorail services.

78 FR 34083 - Proposed Reductions in Levels of Service at Locks and Dams on the J Bennett Johnston Waterway...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

... DEPARTMENT OF DEFENSE Department of the Army; Corps of Engineers Proposed Reductions in Levels of... Marine Transportation System Level of Service Guidelines led to the reduced hours of operation for Lock 3... matches existing lock usage. Pool levels will not be affected by change of operating hours. DATES...

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

PubMed Central

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

2010-01-01

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

Factors that Influence Pre-Service Administrators' Views of Appropriate School Counselor Duties

ERIC Educational Resources Information Center

Mason, Kimberly L.; Perera-Diltz, Dilani M.

2010-01-01

This study surveyed pre-service administrative internship students (N = 61) at an urban Midwestern state university to explore factors that influence duties assigned to school counselors at the elementary, middle, and high school levels. Results indicated variation in duties assigned by pre-service administrators based on school building level.…

Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

PubMed

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-05-01

Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31-0.66; Ptrend < 0.001).This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed.

Income Disparities in the Use of Health Screening Services Among University Students in Korea

PubMed Central

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-01-01

Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31–0.66; Ptrend < 0.001). This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed. PMID:27196475

NEXUS - Resilient Intelligent Middleware

NASA Astrophysics Data System (ADS)

Kaveh, N.; Hercock, R. Ghanea

Service-oriented computing, a composition of distributed-object computing, component-based, and Web-based concepts, is becoming the widespread choice for developing dynamic heterogeneous software assets available as services across a network. One of the major strengths of service-oriented technologies is the high abstraction layer and large granularity level at which software assets are viewed compared to traditional object-oriented technologies. Collaboration through encapsulated and separately defined service interfaces creates a service-oriented environment, whereby multiple services can be linked together through their interfaces to compose a functional system. This approach enables better integration of legacy and non-legacy services, via wrapper interfaces, and allows for service composition at a more abstract level especially in cases such as vertical market stacks. The heterogeneous nature of service-oriented technologies and the granularity of their software components makes them a suitable computing model in the pervasive domain.

An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

PubMed

Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

2015-01-01

In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

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

PubMed

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

2005-12-01

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

Exploring resilience and mindfulness as preventative factors for psychological distress burnout and secondary traumatic stress among human service professionals.

PubMed

Harker, Rachel; Pidgeon, Aileen M; Klaassen, Frances; King, Steven

2016-06-08

Human service professionals are concerned with the intervention and empowerment of vulnerable social populations. The human service industry is laden with employment-related stressors and emotionally demanding interactions, which can lead to deleterious effects, such as burnout and secondary traumatic stress. Little attention has been given to developing knowledge of what might enable human service workers to persist and thrive. Cultivating and sustaining resilience can buffer the impact of occupational stressors on human service professionals. One of the psychological factors associated with cultivating resilience is mindfulness. The aim of this current research is to improve our understanding of the relationship between resilience, mindfulness, burnout, secondary traumatic stress, and psychological distress among human service professionals. The current study surveyed 133 human service professionals working in the fields of psychology, social work, counseling, youth and foster care work to explore the predictive relationship between resilience, mindfulness, and psychological distress. The results showed that higher levels of resilience were a significant predictor of lower levels of psychological distress, burnout and secondary traumatic stress. In addition, higher levels of mindfulness were a significant predictor of lower levels of psychological distress and burnout. The findings suggest that cultivating resilience and mindfulness in human service professionals may assist in preventing psychological distress burnout and secondary traumatic stress. Limitations of this study are discussed together with implications for future research.

An Investigation into Specifying Service Level Agreements for Provisioning Cloud Computing Services

DTIC Science & Technology

2012-12-01

IT .................................................................................................... Information Technology KPI ...the service delivery be measured? 3. Key Performance Indicators ( KPIs ): Describe the KPIs and the responsible party for producing the KPIs . 4...level objectives (SLOs) that are evaluated according to measurable Key Performance Indicators ( KPIs ). Automatic SLA protection enables further

Library Users' Service Desires: A LibQUAL+ Study

ERIC Educational Resources Information Center

Thompson, Bruce; Kyrillidou, Martha; Cook, Colleen

2008-01-01

The present study was conducted to explore library users' desired service quality levels on the twenty-two core LibQUAL+ items. Specifically, we explored similarities and differences in users' desired library service quality levels across user groups (i.e., undergraduate students, graduate students, and faculty), across geographic locations (i.e.,…

Impact of Support Services on Associate Level Nursing Programs

ERIC Educational Resources Information Center

Busby-Parker, Michelle N.

2014-01-01

The goal of the research was to show the impact of the implementation of support services on admissions and graduation from nursing programs. The use of support services has been linked to higher levels of success in nursing students in the classroom and the work place. As nursing schools experience pressure to increase the student capacity to…

Self-reported assistive technology outcomes and personal characteristics in college students with less-apparent disabilities.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-20

The impact of assistive technology (AT) services for college students with less-apparent disabilities is under-reported. Using the Canadian Occupational Performance Measure (COPM), we assessed student Performance and Satisfaction ratings of common academic tasks at the start and end of a semester during which 105 student-clients with less-apparent disabilities received AT services. We examined if COPM scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student's follow-through with an AT service referral (n=231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n=187). COPM ratings significantly increased in all academic tasks (p<.001). Gender predicted initial Satisfaction (male ratings > female ratings; p=.01), and Performance changes (females were more likely to have a service-meaningful change; p=.02). Higher class-level predicted better follow-through with a referral for AT services (p=.006). Increasing class-level (p=.05) and higher initial studying (p<.006) and reading (p<.029) ratings predicted a lower likelihood for dropout. These findings demonstrate that college students with less-apparent disabilities experience substantial improvements in their self-ratings of academic performance and satisfaction following AT services. Gender, class-level, and initial self-perceived reading and studying abilities may influence if and how the student participates with AT services.

Unmet needs for healthcare and social support services in patients with Huntington's disease: a cross-sectional population-based study.

PubMed

van Walsem, Marleen R; Howe, Emilie I; Iversen, Kristin; Frich, Jan C; Andelic, Nada

2015-09-28

In order to plan and improve provision of comprehensive care in Huntington's disease (HD), it is critical to understand the gaps in healthcare and social support services provided to HD patients. Research has described utilization of healthcare services in HD in Europe, however, studies systematically examining needs for healthcare services and social support are lacking. This study aims to identify the level and type of met and unmet needs for health and social care services among patients with HD, and explore associated clinical and socio-demographic factors. Eighty-six patients with a clinical diagnosis of HD living in the South-Eastern region of Norway were recruited. Socio-demographic and clinical characteristics were collected. The Needs and Provision Complexity Scale (NPCS) was used to assess the patients' needs for healthcare and social services. Functional ability and disease stage was assessed using the UHDRS Functional assessment scales. In order to investigate factors determining the level of total unmet needs and the level of unmet needs for Health and personal care and Social care and support services, multivariate logistic regression models were used. A high level of unmet needs for health and personal care and social support services were found across all five disease stages, but most marked in disease stage III. The middle phase (disease stage III) and advanced phase (disease stages IV and V) of HD increased odds of having a high level of total unmet needs by 3.5 times and 1.4 times respectively, compared with the early phase (disease stages I and II). Similar results were found for level of unmet needs in the domain Health and personal care. Higher education tended to decrease odds of high level of unmet needs in this domain (OR = 0.48) and increase odds of higher level of unmet needs in the domain of Social care and support (OR = 1.3). Patients reporting needs on their own tended to decrease odds of having unmet needs in Health and personal care (OR = 0.57). Needs for healthcare and social services in patients with HD should be assessed in a systematic manner, in order to provide adequate comprehensive care during the course of disease.

The effects of discrimination and acculturation to service seeking satisfaction for Latina and Asian American women: implications for mental health professions.

PubMed

Huang, Bu; Appel, Hoa; Ai, Amy L

2011-01-01

There is ample research showing that there are health disparities for minorities with respect to seeking mental health services in the United States. Although there are general barriers for minorities in seeking service health, minority women are more vulnerable due to their negative experiences and lower satisfaction in receiving health care, compared to men. This study utilized the National Latino and Asian American Study (NLAAS) data set, which is the first population-based mental health study on Latino and Asian Americans, to give a full description of Latina and Asian American women's experience in mental health service seeking and identifies the opportunities in increasing their satisfaction levels. The results showed that perceived discrimination attributed to gender or race/ethnicity is negatively predicting levels of satisfaction of mental health service seeking. Older age, higher education levels, longer duration in the United States, and better mental health, are positively related to satisfaction levels for Latina and Asian American women.

Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

PubMed Central

2012-01-01

Background Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and services significantly influenced the unmet needs of youths towards RH services. Conclusion Despite the availability of RH services, youth’s accessibility to and utilization of those services were unsatisfactory. The levels of youths’ unmet RH needs were alarmingly high. PMID:23241510

Patterns of home and community care service delivery to culturally and linguistically diverse residents of rural Victoria.

PubMed

Ward, Bernadette M; Anderson, Karen S; Sheldon, Maria S

2005-12-01

To describe and compare patterns of Home and Community Care (HACC) utilisation among culturally and linguistically diverse (CALD) people and Australian-born residents of rural Victoria. The HACC Minimum Data Set provides information regarding levels of service provision and coverage in Victoria. Data from January to June 2002 were analysed to provide a profile of client characteristics and service usage in rural Victoria. Patterns of service utilisation were compared with the profile of the CALD population in the 2001 Census. The proportion of CALD residents who are HACC clients is consistent with demographic profiles. However, their extent of service usage is not consistent with patterns of use by Australian-born residents. HACC clients born in non-English-speaking countries, receive 35% less hours of HACC service than their Australian-born counterparts. HACC clients born overseas in English-speaking countries receive nine per cent less hours of HACC service than the Australian-born group (F = 8.9, P = 0.00). Both groups of overseas-born clients use a smaller range of HACC services (F = 1.9, P = 0.16). Planners and service providers need to monitor levels of HACC service delivery among population groups to ensure that CALD population groups receive equitable levels of HACC services. The HACC Minimum Data Set is one source of data that can assist in this process.

Facilitators and Barriers of Drop-In Center Use Among Homeless Youth.

PubMed

Pedersen, Eric R; Tucker, Joan S; Kovalchik, Stephanie A

2016-08-01

Drop-in centers for homeless youth address basic needs for food, hygiene, and clothing but can also provide critical services that address youth's "higher level" needs (e.g., substance use treatment, mental health care, HIV-related programs). Unlike other services that have restrictive rules, drop-in centers typically try to break down barriers and take a "come as you are" approach to engaging youth in services. Given their popularity, drop-in centers represent a promising location to deliver higher level services to youth that may not seek services elsewhere. A better understanding of the individual-level factors (e.g., characteristics of homeless youth) and agency-level factors (e.g., characteristics of staff and environment) that facilitate and impede youth engagement in drop-in centers will help inform research and outreach efforts designed to engage these at-risk youth in services. Thus, the goal of this review was to develop a preliminary conceptual model of drop-in center use by homeless youth. Toward this goal, we reviewed 20 available peer-reviewed articles and reports on the facilitators and barriers of drop-in center usage and consulted broader models of service utilization from both youth and adult studies to inform model development. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

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

PubMed

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

2015-10-01

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

Patients'/Clients' Expectation Toward and Satisfaction from Pharmacy Services

PubMed Central

Ayalew, Mohammed Biset; Taye, Kaleab; Asfaw, Daniel; Lemma, Bethlehem; Dadi, Filagot; Solomon, Habtamu; Tazeze, Haile; Tsega, Bayew

2017-01-01

Objective: Satisfaction is becoming a popular health-care quality indicator as it reflects the reality of service or care provided. The aim of this study was to assess the level of patients' expectation toward and satisfaction from pharmacy service provided and to identify associated factor that might affect their expectation and satisfaction. Methods: A cross-sectional study was conducted on 287 patients, who were served in five pharmacies of Gondar University Hospital in May 2015. Data regarding socio-demographic characteristics and parameters that measure patients' expectation and satisfaction were collected through interview using the Amharic version of the questionnaire. Data were entered into SPSS version 21, and descriptive statistics, cross-tabs, and binary logistic regressions were utilized. P < 0.05 was used to declare association. Findings: Among 287 respondents involved in the study, 149 (51.9%) claimed to be satisfied with the pharmacy service and setting. Two hundred and twenty-nine (79.4%) respondents have high expectation toward gaining good services. Even though significant association was observed between the pharmacy type and patients level of satisfaction, sociodemographic characteristics of a patient were not found to predict the level of satisfaction. There is a higher level of expectation among study participants who earn higher income per month (>(2000 Ethiopian birr [ETB]) than those who get less income (<1000 ETB). Conclusion: Although patients have a higher level of expectation toward pharmacy services, their satisfaction from the service was found to be low. PMID:28331862

[Association between Service Utilization Patterns and Frailty in the Elderly Certified at the Support Level in the Long-term Care Insurance System].

PubMed

Yoshiyuki, Noriko; Kono, Ayumi; Soga, Tomoko; Kanaya, Yukiko; Hotta, Kuniko

2016-01-01

This cross-sectional study clarified the association between service utilization patterns and frailty in the elderly certified at the support level in Japan's long-term care insurance (LTCI) system. We analyzed 710 subjects who completed in-home assessments and interviews from 1,033 elderly aged 65 and over living in Izumiotsu who had been certified at the LTCI support level in August 2014. The long-term service utilization data were collected from the local governmental office. Frailty was examined by the in-home structured assessment conducted by local health and welfare professionals. As frailty indicators, we measured subjects' frailty using the Kaigo-Yobo-Checklist (CL frailty), handgrip strength, body mass index, depression, and cognitive function. Long-term service utilization patterns were classified into five patterns: (1) home helper service only, (2) day care service only, (3) home helper and day care service, (4) one or more other services (using at least one other service regardless of home helper or day care), and (5) no service utilization. Odds ratios (ORs) of each frailty indicator were estimated by service utilization patterns by using logistic regression analyses adjusted for demographic characteristics, with the other services group as the reference category. Out of 710 subjects (100%), the proportions of the service utilization patterns were as follows: home helper service only, 17.9%; day care service only, 15.6%; home helper and day care service, 13.1%; one or more other services, 27.0%; and no service utilization, 26.3%. The logistic regression analyses showed that compared with the one or more other services group, the day care service only group had lower odds of CL frailty (OR=0.57, 95% confidence interval (CI)=0.34 to 0.95) and lower odds of low handgrip strength (OR=0.59, 95% CI=0.35 to 1.00). The no service utilization group had lower odds of CL frailty (OR=0.50, 95% CI=0.32 to 0.79) and lower odds of low handgrip strength (OR=0.58, 95% CI=0.37 to 0.91). The home helper service only group had higher odds of low handgrip strength (OR=1.91, 95% CI=1.11 to 3.29). Long-term service utilization patterns of the elderly certified at the support level in the LTCI system were associated with frailty. Classifying frailty characteristics by long-term service utilization patterns may be considered as a method to provide community-based resources and support for older adults in the community.

Improving the Service with the Servqual Method

NASA Astrophysics Data System (ADS)

Midor, Katarzyna; Kučera, Marian

2018-03-01

At the time when economy is growing, there is strong competition in the market, and customers have increasingly higher expectations as regards quality of service and products. Under such conditions, organizations need to improve. One of the areas of improvement for an organization is to research the level of customer satisfaction. The article presents results of customer satisfaction surveys conducted by the Servqual method in a pharmaceutical service company. Use of this method allowed to improve the services provided by that pharmaceutical wholesaler, identify areas that need to be improved as soon as possible in order to improve the level of service provided.

Investigating Pre-Service Science Teachers' Critical Thinking Dispositions and Problem Solving Skills in Terms of Different Variables

ERIC Educational Resources Information Center

Yenice, Nilgun

2011-01-01

This study was conducted to examine pre-service science teachers' critical thinking dispositions and problem solving skills based on gender, grade level and graduated high school variables. Also relationship between pre-service science teachers' critical thinking dispositions and problem solving skills was examined based on gender, grade level and…

A Study of Army Civilian Entry Level and Mid-Level Program Management Leadership Development

DTIC Science & Technology

2016-05-08

and mid-grade level positions is an important responsibility for senior leaders. Mentoring and coaching entry level and mid-grade level...Program Management Leadership Development Craig J. Maurice Defense Acquisition University Senior Service College Fellowship 2015-2016 Huntsville...requirements for the Army’s Senior Service College Fellowship (SSCF) under the direction of SSCF Director, Mr. John Daniels and Research Advisor, Mr. Van

The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees.

PubMed

Parslow, Ruth A; Jorm, Anthony F; Christensen, Helen; Broom, Dorothy H; Strazdins, Lyndall; D' Souza, Rennie M

2004-09-30

This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs) for the six months before and after their survey interview was obtained from health insurance records. When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.

Ecological concerns following Superstorm Sandy: stressor level and recreational activity levels affect perceptions of ecosystem

PubMed Central

2015-01-01

Coastal habitats are vulnerable to storms, and with increasing urbanization, sea level rise, and storm frequency, some urban populations are at risk. This study examined perceptions of respondents in coastal and central New Jersey to Superstorm Sandy, including: 1) concerns about ecological resources and effects (open-ended question), 2) information sources for ecology of the coast (open-ended), and 3) ratings of a list of ecological services as a function of demographics, location (coastal, central Jersey), stressor level (power outages, high winds, flooding) and recreational rates. “Wildlife” and “fish” were the ecological concerns mentioned most often, while beaches and dunes were most often mentioned for environmental concerns. Television, radio, and web/internet were sources trusted for ecological information. The data indicate 1) stressor level was a better predictor of ratings of ecological services than geographical location, but days engaged in recreation contributed the most to variations in ratings, 2) ecological services were rated the highest by respondents with the highest stressor levels, and by those from the coast, compared to others, 3) Caucasians rated ecological services higher than all others, and 4) recreational rates were highest for coastal respondents, and ratings for ecological services increased with recreational rates. Only 20 % of respondents listed specific ecological services as one of their three most important environmental concerns. These data will be useful for increasing preparedness, enhancing educational strategies for shore protection, and providing managers and public policy makers with data essential to developing resiliency strategies. PMID:27011729

Unit-level voluntary turnover rates and customer service quality: implications of group cohesiveness, newcomer concentration, and size.

PubMed

Hausknecht, John P; Trevor, Charlie O; Howard, Michael J

2009-07-01

Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.

Parents' perspectives on centralized cleft services for children: the development of a DCE questionnaire.

PubMed

Ke, K M; Mackichan, F; Sandy, J R; Ness, A R; Hollingworth, W

2013-03-01

Incorporating user's perspectives in healthcare delivery is important. Simple questionnaires may not capture these as well as a discrete choice experiment (DCE) which enables the exploration of users' trade-offs between different service attributes. Qualitative methods are increasingly used to improve a DCE's face validity, but few studies adequately describe them. This paper describes the qualitative investigations in the development of a DCE questionnaire to elicit parents' perspectives on centralized services for children with cleft lip and palate. Semi-structured telephone interviews were conducted with 16 parents from across the UK, except Wales. Data analysis was carried out by the constant comparative method. Five attributes and their levels were inductively identified: usefulness and amount of information (four levels); staff attitude at cleft centres (two levels); continuity of care (two levels); personal costs of attending appointments (four levels); and cleft centres facilities (two levels). An unexpected finding was that parents' sense of responsibility towards their child made a 'willingness-to-travel' attribute unacceptable to them, but they were receptive to a 'willingness-to-pay' attribute. Using qualitative methods with service users in attribute development for a DCE helps to uncover issues that may not be apparent to researchers or health service staff. © 2012 John Wiley & Sons A/S.

Operational support and service concepts for observatories

NASA Astrophysics Data System (ADS)

Emde, Peter; Chapus, Pierre

2014-08-01

The operational support and service for observatories aim at the provision, the preservation and the increase of the availability and performance of the entire structural, mechanical, drive and control systems of telescopes and the related infrastructure. The operational support and service levels range from the basic service with inspections, preventive maintenance, remote diagnostics and spare parts supply over the availability service with telephone hotline, online and on-site support, condition monitoring and spare parts logistics to the extended service with operations and site and facility management. For the level of improvements and lifecycle management support they consist of expert assessments and studies, refurbishments and upgrades including the related engineering and project management activities.

An Investigation of Pre-Service Science Teachers' Level of Efficacy in the Undergraduate Science Teacher Education Program and Pedagogical Formation Program

ERIC Educational Resources Information Center

Çetin, Oguz

2017-01-01

The purpose of this research is to comparatively investigate the efficacy levels of pre-service science (Science, Biology, Physics, and Chemistry) teachers enrolled at the Undergraduate Program of Science Teacher Education and Pedagogical Formation Program. A total of 275 pre-service teachers who were studying in different programmes in the…

The costs of public primary health care services in rural Indonesia.

PubMed Central

Berman, P.; Brotowasisto; Nadjib, M.; Sakai, S.; Gani, A.

1989-01-01

Described are the results of a cost study of national rural health services carried out in Indonesia between November 1986 and March 1987. Detailed costings of government inputs to all public health services below the district hospital level were made for 41 subdistricts in five provinces that were representative of the different regions of the country. The total costs of services as well as the average costs for specific service functions were estimated for the whole country as well as for the different provinces. The results indicate a low overall level of government spending on rural primary health care. Regional differences in this respect were not significant, suggesting that the government policy of encouraging regional balance in allocations has been successful. The average costs for most services were much greater than the charges made to patients, and this provided information on the current level of government subsidies. There was a large variability in the average costs, indicating that the existing system is inefficient, that some districts were able to attain much higher levels of efficiency than others within the existing constraints, and that improvements in this respect are possible. PMID:2517412

An Investigation of the Relationship between Digital Citizenship Levels of Pre-Service Primary School Teachers and Their Democratic Values

ERIC Educational Resources Information Center

Aladag, Soner; Çiftci, Serdar

2017-01-01

This study seeks to investigate the relationship between digital citizenship levels of pre-service primary school teachers and their democratic values. The research was designed in descriptive survey model. The research was conducted with the participation of 346 pre-service primary school teachers (juniors and seniors) from Adnan Menderes…

The Relationship between the Entrepreneurship Characteristics and Metacognitive Awareness Levels of Pre-Service Teachers

ERIC Educational Resources Information Center

Duman, Burcu

2018-01-01

The purpose of this study is to determine the relationship between the entrepreneurship characteristics and metacognitive awareness levels of pre-service teachers. Qualitative research method is used in this study and the study is designed as a relational survey. The sample of the study was 441 pre-service teachers studying at the faculty of…

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

PubMed

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

2014-06-01

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

Using Integrated Student Supports to Keep Kids in School: A Quasi-Experimental Evaluation of Communities in Schools

ERIC Educational Resources Information Center

Somers, Marie-Andrée; Haider, Zeest

2017-01-01

The Communities In Schools (CIS) Model of Integrated Student Supports aims to reduce dropout rates by providing students with integrated and tiered support services based on their levels of need. The model includes preventive services that are available to all students (Level 1 services) as well as intensive, targeted, and sustained services…

Using Integrated Student Supports to Keep Kids in School: A Quasi-Experimental Evaluation of Communities in Schools. Executive Summary

ERIC Educational Resources Information Center

Somers, Marie-Andrée; Haider, Zeest

2017-01-01

The Communities In Schools (CIS) Model of Integrated Student Supports aims to reduce dropout rates by providing students with integrated and tiered support services based on their levels of need. The model includes preventive services that are available to all students (Level 1 services) as well as intensive, targeted, and sustained services…

Prediction of community mental health service utilization by individual and ecological level socio-economic factors.

PubMed

Donisi, Valeria; Tedeschi, Federico; Percudani, Mauro; Fiorillo, Andrea; Confalonieri, Linda; De Rosa, Corrado; Salazzari, Damiano; Tansella, Michele; Thornicroft, Graham; Amaddeo, Francesco

2013-10-30

Individuals with a more deprived socioeconomic status (SES) are more likely to have higher rates of psychiatric morbidity and use of psychiatric services. Such service use is also influenced by socioeconomic factors at the ecological level. The aim of this article is to investigate the influence of these variables on service utilization. All patients in contact with three Italian community psychiatric services (CPS) were included. Community and hospital contacts over 6 months were investigated. Socio-economic characteristics were described using a SES Index and two new Resources Accessibility Indexes. Low SES was found to be associated with more community service contacts. When other individual and ecological variables were controlled for, SES was negatively associated only with the number of home visits, which was about half the rate in deprived areas. An association between service utilization and the resources of the catchment area was also detected. The economic crisis in Europe is increasing inequality of access, so paying attention to SES characteristics at both the individual and the ecological levels is likely to become increasingly important in understanding patterns of psychiatric service utilization and planning care accordingly. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

User Satisfaction Assessment To Edu-Eco Tourism Services Of Cibodas Botanical Garden

NASA Astrophysics Data System (ADS)

Hidayat, I. W.; Winarni

2017-10-01

Cibodas Botanical Garden (CBG) is a government institution which has principal duties and functions as area of conservation ex situ of wet highland plants, research, education and tourism, it very closely related to aspect of the services to user. Good services will support the sustainability and existence of CBG as a world class edu-eco tourism destination. The purpose of this study was to measure the quality of services which delivered and improvement which necessary at the future. Assessments were made based on 14 criteria of services aspect for user which need research-education services and regular tourism services activities. The study was conducted by distributing questionnaires to users of these services. Questionnaires distribution was conducted in early August 2015 and August 2016, the respondents were 124 and 207. The results were showed the user satisfaction at good level, there were 77.685 in 2015 and 72.08 in 2016. Although still at a good level, there were a decline in satisfaction levels based on the value. In the future, the managerial needs to continuously to improve it, in order to get a good or very good valuation.

77 FR 3070 - Electric Engineering, Architectural Services, Design Policies and Construction Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Engineering, Architectural Services, Design Policies and Construction Standards AGENCY: Rural Utilities..., engineering services and architectural services for transactions above the established threshold dollar levels... Code of Federal Regulations as follows: PART 1724--ELECTRIC ENGINEERING, ARCHITECTURAL SERVICES AND...

Virtual in-service training from the librarians' point of view in libraries of medical sciences universities in Tehran.

PubMed

Mohaghegh, Niloofar; Raiesi Dehkordi, Puran; Alibeik, MohammadReza; Ghashghaee, Ahmad; Janbozorgi, Mojgan

2016-01-01

Background: In-service training courses are one of the most available programs that are used to improve the quantity and quality level of the staff services in various organizations, including libraries and information centers. With the advent of new technologies in the field of education, the problems and shortcomings of traditional in-service training courses were replaced with virtual ones. This study aimed to evaluate the virtual in-service training courses from the librarians' point of view in libraries of state universities of medical sciences in Tehran. Methods: This was a descriptive- analytical study. The statistical population consisted of all librarians at libraries of universities of medical sciences in Tehran. Out of 103 librarians working in the libraries under the study, 93 (90%) participated in this study. Data were collected, using a questionnaire. Results: The results revealed that 94/6% of librarians were satisfied to participate in virtual in-service training courses. In this study, only 45 out of 93 participants said that the virtual in-service courses were held in their libraries. Of the participants, 75.6% were satisfied with the length of training courses, and one month seemed to be adequate time duration for the librarians to be more satisfied. The satisfaction level of the individuals who participated in in-service courses of the National Library was moderate to high. A total of 84.4% participants announced that the productivity level of the training courses was moderate to high. The most important problem with which the librarians were confronted in virtual in-service training was the "low speed of the internet and inadequate computer substructures". Conclusion: Effectiveness of in-service training courses from librarians' point of view was at an optimal level in the studied libraries.

Virtual in-service training from the librarians' point of view in libraries of medical sciences universities in Tehran

PubMed Central

Mohaghegh, Niloofar; Raiesi Dehkordi, Puran; Alibeik, MohammadReza; Ghashghaee, Ahmad; Janbozorgi, Mojgan

2016-01-01

Background: In-service training courses are one of the most available programs that are used to improve the quantity and quality level of the staff services in various organizations, including libraries and information centers. With the advent of new technologies in the field of education, the problems and shortcomings of traditional in-service training courses were replaced with virtual ones. This study aimed to evaluate the virtual in-service training courses from the librarians' point of view in libraries of state universities of medical sciences in Tehran. Methods: This was a descriptive- analytical study. The statistical population consisted of all librarians at libraries of universities of medical sciences in Tehran. Out of 103 librarians working in the libraries under the study, 93 (90%) participated in this study. Data were collected, using a questionnaire. Results: The results revealed that 94/6% of librarians were satisfied to participate in virtual in-service training courses. In this study, only 45 out of 93 participants said that the virtual in-service courses were held in their libraries. Of the participants, 75.6% were satisfied with the length of training courses, and one month seemed to be adequate time duration for the librarians to be more satisfied. The satisfaction level of the individuals who participated in in-service courses of the National Library was moderate to high. A total of 84.4% participants announced that the productivity level of the training courses was moderate to high. The most important problem with which the librarians were confronted in virtual in-service training was the "low speed of the internet and inadequate computer substructures". Conclusion: Effectiveness of in-service training courses from librarians’ point of view was at an optimal level in the studied libraries. PMID:28491833

Client expectations and satisfaction of quality in home care services. A consumer perspective.

PubMed

Samuelsson, G; Wister, A

2000-12-01

This study examines clients' expectations of quality in home care services and their perceived satisfaction with services among a random sample of 76 home care recipients in Vancouver, Canada. The researchers conducted face-to-face interviews that applied Multiattribute Utility Technology, a procedure that organizes several quality attributes of "ideal" home care into a tree structure to compare their relative importance and ranking from the clients' perspective. Participants also were asked to state their satisfaction or dissatisfaction with the services received in these domains. Among the five main quality attributes identified, the subjects ranked suitability of the home helper and its subset, personal competence, as the most important indicators of quality, followed by continuity in service. In addition, clients tended to have a high level of satisfaction with regard to the attributes of overall home care services. The highest level of satisfaction was reported for elements of personal dispositions of home care staff. The lowest level of satisfaction involved the time/availability components of the service. Finally, comparisons between client expectations and satisfaction of received home care services showed the highest discrepancy for the attributes of influence and time/availability and the greatest congruence for personal attributes of the staff. The results are discussed in terms of their implications for the delivery of home care services.

Patient satisfaction at the Muhimbili National Hospital in Dar es Salaam, Tanzania.

PubMed

Muhondwa, E P Y; Leshabari, M T; Mwangu, M; Mbembati, N; Ezekiel, M J

2008-08-01

Patients are the primary beneficiaries of the services and care that hospitals provide. The Patient Satisfaction study examined the extent to which patients at the Muhimbili National Hospital (MNH) were satisfied with the services and care they received at MNH. This was part of a baseline study that sought to determine the level of performance of the hospital before massive restructuring, reform, and renovations were undertaken. Exit interviews were the main research method used to determine patient satisfaction. Patients were interviewed as they were leaving the OPD clinics, laboratory, X-ray, pharmacy and inpatient wards. The study found that most patients were satisfied with the services and care they received. This high level of satisfaction must be viewed within the context of a hierarchical public health care delivery system, with MNH at the apex. The services and care MNH provides can only be excellent compared to that provided by lower level health facilities. Indeed, patients covered by this study perceived the services provided by MNH as superior, and this was reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction with specific aspects of the services that they received. They were particularly dissatisfied with long waiting times before receiving services, the high costs of treatment and investigations charged at MNH, poor levels of hygiene in the wards, and negative attitudes of staff towards patients. Although only a small proportion of patients expressed dissatisfaction with these aspects of the services provided, they are significant in that they constitute a call for action by the MNH management to encourage the health personnel to embrace a new staff-patient relationship ethos, in which the patient is a viewed as a customer.

42 CFR 483.132 - Evaluating the need for NF services and NF level of care (PASARR/NF).

Code of Federal Regulations, 2010 CFR

2010-10-01

... and 483.136, the State mental health or mental retardation authority must determine whether an NF... 42 Public Health 5 2010-10-01 2010-10-01 false Evaluating the need for NF services and NF level of care (PASARR/NF). 483.132 Section 483.132 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

Domestic and International Service Learning Experiences: A Comparative Study of Pre-Service Teacher Outcomes

ERIC Educational Resources Information Center

Miller, Kari Knutson; Gonzalez, Amber M.

2010-01-01

This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. Participants included upper-division, undergraduate-level pre-service teachers who participated in service learning experiences in either local, domestic settings (Orange County, CA) or international settings (Shanghai and…

Consumer and case manager perspectives of service empowerment: relationship to mental health recovery.

PubMed

Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee

2006-04-01

This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.

(Biased) Grading of Students' Performance: Students' Names, Performance Level, and Implicit Attitudes.

PubMed

Bonefeld, Meike; Dickhäuser, Oliver

2018-01-01

Biases in pre-service teachers' evaluations of students' performance may arise due to stereotypes (e.g., the assumption that students with a migrant background have lower potential). This study examines the effects of a migrant background, performance level, and implicit attitudes toward individuals with a migrant background on performance assessment (assigned grades and number of errors counted in a dictation). Pre-service teachers ( N = 203) graded the performance of a student who appeared to have a migrant background statistically significantly worse than that of a student without a migrant background. The differences were more pronounced when the performance level was low and when the pre-service teachers held relatively positive implicit attitudes toward individuals with a migrant background. Interestingly, only performance level had an effect on the number of counted errors. Our results support the assumption that pre-service teachers exhibit bias when grading students with a migrant background in a third-grade level dictation assignment.

(Biased) Grading of Students’ Performance: Students’ Names, Performance Level, and Implicit Attitudes

PubMed Central

Bonefeld, Meike; Dickhäuser, Oliver

2018-01-01

Biases in pre-service teachers’ evaluations of students’ performance may arise due to stereotypes (e.g., the assumption that students with a migrant background have lower potential). This study examines the effects of a migrant background, performance level, and implicit attitudes toward individuals with a migrant background on performance assessment (assigned grades and number of errors counted in a dictation). Pre-service teachers (N = 203) graded the performance of a student who appeared to have a migrant background statistically significantly worse than that of a student without a migrant background. The differences were more pronounced when the performance level was low and when the pre-service teachers held relatively positive implicit attitudes toward individuals with a migrant background. Interestingly, only performance level had an effect on the number of counted errors. Our results support the assumption that pre-service teachers exhibit bias when grading students with a migrant background in a third-grade level dictation assignment. PMID:29867618

[Elderly, poor, solitary and marginal patients: geriatric vulnerability in emergency services].

PubMed

Marín Gámez, N; Kessel Sardiñas, H; López Martínez, G; Barnosi Marín, A; Montoya Vergel, J; Navarro Corral, A; Delgado Rodríguez, M

1998-07-01

Status is a powerful determinant of health, and it may influence on the demand of Hospital emergency services. The aim of our investigation is to assess whether elderly patients usually wandering emergency services gather more negative socioeconomic conditions. A cross-sectional study on 800 randomised patients cared in emergency services was carried out. A questionnaire about economic, educational and professional levels, domestic violence, loneliness and life style was applied. A crude analysis was used to assess the age-factor (>/= 65 y.o.) by BMDP (PC 90). The trial was approved by the local Bioethics board. Low incomes, low educational level and loneliness were clinic and statistically related with age (65 and more). Data is offered as n (%), X2 and p < 0.0001 (Fisher exact Test two sided p value). Elderly patients frequently demanding hospital emergency services gather more vulnerability conditions, not merely medical. Low incomes, low educational level and loneliness are probably working as key factors on the geriatric demand of emergency services.

An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

2017-03-21

Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while visiting urban hospitals, primarily for transportation and food. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.

Security Engineering FY17 Systems Aware Cybersecurity

DTIC Science & Technology

2017-12-07

11 Figure 4 A hierarchical controls model that defines the expected service of a UAV. Each level is...defined by a generic control structure. Inadequate control in each level can cause an adversarial action to degrade the expected service and produce a...and can completely violate the systems expected service by escalating their privileges by either using the attack vectors presented individually or

The Relationship between Pre-Service Teachers' Lifelong Learning Tendencies and Teaching Profession Anxiety Levels

ERIC Educational Resources Information Center

Özen, Rasit; Öztürk, Duygu Saniye

2016-01-01

The present study aims to examine the relationship between pre-service teachers' lifelong learning tendencies and teaching profession anxiety levels with respect to certain variables (their gender and subject area) and is designed as a survey study. The fourth year pre-service teachers (n=455) in the spring semester of the 2015-2016 academic year…

An integrated production-inventory model for the singlevendor two-buyer problem with partial backorder, stochastic demand, and service level constraints

NASA Astrophysics Data System (ADS)

Arfawi Kurdhi, Nughthoh; Adi Diwiryo, Toray; Sutanto

2016-02-01

This paper presents an integrated single-vendor two-buyer production-inventory model with stochastic demand and service level constraints. Shortage is permitted in the model, and partial backordered partial lost sale. The lead time demand is assumed follows a normal distribution and the lead time can be reduced by adding crashing cost. The lead time and ordering cost reductions are interdependent with logaritmic function relationship. A service level constraint policy corresponding to each buyer is considered in the model in order to limit the level of inventory shortages. The purpose of this research is to minimize joint total cost inventory model by finding the optimal order quantity, safety stock, lead time, and the number of lots delivered in one production run. The optimal production-inventory policy gained by the Lagrange method is shaped to account for the service level restrictions. Finally, a numerical example and effects of the key parameters are performed to illustrate the results of the proposed model.

NASA GES DISC Level 2 Aerosol Analysis and Visualization Services

NASA Technical Reports Server (NTRS)

Wei, Jennifer; Petrenko, Maksym; Ichoku, Charles; Yang, Wenli; Johnson, James; Zhao, Peisheng; Kempler, Steve

2015-01-01

Overview of NASA GES DISC Level 2 aerosol analysis and visualization services: DQViz (Data Quality Visualization)MAPSS (Multi-sensor Aerosol Products Sampling System), and MAPSS_Explorer (Multi-sensor Aerosol Products Sampling System Explorer).

Improving health systems performance in low- and middle-income countries: a system dynamics model of the pay-for-performance initiative in Afghanistan.

PubMed

Alonge, O; Lin, S; Igusa, T; Peters, D H

2017-12-01

System dynamics methods were used to explore effective implementation pathways for improving health systems performance through pay-for-performance (P4P) schemes. A causal loop diagram was developed to delineate primary causal relationships for service delivery within primary health facilities. A quantitative stock-and-flow model was developed next. The stock-and-flow model was then used to simulate the impact of various P4P implementation scenarios on quality and volume of services. Data from the Afghanistan national facility survey in 2012 was used to calibrate the model. The models show that P4P bonuses could increase health workers' motivation leading to higher levels of quality and volume of services. Gaming could reduce or even reverse this desired effect, leading to levels of quality and volume of services that are below baseline levels. Implementation issues, such as delays in the disbursement of P4P bonuses and low levels of P4P bonuses, also reduce the desired effect of P4P on quality and volume, but they do not cause the outputs to fall below baseline levels. Optimal effect of P4P on quality and volume of services is obtained when P4P bonuses are distributed per the health workers' contributions to the services that triggered the payments. Other distribution algorithms such as equal allocation or allocations proportionate to salaries resulted in quality and volume levels that were substantially lower, sometimes below baseline. The system dynamics models served to inform, with quantitative results, the theory of change underlying P4P intervention. Specific implementation strategies, such as prompt disbursement of adequate levels of performance bonus distributed per health workers' contribution to service, increase the likelihood of P4P success. Poorly designed P4P schemes, such as those without an optimal algorithm for distributing performance bonuses and adequate safeguards for gaming, can have a negative overall impact on health service delivery systems. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Determination of Pre-Service Science Teachers' Level of Awareness of Environmental Ethics in Relation to Different Variables

ERIC Educational Resources Information Center

Keles, Özgül; Özer, Nilgün

2016-01-01

The purpose of the current study is to determine the pre-service science teachers' awareness levels of environmental ethics in relation to different variables. The sampling of the present study is comprised of 1,023 third and fourth year pre-service science teachers selected from 12 different universities in the spring term of 2013-2014 academic…

Active Learning Applications in the History of Chemistry: Pre-Service Chemistry Teachers' Level of Knowledge and Views

ERIC Educational Resources Information Center

Sendur, Gülten; Polat, Merve; Toku, Abdullah; Kazanci, Coskun

2014-01-01

This study aims to investigate the effects of a History and Philosophy of Chemistry-I course based on active learning applications on the level of knowledge of pre-service chemistry teachers about the history of chemistry. The views of pre-service chemistry teachers about these activities were also investigated. The study was carried out with 38…

[IMSS in numbers. Evaluation of the performance of health institutions in Mexico, 2004].

PubMed

2006-01-01

The evaluation of health institutions performance in Mexico during 2004 was done using 29 indicators that describe intra-hospital mortality rates, productivity of health services, availability of health resources, quality of care, security, investment and costs of health care and the satisfaction level by users of health services. This exercise describes the efficiency and organization of health services provided by the different health institutions and allows comparing and balancing the performance of each institution. Results indicate the differences in availability of resources, inequity in the financing health care services, and inefficiency in the use of resources but also describe the level of efficacy of certain institutions and the satisfaction level that different users have of health services. The evaluation of the performance of the entire health institutions should provide the means to improve all the process of health care and to increase the quality of care in all health institutions in the country.

The demand for ambulatory mental health services from specialty providers.

PubMed Central

Horgan, C M

1986-01-01

A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China.

PubMed

Chen, Fei; Xu, Xiang-Long; Yang, Zhan; Tan, Hua-Wei; Zhang, Liang

2015-08-10

In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters' willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters' payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters' general practitioners using contractual service supply cost. This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60-85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox's proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox's proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels.

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China

PubMed Central

Chen, Fei; Xu, Xiang-Long; Yang, Zhan; Tan, Hua-Wei; Zhang, Liang

2015-01-01

Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels. PMID:26266416

Pedestrian Levels of Service (LOS) at Muir Woods National Monument (California): An introduction to multi-modal LOS for parks and protected areas

Treesearch

Peter R. Pettengill; Robert E. Manning; William Valliere; Laura E. Anderson

2010-01-01

Historically, transportation planning and management have been guided largely by principles of efficiency. Specifically, the Transportation Research Board has utilized a levels of service (LOS) framework to assess quality of service in terms of traffic congestion, speed and travel time, and maximum road capacity. In the field of park and outdoor recreation management,...

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.

Blueprint for Incorporating Service Learning: A Basic, Developmental, K-12 Service Learning Typology

ERIC Educational Resources Information Center

Terry, Alice W.; Bohnenberger, Jann E.

2004-01-01

Citing the need for a basic, K-12 developmental framework for service learning, this article describes such a model. This model, an inclusive typology of service learning, distinguishes three levels of service learning: Community Service, Community Exploration, and Community Action. The authors correlate this typology to Piaget's cognitive…

[Research survey on the information gathering methods, attitudes, and requests from care managers about the pharmaceutical service by pharmacists in home care].

PubMed

Nanaumi, Yoko; Onda, Mitsuko; Sakurai, Hidehiko; Tanaka, Rie; Tsubota, Kenichi; Matoba, Shunya; Mukai, Yusuke; Arakawa, Yukio; Hayase, Yukitoshi

2011-01-01

Care Managers (CMs) were surveyed to clarify the issues involving the promotion of cooperation between care managers and pharmacists in long-term-care and explore solutions. The length of work experience, occupational background, experience of pharmaceutical service; pharmacist visit patients' home for providing medicine and pharmaceutical care into a care plan, degree of understanding on pharmaceutical service, and awareness of work involved in pharmaceutical service were studied to see whether there made differences in the requests from CMs for information on pharmacists and for information gathering methods. The χ(2) test was used to this end. The opinions and requests described by the CMs were validated through text mining. More CMs tended to obtain information and knowledge through training sessions and professional magazines than those who did so through cooperation with pharmacists on a practical level. However, the survey strongly indicated that CMs with high level of understanding and awareness of pharmaceutical service wished to obtain information on pharmacists through cooperation with them on a practical level, and CMs with low level of understanding and awareness of pharmaceutical service wished to obtain such information through training sessions and professional magazines. Results of text mining showed that CMs wished pharmacists to strengthen the cooperation with physicians and provide information on pharmaceutical service. These findings have led to the conclusion that the issues surrounding the promotion of cooperation between CMs and pharmacists centered around "work cooperation on a practical level" and "provision of information to CMs about the roles of pharmacies and pharmacists and their work."

Workflow management in large distributed systems

NASA Astrophysics Data System (ADS)

Legrand, I.; Newman, H.; Voicu, R.; Dobre, C.; Grigoras, C.

2011-12-01

The MonALISA (Monitoring Agents using a Large Integrated Services Architecture) framework provides a distributed service system capable of controlling and optimizing large-scale, data-intensive applications. An essential part of managing large-scale, distributed data-processing facilities is a monitoring system for computing facilities, storage, networks, and the very large number of applications running on these systems in near realtime. All this monitoring information gathered for all the subsystems is essential for developing the required higher-level services—the components that provide decision support and some degree of automated decisions—and for maintaining and optimizing workflow in large-scale distributed systems. These management and global optimization functions are performed by higher-level agent-based services. We present several applications of MonALISA's higher-level services including optimized dynamic routing, control, data-transfer scheduling, distributed job scheduling, dynamic allocation of storage resource to running jobs and automated management of remote services among a large set of grid facilities.

5 CFR 630.301 - Annual leave accrual and accumulation-Senior Executive Service, Senior-Level, and Scientific and...

Code of Federal Regulations, 2012 CFR

2012-01-01

... legal authority, for planning, monitoring, developing, evaluating, and rewarding employee performance...-Senior Executive Service, Senior-Level, and Scientific and Professional Employees. 630.301 Section 630...-Level, and Scientific and Professional Employees. (a) Annual leave accrues at the rate of 1 day (8 hours...

5 CFR 630.301 - Annual leave accrual and accumulation-Senior Executive Service, Senior-Level, and Scientific and...

Code of Federal Regulations, 2013 CFR

2013-01-01

... legal authority, for planning, monitoring, developing, evaluating, and rewarding employee performance...-Senior Executive Service, Senior-Level, and Scientific and Professional Employees. 630.301 Section 630...-Level, and Scientific and Professional Employees. (a) Annual leave accrues at the rate of 1 day (8 hours...

5 CFR 630.301 - Annual leave accrual and accumulation-Senior Executive Service, Senior-Level, and Scientific and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... legal authority, for planning, monitoring, developing, evaluating, and rewarding employee performance...-Senior Executive Service, Senior-Level, and Scientific and Professional Employees. 630.301 Section 630...-Level, and Scientific and Professional Employees. (a) Annual leave accrues at the rate of 1 day (8 hours...

5 CFR 630.301 - Annual leave accrual and accumulation-Senior Executive Service, Senior-Level, and Scientific and...

Code of Federal Regulations, 2014 CFR

2014-01-01

... legal authority, for planning, monitoring, developing, evaluating, and rewarding employee performance...-Senior Executive Service, Senior-Level, and Scientific and Professional Employees. 630.301 Section 630...-Level, and Scientific and Professional Employees. (a) Annual leave accrues at the rate of 1 day (8 hours...

Translating national level forest service goals to local level land management: carbon sequestration

Treesearch

Steven McNulty; Emrys Treasure; Lisa Jennings; David Meriwether; David Harris; Paul Arndt

2017-01-01

The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region, and local scale. We...

Development of a concept for non-monetary assessment of urban ecosystem services at the site level.

PubMed

Wurster, Daniel; Artmann, Martina

2014-05-01

Determining the performance of ecosystem services at the city or regional level cannot accurately take into account the fine differences between green or gray structures. The supply of regulating ecosystem services in, for instance, parks can differ as parks vary in their land cover composition. A comprehensive ecosystem service assessment approach also needs to reflect land use to consider the demands placed on ecosystem services, which are mostly neglected by current research yet important for urban planning. For instance, if a sealed surface is no longer used, it could be unsealed to improve ecosystem service supply. Because of these scientific shortcomings, this article argues for a conceptual framework for the non-monetary assessment of urban ecosystem services at the site scale. This paper introduces a standardized method for selecting representative sites and evaluating their supply of and demand on ecosystem services. The conceptual design is supplemented by examples of Salzburg, Austria.

Patients' willingness to pay for pharmaceutical care.

PubMed

Larson, R A

2000-01-01

To determine the level at which patients receive pharmaceutical care services and their willingness to pay for comprehensive pharmaceutical care services. A mail survey was sent to 2,500 adults in the United States. Surveys were mailed to subjects' homes. Subjects were randomly selected from a marketing database that included representation from each of the 50 states of the United States. The survey provided a description of comprehensive pharmaceutical care, and survey items asked about the level of care subjects were receiving and their willingness to pay for these services. Level of various pharmacy services subjects reported receiving, and the dollar amount subjects were willing to pay for comprehensive pharmaceutical care. The majority of the subjects were not receiving pharmaceutical care services. The average amount all respondents were willing to pay for these services was $13 for a one-time consultation and $28 for this plus 1 year of monitoring. Looking only at those respondents willing to pay (56%), the means rise to $23 and $50, respectively. A majority of patients are willing to pay for pharmaceutical care services, even if they are not now receiving this level of care. Direct payment from patients who recognize the therapeutic benefits of pharmaceutical care may be a more viable option than is generally believed, at least until the profession can prove pharmaceutical care's utility and cost-effectiveness to third party payers.

Level of Service Program for INDOT Operations : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

In 2008 the JTRP study SPR-3130, Performance Based : Contracting for Roadway Maintenance Operations, : revealed the state agencies that have developed a : Level of Service (LOS) program benefit. A LOS program : can evaluate and determine maintenance ...

75 FR 38748 - Medicaid Program; Premiums and Cost Sharing; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... more than 150 percent of the Federal poverty level (FPL) does not apply to non-emergency services... more than 150 percent of the Federal poverty level (FPL) does not apply to non-emergency services...

Help-Seeking among Male Employees in Japan: Influence of Workplace Climate and Distress

PubMed Central

Maekawa, Yumiko; Ramos-Cejudo, Juan; Kanai, Atsuko

2016-01-01

Objectives: Although using mental health services is an effective way to cope with work-related stressors and diseases, many employees do not utilize these services despite service improvements in recent years. The present study aimed to investigate the interaction effects of workplace climate and distress on help-seeking attitudes, and elucidate the reasons for mental health service underutilization in Japan. Methods: A questionnaire was distributed to 650 full-time male Japanese employees. Hierarchical multiple regression analysis was used to investigate interaction effects of workplace climate and distress on help-seeking. Results: Results showed that the association between workplace climate and help-seeking attitudes differed depending on employee distress level. For employees experiencing low levels of distress, openness to seeking treatment increased with a higher evaluation of the mental health services available at the workplace. However, the same did not hold true for employees experiencing high levels of distress. Instead, openness to seeking treatment decreased with perceived risk for career disadvantage for high distress employees. Additionally, negative values for seeking treatment in highly distressed employees decreased only when services were perceived as valuable, and the risk to their career was perceived as low. Conclusions: Overall, these findings indicate that distress distorts the perception of social support, which may lead to underutilization of available services. Assessing employees' distress levels and tailoring adequate interventions could facilitate help-seeking in male employees. PMID:27725378

The National Atlas of Ecosystem Services: Spatially Explicit Characterization of Ecosystem Services

EPA Science Inventory

The US EPA’s Ecosystem Services Research Program (ESRP) is conducting transdisciplinary research to develop tools to enable decision-makers at all levels of governance to proactively conserve ecosystem services. One of these tools is a National Atlas of Ecosystem Services which ...

Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study.

PubMed

Dawson, Samantha L; Baker, Tim; Salzman, Scott

2015-04-01

There is little evidence that useful electronic data could be collected at Australian small rural emergency services. If in future their funding model changed to the Activity-Based Funding model, then they would need to collect and submit more data. We determine whether it is possible to collect episode-level data at six small rural emergency services and quantify the accuracy of eight fields. A prospective cross-sectional study. South-West Victoria, Australia. Six small rural emergency services. We collected and audited episode-level emergency data from participating services between 1 February 2011 and 31 January 2012. A random sample of these data were audited monthly. Research assistants located at each service supported data entry and audited data accuracy for four hours per week. Rates for data completeness, accuracy and total accuracy were calculated using audit data. Episode-level data were collected for 20 224 presentations across six facilities. The audit dataset consisted of 8.5% (1504/17 627) of presentations from five facilities. For all fields audited, the accuracy of entered data was high (>93%).Triage category was deemed appropriate for 95.9% (95% confidence interval (CI): 94.9-96.9%) of the patient records reviewed. Some procedures were missing (28.7%, 95%CI: 27.2-30.3%). No significant improvement in data accuracy over 12 months was observed. All six services collected useful episode-level data for 12-months with four hours per week of assistance. Data entry accuracy was high for all fields audited, and data entry completeness was low for procedures. © 2015 National Rural Health Alliance Inc.

The PESPERF Scale: An Instrument for Measuring Service Quality in the School of Physical Education and Sports Sciences (PESS)

ERIC Educational Resources Information Center

Yildiz, Suleyman M.; Kara, Ali

2009-01-01

Purpose: HEdPERF (Higher Education PERFormance) is one of the most recently developed scales in the literature to measure service quality in higher education. However, HEdPERF is designed to measure service quality at a macro level (university level) and may be considered as a more generic measurement instrument. In higher education, new scales…

Assessing Pre-Service Teachers' Computer Phobia Levels in Terms of Gender and Experience, Turkish Sample

ERIC Educational Resources Information Center

Ursavas, Omer Faruk; Karal, Hasan

2009-01-01

In this study it is aimed to determine the level of pre-service teachers' computer phobia. Whether or not computer phobia meaningfully varies statistically according to gender and computer experience has been tested in the study. The study was performed on 430 pre-service teachers at the Education Faculty in Rize/Turkey. Data in the study were…

78 FR 16036 - Service Level Environmental Impact Statement for the Texas Oklahoma Passenger Rail Study Corridor...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

... planning for projects to implement the service. Alternatives under consideration will include a No Action..., at a corridor planning level, the infrastructure and equipment investment requirements for the... describe, at a corridor planning level, the potential environmental consequences (benefits and adverse...

Research on the construction of three level customer service knowledge graph

NASA Astrophysics Data System (ADS)

Cheng, Shi; Shen, Jiajie; Shi, Quan; Cheng, Xianyi

2017-09-01

With the explosion of knowledge and information of the enterprise and the growing demand for intelligent knowledge management and application and improve business performance the knowledge expression and processing of the enterprise has become a hot topic. Aim at the problems of the electric marketing customer service knowledge map (customer service knowledge map) in building theory and method, electric marketing knowledge map of three levels of customer service was discussed, and realizing knowledge reasoning based on Neo4j, achieve good results in practical application.

5 CFR 1603.3 - Service requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5316; (3) A position placed in level IV or level V of the Executive Schedule, pursuant to 5 U.S.C. 5317; (4) A position in the Executive Branch which is excepted from the competitive service by the Office...

5 CFR 1603.3 - Service requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5316; (3) A position placed in level IV or level V of the Executive Schedule, pursuant to 5 U.S.C. 5317; (4) A position in the Executive Branch which is excepted from the competitive service by the Office...

Jobs in Public Service. Job Family Series.

ERIC Educational Resources Information Center

Science Research Associates, Inc., Chicago, IL.

The booklet describes jobs in public service. The introductory chapter provides a definition and overview of public service work. Following chapters describe various levels of public service including: (1) neighborhood workers--letter carriers and postal employees, fire fighters, police officers, service repair workers, and bus drivers; (2) city…

Process model-based atomic service discovery and composition of composite semantic web services using web ontology language for services (OWL-S)

NASA Astrophysics Data System (ADS)

Paulraj, D.; Swamynathan, S.; Madhaiyan, M.

2012-11-01

Web Service composition has become indispensable as a single web service cannot satisfy complex functional requirements. Composition of services has received much interest to support business-to-business (B2B) or enterprise application integration. An important component of the service composition is the discovery of relevant services. In Semantic Web Services (SWS), service discovery is generally achieved by using service profile of Ontology Web Languages for Services (OWL-S). The profile of the service is a derived and concise description but not a functional part of the service. The information contained in the service profile is sufficient for atomic service discovery, but it is not sufficient for the discovery of composite semantic web services (CSWS). The purpose of this article is two-fold: first to prove that the process model is a better choice than the service profile for service discovery. Second, to facilitate the composition of inter-organisational CSWS by proposing a new composition method which uses process ontology. The proposed service composition approach uses an algorithm which performs a fine grained match at the level of atomic process rather than at the level of the entire service in a composite semantic web service. Many works carried out in this area have proposed solutions only for the composition of atomic services and this article proposes a solution for the composition of composite semantic web services.

Functional Severity and Latino Ethnicity in Specialty Services for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Magaña, S.; Parish, S. L.; Son, E.

2016-01-01

Background: Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA…

Assessment of community satisfaction index of population and civil registration office in Malang municipal

NASA Astrophysics Data System (ADS)

Hakim, A. N.

2017-06-01

The demands and needs of the community will be the quality of public services in Malang increased, so that the Government of Malang as organizers and executors of public services must meet these demands. The Municipal Government in its efforts to improve public service performance, forming the regional One Stop Operator (PPTSP) with the goal will be to simplify and improve efficiency in administrative proceedings. But the existence of the one stop service is still not optimal because of the persistence of public complaints about the performance of the one stop service. This study will discuss the performance of services in service counter of Population and Civil Registration through community satisfaction index to measure the service level and the perception of satisfaction and interest to determine which variables are less optimal and need to be improved using IPA method. The results showed that the level of service at the service counter of Population and Civil Registration quite good. Meanwhile, according the results of IPA analysis, there are two important variables for the community on the performance / quality was lacking, namely the service procedure and time.

Community pharmacy-based asthma services--what do patients prefer?

PubMed

Naik Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

2010-12-01

Patient preferences can influence the outcomes of treatment and so understanding and organizing health-care services around these preferences is vital. To explore patient preferences for types of community pharmacy-based asthma services, to investigate the influence of "experience" in molding preferences for such services, and to identify aspects of the services that patients prefer over others. Semistructured face-to-face interviews were conducted with a convenience sample of two types of asthma patients: (1) those naïve to a specialized asthma service and (2) those who had experienced a specialized asthma service. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Eighteen interviews were conducted (8 experienced patients, 10 naïve patients). The majority of the patients wanted the pharmacist to play a greater role in their asthma management. Patients experiencing increased levels of service had increased levels of expectations as well as more specific preferences for various aspects of the service. The key aspects of an asthma service that all patients wanted their pharmacists to provide were the provision of information about asthma and its medications, lung function testing and monitoring of their asthma, and checking/correcting their inhaler technique. Patients also expressed a desire for skilled communication and behavioral aspects from the pharmacist such as friendliness, empathy, attentiveness, and dedicated time. Patients highlighted the importance of privacy in the pharmacy. There was a high level of satisfaction toward the currently delivered asthma service among both naïve and experienced patients. The provision of the specialized service was associated with increased patient loyalty to the particular pharmacy. All patients indicated a willingness to participate in future pharmacy-delivered specialized asthma services. Elements of the specialized pharmacy-based asthma services important from a patient's perspective were identified. It would be important to identify the strength and magnitude of patient's preferences for different elements of such services. Future pharmacy-based services should incorporate patient preferences and tailor services to patient's needs to ensure their long-term viability.

25 CFR 20.205 - Can tribes change eligibility criteria or levels of payments for General Assistance?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can tribes change eligibility criteria or levels of... INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform § 20.205 Can tribes change eligibility criteria or levels of payments for General Assistance? Yes, if you have a...

Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.

PubMed

Passfield, Juanine; Nielsen, Ilsa; Brebner, Neil; Johnstone, Cara

2017-07-24

Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services. Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement. Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated. Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate. What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to delegation and skill sharing to provide an indication of the level of local service influence on workforce and service model decisions. What are the implications for practitioners? Local factors have a modest influence on delegation and skill sharing decisions of AH teams. Practitioners need to be actively engaged in decision making at the local level to ensure the clinical service model meets local needs. However, teams should also capitalise on commonalities between settings to limit duplication of training and resource development through collaborative networks.

Why caregivers of people with dementia and memory loss don't use services.

PubMed

Brodaty, Henry; Thomson, Cathy; Thompson, Claire; Fine, Michael

2005-06-01

To develop a typography of the characteristics of caregivers of community dwelling people with dementia or memory loss who do not use services and empirically investigate the reasons for service non-use. The findings of a literature review were used to develop a typography of caregivers' non-use of services. This typography was applied to a sample of community-based caregivers. One in three caregivers were using no services and one in four only one service. Despite considerable proportions reporting low levels of life satisfaction and high levels of overload and resentment the main reasons caregivers gave for not using services were that they did not consider they needed the services. Other reasons for service non-use included care recipient reluctance to use services, lack of knowledge of services or being in the process of applying for services. Service availability or affordability were not identified as major impediments to service use. Presence of a physical disability and contact with a social worker were associated with service use. Caregivers of people with dementia incur significant strain and have substantial need for a variety of services. Nevertheless many caregivers were not using support services, mainly because of perceived lack of need or lack of awareness. Better public promotion of services, destigmatising dementia and encouraging referrals from health professionals could help overcome the barriers to service use. Copyright (c) 2005 John Wiley & Sons, Ltd

Level of Service Program for INDOT Operations : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

In 2008 the JTRP study SPR-3130, Performance Based Contracting for Roadway Maintenance Operations, revealed the state agencies that have developed a Level of Service (LOS) program benefit. A LOS program can evaluate and determine maintenance performa...

Institute for Home Economics Teachers on Initiating, Developing, and Evaluating Programs at the Post High School Level to Prepare Food Service Supervisors and Assistants to Directors of Child Care Services: Volume I: A Post High School Program in Home Economics (May 1, 1966-June 30, 1967). Final Report.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Coll. of Education.

The institute was designed to provide information and develop some ability in initiating, developing, and evaluating programs for training workers as food service supervisors in post-high school level programs. Organizational details, student and faculty qualifications, a job description and analysis of the food service supervisor occupation are…

CO2 Data Distribution and Support from the Goddard Earth Science Data and Information Services Center (GES-DISC)

NASA Technical Reports Server (NTRS)

Hearty, Thomas; Savtchenko, Andrey; Vollmer, Bruce; Albayrak, Arif; Theobald, Mike; Esfandiari, Ed; Wei, Jennifer

2015-01-01

This talk will describe the support and distribution of CO2 data products from OCO-2, AIRS, and ACOS, that are archived and distributed from the Goddard Earth Sciences Data and Information Services Center. We will provide a brief summary of the current online archive and distribution metrics for the OCO-2 Level 1 products and plans for the Level 2 products. We will also describe collaborative data sets and services (e.g., matchups with other sensors) and solicit feedback for potential future services.

39 CFR 3.3 - Matters reserved for decision by the Board.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Postal Service's independent, certified public accounting firm. (d) Authorization of the Postal Service... an advisory opinion on a proposed change in the nature of postal services which will generally affect... Postal Service whose positions are included in Level II of the Postal Career Executive Service. (k...

Patterns of coordination and clinical outcomes: a study of surgical services.

PubMed Central

Young, G J; Charns, M P; Desai, K; Khuri, S F; Forbes, M G; Henderson, W; Daley, J

1998-01-01

OBJECTIVE: To test the hypothesis that surgical services combining relatively high levels of feedback and programming approaches to the coordination of surgical staff would have better quality of care than surgical services using low levels of both coordination approaches as well as those surgical service using low levels of either coordination approach. STUDY SETTING: A study sample of 44 academically affiliated surgical services that are part of the Department of Veterans Affairs. STUDY DESIGN: In a cross-sectional analysis, surgical services were assigned to one of three groups based on their scores on feedback and programming coordination measures: high on both measures; high on one measure, low on the other; and low on both. Univariate and multivariate analyses were used to assess differences among these groups with respect to three quality indicators: risk-adjusted mortality, risk-adjusted morbidity, and staff perceptions of quality. DATA COLLECTION/EXTRACTION METHODS: Risk-adjusted mortality and morbidity came from an outcomes reporting program within the Department of Veterans Affairs that entails the prospective collection of clinical data from patient charts. Data on coordination practices and perceived quality came from a survey of surgical staff at each of the 44 participating surgical services. PRINCIPAL FINDINGS: The group of surgical services using high feedback and high programming had the best perceived quality. This group also had the lowest morbidity, but the difference was statistically significant with respect to only one of the two other groups: the group with low feedback and low programming. No significant group differences were found for mortality. CONCLUSIONS: Study results provide partial support for the hypothesis that high levels of feedback and programming should be combined for optimal quality of care. Study results also suggest that staff coordination is more important for improving morbidity than mortality in surgical services. PMID:9865218

Pricing the Services in Dynamic Environment: Agent Pricing Model

NASA Astrophysics Data System (ADS)

Žagar, Drago; Rupčić, Slavko; Rimac-Drlje, Snježana

New Internet applications and services as well as new user demands open many new issues concerning dynamic management of quality of service and price for received service, respectively. The main goals of Internet service providers are to maximize profit and maintain a negotiated quality of service. From the users' perspective the main goal is to maximize ratio of received QoS and costs of service. However, achieving these objectives could become very complex if we know that Internet service users might during the session become highly dynamic and proactive. This connotes changes in user profile or network provider/s profile caused by high level of user mobility or variable level of user demands. This paper proposes a new agent based pricing architecture for serving the highly dynamic customers in context of dynamic user/network environment. The proposed architecture comprises main aspects and basic parameters that will enable objective and transparent assessment of the costs for the service those Internet users receive while dynamically change QoS demands and cost profile.

Income Inequality and Use of Dental Services in 66 Countries.

PubMed

Bhandari, B; Newton, J T; Bernabé, E

2015-08-01

This study explored the association between income inequality and use of dental services and the role that investment in health care plays in explaining that association. We pooled individual-level data from 223,299 adults, 18 years or older, in 66 countries, who participated in the World Health Organization (WHO) World Health Surveys with country-level data from different international sources. Income inequality was measured at the national level using the Gini coefficient, and use of dental services was defined as having received treatment to address problems with mouth and/or teeth in the past year. The association between the Gini coefficient and use of dental services was examined in multilevel models controlling for a standard set of individual- and country-level confounders. The individual and joint contributions of 4 indicators of investment in health care were evaluated in sequential modeling. The Gini coefficient and use of dental services were inversely associated after adjustment for confounders. Every 10% increase in the Gini coefficient corresponded with a 15% lower odds of using dental services (odds ratio: 0.85; 95% confidence interval: 0.70-0.99). The association between the Gini coefficient and use of dental services was attenuated and became nonsignificant after individual adjustment for total health expenditure, public expenditure on health, health system responsiveness, or type of dental health system. The 4 indicators together explained 80% of the association between the Gini coefficient and use of dental services. This study suggests that more equal countries have greater use of dental services. It also supports the mediating role of investment in health care in explaining that association. © International & American Associations for Dental Research 2015.

The Role of Psychological Capital and Intragroup Conflict on Employees' Burnout and Quality of Service: A Multilevel Approach

PubMed Central

Leon-Perez, Jose M.; Antino, Mirko; Leon-Rubio, Jose M.

2016-01-01

Previous studies have found a negative association between intragroup conflict and both employees' health and performance, including the quality of service that employees provide. However, some authors have indicated that such negative effects of intragroup conflict depend on how conflict is managed. In addition, at individual level, research is increasingly emphasizing the role of psychological strengths (i.e., psychological capital) as predictors of health and performance. Thus, this research addresses both a main effect at individual level (psychological capital on burnout/quality of service) and a moderated cross-level model (2-2-1: intragroup conflict, conflict management climate and burnout/quality of service) in a cross-sectional survey study (N = 798 workers nested in 55 units/facilities). Results revealed a main effect of psychological capital on both burnout (r = −0.50) and quality of service (r = 0.28). Also, there was an association between intragroup relationship conflict and burnout (r = 0.33). Finally, there was an interaction effect in which conflict management climate buffers the negative association between intragroup conflict and quality of service. Practical implications of these results for developing positive and healthy organizations that prevent potential psychosocial risks at group level while promote individual strengths are discussed. PMID:27895601

The Role of Psychological Capital and Intragroup Conflict on Employees' Burnout and Quality of Service: A Multilevel Approach.

PubMed

Leon-Perez, Jose M; Antino, Mirko; Leon-Rubio, Jose M

2016-01-01

Previous studies have found a negative association between intragroup conflict and both employees' health and performance, including the quality of service that employees provide. However, some authors have indicated that such negative effects of intragroup conflict depend on how conflict is managed. In addition, at individual level, research is increasingly emphasizing the role of psychological strengths (i.e., psychological capital) as predictors of health and performance. Thus, this research addresses both a main effect at individual level (psychological capital on burnout/quality of service) and a moderated cross-level model (2-2-1: intragroup conflict, conflict management climate and burnout/quality of service) in a cross-sectional survey study ( N = 798 workers nested in 55 units/facilities). Results revealed a main effect of psychological capital on both burnout ( r = -0.50) and quality of service ( r = 0.28). Also, there was an association between intragroup relationship conflict and burnout ( r = 0.33). Finally, there was an interaction effect in which conflict management climate buffers the negative association between intragroup conflict and quality of service. Practical implications of these results for developing positive and healthy organizations that prevent potential psychosocial risks at group level while promote individual strengths are discussed.

Personal and Other Services. Industry Training Monograph No. 17.

ERIC Educational Resources Information Center

Dumbrell, Tom

Australia's personal and other services industry is the sixth smallest of the 17 industry divisions in numbers employed. The industry, a collection of quite diverse businesses and services in the public and private sectors, has three subdivisions: personal services, other services, and private households employing staff. The employment level has…

7 CFR 2045.1754 - Scope of gratuitous services performed.

Code of Federal Regulations, 2010 CFR

2010-01-01

... County Office level and conform to a standard FmHA or its successor agency under Public Law 103-354... Gratuitous Services § 2045.1754 Scope of gratuitous services performed. (a) Gratuitous services accepted in... successor agency under Public Law 103-354 employees (excluding Committee members). Such services must not...

An Evaluation of Air Force Food Service Operations at Travis Air Force Base

DTIC Science & Technology

1974-06-01

food service system as represented by food service operations...was base level feeding requirements, excluding non-appropriated fund food service activities, hospital dining facilities and patient feeding, and...inflight food service . Following completion of these studies, proposed solutions to the problems were actually implemented and evaluated in a food service experiment at Travis

Impact of school health management committees on health services delivery in Ghana: A national level assessment.

PubMed

Bowman, Angela S; Owusu, Andrew; Trueblood, Amber B; Bosumtwi-Sam, Cynthia

2018-05-07

To examine the prevalence, determinants, and impact of local school health management committees on implementation of minimum-recommended school health services delivery among basic and secondary schools in Ghana. National level cross-sectional data from the first-ever assessment of Ghana Global-School Health Policies and Practices Survey was utilized. Complex sample analyses were used to quantify school-level implementation of recommended minimum package for health services delivery. Of 307 schools, 98% were basic and government run, and 33% offered at least half of the recommended health service delivery areas measured. Schools with a school health management committee (53%) were 4.8 (95% CI = 3.23-5.18) times as likely to offer at least 50% of the minimum health services package than schools that did not. There is significant deficit concerning delivery of school health services in schools across Ghana. However, school health management committees positively impact implementation of health service delivery. School health management committees provide a significant impact on delivery of school health services; thus, it is recommended that policy makers and programmers place greater emphasis on the value and need for these advisory boards in all Ghanaian schools. Copyright © 2018 John Wiley & Sons, Ltd.

An investigation on the quality of midwifery services from the viewpoint of the clients in Isfahan through SERVQUAL model.

PubMed

Oliaee, Zohreh; Jabbari, Alireza; Ehsanpour, Soheila

2016-01-01

Quality of care is of great importance in health services as these services have the important mission to preserve health, and to give care to the society. The present study aimed to investigate the quality of midwifery services from the viewpoint of the clients, under coverage of health care centers in Isfahan, through SERVQUAL model. This descriptive and analytical study was conducted on 218 subjects in 2014. Study population comprised the women referring to midwifery services clinics in health care centers in Isfahan. Data of the subjects (n = 218) were collected by SERVQUAL model containing the dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Data were analyzed by paired t-test, Spearman and Pearson correlation coefficients, and independent t-test through SPSS 20. There was a negative gap in all five relevant dimensions of giving services. The widest gap was in the mean of dimension of tangibles (-1.5), and the narrowest gap was in the dimension of assurance (-0.9). There was no significant association between the scores of expectations and perceptions, and age, education level, occupation, and marital status. The obtained negative gap showed that the level of service receivers' perception from existing condition was far from their expectation, and there was a wide gap between attaining their satisfaction with midwifery services and their expectation and reaching their appropriate level of services.

Cloud-based hospital information system as a service for grassroots healthcare institutions.

PubMed

Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

2014-09-01

Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh.

PubMed

Shawon, Md Shajedur Rahman; Adhikary, Gourab; Ali, Md Wazed; Shamsuzzaman, Md; Ahmed, Shahabuddin; Alam, Nurul; Shackelford, Katya A; Woldeab, Alexander; Lim, Stephen S; Levine, Aubrey; Gakidou, Emmanuela; Uddin, Md Jasim

2018-01-25

Service readiness of health facilities is an integral part of providing comprehensive quality healthcare to the community. Comprehensive assessment of general and service-specific (i.e. child immunization) readiness will help to identify the bottlenecks in healthcare service delivery and gaps in equitable service provision. Assessing healthcare facilities readiness also helps in optimal policymaking and resource allocation. A health facility survey was conducted between March 2015 and December 2015 in two purposively selected divisions in Bangladesh; i.e. Rajshahi division (high performing) and Sylhet division (low performing). A total of 123 health facilities were randomly selected from different levels of service, both public and private, with variation in sizes and patient loads from the list of facilities. Data on various aspects of healthcare facility were collected by interviewing key personnel. General service and child immunization specific service readiness were assessed using the Service Availability and Readiness Assessment (SARA) manual developed by World Health Organization (WHO). The analyses were stratified by division and level of healthcare facilities. The general service readiness index for pharmacies, community clinics, primary care facilities and higher care facilities were 40.6%, 60.5%, 59.8% and 69.5%, respectively in Rajshahi division and 44.3%, 57.8%, 57.5% and 73.4%, respectively in Sylhet division. Facilities at all levels had the highest scores for basic equipment (ranged between 51.7% and 93.7%) and the lowest scores for diagnostic capacity (ranged between 0.0% and 53.7%). Though facilities with vaccine storage capacity had very high levels of service readiness for child immunization, facilities without vaccine storage capacity lacked availability of many tracer items. Regarding readiness for newly introduced pneumococcal conjugate vaccine (PCV) and inactivated polio vaccine (IPV), most of the surveyed facilities reported lack of sufficient funding and resources (antigen) for training programs. Our study suggested that health facilities suffered from lack of readiness in various aspects, most notably in diagnostic capacity. Conversely, with very few challenges, nearly all the health facilities designated to provide immunization services were ready to deliver routine childhood immunization services as well as newly introduced PCV and IPV.

'Forensic' labelling: an empirical assessment of its effects on self-stigma for people with severe mental illness.

PubMed

Livingston, James D; Rossiter, Katherine R; Verdun-Jones, Simon N

2011-06-30

Increasingly, specialized 'forensic' mental health services are being developed to address the criminogenic and clinical needs of people with mental illness who are involved in the criminal justice system. Theoretically, the construction of such specialized services can produce simultaneous positive benefits and negative consequences. This mixed methods study examined and compared the level of self-stigma that was experienced by people who receive compulsory community-based treatment services in the forensic (n=52) and civil (n=39) mental health systems of British Columbia, Canada. The quantitative findings indicate that 'forensic' labelling was not associated with elevated levels of self-stigma. Quantitative level of self-stigma was significantly associated with psychiatric symptom severity, history of incarceration, and history of homelessness. The qualitative findings suggest that access to high-quality, well-resourced forensic mental health services may, for some service users, come at the risk of increased exposure to social and structural stigma. Together, these findings reveal some of the strengths and weaknesses that are associated with organizing forensic mental health services using a specialized service delivery model. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Constrained Optimization of Average Arrival Time via a Probabilistic Approach to Transport Reliability

PubMed Central

Namazi-Rad, Mohammad-Reza; Dunbar, Michelle; Ghaderi, Hadi; Mokhtarian, Payam

2015-01-01

To achieve greater transit-time reduction and improvement in reliability of transport services, there is an increasing need to assist transport planners in understanding the value of punctuality; i.e. the potential improvements, not only to service quality and the consumer but also to the actual profitability of the service. In order for this to be achieved, it is important to understand the network-specific aspects that affect both the ability to decrease transit-time, and the associated cost-benefit of doing so. In this paper, we outline a framework for evaluating the effectiveness of proposed changes to average transit-time, so as to determine the optimal choice of average arrival time subject to desired punctuality levels whilst simultaneously minimizing operational costs. We model the service transit-time variability using a truncated probability density function, and simultaneously compare the trade-off between potential gains and increased service costs, for several commonly employed cost-benefit functions of general form. We formulate this problem as a constrained optimization problem to determine the optimal choice of average transit time, so as to increase the level of service punctuality, whilst simultaneously ensuring a minimum level of cost-benefit to the service operator. PMID:25992902

Governance - Alignment and Configuration of Business Activities Task Group Report

DTIC Science & Technology

2006-05-01

governance level and the Enterprise Model as a way of ensuring integration at the management and work/execution levels 3. Ensure shared services (i.e...Management Framework o QDR Organizational Model o Secretary of Defense 2006-2008 Priorities o Shared Services Defense Business Board...support for horizontal and vertical organizations • Move “supporting” organizations to shared services model May 2006 "Team Defense" 18 Task Group

The Relation between Pre-Service Music Teachers' Psychological Resilience and Academic Achievement Levels

ERIC Educational Resources Information Center

Yokus, Tuba

2015-01-01

This study aims to examine the relation between pre-service music teachers' psychological resilience and academic achievement levels and to determine what variables influence their psychological resilience levels. The study sample consisted of students enrolled in a music education program in the 2013-2014 academic year (N = 333). In respect with…

Low Levels of Evidence on the Plastic Surgery In-Service Training Exam.

PubMed

Silvestre, Jason; Bilici, Nadir; Serletti, Joseph M; Chang, Benjamin

2016-06-01

The Plastic Surgery In-Service Training Exam is written by the American Society of Plastic Surgeons. Examinees reasonably infer that tested material reflects the Society's vision for the core curriculum in plastic surgery. The purpose of this study was to determine the levels of evidence on which credited answers to the examination questions are based. Two recent Plastic Surgery In-Service Training Exams (2014 and 2015) were analyzed. Questions were categorized using a taxonomy model. Recommended journal article references for Level III (decision-making) questions were assigned a level of evidence. Exam sections were analyzed for differences in question taxonomy distribution and level of evidence. To look for studies with higher levels of evidence, a PubMed search was conducted for a random sample of 10 questions from each section. One hundred three Level I (25.8 percent), 138 Level II (34.5 percent), and 159 Level III (39.8 percent) questions were analyzed (p < 0.001). The hand and lower extremity section had the highest percentage of Level III questions (50.0 percent; p = 0.005). Journal articles had a mean level of evidence of 3.9 ± 0.7. The number of articles with a low level of evidence (IV and V) (p = 0.624) and the percentage of questions supported by articles with a high level of evidence (I and II) (p = 0.406) did not vary by section. The PubMed search revealed no instances of a higher level of evidence than the recommended reading list. A significant percentage of Plastic Surgery In-Service Training Exam questions test clinical management, but most are supported with a low level of evidence. Although that is consistent with low level of evidence of plastic surgery literature, educators should recognize the potential for biases of question writers.

Research Challenges in Managing and Using Service Level Agreements

NASA Astrophysics Data System (ADS)

Rana, Omer; Ziegler, Wolfgang

A Service Level Agreement (SLA) represents an agreement between a service user and a provider in the context of a particular service provision. SLAs contain Quality of Service properties that must be maintained by a provider, and as agreed between a provider and a user/client. These are generally defined as a set of Service Level Objectives (SLOs). These properties need to be measurable and must be monitored during the provision of the service that has been agreed in the SLA. The SLA must also contain a set of penalty clauses specifying what happens when service providers fail to deliver the pre-agreed quality. Hence, an SLA may be used by both a user and a provider - from a user perspective, an SLA defines what is required - often defined using non-functional attributes of service provision. From a providers perspective, an SLA may be used to support capacity planning - especially if a provider is making it's capability available to multiple users. An SLA may be used by a client and provider to manage their behaviour over time - for instance, to optimise their long running revenue (cost) or QoS attributes (such as execution time), for instance. The lifecycle of an SLA is outlined, along with various uses of SLAs to support infrastructure management. A discussion about WS-Agreement - the emerging standard for specifying SLAs - is also provided.

HIV/AIDS Knowledge and Beliefs among Pre-Service and In-Service School Counselors.

ERIC Educational Resources Information Center

Costin, Amanda C.; Page, Betsy J.; Pietrzak, Dale R.; Kerr, Dianne L.; Symons, Cynthia W.

2002-01-01

Investigates in-service and pre-service school counselors' current levels of HIV/AIDS-related knowledge and attitudes, and the demographic factors potentially associated with HIV/AIDS knowledge and attitudes. (Contains 26 references.) (GCP)

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics

PubMed Central

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A.

2015-01-01

Background and Objectives: In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007–2012). Approach: Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. Results: The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. Conclusion: The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. PMID:26742118

From Policy to Practice: Implementation of Treatment for Substance Misuse in Québec Primary Healthcare Clinics.

PubMed

Maynard, Serge; Campbell, Emily; Boodhoo, Katie; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara A; Gill, Kathryn

2015-11-01

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012). Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation. The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care. The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices. Copyright © 2015 Longwoods Publishing.

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

PubMed

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

78 FR 72620 - Federal Acquisition Regulation; Higher-Level Contract Quality Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE.... IV. Regulatory Flexibility Act The Department of Defense (DoD), the General Services Administration...-AM65 Federal Acquisition Regulation; Higher-Level Contract Quality Requirements AGENCY: Department of...

42 CFR 483.120 - Specialized services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... team, which includes a physician, qualified mental health professionals and, as appropriate, other... acute episode of serious mental illness, which necessitates supervision by trained mental health... functioning level that permits reduction in the intensity of mental health services to below the level of...

42 CFR 483.120 - Specialized services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... team, which includes a physician, qualified mental health professionals and, as appropriate, other... acute episode of serious mental illness, which necessitates supervision by trained mental health... functioning level that permits reduction in the intensity of mental health services to below the level of...

42 CFR 483.120 - Specialized services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... team, which includes a physician, qualified mental health professionals and, as appropriate, other... acute episode of serious mental illness, which necessitates supervision by trained mental health... functioning level that permits reduction in the intensity of mental health services to below the level of...

42 CFR 483.120 - Specialized services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... team, which includes a physician, qualified mental health professionals and, as appropriate, other... acute episode of serious mental illness, which necessitates supervision by trained mental health... functioning level that permits reduction in the intensity of mental health services to below the level of...

42 CFR 483.120 - Specialized services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... team, which includes a physician, qualified mental health professionals and, as appropriate, other... acute episode of serious mental illness, which necessitates supervision by trained mental health... functioning level that permits reduction in the intensity of mental health services to below the level of...

Organisation for Change: The British National Health Service.

ERIC Educational Resources Information Center

Chester, T. E.

Begun in 1948, The National Health Service was organized in a "functional" pattern of three main groups: hospital service, primary health care, and community health services and personal social services. Dissatisfaction led to a reorganization in 1974 along geographical divisions for region, area, and district levels, necessitating a…

The Classification Ability with Naked Eyes According to the Understanding Level about Rocks of Pre-service Science Teachers

NASA Astrophysics Data System (ADS)

Seong, Cho Kyu; Ho, Chung Duk; Pyo, Hong Deok; Kyeong Jin, Park

2016-04-01

This study aimed to investigate the classification ability with naked eyes according to the understanding level about rocks of pre-service science teachers. We developed a questionnaire concerning misconception about minerals and rocks. The participant were 132 pre-service science teachers. Data were analyzed using Rasch model. Participants were divided into a master group and a novice group according to their understanding level. Seventeen rocks samples (6 igneous, 5 sedimentary, and 6 metamorphic rocks) were presented to pre-service science teachers to examine their classification ability, and they classified the rocks according to the criteria we provided. The study revealed three major findings. First, the pre-service science teachers mainly classified rocks according to textures, color, and grain size. Second, while they relatively easily classified igneous rocks, participants were confused when distinguishing sedimentary and metamorphic rocks from one another by using the same classification criteria. On the other hand, the understanding level of rocks has shown a statistically significant correlation with the classification ability in terms of the formation mechanism of rocks, whereas there was no statically significant relationship found with determination of correct name of rocks. However, this study found that there was a statistically significant relationship between the classification ability with regard the formation mechanism of rocks and the determination of correct name of rocks Keywords : Pre-service science teacher, Understanding level, Rock classification ability, Formation mechanism, Criterion of classification

Methodological advances in unit cost calculation of psychiatric residential care in Spain.

PubMed

Moreno, Karen; Sanchez, Eduardo; Salvador-Carulla, Luis

2008-06-01

The care of the severe mentally ill who need intensive support for their daily living (dependent persons), accounts for an increasingly large proportion of public expenditure in many European countries. The main aim of this study was the design and implementation of solid methodology to calculate unit costs of different types of care. To date, methodologies used in Spain have produced inaccurate figures, suggesting few variations in patient consumption of the same service. An adaptation of the Activity-Based-Costing methodology was applied in Navarre, a region in the North of Spain, as a pilot project for the public mental health services. A unit cost per care process was obtained for all levels of care considered in each service during 2005. The European Service Mapping Schedule (ESMS) codes were used to classify the services for later comparisons. Finally, in order to avoid problems of asymmetric cost distribution, a simple Bayesian model was used. As an illustration, we report the results obtained for long-term residential care and note that there are important variations between unit costs when considering different levels of care. Considering three levels of care (Level 1-low, Level 2-medium and Level 3-intensive), the cost per bed in Level 3 was 10% higher than that of Level 2. The results obtained using the cost methodology described provide more useful information than those using conventional methods, although its implementation requires much time to compile the necessary information during the initial stages and the collaboration of staff and managers working in the services. However, in some services, if no important variations exist in patient care, another method would be advisable, although our system provides very useful information about patterns of care from a clinical point of view. Detailed work is required at the beginning of the implementation in order to avoid the calculation of distorted figures and to improve the levels of decision making within the Health Care Service. IMPLICATIONS FOR HEALTH CARE POLICY AND FORMULATIONS: As other European countries, Spain has adopted a new care system for the dependent population. To finance this new system, reliable figures must be calculated for each type of user in order to establish tariffs or public prices. This study provides a useful management tool to assist in decision making. The methodology should be implemented in other regions of Spain and even in other countries in order to compare our results and validate the cost system designed.

Ex-post-facto analysis of competitive employment outcomes for individuals with mental retardation: national perspective.

PubMed

Moore, Corey L; Harley, Debra A; Gamble, David

2004-08-01

Disparities in proportions of competitive job placements and provision of vocational rehabilitation services by level of mental retardation were identified for 28,565 individuals. Chi-square results reveal that consumers with mild mental retardation are significantly more likely to achieve competitive jobs compared to those with more severe levels. Logistic regression indicated that the odds of achieving a competitive job for consumers receiving job placement services, business/vocational training, and counseling were nearly two times that of individuals not receiving such services. Findings suggest that a significantly lower proportion of these services were provided to consumers with severe/profound mental retardation. Implications of findings for service, research, and policy are discussed.

Cardiologist service volume, percutaneous coronary intervention and hospital level in relation to medical costs and mortality in patients with acute myocardial infarction: a nationwide study.

PubMed

Liu, C-Y; Lin, Y-N; Lin, C-L; Chang, Y-J; Hsu, Y-H; Tsai, W-C; Kao, C-H

2014-07-01

We explore whether cardiologist service volume, hospital level and percutaneous coronary intervention (PCI) are associated with medical costs and acute myocardial infarction (AMI) mortality. From the 1997-2010 Taiwan National Health Insurance Research Database of the National Health Research Institute, we identified AMI patients and performed multiple regression analyses to explore the relationships among the different hospital levels and treatment factors. We identified 2942 patients with AMI in medical centers and 4325 patients with AMI in regional hospitals. Cardiologist service volume, performing PCI and medical costs per patient were higher in medical centers than in regional hospitals (P < 0.0001). However, the two hospital levels did not differ significantly in in-hospital mortality (P = 0.1557). Post hoc analysis showed significant differences in in-hospital mortality rate and in medical costs among the eight groups subdivided on the basis of hospital level, cardiologist service volume, and whether PCI was performed (P < 0.001 and P = 0.001, respectively). These results highlight the importance of encouraging hospitals to develop PCI capability and increase their cardiologist service volume after taking medical costs into account. Transferring AMI patients to hospitals with higher cardiologist service volume and PCI performed can also be very important. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability.

PubMed

Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel

2017-01-01

Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.

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

PubMed

Maguire-Jack, Kathryn; Klein, Sacha

2015-07-01

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

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

PubMed Central

Maguire-Jack, Kathryn; Klein, Sacha

2015-01-01

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

Impact of Network Activity Levels on the Performance of Passive Network Service Dependency Discovery

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

Carroll, Thomas E.; Chikkagoudar, Satish; Arthur-Durett, Kristine M.

Network services often do not operate alone, but instead, depend on other services distributed throughout a network to correctly function. If a service fails, is disrupted, or degraded, it is likely to impair other services. The web of dependencies can be surprisingly complex---especially within a large enterprise network---and evolve with time. Acquiring, maintaining, and understanding dependency knowledge is critical for many network management and cyber defense activities. While automation can improve situation awareness for network operators and cyber practitioners, poor detection accuracy reduces their confidence and can complicate their roles. In this paper we rigorously study the effects of networkmore » activity levels on the detection accuracy of passive network-based service dependency discovery methods. The accuracy of all except for one method was inversely proportional to network activity levels. Our proposed cross correlation method was particularly robust to the influence of network activity. The proposed experimental treatment will further advance a more scientific evaluation of methods and provide the ability to determine their operational boundaries.« less

Levels and Patterns of Participation and Social Interaction in an Online Learning Community for Learning to Teach

ERIC Educational Resources Information Center

Tsai, I-Chun

2011-01-01

This study investigates how pre-service and in-service teachers participate in an online community for learning to teach. Members' levels and patterns of participation and social interaction were examined via social network analysis of activity logs and content analysis of interviews. The results of the analyses show that (a) members' levels and…

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

PubMed

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

2013-11-01

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

An Investigation into the Perceptions of Mathematics and Information Literacy Self-Efficacy Levels of Pre-Service Primary Mathematics Teachers

ERIC Educational Resources Information Center

Dinçer, Bahar; Yilmaz, Süha

2016-01-01

The purpose of this study is to examine the relationship between perceptions of the self-efficacy levels for both mathematics literacy and information literacy in pre-service primary mathematics teachers and the factors on which the relationship depends (variables include gender, class level, hours spent reading books and computer-access…

The Impact of Local Environmental Health Capacity on Foodborne Illness Morbidity in Maryland

PubMed Central

Resnick, Beth A.; Fox, Mary A.; McGready, John; Yager, James P.; Burke, Thomas A.

2011-01-01

Objectives. We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. Methods. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Results. Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Conclusions. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness. PMID:21750282

Modeling Adaptable Business Service for Enterprise Collaboration

NASA Astrophysics Data System (ADS)

Boukadi, Khouloud; Vincent, Lucien; Burlat, Patrick

Nowadays, a Service Oriented Architecture (SOA) seems to be one of the most promising paradigms for leveraging enterprise information systems. SOA creates opportunities for enterprises to provide value added service tailored for on demand enterprise collaboration. With the emergence and rapid development of Web services technologies, SOA is being paid increasing attention and has become widespread. In spite of the popularity of SOA, a standardized framework for modeling and implementing business services are still in progress. For the purpose of supporting these service-oriented solutions, we adopt a model driven development approach. This paper outlines the Contextual Service Oriented Modeling and Analysis (CSOMA) methodology and presents UML profiles for the PIM level service-oriented architectural modeling, as well as its corresponding meta-models. The proposed PIM (Platform Independent Model) describes the business SOA at a high level of abstraction regardless of techniques involved in the application employment. In addition, all essential service-specific concerns required for delivering quality and context-aware service are covered. Some of the advantages of this approach are that it is generic and thus not closely allied with Web service technology as well as specifically treating the service adaptability during the design stage.

Report of the Council on Library and Network Development on Funding for State Level Resource Providers. Bulletin No. 4150.

ERIC Educational Resources Information Center

Eagon, Burdette; And Others

This publication describes Wisconsin state level library services and their funding and presents recommendations related to state level resource providers, as required by Wisconsin Statutes, Chapter 347, Laws of 1979. Types of and the structure for providing statewide library services and resources are outlined, followed by a description of…

Mental health services in South Africa: taking stock.

PubMed

Lund, C; Petersen, I; Kleintjes, S; Bhana, A

2012-11-01

There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include- training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations.

PubMed

Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M

2010-07-01

Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

77 FR 60450 - Senior Executive Service Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Senior Executive Service Performance... announces the appointment of the members of the Senior Executive Service Performance Review Boards for the... appropriate personnel actions for incumbents of Senior Executive Service, Senior Level and Senior Professional...

An investigation of toll plaza capacity and level of service.

DOT National Transportation Integrated Search

1991-01-01

This study was undertaken to accomplish two objectives pertinent to traffic characteristics at toll plaza areas: (1) to develop a methodology for evaluating the capacity of a toll plaza, and (2) to establish level-of-service criteria for toll area tr...

Availability of HIV-related health services in adolescent substance abuse treatment programs.

PubMed

Knudsen, H K; Oser, C B

2009-10-01

Given that alcohol and drug abuse heightens the risk of adolescents acquiring HIV, substance abuse treatment programs for youths may represent an important site of HIV prevention. In this research, we explored the adoption of three HIV-related health services: risk assessment during intake, HIV prevention programing, and HIV testing. Data were collection through telephone interviews with 149 managers of adolescent-only substance abuse treatment programs in the USA. About half of these programs had adopted HIV risk assessment and HIV prevention. On-site HIV testing was less widely adopted, with only one in four programs offering this service. At the bivariate level, the availability of on-site primary medical care and the availability of an overnight level of care were positively associated with these three types of services. The association for the measure of an overnight level of care was no longer significant once medical services were controlled. However, in a separate analysis, it was found that programs offering an overnight level of care were much more likely to offer on-site medical care than outpatient-only facilities. There was also evidence that publicly funded treatment programs were more likely to offer HIV prevention and on-site HIV testing, after controlling for other organizational characteristics. Much more research about the adoption of HIV-related services in adolescent substance abuse treatment is needed, particularly to offer greater insight into why certain types of organizations are more likely to adopt these health services.

Women's autonomy and maternal healthcare service utilization in Ethiopia.

PubMed

Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Chuang, Ying-Chih

2017-11-13

Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women's autonomy. We assessed whether women's autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women's decision-making power and permissive gender norms associated with wife beating. We used Spearman's correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women's autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Our study shows that women's autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.

EGSIEM combination service: combination of GRACE monthly K-band solutions on normal equation level

NASA Astrophysics Data System (ADS)

Meyer, Ulrich; Jean, Yoomin; Arnold, Daniel; Jäggi, Adrian

2017-04-01

The European Gravity Service for Improved Emergency Management (EGSIEM) project offers a scientific combination service, combining for the first time monthly GRACE gravity fields of different analysis centers (ACs) on normal equation (NEQ) level and thus taking all correlations between the gravity field coefficients and pre-eliminated orbit and instrument parameters correctly into account. Optimal weights for the individual NEQs are commonly derived by variance component estimation (VCE), as is the case for the products of the International VLBI Service (IVS) or the DTRF2008 reference frame realisation that are also derived by combination on NEQ-level. But variance factors are based on post-fit residuals and strongly depend on observation sampling and noise modeling, which both are very diverse in case of the individual EGSIEM ACs. These variance factors do not necessarily represent the true error levels of the estimated gravity field parameters that are still governed by analysis noise. We present a combination approach where weights are derived on solution level, thereby taking the analysis noise into account.

Exploiting Aura OMI Level 2 Data with High Resolution Visualization

NASA Astrophysics Data System (ADS)

Wei, J. C.; Yang, W.; Johnson, J. E.; Zhao, P.; Gerasimov, I. V.; Pham, L.; Vicente, G. A.; Shen, S.

2014-12-01

Satellite data products are important for a wide variety of applications that can bring far-reaching benefits to the science community and the broader society. These benefits can best be achieved if the satellite data are well utilized and interpreted, such as model inputs from satellite, or extreme event (such as volcano eruption, dust storm, …etc) interpretation from satellite. Unfortunately, this is not always the case, despite the abundance and relative maturity of numerous satellite data products provided by NASA and other organizations. One way to help users better understand the satellite data is to provide data along with 'Images', including accurate pixel-level (Level 2) information, pixel coverage area delineation, and science team recommended quality screening for individual geophysical parameters. Goddard Earth Sciences Data and Information Services Center (GES DISC) always strives to best support (i.e., Software-as-a-service, SaaS) the user-community for NASA Earth Science Data. In this case, we will present a new visualization tool that helps users exploiting Aura Ozone Monitoring Instrument (OMI) Level 2 data. This new visualization service utilizes Open Geospatial Consortium (OGC) standard-compliant Web Mapping Service (WMS) and Web Coverage Service (WCS) calls in the backend infrastructure. The functionality of the service allows users to select data sources (e.g., multiple parameters under the same measurement, like NO2 and SO2 from OMI Level 2 or same parameter with different methods of aggregation, like NO2 in OMNO2G and OMNO2D products), defining area-of-interest and temporal extents, zooming, panning, overlaying, sliding, and data subsetting and reformatting. The interface will also be able to connect to other OGC WMS and WCS servers, which will greatly enhance its expandability to integrate additional outside data/map sources (such as Global Imagery Browse Services (GIBS)).

The cost structure of routine infant immunization services: a systematic analysis of six countries.

PubMed

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-10-01

Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77-93% of national routine infant immunization costs. Labour and vaccine costs comprised 14-69% and 13-69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48-78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The cost structure of routine infant immunization services: a systematic analysis of six countries

PubMed Central

Geng, Fangli; Suharlim, Christian; Brenzel, Logan; Resch, Stephen C; Menzies, Nicolas A

2017-01-01

Abstract Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach. For each country, we estimated the economic costs of infant immunization by administrative level, budget category, and programmatic activity from a programme perspective. We used regression models to describe how costs within each category were related to site operating characteristics and efficiency level. Site-level costs (incl. vaccines) represented 77–93% of national routine infant immunization costs. Labour and vaccine costs comprised 14–69% and 13–69% of site-level cost, respectively. The majority of site-level resources were devoted to service provision (facility-based or outreach), comprising 48–78% of site-level costs across the six countries. Based on the regression analyses, sites with the highest service volume had a greater proportion of costs devoted to vaccines, with vaccine costs per dose relatively unaffected by service volume but non-vaccine costs substantially lower with higher service volume. Across all countries, more efficient sites (compared with sites with similar characteristics) had a lower cost share devoted to labour. The cost structure of immunization services varied substantially between countries and across sites within each country, and was related to site characteristics. The substantial variation observed in this sample suggests differences in operating model for otherwise similar sites, and further understanding of these differences could reveal approaches to improve efficiency and performance of immunization sites. PMID:28575193

Measuring Prices in Health Care Markets Using Commercial Claims Data.

PubMed

Neprash, Hannah T; Wallace, Jacob; Chernew, Michael E; McWilliams, J Michael

2015-12-01

To compare methods of price measurement in health care markets. Truven Health Analytics MarketScan commercial claims. We constructed medical prices indices using three approaches: (1) a "sentinel" service approach based on a single common service in a specific clinical domain, (2) a market basket approach, and (3) a spending decomposition approach. We constructed indices at the Metropolitan Statistical Area level and estimated correlations between and within them. Price indices using a spending decomposition approach were strongly and positively correlated with indices constructed from broad market baskets of common services (r > 0.95). Prices of single common services exhibited weak to moderate correlations with each other and other measures. Market-level price measures that reflect broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices. © Health Research and Educational Trust.

CMR Catalog Service for the Web

NASA Technical Reports Server (NTRS)

Newman, Doug; Mitchell, Andrew

2016-01-01

With the impending retirement of Global Change Master Directory (GCMD) Application Programming Interfaces (APIs) the Common Metadata Repository (CMR) was charged with providing a collection-level Catalog Service for the Web (CSW) that provided the same level of functionality as GCMD. This talk describes the capabilities of the CMR CSW API with particular reference to the support of the Committee on Earth Observation Satellites (CEOS) Working Group on Information Systems and Services (WGISS) Integrated Catalog (CWIC).

28 CFR 0.15 - Deputy Attorney General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Executive Service or the equivalent; Senior-Level and Scientific and Professional positions; and of... Executive Office of the President. (4) Coordinate and control the Department's reaction to civil..., including attorneys, in the Senior Executive Service or the equivalent, and Senior-Level and Scientific and...

28 CFR 0.15 - Deputy Attorney General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Executive Service or the equivalent; Senior-Level and Scientific and Professional positions; and of... Executive Office of the President. (4) Coordinate and control the Department's reaction to civil..., including attorneys, in the Senior Executive Service or the equivalent, and Senior-Level and Scientific and...

78 FR 17223 - Notice of Submission of Proposed Information Collection to OMB: Annual Progress Report (APR) for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... homeless clients and service needs at the local level. HUD also uses this information to provide... information assists HUD in understanding homeless clients and service needs at the local level. HUD also uses...

When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services.

PubMed

Moore, Megan; Cristofalo, Margaret; Dotolo, Danae; Torres, Nicole; Lahdya, Alexandra; Ho, Leyna; Vogel, Mia; Forrester, Mollie; Conley, Bonnie; Fouts, Susan

2017-04-01

The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10). Eight major social work roles were identified: investigator, gatekeeper, resource broker, care coordinator, problem solver, crisis manager, advocate, discharge planner. Analyses revealed a complex interplay between ED social work services and multi-layered contexts. Using a social-ecological framework, we identified the interactions between micro or individual level factors, mezzo or local system level factors and macro environmental and systemic factors that play a role in ED interactions and patient services. Macro-level contextual influences were socio-structural forces including socioeconomic barriers to health, social hierarchies that reflected power differentials between providers and patients, and distrust or bias. Mezzo-level forces were limited resources, lack of healthcare system coordination, a challenging hierarchy within the medical model and the pressure to discharge patients quickly. Micro-level factors included characteristics of patients and social workers, complexity of patient stressors, empathic strain, lack of closure and compassion. All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker interactions was developed to assist in guiding innovative research and practice models to improve services and outcomes in the complex, fast-paced ED. Copyright © 2017 Elsevier Ltd. All rights reserved.

When high pressure, system constraints, and a social justice mission collide: a socio-structural analysis of emergency department social work services

PubMed Central

Cristofalo, Margaret; Dotolo, Danae; Torres, Nicole; Lahdya, Alexandra; Ho, Leyna; Vogel, Mia; Forrester, Mollie; Conley, Bonnie; Fouts, Susan

2017-01-01

The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N=1,509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N=10). Eight major social work roles were identified: investigator, gatekeeper, resource broker, care coordinator, problem solver, crisis manager, advocate, discharge planner. Analyses revealed a complex interplay between ED social work services and multi-layered contexts. Using a social-ecological framework, we identified the interactions between micro or individual level factors, mezzo or local system level factors and macro environmental and systemic factors that play a role in ED interactions and patient services. Macro-level contextual influences were socio-structural forces including socioeconomic barriers to health, social hierarchies that reflected power differentials between providers and patients, and distrust or bias. Mezzo-level forces were limited resources, lack of healthcare system coordination, a challenging hierarchy within the medical model and the pressure to discharge patients quickly. Micro-level factors included characteristics of patients and social workers, complexity of patient stressors, empathic strain, lack of closure and compassion. All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker interactions was developed to assist in guiding innovative research and practice models to improve services and outcomes in the complex, fast-paced ED. PMID:28214722

EnviroAtlas - NHDPlus V2 Hydrologic Unit Boundaries Web Service - Conterminous United States

EPA Pesticide Factsheets

This EnviroAtlas web service contains layers depicting hydrologic unit boundary layers and labels for the Subregion level (4-digit HUCs), Subbasin level (8-digit HUCs), and Subwatershed level (12-digit HUCs) for the conterminous United States. 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).

When ecosystem services interact: crop pollination benefits depend on the level of pest control

PubMed Central

Lundin, Ola; Smith, Henrik G.; Rundlöf, Maj; Bommarco, Riccardo

2013-01-01

Pollination is a key ecosystem service which most often has been studied in isolation although effects of pollination on seed set might depend on, and interact with, other services important for crop production. We tested three competing hypotheses on how insect pollination and pest control might jointly affect seed set: independent, compensatory or synergistic effects. For this, we performed a cage experiment with two levels of insect pollination and simulated pest control in red clover (Trifolium pratense L.) grown for seed. There was a synergistic interaction between the two services: the gain in seed set obtained when simultaneously increasing pollination and pest control outweighed the sum of seed set gains obtained when increasing each service separately. This study shows that interactions can alter the benefits obtained from service-providing organisms, and this needs to be considered to properly manage multiple ecosystem services. PMID:23269852

Expansion of Safe Abortion Services in Nepal Through Auxiliary Nurse‐Midwife Provision of Medical Abortion, 2011‐2013

PubMed Central

Basnett, Indira; Shrestha, Dirgha Raj; Shrestha, Meena Kumari; Shah, Mukta; Aryal, Shilu

2016-01-01

Introduction The termination of unwanted pregnancies up to 12 weeks’ gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse‐midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal. Methods This was a descriptive program evaluation. Sites and trainees were selected using standardized assessment tools to determine minimum facility requirements and willingness to provide medical abortion after training. Training was evaluated via posttests and observational checklists. Service statistics were collected through the government's facility logbook for safe abortion services (HMIS‐11). Results By the end of June 2014, medical abortion service had been expanded to 25 districts through 463 listed ANMs at 290 listed primary‐level facilities and served 25,187 women. Providers report a high level of confidence in their medical abortion skills and considerable clinical knowledge and capacity in medical abortion. Discussion The Nepali experience demonstrates that safe induced abortion care can be provided by ANMs, even in remote primary‐level health facilities. Post‐training support for providers is critical in helping ANMs handle potential barriers to medical abortion service provision and build lasting capacity in medical abortion. PMID:26860072

Dissatisfaction with cardiovascular health and primary health care services: Southern Mani, isolated area in Europe. A case study.

PubMed

Mariolis, Anargiros; Mihas, Constantinos; Alevizos, Alevizos; Mariolis-Sapsakos, Theodoros; Sergentanis, Theodoros N; Kalogerakos, Nikolaos; Virvilis, Christos; Fourkas, Constantinos; Skandalakis, Panayiotis; Stefanadis, Christodoulos

2008-01-01

Access to local providers of primary health care (PHC) services and their utilisation is a challenge faced by the authorities of developed as well as developing countries. The aim of our study was to assess and evaluate the level of satisfaction with the currently provided cardiovascular and PHC services in the southernmost region of continental Greece (and of the European Union), Southern Mani. The sample (422 individuals, 375 of whom finally participated: 187 men and 188 women, response ratio: 88.86%), was selected between January-December 2006, using stratified randomisation by sex and age. Participants were asked to fill in a validated questionnaire containing socio-demographic data and items about the health needs/level of satisfaction with cardiovascular health and PHC services, as well as two indices for cardiovascular health: i) frequency of international normalised ratio (INR) measurement in case of atrial fibrillation, and ii) history of timely thrombolysis in case of acute myocardial infarction. The majority of the responders stated that their level of satisfaction with PHC services was "low" or "very low" (total: 52.80%), while the percentage of dissatisfaction with cardiovascular health services was 56.0%. In addition, most of the participants expressed a strong wish for improvement of PHC services (71.33%). The level of satisfaction with PHC services was higher than with cardiovascular health services (2.49 +/- 1.26 vs. 2.38 +/- 1.24; p < 0.001). Satisfaction scores for both cardiovascular health and PHC services were negatively associated with the distance from the nearest PHC Unit. Only 11.1% of patients (95% CI: 0.3%-48.2%) reported annual testing of prothrombin time more than once, while among those with a history of acute myocardial infarction, none reported timely thrombolysis (0%, one-sided 97.5% CI: 0%-41.0%). It is evident that a large portion of the Southern Mani population perceives the provided cardiovascular health and PHC services as problematic, while the distance from the nearest PHC unit seems to be one of the most important factors and predictors of dissatisfaction. The provision of efficient PHC services in isolated areas is a matter that should be re-evaluated.

What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?

PubMed

Hetrick, Sarah E; Simmons, Magenta; Thompson, Andrew; Parker, Alexandra G

2011-11-01

We sought to examine potential barriers to the use of evidence-based guidelines for youth depression in a tertiary specialist mental health service, as part of an initiative to implement evidence based practice within the service. This was a qualitative study adopting a social constructionist perspective using focus groups. The focus groups, conducted with all clinicians (medical and allied health), were audiotaped, transcribed and thematic analysis was undertaken. Clinicians were asked about the barriers to implementing four key recommendations from the National Institute for Health and Clinical Excellence (NICE) guidelines. Barriers existed at (i) the individual clinician level; (ii) the clinical level in terms of the presentation of young people; and (iii) the service level. The key individual clinician level barrier was a stated belief that the guidelines were not relevant to the young people presenting to the service, with little evidence to guide practice. Related, the main barrier with regard to the clinical presentation was the severity and complexity of this presentation, often making the delivery of interventions like cognitive behavioural therapy (CBT) difficult. At the service level, a lack of integration with primary and secondary level care meant sequencing interventions according to guideline recommendations was difficult. There is a clear imperative to develop the evidence base to ensure that effective treatments for young people aged up to 25 years with severe and complex disorders that include comorbid conditions, suicide risk and psychosocial difficulties are investigated and disseminated. Furthermore, this work has highlighted the need for greater investment in models of care that ensure integration between existing primary and secondary care and enhanced specialist early intervention mental health services for young people.

[The carrier model of neurology in Hungary: a proposal for the solution until 2020].

PubMed

Bereczki, Dániel; Csiba, László; Komoly, Sámuel; Vécsei, László; Ajtay, András

2011-11-30

Based on our previous survey on the capacities of neurological services and on the predictable changes in the neurologist workforce in Hungary, we present a proposal for the organization of the structure of neurological services in the future. We discuss the diagnostic groups treated by neurologists, the neurological services and their progressive organization. Using the current capacities as baseline, we propose patient groups to be treated by neurologists in the future, and the levels of services. Based on the tendencies seen in the last years we suggest to consider to allocate acute stroke services exclusively to stroke units in neurological departments, and we identify a few other diagnostic groups where neurology should have a larger share in patient care. We define three levels for inpatient care: university departments, regional/county hospitals, city hospitals. Instead of minimum criteria we assign outpatient and inpatient standards that are functional from the economic point of view as well. University departments cover all areas of neurological services, have a function in graduate and postgraduate training, and on a regional basis they participate in professional quality assurance activities at the county and city hospital levels, and would have a more independent role in residency training. As far as patient care is concerned, the task of the regional/county hospitals would be similar to that of university departments - without the exclusively university functions. A general neurological service would be offered at the city hospital level - the representation of all subspecialties of neurology is not required. Neurorehabilitation would be organized at special units of neurological wards at the city hospital level, at independent neurorehabilitation wards in regional/county hospitals, and also as an outpatient service offered at the patients' home. The most significant organizational change would affect the outpatient neurological services. In addition to the special outpatient units associated with university departments and regional/county hospitals, the general neurological outpatient services would be organized as private practices, similarly to the current system of general practitioners, where the individual practices contract independently with the health insurance fund. Their task would be a general neurological service offered 30 hours per week, and also basic, screening neurophysiological and neurosonological examinations, with proper equipment and trained assistance. A transformation in residency training and a change in financing is needed for this plan to fulfill.

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

PubMed

Tang, Liyang

2012-09-14

Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in recommended medical examination could all help promote patient's life satisfaction. But their promotion effects were different among low level public hospital, high level public hospital, and private hospital.

Is place of birth associated with mode of birth? The effect of hospital on caesarean section rates in a public metropolitan health service.

PubMed

Biro, Mary A; Knight, Michelle; Wallace, Euan; Papacostas, Kerrie; East, Christine

2014-02-01

The effects of place of birth on birth outcomes have been examined in several studies both locally and internationally. However, none has examined the impact on caesarean section rates of different level maternity hospitals operating within the one health service. This study aimed to examine the impact of place of (Hospital level 6; 4-5 or 4) on birth outcomes in a large metropolitan health service in Victoria. A cross-sectional study utilising data on births to low-risk first-time mothers during 2010-2011. Data were obtained from the Birthing Outcome System (BOS) database of Monash Health. Unadjusted and adjusted analyses were undertaken using logistic regression to examine the association between place of birth and caesarean section. In this group of low-risk nulliparae, there was evidence of a significant association between place of birth and caesarean section. The lower the acuity of the hospital, the higher the odds for the caesarean section. Compared with the level 6 hospital, the AdjOR for caesarean section at the level 4 hospital was 1.81 (95% CI: 1.37-2.41) and at the level 4-5 hospital, 1.30 (95% CI: 1.0-1.7). Low-risk nulliparae in spontaneous labour giving birth at the level 4 hospital in this health service are at significantly increased risk of caesarean section. This may have implications for the organisation and resource management of other level 4 public maternity units. Care in a tertiary (level 6) service may not necessarily equate to the higher rates of intervention reported by others. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Why Change to Active Learning? Pre-Service and In-Service Science Teachers' Perceptions

ERIC Educational Resources Information Center

O'Grady, Audrey; Simmie, Geraldine Mooney; Kennedy, Therese

2014-01-01

This article explores pre-service and in-service science teachers' perceptions on active learning, and examines the effectiveness of active learning by pre-service science teachers in the Irish second level classroom through a two-phase study. In the first phase, data on perceptions were gathered from final year pre-service teachers and in-service…

Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey

PubMed Central

Pachankis, John E.; Hatzenbuehler, Mark L.; Hickson, Ford; Weatherburn, Peter; Berg, Rigmor C.; Marcus, Ulrich; Schmidt, Axel J.

2016-01-01

Objective Substantial country-level variation exists in prejudiced attitudes towards male homosexuality and in the extent to which countries promote the unequal treatment of MSM through discriminatory laws. The impact and underlying mechanisms of country-level stigma on odds of diagnosed HIV, sexual opportunities, and experience of HIV-prevention services, needs and behaviours have rarely been examined, however. Design Data come from the European MSM Internet Survey (EMIS), which was administered between June and August 2010 across 38 European countries (N =174 209). Methods Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes held by the citizens of each country. We also assessed concealment, HIV status, number of past 12-month male sex partners, and eight HIV-preventive services, knowledge, and behavioural outcomes. Results MSM living in countries with higher levels of stigma had reduced odds of diagnosed HIV and fewer partners but higher odds of sexual risk behaviour, unmet prevention needs, not using testing services, and not discussing their sexuality in testing services. Sexual orientation concealment mediated associations between country-level stigma and these outcomes. Conclusion Country-level stigma may have historically limited HIV transmission opportunities among MSM, but by restricting MSM’s public visibility, it also reduces MSM’s ability to access HIV-preventive services, knowledge and precautionary behaviours. These findings suggest that MSM in European countries with high levels of stigma are vulnerable to HIV infection. Although they have less opportunity to identify and contact other MSM, this might change with emerging technologies. PMID:26035323

The Personal Norm of Reciprocity among mental health service users: conceptual development and measurement.

PubMed

Matejkowski, Jason; McCarthy, Kevin S; Draine, Jeffrey

2011-01-01

A measure of an individual's level of internalization of the norm of reciprocity may signal exchange preferences and indicate whether "active" or "passive" mental health services are preferable to consumers. We evaluated the psychometric properties of one such measure, the Personal Norm of Reciprocity (PNR) scale. We recruited 70 persons receiving mental health services and 65 comparison participants to complete questionnaires assessing reciprocity tendencies and correlates of mental illness. Two of three subscales of a shortened PNR showed evidence of reliability and validity. Consumers endorsed higher levels of the reciprocity norm than persons not seeking services. Persons in "active" service settings displayed greater rigidity in application of the reciprocity norm than individuals in "passive" service settings or comparison participants. The shortened PNR can be a useful measure of individual reciprocity preferences. Measurement of the internalization of the norm of reciprocity may assist practitioners in identifying what types of services are more likely to retain and benefit mental health service consumers.

42 CFR 403.754 - Monitoring expenditure level.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Monitoring expenditure level. 403.754 Section 403.754 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

42 CFR 403.754 - Monitoring expenditure level.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Monitoring expenditure level. 403.754 Section 403.754 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

42 CFR 403.754 - Monitoring expenditure level.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Monitoring expenditure level. 403.754 Section 403.754 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

42 CFR 403.754 - Monitoring expenditure level.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Monitoring expenditure level. 403.754 Section 403.754 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

42 CFR 403.754 - Monitoring expenditure level.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Monitoring expenditure level. 403.754 Section 403.754 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions-Benefits...

Immunization Services for Adolescents within Comprehensive School Health Programs.

ERIC Educational Resources Information Center

Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly

1997-01-01

Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…

An innovative Oklahoma program to coordinate interdisciplinary and interagency services for children with special healthcare needs at a county level.

PubMed

Wolraich, Mark; Lockhart, Jennifer; Worley, Louis

2013-03-01

Children and youth with special health care needs (CYSHCN) and their families often require multiple services from multiple providers in order to meet their needs. The Sooner SUCCESS (State Unified Children's Comprehensive Exemplary Services for Special Needs), was developed based on a complex adaptive systems approach allowing local coalitions to address their unique needs. Sooner SUCCESS provides support to families and service providers at the community level including a broad range of supports from simply helping a family identify and access a service that already exists to innovatively marshaling generic resources to meet a unique need. The program uses these family support activities coupled with the Community Needs Assessment to identify local service needs encouraging community capacity building by coordinating the efforts of the health, mental health, social and education systems to identify service gaps and develop community-based strategies to fill those gaps.

Relationships between factors affecting the level of service provided by a pavement and maintenance costs.

DOT National Transportation Integrated Search

1983-01-01

This study attempted to establish and analyze relationships between forms of deterioration or distress that reduce the level of service provided by a highway pavement and the cost of correcting them. Using statistical computer analyses of 30 highway ...

Out-of-pocket expenditure by private households for dental services - empirical evidence from Austria.

PubMed

Sanwald, Alice; Theurl, Engelbert

2016-12-01

Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services-especially costs beyond routine dental treatment-is paid directly by the patient out-of-pocket. This study analyses the socio-economic determinants of out-of-pocket expenditure for dental services (OOPE) in Austria at the household level. Cross-sectional information on OOPE and household characteristics provided by the Austrian household budget survey 2009/10 was analysed. A two-part model (Logit/GLM) and one-part GLM was applied. The probability of OOPE is strongly affected by the life cycle (structure) of the household. It is higher for higher age classes, higher income, and partially higher levels of education. The type of public insurance has an influence on expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage, the covariates of the second stage remain predominantly insignificant. According to the results, the level of expenditure is driven mainly by the level of education and income. The results of the one-part GLM confirm the results of the two-part model. The results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although caution should be applied before jumping to conclusions for the individual level.

[Inter-Occupational Cooperation Levels in a Day Care Service and Its Subjects - From the Viewpoint of Multiple Occupations].

PubMed

Ugai, Chizuru; Hata, Kiyomi

2016-12-01

We clarified the role of cooperation of nursing personnel who work in day care services, to precede our examination of inter-occupational cooperation. The study results revealed that there were four cooperation levels. Subjects for the cooperation included:"difficulty in sharing information,"difficulty in understanding the whole picture,"difficulty in finding directions, "and"difficulty in dealing with emergency cases."The purpose of this study was to clarify the inter-occupational cooperation levels in a day care service and its subjects. We also conducted semi-structured interviews with 13 persons of differing occupations(other than nurses), and who worked in day-care services in A prefecture. As a result, it was revealed that there were three inter-occupational cooperation levels and its subjects included:"difficulty in sharing information" (which was answered the same as the nurses),"difficulty in sharing goals"(which were different among individual occupations), "lack of consistency in care,"necessity of learning because of insufficient knowledge,"and"hesitation to notify."

What happens when capitated behavioral health comes to town? The transition from the Fort Bragg demonstration to a capitated managed behavioral health contract.

PubMed

Heflinger, C A; Northrup, D A

2000-11-01

Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact--at both the service system and the individual consumer level--pertaining to the start-up and maintenance of a capitated managed behavioral health program. A case study using multiple methods and multiple sources of information incorporated a program fidelity framework that examined micro to macro levels of program implementation. The findings of this study include the following: access to services decreased, the lengths of stay and average daily census in the more intensive levels of treatment declined, difficult-to-treat children were shifted to the public sector, and ratings of service system performance and coordination fell.

Mental Health Treatment Involvement and Religious Coping among African American, Hispanic, and White Veterans of the Wars of Iraq and Afghanistan

PubMed Central

Greenawalt, David S.; Tsan, Jack Y.; Kimbrel, Nathan A.; Meyer, Eric C.; Kruse, Marc I.; Tharp, David F.; Gulliver, Suzy Bird; Morissette, Sandra B.

2011-01-01

Although racial/ethnic differences have been found in the use of mental health services for depression in the general population, research among Veterans has produced mixed results. This study examined racial/ethnic differences in the use of mental health services among 148 Operation Enduring/Iraqi Freedom (OEF/OIF) Veterans with high levels of depression and posttraumatic stress disorder (PTSD) symptoms and evaluated whether religious coping affected service use. No differences between African American, Hispanic, and Non-Hispanic white Veterans were found in use of secular mental health services or religious counseling. Women Veterans were more likely than men to seek secular treatment. After controlling for PTSD symptoms, depression symptom level was a significant predictor of psychotherapy attendance but not medication treatment. African American Veterans reported higher levels of religious coping than whites. Religious coping was associated with participation in religious counseling, but not secular mental health services. PMID:21785719

Assessment of antiretroviral treatment (ART) care service provision in Tigray Region health centers, North Ethiopia.

PubMed

Tessema, Shewaye Belay; Adane, Mesafint Molla

2015-09-10

Client satisfaction is a vital component and main concern intertwined with strategic decisions in service provisions. To improve efficiency of services, eliciting the opinion of users about the available services and identifying factors associated with dissatisfaction is very critical. Thus, the main objective of this study was to assess the perceived levels of clients' satisfaction with health services at ART clinic level in health centres of Tigray Region in Ethiopia. Cross sectional study was conducted from May to June 2013 in Tigray Region ART clinics. A total of 714 ART care user were included in the study using both purposive and probability sampling technique. Data was collected by using structured questionnaire and the collected data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Crude and Adjusted logistic regression analyses were carried out to identify the associated factors underlying perceived levels of clients' overall satisfaction. Finally, the results were presented with table as well as odds ratio (OR) and 95% confidence interval (CI). A total of 714 study participants were enrolled in this study. An overall satisfaction level of 89.6% was reported by ART care service users. Higher scores of satisfaction of services provisions were reported for courtesy and respect (95.80%) followed by privacy (93.28%). On the other hand, respondents' dissatisfaction was rated 35.32% for toilet cleanliness followed by 26.19% for availability of additional drugs. As for overall satisfaction and associated factors, adjusted logistic regression analyses showed that marital status [AOR = 2.01 (95% CI: 1.11, 3.60)], educational status [AOR = 3.13 (95% CI: 1.15, 8.53)], travel distance to reach health centre [AOR = 3.59 (95% CI: 1.23, 10.50)], toilet cleanliness [AOR = 2.22 (95% CI :1.62, 6.32)], and ART drug availability [AOR = 2.60 (95% CI :1.18, 6.52)] were found to have influence on overall ART service satisfaction status. This study revealed high level of client satisfaction rate and were associated with preventable and modifiable factors such as marital status, educational status, travel distance to reach health centre, toilet cleanliness and ART drug availability. Therefore, countermeasures such as increasing access to ART service, availing clean toilet and ART drugs may further increase client satisfaction level in the region.

Swiss and Turkish Pre-Service Science Teachers' Anxiety Levels for Educational Technology

ERIC Educational Resources Information Center

Efe, Hulya Aslan; Efe, Rifat

2016-01-01

This study aims to culturally explain pre-service science teachers' instructional technology-related anxiety levels by analyzing the variables of their instructional technology using experiences, frequency of using instructional technologies, access to instructional technologies, instructional technology-related attitude and their instructional…

Design and Testing of an Air Force Services Mystery Shopping Program.

DTIC Science & Technology

1998-11-01

Base level Air Force Services’ lodging and foodservice activities use limited service quality measurement tools to determine customer perceptions of... service quality . These tools, specifically management observation and customer comment cards, do not provide a complete picture of service quality . Other... service quality measurement methods such as mystery shopping are rarely used. Bases do not consider using mystery shopping programs because of the

Service quality in community pharmacy: an exploration of determinants.

PubMed

White, Lesley; Klinner, Christiane

2012-01-01

Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

Dental Workforce Availability and Dental Services Utilization in Appalachia: A Geospatial Analysis

PubMed Central

Feng, Xue; Sambamoorthi, Usha; Wiener, R. Constance

2016-01-01

Objectives There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. Methods We derived county-level (n = 364) data on demographic, socio-economic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resource File, and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate Local Indicators of Spatial Association (LISA) and geographically weighted regression (GWR). Results Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (p < .05) low-low spatial clusters (low dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics >1.96) and 13.45% (t-statistics >1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. Conclusions Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to improve dental services utilization need to focus on factors other than increasing the dental workforce availability for many counties in Appalachia. PMID:27957773

An investigation on the quality of midwifery services from the viewpoint of the clients in Isfahan through SERVQUAL model

PubMed Central

Oliaee, Zohreh; Jabbari, Alireza; Ehsanpour, Soheila

2016-01-01

Background: Quality of care is of great importance in health services as these services have the important mission to preserve health, and to give care to the society. The present study aimed to investigate the quality of midwifery services from the viewpoint of the clients, under coverage of health care centers in Isfahan, through SERVQUAL model. Materials and Methods: This descriptive and analytical study was conducted on 218 subjects in 2014. Study population comprised the women referring to midwifery services clinics in health care centers in Isfahan. Data of the subjects (n = 218) were collected by SERVQUAL model containing the dimensions of tangibles, reliability, responsiveness, assurance, and empathy. Data were analyzed by paired t-test, Spearman and Pearson correlation coefficients, and independent t-test through SPSS 20. Results: There was a negative gap in all five relevant dimensions of giving services. The widest gap was in the mean of dimension of tangibles (−1.5), and the narrowest gap was in the dimension of assurance (−0.9). There was no significant association between the scores of expectations and perceptions, and age, education level, occupation, and marital status. Conclusions: The obtained negative gap showed that the level of service receivers' perception from existing condition was far from their expectation, and there was a wide gap between attaining their satisfaction with midwifery services and their expectation and reaching their appropriate level of services. PMID:27186207

Ongoing child welfare services: Understanding the relationship of worker and organizational characteristics to service provision.

PubMed

Lwin, Kristen; Fluke, John; Trocmé, Nico; Fallon, Barbara; Mishna, Faye

2018-06-01

Ongoing child welfare services are put in place after completion of the initial maltreatment investigation when there is a perceived need to mitigate the risk of future harm. The knowledge of how clinical, worker, and organizational characteristics interact with this decision to provide ongoing child welfare services is not well integrated in the research literature. Using secondary data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008, this study's primary objective is to understand the relationship of clinical, worker, and organizational characteristics to the decision to transfer a case to ongoing child welfare services and their relative contribution to the transfer decision in Canada. Findings indicate that several clinical level variables are associated with families receiving ongoing services. Additionally, organizational factors, such as type of services offered by the organization and the number of employee support programs available to workers, significantly predicted the decision to transfer a case to ongoing services. While no worker factors, such as education, amount of training, experience, or caseload, were associated with ongoing service receipt, the intraclass correlation coefficient of the final three-level parsimonious model indicated substantial clustering at the worker level. Results indicate that Canadian child welfare workers make decisions differently based on factors not available in the current study and that what would be deemed as important worker characteristics do not necessarily predict this outcome. Findings and implications for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

47 CFR 80.91 - Order of priority of communications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Operating Procedures-General § 80.91 Order of priority of communications. (a) All stations in the maritime mobile service and the maritime mobile-satellite service shall be capable of offering four levels of priority in the...

47 CFR 80.91 - Order of priority of communications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES STATIONS IN THE MARITIME SERVICES Operating Requirements and Procedures Operating Procedures-General § 80.91 Order of priority of communications. (a) All stations in the maritime mobile service and the maritime mobile-satellite service shall be capable of offering four levels of priority in the...

Tidewater Multi-Service Market Perspectives: Driving change through MTF and market-level assessment and strategies

DTIC Science & Technology

2011-01-25

The Quadruple Aim: Working Together, Achieving Success 2011 Military Health System Conference Driving change through MTF and market -level assessment...and strategies Tidewater Multi-Service Market Perspectives January 25, 2011 Rear Admiral A. Stocks, MC, USN Colonel E. Stone, MC, USAF...Colonel K. Gausman, NC, USA 1 Military Health System Conference Tidewater Multi-Service Market Report Documentation Page Form ApprovedOMB No. 0704-0188

Service bay area, pump room level, showing ventilation fans and ...

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

Service bay area, pump room level, showing ventilation fans and ducts association with evaporative-cooling system. Note battery bank at far right. View to the east - Wellton-Mohawk Irrigation System, Pumping Plant No. 3, South of Interstate 8, Wellton, Yuma County, AZ

SNMG: a social-level norm-based methodology for macro-governing service collaboration processes

NASA Astrophysics Data System (ADS)

Gao, Ji; Lv, Hexin; Jin, Zhiyong; Xu, Ping

2017-08-01

In order to adapt to the accelerative open tendency of collaborations between enterprises, this paper proposes a Social-level Norm-based methodology for Macro-Governing service collaboration processes, called SNMG, to regulate and control the social-level visible macro-behaviors of the social individuals participating in collaborations. SNMG not only can remove effectively the uncontrollability hindrance confronted with by open social activities, but also enables across-management-domain collaborations to be implemented by uniting the centralized controls of social individuals for respective social activities. Therefore, this paper provides a brand-new system construction mode to promote the development and large-scale deployment of service collaborations.

Environmental and occupational exposure to benzene in Thailand.

PubMed

Navasumrit, Panida; Chanvaivit, Sirirat; Intarasunanont, Pornpat; Arayasiri, Manaswee; Lauhareungpanya, Narumon; Parnlob, Varaporn; Settachan, Daam; Ruchirawat, Mathuros

2005-05-30

Exposure to benzene in air is a concern in Thailand, particularly since it was observed that the incidence of blood-related cancers, such as leukemia and lymphoma, has increased in the past few decades. In Bangkok, the mean atmospheric levels of benzene on main roads and in schools were 33.71 and 8.25 ppb, respectively, while in gasoline service stations and petrochemical factories the mean ambient levels were 64.78 and 66.24 ppb, respectively. Cloth vendors (22.61 ppb) and grilled-meat vendors (28.19 ppb) working on the roadsides were exposed to significantly higher levels of benzene than the control group (12.95 ppb; p<0.05). Bangkok school children (5.50 ppb) were exposed to significantly higher levels of benzene than provincial school children (2.54 ppb; p<0.01). Factory workers (73.55 ppb) and gasoline service attendants (121.67 ppb) were exposed to significantly higher levels of benzene than control workers (4.77 ppb; p<0.001). In accordance with the increased benzene exposures, levels of urinary trans,trans-muconic acid (MA) were significantly increased in all benzene-exposed groups. In school children, the levels of MA were relatively high, taking into account the much lower level of exposure. Blood benzene levels were also significantly increased in Bangkok school children (77.97 ppt; p<0.01), gasoline service attendants (641.84 ppt; p<0.05) and factory workers (572.61 ppt; p<0.001), when compared with the respective controls. DNA damage, determined as DNA strand breaks, was found to be elevated in gasoline service attendants, petrochemical factory workers, and Bangkok school children (p<0.001). The cytogenetic challenge assay, which measures DNA repair capacity, showed varying levels of significant increases in the numbers of dicentrics and deletions in gasoline service attendants, petrochemical factory workers and Bangkok school children, indicating a decrease in DNA repair capacity in these subjects.

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

PubMed

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

2012-10-01

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

Effects of service provider attitudes and employment status on citizenship behaviors and customers' attitudes and loyalty behavior.

PubMed

Payne, Stephanie C; Webber, Sheila Simsarian

2006-03-01

The relationship among job satisfaction, affective commitment, service-oriented organizational citizenship behaviors (OCBs), customer satisfaction, and customer loyalty were examined for a sample of 249 hairstylists and 1 of their corresponding customers. Employee satisfaction was positively related to service-oriented OCBs, customer satisfaction, and customer loyalty, whereas affective commitment was not related to these outcomes. The extent to which the predictor variables interacted with one another and the role of employment status on these relationships was also explored. High levels of job satisfaction or affective commitment resulted in more service-oriented OCBs for employees and self-employed workers, whereas high levels of both resulted in more service-oriented OCBs for owners.

Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model.

PubMed

Koniotou, Marina; Evans, Bridie Angela; Chatters, Robin; Fothergill, Rachael; Garnsworthy, Christopher; Gaze, Sarah; Halter, Mary; Mason, Suzanne; Peconi, Julie; Porter, Alison; Siriwardena, A Niroshan; Toghill, Alun; Snooks, Helen

2015-07-10

Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial. In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed. Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial. Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009.

STRUCTURING EDUCATION FOR BUSINESS MANAGEMENT.

ERIC Educational Resources Information Center

WHITT, ROBERT L.

IN TERMS OF SERVICES RECEIVED, LOCAL SCHOOLS BENEFIT SUBSTANTIALLY FROM EDUCATIONAL BUSINESS MANAGEMENT. IN ORDER TO ISOLATE BUSINESS ADMINISTRATIVE PROBLEMS OF THE SCHOOL SYSTEM, AN ANALYSIS WAS CONDUCTED AT EACH OF 6 ADMINISTRATIVE SERVICE LEVELS--LOCAL (ATTENDANCE LEVEL), DISTRICT, AREA, REGIONAL, STATE, AND MULTI-STATE. AS A RESULT OF MERGED…

Family Centered Care. Triennial Report 1986-1989.

ERIC Educational Resources Information Center

Michigan State Dept. of Public Health, Lansing, MI. Div. of Services to Crippled Children.

The report describes services, administration, and future directions of the Children's Special Health Care Services program, part of the Michigan Department of Public Health. Division programs are carried out at local, regional, and state levels and provide: preventive services (through generic and newborn screening services and neonatal intensive…

Climate Change and Ecosystem Services Output Efficiency in Southern Loblolly Pine Forests.

PubMed

Susaeta, Andres; Adams, Damian C; Carter, Douglas R; Dwivedi, Puneet

2016-09-01

Forests provide myriad ecosystem services that are vital to humanity. With climate change, we expect to see significant changes to forests that will alter the supply of these critical services and affect human well-being. To better understand the impacts of climate change on forest-based ecosystem services, we applied a data envelopment analysis method to assess plot-level efficiency in the provision of ecosystem services in Florida natural loblolly pine (Pinus taeda L.) forests. Using field data for n = 16 loblolly pine forest plots, including inputs such as site index, tree density, age, precipitation, and temperatures for each forest plot, we assessed the relative plot-level production of three ecosystem services: timber, carbon sequestered, and species richness. The results suggested that loblolly pine forests in Florida were largely inefficient in the provision of these ecosystem services under current climatic conditions. Climate change had a small negative impact on the loblolly pine forests efficiency in the provision of ecosystem services. In this context, we discussed the reduction of tree density that may not improve ecosystem services production.

Climate Change and Ecosystem Services Output Efficiency in Southern Loblolly Pine Forests

NASA Astrophysics Data System (ADS)

Susaeta, Andres; Adams, Damian C.; Carter, Douglas R.; Dwivedi, Puneet

2016-09-01

Forests provide myriad ecosystem services that are vital to humanity. With climate change, we expect to see significant changes to forests that will alter the supply of these critical services and affect human well-being. To better understand the impacts of climate change on forest-based ecosystem services, we applied a data envelopment analysis method to assess plot-level efficiency in the provision of ecosystem services in Florida natural loblolly pine ( Pinus taeda L.) forests. Using field data for n = 16 loblolly pine forest plots, including inputs such as site index, tree density, age, precipitation, and temperatures for each forest plot, we assessed the relative plot-level production of three ecosystem services: timber, carbon sequestered, and species richness. The results suggested that loblolly pine forests in Florida were largely inefficient in the provision of these ecosystem services under current climatic conditions. Climate change had a small negative impact on the loblolly pine forests efficiency in the provision of ecosystem services. In this context, we discussed the reduction of tree density that may not improve ecosystem services production.

Should the provision of home help services be contained?: Validation of the new preventive care policy in Japan

PubMed Central

2010-01-01

Background To maintain the sustainability of public long-term care insurance (LTCI) in Japan, a preventive care policy was introduced in 2006 that seeks to promote active improvement in functional status of elderly people who need only light care. This policy promotes the use of day care services to facilitate functional improvement, and contains the use of home help services that provide instrumental activity of daily living (IADL) support. However, the validity of this approach remains to be demonstrated. Methods Subjects comprised 241 people aged 65 years and over who had recently been certified as being eligible for the lightest eligibility level and had began using either home help or day care services between April 2007 and October 2008 in a suburban city of Tokyo. A retrospective cohort study was conducted ending October 2009 to assess changes in the LTCI eligibility level of these subjects. Cox's proportional hazards model was used to calculate the relative risk of declining in function to eligibility Level 4 among users of the respective services. Results Multivariate analysis adjusted for factors related to service use demonstrated that the risk of decline in functional status was lower for users of home help services than for users of day care services (HR = 0.55, 95% CI: 0.31-0.98). The same result was obtained when stratified by whether the subject lived with family or not. Furthermore, those who used two or more hours of home help services did not show an increase in risk of decline when compared with those who used less than two hours. Conclusions No evidence was obtained to support the effectiveness of the policy of promoting day care services and containing home help services for those requiring light care. PMID:20678189

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation

PubMed Central

2012-01-01

Purpose A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a “real-lifeâ application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. Key messages (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. Conclusion (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care. PMID:22506504

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.

PubMed

Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar

2012-01-01

A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.

Facilitators and barriers of drop-in center use among homeless youth

PubMed Central

Pedersen, Eric R.; Tucker, Joan S.; Kovalchik, Stephanie A.

2016-01-01

Drop-in centers for homeless youth address basic needs for food, hygiene, and clothing, but can also provide critical services that address youth’s “higher-level” needs (e.g., substance use treatment, mental health care, HIV-related programs). Unlike other services that have restrictive rules, drop-in centers typically try to break down barriers and take a “come as you are” approach to engaging youth in services. Given their popularity, drop-in centers represent a promising location to deliver higher level services to youth that may not seek services elsewhere. A better understanding of the individual-level factors (e.g., characteristics of homeless youth) and agency-level factors (e.g., characteristics of staff and environment) that facilitate and impede youth engagement in drop-in centers will help inform research and outreach efforts designed to engage these at-risk youth in services. Thus, the goal of this review was to develop a preliminary conceptual model of drop-in center use by homeless youth. Towards this goal, we reviewed 20 available peer-reviewed papers and reports on the facilitators and barriers of drop-in center usage and consulted broader models of service utilization from both youth and adult studies to inform model development. PMID:27238839

Travel Services, Levels 2-4. Travel Services (Field Operations), Levels 2-4. National Vocational Qualifications.

ERIC Educational Resources Information Center

Business and Technology Education Council, London (England).

Britain's National Vocational Qualifications (NVQs) are work qualifications that measure what an employee or potential employee can do as well as how much he or she knows and understands about a particular job. Used as written proof of usable workplace skills that can be put to profitable use by an employer, NVQs range from basic Level 1, for…

Coordinating Resource Usage through Adaptive Service Provisioning in Wireless Sensor Networks

NASA Astrophysics Data System (ADS)

Fok, Chien-Liang; Roman, Gruia-Catalin; Lu, Chenyang

Wireless sensor networks (WSNs) exhibit high levels of network dynamics and consist of devices with limited energy. This results in the need to coordinate applications not only at the functional level, as is traditionally done, but also in terms of resource utilization. In this paper, we present a middleware that does this using adaptive service provisioning. Novel service binding strategies automatically adapt application behavior when opportunities for energy savings surface, and switch providers when the network topology changes. The former is accomplished by providing limited information about the energy consumption associated with using various services, systematically exploiting opportunities for sharing service invocations, and exploiting the broadcast nature of wireless communication in WSNs. The middleware has been implemented and evaluated on two disparate WSN platforms, the TelosB and Imote2. Empirical results show that adaptive service provisioning can enable energy-aware service binding decisions that result in increased energy efficiency and significantly increase service availability, while imposing minimal additional burden on the application, service, and device developers. Two applications, medical patient monitoring and structural health monitoring, demonstrate the middleware's efficacy.

Process improvement by cycle time reduction through Lean Methodology

NASA Astrophysics Data System (ADS)

Siva, R.; patan, Mahamed naveed khan; lakshmi pavan kumar, Mane; Purusothaman, M.; pitchai, S. Antony; Jegathish, Y.

2017-05-01

In present world, every customer needs their products to get on time with good quality. Presently every industry is striving to satisfy their customer requirements. An aviation concern trying to accomplish continuous improvement in all its projects. In this project the maintenance service for the customer is analyzed. The maintenance part service is split up into four levels. Out of it, three levels are done in service shops and the fourth level falls under customer’s privilege to change the parts in their aircraft engines at their location. An enhancement for electronics initial provisioning (eIP) is done for fourth level. Customers request service shops to get their requirements through Recommended Spare Parts List (RSPL) by eIP. To complete this RSPL for one customer, it takes 61.5 hours as a cycle time which is very high. By mapping current state VSM and takt time, future state improvement can be done in order to reduce cycle time using Lean tools such as Poke-Yoke, Jidoka, 5S, Muda etc.,

[Web accessibility of Internet appointment scheduling in primary care].

PubMed

Casasola Balsells, Luis Alejandro; Guerra González, Juan Carlos; Casasola Balsells, María Araceli; Pérez Chamorro, Vicente Antonio

2017-12-16

To assess the accessibility level of Internet appointment scheduling in primary care and the fulfilment of the requirements of Spanish legislation. Descriptive study of the accessibility of 18 web sites corresponding to the autonomic health services responsible for Internet appointment scheduling for primary health care services. The level of web accessibility was evaluated by means of five automated tools. Only six websites self-declared to be in compliance with level AA of WCAG 2.0. The level of web accessibility according to the legal requirements in Spain is low. The evaluation tools identified the main errors to be corrected. Most of the autonomic health services responsible for Internet appointment scheduling in primary care need to improve their level of web accessibility and ensure that it complies with Spanish legislation. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Identifying factors associated with the uptake of prevention of mother to child HIV transmission programme in Tigray region, Ethiopia: a multilevel modeling approach.

PubMed

Lerebo, Wondwossen; Callens, Steven; Jackson, Debra; Zarowsky, Christina; Temmerman, Marleen

2014-04-23

Prevention of mother to child HIV transmission (PMTCT) remains a challenge in low and middle-income countries. Determinants of utilization occur--and often interact--at both individual and community levels, but most studies do not address how determinants interact across levels. Multilevel models allow for the importance of both groups and individuals in understanding health outcomes and provide one way to link the traditionally distinct ecological- and individual-level studies. This study examined individual and community level determinants of mother and child receiving PMTCT services in Tigray region, Ethiopia. A multistage probability sampling method was used for this 2011 cross-sectional study of 220 HIV positive post-partum women attending child immunization services at 50 health facilities in 46 districts. In view of the nested nature of the data, we used multilevel modeling methods and assessed macro level random effects. Seventy nine percent of mothers and 55.7% of their children had received PMTCT services. Multivariate multilevel modeling found that mothers who delivered at a health facility were 18 times (AOR = 18.21; 95% CI 4.37,75.91) and children born at a health facility were 5 times (AOR = 4.77; 95% CI 1.21,18.83) more likely to receive PMTCT services, compared to mothers delivering at home. For every addition of one nurse per 1500 people, the likelihood of getting PMTCT services for a mother increases by 7.22 fold (AOR = 7.22; 95% CI 1.02,51.26), when other individual and community level factors were controlled simultaneously. In addition, district-level variation was low for mothers receiving PMTCT services (0.6% between districts) but higher for children (27.2% variation between districts). This study, using a multilevel modeling approach, was able to identify factors operating at both individual and community levels that affect mothers and children getting PMTCT services. This may allow differentiating and accentuating approaches for different settings in Ethiopia. Increasing health facility delivery and HCT coverage could increase mother-child pairs who are getting PMTCT. Reducing the distance to health facility and increasing the number of nurses and laboratory technicians are also important variables to be considered by the government.

Oregon School-Based Health Centers, 1992-1994 Services Report.

ERIC Educational Resources Information Center

Nystrom, Robert J.

This report describes the activities of Oregon's 25 high school-based health centers between 1992 and 1994. Information is provided on funding sources, services offered (including general medical services and reproductive health, mental health, health promotion services, and hours of operation), staffing (including levels of staffing and…

45 CFR 98.84 - Construction and renovation of child care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services, quality activities, or administrative costs). (h) A construction or renovation project that... facilities. 98.84 Section 98.84 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION... child care services provided by the Tribal Lead Agency as compared to the level of services provided by...

Theoretical Comparison of Fixed Route Bus and Flexible Route Subscription Bus Feeder Service in Low Density Areas

DOT National Transportation Integrated Search

1975-03-01

parametric variation of demand density was used to compare service level and cost of two alternative systems for providing low density feeder service. Supply models for fixed route and flexible route service were developed and applied to determine ra...

An Examination of Organizations' Frontline Service Employee Development Practices

ERIC Educational Resources Information Center

Ellinger, Alexander E.; Elmadag, Ayse Banu; Ellinger, Andrea D.

2007-01-01

Firms with the ability to provide superior customer service can accrue significant competitive advantage and research suggests that frontline service employees' (FLSEs) actions have a considerable influence on the success of service operations. Yet, the high level of customer defections consistently attributed to poor and indifferent service…

18 CFR 2.105 - Gas supply charges.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Implement the Economic Stabilization Act of 1970, As Amended, and Executive Orders 11615 and 11627 § 2.105... customers to nominate levels of service freely within their firm sales entitlements or otherwise employ a mechanism for the renegotiation of levels of service at regular intervals. (c) The pipeline must announce...

Patient satisfaction with outpatient health care services: evaluation of the components of this service using regression analysis.

PubMed

Vural, Fisun; Ciftci, Seval; Cakiroglu, Yigit; Vural, Birol

2014-01-01

In health care services, patient's expectations, and satisfaction levels are important markers of the services provided. The aim of this study is to determine patient satisfaction level, and its influential factors in patients receiving treatment on an ambulatory basis who applied to a state hospital. In this cross-sectional study a total of 210 patients were face-to-face interviewed, and patient satisfaction questionnaire survey was performed. Socioeconomic characteristics, physical conditions of the hospital, pecularities of the health care providers, and satisfaction from health care services received were questioned independently. Regression analysis was performed to investigate factors effective on patient satisfaction. A significant correlation was not found between sociodemographic factors, and patient satisfaction (p<0.05). Favourable patient acceptance of the health care services received is effected by the duration of the waiting period. Communication skills of the health care professionals have been found to be the fundamental factors effective on the preference or recommendation of a certain health care institute once more (p<0.005). Empowering the communication skills of health care professionals, and decreasing the waiting period were found to be necessary in order to increase the satisfaction levels of ambulatory patients.

Information Technology Manager's Perspective on Experiences with Service Quality and Customer Satisfaction: A Phenomenology Study

ERIC Educational Resources Information Center

Porter, Sherry A.

2016-01-01

The general problem was that, in the competitive telecommunications industry, information technology service providers have to develop ways to improve on customer satisfaction and service quality during service disruptions to meet service level agreements. A descriptive phenomenological study was used to explore the lived experiences and…

Creating organizational value by leveraging the multihospital pharmacy enterprise.

PubMed

Schenkat, Dan; Rough, Steve; Hansen, Amanda; Chen, David; Knoer, Scott

2018-04-01

The results of a survey of multihospital pharmacy leaders are summarized, and a road map for creating organizational value with the pharmacy enterprise is presented. A survey was designed to evaluate the level of integration of pharmacy services across each system's multiple hospitals, determine the most commonly integrated services, determine whether value was quantified when services were integrated, collect common barriers for finding value through integration, and identify strategies for successfully overcoming these barriers. The comprehensive, 59-question survey was distributed electronically in September 2016 to the top pharmacy executive at approximately 160 multihospital systems located throughout the United States. Survey respondents indicated that health systems are taking a wide range of approaches to integrating services systemwide. Several themes emerged from the survey responses: (1) having a system-level pharmacy leader with solid-line reporting across the enterprise increased the likelihood of integrating pharmacy services effectively, (2) integration of pharmacy services across a multihospital system was unlikely to decrease the number of pharmacy full-time equivalents within the enterprise, and (3) significant opportunities exist for creating value for the multihospital health system with the pharmacy enterprise, particularly within 4 core areas: system-level drug formulary and clinical standardization initiatives, supply chain initiatives, electronic health record integration, and specialty and retail pharmacy services. Consistently demonstrating strong organizational leadership, entrepreneurialism, and the ability to create value for the organization will lead to the system-level pharmacy leader and the pharmacy enterprise being well-positioned to achieve positive outcomes for patients, payers, and the broader health system. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Extravehicular Crewman Work System (ECWS) study program. Volume 3: Satellite service

NASA Technical Reports Server (NTRS)

Wilde, R. C.

1980-01-01

The satellite service portion of the Extravehicular Crewman Work System Study defines requirements and service equipment concepts for performing satellite service from the space shuttle orbiter. Both normal and contingency orbital satellite service is required. Service oriented satellite design practices are required to provide on orbit satellite service capability for the wide variety of satellites at the subsystem level. Development of additional satellite service equipment is required. The existing space transportation system provides a limited capability for performing satellite service tasks in the shuttle payload bay area.

Voices from the Trenches: Faculty Perspectives on Support for Sustaining Service-Learning

ERIC Educational Resources Information Center

Lambright, Kristina T.; Alden, Allison F.

2012-01-01

Using data collected from three colleges, the authors examine how faculty members view the level of support for service-learning at their respective institutions. There is variation among the institutions in perceived instructor and administrator support for service-learning, availability of support services, and attitudes regarding consideration…

Pre-Service Physics Teachers' Metacognitive Knowledge about Their Instructional Practices

ERIC Educational Resources Information Center

Yerdelen-Damar, Sevda; Özdemir, Ömer Faruk; Ünal, Cezmi

2015-01-01

This study aims to investigate pre-service physics teachers' metacognitive knowledge about their teaching practices. The participants included six pre-service physics teachers. A taxonomy of metacognition for teaching was developed to analyze the level of pre-service physics teachers' metacognitive knowledge about their teaching practices.…

Objections to routine clinical outcomes measurement in mental health services: any evidence so far?

PubMed

MacDonald, Alastair J D; Trauer, Tom

2010-12-01

Routine clinical outcomes measurement (RCOM) is gaining importance in mental health services. To examine whether criticisms published in advance of the development of RCOM have been borne out by data now available from such a programme. This was an observational study of routine ratings using HoNOS65+ at inception/admission and again at discharge in an old age psychiatry service from 1997 to 2008. Testable hypotheses were generated from each criticism amenable to empirical examination. Inter-rater reliability estimates were applied to observed differences between scores between community and ward patients using resampling. Five thousand one hundred eighty community inceptions and 862 admissions had HoNOS65+ ratings at referral/admission and discharge. We could find no evidence of gaming (artificially worse scores at inception and better at discharge), selection, attrition or detection bias, and ratings were consistent with diagnosis and level of service. Anticipated low levels of inter-rater reliability did not vitiate differences between levels of service. Although only hypotheses testable from within RCOM data were examined, and only 46% of eligible episodes had complete outcomes data, no evidence of the alleged biases were found. RCOM seems valid and practical in mental health services.

Barriers and facilitators for implementing programmes and services to address hyperglycaemia in pregnancy in low and middle income countries: A systematic review.

PubMed

Kragelund Nielsen, Karoline; Damm, Peter; Bygbjerg, Ib C; Kapur, Anil

2018-04-21

An estimated 87.6% of hyperglycaemia in pregnancy cases are in low and middle income countries (LMICs). The aim of this study is to review the evidence on barriers and facilitators to programmes and services addressing hyperglycaemia in pregnancy in LMICs. A systematic review and narrative synthesis was conducted based on searches in PubMed. A total of 23 qualitative and quantitative studies were included. Barriers and facilitators exist at the health system level, individual level and social and societal levels and are often interacting. At the health system level they relate to capacity in terms of human and material resources; availability of feasible and appropriate guidelines; organisational management and referral pathways. Individual level barriers and facilitators include knowledge; risk perception; illness beliefs; financial condition; work obligations; concerns for the baby and hardship associated with services. At the social and societal level important factors are: perceptions and norms related to women's roles, mobility and health; the knowledge and support of women's social network; and structural aspects. Numerous factors influence programmes and services addressing hyperglycaemia in pregnancy in LMICs. Thus, several components are needed to ensure detection, treatment and follow-up of women with hyperglycaemia in pregnancy. Copyright © 2018 Elsevier B.V. All rights reserved.

Cost of curative pediatric services in a public sector setting.

PubMed

Krishnan, Anand; Arora, Narendra K; Pandav, Chandrakant S; Kapoor, Suresh K

2005-08-01

To estimate the cost of ambulatory (out-patient) and in-patient pediatric health services for the year 1999 provided by All India Institute of Medical Sciences (AIIMS) at all the three levels-primary, secondary and tertiary level. The costing module developed by Children's Vaccines Initiative (CVI) was used. This rapid assessment tool focuses on collection of data at macro level by using key informants like doctors, nursing staff, accountant, store keeper, engineer etc. Cost per beneficiary was estimated separately for in-patients and out-patients and was calculated by dividing the total cost of the services by the number of beneficiaries for the year 1999. For the out-patient, the beneficiaries were the total out-patient attendees and for the in-patient, it was the total pediatric admissions multiplied by mean duration of stay in days. The cost per out-patient visit was INR.20.2 (US0.44 dollars@1US dollars=INR.46) at primary level, higher than INR14.5 (US0.31 dollars) at the secondary level, while at tertiary level it was INR 33.8 (US 0.73 dollars). At the primary and secondary level, non-physician cost was more than the physician cost, and for tertiary level, physician cost was much higher than the other costs. There were no in-patient services at primary level. The cost of in-patient services at secondary level was estimated as INR 419.30 (US 9.1 dollars) per patient per day with a bed occupancy rate of 60%. Two-fifths of the cost was due to nursing and other supportive staff and one fifth due to the doctor costs and overhead costs. The unit cost of INR 928 (US 20.2 dollars) per patient per day incurred at AIIMS with a bed occupancy rate of 100% was almost twice that of secondary level. In contrast to the secondary level, almost half the total costs at tertiary level was due to the doctors costs. Effective use of resources at lower level of care especially ambulatory care at primary level and inpatient care at secondary level can result in much higher savings for the system and also, the society. These would need to be appropriately strengthened.

41 CFR 102-85.165 - What are standard levels of service?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are standard levels of service? 102-85.165 Section 102-85.165 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING POLICY FOR...

Design of ERIC Usage Studies. Volume II.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Information Resources, Syracuse, NY.

This document contains reports examining research designs for Educational Resources Information Center (ERIC) usage studies at three levels: (1) system operations; (2) subscribers to the services provided; and (3) the ultimate "end-users" of the service. The first level report, which addresses ERIC as an information network, proposes two…

Incorporating Ecosystem Services into Community-level Decision-Making: A San Juan, Puerto Rico Case Study

EPA Science Inventory

EPA’s Office of Research and Development’s Sustainable and Healthy Communities Research Program is developing tools and approaches to incorporate ecosystem goods and services concepts into community-level decision-making. The San Juan Community Study is one of a serie...

Are the poor differentially benefiting from provision of priority public health services? A benefit incidence analysis in Nigeria

PubMed Central

2012-01-01

Background The paper presents evidence about the distribution of the benefits of public expenditures on a subset of priority public health services that are supposed to be provided free of charge in the public sector, using the framework of benefit incidence analysis. Methods The study took place in 2 rural and 2 urban Local Government Areas from Enugu and Anambra states, southeast Nigeria. A questionnaire was used to collect data on use of the priority public health services by all individuals in the households (n=22,169). The level of use was disaggregated by socio-economic status (SES), rural-urban location and gender. Benefits were valued using the cost of providing the service. Net benefit incidence was calculated by subtracting payments made for services from the value of benefits. Results The results showed that 3,281 (14.8%) individuals consumed wholly free services. There was a greater consumption of most free services by rural dwellers, females and those from poorer SES quintiles (but not for insecticide-treated nets and ante-natal care services). High levels of payment were observed for immunisation services, insecticide-treated nets, anti-malarial medicines, antenatal care and childbirth services, all of which are supposed to be provided for free. The net benefits were significantly higher for the rural residents, males and the poor compared to the urban residents, females and better-off quintiles. Conclusion It is concluded that coverage of all of these priority public health services fell well below target levels, but the poorer quintiles and rural residents that are in greater need received more benefits, although not so for females. Payments for services that are supposed to be delivered free of charge suggests that there may have been illegal payments which probably hindered access to the public health services. PMID:23158434

Continuous estimates of Survival through Eight Years of Service Using FY 1979 Cross-Sectional Data.

DTIC Science & Technology

1981-07-01

performed for Class A school attendees and non-A school attendees, holding constant the effects of age, educational level, and mental group.* Mean...through eight years of service for _ non-prior service mail recruits. Average survival 0 times by education , mental group, and age are calculated from...attendees is 35 months and for non-A school attendees is 28 months. As expected, we found that educational level has the great- est impact on survival

Diversification of health care services: the effects of ownership, environment, and strategy.

PubMed

Shortell, S M; Morrison, E M; Hughes, S L; Friedman, B S; Vitek, J L

1987-01-01

The present findings suggest that the trend toward greater diversification of hospital services is likely to be most strongly influenced by state Medicaid policies and certain hospital characteristics. Increasing Medicaid eligibility and payment levels is likely to have a positive effect on services diversification. Growth in the number of inpatient services provided and a more severe case mix are also likely to be involved with greater service diversification. Affiliation with a not-for-profit hospital system is likely to be associated with more diversified hospital services but not affiliation with an investor-owned system. There is also some indication that the overall portfolio of services which a hospital offers in regard to market share and market growth characteristics influences diversification. Specifically, a low market share portfolio is likely to be associated with less diversification. Competition is likely to be associated with more diversification; particularly for hospitals belonging to systems. The effect of competition on hospital strategy and services diversification is a particularly important area for further investigation. Increasing Medicaid payment and eligibility levels are also likely to have a positive effect on the provision of services which are usually unprofitable. Raising such levels is likely to be particularly beneficial to inner-city hospitals who are already providing a greater number of such services. However, the present data suggest that investor-owned hospitals are least likely to provide such services. Increasing Medicaid eligibility levels is also likely to be associated with fewer services for which charity care has to be provided. State regulation in the form of rate review and certificate of need is likely to be associated with more services for which hospitals provide some charity care. But such policies alone do not deal with the larger issue of how to finance care for the medically indigent. Present data suggest the charity care issue may be particularly salient in markets characterized by a relatively high degree of competition. Finally, investor-owned hospitals provide as many services involving charity care as not-for-profit system hospitals, although investor-owned system hospitals provide fewer such services than not-for-profit freestanding hospitals. Throughout, the findings indicate the importance of distinguishing between ownership and system affiliation. Previous research has failed to make a distinction between ownership form and system affiliation, thus attributing to ownership form differences which, as present findings suggest, appear to be more associated with system affiliation.(ABSTRACT TRUNCATED AT 400 WORDS)

Association between attendance at religious services and self-reported health in 22 European countries.

PubMed

Nicholson, Amanda; Rose, Richard; Bobak, Martin

2009-08-01

There are consistent reports of protective associations between attendance at religious services and better self-rated health but existing data rarely consider the social or individual context of religious behaviour. This paper investigates whether attendance at religious services is associated with better self-rated health in diverse countries across Europe. It also explores whether the association varies with either individual-level (gender, educational, social contact) or country-level characteristics (overall level of religious practice, corruption, GDP). Cross-sectional data from round 2 of the European Social Survey were used and 18,328 men and 21,373 women from 22 European countries were included in multilevel analyses, with country as higher level. Compared to men who attended religious services at least once a week, men who never attended were almost twice as likely to describe their health as poor, with an age and education adjusted odds ratio of 1.83 [95% CI, 1.49-2.26]. A similar but weaker effect was seen in women, with an age and education adjusted odds ratio of 1.38 [1.19-1.61]. The associations were reduced only marginally in men by controlling for health status, social contact and country-level variables, but weakened in women. The relationships were stronger in people with longstanding illness, less than university education and in more affluent countries with lower levels of corruption and higher levels of religious belief. These analyses confirm that an association between less frequent attendance at religious services and poor health exists across Europe, but emphasise the importance of taking individual and contextual factors into account. It remains unclear to what extent the observed associations reflect reverse causality or are due to differing perceptions of health.

Evaluation of Military Criminal Investigative Organizations Child Death Investigations

DTIC Science & Technology

2014-12-22

medical examiner, Child Protective Services (CPS), Family Advocacy Programs ( FAP ), Social Work Services (SWS), Sexual Assault Nurse Examiners, local and...assessments and investigations. 29 FAP works to promote public awareness within the military and civilian communities and coordinate professional...intervention at all levels, including law enforcement, social services, health services, and legal services. FAP is designed to break the cycle of

Barriers to formal emergency obstetric care services' utilization.

PubMed

Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be put in place to enhance security in the slums at night.

Library 2.0: Service for the Next-Generation Library

ERIC Educational Resources Information Center

Casey, Michael E.; Savastinuk, Laura C.

2006-01-01

Libraries are changing. Funding limits and customer demands are transforming staffing levels, service models, access to resources, and services to the public. Administrators and taxpayers are seeking more efficient ways of delivering services to achieve greater returns on financial investments. In this article, the author discusses the benefits of…

Incorporating threat in hotspots and coldspots of biodiversity and ecosystem services.

PubMed

Schröter, Matthias; Kraemer, Roland; Ceauşu, Silvia; Rusch, Graciela M

2017-11-01

Spatial prioritization could help target conservation actions directed to maintain both biodiversity and ecosystem services. We delineate hotspots and coldspots of two biodiversity conservation features and five regulating and cultural services by incorporating an indicator of 'threat', i.e. timber harvest profitability for forest areas in Telemark (Norway). We found hotspots, where high values of biodiversity, ecosystem services and threat coincide, ranging from 0.1 to 7.1% of the area, depending on varying threshold levels. Targeting of these areas for conservation follows reactive conservation approaches. In coldspots, high biodiversity and ecosystem service values coincide with low levels of threat, and cover 0.1-3.4% of the forest area. These areas might serve proactive conservation approaches at lower opportunity cost (foregone timber harvest profits). We conclude that a combination of indicators of biodiversity, ecosystem services and potential threat is an appropriate approach for spatial prioritization of proactive and reactive conservation strategies.

Economic planning and equilibrium growth of human resources and capital in health-care sector: Case study of Iran.

PubMed

Mahboobi-Ardakan, Payman; Kazemian, Mahmood; Mehraban, Sattar

2017-01-01

During different planning periods, human resources factor has been considerably increased in the health-care sector. The main goal is to determine economic planning conditions and equilibrium growth for services level and specialized workforce resources in health-care sector and also to determine the gap between levels of health-care services and specialized workforce resources in the equilibrium growth conditions and their available levels during the periods of the first to fourth development plansin Iran. In the study after data collection, econometric methods and EViews version 8.0 were used for data processing. The used model was based on neoclassical economic growth model. The results indicated that during the former planning periods, although specialized workforce has been increased significantly in health-care sector, lack of attention to equilibrium growth conditions caused imbalance conditions for product level and specialized workforce in health-care sector. In the past development plans for health services, equilibrium conditions based on the full employment in the capital stock, and specialized labor are not considered. The government could act by choosing policies determined by the growth model to achieve equilibrium level in the field of human resources and services during the next planning periods.

Knowledge of Alzheimer's disease, feelings of shame, and awareness of services among Korean American elders.

PubMed

Yuri Jang; Kim, Giyeon; Chiriboga, David

2010-06-01

To explore predictors of knowledge of Alzheimer's disease (AD), feelings of shame if a family member were to have AD, and awareness of AD-related services among Korean American elders. Using data from 675 Korean American elders (mean age = 70.2, SD = 6.87), the study estimates hierarchical linear or logistic regression models. Greater knowledge of AD is predicted by higher levels of education and acculturation. Feelings of shame associated with family members having AD are more likely to be reported by individuals with lower levels of education, acculturation, and knowledge of AD. Those who are married have greater levels of education and acculturation, and those who have a family member with AD are more aware of AD-related services. The study findings underscore the pivotal role of education and acculturation in predicting knowledge of AD, feelings of shame, and awareness of AD-related services.

Do guidelines influence the implementation of health programs? — Uganda’s experience

PubMed Central

2012-01-01

Background A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines. Methods Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. Results There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their utilization, and provide feedback was noted. Conclusions Guideline effectiveness is compromised by the development process. To ensure the production of high-quality guidelines, efforts must be employed at the country and regional levels. The regional level can facilitate pooling resources and expertise in knowledge generation, methodology development, guideline repositories, and capacity building. Countries should establish and enforce systems and guidance on guideline development. PMID:23068082

42 CFR 124.503 - Compliance level.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance level. 124.503 Section 124.503 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... for which a published index is available. (b) Deficits. If in any fiscal year a facility fails to meet...

Rates of trauma-informed counseling at substance abuse treatment facilities: reports from over 10,000 programs.

PubMed

Capezza, Nicole M; Najavits, Lisa M

2012-04-01

Trauma-informed treatment increasingly is recognized as an important component of service delivery. This study examined differences in treatment-related characteristics of facilities that offer moderate or high levels of trauma-informed counseling versus those that offer no or low levels of such counseling. Responses from 13,223 substance abuse treatment facilities surveyed in 2009 by the National Survey of Substance Abuse Treatment Services (NSSATS) were used. A majority (66.6%) of facilities reported using trauma counseling sometimes or always or often. Facilities that provided moderate or high levels of trauma counseling were more likely to provide additional treatment services, such as disease testing and specialized group therapy, as well as child care, employment counseling, and other ancillary services. A majority of facilities reported provision of trauma counseling. Additional training and resources may be needed for programs that reported low rates of trauma counseling.

Contract management survey 2002.

PubMed

Hoppszallern, Suzanna

2002-10-01

Spending on clinical contracts continues to outpace spending on business services, but may be leveling off. The 12th annual Contract Management Survey shows that the performance of clinical vendors is now comparable to business service vendors in meeting savings targets. Both business and clinical vendors are receiving higher marks from hospital leaders, but execs quickly respond to low marks by bringing the service back in-house of changing vendors. This report examines trends in outsourcing, satisfaction levels, the decision-making process, contract features and performance, and spending.

Differences in Use of Government Subsidised Mental Health Services by Men and Women with Psychological Distress: A Study of 229,628 Australians Aged 45 Years and Over.

PubMed

Dolja-Gore, Xenia; Loxton, Deborah; D'Este, Catherine; Blyth, Fiona; Byles, Julie

2018-04-17

This study examined factors associated with use of government subsidised mental health services by 229,628 men and women from the Sax Institute's 45 and Up Study. Logistical regression models assessed use of mental health services by gender and according to level of psychological distress. Approximately equal proportion of men and women had high psychological distress scores (approximately 7%) but only 7% of these men and 11% of these women used services. Use was associated with predisposing (younger age and higher education), enabling (private health insurance) and need factors (higher psychological distress scores). Associations were similar for men and women except urban area of residence, separated/divorced marital status, and smoking were associated with service use for women but not men. Results suggest some inequity in the use of services by those with higher levels of need and further efforts may be required to reach people with higher need but lower service use.

Attending surgeon burnout and satisfaction with the establishment of a regional acute care surgical service

PubMed Central

Helewa, Ramzi M.; Kholdebarin, Ramin; Hochman, David J.

2012-01-01

Background Establishment of the Acute Care Surgical Service (ACSS) has dramatically changed the management of acute, nontrauma surgical patients in Winnipeg, Manitoba. Its formation was partially driven by increasing strain on surgeons and surgical services. We sought to determine surgeon level of burnout and satisfaction with the ACSS. Methods All Winnipeg ACSS surgeons were mailed surveys. Burnout was established using the Maslach Burnout Inventory Human Services Survey. Satisfaction was ascertained with a series of questions. Results We attained a response rate of 76%. Most surgeons were married men with children. A burnout level of 61% was determined. Although most surgeons felt the ACSS was a positive change in their careers, they felt that operating room accessibility and teaching opportunities were lacking. Conclusion Although a high level of burnout exists among ACSS surgeons, most are satisfied with its establishment. Factors such as operating room accessibility and teaching opportunities must be addressed. PMID:22854111

Evaluation of Service Level Agreement Approaches for Portfolio Management in the Financial Industry

NASA Astrophysics Data System (ADS)

Pontz, Tobias; Grauer, Manfred; Kuebert, Roland; Tenschert, Axel; Koller, Bastian

The idea of service-oriented Grid computing seems to have the potential for fundamental paradigm change and a new architectural alignment concerning the design of IT infrastructures. There is a wide range of technical approaches from scientific communities which describe basic infrastructures and middlewares for integrating Grid resources in order that by now Grid applications are technically realizable. Hence, Grid computing needs viable business models and enhanced infrastructures to move from academic application right up to commercial application. For a commercial usage of these evolutions service level agreements are needed. The developed approaches are primary of academic interest and mostly have not been put into practice. Based on a business use case of the financial industry, five service level agreement approaches have been evaluated in this paper. Based on the evaluation, a management architecture has been designed and implemented as a prototype.

Disabled persons' knowledge of HIV prevention and access to health care prevention services in South Africa.

PubMed

Eide, Arne Henning; Schür, Clare; Ranchod, Chitra; Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite

2011-12-01

The main research question in this article is how access to information about HIV/AIDS and level of HIV/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed that gender and level of education, together with geographical differences, are key predictors for access to information and knowledge about HIV/AIDS among disabled people. For male respondents number of information sources predicts access to voluntary counselling and testing services and HIV testing, while knowledge about prevention predicts access to Voluntary Counselling and Testing centres. Significant gender differences with regards to information, knowledge and access to services highlight the need for gender specific prevention strategies among disabled people.

The role of the neonatal nurse practitioner in the community hospital level I nursery.

PubMed

Hatch, Julie

2012-01-01

Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country's Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP's experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

A Mediator-Based Approach to Resolving Interface Heterogeneity of Web Services

NASA Astrophysics Data System (ADS)

Leitner, Philipp; Rosenberg, Florian; Michlmayr, Anton; Huber, Andreas; Dustdar, Schahram

In theory, service-oriented architectures are based on the idea of increasing flexibility in the selection of internal and external business partners using loosely-coupled services. However, in practice this flexibility is limited by the fact that partners need not only to provide the same service, but to do so via virtually the same interface in order to actually be interchangeable easily. Invocation-level mediation may be used to overcome this issue — by using mediation interface differences can be resolved transparently at runtime. In this chapter we discuss the basic ideas of mediation, with a focus on interface-level mediation. We show how interface mediation is integrated into our dynamic Web service invocation framework DAIOS, and present three different mediation strategies, one based on structural message similarity, one based on semantically annotated WSDL, and one which is embedded into the VRESCo SOA runtime, a larger research project with explicit support for service mediation.

Emergency Medical Services Program Guide.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Dept. of Vocational Education.

This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

Measuring the performance of G2G services in Iran

NASA Astrophysics Data System (ADS)

Zarei, Behrouz; Safdari, Maryam

To highlight the growth of e-government and the importance of its services it is essential to evaluate the performance of the service delivery to customers. Research indicates that traditional performance indexes are not suitable for this evaluation; moreover, it is noticeable that the e-government services are intangible and invisible. Among different e-government services, measurement of quality government to government (G2G) services has been less attractive for researchers while crucial for government policy-makers. This calls for a better understanding of the specific needs of users of these services in order to provide appropriate type and level of services that meets those needs. In this paper, the performance of the G2G services is measured in the Iranian context. For this purpose, SERVQUAL, which is a well-known method for assessing service quality, is employed. This study proposes and tests a five-factor of SERVQUAL instrument to explain user satisfaction and gap analysis, between expectations and perceptions of its customers, consisting thirty ministries and main governmental organizations. Based on a Chi-square test, factor analysis, gap analysis and correlations, it is concluded the gap between expectations and perceptions of G2G customers is significant and customer satisfaction of G2G services is at low level.

48 CFR 970.4102-1 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DOE to acquire utility service(s) by subcontract, i.e., what the benefits are, such as economic..., shall be applied to a subcontract level acquisition for furnishing utility services to a facility owned...

School bus’s level of service in Malang City

NASA Astrophysics Data System (ADS)

Hariyani, S.

2017-06-01

School Bus began operated on the 12th of January 2015. Provision of school buses is expected to reduce not only the use of vehicles by students, but it is also to reduce the number of traffic jams. Malang school bus facilities provided by the Department of Transport in cooperation with the Department of Education to serve students in elementary school, junior and senior high schools. After the service running two years, based on the preliminary observation not all students are interested in using the school bus. The research objective was to measure the school bus’s level service. The method to measure school bus’s level of service was used Importance Performance analysis (IPA). The results showed that through IPA, it can be concluded that school bus’s level of service in Malang City have been able to serve students/customers with the mean of degree suitability (Tki) is 111. Meanwhile it must be observed and get more attention to improve by government, attributes which is lies in the first quadrant or concentrate here (attribute Adequate space, Seating capacity, Availability trash can, Passenger facility down in points, The availability of information boards in each bus stop, Availability public telephone in each bus stop, and Availability CCTV in each bus), in order to increase its performance.

Users' demographic profile and quality attributes of bus services: The perspectives of users, operators and local authorities

NASA Astrophysics Data System (ADS)

Noh, Nur'Amirah Mhd.; Hamid, Ahmad Hilmy Abd

2017-10-01

Bus services that can help meet almost every bus user's needs are the goals of bus operators. Despite such an idealistic view, the operators themselves, users and even the local authorities have been found to hold different views about the quality of service that the bus should deliver. As the users i.e., customers are considered as important stakeholders, understanding their characteristics, profile and pattern is very crucial. To this end, the present study has attempted to gauge the perspectives of all the above-mentioned stakeholders. For the users, a customer satisfaction survey was employed to look into the relative influence of service attributes. In addition, surveys were also administered to bus operators and local authorities to study their perspectives in relation to this matter. 450 randomly selected respondents were surveyed. Identification of the service level was analyzed through the Likert scale whereas the perspectives of the operators and authorities were dealt with through mean value Analysis. Specifically, this study aims to identify the crucial attributes in determining the quality of the bus services. Findings of the study indicated that different attributes were selected by users, operators and authorities, which clearly enlightened the variations of the important attributes in determining the level of bus service quality. In its attempt to compare the service level attributes from three perspectives, this study has helped advance better improvement and strategies for the urban public bus operators and planners, in addition to the authorities in delivering user-friendly bus services by taking into account the local context, user profile and demographic characteristics.

Trust-Based Service Composition and Binding for Tactical Networks with Multiple Objectives

DTIC Science & Technology

2013-12-01

services, then it will have a set of four-tuple records for each abstract service that it can provide. We assume that the service quality of a SP in...user (i.e., a SR) does not have knowledge of the “best” service quality , so its satisfaction level with services received is based on what has been...hand, when USRm is less than USTm, identifies the culprits with low performance (by comparing the advertised service quality profile with the

A descriptive study of access to services in a random sample of Canadian rural emergency departments.

PubMed

Fleet, Richard; Poitras, Julien; Maltais-Giguère, Julie; Villa, Julie; Archambault, Patrick

2013-11-27

To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs). Cross-sectional study-mixed methods (structured interview, survey and government data bases) with random sampling of hospitals. Canadian rural EDs (rural small town (RST) definition-Statistics Canada). 28% (95/336) of Canadian rural EDs providing 24/7 physician coverage located in hospitals with acute care hospitalisation beds. General characteristics of the rural EDs, information about 24/7 access to consultants, equipment and services, and the proportion of rural hospitals more than 300 km from levels 1 and 2 trauma centres. Of the 336 rural EDs identified, 122 (36%) were randomly selected and contacted. Overall, 95 EDs participated in the study (participation rate, 78%). Hospitals had, on an average, 23 acute care beds, 7 ED stretchers and 13 500 annual ED visits. The proportion of rural hospitals with local access to the following 24/7 services was paediatrician, 5%; obstetrician, 10%; psychiatrist, 11%; internist, 12%; intensive care unit, 17%; CT scanner, 20%; surgeon, 26%; ultrasound, 28%; basic X-ray, 97% and laboratory services, 99%. Forty-four per cent and 54% of the RST EDs were more than 300 km from a level 1 and level 2 trauma centre, respectively. This is the first study describing the services available in Canadian rural EDs. Apart from basic laboratory and X-ray services, most rural EDs have limited access to consultants, advanced imaging and critical care services. A detailed study is needed to evaluate the impact of these limited services on patient outcomes, costs and interfacility transport demands.

Equity in access to maternal and child health services in five developing countries: what works.

PubMed

Talukder, M D Noorunnabi; Rob, Ubaidur

2010-01-01

People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Student Health Services at Orchard Ridge.

ERIC Educational Resources Information Center

Nichols, Don D.

This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…

Trauma and PTSD rates in an irish psychiatric population

PubMed Central

Wilson, Fiona E; Hennessy, Eilis; Dooley, Barbara; Kelly, Brendan D; Ryan, Dermot A

2013-01-01

Although Western mental health services are increasingly finding themselves concerned with assisting traumatized individuals migrating from other countries, trauma and posttraumatic stress disorder (PTSD) are under-detected and undiagnosed in psychiatric populations. This study examined and compared rates of traumatic experiences, frequency of traumatic events, trauma symptomatology levels, rates of torture, rates of PTSD and chart documentation of trauma and PTSD between (a) Irish and migrant service-users and (b) forced migrant and voluntary migrant service-users in Dublin, Ireland. Data were gathered from 178 psychiatric outpatients attending using a sociodemographic questionnaire, the Harvard Trauma Questionnaire-Revised Cambodian Version and the SCID-I/P. A substantial number of service-users had experienced at least one lifetime trauma (71.3%), and a high percentage of both the Irish (47.4%) and migrant groups (70.3%) of service-users had experienced two or more events. Overall, analyses comparing rates between Irish, forced migrant and voluntary migrant service-users found that forced migrants displayed more traumatic life events, posttraumatic symptoms, and higher levels of PTSD than their voluntary migrant and Irish counterparts, with over 50% experiencing torture prior to arrival in Ireland. The lifetime rate of PTSD in the overall sample was 15.7% but only 53.57% of cases were documented in patient charts. The results of this study are informative about the nature and extent of the problem of trauma and PTSD among migrant mental health service users as well as highlighting the under-detected levels of trauma among native-born service users. PMID:28228990

Service dogs and people with physical disabilities partnerships: a systematic review.

PubMed

Winkle, Melissa; Crowe, Terry K; Hendrix, Ingrid

2012-03-01

Occupational therapists have recognized the benefits that service dogs can provide people with disabilities. There are many anecdotal publications extolling the benefits of working with service dogs, but few rigorous studies exist to provide the evidence of the usefulness of this type of assistive technology option. This systematic review evaluates the published research that supports the use of service dogs for people with mobility-related physical disabilities. Articles were identified by computerized search of PubMed, CINAHL, PsycINFO, OT Seeker, the Cochrane Database of Systematic Reviews, SportDiscus, Education Research Complete, Public Administration Abstracts, Web of Knowledge and Academic Search Premier databases with no date range specified. The keywords used in the search included disabled persons, assistance dogs or service dogs and mobility impairments. The reference lists of the research papers were checked as was the personal citation database of the lead author. Twelve studies met the inclusion criteria and whereas the findings are promising, they are inconclusive and limited because of the level of evidence, which included one Level I, six Level III, four Level IV and one Level V. All of the studies reviewed had research design quality concerns including small participant sizes, poor descriptions of the interventions, outcome measures with minimal psychometrics and lack of power calculations. Findings indicated three major themes including social/participation, functional and psychological outcomes; all of which are areas in the occupational therapy scope of practice. Occupational therapists may play a critical role in referral, assessment, assisting clients and consulting with training organizations before, during and after the service dog placement process. In order for health care professionals to have confidence in recommending this type of assistive technology, the evidence to support such decisions must be strengthened. Copyright © 2011 John Wiley & Sons, Ltd.

Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement.

PubMed

Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

2017-06-27

To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services ( P <.001). Public facilities were less likely than private facilities to have high-quality services ( P =.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely available methods were male condoms, combined oral contraceptive pills, and progestin-only injectable contraceptives. Availability and quality of family planning services in health facilities in the DRC remain low, with inequitable distribution of services throughout the country. To improve access to and use of family planning, efforts should focus on improving availability and quality at lower health system levels and in rural areas where the majority of the population lives. © Mpunga et al.

[Personality determinants of effectiveness in performing duties by soldiers in active service in the landing-shock brigade].

PubMed

Florkowski, A; Caban, Z; Szczesny, D; Zboralski, K

1996-01-01

After studies in the Brigade the authors identified and qualified personality traits which co-determine effectiveness in performing duties in active service. The efficiency of performing duties is determined by: high emotional resistance, high level of ability to logical conclusion, high level of self-control, low extroversion level, lack of antisocial tendencies. The authors worked out some indications concerning choice and selection for this military formation.

Gender Disparities in Mental Health Service Use of Puerto Rican Children and Adolescents

ERIC Educational Resources Information Center

Cabiya, Jose J.; Canino, Glorisa; Chavez, Ligra; Ramirez, Rafael; Alegria, Margenta; Shrout, Patrick; Hohman, Ann; Bravo, Milagros; Bauermeister, Jose J.; Maritinez-Taboas, Alfonso

2006-01-01

Background: Differences in service utilization indicating that boys use more mental health services than girls were analyzed to see if they could be explained by known correlates of service use. These correlates were arranged into individual (severe emotional disturbance, level of impairment and externalizing disorders), family (parental…

The Delivery of Recreation Programs: Students Gain Entry Level Management Skills through Service Learning

ERIC Educational Resources Information Center

Zimmermann, Jo An M.; Dupree, Jessica; Hodges, Jan S.

2014-01-01

Service learning is a well established pedagogy within higher education. Specifically, service learning allows students to engage in "real world" activities to practice skills and reflect upon their own competence. To enhance the effectiveness of service learning, instructors need to consider a multitude of learning influences. This…

Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China.

PubMed

Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

2015-06-26

This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China

PubMed Central

Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

2015-01-01

This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking. PMID:26132475

Teledermatology: quality assessment by user satisfaction and clinical efficiency.

PubMed

Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

2005-08-01

The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.

Indicators for evaluating cancer organizations' support services: performance and associations with empowerment.

PubMed

Lauzier, Sophie; Campbell, H Sharon; Livingston, Patricia M; Maunsell, Elizabeth

2014-10-15

Community-based cancer organizations provide services to support patients. An anticipated benefit of these services is patient empowerment. However, this outcome has not been evaluated because of the lack of validated health-related empowerment questionnaires in the cancer context. In this validation study, the authors assessed the extent to which 16 indicators used by the Canadian Cancer Society (CCS) and the Cancer Council Victoria, Australia (CCV) to evaluate their services were associated with health-related empowerment. Cancer patients/survivors who were diagnosed < 3 years earlier and who used CCS programs completed a questionnaire that included the 16 CCS-CCV indicators and 5 scales from the Health Education Impact Questionnaire (heiQ) measuring key dimensions of empowerment. To determine whether the CCS-CCV indicators captured empowerment, differences in heiQ scores were compared between 2 groups: those with higher levels of agreement (agreeing or agreeing strongly) with an indicator and those with lower levels of agreement (agreeing slightly or disagreeing to any degree). Participation was 72% (207 of 289 eligible CCS users). Compared with participants who had lower levels of agreement on CCS-CCV indicators, those who had higher levels of agreement were more likely to report higher levels of empowerment on the different heiQ scales. For 15 of 16 indicators, these differences were significant (Wilcoxon rank-sum test; P < .10) on ≥ 1 of 5 heiQ scales and for 10 of 16 indicators on ≥ 3 of 5 heiQ scales. Two indicators were associated significantly with all 5 heiQ scales (cope better and feel more in control). Using CCS-CCV indicators to evaluate community-based cancer organizations' services will help determine whether these services are reaching one of their important goals: namely empowering patients. © 2014 American Cancer Society.

Race, ethnicity, religious affiliation, and education are associated with gay and bisexual men's religious and spiritual participation and beliefs: Results from the One Thousand Strong cohort.

PubMed

Lassiter, Jonathan M; Saleh, Lena; Starks, Tyrel; Grov, Christian; Ventuneac, Ana; Parsons, Jeffrey T

2017-10-01

This study examined the rates of spirituality, religiosity, religious coping, and religious service attendance in addition to the sociodemographic correlates of those factors in a U.S. national cohort of 1,071 racially and ethnically diverse HIV-negative gay and bisexual men. Descriptive statistics were used to assess levels of spirituality, religiosity, religious coping, and religious service attendance. Multivariable regressions were used to determine the associations between sociodemographic characteristics, religious affiliation, and race/ethnicity with four outcome variables: (1) spirituality, (2) religiosity, (3) religious coping, and (4) current religious service attendance. Overall, participants endorsed low levels of spirituality, religiosity, and religious coping, as well as current religious service attendance. Education, religious affiliation, and race/ethnicity were associated with differences in endorsement of spirituality and religious beliefs and behaviors among gay and bisexual men. Men without a 4-year college education had significantly higher levels of religiosity and religious coping as well as higher odds of attending religious services than those with a 4-year college education. Gay and bisexual men who endorsed being religiously affiliated had higher levels of spirituality, religiosity, and religious coping as well as higher odds of religious service attendance than those who endorsed being atheist/agnostic. White men had significantly lower levels of spirituality, religiosity, and religious coping compared to Black men. Latino men also endorsed using religious coping significantly less than Black men. The implications of these findings for future research and psychological interventions with gay and bisexual men are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The profile of conceptual comprehension of pre-service teacher in the mathematical problem solving with low emotional intelligence

NASA Astrophysics Data System (ADS)

Prayitno, S. H.; Suwarsono, St.; Siswono, T. Y. E.

2018-03-01

Conceptual comprehension in this research is the ability to use the procedures that are owned by pre-service teachers to solve problems by finding the relation of the concept to another, or can be done by identifying the type of problem and associating it with a troubleshooting procedures, or connect the mathematical symbols with mathematical ideas and incorporate them into a series of logical reasoning, or by using prior knowledge that occurred directly, through its conceptual knowledge. The goal of this research is to describe the profile of conceptual comprehensin of pre-service teachers with low emotional intelligence in mathematical problems solving. Through observation and in-depth interview with the research subject the conclusion was that: pre-service teachers with low emotional intelligence pertained to the level of formal understanding in understanding the issues, relatively to the level of intuitive understanding in planning problem solving, to the level of relational understanding in implementing the relational problem solving plan, and pertained to the level of formal understanding in looking back to solve the problem.

Knowledge of free delivery policy among women who delivered at health facilities in Oudomxay Province, Lao PDR.

PubMed

Chankham, Tengbriacheu; Yamamoto, Eiko; Reyer, Joshua A; Arafat, Rahman; Khonemany, Innoukham; Panome, Sayamoungkhoun; Hongkham, Dalavong; Bounfeng, Phommalaysith; Anonh, Xeuthvongsa; Hamajima, Nobuyuki

2017-02-01

To promote the utilization of maternal health services and reduce financial barriers, the Laos government introduced its "Free Maternal Health Services Policy" in 2012. This policy provides free maternal health services for pregnant women, which includes costs related to treatment, transportation, food fees, referral and an incentive for four antenatal care appointments. This study aims to ascertain the knowledge level regarding this policy among Lao women and determine their level of satisfaction with the maternal service provision. This is a cross-sectional study conducted in Xay district, La district, and Namore district of Oudomxay province, in August 2015. Three hundred and sixty women who delivered their children at the health facilities from July 2014 to June 2015 were randomly selected from the list of mothers who lived in each area. The majority of women had heard about the free delivery policy and knew that the main health services related to delivery and pregnancy were free of charge. Logistic regression analysis showed that education level (P=0.026), length of stay (P<0.0001) and receiving transportation support (P=0.005) had significant associations with the knowledge level. The women were highly satisfied with the quality of the services, health care providers, and health facilities. However, most mothers were not satisfied with accessibility to health facilities. To increase utilization of health facilities and reduce the maternal mortality ratio in rural areas, the government needs to improve people's education status and health care accessibility.

Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services.

PubMed

Kohler, Racquel E; Lee, Clara N; Gopal, Satish; Reeve, Bryce B; Weiner, Bryan J; Wheeler, Stephanie B

2015-01-01

In Malawi, routine breast cancer screening is not available and little is known about women's preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment. To identify important factors that are relevant to Malawian women's preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare. We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs. Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants' responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes, comprehension of choice tasks, and women's abilities to make trade-offs. Applying a discrete choice experiment for breast cancer early detection was feasible with appropriate tailoring for a low-income, low-literacy African setting.

Availing services for developmental disabilities: parental experiences from a referral center in developing country.

PubMed

Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra

2012-09-01

To identify the problems faced by parents of children with developmental disabilities in availing rehabilitative services and to find their satisfaction level. This study was carried out at a Child Development Clinic (CDC) located in Northern India. Children with developmental disabilities, who were availing services at CDC for at least last 3 mo and had at least 3 follow-up visits, were enrolled. A questionnaire pertaining to the socio-demographic profile, problems faced in availing services and satisfaction level was filled by the parents of the enrolled children. During the study period, 161 parents filled the questionnaire. 77.6% had some problems in getting the services, the major being difficulty in commuting (50%) and financial constraint (21.7%). More than 80% parents use public transport to reach CDC with 19% travelling more than 50 Km. 29.8% had difficulty in bringing their child to the clinic, either due to severe behavioral problems or physical disability. However, majority of the families were well satisfied with the services as 95% of them graded their satisfaction level at 3 or more on the scale of 0-5. Parents of children with developmental disabilities face many problems in getting rehabilitative services. They travel long distances, face hardships in carrying their child, and lose their day's earnings, apart from spending time and money for their child's therapy. However, most of the parents are well satisfied with the services.

Research into the influence of internal interdepartmental integration on service innovation and customer loyalty

NASA Astrophysics Data System (ADS)

Huang, Jui-Chan; Wu, Tzu-Jung; Wen, Hao-Ming; Hsin-Fei, Wu; Hairui, Ji

2017-06-01

It is the most important for the company to improve customer value and customer loyalty through service innovation. However, at present, only researches related to organizations or consumer behaviors are conducted, there is rare research into the combination between organization level and consumer behavior, and this research tries to explore this aspect, which is the motivation and contribution of this research. This research aims to explore the relationship between "Interdepartmental Integration", "Service Innovation" and "Customer Loyalty", according to the analysis results, the relationship between "interdepartmental integration and service innovation" and "service innovation and customer loyalty" has a low positive correlation and it reaches significant level; it shows the relationship between "interdepartmental interaction and progressive innovation" and "interdepartmental collaboration and fundamental innovation" is significant.

Hubble Space Telescope servicing mission scientific instrument protective enclosure design requirements and contamination controls

NASA Technical Reports Server (NTRS)

Hansen, Patricia A.; Hughes, David W.; Hedgeland, Randy J.; Chivatero, Craig J.; Studer, Robert J.; Kostos, Peter J.

1994-01-01

The Scientific Instrument Protective Enclosures were designed for the Hubble Space Telescope Servicing Missions to provide a beginning environment to a Scientific Instrument during ground and on orbit activities. The Scientific Instruments required very stringent surface cleanliness and molecular outgassing levels to maintain ultraviolet performance. Data from the First Servicing Mission verified that both the Scientific Instruments and Scientific Instrument Protective Enclosures met surface cleanliness level requirements during ground and on-orbit activities.

The Measurement of Change in English Language Proficiency

ERIC Educational Resources Information Center

Nallaya, Sasikala

2012-01-01

This study investigated the measurement of change in English language proficiency levels of pre-service and in-service teachers enrolled in a public university in Malaysia. Path analysis was used to measure change on three occasions by examining the effects of student characteristics, learning needs and multimodal technology on proficiency levels.…

Examination of Occupational Anxiety Levels and Academic Self-Efficacy of Physical Education Teacher Candidates

ERIC Educational Resources Information Center

Pehlevan, Zeka; Mustu,Eda; Çepikkurt, Fatma

2017-01-01

This study aims at determining the occupational anxiety level of pre-service physical education teachers according to variables, and revealing the correlation between occupational anxiety and academic self-efficacy. Study group consists of 586 pre-service teachers from 10 different universities in Turkey. Data is collected by "Occupational…

Racial Differences in Perceptions of Social Support in Consumer-Centered Services

ERIC Educational Resources Information Center

Woodward, Amanda Toler; Mowbray, Carol T.; Holter, Mark C.; Bybee, Deborah

2007-01-01

The purpose of this study was to explore potential racial differences in the experience of support offered by consumer-centered services for adults with serious mental illness. The study used hierarchical linear modeling to examine the level of support consumers report receiving from programs and the extent to which program-level characteristics…

Reflective Writing in Pre-Service Teachers' Teaching: What Does It Promote?

ERIC Educational Resources Information Center

Cohen-Sayag, Etty; Fischl, Dita

2012-01-01

In this study, we examined changes in levels of pre service teachers' reflective writing and tried to identify links between these changes and pre service teachers' success in teaching. Participants were two groups of pre-service special education teachers that taught in two different special education settings: learning difficulties classes and…

38 CFR 3.310 - Disabilities that are proximately due to, or aggravated by, service-connected disease or injury.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Dependency and Indemnity Compensation Ratings and Evaluations; Service Connection § 3.310 Disabilities that... or injury shall be service connected. When service connection is thus established for a secondary... current level of severity of the nonservice-connected disease or injury. The rating activity will...

Client Assessment in an Industrial Setting: A Cross-Sectional Method.

ERIC Educational Resources Information Center

Yamatani, Hide

1988-01-01

Used cross-sectional method for evaluating social service programs in industrial setting to estimate numbers of workers needing social services, levels of program use, and penetration and to examine program outcome. Workers served by social service or employee assistance programs can be examined to determine additional services needed, adequacy of…

Student Satisfaction with International Student Support Services at a Mid-Atlantic University

ERIC Educational Resources Information Center

Yobol, Jean Paul

2014-01-01

This study investigated the level of satisfaction that international students experienced with student support services at a liberal arts University in the North East. The University's International Students Services Office (ISSO) is the sole point of contact for students studying under an F1 VISA. Services offered range from government…

Pre-Service Primary Teachers' Attitudes towards Energy Conservation

ERIC Educational Resources Information Center

Tekbiyik, Ahmet; Ipek, Cemalettin

2008-01-01

This study aims to examine the pre-service primary teachers' attitudes towards energy conservation. In order to reach this main aim following research questions are formulated: (1) What are the attitude levels of pre-service primary teachers in terms of energy conservation? (2) Do pre-service primary teachers' attitudes towards energy conservation…

Incorporating Professional Service as a Component of General Chemistry Laboratory by Demonstrating Chemistry to Elementary Students

ERIC Educational Resources Information Center

Theall, Rachel A. Morgan; Bond, Marcus R.

2013-01-01

Formalized participation in professional service is not often part of the college experience, especially for first-year students in chemistry courses. When service opportunities are offered, they are most often through elective credit, upper-level courses, extracurricular clubs, and the rare service-learning courses. We have successfully…

Mechanisms for Institutionalizing Service-Learning and Community Partner Outcomes

ERIC Educational Resources Information Center

Stater, Keely Jones; Fotheringham, Eric

2009-01-01

Using data on service-learning partnerships from 255 universities receiving Learn and Serve America Grants in 2005, we ask (1) how different strategies used to institutionalize service-learning shape the perceived impact of the partnership on community groups, (2) how the level of service-learning program formality affects the perceived impact of…

The Italian economic crisis and its impact on nursing services and education: hard and challenging times.

PubMed

Bortoluzzi, Guido; Palese, Alvisa

2010-07-01

Three levels of impact are reported and discussed in this commentary: the 'macro' level, which corresponds to policy(ies); the 'meso' level, which corresponds to nursing services and nursing education; and the 'micro' level, which deals with clinical practice and education, where interactions between patients and nurses and/or students take place. The Italian economy is showing some signs of recovery after the worst economic crisis of past decades. However, these signs are still quite weak and insufficient to declare that the country is finally coming out of it. Several negative impacts of the economic crisis on nursing services and nursing education are documented. Reports have started to document initial signs of the economical crisis impact on patients too. Present and future issues related to nursing services, education and clinical practice are commented both from national data and from nurses' daily perceptions. The Italian economic crisis will leave a heavy burden on the shoulders of future generations. Nurses' leaders are coping with these challenges, innovating the nursing system and preparing a sustainable future for generations of patients and nurses.

Patient satisfaction with the service at Menopause Clinic, Maharaj Nakorn Chiang Mai Hospital.

PubMed

Chaovisitsaree, Somsak; Sribanditmongkol, Narisa; Chandrawongse, Waraporn; Noi-um, Supranee; Sangchun, Kullaya

2010-09-01

To evaluate patient satisfaction of service at the Menopause Clinic and to identify factors affecting patient satisfaction. Cross sectional descriptive study was conducted at the Menopause Clinic, Maharaj Nakorn Chiang Mai hospital. Three hundred twenty six subjects were included. The questionnaire consists of two parts, demographic and patient satisfaction. The patient satisfaction was evaluated in five aspects. The overall patient satisfaction level was good (mean 4.2 +/- 0.71). The satisfactions about service behavior quality of care and health information were in excellent level (mean 4.29 +/- 0.69, 4.25 +/- 0.65, and 4.26 +/- 0.69, respectively). The satisfaction about clinic facilities/conveniences and medical expense were in good level (mean 3.83 +/- 0.79 and 3.87 +/- 0.75). There are three variables that could affect patient satisfaction: Occupation and level of education affected satisfaction in medical expense aspect (p < 0.001 and p < 0.05) and number of visits affected the clinic facilities/convenience aspect (p < 0.05). Some patient characteristics affected the patient satisfaction. However, system and structure of service in different setting hospitals are of concerned.

Training Guidelines for Healthy School Meals for Food Service Professionals.

ERIC Educational Resources Information Center

Food and Consumer Service (USDA), Washington, DC.

These guidelines offer recommended topic areas and content for training local-level food service personnel. The recommended topic areas for training school food service directors/supervisors and food service managers are nutrition requirements, menu planning for school meals, procurement, financial management, marketing, food production, program…

Leadership in Children's Services

ERIC Educational Resources Information Center

Booker, Roger

2012-01-01

This paper examines the different contexts for leadership in children's services with a particular focus on integrated working. It reviews contemporary theories that appear to offer relevant frameworks for thinking about children's service leadership. It is argued that children's services require leadership at all levels to enable a dynamic,…

Pre-Professional Training for Serving Children with ASD: An Apprenticeship Model of Supervision

ERIC Educational Resources Information Center

Donaldson, Amy L.

2015-01-01

Children with autism spectrum disorder (ASD) often present with varied skill profiles and levels of severity making development and implementation of specialized school services challenging. Research indicates that school professionals require and desire additional ASD-specific professional development, both at the pre-and in-service levels.…

Pre-Service Science Teachers' Reflective Thinking Skills toward Problem Solving

ERIC Educational Resources Information Center

Can, Sendil

2015-01-01

The purpose of the present study is to investigate the pre-service science teachers' reflective thinking skills toward problem solving and the effects of gender, grade level, academic achievement, type of graduated high school and father and mother's education level on these skills. The study was conducted through the survey method with the…

Agricultural In-Service Needs of Introductory Level Career and Technical Education Teachers

ERIC Educational Resources Information Center

Christensen, Jolene; Warnick, Brian K.; Spielmaker, Debra; Tarpley, Rudy S.; Straquadine, Gary S.

2009-01-01

This study identified and prioritized the agricultural in-service needs of introductory level career and technical education teachers in Utah. The Utah State Board of Education requires that all seventh grade students complete an introductory career and technical education course as their first formal career exploration experience. One component…

Pre-Service Teachers' Attendance at Lectures and Tutorials: Why Don't They Turn up?

ERIC Educational Resources Information Center

Oakley, Grace; Lock, Graeme; Budgen, Fiona; Hamlett, Brenda

2011-01-01

Research indicates that attendance at lectures and tutorials is associated with university students' level of success and satisfaction, and pre-service teachers' relatively low levels of attendance at scheduled classes is of significant concern to many lecturers. However, little research has been undertaken to investigate the factors associated…

Student-Life Stress in Education and Health Service Majors

ERIC Educational Resources Information Center

Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie

2012-01-01

In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…

5 CFR 842.811 - Deposits for second-level supervisory air traffic controller service performed before February 10...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES... made for a distinct period of service; however, such a deposit shall be ineffective if deposits are not...

5 CFR 842.811 - Deposits for second-level supervisory air traffic controller service performed before February 10...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES... made for a distinct period of service; however, such a deposit shall be ineffective if deposits are not...

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

Towards Simpler Custom and OpenSearch Services for Voluminous NEWS Merged A-Train Data (Invited)

NASA Astrophysics Data System (ADS)

Hua, H.; Fetzer, E.; Braverman, A. J.; Lewis, S.; Henderson, M. L.; Guillaume, A.; Lee, S.; de La Torre Juarez, M.; Dang, H. T.

2010-12-01

To simplify access to large and complex satellite data sets for climate analysis and model verification, we developed web services that is used to study long-term and global-scale trends in climate, water and energy cycle, and weather variability. A related NASA Energy and Water Cycle Study (NEWS) task has created a merged NEWS Level 2 data from multiple instruments in NASA’s A-Train constellation of satellites. We used this data to enable creation of climatologies that include correlation between observed temperature, water vapor and cloud properties from the A-Train sensors. Instead of imposing on the user an often rigid and limiting web-based analysis environment, we recognize the need for simple and well-designed services so that users can perform analysis in their own familiar computing environments. Custom on-demand services were developed to improve data accessibility of voluminous multi-sensor data. Services enabling geospatial, geographical, and multi-sensor parameter subsets of the data, as well a custom time-averaged Level 3 service will be presented. We will also show how a Level 3Q data reduction approach can be used to help “browse” the voluminous multi-sensor Level 2 data. An OpenSearch capability with full text + space + time search of data products will also be presented as an approach to facilitated interoperability with other data systems. We will present our experiences for improving user usability as well as strategies for facilitating interoperability with other data systems.

Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania

PubMed Central

Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

2017-01-01

Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities’ capacity to provide newborn care services in low and middle income countries. Methods In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally–representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn–related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. Findings In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Conclusions Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential newborn care services for rural areas and for people accessing lower–level facilities. Together, the low levels of both service availability and readiness across the five countries reinforce the vital importance of monitoring health facility capacity to provide care. In order to save newborn lives and improve equity in child survival, not only does women’s use of services need to increase, but facility capacity to provide those services must also be enhanced. PMID:29423186

Spatial Skill Profile of Mathematics Pre-Service Teachers

NASA Astrophysics Data System (ADS)

Putri, R. O. E.

2018-01-01

This study is aimed to investigate the spatial intelligence of mathematics pre-service teachers and find the best instructional strategy that facilitates this aspect. Data were collected from 35 mathematics pre-service teachers. The Purdue Spatial Visualization Test (PSVT) was used to identify the spatial skill of mathematics pre-service teachers. Statistical analysis indicate that more than 50% of the participants possessed spatial skill in intermediate level, whereas the other were in high and low level of spatial skill. The result also shows that there is a positive correlation between spatial skill and mathematics ability, especially in geometrical problem solving. High spatial skill students tend to have better mathematical performance compare to those in two other levels. Furthermore, qualitative analysis reveals that most students have difficulty in manipulating geometrical objects mentally. This problem mostly appears in intermediate and low-level spatial skill students. The observation revealed that 3-D geometrical figures is the best method that can overcome the mentally manipulation problem and develop the spatial visualization. Computer application can also be used to improve students’ spatial skill.

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China

PubMed Central

2012-01-01

Background Patient’s satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. The aim of this study was to test whether and to what extent patient’s satisfaction with medical service delivery/patient’s assessments of various major aspects of medical service/various major aspects of patient’s trust in health delivery system influenced patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. Methods This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. Results The key considerations in generating patient’s life satisfaction involved patient’s overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient’s life satisfaction were different among low level public hospital, high level public hospital, and private hospital. Conclusion The promotion of patient’s overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient’s trust in prescription, the promotion of patient’s trust in doctor, and the promotion of patient’s trust in recommended medical examination could all help promote patient’s life satisfaction. But their promotion effects were different among low level public hospital, high level public hospital, and private hospital. PMID:22978432

Variation of ecosystem services and human activities: A case study in the Yanhe Watershed of China

NASA Astrophysics Data System (ADS)

Su, Chang-hong; Fu, Bo-Jie; He, Chan-Sheng; Lü, Yi-He

2012-10-01

The concept of 'ecosystem service' provides cohesive views on mechanisms by which nature contributes to human well-being. Fast social and economic development calls for research on interactions between human and natural systems. We took the Yanhe Watershed as our study area, and valued the variation of ecosystem services and human activities of 2000 and 2008. Five ecosystem services were selected i.e. net primary production (NPP), carbon sequestration and oxygen production (CSOP), water conservation, soil conservation, and grain production. Human activity was represented by a composite human activity index (HAI) that integrates human population density, farmland ratio, influence of residential sites and road network. Analysis results of the five ecosystem services and human activity (HAI) are as follows: (i) NPP, CSOP, water conservation, and soil conservation increased from 2000 to 2008, while grain production declined. HAI decreased from 2000 to 2008. Spatially, NPP, CSOP, and water conservation in 2000 and 2008 roughly demonstrated a pattern of decline from south to north, while grain production shows an endocentric increasing spatial pattern. Soil conservation showed a spatial pattern of high in the south and low in the north in 2000 and a different pattern of high in the west and low in the east in 2008 respectively. HAI is proportional to the administrative level and economic development. Variation of NPP/CSOP between 2000 and 2008 show an increasing spatial pattern from northwest to southeast. In contrast, the variation of soil conservation shows an increasing pattern from southeast to northwest. Variation of water conservation shows a fanning out decreasing pattern. Variation of grain production doesn't show conspicuous spatial pattern. (ii) Variation of water conservation and of soil conservation is significantly positively correlated at 0.01 level. Both variations of water conservation and soil conservation are negatively correlated with variation of HAI at 0.01 level. Variations of NPP/CSOP are negatively correlated with variations of soil conservation and grain production at 0.05 level. (iii) Strong tradeoffs exist between regulation services and provision service, while synergies exist within regulation services. Driving effect of human activities on ecosystem services and tradeoffs and synergies among ecosystem service are also discussed.

Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis

PubMed Central

2012-01-01

Background A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge. PMID:23176397

An Investigation of Pre-Service Science and Mathematics Teachers' Personal Growth Initiative

ERIC Educational Resources Information Center

Büyükgöze, Hilal

2015-01-01

The current paper primarily aims to investigate pre-service science and mathematics teachers' personal growth initiative levels. The second aim of the study is to examine whether participants' initiative levels differ in relation to their gender, grade, department, perceived academic achievement, and willingness to attend graduate education after…

Should Master's Level Training To Provide Rural Services Survive?

ERIC Educational Resources Information Center

Keller, Peter A.

Despite recent efforts to encourage federal funding of psychological services for underserved populations such as the elderly and residents of rural areas, ample evidence suggests that rural areas are underserved by psychologists. Drawing on data from rural and urban areas in Pennsylvania, this paper argues that master's level training can provide…

42 CFR 84.1139 - Air velocity and noise levels; hoods and helmets; minimum requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Air velocity and noise levels; hoods and helmets; minimum requirements. 84.1139 Section 84.1139 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

42 CFR 84.1139 - Air velocity and noise levels; hoods and helmets; minimum requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Air velocity and noise levels; hoods and helmets; minimum requirements. 84.1139 Section 84.1139 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

42 CFR 84.1139 - Air velocity and noise levels; hoods and helmets; minimum requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Air velocity and noise levels; hoods and helmets; minimum requirements. 84.1139 Section 84.1139 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

42 CFR 84.1139 - Air velocity and noise levels; hoods and helmets; minimum requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Air velocity and noise levels; hoods and helmets; minimum requirements. 84.1139 Section 84.1139 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

42 CFR 84.1139 - Air velocity and noise levels; hoods and helmets; minimum requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Air velocity and noise levels; hoods and helmets; minimum requirements. 84.1139 Section 84.1139 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF...

Investigation and Development of Competency Standards and Certification Requirements for Secondary-Level Vocational Foodservice Programs. Final Report.

ERIC Educational Resources Information Center

Usiewicz, Ronald A.

An investigation ascertained, analyzed, and documented competency standards and certification requirements for secondary-level vocational food service programs. A literature review produced no instruments used in past studies to measure the attitudes of food service professionals toward task competencies. Six occupations were selected for the…

An Agent Allocation System for the West Virginia University Extension Service

ERIC Educational Resources Information Center

Dougherty, Michael John; Eades, Daniel

2015-01-01

Extension recognizes the importance of data in guiding programming decisions at the local level. However, allocating personnel resources and specializations at the state level is a more complex process. The West Virginia University Extension Service has adopted a data-driven process to determine the number, location, and specializations of county…

Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study.

PubMed

Mutemwa, Richard; Mayhew, Susannah; Colombini, Manuela; Busza, Joanna; Kivunaga, Jackline; Ndwiga, Charity

2013-01-11

There is broad consensus on the value of integration of HIV services and reproductive health services in regions of the world with generalised HIV/AIDS epidemics and high reproductive morbidity. Integration is thought to increase access to and uptake of health services; and improves their efficiency and cost-effectiveness through better use of available resources. However, there is still very limited empirical literature on health service providers and how they experience and operationalize integration. This qualitative study was conducted among frontline health workers to explore provider experiences with integration in order to ascertain their significance to the performance of integrated health facilities. Semi-structured in-depth interviews were conducted with 32 frontline clinical officers, registered nurses, and enrolled nurses in Kitui district (Eastern province) and Thika and Nyeri districts (Central province) in Kenya. The study was conducted in health facilities providing integrated HIV and reproductive health services (post-natal care and family planning). All interviews were conducted in English, transcribed and analysed using Nvivo 8 qualitative data analysis software. Providers reported delivering services in provider-level and unit-level integration, as well as a combination of both. Provider experiences of actual integration were mixed. At personal level, providers valued skills enhancement, more variety and challenge in their work, better job satisfaction through increased client-satisfaction. However, they also felt that their salaries were poor, they faced increased occupational stress from: increased workload, treating very sick/poor clients, and less quality time with clients. At operational level, providers reported increased service uptake, increased willingness among clients to take an HIV test, and reduced loss of clients. But the majority also reported infrastructural and logistic deficiencies (insufficient physical room space, equipment, drugs and other medical supplies), as well as increased workload, waiting times, contact session times and low staffing levels. The success of integration primarily depends on the performance of service providers which, in turn, depends on a whole range of facilitative organisational factors. The central Ministry of Health should create a coherent policy environment, spearhead strategic planning and ensure availability of resources for implementation at lower levels of the health system. Health facility staffing norms, technical support, cost-sharing policies, clinical reporting procedures, salary and incentive schemes, clinical supply chains, and resourcing of health facility physical space upgrades, all need attention. Yet, despite these system challenges, this study has shown that integration can have a positive motivating effect on staff and can lead to better sharing of workload - these are important opportunities that deserve to be built on.

Patient satisfaction with clinical laboratory services at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

PubMed Central

Abera, Rodas Getachew; Abota, Boaz Arka; Legese, Melese Hailu; Negesso, Abebe Edao

2017-01-01

Background Monitoring patient satisfaction is an important and useful quality improvement tool for clinical laboratories in particular and health care organizations in general. Thus, this study aimed to assess patient satisfaction toward clinical laboratory services at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Methods A hospital-based cross-sectional study was conducted and a convenient sampling technique was applied to recruit study participants. A total of 210 patients who had received laboratory services were included. A self-administered predesigned, pretested, structured questionnaire was used, and data were collected through face-to-face interviews. A 5-point Likert scale with 1 and 5 indicating the lowest and highest levels of satisfaction, respectively, was used and their weighted average was used to categorize the satisfaction level of the patients. Chi square test was used (taking P≤0.05 as the statistically significant level) to find out if any association existed between the level of satisfaction and different attributes. Data were analyzed using SPSS version 20. Results The overall level of patient satisfaction toward clinical laboratory services in this study was 59.7% with a response rate of 210 (100%). The Likert scale results of patient satisfaction of the laboratory services revealed that the mean rating values ranged from 3.05 (±1.12) to 4.12 (±1.08) out of a possible 5. Among the different indicators, patients were highly satisfied with the cleanliness of facility (82%), maintenance of privacy and confidentiality (83.2%), and the cost of the laboratory service (86.5%), while they were dissatisfied with the location of the laboratory (56%), latrine accessibility and availability (58.4%), and latrine cleanness and comfort (63.8%). Conclusion The whole availability of requested tests, availability of place in blood drawing room to put personal things, and waiting time for specimen collection were found to have a statistically significant association with the overall satisfaction of patients toward clinical laboratory services. Therefore, these could be the possible determinants among others that account for the dissatisfaction of patients with clinical laboratory services. PMID:28761333

Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services.

PubMed

Ng, Wai Hoe; Wang, Ernest; Ng, Ivan

2007-04-01

Neurosurgical emergencies constitute a significant proportion of workload of a tertiary neurosurgical service. Prompt diagnosis and emergent institution of definitive treatment are critical to reduce neurological mortality and morbidity. Diagnosis is highly dependent on accurate interpretation of scans by experienced clinicians. This expertise may not be readily available especially after office hours because many neurosurgical units are manned by middle-level neurosurgical staff with varying levels of experience in scan interpretation. Multimedia Messaging Service mobile phone technology offers a simple, cheap, quick, and effective solution to the problem of scan interpretation. An MMS takes only a few minutes to send and receive and allows senior doctors to view important images and make important clinical decisions to enhance patient management in an emergency situation. A mobile phone (with VGA camera and MMS capabilities) was provided to the neurosurgery registrar on call. The on-call mobile phone is passed on to the corresponding registrar on-call the next day. All consultants had personal mobile phones that are MMS-enabled. Relevant representative CT/MRI images can be taken directly from the mobile phone from the PACS off the computer screen. When only hard copies are available, the images can be taken off the light box. After a 12-month trial period, a questionnaire was given to all staff involved in the project to ascertain the usefulness of the MMS teleradiology service. The survey on the use of the MMS service in a tertiary neurosurgical service demonstrated that the technology significantly improved the level of confidence of the senior-level staff in emergent clinical decision making. Significantly, the MMS images were of sufficient quality and resolution to obviate the need to view the actual scans. The impact of MMS is less pronounced in the middle-level staff, but there was a trend that most of the junior staff found the service more useful. The MMS technology is demonstrated to be a useful media for the transmission of high-quality images to assist in the diagnostic process and implementation of emergent clinical therapy. It is already in widespread use and can be seamlessly and rapidly implemented in the clinical arena to improve the quality of patient care.

Health Services: Results from the School Health Policies and Programs Study 2006

ERIC Educational Resources Information Center

Brener, Nancy D.; Wheeler, Lani; Wolfe, Linda C.; Vernon-Smiley, Mary; Caldart-Olson, Linda

2007-01-01

Background: The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state- and district-level policies and school practices. Methods: The Centers for Disease Control…

Utilizing Service Learning in a College-Level Human Sexuality Course

ERIC Educational Resources Information Center

Jenkins, Dusty D.

2017-01-01

Implementing service learning into college courses has been shown to have positive benefits for both students and community members; however, service learning has not been largely evaluated in the literature on human sexuality courses. Thus, the purpose of the current study was to design, implement, and evaluate a service learning project in a…

Transitioning from High School Service to College Service-Learning in a First-Year Seminar

ERIC Educational Resources Information Center

Ross, Laurie; Boyle, Mary-Ellen

2007-01-01

This article analyzes the challenges encountered in a first-year service-learning course in which students had high expectations for community involvement and a commitment to social responsibility, yet significant difficulty connecting their service orientation to the intellectual inquiry expected of them at the college level. This conflict…

An Academic Club Service Learning Project as a Demonstration of Experiential Teaching Tools

ERIC Educational Resources Information Center

Bonczek, James L.; Snyder, Lori Unruh; Ellis, Larry R.

2007-01-01

We describe our pedagogical approaches and experiences with an academic club service learning project (one semester, 20 club participants, including both graduate students and lower and upper-level undergraduates). Our service learning project responds to the recent demand for more community service-based club projects within the College of…

22 CFR 11.11 - Mid-level Foreign Service officer career candidate appointments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... particular post. No person shall be eligible for appointment as a Foreign Service officer unless that person... studies, particularly those related to Foreign Service work, may be substituted for part of the required... given in other American cities, or at Foreign Service posts, selected by the Board. (iii) Examining...

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Individuals needing NF services. If the State mental health or mental retardation authority determines that a... individual. (b) Individuals needing NF services and specialized services. If the State mental health or... 42 Public Health 5 2011-10-01 2011-10-01 false Residents and applicants determined to require NF...

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Individuals needing NF services. If the State mental health or mental retardation authority determines that a... individual. (b) Individuals needing NF services and specialized services. If the State mental health or... 42 Public Health 5 2010-10-01 2010-10-01 false Residents and applicants determined to require NF...

A decade of progress providing safe abortion services in Ethiopia: results of national assessments in 2008 and 2014.

PubMed

Dibaba, Yohannes; Dijkerman, Sally; Fetters, Tamara; Moore, Ann; Gebreselassie, Hailemichael; Gebrehiwot, Yirgu; Benson, Janie

2017-03-04

Ethiopia has one of the highest maternal mortality ratios in the world (420 per 100,000 live births in 2013), and unsafe abortion continues to be one of the major causes. To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia. This paper draws on results from nationally representative health facility studies conducted in Ethiopia in 2008 and 2014. The data come from three sources at two points in time: 1) interviews with 335 health providers in 2008 and 822 health care providers in 2014, 2) review of facility logbooks, and 3) prospective data on 3092 women in 2008 and 5604 women in 2014 seeking treatment for abortion complications or induced abortion over a one month period. The Safe Abortion Care Model was used as a framework of analysis. There has been a rapid expansion of health facilities eligible to provide legal abortion services in Ethiopia since 2008. Between 2008 and 2014, the number of facilities reporting basic and comprehensive signal functions for abortion care increased. In 2014, access to basic abortion care services exceeded the recommended level of available facilities providing the service, increasing from 25 to 117%, with more than half of regions meeting the recommended level. Comprehensive abortion services increased from 20% of the recommended level in 2008 to 38% in 2014. Smaller regions and city administrations achieved or exceeded the recommended level of comprehensive service facilities, yet larger regions fall short. Between 2008 and 2014, the use of appropriate technology for conducting first and second trimester abortion and the provision of post abortion family planning has increased at the same time that abortion-related obstetric complications have decreased. Ten years after the change in abortion law, service availability and quality has increased, but access to lifesaving comprehensive care still falls short of recommended levels.

Ethical sensitivity, burnout, and job satisfaction in emergency nurses.

PubMed

Palazoğlu, Cansu Atmaca; Koç, Zeliha

2017-01-01

Rising levels of burnout and decreasing job satisfaction can inhibit healthcare professionals from providing high-quality care due to a corresponding decrease in their ethical sensitivity. This study aimed to determine the relationship between the level of ethical sensitivity in emergency service nurses and their levels of burnout and job satisfaction. This research employed a descriptive and cross-sectional design. Participants and research context: This study was conducted with a sample of 236 nurses, all of whom worked in emergency service between 24 July 2015 and 28 April 2016. Data were collected using the Moral Sensitivity Questionnaire, Maslach Burnout Inventory, and Minnesota Job Satisfaction Scale. Ethical considerations: This study was approved by the Institutional Ethics Review Board of Ondokuz Mayıs University. There was a weak and negative correlation (r = -0.158, p = 0.015) between Moral Sensitivity Questionnaire and Maslach Burnout Inventory scores. There was also a weak and negative correlation (r = -0.335, p < 0.001) between the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale scores. Decreased job satisfaction and increased burnout levels among emergency service nurses might result in them indulging in improper practices, frequently facing ethical problems, and a decrease in the overall quality of service in hospitals. In order for emergency service nurses to recognize ethical problems and make the most accurate decisions, a high level of ethical sensitivity is critical. In this respect, it is suggested that continuing education after graduation and training programs should be organized.

Future-proofing the pharmacy profession in a hypercompetitive market.

PubMed

Singleton, Judith A; Nissen, Lisa M

2014-01-01

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

Can Family Planning Service Statistics Be Used to Track Population-Level Outcomes?

PubMed

Magnani, Robert J; Ross, John; Williamson, Jessica; Weinberger, Michelle

2018-03-21

The need for annual family planning program tracking data under the Family Planning 2020 (FP2020) initiative has contributed to renewed interest in family planning service statistics as a potential data source for annual estimates of the modern contraceptive prevalence rate (mCPR). We sought to assess (1) how well a set of commonly recorded data elements in routine service statistics systems could, with some fairly simple adjustments, track key population-level outcome indicators, and (2) whether some data elements performed better than others. We used data from 22 countries in Africa and Asia to analyze 3 data elements collected from service statistics: (1) number of contraceptive commodities distributed to clients, (2) number of family planning service visits, and (3) number of current contraceptive users. Data quality was assessed via analysis of mean square errors, using the United Nations Population Division World Contraceptive Use annual mCPR estimates as the "gold standard." We also examined the magnitude of several components of measurement error: (1) variance, (2) level bias, and (3) slope (or trend) bias. Our results indicate modest levels of tracking error for data on commodities to clients (7%) and service visits (10%), and somewhat higher error rates for data on current users (19%). Variance and slope bias were relatively small for all data elements. Level bias was by far the largest contributor to tracking error. Paired comparisons of data elements in countries that collected at least 2 of the 3 data elements indicated a modest advantage of data on commodities to clients. None of the data elements considered was sufficiently accurate to be used to produce reliable stand-alone annual estimates of mCPR. However, the relatively low levels of variance and slope bias indicate that trends calculated from these 3 data elements can be productively used in conjunction with the Family Planning Estimation Tool (FPET) currently used to produce annual mCPR tracking estimates for FP2020. © Magnani et al.

The effect of poverty and caregiver education on perceived need and access to health services among children with special health care needs.

PubMed

Porterfield, Shirley L; McBride, Timothy D

2007-02-01

We examined the association between several variables and the use of specialist physician services, developmental therapies, and prescription medications among children with special health care needs (N=38866). We used a bivariate probit model to estimate whether a given child needed specialized services and whether that child accessed those services; we controlled for activity limitations and severity of special needs. Variables included family income, mother's (or other caregiver's) educational level, health insurance coverage, and perceived need for specialized services. We used data from the 2001 National Survey of Children with Special Health Care Needs. Lower-income and less-educated parents were less likely than higher-income and more-educated parents to say their special needs children needed specialized health services. The probability of accessing specialized health services-when needed-increased with both higher family income and insurance coverage. Children with special health care needs have less access to health services because their parents do not recognize the need for those services. An intervention in the form of information at the family level may be an appropriate policy response.

Security Broker—A Complementary Tool for SOA Security

NASA Astrophysics Data System (ADS)

Kamatchi, R.; Rakshit, Atanu

2011-09-01

The Service Oriented Architecture along with web services is providing a new dimension to the world of reusability and resource sharing. The services developed by a creator can be used by any service consumers from anywhere despite of their platforms used. This open nature of the SOA architecture is also raising the issues of security at various levels of usage. This is paper is discussing on the implementation benefits of a service broker with the Service Oriented Architecture.

[Peculiarities of adaptation of servicemen service].

PubMed

Shelepov, A M; Smagulov, N K; Mukhametzhanov, A M

2012-09-01

Review of issues about the adaptation of servicemen in the process of military service is presented. Characteristics of military service, conditions and levels of official-military activity, peculiarities of adaptation, factors providing progression of psychosomatic diseases and dysaptation, concept "occupational health" are considered.

Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria.

PubMed

Adedokun, Sulaimon T; Adekanmbi, Victor T; Uthman, Olalekan A; Lilford, Richard J

2017-01-01

To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria. The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1), nested within 896 communities (level 2) from 37 states (level 3). About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%). While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31-2.03), from rich households (aOR = 1.76; 95% CrI = 1.35-2.25), with access to media (radio, television or magazine) (aOR = 1.18; 95% CrI = 1.08-1.29), and engaging in employment (aOR = 1.18; 95% CrI = 1.02-1.37) were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75-0.99) were less likely to have used health service for their children. Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care centres.

The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons.

PubMed

Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

2007-03-01

The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.

The Allegheny Initiative for Mental Health Integration for the Homeless: Integrating Heterogeneous Health Services for Homeless Persons

PubMed Central

Gordon, Adam J.; Montlack, Melissa L.; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

2007-01-01

The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment. PMID:17267708

42 CFR 82.19 - How will NIOSH address uncertainty about dose levels?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will NIOSH address uncertainty about dose levels? 82.19 Section 82.19 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES METHODS FOR CONDUCTING DOSE RECONSTRUCTION UNDER...

LEO cooperative multi-spacecraft refueling mission optimization considering J2 perturbation and target's surplus propellant constraint

NASA Astrophysics Data System (ADS)

Zhao, Zhao; Zhang, Jin; Li, Hai-yang; Zhou, Jian-yong

2017-01-01

The optimization of an LEO cooperative multi-spacecraft refueling mission considering the J2 perturbation and target's surplus propellant constraint is studied in the paper. First, a mission scenario is introduced. One service spacecraft and several target spacecraft run on an LEO near-circular orbit, the service spacecraft rendezvouses with some service positions one by one, and target spacecraft transfer to corresponding service positions respectively. Each target spacecraft returns to its original position after obtaining required propellant and the service spacecraft returns to its original position after refueling all target spacecraft. Next, an optimization model of this mission is built. The service sequence, orbital transfer time, and service position are used as deign variables, whereas the propellant cost is used as the design objective. The J2 perturbation, time constraint and the target spacecraft's surplus propellant capability constraint are taken into account. Then, a hybrid two-level optimization approach is presented to solve the formulated mixed integer nonlinear programming (MINLP) problem. A hybrid-encoding genetic algorithm is adopted to seek the near optimal solution in the up-level optimization, while a linear relative dynamic equation considering the J2 perturbation is used to obtain the impulses of orbital transfer in the low-level optimization. Finally, the effectiveness of the proposed model and method is validated by numerical examples.

The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

PubMed

Signorelli, C; Riccò, M; Odone, A

2016-01-01

The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

78 FR 32067 - User Fees for 2013 Crop Cotton Classification Services to Growers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... Fees for 2013 Crop Cotton Classification Services to Growers AGENCY: Agricultural Marketing Service... cotton producers for 2013 crop cotton classification services at $2.20 per bale--the same level as in 2012. Revenues resulting from this cotton classing fee and existing reserves are sufficient to cover...

Effect of Disease Improvement with Self-Measurement Compliance (Measurement Frequency Level) in SmartCare Hypertension Management Service.

PubMed

Lee, Chang-Hee; Chang, Byeong-Yun

2016-03-01

This study's purpose was to analyze the effect of the SmartCare pilot project, which was conducted in 2011 in South Korea. Recent studies of telehealth mostly compare the intervention group and the control group. Therefore, it is necessary to analyze the disease improvement effect depending on the self-measurement compliance (measurement frequency level) of patients who are receiving the hypertension management services. In the SmartCare center, health managers (nurses, nutritionists, and exercise prescribers) monitored the measurement data transmitted by participants through the SmartCare system. The health managers provided the prevention, consultation, and education services remotely to patients. Of the 231 participants who were enrolled in the study, the final analysis involved 213 individuals who completed their blood pressure measurements and SmartCare services until the end of a 6-month service period. The evaluated measurement group was classified into three groups (Low, Middle, and High) by evenly dividing the monthly average frequency of measurement for 6 months. The evaluation indices were systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and body mass index (BMI); this information was transmitted through the SmartCare system. For changes in the evaluation indices after 6 months compared with the initial baseline, in the Low Group, SBP and DBP slightly decreased, and weight and BMI slightly increased (difference not statistically significant). In the Middle Group, SBP and DBP decreased slightly (difference not statistically significant); however, both weight and BMI decreased (difference statistically significant). In the High Group, SBP, DBP, weight, and BMI decreased (difference statistically significant). Patients who received the SmartCare services with higher measurement frequency levels at home showed greater effectiveness regarding the provided services compared with those patients with lower levels of BP, weight, and BMI control.

SPDF Data and Orbit Services Supporting Open Access, Use and Archiving of MMS Data

NASA Astrophysics Data System (ADS)

McGuire, R. E.; Bilitza, D.; Candey, R. M.; Chimiak, R.; Cooper, J. F.; Garcia, L. N.; Harris, B. T.; Johnson, R. C.; Kovalick, T. J.; Lal, N.; Leckner, H. A.; Liu, M. H.; Papitashvili, N. E.; Roberts, D. A.; Yurow, R. E.

2015-12-01

NASA's Space Physics Data Facility (SPDF) project is now serving MMS definitive and predictive interactive orbit plots, listings and conjunction calculations through our SSCWeb and 4D Orbit Viewer services. In March 2016 and in parallel with the MMS Science Data Center (SDC) at LASP, SPDF will begin publicly serving a complete set of MMS Level-2 and higher, survey and burst-mode science data products from all four spacecraft and all instruments. The initial Level-2 data available will be from September 2015 to early February 2016, with Level-2 products subsequently validated and publicly available with an approximate one month lag. All MMS Level-2 and higher data products are produced in standard CDF format with standard ISTP/SPDF metadata and will be served by SPDF through our CDAWeb data service, including our web services and associated APIs for IDL and Matlab users, and through direct FTP/HTTP directory browse and file downloads. SPDF's ingest, archival preservation and active serving of current MMS science data is part of our role as an active heliophysics final archive. SPDF's ingest of complete and current science data products from other active heliophysics missions with SPDF services will help enable coordinated and correlative MMS science analysis by the open international science community with current data from THEMIS, the Van Allen Probes and other missions including TWINS, Cluster, ACE, Wind, >120 ground magnetometer stations as well as instruments on the NOAA GOES and POES spacecraft. Please see the related Candey et.al. paper on "SPDF Ancillary Services and Technologies Supporting Open Access, Use and Archiving of MMS Data" for other aspects of what SPDF is doing. All SPDF data and services are available from the SPDF home page at http://spdf.gsfc.nasa.gov .

Speech-Language Pathologists' Comfort Levels in English Language Learner Service Delivery

ERIC Educational Resources Information Center

Kimble, Carlotta

2013-01-01

This study examined speech-language pathologists' (SLPs) comfort levels in providing service delivery to English language learners (ELLs) and limited English proficient (LEP) students. Participants included 192 SLPs from the United States and Guam. Participants completed a brief, six-item questionnaire that investigated their perceptions regarding…

5 CFR 330.604 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: (1) A current career or career conditional competitive service employee in tenure group 1 or 2, at grade levels GS-15 or equivalent and below, who has received a specific reduction in force (RIF... service, serving on an appointment without time limit, at grade levels GS-15 or equivalent and below, who...

5 CFR 330.703 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... career or career-conditional competitive service employee, in tenure group 1 or 2, at grades GS-15 level... employee means: (1) A current career or career-conditional competitive service employee, in tenure group 1 or 2, at grade levels GS-15 or equivalent and below, who has received a specific RIF separation...

78 FR 55244 - Senior Executive Service Performance Review Board; Membership

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Senior Executive Service Performance Review Board... the membership of the Defense Nuclear Facilities Safety Board (DNFSB) Senior Executive Service (SES... rating of a senior executive's performance, the executive's response, and the higher level official's...

45 CFR 1302.10 - Selection among applicants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... comprehensive child development services at the community level, including the administrative and fiscal....10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1302.10 - Selection among applicants.

Code of Federal Regulations, 2012 CFR

2012-10-01

... comprehensive child development services at the community level, including the administrative and fiscal....10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1302.10 - Selection among applicants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... comprehensive child development services at the community level, including the administrative and fiscal....10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

45 CFR 1302.10 - Selection among applicants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... comprehensive child development services at the community level, including the administrative and fiscal....10 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

Use of general medical services among Medicaid patients with severe and persistent mental illness.

PubMed

Salsberry, Pamela J; Chipps, Esther; Kennedy, Carol

2005-04-01

The aim of this study was to examine patterns of use of general medical services among persons with a severe and persistent mental illness enrolled in Medicaid from 1996 to 1998. A total of 669 persons with a severe and persistent mental illness were identified by using statewide clinical criteria. A three-year database of Medicaid claims was developed to examine service use. The main outcome measures were use of outpatient services for a general medical problem, use of dental and vision services, and use of screening tests for women. Service use was examined by primary psychiatric diagnosis (schizophrenic, affective, paranoid, and anxiety disorders), and analyses controlled for the presence of a chronic medical condition, age, race, and sex. This study found high levels of service use for outpatient services but very low levels for primary and preventive services. Although 78 percent of persons with a schizophrenic disorder had an office-based visit during the three-year period, all persons with an anxiety disorder had such a visit. Sixty-nine percent of persons with a schizophrenic disorder had at least one emergency department visit, whereas 83 percent of those with an anxiety disorder had such a visit. Dental and vision visits and the use of mammograms and pap tests followed the same pattern; persons with a schizophrenic disorder had fewer visits and had less overall use than the other diagnostic groups. The use patterns across the four groups were significantly different in outpatient service use, dental and vision service use, and screening tests for women. Compared with persons with a schizophrenic disorder, those with an anxiety disorder were more likely to have had an office-based visit and to have received vision services, those with a paranoid disorder were more likely to have used dental services or received a mammogram, and those with an affective disorder were more likely to have had a pap test. Although this group of Medicaid patients with severe and persistent mental illness had access to providers, they received an unacceptably low level of preventive care. Use of health services for general medical problems differed somewhat by primary psychiatric illness.

A Study of Teachers' Perceptions of School-Level Factors Affecting Transition Services

ERIC Educational Resources Information Center

Lazaroff, Kurt Charles

2013-01-01

The purpose of this study was to explore teacher perceptions of providing transition services to high school students with special needs and to understand the variables that act as facilitators or barriers to providing those services. A qualitative research method was used to understand the perceptions of school personnel of transition services in…

The Opinions of Administrators about In-Service Training Related to the Administration and Investigation

ERIC Educational Resources Information Center

Demirel, Ihsan Nuri

2018-01-01

The purpose of this study is to determine the opinions of administrators of National Education Directiorate, School Directors and Vice-school Directors about the in-service activities and the system of in-service training programs related to work security. Moreover, it is investigated the level of the knowledge whether in-service training ignores…

Understanding Whole Systems Change in Health Care: Insights into System Level Diffusion from Nursing Service Delivery Innovations--A Multiple Case Study

ERIC Educational Resources Information Center

Berta, Whitney; Virani, Tazim; Bajnok, Irmajean; Edwards, Nancy; Rowan, Margo

2014-01-01

Our study responds to calls for theory-driven approaches to studying innovation diffusion processes in health care. While most research on diffusion in health care is situated at the service delivery level, we study innovations and associated processes that have diffused to the system level, and refer to work on complex adaptive systems and whole…

Few Americans Receive All High-Priority, Appropriate Clinical Preventive Services.

PubMed

Borsky, Amanda; Zhan, Chunliu; Miller, Therese; Ngo-Metzger, Quyen; Bierman, Arlene S; Meyers, David

2018-06-01

As of 2015, only 8 percent of US adults ages thirty-five and older had received all of the high-priority, appropriate clinical preventive services recommended for them. Nearly 5 percent of adults did not receive any such services. Further delivery system-level efforts are needed to increase the use of preventive services.

Quality Assessment of University Studies as a Service: Dimensions and Criteria

ERIC Educational Resources Information Center

Pukelyte, Rasa

2010-01-01

This article reviews a possibility to assess university studies as a service. University studies have to be of high quality both in their content and in the administrative level. Therefore, quality of studies as a service is an important constituent part of study quality assurance. When assessing quality of university studies as a service, it is…

Public funding of health at the district level in Indonesia after decentralization – sources, flows and contradictions

PubMed Central

Heywood, Peter; Harahap, Nida P

2009-01-01

Background During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. Methods We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. Results The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. Conclusion In contrast to the promise of decentralization there has been little increase in the potential for discretion at the district level in managing public funds for health – this is likely to be an important reason for the lack of improvement in publicly funded health services. Key decisions about money are still made by the central government, and no one is held accountable for the performance of the sector – the district blames the center and the central ministries (and their ministers) are not accountable to district populations. PMID:19371410

Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

PubMed

Heywood, Peter; Harahap, Nida P

2009-04-16

During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been little increase in the potential for discretion at the district level in managing public funds for health - this is likely to be an important reason for the lack of improvement in publicly funded health services. Key decisions about money are still made by the central government, and no one is held accountable for the performance of the sector - the district blames the center and the central ministries (and their ministers) are not accountable to district populations.

Attitudes of Social Service Providers towards the Sexuality of Individuals with Intellectual Disability

ERIC Educational Resources Information Center

Bazzo, Giuseppe; Nota, Laura; Soresi, Salvatore; Ferrari, Lea; Minnes, Patricia

2007-01-01

Background: The sexual lives of people with intellectual disability is made complex by the involvement and influence of social service providers, whose beliefs and values have a great impact on the support they provide. We hypothesized that social service providers' role, educational level and service in which they worked could affect attitudes…

A pharmacy asthma service achieves a change in patient responses from increased awareness to taking responsibility for their asthma.

PubMed

Naik-Panvelkar, Pradnya; Saini, Bandana; LeMay, Kate S; Emmerton, Lynne M; Stewart, Kay; Burton, Deborah L; Bosnic-Anticevich, Sinthia Z; Krass, Ines; Smith, Lorraine D; Armour, Carol L

2015-06-01

If novel health services are to be implemented and sustained in practice, the perceptions and views of patients form a critical part of their evaluation. The aims of this study were to explore patient's perceptions and experiences with a pharmacy asthma service and to investigate if there was a change over time. Interviews and focus groups were conducted with patients participating in the asthma service at three time points. Data were transcribed verbatim and thematically analyzed using a framework approach. The service led to an enhanced awareness and understanding of asthma, changes in participants' beliefs and attitudes towards asthma management, changes in asthma-related health behaviours and improved self-efficacy. Participants were very positive about the service and the role of the pharmacist in asthma management. There was a shift in participant perceptions and views, from being at an abstract level in those who had completed just one visit of the service to a more experiential level in those who had experienced the entire comprehensive asthma service. A sustained experience/multiple visits in a service may lead to more concrete changes in patient perceptions of severity, beliefs, health behaviours and enhanced self-efficacy and control. The study highlights a need for such asthma services in the community. © 2014 Royal Pharmaceutical Society.

Taking stock: payments for forest ecosystem services in the United States

Treesearch

D Evan Mercer; David Cooley; Katherine Hamilton

2011-01-01

Forests provide a variety of critical services to human societies, including carbon sequestration, water purification, and habitat for millions of species. Because landowners have traditionally not been paid for the services their land provides to society, financial incentives are usually too low to sustain production of services at optimal levels. To remedy this, a...

Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

PubMed

Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

2011-02-01

To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

U.S. Level III and IV Ecoregions (U.S. EPA)

EPA Pesticide Factsheets

This map service displays Level III and Level IV Ecoregions of the United States and was created from ecoregion data obtained from the U.S. Environmental Protection Agency Office of Research and Development's Western Ecology Division. The original ecoregion data was projected from Albers to Web Mercator for this map service. To download shapefiles of ecoregion data (in Albers), please go to: ftp://newftp.epa.gov/EPADataCommons/ORD/Ecoregions/. IMPORTANT NOTE ABOUT LEVEL IV POLYGON LEGEND DISPLAY IN ARCMAP: Due to the limitations of Graphical Device Interface (GDI) resources per application on Windows, ArcMap does not display the legend in the Table of Contents for the ArcGIS Server service layer if the legend has more than 100 items. As of December 2011, there are 968 unique legend items in the Level IV Ecoregion Polygon legend. Follow this link (http://support.esri.com/en/knowledgebase/techarticles/detail/33741) for instructions about how to increase the maximum number of ArcGIS Server service layer legend items allowed for display in ArcMap. Note the instructions at this link provide a slightly incorrect path to Maximum Legend Count. The correct path is HKEY_CURRENT_USER > Software > ESRI > ArcMap > Server > MapServerLayer > Maximum Legend Count. When editing the Maximum Legend Count, update the field, Value data to 1000. To download a PDF version of the Level IV ecoregion map and legend, go to ftp://newftp.epa.gov/EPADataCommons/ORD/Ecoregions/us/Eco_Level_IV

National Water Quality Laboratory, 1995 services catalog

USGS Publications Warehouse

Timme, P.J.

1995-01-01

This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey. To assist personnel in the selection of analytical services, this catalog lists sample volume, required containers, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples.

Protective Services for Abused and Neglected Children and Their Families. A Guide for State and Local Department of Public Social Services on the Delivery of Protective Services.

ERIC Educational Resources Information Center

Community Research Applications, Inc., New York, NY.

Provided is a guide to assist state and local agencies in improving the administration and management of services to abused and neglected children and their families. Protective services at the state level are covered in the first section, including such topics as organization; initiating and reacting to proposed state legislation; developing…

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.

A grounded theory of bisexual individuals' experiences of help seeking.

PubMed

MacKay, Jenna; Robinson, Margaret; Pinder, Sarah; Ross, Lori E

2017-01-01

Bisexual people constitute the largest sexual minority group in North America and experience significant mental health disparities in relation to heterosexuals, gays, and lesbians. In this article, we will examine the process and experience of help seeking among bisexuals. This was a community-based study that collected qualitative interview data from 41 diverse bisexual people from across Ontario, Canada. We analyzed the interview data using grounded theory and constructed an understanding of bisexuals' experiences of help seeking. We have conceptualized an overarching model that illustrates 4 interrelated stages: (a) the consideration of services, (b) the process of finding services, (c) barriers and facilitators to accessing services, and (d) experience of service utilization. This model is nonlinear, in that participants do not necessarily move through stages in sequence. Although many stages are experienced at the individual level, they are simultaneously informed by multiple factors at interpersonal and system levels. Our findings suggest a need for interventions at the policy, service and provider levels to improve accessibility of culturally competent services for this population. Understanding the mental health experiences of bisexual people will allow mental health professionals to build competencies working with this population and thereby contribute to a reduction in mental health disparities. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Training in youth-friendly service provision improves nurses' competency level in the Great Lakes Region.

PubMed

Weiss, Carine; Elouard, Yajna; Gerold, Jana; Merten, Sonja

2018-05-05

This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills. In South-Kivu, Burundi, and Rwanda, 135, 131, and 99 nurses were interviewed, respectively. Overall differences of service and guideline availability and self-rated competencies can be observed between the three countries. In two countries, more than one in five nurses considered themselves to be only somewhat or not confident to counsel young people. Nurses from Rwanda showed the highest level of competencies followed by Burundi and South-Kivu. Lack of training in youth-friendly health services or family planning showed significant associations with reporting feeling somehow or not competent. The lack of training, supervision, and guidelines expressed by the nurses is of great concern. Competency-based training in youth-friendly health services is an important approach in improving nurses' competency level.

76 FR 57980 - Senior Executive Service Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Senior Executive Service Performance Review Board AGENCY... the Defense Nuclear Facilities Safety Board (DNFSB) Senior Executive Service (SES) Performance Review... summary rating of the senior executive's performance, the executive's response, and the higher level...

The role of the medical departmental library.

PubMed Central

Moran, B

1996-01-01

At most academic medical institutions, the first level of library service is provided by health sciences or medical school libraries. For many medical departments, however, these services are also provided by a second-level library, the departmental library. These libraries are usually supported by a specific department, such as surgery, and provide customized services to this sponsor. Departmental libraries continue to play an important role amid the debate over centralized, versus decentralized, library systems. On the basis of a limited survey, this paper describes a representative medical departmental library. PMID:8938327

42 CFR 410.71 - Clinical psychologist services and services and supplies incident to clinical psychologist services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... individual who— (1) Holds a doctoral degree in psychology; and (2) Is licensed or certified, on the basis of the doctoral degree in psychology, by the State in which he or she practices, at the independent practice level of psychology to furnish diagnostic, assessment, preventive, and therapeutic services...

Guidelines for Creating Student Services Online

ERIC Educational Resources Information Center

WCET, 2002

2002-01-01

Most campuses, recognizing the important role that student services play in learner success and retention, have a full range of student services in place to support their on-campus learners. Yet, many have failed to provide the same level of service to their off-campus learners who cannot come to campus. All students deserve access to a full array…