The Politics of Pipes: The Persistence of Small Water Networks in Post-Privatization Manila

NASA Astrophysics Data System (ADS)

Cheng, Deborah

This project examines the politics of water provision in low-income areas of large, developing cities. In the last two decades, water privatization has become a global paradigm, emerging as a potential means for addressing the urban water crisis. In Manila, the site of the world's largest water privatization project, service to low-income areas has improved significantly in the post-privatization era. But whereas expansion of a water utility typically involves the replacement of informal providers, the experience in Manila demonstrates that the rapid connection of low-income areas actually hinges, in part, on the selective inclusion and exclusion of these smaller actors. Based on an ethnography of the private utilities and community-based providers, I use the persistence of small water networks as a lens for exploring the limits of water privatization in Manila. I focus on what I call micro-networks---community-built infrastructure that extends the formal, private utilities into low-income neighborhoods that the utilities do not wish to serve directly. In such a setup, the utility provides water only as far as the community boundary; beyond that, the micro-network operator constructs internal infrastructure, monitors for leakage and theft, and collects bills. But while these communities may gain access to safer water, they are also subject to higher costs and heightened disciplinary measures. By tracing the ways in which the utilities selectively use micro-networks to manage sub-populations, I show how the utilities make low-income spaces more governable. Delegating localized water management to micro-network operators depoliticizes the utilities' roles, shifting the sociopolitical difficulties of water provision to community organizations, while allowing the utilities to claim that these areas are served. This research leads to three related arguments. First, the persistence of small water networks highlights lingering inequities in access to water, for micro-network consumers are subject to disparities in cost, materials, and personal freedoms. Though Manila's water privatization project has resulted in significant improvements to the centralized system, its success must be tempered by the inequalities that remain. Second, the two utilities are largely able to shape both the geographies of water access and the production of knowledge. For this reason, the utilities typically use micro-networks where cost recovery may be difficult---such as in areas with uncertain land tenure or where higher levels of nonpayment are perceived---while including these areas in their aggregate coverage statistics. Third, the presence of multiple providers of water and other basic services blurs the boundaries between public, private, and community. But that blurriness serves to consolidate the private utilities' power, while increasing the opacity by which citizens navigate processes related to urban water provision. The persistence of micro-networks thus allows us to understand the ways in which low-income spaces are made more governable. By focusing on this peri-urban frontier, this project asserts that differentiation and discipline serve simultaneously as tools of governance and as points of contestation. What emerges is a waterscape consisting not of one type of privatization---where service and access are uniformly provided---but multiple, coexisting, and differentiated privatizations.

The development of a framework for high-quality, sustainable and accessible rural private therapy under the Australian National Disability Insurance Scheme.

PubMed

Dew, Angela; Barton, Rebecca; Ragen, Jo; Bulkeley, Kim; Iljadica, Alexandra; Chedid, Rebecca; Brentnall, Jennie; Bundy, Anita; Lincoln, Michelle; Gallego, Gisselle; Veitch, Craig

2016-12-01

The Australian National Disability Insurance Scheme (NDIS) will provide people with individual funding with which to purchase services such as therapy from private providers. This study developed a framework to support rural private therapists to meet the anticipated increase in demand. The study consisted of three stages utilizing focus groups, interviews and an online expert panel. Participants included private therapists delivering services in rural New South Wales (n = 28), disability service users (n = 9) and key representatives from a range of relevant consumer and service organizations (n = 16). We conducted a thematic analysis of focus groups and interview data and developed a draft framework which was subsequently refined based on feedback from stakeholders. The framework highlights the need for a 'rural-proofed' policy context in which service users, therapists and communities engage collaboratively in a therapy pathway. This collaborative engagement is supported by enablers, including networks, resources and processes which are influenced by the drivers of time, cost, opportunity and motivation. The framework identifies factors that will facilitate delivery of high-quality, sustainable, individualized private therapy services for people with a disability in rural Australia under the NDIS and emphasizes the need to reconceptualize the nature of private therapy service delivery. Implications for Rehabilitation Rural private therapists need upskilling to work with individuals with disability who have individual funding such as that provided by the Australian National Disability Insurance Scheme. Therapists working in rural communities need to consider alternative ways of delivering therapy to individuals with disability beyond the traditional one-on-one therapy models. Rural private therapists need support to work collaboratively with individuals with disability and the local community. Rural private therapists should harness locally available and broader networks, resources and processes to meet the needs and goals of individuals with disability.

A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

PubMed

McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

2015-06-01

Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

Virtual private networks can provide reliable IT connections.

PubMed

Kabachinski, Jeff

2006-01-01

A VPN is a private network that uses a public network, such as the Internet, to connect remote sites and users together. Instead of using a dedicated hard-wired connection as in a trusted connection or leased lines, a VPN uses a virtual connection routed through the Internet from the organization's private network to the remote site or employee. Typical VPN services allow for security in terms of data encryption as well as means to authenticate, authorize, and account for all the traffic. VPN services allow the organization to use whatever network operating system they wish as it also encapsulate your data into the protocols needed to transport data across public lines. The intention of this IT World article was to give the reader an introduction to VPNs. Keep in mind that there are no standard models for a VPN. You're likely to come across many vendors presenting the virtues of their VPN applications and devices when you Google "VPN." However the general uses, concepts, and principles outlined here should give you a fighting chance to read through the marketing language in the online ads and "white papers."

[The contracting process and outsourcing in health: the scenario for dispute between public and private interests].

PubMed

Albuquerque, Maria do Socorro Veloso; Morais, Heloísa Maria Mendonça de; Lima, Luci Praciano

2015-06-01

This research analyzed the public-private composition in the municipal health network and aspects of the contracting/outsourcing process for services over the period from 2001 to 2008. The research method used was a case study with documentary research and interviews. The interviewees were former secretaries of health, directors of regulation and district managers. The categories of analysis used were public funds, care networks and public control. The results showed that the contracting was restricted to philanthropic units. With respect to the other private establishments linked to the public care network, non-compliance with programmatic aspects was detected, such as the lack of regulation of bidding processes required for contracting. Management authorities did not actively pursue building up state public services, or the formation of care networks. The contracted establishments conducted their activities without effective external and internal control mechanisms, which are paramount for the proper use of public resources. The authors conclude that the contracting process does not significantly alter the standard of buying and selling of services and indeed does not enhance the empowering process of the role of the public domain.

TD-LTE Wireless Private Network QoS Transmission Protection

NASA Astrophysics Data System (ADS)

Zhang, Jianming; Cheng, Chao; Wu, Zanhong

With the commencement of construction of the smart grid, the demand power business for reliability and security continues to improve, the reliability transmission of power TD-LTE Wireless Private Network are more and more attention. For TD-LTE power private network, it can provide different QoS services according to the user's business type, to protect the reliable transmission of business. This article describes in detail the AF module of PCC in the EPC network, specifically introduces set up AF module station and QoS mechanisms in the EPS load, fully considers the business characteristics of the special power network, establishing a suitable architecture for mapping QoS parameters, ensuring the implementation of each QoS business. Through using radio bearer management, we can achieve the reliable transmission of each business on physical channel.

Information technology as tool for change.

PubMed

Itkonen, P

1999-12-01

It looks that networking welfare thinking and implementations of network projects only follow the development of data transfer possibilities. It is a danger that seamless chain of care in health care is just a data transferring generator based on easy connections, only creating needs for new data transferring. This is an 'illusion of core skills' that does not extend to the development of the contents of services. Easy access to the system makes more contacts and need for more also clinical services. New needs for data transfer burden the personnel with unnecessary information and networking functional model does not emancipate them to use their substantial skills. It means more costs and it is also a danger that normal life will be medicated. Public sector cannot finance all these new possibilities and consequences of modern technology. Does all this create a new combination of public and private sector and push them to allocate responsibilities in developing work? If the public and private sectors do not find the balance in controlling this development, also actors outside health care get to influence the choices and health care loses its autonomy. It becomes a business means for companies producing data transfer and network services. From the prioritization point of view this is not a good vision for financing and delivery of health care services either in public or private sector.

Research on private cloud computing based on analysis on typical opensource platform: a case study with Eucalyptus and Wavemaker

NASA Astrophysics Data System (ADS)

Yu, Xiaoyuan; Yuan, Jian; Chen, Shi

2013-03-01

Cloud computing is one of the most popular topics in the IT industry and is recently being adopted by many companies. It has four development models, as: public cloud, community cloud, hybrid cloud and private cloud. Except others, private cloud can be implemented in a private network, and delivers some benefits of cloud computing without pitfalls. This paper makes a comparison of typical open source platforms through which we can implement a private cloud. After this comparison, we choose Eucalyptus and Wavemaker to do a case study on the private cloud. We also do some performance estimation of cloud platform services and development of prototype software as cloud services.

Convergence

NASA Astrophysics Data System (ADS)

Darcie, Thomas E.; Doverspike, Robert; Zirngibl, Martin; Korotky, Steven K.

2005-09-01

Call for Papers: Convergence The Journal of Optical Networking (JON) invites submissions to a special issue on Convergence. Convergence has become a popular theme in telecommunications, one that has broad implications across all segments of the industry. Continual evolution of technology and applications continues to erase lines between traditionally separate lines of business, with dramatic consequences for vendors, service providers, and consumers. Spectacular advances in all layers of optical networking-leading to abundant, dynamic, cost-effective, and reliable wide-area and local-area connections-have been essential drivers of this evolution. As services and networks continue to evolve towards some notion of convergence, the continued role of optical networks must be explored. One vision of convergence renders all information in a common packet (especially IP) format. This vision is driven by the proliferation of data services. For example, time-division multiplexed (TDM) voice becomes VoIP. Analog cable-television signals become MPEG bits streamed to digital set-top boxes. T1 or OC-N private lines migrate to Ethernet virtual private networks (VPNs). All these packets coexist peacefully within a single packet-routing methodology built on an optical transport layer that combines the flexibility and cost of data networks with telecom-grade reliability. While this vision is appealing in its simplicity and shared widely, specifics of implementation raise many challenges and differences of opinion. For example, many seek to expand the role of Ethernet in these transport networks, while massive efforts are underway to make traditional TDM networks more data friendly within an evolved but backward-compatible SDH/SONET (synchronous digital hierarchy and synchronous optical network) multiplexing hierarchy. From this common underlying theme follow many specific instantiations. Examples include the convergence at the physical, logical, and operational levels of voice and data, video and data, private-line and virtual private-line, fixed and mobile, and local and long-haul services. These trends have many consequences for consumers, vendors, and carriers. Faced with large volumes of low-margin data traffic mixed with traditional voice services, the need for capital conservation and operational efficiency drives carriers away from today's separate overlay networks for each service and towards "converged" platforms. For example, cable operators require transport of multiple services over both hybrid fiber coax (HFC) and DWDM transport technologies. Local carriers seek an economical architecture to deliver integrated services on optically enabled broadband-access networks. Services over wireless-access networks must coexist with those from wired networks. In each case, convergence of networks and services inspires an important set of questions and challenges, driven by the need for low cost, operational efficiency, service performance requirements, and optical transport technology options. This Feature Issue explores the various interpretations and implications of network convergence pertinent to optical networking. How does convergence affect the evolution of optical transport-layer and control approaches? Are the implied directions consistent with research vision for optical networks? Substantial challenges remain. Papers are solicited across the broad spectrum of interests. These include, but are not limited to: Architecture, design and performance of optical wide-area-network (WAN), metro, and access networks Integration strategies for multiservice transport platforms Access methods that bridge traditional and emerging services Network signaling and control methodologies All-optical packet routing and switching techniques To submit to this special issue, follow the normal procedure for submission to JON, indicating "Convergence feature" in the "Comments" field of the online submission form. For all other questions relating to this feature issue, please send an e-mail to jon@osa.org, subject line "Convergence." Additional information can be found on the JON website: http://www.osa-jon.org/submission/ Submission Deadline: 1 October 2005

47 CFR 27.1310 - Network sharing agreement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network sharing agreement. 27.1310 Section 27... MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1310 Network sharing..., and related entities as the Commission may require or allow will be governed by the Network Sharing...

47 CFR 27.1310 - Network sharing agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network sharing agreement. 27.1310 Section 27... MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1310 Network sharing..., and related entities as the Commission may require or allow will be governed by the Network Sharing...

47 CFR 27.1310 - Network sharing agreement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Network sharing agreement. 27.1310 Section 27... MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1310 Network sharing..., and related entities as the Commission may require or allow will be governed by the Network Sharing...

Quantifying patron needs at intermodal facilities.

DOT National Transportation Integrated Search

2011-07-01

New Jersey has a varied network of commuter rail, light rail, bus, paratransit, county and private : shuttle services. These services meet a range of needs including commuter travel to major : employment centers, local bus service for various trip pu...

Convergence

NASA Astrophysics Data System (ADS)

Darcie, Thomas E.; Doverspike, Robert; Zirngibl, Martin; Korotky, Steven K.

2004-12-01

Convergence has become a popular theme in telecommunications, one that has broad implications across all segments of the industry. Continual evolution of technology and applications continues to erase lines between traditionally separate lines of business, with dramatic consequences for vendors, service providers, and consumers. Spectacular advances in all layers of optical networking-leading to abundant, dynamic, cost-effective, and reliable wide-area and local-area connections-have been essential drivers of this evolution. As services and networks continue to evolve towards some notion of convergence, the continued role of optical networks must be explored. One vision of convergence renders all information in a common packet (especially IP) format. This vision is driven by the proliferation of data services. For example, time-division multiplexed (TDM) voice becomes VoIP. Analog cable-television signals become MPEG bits streamed to digital set-top boxes. T1 or OC-N private lines migrate to Ethernet virtual private networks (VPNs). All these packets coexist peacefully within a single packet-routing methodology built on an optical transport layer that combines the flexibility and cost of data networks with telecom-grade reliability. While this vision is appealing in its simplicity and shared widely, specifics of implementation raise many challenges and differences of opinion. For example, many seek to expand the role of Ethernet in these transport networks, while massive efforts are underway to make traditional TDM networks more data friendly within an evolved but backward-compatible SDH/SONET (synchronous digital hierarchy and synchronous optical network) multiplexing hierarchy. From this common underlying theme follow many specific instantiations. Examples include the convergence at the physical, logical, and operational levels of voice and data, video and data, private-line and virtual private-line, fixed and mobile, and local and long-haul services. These trends have many consequences for consumers, vendors, and carriers. Faced with large volumes of low-margin data traffic mixed with traditional voice services, the need for capital conservation and operational efficiency drives carriers away from today's separate overlay networks for each service and towards "converged" platforms. For example, cable operators require transport of multiple services over both hybrid fiber coax (HFC) and DWDM transport technologies. Local carriers seek an economical architecture to deliver integrated services on optically enabled broadband-access networks. Services over wireless-access networks must coexist with those from wired networks. In each case, convergence of networks and services inspires an important set of questions and challenges, driven by the need for low cost, operational efficiency, service performance requirements, and optical transport technology options. This Feature Issue explores the various interpretations and implications of network convergence pertinent to optical networking. How does convergence affect the evolution of optical transport-layer and control approaches? Are the implied directions consistent with research vision for optical networks? Substantial challenges remain. Papers are solicited across the broad spectrum of interests. These include, but are not limited to:

• Architecture, design and performance of optical wide-area-network (WAN), metro, and access networks
• Integration strategies for multiservice transport platforms
• Access methods that bridge traditional and emerging services
• Network signaling and control methodologies
• All-optical packet routing and switching techniques

Manuscript Submission

47 CFR 32.5040 - Private line revenue.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS... communications between specific locations (e.g., point-to-point communications. It includes revenue from subvoice grade, voice grade, audio and video program grade, digital transmission and local private network...

Inequity in ecosystem service delivery: Socioeconomic gaps in the public-private conservation network

USGS Publications Warehouse

Villamagna, Amy M.; Mogollón, Beatriz; Angermeier, Paul L.

2017-01-01

Conservation areas, both public and private, are critical tools to protect biodiversity and deliver important ecosystem services (ES) to society. Although societal benefits from such ES are increasingly used to promote public support of conservation, the number of beneficiaries, their identity, and the magnitude of benefits are largely unknown for the vast majority of conservation areas in the United States public-private conservation network. The location of conservation areas in relation to people strongly influences the direction and magnitude of ES flows as well as the identity of beneficiaries. We analyzed benefit zones, the areas to which selected ES could be conveyed to beneficiaries, to assess who benefits from a typical conservation network. Better knowledge of ES flows and beneficiaries will help land conservationists make a stronger case for the broad collateral benefits of conservation and help to address issues of social-environmental justice. To evaluate who benefits the most from the current public-private conservation network, we delineated the benefit zones for local ES (within 16 km) that are conveyed along hydrological paths from public (federal and state) and private (easements) conservation lands in the states of North Carolina and Virginia, USA. We also discuss the challenges and demonstrate an approach for delineating nonhydrological benefits that are passively conveyed to beneficiaries. We mapped and compared the geographic distribution of benefit zones within and among conservation area types. We further compared beneficiary demographics across benefit zones of the conservation area types and found that hydrological benefit zones of federal protected areas encompass disproportionately fewer minority beneficiaries compared to statewide demographic patterns. In contrast, benefit zones of state protected areas and private easements encompassed a much greater proportion of minority beneficiaries (~22–25%). Benefit zones associated with private conservation lands included beneficiaries of significantly greater household income than benefit zones of other types of conservation areas. Our analysis of ES flows revealed significant socioeconomic gaps in how the current public-private conservation network benefits the public. These gaps warrant consideration in regional conservation plans and suggest that private conservation initiatives may be best suited for responding to the equity challenge. Enhancing the ecosystem benefits and the equity of benefit delivery from private conservation networks could build public and political support for long-term conservation strategies and ultimately enhance conservation efficacy.

Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International

PubMed Central

Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

2015-01-01

In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage. PMID:26085017

Evaluation of New Jersey After 3: Reaching and Engaging New Jersey's Youth through Afterschool Programs, 2005-2008

ERIC Educational Resources Information Center

Walking Eagle, Karen P.; Miller, Tiffany D.; Cooc, North; LaFleur, Jennifer; Reisner, Elizabeth R.

2009-01-01

New Jersey After 3 (NJ After 3) is a private, nonprofit organization whose mission is to expand and improve afterschool opportunities for New Jersey's youth. Using both public and private resources, it supports a network of youth-service providers that deliver afterschool services based on NJ After 3's program model. Under an agreement with NJ…

7 CFR 3430.603 - Eligibility.

Code of Federal Regulations, 2013 CFR

2013-01-01

... college or university (including a junior college offering an associate's degree) or foundation maintained by a college or university; (e) A private for-profit organization; or (f) Any other appropriate... network or partnership of public or private entities, including: (a) A State cooperative extension service...

7 CFR 3430.603 - Eligibility.

Code of Federal Regulations, 2012 CFR

2012-01-01

... college or university (including a junior college offering an associate's degree) or foundation maintained by a college or university; (e) A private for-profit organization; or (f) Any other appropriate... network or partnership of public or private entities, including: (a) A State cooperative extension service...

7 CFR 3430.603 - Eligibility.

Code of Federal Regulations, 2014 CFR

2014-01-01

... college or university (including a junior college offering an associate's degree) or foundation maintained by a college or university; (e) A private for-profit organization; or (f) Any other appropriate... network or partnership of public or private entities, including: (a) A State cooperative extension service...

7 CFR 3430.603 - Eligibility.

Code of Federal Regulations, 2011 CFR

2011-01-01

... college or university (including a junior college offering an associate's degree) or foundation maintained by a college or university; (e) A private for-profit organization; or (f) Any other appropriate... network or partnership of public or private entities, including: (a) A State cooperative extension service...

Using and joining a franchised private sector provider network in Myanmar.

PubMed

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor.

Using and Joining a Franchised Private Sector Provider Network in Myanmar

PubMed Central

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Background Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Methods and Findings Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor. PMID:22180781

Primary health care service delivery networks for the prevention and management of type 2 diabetes: using social network methods to describe interorganisational collaboration in a rural setting.

PubMed

McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

2011-01-01

Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.

Choosing the route to traveler information systems deployment : decision factors for creating public-private business plans : an action guide

DOT National Transportation Integrated Search

1998-01-01

This document presents a guide designed to help public private partnerships in their efforts to provide Advanced Traveler Information Systems (ATIS) services. It first examines why ATIS can be useful in managing transportation networks and increasing...

Smart Valley Infrastructure.

ERIC Educational Resources Information Center

Maule, R. William

1994-01-01

Discusses prototype information infrastructure projects in northern California's Silicon Valley. The strategies of the public and private telecommunications carriers vying for backbone services and industries developing end-user infrastructure technologies via office networks, set-top box networks, Internet multimedia, and "smart homes"…

[Datanet 1 and the convergence of the computer and telecommunications].

PubMed

de Wit, Onno

2008-01-01

This article describes the efforts of the Dutch national company for telecommunication, PTT, in introducing and developing a public network for data communication in the Netherlands in the last decades of the twentieth century. As early as the 1960s, private companies started to connect their local computers. As a result, small private computer networks started to emerge. As the state company offering general access to public services in telephony, the PTT strove to develop a public data network, accessible to every user and telephone subscriber. This ambition was realized with Datanet 1, the public data network which was officially opened in 1982. In the years that followed, Datanet became the dominant network for data transmission, despite competing efforts by private companies and computer manufacturers. The large-scale application of Datanet in public municipal administration serves as a case study for the development of data communication in practice, that shows that there was a gradual migration from X-25 to TCP/IP protocols. The article concludes by stating that the introduction and development of data transmission transformed the role of the PTT in Dutch society, brought new working practices, new services and new responsibilities, and resulted in a whole new phase in the history of the computer.

Convergence

NASA Astrophysics Data System (ADS)

Darcie, Thomas E.; Doverspike, Robert; Zirngibl, Martin; Korotky, Steven K.

2005-01-01

Call for Papers: Convergence

Guest Editors: Thomas E. Darcie, University of Victoria Robert Doverspike, AT&T Martin Zirngibl, Lucent Technologies

Coordinating Associate Editor: Steven K. Korotky, Lucent Technologies

• Architecture, design and performance of optical wide-area-network (WAN), metro, and access networks
• Integration strategies for multiservice transport platforms
• Access methods that bridge traditional and emerging services
• Network signaling and control methodologies
• All-optical packet routing and switching techniques

Manuscript Submission

Design and implementation considerations of a MSAT packet data network

NASA Technical Reports Server (NTRS)

Karam, Fouad G.; Hearn, Terry; Rohr, Doug; Guibord, Arthur F.

1993-01-01

The Mobile Data System, which is intended to provide for packet switched data services is currently under development. The system is based on a star network topology consisting of a centralized Data Hub (DH) serving a large number of mobile terminals. Through the Data Hub, end-to-end connections can be established between terrestrial users on public or private data networks and mobile users. The MDS network will be capable of offering a variety of services some of which are based on the standard X.25 network interface protocol, and others optimized for short messages and broadcast messages. A description of these services and the trade-offs in the DH design are presented.

Network integration modelling of feeder and BRT(bus rapid transit) to reduce the usage of private vehicles in Palembang’s suburban area

NASA Astrophysics Data System (ADS)

Nur'afalia, D.; Afifa, F.; Rubianto, L.; Handayeni, K. D. M. E.

2018-01-01

The aim of this research is to determine the optimal feeder network route that integrates with BRT (Bus Rapid Transit). Palembang, a high growing population city with unresolved transportation demand sector. BRT as main public transportation could not fulfill people’s demand in transportation, especially in Alang-Alang Lebar sub-district. As an impact, the usage of private vehicles increases along the movement toward the city center. The concept of Network Integration that integrates feeder network with BRT is expected to be a solution to suppress the rate of private vehicles’ usage and to improve public transportation service, so that the use of BRT will be increased in the suburban area of Palembang. The method used to identifying the optimal route using Route Analysis method is route analysis using Tranetsim 0.4. The best route is obtained based on 156 movement samples. The result is 58,7% from 199 mobility’s potency of private vehicle usage’s can be reduced if there is a feeder network’s route in Alang-Alang Lebar’s sub-district. From the result, the existance of integration between feeder network and BRT is potential enough to reduce the usage of private vehicles and supports the sustainability of transportation mobility in Palembang City.

First field trial of Virtual Network Operator oriented network on demand (NoD) service provisioning over software defined multi-vendor OTN networks

NASA Astrophysics Data System (ADS)

Li, Yajie; Zhao, Yongli; Zhang, Jie; Yu, Xiaosong; Chen, Haoran; Zhu, Ruijie; Zhou, Quanwei; Yu, Chenbei; Cui, Rui

2017-01-01

A Virtual Network Operator (VNO) is a provider and reseller of network services from other telecommunications suppliers. These network providers are categorized as virtual because they do not own the underlying telecommunication infrastructure. In terms of business operation, VNO can provide customers with personalized services by leasing network infrastructure from traditional network providers. The unique business modes of VNO lead to the emergence of network on demand (NoD) services. The conventional network provisioning involves a series of manual operation and configuration, which leads to high cost in time. Considering the advantages of Software Defined Networking (SDN), this paper proposes a novel NoD service provisioning solution to satisfy the private network need of VNOs. The solution is first verified in the real software defined multi-domain optical networks with multi-vendor OTN equipment. With the proposed solution, NoD service can be deployed via online web portals in near-real time. It reinvents the customer experience and redefines how network services are delivered to customers via an online self-service portal. Ultimately, this means a customer will be able to simply go online, click a few buttons and have new services almost instantaneously.

Bootstrapping disaster: The challenge of growing and maintaining a cross-sector collaborative network.

PubMed

Wachhaus, Aaron

This article examines the interaction of nonprofit and private actors with the traditional bureaucratic structures of government in central Pennsylvania&s recovery from hurricane Irene and tropical storm Lee. That effort relied heavily on private and nonprofit organizations as drivers of the response and recovery. The author maps the organizations involved in the recovery effort and explores the impact of the recovery effort on those organizations. A social network analysis was conducted and complemented with follow-up interviews with key actors. The network analysis reveals weak communication between sectors and a reliance on nonprofits to deliver services; interviews uncover the challenges of intersectoral collaboration. The author addresses the successes and limitations of the means by which a network of nonprofit efforts were coordinated with federal and state relief efforts and draw lessons for improving future practices. The author finds that this case deviates from theory in several ways that complicated community response and recovery. In particular, the challenges of developing and maintaining a recovery network while simultaneously delivering services placed great strain on several organizations, as well as on the fledgling network as a whole.

Network survivability performance

NASA Astrophysics Data System (ADS)

1993-11-01

This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

Analysis and application of intelligence network based on FTTH

NASA Astrophysics Data System (ADS)

Feng, Xiancheng; Yun, Xiang

2008-12-01

With the continued rapid growth of Internet, new network service emerges in endless stream, especially the increase of network game, meeting TV, video on demand, etc. The bandwidth requirement increase continuously. Network technique, optical device technical development is swift and violent. FTTH supports all present and future service with enormous bandwidth, including traditional telecommunication service, traditional data service and traditional TV service, and the future digital TV and VOD. With huge bandwidth of FTTH, it wins the final solution of broadband network, becomes the final goal of development of optical access network. Firstly, it introduces the main service which FTTH supports, main analysis key technology such as FTTH system composition way, topological structure, multiplexing, optical cable and device. It focus two kinds of realization methods - PON, P2P technology. Then it proposed that the solution of FTTH can support comprehensive access (service such as broadband data, voice, video and narrowband private line). Finally, it shows the engineering application for FTTH in the district and building. It brings enormous economic benefits and social benefit.

Contrasting Intermediation Practices in Various Advisory Service Networks in the Case of the French Ecophyto Plan

ERIC Educational Resources Information Center

Cerf, M.; Bail, Le; Lusson, J. M.; Omon, B.

2017-01-01

Purpose: To highlight the way a public policy aiming to achieve a 50% decrease of pesticides use in France reframed advice provision in public and private networks. Design/methodology/approach: We developed a framework to analyze intermediation in a public funded network, a farmers' association, and a network of co-operatives. The framework…

75 FR 62424 - EDS, an HP Company (Re-Branded as HP-Enterprise Services) Including On-Site Workers From: Abel...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... Floyd and Company, Trinity Government SYS a Private Co, Verizon Network Integration Corp, Vision... Provider Inc., Teksystems, The Experts Inc., TM Floyd and Company, Trinity Government SYS a Private Co... Compuware Corp Comsys Information Technology SVC, Diversified Systems Inc., E- Corn LLC, Farrington...

Private sector, human resources and health franchising in Africa.

PubMed

Prata, Ndola; Montagu, Dominic; Jefferys, Emma

2005-04-01

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance.

Layer 1 VPN services in distributed next-generation SONET/SDH networks with inverse multiplexing

NASA Astrophysics Data System (ADS)

Ghani, N.; Muthalaly, M. V.; Benhaddou, D.; Alanqar, W.

2006-05-01

Advances in next-generation SONET/SDH along with GMPLS control architectures have enabled many new service provisioning capabilities. In particular, a key services paradigm is the emergent Layer 1 virtual private network (L1 VPN) framework, which allows multiple clients to utilize a common physical infrastructure and provision their own 'virtualized' circuit-switched networks. This precludes expensive infrastructure builds and increases resource utilization for carriers. Along these lines, a novel L1 VPN services resource management scheme for next-generation SONET/SDH networks is proposed that fully leverages advanced virtual concatenation and inverse multiplexing features. Additionally, both centralized and distributed GMPLS-based implementations are also tabled to support the proposed L1 VPN services model. Detailed performance analysis results are presented along with avenues for future research.

Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area

PubMed Central

Peipins, Lucy A.; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

2018-01-01

Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. PMID:23726213

Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area.

PubMed

Peipins, Lucy A; Graham, Shannon; Young, Randall; Lewis, Brian; Flanagan, Barry

2013-07-01

Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment. Published by Elsevier Ltd.

An efficient quantum scheme for Private Set Intersection

NASA Astrophysics Data System (ADS)

Shi, Run-hua; Mu, Yi; Zhong, Hong; Cui, Jie; Zhang, Shun

2016-01-01

Private Set Intersection allows a client to privately compute set intersection with the collaboration of the server, which is one of the most fundamental and key problems within the multiparty collaborative computation of protecting the privacy of the parties. In this paper, we first present a cheat-sensitive quantum scheme for Private Set Intersection. Compared with classical schemes, our scheme has lower communication complexity, which is independent of the size of the server's set. Therefore, it is very suitable for big data services in Cloud or large-scale client-server networks.

Connecting pills and people: an ethnography of the pharmaceutical nexus in Odisha, India.

PubMed

Seeberg, Jens

2012-06-01

This article explores the impact of intensive competition within the pharmaceutical industry and among private providers on health care in an Indian city. In-depth interviewing and clinical observation were used over a period of 18 months. Private practitioners and chemists who provided regular services to inhabitants of a poor neighborhood in central Bhubaneswar were included. Fierce competition in private health in Odisha, India, reduced quality of care for the poor. The pharmaceutical industry exploited weak links in the health system to push drugs aggressively, including through illegal channels. The private health market is organized in small "network molecules" that maximize profit at the cost of health. The large private share of health care in India and stiff competition are detrimental for primary care in urban India. Free government services are urgently needed and a planned health insurance scheme should be linked to quality control measures.

Private sector, human resources and health franchising in Africa.

PubMed Central

Prata, Ndola; Montagu, Dominic; Jefferys, Emma

2005-01-01

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance. PMID:15868018

Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

PubMed

Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

2007-01-01

Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

Software Defined Networking challenges and future direction: A case study of implementing SDN features on OpenStack private cloud

NASA Astrophysics Data System (ADS)

Shamugam, Veeramani; Murray, I.; Leong, J. A.; Sidhu, Amandeep S.

2016-03-01

Cloud computing provides services on demand instantly, such as access to network infrastructure consisting of computing hardware, operating systems, network storage, database and applications. Network usage and demands are growing at a very fast rate and to meet the current requirements, there is a need for automatic infrastructure scaling. Traditional networks are difficult to automate because of the distributed nature of their decision making process for switching or routing which are collocated on the same device. Managing complex environments using traditional networks is time-consuming and expensive, especially in the case of generating virtual machines, migration and network configuration. To mitigate the challenges, network operations require efficient, flexible, agile and scalable software defined networks (SDN). This paper discuss various issues in SDN and suggests how to mitigate the network management related issues. A private cloud prototype test bed was setup to implement the SDN on the OpenStack platform to test and evaluate the various network performances provided by the various configurations.

MONET 2009 PC Co-chairs' Message

NASA Astrophysics Data System (ADS)

Grifoni, Patrizia; Ferri, Fernando; Kondratova, Irina; D'Ulizia, Arianna

The research areas of mobile technologies, social networking and mobile services applications are receiving wide interest from private and public companies as well as from academic and research institutions.

Protesting on Twitter: Citizenship and Empowerment from Public Education

ERIC Educational Resources Information Center

Saura, Geo; Muñoz-Moreno, José-Luis; Luengo-Navas, Julián; Martos, José-Manuel

2017-01-01

The use of social networks for protest purposes has been an essential element in recent global protests against the economic measures of privatization of public services. Social networks are changing political communication, mobilization and organization of collective protests. Taking into account the relationship between collective protests and…

A metro-access integrated network with all-optical virtual private network function using DPSK/ASK modulation format

NASA Astrophysics Data System (ADS)

Tian, Yue; Leng, Lufeng; Su, Yikai

2008-11-01

All-optical virtual private network (VPN), which offers dedicated optical channels to connect users within a VPN group, is considered a promising approach to efficient internetworking with low latency and enhanced security implemented in the physical layer. On the other hand, time-division multiplexed (TDM) / wavelength-division multiplexed (WDM) network architecture based on a feeder-ring with access-tree topology, is considered a pragmatic migration scenario from current TDM-PONs to future WDM-PONs and a potential convergence scheme for access and metropolitan networks, due to its efficiently shared hardware and bandwidth resources. All-optical VPN internetworking in such a metro-access integrated structure is expected to cover a wider service area and therefore is highly desirable. In this paper, we present a TDM/WDM metro-access integrated network supporting all-optical VPN internetworking among ONUs in different sub- PONs based on orthogonal differential-phase-shift keying (DPSK) / amplitude-shift keying (ASK) modulation format. In each ONU, no laser but a single Mach-Zehnder modulator (MZM) is needed for the upstream and VPN signal generation, which is cost-effective. Experiments and simulations are performed to verify its feasibility as a potential solution to the future access service.

Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International.

PubMed

Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

2015-06-17

In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014-up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI's 17 and PSI's 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations' operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage. © Thurston et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

Universal Service Brings Fiber to Their Doorsteps.

ERIC Educational Resources Information Center

Vedro, Steven

1996-01-01

In a time of fiscal belt tightening, many states will hesitate to launch new multimillion-dollar distance education network projects. Instead they will concentrate on regulatory initiatives to stimulate the development of affordable advanced universal service by the private sector. Discusses the limitations of state regulatory strategies in the…

The value of improved telecommunications service to hospitals: A preliminary assessment

NASA Technical Reports Server (NTRS)

Potter, J. G.

1979-01-01

In view of the rapid rate of development of domestic telecommunication services and the emphasis on private networks, it was sought to determine if hospitals had major requirements which could be aggregated and served by such networks. The value of the information transfer services judged to be most promising over the next twenty years was evaluated, based on expenditures and activity levels in five hospitals and one management services firm and the judgement of their senior staff. An implicit assumption is that services will become affordable once the hospital industry aggregates its requirements. A methodology to evaluate the value of telecommunication services in a hospital was developed and tested.

Economic Feasibility of Wireless Sensor Network-Based Service Provision in a Duopoly Setting with a Monopolist Operator.

PubMed

Sanchis-Cano, Angel; Romero, Julián; Sacoto-Cabrera, Erwin J; Guijarro, Luis

2017-11-25

We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services.

U.S. Geological Survey Business Partner Program

USGS Publications Warehouse

,

1999-01-01

The Business Partner Program is composed of a network of private sector organizations that distribute U.S. Geological Survey (USGS) products. By engaging the private sector, State and local government, and academic and nonprofit organizations in product dissemination, the USGS expects to increase the availability of its products to end users, locate customer service closer to the user, and provide cost savings to the Federal Government.

Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

PubMed Central

2011-01-01

Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs) staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are important providers. PHCC services are indeed free, with little evidence of informal payments to providers. PMID:22176866

Innovation Networks to Stimulate Public and Private Sector Collaboration for Advisory Services Innovation and Coordination: The Case of Pasture Performance Issues in the New Zealand Dairy Industry

ERIC Educational Resources Information Center

Rijswijk, K.; Brazendale, R.

2017-01-01

Purpose: An innovation network, called the Pasture Improvement Leadership Group (PILG), was formed to improve the quality and consistency of advice provided to dairy farmers in New Zealand, after they expressed dissatisfaction with their pastures. The aim of this paper is to better understand the challenges of forming and maintaining networks to…

Spatial Distribution Characteristics of Healthcare Facilities in Nanjing: Network Point Pattern Analysis and Correlation Analysis.

PubMed

Ni, Jianhua; Qian, Tianlu; Xi, Changbai; Rui, Yikang; Wang, Jiechen

2016-08-18

The spatial distribution of urban service facilities is largely constrained by the road network. In this study, network point pattern analysis and correlation analysis were used to analyze the relationship between road network and healthcare facility distribution. The weighted network kernel density estimation method proposed in this study identifies significant differences between the outside and inside areas of the Ming city wall. The results of network K-function analysis show that private hospitals are more evenly distributed than public hospitals, and pharmacy stores tend to cluster around hospitals along the road network. After computing the correlation analysis between different categorized hospitals and street centrality, we find that the distribution of these hospitals correlates highly with the street centralities, and that the correlations are higher with private and small hospitals than with public and large hospitals. The comprehensive analysis results could help examine the reasonability of existing urban healthcare facility distribution and optimize the location of new healthcare facilities.

System services and architecture of the TMI satellite mobile data system

NASA Technical Reports Server (NTRS)

Gokhale, D.; Agarwal, A.; Guibord, A.

1993-01-01

The North American Mobile Satellite Service (MSS) system being developed by AMSC/TMI and scheduled to go into service in early 1995 will include the provision for real time packet switched services (mobile data service - MDS) and circuit switched services (mobile telephony service - MTS). These services will utilize geostationary satellites which provide access to mobile terminals (MT's) through L-band beams. The MDS system utilizes a star topology with a centralized data hub (DH) and will support a large number of mobile terminals. The DH, which accesses the satellite via a single Ku band beam, is responsible for satellite resource management, for providing mobile users with access to public and private data networks, and for comprehensive network management of the system. This paper describes the various MDS services available for the users, the ground segment elements involved in the provisioning of these services, and a summary description of the channel types, protocol architecture, and network management capabilities provided within the system.

Principle and verification of novel optical virtual private networks over multiprotocol label switching/optical packet switching networks

NASA Astrophysics Data System (ADS)

Zhang, Chongfu; Wang, Zhengsuan; Jin, Wei; Qiu, Kun

2012-11-01

A novel realization method of the optical virtual private networks (OVPN) over multiprotocol label switching/optical packet switching (MPLS/OPS) networks is proposed. In this scheme, the introduction of MPLS control plane makes OVPN over OPS networks more reliable and easier; OVPN makes use of the concept of high reconfiguration of light-paths offered by MPLS, to set up secure tunnels of high bandwidth across intelligent OPS networks. Through resource management, the signal mechanism, connection control, and the architecture of the creation and maintenance of OVPN are efficiently realized. We also present an OVPN architecture with two traffic priorities, which is used to analyze the capacity, throughput, delay time of the proposed networks, and the packet loss rate performance of the OVPN over MPLS/OPS networks based on full mesh topology. The results validate the applicability of such reliable connectivity to high quality services in the OVPN over MPLS/OPS networks. Along with the results, the feasibility of the approach as the basis for the next generation networks is demonstrated and discussed.

[Development of second-line occupational health services: toward an integrated network of insurers and care providers].

PubMed

Plomp, H N

2000-06-10

To describe the development of the second-line Occupational Health Services and the role of private insurance companies in it over the period 1994-1999. Descriptive cross-sectional study. Data were collected in 1999 from written documents and supplementary interviews with the five largest private providers of disability insurance, the National Insurance Institute, nine Occupational Health Services of different natures and 24 institutions for second-line occupational health service. After the privatization of the Health Law in 1996 and parts of the Law on disability Insurance, most employers covered the risk of continued payment of wages in case of disability with private insurers. These attempted to keep claims down by active engagement in arbitration, treatment and diagnostics of disabled employees so as to counteract avoidable absenteeism. Under the influence of the insurance companies, a trend developed toward integrated nation-wide chains in which the services provided by insurers, by occupational health services and by implementing institutions are geared for one another. Commercial provision of Occupational Health Service is a new, demand-active form of care provision in which the financier plays a key part. This provision of services supplied important innovating impulses for health care in its entirety because of its large scale, strong protocolling of processes and management on the basis of continuous cost-benefit analyses. A lucid and socially acceptable regulation of commercial providers of occupational health services was lacking.

Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

PubMed

Agha, Sohail; Gage, Anastasia; Balal, Asma

2007-05-01

With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to increased provider willingness to remain part of the franchise and to abide by the standards of quality set by the franchiser.

Economic Feasibility of Wireless Sensor Network-Based Service Provision in a Duopoly Setting with a Monopolist Operator

PubMed Central

Romero, Julián; Sacoto-Cabrera, Erwin J.

2017-01-01

We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services. PMID:29186847

Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?

PubMed Central

Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.

2014-01-01

Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313

Onsite provision of specialized contraceptive services: does Title X funding enhance access?

PubMed

Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D

2014-05-01

This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.

Privatisation in reproductive health services in Pakistan: three case studies.

PubMed

Ravindran, T K Sundari

2010-11-01

Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

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.

The Information Highway.

ERIC Educational Resources Information Center

Gore, Al

1994-01-01

The new information marketplace is based on a network of wide, two-way highways comprised of private owners and developers, makers of information appliances (televisions, telephones, computers, and combinations of all three), information providers (local broadcasters, digital libraries, information service providers, and entrepreneurs), and…

An overview of the technical design of MSAT mobile satellite communications services

NASA Astrophysics Data System (ADS)

Davies, N. George

The Canadian MSAT mobile satellite communications system is being implemented in cooperation with the American Mobile Satellite Consortium (AMSC). Two satellites are to be jointly acquired and each satellite is expected to backup the other. This paper describes the technical concepts of the services to be offered and the baseline planning of the infrastructure for the ground segment. MSAT service requirements are analyzed for mobile radio, telephone, data, and aeronautical services. The MSAT system will use nine beams in a narrow range of L-band frequencies with frequency reuse. Beams may be added to cover flight information areas in the Atlantic and Pacific oceans. The elements of the network architecture are: a network control centre, data hub stations, gateway stations, base stations, mobile terminals, and a signalling system to interconnect the elements of the system. The network control center will manage the network and allocate space segment capacity; data hub stations will support a switched packet mobile data service; the gateway stations will provide interconnection to the public telephone system and data networks; and the base stations will support private circuit switched voice and data services. Several alternative designs for the signalling system are described.

Integrating Containers in the CERN Private Cloud

NASA Astrophysics Data System (ADS)

Noel, Bertrand; Michelino, Davide; Velten, Mathieu; Rocha, Ricardo; Trigazis, Spyridon

2017-10-01

Containers remain a hot topic in computing, with new use cases and tools appearing every day. Basic functionality such as spawning containers seems to have settled, but topics like volume support or networking are still evolving. Solutions like Docker Swarm, Kubernetes or Mesos provide similar functionality but target different use cases, exposing distinct interfaces and APIs. The CERN private cloud is made of thousands of nodes and users, with many different use cases. A single solution for container deployment would not cover every one of them, and supporting multiple solutions involves repeating the same process multiple times for integration with authentication services, storage services or networking. In this paper we describe OpenStack Magnum as the solution to offer container management in the CERN cloud. We will cover its main functionality and some advanced use cases using Docker Swarm and Kubernetes, highlighting some relevant differences between the two. We will describe the most common use cases in HEP and how we integrated popular services like CVMFS or AFS in the most transparent way possible, along with some limitations found. Finally we will look into ongoing work on advanced scheduling for both Swarm and Kubernetes, support for running batch like workloads and integration of container networking technologies with the CERN infrastructure.

[Emergency care for victims of violence and accidents: differences in the epidemiological profile between the public and private health services. VIVA--Campinas, São Paulo, Brazil, 2009].

PubMed

Belon, Ana Paula; da Silveira, Naoko Yanagizawa Jardim; Barros, Marilisa Berti de Azevedo; Baldo, Caroline; da Silva, Marta Maria Alves

2012-09-01

The scope of this study is to analyze the differences in the profile of emergency care for external causes between public and private emergency departments. With data come from VIVA-Campinas 2009, the association between the nature of healthcare and the characteristics of the victims was verified using the chi-square test. Using Poisson regression, proportion ratios of care in the public and private network were estimated. In the sample of 1094 victims, 67.8% were treated by public health. Traffic accidents, animal-related accidents, and assaults were 2 times higher in public units, whereas collisions with objects and sprains were 75% and 2.7 times higher in private units. Cranium-encephalic trauma/polytrauma and cuts/lacerations were 3.8 times and 61% more frequent in public care, while victims with no injuries, with dislocations/sprains or fractures being predominant in private care. Head and multiple organ injuries, road accident and work-related injuries, the use of public transport or mobile emergency care services/ambulances were predominant in public care. Revealing significant differences in care in public and private care can contribute to the organization of healthcare.

47 CFR 32.5100 - Long distance message revenue.

Code of Federal Regulations, 2013 CFR

2013-10-01

... UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5100..., signaling, remote metering, and supervisory services. (2) Private network circuits and facilities (including..., supervisory control, miscellaneous signaling and channels furnished for the purpose of extending customer...

47 CFR 32.5100 - Long distance message revenue.

Code of Federal Regulations, 2012 CFR

2012-10-01

... UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions For Revenue Accounts § 32.5100..., signaling, remote metering, and supervisory services. (2) Private network circuits and facilities (including..., supervisory control, miscellaneous signaling and channels furnished for the purpose of extending customer...

The National Information Infrastructure: Agenda for Action.

ERIC Educational Resources Information Center

Microcomputers for Information Management, 1995

1995-01-01

Discusses the National Information Infrastructure and the role of the government. Topics include private sector investment; universal service; technological innovation; user orientation; information security and network reliability; management of the radio frequency spectrum; intellectual property rights; coordination with other levels of…

Consumer cost sharing in private health insurance: on the threshold of change.

PubMed

Goff, Veronica

2004-05-14

Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.

Quality of service policy control in virtual private networks

NASA Astrophysics Data System (ADS)

Yu, Yiqing; Wang, Hongbin; Zhou, Zhi; Zhou, Dongru

2004-04-01

This paper studies the QoS of VPN in an environment where the public network prices connection-oriented services based on source, destination and grade of service, and advertises these prices to its VPN customers (users). As different QoS technologies can produce different QoS, there are according different traffic classification rules and priority rules. The internet service provider (ISP) may need to build complex mechanisms separately for each node. In order to reduce the burden of network configuration, we need to design policy control technologies. We considers mainly directory server, policy server, policy manager and policy enforcers. Policy decision point (PDP) decide its control according to policy rules. In network, policy enforce point (PEP) decide its network controlled unit. For InterServ and DiffServ, we will adopt different policy control methods as following: (1) In InterServ, traffic uses resource reservation protocol (RSVP) to guarantee the network resource. (2) In DiffServ, policy server controls the DiffServ code points and per hop behavior (PHB), its PDP distributes information to each network node. Policy server will function as following: information searching; decision mechanism; decision delivering; auto-configuration. In order to prove the effectiveness of QoS policy control, we make the corrective simulation.

Dynamic Online Bandwidth Adjustment Scheme Based on Kalai-Smorodinsky Bargaining Solution

NASA Astrophysics Data System (ADS)

Kim, Sungwook

Virtual Private Network (VPN) is a cost effective method to provide integrated multimedia services. Usually heterogeneous multimedia data can be categorized into different types according to the required Quality of Service (QoS). Therefore, VPN should support the prioritization among different services. In order to support multiple types of services with different QoS requirements, efficient bandwidth management algorithms are important issues. In this paper, I employ the Kalai-Smorodinsky Bargaining Solution (KSBS) for the development of an adaptive bandwidth adjustment algorithm. In addition, to effectively manage the bandwidth in VPNs, the proposed control paradigm is realized in a dynamic online approach, which is practical for real network operations. The simulations show that the proposed scheme can significantly improve the system performances.

Development of satellite telecommunications during the period 1990 - 2005

NASA Astrophysics Data System (ADS)

Kumar, D.

1993-01-01

The evolution of the global telecommunications market is reviewed. The changes that take place are a result of advances in technology as well as three powerful and interconnected forces: privatization, globalization, and liberalization. The introduction of new technologies in the form of Integrated Services Digital Networks (ISDN's) and integrated terminal equipment resulted in the transformation of the telecommunications services market from a single service industry limited by technology constraints into a multiservice industry limited by applications. As a result of privatization and globalization, the former national telecommunications carriers are beginning to expand overseas in order to grow. The changes indicate a shift in traffic structure as well as in the global satellite market structure. The analysis shows that satellite telecommunications will grow over the next fifteen years.

The research and application of Ethernet over RPR technology

NASA Astrophysics Data System (ADS)

Feng, Xiancheng; Yun, Xiang

2008-11-01

With service competitions of carriers aggravating and client's higher service experience requirement, it urges the MAN technology develops forward. When the Core Layer and Distribution Layer technology are mature, all kinds of reliability technologies of MAN access Layer are proposed. EoRPR is one of reliability technologies for MAN access network service protection. This paper elaborates Ethernet over RPR technology's many advantages through analyzing basic principle, address learning and key technologies of Ethernet over RPR. EpRPR has quicker replacing speed, plug and play, stronger QoS ability, convenient service deployment, band fairly sharing, and so on. At the same time the paper proposed solution of Ethernet over RPR in MAN, NGN network and enterprise Private network. So, among many technologies of MAN access network, EoRPR technology has higher reliability and manageable and highly effectiveness and lower costive of Ethernet. It is not only suitable for enterprise interconnection, BTV and NGN access services and so on, but also can meet the requirement of carriers' reducing CAPEX and OPEX's and increase the rate of investment.

Lessons drawn from 2 existing satellite networks: ARABSAT and EUTELSAT. Application to the Pacific basin projects

NASA Astrophysics Data System (ADS)

Bloch, Jean-Jacques

The Arabsat and Eutelsat systems are described. The Arabsat belongs to an organization which includes 20 countries of the Arab League. The Eutelsat belongs to the European telecommunication system which includes 29 countries, and is based op the Intelsat model. The current use of their payload is reviewed and compared with their respective planning stage predictions. From this perspective, some teachings are drawn which could be profitable for emerging region Pacific basin networks, now in the planning stage. In the Pacific basin several private and governmental regional satellite networks either newly existing or in the design phase are vying to deliver services to potential customers. These services include national television, commercial television, VSAT (Very Small Aperture Terminal) networks, and regional or domestic telephony.

Fixing unfair advantages? Providers hope to see more transparency, networks with Medicare private fee-for-service plans in wake of veto override.

PubMed

Lubell, Jennifer

2008-07-21

The new Medicare law delivers a raft of changes. But physicians are cheering the loudest for the rollback of the 10.6% reimbursement cut and the revamping of Medicare Advantage. "It doesn't make any sense that these private plans are paid 17% more than traditional Medicare and don't have to share a dime with the hospitals or physicians," says Albert Fisk, left, a Washington state physician.

Applications of satellite technology to broadband ISDN networks

NASA Technical Reports Server (NTRS)

Price, Kent M.; Kwan, Robert K.; Chitre, D. M.; Henderson, T. R.; White, L. W.; Morgan, W. L.

1992-01-01

Two satellite architectures for delivering broadband integrated services digital network (B-ISDN) service are evaluated. The first is assumed integral to an existing terrestrial network, and provides complementary services such as interconnects to remote nodes as well as high-rate multicast and broadcast service. The interconnects are at a 155 Mbs rate and are shown as being met with a nonregenerative multibeam satellite having 10-1.5 degree spots. The second satellite architecture focuses on providing private B-ISDN networks as well as acting as a gateway to the public network. This is conceived as being provided by a regenerative multibeam satellite with on-board ATM (asynchronous transfer mode) processing payload. With up to 800 Mbs offered, higher satellite EIRP is required. This is accomplished with 12-0.4 degree hopping beams, covering a total of 110 dwell positions. It is estimated the space segment capital cost for architecture one would be about $190M whereas the second architecture would be about $250M. The net user cost is given for a variety of scenarios, but the cost for 155 Mbs services is shown to be about $15-22/minute for 25 percent system utilization.

Understanding Student Recommendations to Attend NIACC

ERIC Educational Resources Information Center

Morrison, Michael C.

2008-01-01

Successful organizations, both public and private, rely heavily on "word-of-mouth recommendations" for their products and services. Financial viability of any organization depends profoundly on formal and informal networks of customers who pass their assessments of an organization's performance to acquaintances, friends and families.…

The Globalstar mobile satellite system for worldwide personal communications

NASA Astrophysics Data System (ADS)

Wiedeman, Robert A.; Viterbi, Andrew J.

Loral Aerospace Corporation along with Qualcomm Inc. have developed a satellite system which offers global mobile voice and data services to and from handheld and mobile user terminals with omni-directional antennas. By combining the use of low-earth orbit (LEO) satellites with existing terrestrial communications systems and innovative, highly efficient spread spectrum techniques, the Globalstar system provides users with low-cost, reliable communications throughout the world. The Globalstar space segment consists of a constellation of 48 LEO satellites in circular orbits with 750 NM (1389 km) altitude. Each satellite communicates with the mobile users via the satellite-user links and with gateway stations. The gateway stations handle the interface between the Globalstar network and the OSTN/PLMN systems. Globalstar transceivers are similar to currently proposed digital cellular telephones in size and have a serial number that will allow the end user to make and receive calls from or to that device anywhere in the world. The Globalstar system is designed to operate as a complement to existing local, long-distance, public, private and specialized telecommunications networks. Service is primarily designed to serve the rural and thin route communications needs of consumers, government users, and private networks.

The Globalstar mobile satellite system for worldwide personal communications

NASA Technical Reports Server (NTRS)

Wiedeman, Robert A.; Viterbi, Andrew J.

1993-01-01

Loral Aerospace Corporation along with Qualcomm Inc. have developed a satellite system which offers global mobile voice and data services to and from handheld and mobile user terminals with omni-directional antennas. By combining the use of low-earth orbit (LEO) satellites with existing terrestrial communications systems and innovative, highly efficient spread spectrum techniques, the Globalstar system provides users with low-cost, reliable communications throughout the world. The Globalstar space segment consists of a constellation of 48 LEO satellites in circular orbits with 750 NM (1389 km) altitude. Each satellite communicates with the mobile users via the satellite-user links and with gateway stations. The gateway stations handle the interface between the Globalstar network and the OSTN/PLMN systems. Globalstar transceivers are similar to currently proposed digital cellular telephones in size and have a serial number that will allow the end user to make and receive calls from or to that device anywhere in the world. The Globalstar system is designed to operate as a complement to existing local, long-distance, public, private and specialized telecommunications networks. Service is primarily designed to serve the rural and thin route communications needs of consumers, government users, and private networks.

A Framework for Integration of Heterogeneous Medical Imaging Networks

PubMed Central

Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos

2014-01-01

Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS. PMID:25279021

A framework for integration of heterogeneous medical imaging networks.

PubMed

Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos

2014-01-01

Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS.

Technology Directions for the 21st Century. Volume 3

NASA Technical Reports Server (NTRS)

Crimi, Giles F.; Botta, Robert; Ditanna, Thomas; Verheggen, Henry; Stancati, Michael; Feingold, Harvey; Jacobs, Mark

1996-01-01

New technologies will unleash the huge capacity of fiber-optic cable to meet growing demands for bandwidth. Companies will continue to replace private networks with public network bandwidth-on-demand. Although asynchronous transfer mode (ATM) is the transmission technology favored by many, its penetration will be slower than anticipated. Hybrid networks - e.g., a mix of ATM, frame relay, and fast Ethernet - may predominate, both as interim and long-term solutions, based on factors such as availability, interoperability, and cost. Telecommunications equipment and services prices will decrease further due to increased supply and more competition. Explosive Internet growth will continue, requiring additional backbone transmission capacity and enhanced protocols, but it is not clear who will fund the upgrade. Within ten years, space-based constellations of satellites in Low Earth orbit (LEO) will serve mobile users employing small, low-power terminals. 'Little LEO's' will provide packet transmission services and geo-position determination. 'Big LEO's' will function as global cellular telephone networks, with some planning to offer video and interactive multimedia services. Geosynchronous satellites also are proposed for mobile voice grade links and high-bandwidth services. NASA may benefit from resulting cost reductions in components, space hardware, launch services, and telecommunications services.

The feasibility of charging private vehicles an airport drop-off and pick-up charge.

DOT National Transportation Integrated Search

2016-01-01

As transportation network companies (TNCs) like Uber and Lyft drive a change in modern transport behaviors, fewer passengers pay for services such as parking or commercial vehicle drop-off at airports, meaning that what once was a primary revenue sou...

An Optimization of the Maintenance Assets Distribution Network in the Argentine Air Force

DTIC Science & Technology

2015-03-26

Air Force (2010). Manual de Conduccion Logistica . Buenos Aires: HQ Argentine Air Force. Argentine Air Force (2012). El vuelo del condor: 1912-2012...recommendation was made to consider organic or private transportation and reduce transportation time in order to improve responsiveness and drive down...determine overall transportation demand and capacity required for a defined level of service, and to evaluate the tradeoffs between costs and service

The impact of a quality-improvement package on reproductive health services delivered by private providers in Uganda.

PubMed

Agha, Sohail

2010-09-01

This study assesses the effectiveness of a quality-improvement (QI) package designed to enable small-scale commercial reproductive health (RH) service providers to improve the services they offer. The study was conducted among midwives who are members of the Uganda Private Midwives Association. A pretest-post-test quasi-experimental panel study design was used wherein midwife clinics were allocated to two experimental groups and one control group. Baseline and follow-up measurements of structural and process attributes of quality were taken at the clinics by means of a facility inventory, interviews with midwives, and observations of client-provider interactions. Nearly 70 percent of the midwives who were trained to use the package reported that it was easy to use. Among clinics in which midwives received training in the use of the self-assessment tool and in developing action plans, structural and process attributes of quality improved only among those clinics in which the midwives' supervisors received training in finding solutions to the problems identified through self-assessments. The QI package may be implemented with small-scale private providers of RH services who are part of a professional association, network, or franchise that supervises their performance.

[A phone survey of prostitute services in homes].

PubMed

Mravcík, V; Sebáková, H

2002-10-25

Home prostitution is the hidden form of commercial sex network. We had done a phone survey of commercial sexual services provided in the private flats. We had used advertisements in the section "Intim services" of local adnewspaper "Avizo" as the primary source of relevant phone numbers. "Avizo" is sold in Northern Moravia--mainly in Ostrava, Karvina and Frydek-Mistek districts. We accomplished the phone interview with 48 subjects (individual persons or groups working in the particular flat) using the set of prepared questions. Three of these subjects were male, providing commercial sex for women. We estimated the number of such private flats, number of persons working there and number of professional contacts of this type in Karvina, Ostrava districts and whole Czech republic. We constructed an estimate of sexual sex workers for whole Czech republic--10,200 persons, therefrom 5100 persons in 1750 private flats, who accomplish to 1.36 mil sexual contact with customers annually. Regarding the risk behaviour nearly all of interviewed subjects indicated the use of condoms; 80% of subjects reported to be HIV-tested.

Body Area Network BAN--a key infrastructure element for patient-centered medical applications.

PubMed

Schmidt, Robert; Norgall, Thomas; Mörsdorf, Joachim; Bernhard, Josef; von der Grün, Thomas

2002-01-01

The Body Area Network (BAN) concept enables wireless communication between several miniaturized, intelligent Body Sensor (or actor) Units (BSU) and a single Body Central Unit (BCU) worn at the human body. A separate wireless transmission link from the BCU to a network access point--using different technology--provides for online access to BAN data via usual network infrastructure. BAN is expected to become a basic infrastructure element for service-based electronic health assistance: By integrating patient-attached sensors and control of mobile dedicated actor units, the range of medical workflow can be extended by wireless patient monitoring and therapy support. Beyond clinical use, professional disease management environments, and private personal health assistance scenarios (without financial reimbursement by health agencies/insurance companies), BAN enables a wide range of health care applications and related services.

Body area network--a key infrastructure element for patient-centered telemedicine.

PubMed

Norgall, Thomas; Schmidt, Robert; von der Grün, Thomas

2004-01-01

The Body Area Network (BAN) extends the range of existing wireless network technologies by an ultra-low range, ultra-low power network solution optimised for long-term or continuous healthcare applications. It enables wireless radio communication between several miniaturised, intelligent Body Sensor (or actor) Units (BSU) and a single Body Central Unit (BCU) worn at the human body. A separate wireless transmission link from the BCU to a network access point--using different technology--provides for online access to BAN components via usual network infrastructure. The BAN network protocol maintains dynamic ad-hoc network configuration scenarios and co-existence of multiple networks.BAN is expected to become a basic infrastructure element for electronic health services: By integrating patient-attached sensors and mobile actor units, distributed information and data processing systems, the range of medical workflow can be extended to include applications like wireless multi-parameter patient monitoring and therapy support. Beyond clinical use and professional disease management environments, private personal health assistance scenarios (without financial reimbursement by health agencies / insurance companies) enable a wide range of applications and services in future pervasive computing and networking environments.

18 CFR 284.12 - Standards for pipeline business operations and communications.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Standards for pipeline business operations and communications. 284.12 Section 284.12 Conservation of Power and Water Resources..., private network connections using internet tools, internet directory services, and internet communication...

Social Media Ethics in English Language Teaching

ERIC Educational Resources Information Center

Blyth, Andrew

2015-01-01

Many teachers are increasingly using Social Networking Services (SNS) in their classrooms, which allows for the first time the outside world to peer into students' private learning spaces (Blyth, 2011). However, the adoption of social media has mostly been done without careful consideration of possible ramifications students may suffer.…

A history of forest management in the Ozark Mountains

Treesearch

James M. Guldin

2008-01-01

The network of experimental forests and ranges within the Forest Service, U.S. Department of Agriculture has unique attributes for research, demonstration, and technology transfer. Public forest lands experience a slower rate of ownership change than private forest lands, and this provides greater stability for long-term research studies...

Implementation and Integration of Regional Health Care Data Networks in the Hellenic National Health Service

PubMed Central

Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

2002-01-01

Background Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. Objectives To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. Methods The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. Results The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. Conclusions The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications. PMID:12554551

Implementation and integration of regional health care data networks in the Hellenic National Health Service.

PubMed

Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

2002-12-01

Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

How do countries regulate the health sector? Evidence from Tanzania and Zimbabwe.

PubMed

Kumaranayake, L; Mujinja, P; Hongoro, C; Mpembeni, R

2000-12-01

The health sectors in many low- and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public-private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.

Packet-aware transport for video distribution [Invited

NASA Astrophysics Data System (ADS)

Aguirre-Torres, Luis; Rosenfeld, Gady; Bruckman, Leon; O'Connor, Mannix

2006-05-01

We describe a solution based on resilient packet rings (RPR) for the distribution of broadcast video and video-on-demand (VoD) content over a packet-aware transport network. The proposed solution is based on our experience in the design and deployment of nationwide Triple Play networks and relies on technologies such as RPR, multiprotocol label switching (MPLS), and virtual private LAN service (VPLS) to provide the most efficient solution in terms of utilization, scalability, and availability.

[The health system of Argentina].

PubMed

Belló, Mariana; Becerril-Montekio, Victor M

2011-01-01

This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar.

cisPath: an R/Bioconductor package for cloud users for visualization and management of functional protein interaction networks.

PubMed

Wang, Likun; Yang, Luhe; Peng, Zuohan; Lu, Dan; Jin, Yan; McNutt, Michael; Yin, Yuxin

2015-01-01

With the burgeoning development of cloud technology and services, there are an increasing number of users who prefer cloud to run their applications. All software and associated data are hosted on the cloud, allowing users to access them via a web browser from any computer, anywhere. This paper presents cisPath, an R/Bioconductor package deployed on cloud servers for client users to visualize, manage, and share functional protein interaction networks. With this R package, users can easily integrate downloaded protein-protein interaction information from different online databases with private data to construct new and personalized interaction networks. Additional functions allow users to generate specific networks based on private databases. Since the results produced with the use of this package are in the form of web pages, cloud users can easily view and edit the network graphs via the browser, using a mouse or touch screen, without the need to download them to a local computer. This package can also be installed and run on a local desktop computer. Depending on user preference, results can be publicized or shared by uploading to a web server or cloud driver, allowing other users to directly access results via a web browser. This package can be installed and run on a variety of platforms. Since all network views are shown in web pages, such package is particularly useful for cloud users. The easy installation and operation is an attractive quality for R beginners and users with no previous experience with cloud services.

cisPath: an R/Bioconductor package for cloud users for visualization and management of functional protein interaction networks

PubMed Central

2015-01-01

Background With the burgeoning development of cloud technology and services, there are an increasing number of users who prefer cloud to run their applications. All software and associated data are hosted on the cloud, allowing users to access them via a web browser from any computer, anywhere. This paper presents cisPath, an R/Bioconductor package deployed on cloud servers for client users to visualize, manage, and share functional protein interaction networks. Results With this R package, users can easily integrate downloaded protein-protein interaction information from different online databases with private data to construct new and personalized interaction networks. Additional functions allow users to generate specific networks based on private databases. Since the results produced with the use of this package are in the form of web pages, cloud users can easily view and edit the network graphs via the browser, using a mouse or touch screen, without the need to download them to a local computer. This package can also be installed and run on a local desktop computer. Depending on user preference, results can be publicized or shared by uploading to a web server or cloud driver, allowing other users to directly access results via a web browser. Conclusions This package can be installed and run on a variety of platforms. Since all network views are shown in web pages, such package is particularly useful for cloud users. The easy installation and operation is an attractive quality for R beginners and users with no previous experience with cloud services. PMID:25708840

An Impact Evaluation of the Resource Access Projects, 1981-1982.

ERIC Educational Resources Information Center

Empson, Judith V.; And Others

In 1976, the Administration for Children, Youth, and Families (ACYF) designed the Resource Access Project (RAP) to strengthen services that Head Start programs provide to handicapped preschool children. Today, 15 RAPs are sponsored by public and private agencies and universities throughout the country. The ACYF-funded network of projects links…

VoIP in a Campus Environment

ERIC Educational Resources Information Center

Young, Dan

2005-01-01

Internet Protocol (IP) Telephony, or voice-over IP (VoIP), has proved to be a wise decision for many organizations. This technology crosses the boundaries of public and private networks, enterprise and residential markets, voice and data technologies, as well as local and long-distance services. The convergence of voice and data into a single,…

The Effectiveness and Feasibility of a TRISNET Regional Center in Information Transfer. Final Report.

ERIC Educational Resources Information Center

Rath, Gustave J.; And Others

A study was conducted to assess the feasibility of establishing a regional information transfer center within the context of the National Network of Transportation Research Information Services (TRISNET). The principle areas of investigation were: (1) the transportation information needs of the public and private sectors; (2) the utility of…

An integrated Ka/Ku-band payload for personal, mobile and private business communications

NASA Technical Reports Server (NTRS)

Hayes, Edward J.; Keelty, J. Malcolm

1991-01-01

The Canadian Department of Communications has been studying options for a government-sponsored demonstration payload to be launched before the end of the century. A summary of the proposed system concepts and network architectures for providing an advanced private business network service at Ku-band and personal and mobile communications at Ka-band is presented. The system aspects addressed include coverage patterns, traffic capacity, and grade of service, multiple access options as well as special problems, such as Doppler in mobile applications. Earth terminal types and the advanced payload concept proposed in a feasibility study for the demonstration mission are described. This concept is a combined Ka-band/Ku-band payload which incorporates a number of advanced satellite technologies including a group demodulator to convert single-channel-per-carrier frequency division multiple access uplink signals to a time division multiplex downlink, on-board signal regeneration, and baseband switching to support packet switched data operation. The on-board processing capability of the payload provides a hubless VSAT architecture which permits single-hop full mesh interconnectivity. The Ka-band and Ku-band portions of the payload are fully integrated through an on-board switch, thereby providing the capability for fully integrated services, such as using the Ku-band VSAT terminals as gateway stations for the Ka-band personal and mobile communications services.

The Brazilian health system between norms and facts: mitigated universalization and subsidized stratification.

PubMed

Bahia, Lígia

2009-01-01

This paper will focus on recent changes in the relationships between the public and the private sector within the health assistance network, by analyzing selected information on health services and on legal rules related to supporting the private assistance subsystem. This approach recasts analyses which articulate the simultaneous examination of both the material and political instances that permanently redefine the range of activity of SUS. Considering the limitations of the empirical bases here analyzed, one questions the implied assumptions in the meanings of autonomy sustained both in the public and in the private components, departing from hypotheses on the delineation of independent tendencies toward the expansion of universal coverage and he restratification of supply and demand.

[The health system of Brazil].

PubMed

Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

2011-01-01

This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

The Lesotho Hospital PPP experience: catalyst for integrated service delivery.

PubMed

Coelho, Carla Faustino; O'Farrell, Catherine Commander

2011-01-01

For many years, Lesotho urgently needed to replace its main public hospital, Queen Elizabeth II. The project was initially conceived as a single replacement hospital, but eventually included the design and construction of a new 425 bed public hospital and adjacent primary care clinic, the renovation and expansion of three strategically located primary care clinics in the region and the management of all facilities, equipment and delivery of all clinical services in the health network by a private operator under contract for 18 years. The project's design was influenced by the recognition that a new facility alone would not address the underlying issues in service provision. The creation of this PPP health network and the contracting mechanism has increased accountability for service quality, shifted Government to a more strategic role and may also benefit other public facilities and providers in Lesotho. The county is considering the PPP approach for other health facilities.

[The strategic purchasing of health services: a big opportunity for the National Universal Health System].

PubMed

González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

2015-01-01

proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a plurality of providers - including eventually those in the private sector. A unified approach to financing health through a unique, exclusively tax-based fund would be established. Alternatives are

76 FR 27052 - Information Collection Being Submitted for Review by the Federal Communication Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... both within 120 km of the center of the city, and with 120 km of the interconnected base station... interconnection of private land mobile radio service stations with the public switched telephone network as follows: (1) Pursuant to 47 CFR section 90.477(a), licensees of interconnected land stations must maintain...

E-Rate: Keeping the Promise To Connect Kids and Communities to the Future.

ERIC Educational Resources Information Center

Johnson, Aleck; Harris, Leslie; Bond, Jill; Lee, Jee Hang; Raines, Ghani

Enacted as part of the Telecommunications Act of 1996, the E-rate provides discounts to public and private schools, libraries, and consortia on telecommunications services, Internet access, and internal networking. Discounts vary based on the poverty level of the community. The first section of this report presents findings from surveys returned…

Youthful High School Noncompleters: Enhancing Opportunities for Employment and Education. Information Series No. 316.

ERIC Educational Resources Information Center

Martin, Larry G.

High school noncompletion is a complex problem that requires complex solutions that schools are often inhibited from implementing quickly. Alternative educational services are often necessary for students who are able to complete high school but who find school an unrewarding place in which to learn. A loose network of public and private programs…

A Migrant Educator's Resource Kit: Where to Find the Help You Need. Harvesting the Harvesters. Book 3.

ERIC Educational Resources Information Center

Lawless, Ken

This third in a series of 10 study units for a Migrant Educators' National Training OutReach (MENTOR) correspondence course provides names, addresses, and descriptions of more than 35 federal, state, and private agencies, publications, services, programs, and support networks concerned with the education and welfare of migrant children. It…

NOAA data service

NASA Astrophysics Data System (ADS)

Beginning this month, the National Oceanic and Atmospheric Administration (NOAA) has a new source of information for scientists seeking information on environmental assessment and impact studies, facility site planning, research program planning, project data tracking and management, and new data.The agency's new National Environmental Data Referral Service (NEDRES) is an electronic catalog that identifies the existence, location, characteristics, and availability of conditions of environmental data. NOAA expects NEDRES to develop into a national network serving federal, state, and private organizations. NEDRES now contains about 13,000 data files.

Integration between terrestrial-based and satellite-based land mobile communications systems

NASA Technical Reports Server (NTRS)

Arcidiancono, Antonio

1990-01-01

A survey is given of several approaches to improving the performance and marketability of mobile satellite systems (MSS). The provision of voice/data services in the future regional European Land Mobile Satellite System (LMSS), network integration between the Digital Cellular Mobile System (GSM) and LMSS, the identification of critical areas for the implementation of integrated GSM/LMSS areas, space segment scenarios, LMSS for digital trunked private mobile radio (PMR) services, and code division multiple access (CDMA) techniques for a terrestrial/satellite system are covered.

European Mobile Satellite Services (EMSS): A regional system for Europe

NASA Technical Reports Server (NTRS)

Loisy, C.; Edin, P.; Benedicto, F. J.

1995-01-01

The European Space Agency is presently procuring two L-band payloads in order to promote a regional system for the provision of European Mobile Satellite Services (EMSS). These are the EMS payload on the Italsat I-F2 satellite and the LLM payload on the ARTEMIS satellite. Telecommunication system studies have been concentrating on mobile applications where full European geographical coverage is required. Potential applications include high priority Private Mobile Radio networks requiring national or European coverage, such as civil security, fire brigades, police and health services, as well as a dedicated system for provision of Air Traffic Services to the civil aviation community. A typical application is an intelligent road traffic management system combining a geographically selective traffic data collection service based on probe vehicles with a geographically selective traffic information broadcast service. Network architectures and bearer services have been developed both for data only and voice/data services. Vehicle mounted mobile transceivers using CDMA access techniques have been developed. The EMSS operational phase will start with the EMS payload in orbit in 1996 and continue with the LLM payload in 1997.

Next generation satellite communications networks

NASA Astrophysics Data System (ADS)

Garland, P. J.; Osborne, F. J.; Streibl, I.

The paper introduces two potential uses for new space hardware to permit enhanced levels of signal handling and switching in satellite communication service for Canada. One application involves increased private-sector services in the Ku band; the second supports new personal/mobile services by employing higher levels of handling and switching in the Ka band. First-generation satellite regeneration and switching experiments involving the NASA/ACTS spacecraft are described, where the Ka band and switching satellite network problems are emphasized. Second-generation satellite development is outlined based on demand trends for more packet-based switching, low-cost earth stations, and closed user groups. A demonstration mission for new Ka- and Ku-band technologies is proposed, including the payload configuration. The half ANIK E payload is shown to meet the demonstration objectives, and projected to maintain a fully operational payload for at least 10 years.

Workplace Stress, Organizational Factors and EAP Utilization.

PubMed

Azzone, Vanessa; McCann, Bernard; Merrick, Elizabeth Levy; Hiatt, Deirdre; Hodgkin, Dominic; Horgan, Constance

2009-01-01

This study examined relationships between workplace stress, organizational factors and use of EAP counseling services delivered by network providers in a large, privately-insured population. Claims data were linked to measures of workplace stress, focus on wellness/prevention, EAP promotion, and EAP activities for health care plan enrollees from 26 employers. The association of external environment and work organization variables with use of EAP counseling services was examined. Higher levels of EAP promotion and worksite activities were associated with greater likelihood of service use. Greater focus on wellness/prevention and unusual and significant stress were associated with lower likelihood of service use. Results provide stakeholders with insights on approaches to increasing utilization of EAP services.

Workplace Stress, Organizational Factors and EAP Utilization

PubMed Central

Azzone, Vanessa; McCann, Bernard; Merrick, Elizabeth Levy; Hiatt, Deirdre; Hodgkin, Dominic; Horgan, Constance

2013-01-01

This study examined relationships between workplace stress, organizational factors and use of EAP counseling services delivered by network providers in a large, privately-insured population. Claims data were linked to measures of workplace stress, focus on wellness/prevention, EAP promotion, and EAP activities for health care plan enrollees from 26 employers. The association of external environment and work organization variables with use of EAP counseling services was examined. Higher levels of EAP promotion and worksite activities were associated with greater likelihood of service use. Greater focus on wellness/prevention and unusual and significant stress were associated with lower likelihood of service use. Results provide stakeholders with insights on approaches to increasing utilization of EAP services. PMID:24058322

Manufacturing Consent for Privatization in Public Education: The Rise of a Social Finance Network in Canada

ERIC Educational Resources Information Center

Poole, Wendy; Sen, Vicheth; Fallon, Gerald

2016-01-01

Multiple forms of privatization are emerging in the Canadian public sector, including public-private partnerships. This article focuses on one approach to public-private partnerships called "social finance," and a network of public, private, and not-for-profit organizations that promotes social finance as a means of funding public…

[The impact on costs and care of two approaches to reduce employees' dental plan expenses in a private company].

PubMed

Costa Filho, Luiz Cesar da; Duncan, Bruce Bartholow; Polanczyk, Carisi Anne; Sória, Marina Lara; Habekost, Ana Paula; Costa, Carolina Covolo da

2008-05-01

The present study evaluated the dental care plan offered to 4,000 employees of a private hospital and their respective families. The analysis covered three stages: (1) baseline (control), when dental care was provided by an outsourced company with a network of dentists paid for services, (2) a renegotiation of costs with the original dental care provider, and (3) provision of dental care by the hospital itself, through directly hired dentists on regular salaries. Monthly economic and clinical data were collected for this research. The dental plan renegotiation reduced costs by 37% in relation to baseline, and the hospital's own dental service reduced costs by 50%. Renegotiation led to a 31% reduction in clinical procedures, without altering the dental care profile; the hospital's own dental service did not reduce the total number of clinical procedures, but modified the profile of dental care, since procedures related to the causes of diseases increased and surgical/restorative procedures decreased.

SEEMP: A Networked Marketplace for Employment Services

NASA Astrophysics Data System (ADS)

Celino, Irene; Cerizza, Dario; Cesarini, Mirko; Valle, Emanuele Della; de Paoli, Flavio; Estublier, Jacky; Fugini, Mariagrazia; Pérez, Asuncion Gómez; Kerrigan, Mick; Guarrera, Pascal; Mezzanzanica, Mario; Ramìrez, Jaime; Villazon, Boris; Zhao, Gang

Human capital is more and more the key factor of economic growth and competitiveness in the information age and knowledge economy. But due to a still fragmented employment market compounded by the enlargement of the EU, the human resources are not effectively exchanged and deployed. The business innovation of SEEMP1 develops a vision of an Employment Mediation Marketplace (EMM) for market transparency and effic ient mediation. Its technological innovation provides a federated marketplace of employment agencies through a peer-to-peer network of employment data and mediation services. In other words, the solution under development is a de-fragmentation of the employment market by a web-based collaborative network. The SEEMP-enabled employment marketplace will strengthen the social organization of public employment administration, maximize the business turnover of private employment agencies, improve citizens' productivity and welfare, and increase the competitiveness and performance of business.

Key handling in wireless sensor networks

NASA Astrophysics Data System (ADS)

Li, Y.; Newe, T.

2007-07-01

With the rapid growth of Wireless Sensor Networks (WSNs), many advanced application areas have received significant attention. However, security will be an important factor for their full adoption. Wireless sensor nodes pose unique challenges and as such traditional security protocols, used in traditional networks cannot be applied directly. Some new protocols have been published recently with the goal of providing both privacy of data and authentication of sensor nodes for WSNs. Such protocols can employ private-key and/or public key cryptographic algorithms. Public key algorithms hold the promise of simplifying the network infrastructure required to provide security services such as: privacy, authentication and non-repudiation, while symmetric algorithms require less processing power on the lower power wireless node. In this paper a selection of key establishment/agreement protocols are reviewed and they are broadly divided into two categories: group key agreement protocols and pair-wise key establishment protocols. A summary of the capabilities and security related services provided by each protocol is provided.

Army Communicator. Volume 34, Number 2

DTIC Science & Technology

2009-01-01

tunneled into the NIPRNet traffic. The encryption hides the contents of the SIPRNet data through a process that randomizes the bit patterns...and technologies such as desktop applications, Virtual Private Network, Blackberry support, and the training and troubleshoot- ing of complex computer...to your own Standing Operating Procedure and then contract for services off the backside to a local Strategic Entry Point or tunnel through

The Crossett Experimental Forest--72 years of science delivery in the silviculture of southern pines

Treesearch

J. M. Guldin

2009-01-01

The network of experimental forests and ranges within the Forest Service, U.S. Department of Agriculture has unique attributes for research, demonstration, and technology transfer. Public forest lands experience a slower rate of ownership change than private forest lands, and this provides greater stability for long-term research studies and demonstrations over time....

75 FR 19677 - Medicare Program; Policy and Technical Changes to the Medicare Advantage and the Medicare...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-15

... Care and Network-Based Private Fee-for-Service Plans Under Part C (Sec. 422.112) 7. Deemable Program... Cost by HMO/CMP Cost Contractors and Health Care Prepayment Plans (HCPPs) (Sec. 417.564) 4. Calculation... and Other Technical Changes 1. Application of Subpart M to Health Care Prepayment Plans (Sec. 417.840...

JPRS Report: Telecommunications.

DTIC Science & Technology

1988-03-31

Services, Integrated Business Systems , Computasia, Unitel, Cable Television and Telco Properties. 07310 Cable TV License Bidder Eyes Intermediate...international network: ARPA CNUCE (CNR) Pisa EAN IASI (CNR) Roma EARN CNUCE (CNR) Pisa SPAN INFN (CNR) Bologna UCCP Systems & Management (Private company ...largest interna- tional telecommunications companies , in a joint venture with PTAT Systems Incorporated of the U.S. The cable will form a key link in

The privatization of environmental health services: a national survey of practices and perspectives in local health departments.

PubMed

Keane, Christopher; Marx, John; Ricci, Edmund

2002-01-01

This article presents nationally representative data on environmental health (EH) services privatized by local public health departments, enforcement and assurance mechanisms for privatized services, and administrators' views about EH services that should not be privatized. A national sample of 380 local public health departments, stratified by jurisdiction size, was drawn from a universe of 2,488 departments. Telephone interviews were conducted with 347 administrators of departments. Results were weighted to be nationally representative. Approximately one-quarter of departments had privatized at least one EH service, almost always to for-profit organizations. The two most common reasons given for privatizing EH services were cost savings or increased efficiency and lack of capacity or expertise to carry out the service. The most rigorous, although infrequent, technique of enforcement and assurance of EH standards when services were privatized was double-testing of samples. Departments more commonly relied on state licensing and certification of contractors. When asked what services should not be privatized, 27% of respondents cited EH services. Many respondents argued against privatizing environmental services that have inherent regulatory functions. They expressed concern that privatization would fragment the public health infrastructure by impairing communication, diminishing control over performance, or weakening health departments' capacity to respond to environmental and other health crises. These findings raise serious concerns about the privatization of EH.

Multimedia telehomecare system using standard TV set.

PubMed

Guillén, S; Arredondo, M T; Traver, V; García, J M; Fernández, C

2002-12-01

Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.

Integrated care networks and quality of life: linking research and practice

PubMed Central

Warner, Morton; Gould, Nicholas

2003-01-01

Abstract Purpose To report on the development of a project dedicated to improving the quality of life of older people through the creation of integrated networks. Context The project is set within a post-industrial community and against a backdrop of government re-organisation and devolution within Wales. The immediate research context is determined by utilising an approach to the structure of integration derived theoretically. Case description Project CHAIN (Community Health Alliances through Integrated Networks) adopts a network perspective as a means of addressing both the determinants of health and service delivery in health and social care. The Project partners are: healthcare commissioners and providers; local authority directorates including community services and transportation; the voluntary and private sectors; and a university institute. Co-opted participants include fora representing older people's interests. Data sources The Project incorporates an action research method. This paper highlights qualitative data elicited from interviews with health and social care managers and practitioners. Conclusions and discussion The Project is ongoing and we record progress in building five integrated networks. PMID:16896421

Divergent modes of integration: the Canadian way.

PubMed

Jiwani, Izzat; Fleury, Marie-Josée

2011-01-01

The paper highlights key trajectories and outcomes of the recent policy developments toward integrated health care delivery systems in Quebec and Ontario in the primary care sector and in the development of regional networks of health and social services. It particularly explores how policy legacies, interests and cultures may be mitigated to develop and sustain different models of integrated health care that are pertinent to the local contexts. In Quebec, three decades of iterative developments in health and social services evolved in 2005 into integrated centres for health and social services at the local levels (CSSSs). Four integrated university-based health care networks provide ultra-specialised services. Family Medicine Groups and network clinics are designed to enhance access and continuity of care. Ontario's Family Health Teams (2004) constitute an innovative public funding for private delivery model that is set up to enhance the capacity of primary care and to facilitate patient-based care. Ontario's Local Health Integration Networks (LHINs) with autonomous boards of provider organisations are intended to coordinate and integrate care. Integration strategies in Quebec and Ontario yield clinical autonomy and power to physicians while simultaneously making them key partners in change. Contextual factors combined with increased and varied forms of physician remunerations and incentives mitigated some of the challenges from policy legacies, interests and cultures. Virtual partnerships and accountability agreements between providers promise positive but gradual movement toward integrated health service systems.

The quality of family planning services and client satisfaction in the public and private sectors in Kenya.

PubMed

Agha, Sohail; Do, Mai

2009-04-01

To compare the quality of family planning services delivered at public and private facilities in Kenya. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.

A New Heuristic Anonymization Technique for Privacy Preserved Datasets Publication on Cloud Computing

NASA Astrophysics Data System (ADS)

Aldeen Yousra, S.; Mazleena, Salleh

2018-05-01

Recent advancement in Information and Communication Technologies (ICT) demanded much of cloud services to sharing users’ private data. Data from various organizations are the vital information source for analysis and research. Generally, this sensitive or private data information involves medical, census, voter registration, social network, and customer services. Primary concern of cloud service providers in data publishing is to hide the sensitive information of individuals. One of the cloud services that fulfill the confidentiality concerns is Privacy Preserving Data Mining (PPDM). The PPDM service in Cloud Computing (CC) enables data publishing with minimized distortion and absolute privacy. In this method, datasets are anonymized via generalization to accomplish the privacy requirements. However, the well-known privacy preserving data mining technique called K-anonymity suffers from several limitations. To surmount those shortcomings, I propose a new heuristic anonymization framework for preserving the privacy of sensitive datasets when publishing on cloud. The advantages of K-anonymity, L-diversity and (α, k)-anonymity methods for efficient information utilization and privacy protection are emphasized. Experimental results revealed the superiority and outperformance of the developed technique than K-anonymity, L-diversity, and (α, k)-anonymity measure.

[Teledermatology in Midi-Pyrenees].

PubMed

Bazex, Jacques

2006-02-01

Telemedicine has become commonplace since the creation of the European Center of Telemedicine, and dermatology was a pioneering discipline in this new technology. The Division of Dermatology is now involved at three different levels--The Midi-Pyrénées regional network, which allows doctors in the private and public sectors to seek expert advice, in real time, from university hospital specialists.--He Division of Dermatology pioneered telemedicine sessions devoted to file review, histological/clinical diagnosis, and information exchanges among subspecialists in dermatology. Both French and foreign specialists attend these sessions.--Teaching, particularly for students and private practitioners. Telemedicine has clear benefits for patients, doctors and society as a whole. The private and hospital community of the Midi-Pyrénées region is constantly seeking to improve its health services, and ensures that all new approaches are subject to strict quality controls.

Comparing public and private hospitals in China: evidence from Guangdong.

PubMed

Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude

2010-03-23

The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type.

Comparing public and private hospitals in China: Evidence from Guangdong

PubMed Central

2010-01-01

Background The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. Methods We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Results Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. Conclusions In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type. PMID:20331886

42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...

42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...

42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

Leveraging the private health sector to enhance HIV service delivery in lower-income countries.

PubMed

Rao, Pamela; Gabre-Kidan, Tesfai; Mubangizi, Deus Bazira; Sulzbach, Sara

2011-08-01

Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.

Collins Center Update. Volume 16, Issue 1 & 2. October 2013-March 2014

DTIC Science & Technology

2014-03-01

communications companies with major interests in newspaper, magazine, and business publishing, television and radio broadcasting, cable network...Experiential Education Division. In Late May, Deloitte , the largest private professional services organization in the world, once again chose the...USAWC’s SLSR Program to meet their leader development needs. Because of the success they have had with the program over the years, Deloitte has formally

ADS pilot program Plan

NASA Technical Reports Server (NTRS)

Clauson, J.; Heuser, J.

1981-01-01

The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

Safety management of Ethernet broadband access based on VLAN aggregation

NASA Astrophysics Data System (ADS)

Wang, Li

2004-04-01

With broadband access network development, the Ethernet technology is more and more applied access network now. It is different from the private network -LAN. The differences lie in four points: customer management, safety management, service management and count-fee management. This paper mainly discusses the safety management related questions. Safety management means that the access network must secure the customer data safety, isolate the broad message which brings the customer private information, such as ARP, DHCP, and protect key equipment from attack. Virtue LAN (VLAN) technology can restrict network broadcast flow. We can config each customer port with a VLAN, so each customer is isolated with others. The IP address bound with VLAN ID can be routed rightly. But this technology brings another question: IP address shortage. VLAN aggregation technology can solve this problem well. Such a mechanism provides several advantages over traditional IPv4 addressing architectures employed in large switched LANs today. With VLAN aggregation technology, we introduce the notion of sub-VLANs and super-VLANs, a much more optimal approach to IP addressing can be realized. This paper will expatiate the VLAN aggregation model and its implementation in Ethernet access network. It is obvious that the customers in different sub-VLANs can not communication to each other because the ARP packet is isolated. Proxy ARP can enable the communication among them. This paper will also expatiate the proxy ARP model and its implementation in Ethernet access network.

49 CFR 37.29 - Private entities providing taxi service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Private entities providing taxi service. 37.29... INDIVIDUALS WITH DISABILITIES (ADA) Applicability § 37.29 Private entities providing taxi service. (a) Providers of taxi service are subject to the requirements of this part for private entities primarily...

49 CFR 37.29 - Private entities providing taxi service.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Private entities providing taxi service. 37.29... INDIVIDUALS WITH DISABILITIES (ADA) Applicability § 37.29 Private entities providing taxi service. (a) Providers of taxi service are subject to the requirements of this part for private entities primarily...

Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

PubMed

Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

2009-01-01

To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to enhance the ambulatory pharmacy practice model.

Experiences of care by Australians with a diagnosis of borderline personality disorder

PubMed Central

McMahon, J.

2015-01-01

Accessible summary Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them.This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types.People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD. Abstract There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population. PMID:26122817

Characteristics of practitioners in a private managed behavioral health plan.

PubMed

Reif, Sharon; Torres, Maria E; Horgan, Constance M; Merrick, Elizabeth L

2012-08-28

Little is known about the practitioners in managed behavioral healthcare organization (MBHO) networks who are treating mental and substance use disorders among privately insured patients in the United States. It is likely that the role of the private sector in treating behavioral health will increase due to the recent implementation of federal parity legislation and the inclusion of behavioral health as a required service in the insurance exchange plans created under healthcare reform. Further, the healthcare reform legislation has highlighted the need to ensure a qualified workforce in order to improve access to quality healthcare, and provides an additional focus on the behavioral health workforce. To expand understanding of treatment of mental and substance use disorders among privately insured patients, this study examines practitioner types, experience, specialized expertise, and demographics of in-network practitioners providing outpatient care in one large national MBHO. Descriptive analyses used 2004 practitioner credentialing and other administrative data for one MBHO. The sample included 28,897 practitioners who submitted at least one outpatient claim in 2004. Chi-square and t-tests were used to compare findings across types of practitioners. About half of practitioners were female, 12% were bilingual, and mean age was 53, with significant variation by practitioner type. On average, practitioners report 15.3 years of experience (SD = 9.4), also with significant variation by practitioner type. Many practitioners reported specialized expertise, with about 40% reporting expertise for treating children and about 60% for treating adolescents. Overall, these results based on self-report indicate that the practitioner network in this large MBHO is experienced and has specialized training, but echo concerns about the aging of this workforce. These data should provide us with a baseline of practitioner characteristics as we enter an era that anticipates great change in the behavioral health workforce.

Open for business: private networks create a marketplace for health information exchange.

PubMed

Dimick, Chris

2012-05-01

Large health systems and their IT vendors are creating private information exchange networks at a time when federally funded state operations are gearing up for launch, Is there room for private and public offerings in the new HIE marketplace?

Setting Access Permission through Transitive Relationship in Web-based Social Networks

NASA Astrophysics Data System (ADS)

Hong, Dan; Shen, Vincent Y.

The rising popularity of various social networking websites has created a huge problem on Internet privacy. Although it is easy to post photos, comments, opinions on some events, etc. on the Web, some of these data (such as a person’s location at a particular time, criticisms of a politician, etc.) are private and should not be accessed by unauthorized users. Although social networks facilitate sharing, the fear of sending sensitive data to a third party without knowledge or permission of the data owners discourages people from taking full advantage of some social networking applications. We exploit the existing relationships on social networks and build a ‘‘trust network’’ with transitive relationship to allow controlled data sharing so that the privacy and preferences of data owners are respected. The trust network linking private data owners, private data requesters, and intermediary users is a directed weighted graph. The permission value for each private data requester can be automatically assigned in this network based on the transitive relationship. Experiments were conducted to confirm the feasibility of constructing the trust network from existing social networks, and to assess the validity of permission value assignments in the query process. Since the data owners only need to define the access rights of their closest contacts once, this privacy scheme can make private data sharing easily manageable by social network participants.

47 CFR 101.1305 - Private internal service.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Private internal service. 101.1305 Section 101.1305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Multiple Address Systems General Provisions § 101.1305 Private internal service...

47 CFR 101.1305 - Private internal service.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Private internal service. 101.1305 Section 101.1305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Multiple Address Systems General Provisions § 101.1305 Private internal service...

47 CFR 101.1305 - Private internal service.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Private internal service. 101.1305 Section 101.1305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Multiple Address Systems General Provisions § 101.1305 Private internal service...

Perceived outcomes of public health privatization: a national survey of local health department directors.

PubMed

Keane, C; Marx, J; Ricci, E

2001-01-01

Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their performance of the core public health functions. Expanded access to services was the most commonly reported positive outcome. Of those privatizing, over two-fifths of LHDs reported a resulting increase in time devoted to management. Yet, one-third of directors reported difficulty monitoring and controlling services that have been contracted out. Communicable disease services was cited most often as a service that should not be privatized. There is a pervasive concern that by contracting out services, health departments can lose the capacity to respond to disease outbreaks and other crises.

Perceived Outcomes of Public Health Privatization: A National Survey of Local Health Department Directors

PubMed Central

Keane, Christopher; Marx, John; Ricci, Edmund

2001-01-01

Almost three quarters of the nation's local health departments (LHDs) have privatized some services. About half of LHD directors who privatized services reported cost savings and half reported that privatization had facilitated their performance of the core public health functions. Expanded access to services was the most commonly reported positive outcome. Of those privatizing, over two-fifths of LHDs reported a resulting increase in time devoted to management. Yet, one-third of directors reported difficulty monitoring and controlling services that have been contracted out. Communicable disease services was cited most often as a service that should not be privatized. There is a pervasive concern that by contracting out services, health departments can lose the capacity to respond to disease outbreaks and other crises. PMID:11286093

Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa

PubMed Central

Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N.

2016-01-01

After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. PMID:27025696

Marine Corps Private Cloud Computing Environment Strategy

DTIC Science & Technology

2012-05-15

leveraging economies of scale through the MCEITS PCCE, the Marine Corps will measure consumed IT resources more effectively, increase or decrease...flexible broad network access, resource pooling, elastic provisioning and measured services. By leveraging economies of scale the Marine Corps will be able...IaaS SaaS / IaaS 1 1 LCE I ACE Dets I I I I ------------------~ GIG / CJ Internet Security Boundary MCEN I DISN r :------------------ MCEN

Ways and Means to Utilize Private Practitioners for Tuberculosis Care in India.

PubMed

Samal, Janmejaya

2017-02-01

The growing interest of utilizing the private practitioners in improving the outreach of public health services including Tuberculosis (TB) control programme stemmed out of people's preference for private health facilities in situations where public health facilities fail to meet the expectations. In different parts of India, many models of Public Private Partnership have been tried and tested and proved successful in providing quality TB care in the concerned community. In this paper, several ways and means have been proposed to effectively utilize private practitioners for TB care in India. These strategies are discussed under different headings: (1) identification of potential private practitioners: (2) orientation of private practitioners: (3) networking of private practitioners with patients and Directly Observed Treatment Short course (DOTS) provider: (4) follow-up and sensitization of patients by private practitioners: (5) let the word of mouth work: and (6) evaluation of the involvement of private practitioners in TB care. However the following points must be addressed before utilizing the private practitioners for TB care: time constraints in notifying the disease, adherence to DOTS regime/alternative to DOTS regime, referral of patients to public health facilities for diagnosis and treatment, follow-up and sensitization of the patients and behaviour change communication and awareness in the community by the private practitioners. Few of these are mandatory for the private practitioners; most are practicable. With the effective utilization of private practitioners many problems can be sorted out that are currently plaguing the system such as irrational and excessive use of certain drugs, over reliance on chest X-ray for diagnosis, under use of sputum microscopy, lack of knowledge regarding standard treatment protocols and varied prescription practices.

Integration opportunities for HIV and family planning services in Addis Ababa, Ethiopia: an organizational network analysis

PubMed Central

2014-01-01

Background Public health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening. Methods In two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations. Results The two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations. Conclusions Because of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the overall referral densities suggests that improved connections throughout might benefit conditions in addition to HIV and family planning that need service integration. PMID:24438522

Integration opportunities for HIV and family planning services in Addis Ababa, Ethiopia: an organizational network analysis.

PubMed

Thomas, James C; Reynolds, Heidi; Bevc, Christine; Tsegaye, Ademe

2014-01-18

Public health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening. In two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations. The two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations. Because of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the overall referral densities suggests that improved connections throughout might benefit conditions in addition to HIV and family planning that need service integration.

Public and private funding of general practice services for children and adolescents in New Zealand.

PubMed

Dovey, Susan; Tilyard, Murray; Cunningham, Wayne; Williamson, Martyn

2011-11-01

To measure public and private funding of general practice services for New Zealand children. Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6-17 years. Government subsidies and public insurance payments provided public funding amounts for seven services. Overall and for each service we estimated the ratio of public:private payments (RPPP). 64.0% of annual expenditure was public, 36.0% private, (RPPP=1:0.56). General medical consultations were 67.2% of services (RPPP=1:0.57); 15.3% were injury-related (RPPP=1:0.36); 5.2% were prescribing services (all private); 4.9% were immunizations (RPPP=1:0.12); 2.9% were nursing (RPPP=1:1.33); 4.4% were administration (all private); and 0.1% were for maternity care (RPPP=1:0.007). Before capitation funding, public and private funding levels for general medical consultations were similar (RPPP=1:0.93) but after capitation public payments more than doubled (RPPP=1:0.40). There is a complex of pattern of public and private payments for general practice services for children and adolescents in New Zealand. Both funding sources are critical. Capitation funding changed the balance substantially but did not remove ongoing reliance on private funding to support general practice care for children. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Users of home-care services in a Nordic welfare state under marketisation: the rich, the poor and the sick.

PubMed

Mathew Puthenparambil, Jiby; Kröger, Teppo; Van Aerschot, Lina

2017-01-01

Stricter access to public services, outsourcing of municipal services and increasing allocation of public funding for the purchase of private services have resulted in a marketisation wave in Finland. In this context of a Nordic welfare state undergoing marketisation, this paper aims to examine the use of Finnish care services among older people and find out who are using these new kinds of private services. How wide is their use and do the users of private care services differ from those who are using public services? How usual is it to mix both public and private care services? The questionnaire survey data set used here was gathered in 2010 among the population aged 75 and over in the cities of Jyväskylä and Tampere (N = 1436). The methods of analysis used include cross-tabulation, chi-square tests and multinomial logistic regression. The findings showed that among those respondents who used care services (n = 681), 50% used only public services, 24% utilised solely private services and the remaining 26% used both kinds of services. Users of solely private services had significantly higher income and education as well as better health than those using public services only. The users of public services had the lowest education and income levels and usually lived in rented housing. The third group, those mixing both public and private services, reported poorer health than others. The results increase concerns about the development towards a two-tier service system, jeopardising universalistic Nordic principles, and also suggest that older people with the highest needs do not receive adequate services without complementing their public provisions with private services. © 2015 John Wiley & Sons Ltd.

[Oral health knowledge and practices among pregnant women using health services in São Luís, Maranhão, Brazil, 2007-2008].

PubMed

Lopes, Fernanda Ferreira; Ribeiro, Tafnes Valverde; Fernandes, Daniela Braga; Calixto, Nayra Rodrigues de Vasconcelos; Alves, Cláudia Maria Coêlho; Pereira, Antônio Luiz Amaral; Pereira, Adriana de Fátima Vasconcelos

2016-01-01

to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.

A-21st-century-approach to firefighting in the Western US: How microwave-based seismic networks can change fire suppression from reactive to proactive

NASA Astrophysics Data System (ADS)

Kent, G. M.; Smith, K. D.; Williams, M. C.; Slater, D. E.; Plank, G.; McCarthy, M.; Rojas-Gonzalez, R.; Vernon, F.; Driscoll, N. W.; Hidley, G.

2015-12-01

The Nevada Seismological Laboratory (NSL) at UNR has recently embarked on a bold technical initiative, installing a high-speed (up to 190 Mb/sec) mountaintop-based Internet Protocol (IP) microwave network, enabling a myriad of sensor systems for Multi-Hazard Early Warning detection and response. In the Tahoe Basin, this system is known as AlertTahoe; a similar network has been deployed in north-central Nevada as part of a 5-year-long grant with BLM. The UNR network mirrors the successful HPWREN multi-hazard network run through UCSD; the UNR "Alert" program (Access to Leverage Emergency information in Real Time) has expanded on the original concept by providing a framework for early fire detection and discovery. Both systems do not rely on open-access public Internet services such as those provided by cellular service providers. Instead, they utilize private wireless communication networks to collect data 24/7 in real-time from multiple sensors throughout the system. Utilizing this restricted-access private communication platform enhances system reliability, capability, capacity and versatility for staff and its community of certified users. Both UNR and UCSD fire camera systems are presently being confederated under a common framework to provide end users (e.g., BLM, USFS, CalFire) a unified interface. Earthquake response has been both organizations' primary mission for decades; high-speed IP microwave fundamentally changes the playing field allowing for rapid early detection of wildfires, earthquakes and other natural disasters, greatly improving local and regional disaster response/recovery. For example, networked cameras can be optimally placed for wildfire detection and are significantly less vulnerable due infrastructure hardening and the ability to avoid extreme demands by the public on cellular and other public networks during a crisis. These systems also provide a backup for emergency responders to use when public access communications become overwhelmed or fail during an event. The crowd-sourced fire cameras can be viewed year round through AlertTahoe and AlertSoCal websites with on-demand time-lapse, an integrated real time lightning map, and other useful features.

The perceived impact of privatization on local health departments.

PubMed

Keane, Christopher; Marx, John; Ricci, Edmund; Barron, Gerald

2002-07-01

This article presents nationally representative data on the effects of privatization on local health departments (LHDs). A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.

Organization of the Saudi health system.

PubMed

Al-Yousuf, M; Akerele, T M; Al-Mazrou, Y Y

2002-01-01

Using existing data, we reviewed the organizational structure of the Saudi Arabian health system: its demography and history, principal health indicators, organization and management, type and distribution of facilities, financial base, and the impact on it of the Haj. We noted duplication of services, inadequate coordination between some health industry sectors, and the need for a more extensive and rational health centre network with improved information systems and data collection. We also noted scope for a greater role for the private health sector and increased cooperation between it and the public sector to improve health service delivery and population health.

Evaluation of Immunization Knowledge, Practices, and Service-delivery in the Private Sector in Cambodia

PubMed Central

Soeung, Sann Chan; Grundy, John; Morn, Cheng; Samnang, Chham

2008-01-01

A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facilities; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. In terms of prevalence of private-sector provision of immunization services, 93% of the private inpatient clinics surveyed provided immunization services. The private sector demonstrated a lack of quality of care and management in terms of health workers’ knowledge of immunization schedules, waste and vaccine management practices, and exchange of health information with the public sector. Policy and operational guidelines are required for private-sector immunization practices that address critical subject areas, such as setting of standards, capacity-building, public-sector monitoring, and exchange of health information between the public and the private sector. Such public/private collaborations will keep pace with the trends towards the development of private-sector provision of health services in developing countries. PMID:18637533

Maternal and child health services in India with special focus on perinatal services.

PubMed

Singh, M; Paul, V K

1997-01-01

India has an excellent infrastructural layout for the delivery of MCH services in the community through a network of subcenters, primary health centers, community health centers, district hospitals, state medical college hospitals, and other hospitals in the public and private sectors. However, the health pyramid does not function effectively because of limited resources, communication delays, a lack of commitment on the part of health professionals, and, above all, a lack of managerial skills, supervision, and political will. The allocation of financial resources for the delivery of health care continues to be meager. Nevertheless, in spite of obvious constraints, the country has made laudable progress in reducing post-neonatal mortality in recent years. Indeed, the focus has shifted to the young infants and the perinates. Under the CSSM program, a massive expansion of MCH services has occurred at the sub-district and the district levels. The RCH program, to be launched shortly, aims at effective utilization of these facilities to ensure delivery of integrated services of assured quality through decentralized planning. Simultaneously, as a result of the ongoing economic liberalization, the MCH care in the private sector will also expand rapidly. Indeed, India is on the threshold of an extraordinary improvement in the status of its neonatal-perinatal health.

Neoliberal Long-Term Care: From Community to Corporate Control.

PubMed

Polivka, Larry; Luo, Baozhen

2017-09-23

Publicly (mainly Medicaid) funded long-term care (LTC) services have evolved from a nursing home dominated system of service to a much more balanced system including home- and community-based services (HCBS) programs over the last 30 years. The HCBS programs have been largely administered by the state and local level nonprofit aging networks (ANs) consisting of Area Agencies on Aging and thousands of service providers. Over the last decade, however, for-profit HMOs administered primarily by large insurance companies have begun to displace AN organizations. State policymakers have embraced for-profit privatizations under the rationale that this approach will generate greater savings, efficiencies, and higher quality outcomes than the traditional public or private nonprofit models of program administration. As we show here, there is very little evidence for this rationale; yet, this lack of evidence has not prevented the continuing growth of for-profit managed LTC programs supported more by an ideology of market fundamentalism than empirical evidence. We also describe six possible consequences of the trend toward corporate control of public LTC services in the years ahead. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Integrated primary health care in Australia.

PubMed

Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

2009-10-14

To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

Implementation of a light-route TDMA communications satellite system for advanced business networks

NASA Astrophysics Data System (ADS)

Hanson, B.; Smalley, A.; Zuliani, M.

The application of Light Route TDMA systems to various business communication requirements is discussed. It is noted that full development of this technology for use in advanced business networks will be guided by considerations of flexibility, reliability, security, and cost. The implementation of the TDMA system for demonstrating these advantages to a wide range of public and private organizations is described in detail. Among the advantages offered by this system are point-to-point and point-to-multipoint (broadcast) capability; the ability to vary the mix and quantity of services between destinations in a fully connected mesh network on an almost instantaneous basis through software control; and enhanced reliability with centralized monitor, alarm and control functions by virtue of an overhead channel.

Private Peer-to-Peer Networks

NASA Astrophysics Data System (ADS)

Rogers, Michael; Bhatti, Saleem

This chapter offers a survey of the emerging field of private peer-to-peer networks, which can be defined as internet overlays in which the resources and infrastructure are provided by the users, and which new users may only join by personal invitation. The last few years have seen rapid developments in this field. We describe deployed systems, classify them architecturally, and identify some technical and social tradeoffs in the design of private peer-to-peer networks.

The thinking of Cloud computing in the digital construction of the oil companies

NASA Astrophysics Data System (ADS)

CaoLei, Qizhilin; Dengsheng, Lei

In order to speed up digital construction of the oil companies and enhance productivity and decision-support capabilities while avoiding the disadvantages from the waste of the original process of building digital and duplication of development and input. This paper presents a cloud-based models for the build in the digital construction of the oil companies that National oil companies though the private network will join the cloud data of the oil companies and service center equipment integrated into a whole cloud system, then according to the needs of various departments to prepare their own virtual service center, which can provide a strong service industry and computing power for the Oil companies.

Comparing the services and quality of private and public clinics in rural China.

PubMed

Meng, Q; Liu, X; Shi, J

2000-12-01

After 15 years eradication of the private health sector in Socialist China, private practice was restored in 1980 along with the market oriented economic reform. In recent years, however, debates on its pros and cons are increasing. Arguments against private practice have led to a ban on private practice in some rural counties. The arguments against private practice state that the service quality of private clinics tends to be lower than that of public ones; private clinics are less likely to provide preventive care; and private clinics are more likely to provide over-treatment. This paper presents the major findings from a study conducted in China, aiming at comparing private and public village health clinics in terms of quality of services, willingness to provide preventive care and over-prescription of drugs. While it was found that the quality of services was poor and a large proportion of patient expenditure was due to over-treatment for all village clinics, there was no difference between public and private clinics. Both private and public clinics were willing to provide preventive services if they were subsidized for the provision. This study finds no evidence that care provided by private clinics is inferior to that of public clinics.

42 CFR 440.80 - Private duty nursing services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for beneficiaries who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

42 CFR 440.80 - Private duty nursing services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for beneficiaries who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

42 CFR 440.80 - Private duty nursing services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for beneficiaries who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

42 CFR 440.80 - Private duty nursing services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

42 CFR 440.80 - Private duty nursing services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

Implementing the National Integrated Ocean Observing System (IOOS): from the federal agency perspective

USGS Publications Warehouse

Bassett, R.; Beard, R.; Burnett, W.; Crout, R.; Griffith, B.; Jensen, R.; Signell, R.

2010-01-01

The national Integrated Ocean Observing System (IOOS??) is responsible for coordinating a network of people, resources, and technology to disseminate continuous data, information, models, products, and services made throughout our coastal waters, Great Lakes, and the oceans. There are many components of the IOOS-including government, academic, and private entities. This article will focus on some of the federal contributions to IOOS and describe the capabilities of several agency partners.

Private payer telehealth reimbursement in the United States.

PubMed

Antoniotti, Nina M; Drude, Kenneth P; Rowe, Nancy

2014-06-01

Significant information is available about government-reimbursed telehealth services such as Medicare and Medicaid across the United States. Although currently 20 states mandate reimbursement for telehealth services and some private insurers have voluntarily covered those services in other states, relatively little is known about telehealth provider experiences with reimbursement from private insurance payers. To investigate this, the American Telemedicine Association's (ATA's) Telemental Health Special Interest Group (SIG), the Policy Group, and the Business and Finance SIG, with the help of ATA staff, conducted a national private payer reimbursement online survey in 2012 using Survey Monkey™ (Palo Alto, CA) ( www.surveymonkey.com/ ). Survey responses were received from respondents in 46 of the 50 states. The survey found that telehealth services are being reimbursed by private payers but that progress in reimbursement has been relatively slow compared with earlier surveys. Key findings from this study were that government payers as well as several major private payers are highly influential in payment policies for telehealth private payers, that private payers have administrative rules regarding telehealth reimbursement that are barriers to services and reimbursement, and that some providers would benefit from being better informed about billing and coding for telehealth services and how to advocate for telehealth services reimbursement.

49 CFR 37.171 - Equivalency requirement for demand responsive service operated by private entities not primarily...

Code of Federal Regulations, 2010 CFR

2010-10-01

... service operated by private entities not primarily engaged in the business of transporting people. 37.171... responsive service operated by private entities not primarily engaged in the business of transporting people. A private entity not primarily engaged in the business of transporting people which operates a...

49 CFR 37.171 - Equivalency requirement for demand responsive service operated by private entities not primarily...

Code of Federal Regulations, 2012 CFR

2012-10-01

... service operated by private entities not primarily engaged in the business of transporting people. 37.171... responsive service operated by private entities not primarily engaged in the business of transporting people. A private entity not primarily engaged in the business of transporting people which operates a...

49 CFR 37.171 - Equivalency requirement for demand responsive service operated by private entities not primarily...

Code of Federal Regulations, 2013 CFR

2013-10-01

... service operated by private entities not primarily engaged in the business of transporting people. 37.171... responsive service operated by private entities not primarily engaged in the business of transporting people. A private entity not primarily engaged in the business of transporting people which operates a...

49 CFR 37.171 - Equivalency requirement for demand responsive service operated by private entities not primarily...

Code of Federal Regulations, 2011 CFR

2011-10-01

... service operated by private entities not primarily engaged in the business of transporting people. 37.171... responsive service operated by private entities not primarily engaged in the business of transporting people. A private entity not primarily engaged in the business of transporting people which operates a...

49 CFR 37.171 - Equivalency requirement for demand responsive service operated by private entities not primarily...

Code of Federal Regulations, 2014 CFR

2014-10-01

... service operated by private entities not primarily engaged in the business of transporting people. 37.171... responsive service operated by private entities not primarily engaged in the business of transporting people. A private entity not primarily engaged in the business of transporting people which operates a...

34 CFR 300.139 - Location of services and transportation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in Private Schools § 300.139 Location of services and transportation. (a) Services on private school premises. Services to parentally-placed private school children with disabilities may be provided...

34 CFR 300.139 - Location of services and transportation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in Private Schools § 300.139 Location of services and transportation. (a) Services on private school premises. Services to parentally-placed private school children with disabilities may be provided...

Disaster-hardened imaging POD for PACS

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice; Frost, Meryll

2005-04-01

After the events of 9/11, many people questioned their ability to keep critical services operational in the face of massive infrastructure failure. Hospitals increased their backup and recovery power, made plans for emergency water and food, and operated on a heightened alert awareness with more frequent disaster drills. In a film-based radiology department, if a portable X-ray unit, a CT unit, an Ultrasound unit, and an film processor could be operated on emergency power, a limited, but effective number of studies could be performed. However, in a digital department, there is a reliance on the network infrastructure to deliver images to viewing locations. The system developed for our institution uses several imaging PODS, a name we chose because it implied to us a safe, contained environment. Each POD is a stand-alone emergency powered network capable of generating images and displaying them in the POD or printing them to a DICOM printer. The technology we used to create a POD consists of a computer with dual network interface cards joining our private, local POD network, to the hospital network. In the case of an infrastructure failure, each POD can and does work independently to produce CTs, CRs, and Ultrasounds. The system has been tested during disaster drills and works correctly, producing images using equipment technologists are comfortable using with very few emergency switch-over tasks. Purpose: To provide imaging capabilities in the event of a natural or man-made disaster with infrastructure failure. Method: After the events of 9/11, many people questioned their ability to keep critical services operational in the face of massive infrastructure failure. Hospitals increased their backup and recovery power, made plans for emergency water and food, and operated on a heightened alert awareness with more frequent disaster drills. In a film-based radiology department, if a portable X-ray unit, a CT unit, an Ultrasound unit, and an film processor could be operated on emergency power, a limited, but effective number of studies could be performed. However, in a digital department, there is a reliance on the network infrastructure to deliver images to viewing locations. The system developed for our institution uses several imaging PODS, a name we chose because it implied to us a safe, contained environment. Each POD is on both the standard and the emergency power systems. All the vendor equipment that produces images is on a private, stand-alone network controlled either by a simple or a managed switch. Included in each POD is a dry-process DICOM printer that is rarely used during normal operations and a display workstation. One node on the private network is a PACS application processor (AP) with two network interface cards, one for the private network, one for the standard PACS network. During ordinary daily operations, all acquired images pass through this AP and are routed to the PACS archives, web servers, and workstations. However, if the power and network to much of the hospital were to fail, the stand-alone POD could still function. Images are routed to the AP, but cannot forward to the main network. However, they can be routed to the printer and display in the POD. They are also stored on the AP to continue normal routing when the infrastructure is restored. Results: The imaging PODS have been tested in actual disaster testing where the infrastructure was intentionally removed and worked as designed. To date, we have not had to use them in a real-life scenario and we hope we never do, but we feel we have a reasonable level of emergency imaging capability if we ever need it. Conclusions: Our testing indicates our PODS are a viable way to continue medical imaging in the face of an emergency with a major part of our network and electrical infrastructure destroyed.

The Perceived Impact of Privatization on Local Health Departments

PubMed Central

Keane, Christopher; Marx, John; Ricci, Edmund; Barron, Gerald

2002-01-01

Objectives. This article presents nationally representative data on the effects of privatization on local health departments (LHDs). Methods. A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. Results. One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. Conclusions. Privatization is part of a broader shift toward “managing” rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services. (Am J Public Health. 2002;92:1178–1180) PMID:12084705

Athletic Trainer Services in Public and Private Secondary Schools.

PubMed

Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

2017-01-01

 The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

Athletic Trainer Services in Public and Private Secondary Schools

PubMed Central

Pike, Alicia M.; Pryor, Riana R.; Vandermark, Lesley W.; Mazerolle, Stephanie M.; Casa, Douglas J.

2017-01-01

Context: The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored. Objective: To compare the level of AT services in public and private secondary schools. Design: Concurrent mixed-methods study. Setting: Public and private secondary schools in the United States. Patients or Other Participants: A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private). Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis. Results: A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators. Conclusions: Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector. PMID:28157403

Impact of different cloud deployments on real-time video applications for mobile video cloud users

NASA Astrophysics Data System (ADS)

Khan, Kashif A.; Wang, Qi; Luo, Chunbo; Wang, Xinheng; Grecos, Christos

2015-02-01

The latest trend to access mobile cloud services through wireless network connectivity has amplified globally among both entrepreneurs and home end users. Although existing public cloud service vendors such as Google, Microsoft Azure etc. are providing on-demand cloud services with affordable cost for mobile users, there are still a number of challenges to achieve high-quality mobile cloud based video applications, especially due to the bandwidth-constrained and errorprone mobile network connectivity, which is the communication bottleneck for end-to-end video delivery. In addition, existing accessible clouds networking architectures are different in term of their implementation, services, resources, storage, pricing, support and so on, and these differences have varied impact on the performance of cloud-based real-time video applications. Nevertheless, these challenges and impacts have not been thoroughly investigated in the literature. In our previous work, we have implemented a mobile cloud network model that integrates localized and decentralized cloudlets (mini-clouds) and wireless mesh networks. In this paper, we deploy a real-time framework consisting of various existing Internet cloud networking architectures (Google Cloud, Microsoft Azure and Eucalyptus Cloud) and a cloudlet based on Ubuntu Enterprise Cloud over wireless mesh networking technology for mobile cloud end users. It is noted that the increasing trend to access real-time video streaming over HTTP/HTTPS is gaining popularity among both research and industrial communities to leverage the existing web services and HTTP infrastructure in the Internet. To study the performance under different deployments using different public and private cloud service providers, we employ real-time video streaming over the HTTP/HTTPS standard, and conduct experimental evaluation and in-depth comparative analysis of the impact of different deployments on the quality of service for mobile video cloud users. Empirical results are presented and discussed to quantify and explain the different impacts resulted from various cloud deployments, video application and wireless/mobile network setting, and user mobility. Additionally, this paper analyses the advantages, disadvantages, limitations and optimization techniques in various cloud networking deployments, in particular the cloudlet approach compared with the Internet cloud approach, with recommendations of optimized deployments highlighted. Finally, federated clouds and inter-cloud collaboration challenges and opportunities are discussed in the context of supporting real-time video applications for mobile users.

Volunteer provision of long-term care for older people in Thailand and Costa Rica.

PubMed

Lloyd-Sherlock, Peter; Pot, Anne Margriet; Sasat, Siriphan; Morales-Martinez, Fernando

2017-11-01

Demand for long-term care services for older people is increasing rapidly in low- and middle-income countries. Countries need to establish national long-term care systems that are sustainable and equitable. The Governments of Costa Rica and Thailand have implemented broadly comparable interventions to deploy volunteers in long-term home care. Both countries trained older volunteers from local communities to make home visits to impoverished and vulnerable older people and to facilitate access to health services and other social services. Costa Rica and Thailand are upper-middle-income countries with strong traditions of community-based health services that they are now extending into long-term care for older people. Between 2003 and 2013 Thailand's programme trained over 51 000 volunteers, reaching almost 800 000 older people. Between 2010 and 2016 Costa Rica established 50 community care networks, serving around 10 000 people and involving over 5000 volunteers. Despite some evidence of benefits to the physical and mental health of older people and greater uptake of other services, a large burden of unmet care needs and signs of a growth of unregulated private services still exist. There is scope for low- and middle-income countries to develop large-scale networks of community-based long-term care volunteers. The capacity of volunteers to enhance the quality of life of clients is affected by the local availability of care services. Volunteer care networks should be complemented by other initiatives, including training about health in later life for volunteers, and investment in community long-term care services.

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.112 Government... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Government use of private... service firms for the brief or intermittent use of the skills of private sector temporaries. Services...

29 CFR 553.104 - Private individuals who volunteer services to public agencies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Private individuals who volunteer services to public... GOVERNMENTS Volunteers § 553.104 Private individuals who volunteer services to public agencies. (a... service to a public agency for civic or humanitarian reasons. Such individuals are considered volunteers...

29 CFR 553.104 - Private individuals who volunteer services to public agencies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Private individuals who volunteer services to public... GOVERNMENTS Volunteers § 553.104 Private individuals who volunteer services to public agencies. (a... service to a public agency for civic or humanitarian reasons. Such individuals are considered volunteers...

29 CFR 553.104 - Private individuals who volunteer services to public agencies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Private individuals who volunteer services to public... GOVERNMENTS Volunteers § 553.104 Private individuals who volunteer services to public agencies. (a... service to a public agency for civic or humanitarian reasons. Such individuals are considered volunteers...

29 CFR 553.104 - Private individuals who volunteer services to public agencies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Private individuals who volunteer services to public... GOVERNMENTS Volunteers § 553.104 Private individuals who volunteer services to public agencies. (a... service to a public agency for civic or humanitarian reasons. Such individuals are considered volunteers...

Blood banking services in India.

PubMed

Sardana, V N

1996-01-01

India's health care sector has made impressive strides toward providing health for all by the year 2000. That progress, however, has not been supported by a modern transfusion services network which continues to improve itself. In India, blood collection, storage, and delivery occur mainly in blood banks attached to hospitals, most of which are under central and state government controls. A significant portion of blood banking activity is also done by voluntary agencies and private sector blood banks. A study found the blood transfusion services infrastructure to be highly decentralized and lacking of many critical resources; an overall shortage of blood, especially from volunteer donors; limited and erratic testing facilities; an extremely limited blood component production/availability/use; and a shortage of health care professionals in the field of transfusion services. Infrastructural modernization and the technical upgrading of skills in the blood banks would, however, provide India with a dynamic transfusion services network. The safety of blood transfusion, the national blood safety program, HIV testing facilities, modernization of blood banks, the rational use of blood, program management, manpower development, the legal framework, voluntary blood donation, and a 1996 Supreme Court judgement on the need to focus greater attention upon the blood program are discussed.

Cloud Based Drive Forensic and DDoS Analysis on Seafile as Case Study

NASA Astrophysics Data System (ADS)

Bahaweres, R. B.; Santo, N. B.; Ningsih, A. S.

2017-01-01

The rapid development of Internet due to increasing data rates through both broadband cable networks and 4G wireless mobile, make everyone easily connected to the internet. Storages as Services (StaaS) is more popular and many users want to store their data in one place so that whenever they need they can easily access anywhere, any place and anytime in the cloud. The use of the service makes it vulnerable to use by someone to commit a crime or can do Denial of Service (DoS) on cloud storage services. The criminals can use the cloud storage services to store, upload and download illegal file or document to the cloud storage. In this study, we try to implement a private cloud storage using Seafile on Raspberry Pi and perform simulations in Local Area Network and Wi-Fi environment to analyze forensically to discover or open a criminal act can be traced and proved forensically. Also, we can identify, collect and analyze the artifact of server and client, such as a registry of the desktop client, the file system, the log of seafile, the cache of the browser, and database forensic.

Abortion services at hospitals in Istanbul.

PubMed

O'Neil, Mary Lou

2017-04-01

Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications. Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted. 14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances. State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.

Provision of family planning services in Tanzania: a comparative analysis of public and private facilities.

PubMed

Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd

2012-12-01

Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health facilities. Majority of public facilities (95.4%) offered family planning services, whereas more than half of private facilities (52.1%) did not offer those. Public facilities were more likely to offer modern contraceptives as compared to private facilities. However, private facilities were more likely to offer counseling on natural methods of family planning [AOR = 2.12 (1.15-3.92), P < or = 0.001]. Public facilities were more likely to report having guidelines or protocols for family planning services and various kinds of visual aids for family planning and STIs when compared to private facilities. This comparative analysis entails the need to enforce the standards of family planning services in Tanzania.

An Efficient Conflict Detection Algorithm for Packet Filters

NASA Astrophysics Data System (ADS)

Lee, Chun-Liang; Lin, Guan-Yu; Chen, Yaw-Chung

Packet classification is essential for supporting advanced network services such as firewalls, quality-of-service (QoS), virtual private networks (VPN), and policy-based routing. The rules that routers use to classify packets are called packet filters. If two or more filters overlap, a conflict occurs and leads to ambiguity in packet classification. This study proposes an algorithm that can efficiently detect and resolve filter conflicts using tuple based search. The time complexity of the proposed algorithm is O(nW+s), and the space complexity is O(nW), where n is the number of filters, W is the number of bits in a header field, and s is the number of conflicts. This study uses the synthetic filter databases generated by ClassBench to evaluate the proposed algorithm. Simulation results show that the proposed algorithm can achieve better performance than existing conflict detection algorithms both in time and space, particularly for databases with large numbers of conflicts.

Needs Assessment on the Use of Health Services Among Men Who Have Sex with Men in Ho Chi Minh City, Vietnam.

PubMed

Hoang, Huyen T; Mai, Thi D A; Nguyen, Ngoc Anh; Thu, Nguyen Tan; Van Hiep, Nguyen; Le, Bao; Colby, Donn J

2015-12-01

Men who have sex with men (MSM) in Vietnam are at high risk for HIV and sexually transmitted infections (STI). However, few MSM in Vietnam routinely utilize HIV/STI testing and treatment services. We conducted a survey among MSM in Ho Chi Minh City to assess practices and preferences for accessing health services. In this qualitative study, 19 individual interviews and 3 focus group discussions were conducted with a total of 50 MSM. All participants self-identified as gay or bisexual and were stratified by age group. Recruitment was by convenience sampling through social networks. Semi-structured interview guides included experience accessing health services, stigma and discrimination in the health care setting, and preferences for HIV and STI counseling and services. Fifty MSM aged 17 to 40 participated in the assessment. The majority had post-secondary education (92%) and above-average incomes. Almost all participants appreciated the cleanliness and quicker service in the private sector, while services in public hospitals were described as lower in quality but acceptable and uniform. The majority of the participants expressed a preference for MSM-specific services focusing on HIV/STI counseling, testing, and treatment. There was a strong preference for accessing HIV and STI services at a stand-alone clinic independent from other health facilities, where confidentiality could be assured. The majority were willing to pay a higher cost for private sector services, provided the service was of high quality, confidential, and non-stigmatizing. This study confirms the need for high quality, nonjudgmental, and confidential HIV/STI health services for MSM in Vietnam. There is generally a willingness to pay for health services provided that the services are seen to be tolerant and friendly to MSM.

Open source system OpenVPN in a function of Virtual Private Network

NASA Astrophysics Data System (ADS)

Skendzic, A.; Kovacic, B.

2017-05-01

Using of Virtual Private Networks (VPN) can establish high security level in network communication. VPN technology enables high security networking using distributed or public network infrastructure. VPN uses different security and managing rules inside networks. It can be set up using different communication channels like Internet or separate ISP communication infrastructure. VPN private network makes security communication channel over public network between two endpoints (computers). OpenVPN is an open source software product under GNU General Public License (GPL) that can be used to establish VPN communication between two computers inside business local network over public communication infrastructure. It uses special security protocols and 256-bit Encryption and it is capable of traversing network address translators (NATs) and firewalls. It allows computers to authenticate each other using a pre-shared secret key, certificates or username and password. This work gives review of VPN technology with a special accent on OpenVPN. This paper will also give comparison and financial benefits of using open source VPN software in business environment.

Mechanisms of microregulation of private hospitals by health plan operators.

PubMed

Ugá, Maria Alicia Domínguez; Vasconcellos, Miguel Murat; Lima, Sheyla Maria Lemos; Portela, Margareth Crisóstomo; Gerschman, Silvia

2009-10-01

To analyze the mechanisms employed by health plan operators for microregulation of clinical management and health care qualification within care-providing hospitals. A nation-wide cross-sectional study was carried out. The universe consisted of hospitals which provided care to health plan operators in 2006. A sample of 83 units was selected, stratified by Brazilian macroregion and type of hospital. Data were obtained by means of a questionnaire administered to hospital managers. Microregulation of hospitals by health plan operators was minimal or almost absent in terms of health care qualification. Operator activity focused predominantly on intense control of the amount of services used by patients. Hospitals providing services to health plan operators did not constitute health micro-systems parallel or supplementary to the Sistema Unico de Saúde (SUS - Brazilian National Health System). The private care-providing hospitals were predominantly associated with SUS. However, these did not belong to a private care-provider network, even though their service usage was subject to strong regulation by health plan operators. Operator intervention in the form of system management was incipient or virtually absent. Roughly one-half of investigated hospitals reported adopting clinical directives, whereas only 25.4% reported managing pathology and 30.5% reported managing cases. Contractual relationships between hospitals and health plan operators are merely commercial contracts with little if any incorporation of aspects related to the quality of care, being generally limited to aspects such as establishment of prices, timeframes, and payment procedures.

Supplemental care from a bioethical perspective.

PubMed

Carvalho, Regina Ribeiro Parizi; Fortes, Paulo Antônio de Carvalho; Garrafa, Volnei

2013-01-01

To describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010. Qualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board. There was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care. Private participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model. It is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS). Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

[Medical conglomerates].

PubMed

Austruy, P; Alexandre, L; Richard, F

1988-01-01

Community hospitals is undergoing rapid consolidation into network of private corporations providing health care services. So, the industrialization of health care lead to mega corporate health care. The multi-nationalization of U.S. multi-health care systems as HCA or Humana, has began at the end of the 70. The impact of this phenomena on the French health care system will be important. In order to protect technological independence and to integrate physicians into medical industrial complex, we have to create european multi-health systems.

[Colombia: what has happened with its health reform?].

PubMed

Gómez-Arias, Rubén Darío; Nieto, Emmanuel

2014-01-01

The health reform adopted in Colombia in 1993 was promoted by different agencies as the model to follow in matters of health policy. Following the guidelines of the Washington Consensus and the World Bank, the Government of Colombia, with the support of national political and economic elites, reorganized the management of health services based on market principles, dismantled the state system, increased finances of the sector, assigned the management of the system to the private sector, segmented the provision of services, and promoted interaction of actors in a competitive scheme of low regulation. After 20 years of implementation, the Colombian model shows serious flaws and is an object of controversy. The Government has weakened as the governing entity for health; private groups that manage the resources were established as strong centers of economic and political power; and violations of the right to health increased. Additionally, corruption and service cost overruns have put a strain on the sustainability of the system, and the state network is in danger of closing. Despite its loss of prestige at the internal level, various actors within and outside the country tend to keep the model based on contextual reforms.

Primary Health Care: care coordinator in regionalized networks?

PubMed Central

de Almeida, Patty Fidelis; dos Santos, Adriano Maia

2016-01-01

RESUMO OBJECTIVE To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. RESULTS Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. CONCLUSIONS Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries. PMID:28099663

Blocking performance of the hose model and the pipe model for VPN service provisioning over WDM optical networks

NASA Astrophysics Data System (ADS)

Wang, Haibo; Swee Poo, Gee

2004-08-01

We study the provisioning of virtual private network (VPN) service over WDM optical networks. For this purpose, we investigate the blocking performance of the hose model versus the pipe model for the provisioning. Two techniques are presented: an analytical queuing model and a discrete event simulation. The queuing model is developed from the multirate reduced-load approximation technique. The simulation is done with the OPNET simulator. Several experimental situations were used. The blocking probabilities calculated from the two approaches show a close match, indicating that the multirate reduced-load approximation technique is capable of predicting the blocking performance for the pipe model and the hose model in WDM networks. A comparison of the blocking behavior of the two models shows that the hose model has superior blocking performance as compared with pipe model. By and large, the blocking probability of the hose model is better than that of the pipe model by a few orders of magnitude, particularly at low load regions. The flexibility of the hose model allowing for the sharing of resources on a link among all connections accounts for its superior performance.

Blocking probability in the hose-model optical VPN with different number of wavelengths

NASA Astrophysics Data System (ADS)

Roslyakov, Alexander V.

2017-04-01

Connection setup with guaranteed quality of service (QoS) in the optical virtual private network (OVPN) is a major goal for the network providers. In order to support this we propose a QoS based OVPN connection set up mechanism over WDM network to the end customer. The proposed WDM network model can be specified in terms of QoS parameter such as blocking probability. We estimated this QoS parameter based on the hose-model OVPN. In this mechanism the OVPN connections also can be created or deleted according to the availability of the wavelengths in the optical path. In this paper we have considered the impact of the number of wavelengths on the computation of blocking probability. The goal of the work is to dynamically provide a best OVPN connection during frequent arrival of connection requests with QoS requirements.

Characteristics of private abortion services in Mexico City after legalization.

PubMed

Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia

2010-11-01

In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Privatization of School Food Services and Its Effect on the Financial Status of the Cafeteria Fund in Participating California Public School Districts.

ERIC Educational Resources Information Center

Schmieder, June; And Others

The opportunity to increase private company revenues and the pressure to minimize losses within a public school district's cafeteria and general funds have propelled the emergence of private food-service-management companies (FSMCs). This paper presents findings of a study that examined privatization of school food services and its effect on the…

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN).

PubMed

Gaynor, Mark; Lenert, Leslie; Wilson, Kristin D; Bradner, Scott

2014-01-01

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions--for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of 'common carriage' or 'public calling,' the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN)

PubMed Central

Gaynor, Mark; Lenert, Leslie; Wilson, Kristin D; Bradner, Scott

2014-01-01

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions—for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of ‘common carriage’ or ‘public calling,’ the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare. PMID:23837992

The Development of the Command and Control Centre for Trial Kondari

DTIC Science & Technology

2010-07-01

the C2 centre inside a blue bubble whose modems have privately assigned IP addresses which are authenticated by Telstra’s radius server. No other sim...cards can communicate on this private network unless authorised by the radius server. The Next IP network is a network bubble within the larger Next...for all machines on the network.  EPLRS Network Manager (ENM) radio – authenticates and manages all the EPLRS radios. The basic plan’s final

Private industrial foresters and Forest Service research - the relevancy question

Treesearch

Janie Canton-Thomas

2007-01-01

What is the nature of the relationship between U.S. Forest Service researchers and private industrial foresters? How can Forest Service Research maintain independence while serving agency and private forestry managers? We decided to seek input from someone outside of the Forest Service, so I asked Pat Connell, Vice President of Resource Operations for Rocky Mountain...

Household utilization and expenditure on private and public health services in Vietnam.

PubMed

Ha, Nguyen Thi Hong; Berman, Peter; Larsen, Ulla

2002-03-01

The private provision of health services in Vietnam was legalized in 1989 as one of the country's means to mobilize resources and improve efficiency in the health system. Ten years after its legalization, the private sector has widely expanded its activities and become an important provider of health services for the Vietnamese people. However, little is known about its contribution to the overall objectives of the health system in Vietnam. This paper assesses the role of the private health care provider by examining utilization patterns and financial burden for households of private, as compared with public, services. We found that the private sector provided 60% of all outpatient contacts in Vietnam. There was no difference by education, sex or place of residence in the use of private ambulatory health care. Although there was evidence suggesting that rich people use private care more than the poor, this finding was not consistent across all income groups. The private sector served young children in particular. Also, people in households with several sick members at the same time relied more on private than public care, while those with severe illnesses tended to use less private care than public. The financial burden for households from private health care services was roughly a half of that imposed by the public providers. Expenditure on drugs accounted for a substantial percentage of household expenditure in general and health care expenditure in particular. These findings call for a prompt recognition of the private sector as a key player in Vietnam's health system. Health system policies should mobilize positive private sector contributions to health system goals where possible and reduce the negative effects of private provision development.

75 FR 41381 - Private Land Mobile Radio Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

...] Private Land Mobile Radio Services AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY... to the January 1, 2011 interim deadlines associated with the narrowbanding of private land mobile... to the January 1, 2011 interim deadlines associated with the narrowbanding of private land mobile...

Is there a (volunteer) doctor in the house? Free clinics and volunteer physician referral networks in the United States.

PubMed

Isaacs, Stephen L; Jellinek, Paul

2007-01-01

Although community health centers and public hospitals are the most visible safety-net providers, physicians in private practice are the main source of care for the uninsured and Medicaid enrollees. Yet the number of these physicians providing free care is declining, even as the need for their services increases. One promising strategy for halting the decline is to strengthen and increase volunteer health care programs: free clinics and physician-referral networks. This report reviews the state of these programs and suggests ways to improve them. Given the limits of volunteerism, the authors conclude that only national health insurance will solve the problem of the uninsured.

Evaluating the impact of social franchising on family planning use in Kenya.

PubMed

Chakraborty, Nirali M; Mbondo, Mwende; Wanderi, Joyce

2016-06-18

In Kenya, as in many low-income countries, the private sector is an important component of health service delivery and of providing access to preventive and curative health services. The Tunza Social Franchise Network, operated by Population Services Kenya, is Kenya's largest network of private providers, comprising 329 clinics. Franchised clinics are only one source of family planning (FP), and this study seeks to understand whether access to a franchise increases the overall use or provides another alternative for women who would have found FP services in the public sector. A quasi-experimental study compared 50 catchment areas where there is a Tunza franchise and no other franchised provider with 50 purposively matched control areas within 20 km of each selected Tunza area, with a health facility, but no franchised facility. Data from 5609 women of reproductive age were collected on demographic and socioeconomic status, FP use, and care-seeking behavior. Multivariate logistic regression, with intervention and control respondents matched using coarsened exact matching, was conducted. Overall modern contraceptive use in this population was 53 %, with 24.8 % of women using a long-acting or permanent method (LAPM). There was no significant difference in odds of current or new FP use by group, adjusted for age. However, respondents in Tunza catchment areas are significantly more likely to be LAPM users (adj. OR = 1.49, p = 0.015). Further, women aged 18-24 and 41-49 in Tunza catchment areas have a significantly higher marginal probability of LAPM use than those in control areas. This study indicates that access to a franchise is correlated with access to and increased use of LAPMs, which are more effective, and cost-effective, methods of FP. While franchised facilities may provide additional points of access for FP and other services, the presence of the franchise does not, in and of itself, increase the use of FP in Kenya.

Shaping Collective Functions in Privatized Agricultural Knowledge and Information Systems: The Positioning and Embedding of a Network Broker in the Dutch Dairy Sector

ERIC Educational Resources Information Center

Klerkx, Laurens; Leeuwis, Cees

2009-01-01

This paper examines new organizational arrangements that have emerged in the context of a privatized extension system. It investigates the positioning and embedding of a network broker aimed at enhancing interaction in the privatized agricultural knowledge and information system (AKIS), to assess whether tensions reported in other sectors also…

Socioeconomic patterns in use of private and public health services in Spain and Britain: implications for equity in health care.

PubMed

Lostao, Lourdes; Blane, David; Gimeno, David; Netuveli, Gopalakrishnan; Regidor, Enrique

2014-01-01

This paper estimates the pattern of private and public physician visits and hospitalisation by socioeconomic position in two countries in which private healthcare expenditure constitutes a different proportion of the total amount spent on health care: Britain and Spain. Private physician visits and private hospitalisations were quantitatively more important in Spain than in Britain. In both countries, the use of private services showed a direct socioeconomic gradient. In Spain, the use of public GPs and public specialists tends to favour the worst-off, but no significant differences were observed in public hospitalisation. In Britain, with some exceptions, no significant socioeconomic differences were observed in the use of public health care services. The different pattern observed in the use of public specialist services may be due to the high frequency of visits to private specialists in Spain. © 2013 Published by Elsevier Ltd.

Role of the private sector in the provision of immunization services in low- and middle-income countries.

PubMed

Levin, Ann; Kaddar, Miloud

2011-07-01

The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization services in low- and middle-income countries.

29 CFR 825.310 - Certification for leave taken to care for a covered servicemember (military caregiver leave).

Code of Federal Regulations, 2013 CFR

2013-07-01

...”) health care provider; (3) A DOD TRICARE network authorized private health care provider; (4) A DOD non..., and appropriate contact information (telephone number, fax number, and/or email address) of the health... DOD TRICARE network authorized private health care provider; (iv) A DOD non-network TRICARE authorized...

29 CFR 825.310 - Certification for leave taken to care for a covered servicemember (military caregiver leave).

Code of Federal Regulations, 2011 CFR

2011-07-01

...”) health care provider; (3) A DOD TRICARE network authorized private health care provider; or (4) A DOD non... name, address, and appropriate contact information (telephone number, fax number, and/or email address... provider; (iii) A DOD TRICARE network authorized private health care provider; or (iv) A DOD non-network...

29 CFR 825.310 - Certification for leave taken to care for a covered servicemember (military caregiver leave).

Code of Federal Regulations, 2014 CFR

2014-07-01

...”) health care provider; (3) A DOD TRICARE network authorized private health care provider; (4) A DOD non..., and appropriate contact information (telephone number, fax number, and/or email address) of the health... DOD TRICARE network authorized private health care provider; (iv) A DOD non-network TRICARE authorized...

29 CFR 825.310 - Certification for leave taken to care for a covered servicemember (military caregiver leave).

Code of Federal Regulations, 2012 CFR

2012-07-01

...”) health care provider; (3) A DOD TRICARE network authorized private health care provider; or (4) A DOD non... name, address, and appropriate contact information (telephone number, fax number, and/or email address... provider; (iii) A DOD TRICARE network authorized private health care provider; or (iv) A DOD non-network...

42 CFR 422.216 - Special rules for MA private fee-for-service plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for MA private fee-for-service plans... Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and services that...

42 CFR 422.216 - Special rules for MA private fee-for-service plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Special rules for MA private fee-for-service plans... Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and services that...

Mobile Virtual Private Networking

NASA Astrophysics Data System (ADS)

Pulkkis, Göran; Grahn, Kaj; Mårtens, Mathias; Mattsson, Jonny

Mobile Virtual Private Networking (VPN) solutions based on the Internet Security Protocol (IPSec), Transport Layer Security/Secure Socket Layer (SSL/TLS), Secure Shell (SSH), 3G/GPRS cellular networks, Mobile IP, and the presently experimental Host Identity Protocol (HIP) are described, compared and evaluated. Mobile VPN solutions based on HIP are recommended for future networking because of superior processing efficiency and network capacity demand features. Mobile VPN implementation issues associated with the IP protocol versions IPv4 and IPv6 are also evaluated. Mobile VPN implementation experiences are presented and discussed.

Ubiquitous virtual private network: a solution for WSN seamless integration.

PubMed

Villa, David; Moya, Francisco; Villanueva, Félix Jesús; Aceña, Óscar; López, Juan Carlos

2014-01-06

Sensor networks are becoming an essential part of ubiquitous systems and applications. However, there are no well-defined protocols or mechanisms to access the sensor network from the enterprise information system. We consider this issue as a heterogeneous network interconnection problem, and as a result, the same concepts may be applied. Specifically, we propose the use of object-oriented middlewares to provide a virtual private network in which all involved elements (sensor nodes or computer applications) will be able to communicate as if all of them were in a single and uniform network.

The USDA Long-Term Agro-ecosystems Research (LTAR) Network

NASA Astrophysics Data System (ADS)

Goodrich, D. C.; Walthall, C. L.; Campbell, J. D.; Derner, J. D.; Huggins, D. R.; Kleinman, P. J. A.; Locke, M. A.; Sadler, J.; Steiner, J. L.; Strickland, T.; Swain, H.

2016-12-01

The USDA-Agricultural Research Service (ARS) has a multi-decadal to century long history of experimental watersheds, ranges and research farms throughout the USA. Many of these ARS research facilities, as well as three led by private foundations or land grant universities, are now part of the USDA Long-Term Agro-ecosystem Research (LTAR) network that currently has 18 locations. These 18 locations encompass a diversity of agricultural systems as well as provide a research platform for regional to national scale assessments and modeling scenarios of ecosystem goods and services for society. A central challenge that LTAR will address is: How can we sustain or enhance agricultural productivity, profitability, and ecosystem services to feed 9 billion people by 2050? Each LTAR location is designing a common experiment that consists of comparing "business as usual" to "aspirational agriculture" management strategies that reflect prevailing local to regional agricultural systems. The "aspirational agriculture" management strategy for each location will be forward-looking with innovative incorporations of cutting-edge technology, social-ecological systems involving human dimensions and economics, ecosystem services such as pollinator habitat and soil health, and paradigm shifting agricultural enterprise transformations. To accomplish the central challenge, LTAR locations will leverage existing historical data with new network-level initiatives such as wind erosion, phenology, water/carbon/nutrient/energy fluxes, complete water balances, greenhouse gas fluxes and remote sensing/modeling efforts to determine the sustainability of US agriculture across regional to continental scales. This presentation will provide an overview of the current status of the LTAR network, describe several common experiments, showcase the data management systems and web presentations of this data, as well as recent network findings.

47 CFR 90.483 - Permissible methods and requirements of interconnecting private and public systems of...

Code of Federal Regulations, 2011 CFR

2011-10-01

... interconnecting private and public systems of communications. 90.483 Section 90.483 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES... private and public systems of communications. Interconnection may be accomplished by commercial mobile...

47 CFR 90.483 - Permissible methods and requirements of interconnecting private and public systems of...

Code of Federal Regulations, 2014 CFR

2014-10-01

... interconnecting private and public systems of communications. 90.483 Section 90.483 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES... private and public systems of communications. Interconnection may be accomplished by commercial mobile...

47 CFR 90.483 - Permissible methods and requirements of interconnecting private and public systems of...

Code of Federal Regulations, 2013 CFR

2013-10-01

... interconnecting private and public systems of communications. 90.483 Section 90.483 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES... private and public systems of communications. Interconnection may be accomplished by commercial mobile...

47 CFR 90.483 - Permissible methods and requirements of interconnecting private and public systems of...

Code of Federal Regulations, 2012 CFR

2012-10-01

... interconnecting private and public systems of communications. 90.483 Section 90.483 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES... private and public systems of communications. Interconnection may be accomplished by commercial mobile...

34 CFR 300.137 - Equitable services determined.

Code of Federal Regulations, 2011 CFR

2011-07-01

... parentally-placed private school children with disabilities under §§ 300.130 through 300.144 must be made in... Private Schools § 300.137 Equitable services determined. (a) No individual right to special education and related services. No parentally-placed private school child with a disability has an individual right to...

Management, Entrepreneurship and Private Service Orientation: A Framework for Undergraduate Veterinary Education

ERIC Educational Resources Information Center

Sasidhar, P. V. K.; Van Den Ban, Anne W.

2006-01-01

The changing nature of livestock outreach service delivery, manpower requirements and opportunities in the private sector provide both push and pull dynamics for veterinary graduates to engage in managerial, entrepreneurial, public and private service activities. The veterinary schools should support this transition by integrating Managerial,…

Public and Private Adoption: A Comparison of Service and Accessibility.

ERIC Educational Resources Information Center

Daly, Kerry J.; Sobol, Michael P.

1994-01-01

Used data from national survey of public and private adoption service providers in Canada to examine similarities and differences with respect to clients served, issues associated with adoption accessibility, and nature of postadoption services. Found high degree of homogeneity that cut across public and private division, with typical adoptive…

Utilization of skilled birth attendants in public and private sectors in Vietnam.

PubMed

Do, Mai

2009-05-01

The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

A new view of petroleum's patrimony: Focus on Mexico's gasoline stations

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

Not Available

1993-07-29

An oil giant, and a developing country, Mexico has taken steps to fundamentally change the end-user experience of its natural resource heritage. As investments in environmental protection, privatization, and expansion of retail fuel network goods and services converge, the motoring public will encounter sweeping changes in priorities and lifestyle. This issue details developments in gasoline retailing in Mexico. Special emphasis is placed on increasing and modernizing the number of gasoline stations, and also on developing chains of convenience stores which sell gasoline.

Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

PubMed

Grépin, Karen A

2016-07-01

There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. Project HOPE—The People-to-People Health Foundation, Inc.

Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

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

Jacobsen, R., E-mail: ray.jacobsen@ugent.be; Buysse, J., E-mail: j.buysse@ugent.be; Gellynck, X., E-mail: xavier.gellynck@ugent.be

2013-01-15

Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticedmore » in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.« less

Cloud services for the Fermilab scientific stakeholders

DOE PAGES

Timm, S.; Garzoglio, G.; Mhashilkar, P.; ...

2015-12-23

As part of the Fermilab/KISTI cooperative research project, Fermilab has successfully run an experimental simulation workflow at scale on a federation of Amazon Web Services (AWS), FermiCloud, and local FermiGrid resources. We used the CernVM-FS (CVMFS) file system to deliver the application software. We established Squid caching servers in AWS as well, using the Shoal system to let each individual virtual machine find the closest squid server. We also developed an automatic virtual machine conversion system so that we could transition virtual machines made on FermiCloud to Amazon Web Services. We used this system to successfully run a cosmic raymore » simulation of the NOvA detector at Fermilab, making use of both AWS spot pricing and network bandwidth discounts to minimize the cost. On FermiCloud we also were able to run the workflow at the scale of 1000 virtual machines, using a private network routable inside of Fermilab. As a result, we present in detail the technological improvements that were used to make this work a reality.« less

Cloud services for the Fermilab scientific stakeholders

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

Timm, S.; Garzoglio, G.; Mhashilkar, P.

As part of the Fermilab/KISTI cooperative research project, Fermilab has successfully run an experimental simulation workflow at scale on a federation of Amazon Web Services (AWS), FermiCloud, and local FermiGrid resources. We used the CernVM-FS (CVMFS) file system to deliver the application software. We established Squid caching servers in AWS as well, using the Shoal system to let each individual virtual machine find the closest squid server. We also developed an automatic virtual machine conversion system so that we could transition virtual machines made on FermiCloud to Amazon Web Services. We used this system to successfully run a cosmic raymore » simulation of the NOvA detector at Fermilab, making use of both AWS spot pricing and network bandwidth discounts to minimize the cost. On FermiCloud we also were able to run the workflow at the scale of 1000 virtual machines, using a private network routable inside of Fermilab. As a result, we present in detail the technological improvements that were used to make this work a reality.« less

Evaluation of Workload and its Impact on Satisfaction Among Pharmacy Academicians in Southern India.

PubMed

Ahmad, Akram; Khan, Muhammad Umair; Srikanth, Akshaya B; Patel, Isha; Nagappa, Anantha Naik; Jamshed, Shazia Qasim

2015-06-01

The purpose of this study was to determine the level of workload among pharmacy academicians working in public and private sector universities in India. The study also aimed to assess the satisfaction of academicians towards their workload. A cross-sectional study was conducted for a period of 2 months among pharmacy academicians in Karnataka state of Southern India. Convenience sampling was used to select a sample and was contacted via email and/or social networking sites. Questionnaire designed by thorough review literature was used as a tool to collect data on workload (teaching, research, extracurricular services) and satisfaction. Of 214 participants, 95 returned the filled questionnaire giving the response rate of 44.39%. Private sector academicians had more load of teaching (p=0.046) and they appeared to be less involved in research activities (p=0.046) as compared to public sector academicians. More than half of the respondents (57.9%) were satisfied with their workload with Assistant Professors were least satisfied as compared to Professors (p=0.01). Overall, private sector academicians are more burdened by teaching load and also are less satisfied of their workload. Revision of private universities policies may aid in addressing this issue.

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2010 CFR

2010-10-01

... use of private sector temporaries. Contracting officers may enter into contracts with temporary help service firms for the brief or intermittent use of the skills of private sector temporaries. Services... part 300, subpart E, Use of Private Sector Temporaries, and agency procedures. [56 FR 55380, Oct. 25...

47 CFR 27.1308 - Organization and structure of the 700 MHz public/private partnership.

Code of Federal Regulations, 2011 CFR

2011-10-01

... public/private partnership. 27.1308 Section 27.1308 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1308 Organization and structure of the 700 MHz public/private partnership. (a) The Upper 700...

47 CFR 27.1308 - Organization and structure of the 700 MHz public/private partnership.

Code of Federal Regulations, 2010 CFR

2010-10-01

... public/private partnership. 27.1308 Section 27.1308 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1308 Organization and structure of the 700 MHz public/private partnership. (a) The Upper 700...

47 CFR 27.1308 - Organization and structure of the 700 MHz public/private partnership.

Code of Federal Regulations, 2012 CFR

2012-10-01

... public/private partnership. 27.1308 Section 27.1308 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 700 MHz Public/Private Partnership § 27.1308 Organization and structure of the 700 MHz public/private partnership. (a) The Upper 700...

Exploring a public-private partnership new-graduate physiotherapy recruitment program: a qualitative study.

PubMed

Schmidt, David; Dmytryk, Neil

2014-12-01

Difficulty in attracting allied health staff to rural areas is well known. In 2012, a small rural health facility and local private practice created an informal public-private partnership to recruit two new-graduate physiotherapists. Graduates were employed part-time in both the public and private sectors. This qualitative case study employed an appreciative enquiry framework to explore this partnership model. Three focus groups were held, and a combination of content and thematic analysis was used to derive and organise themes arising from the data. A regional public health service and private physiotherapy practice in the Bega Valley region of south-eastern New South Wales, Australia. New-graduate and second-year physiotherapists (n = 5), private sector managers (n = 3), and public sector managers (n = 4). Perceived benefits of the partnership model and improvements that could be made to further develop the model. Organisational benefits of a shared public-private role included the ability to attract high-quality applicants to difficult-to-fill positions, reduced the risk of new-graduate attrition due to social isolation, enhanced networking between sectors, and enhanced staff skill development through a broad range of clinical and non-clinical experiences. The model relied on management flexibility and has potential to expand to other areas and professions. Dedicated funding support, targeted recruitment strategies and increased planning to ease the transition into the workplace would further enhance the model. An informal public-private partnership to overcome established workforce shortages has proven successful to the benefit of the new graduates and both the public and private sectors. © 2014 National Rural Health Alliance Inc.

Safe and Secure Services Based on NGN

NASA Astrophysics Data System (ADS)

Fukazawa, Tomoo; Nisase, Takemi; Kawashima, Masahisa; Hariu, Takeo; Oshima, Yoshihito

Next Generation Network (NGN), which has been undergoing standardization as it has developed, is expected to create new services that converge the fixed and mobile networks. This paper introduces the basic requirements for NGN in terms of security and explains the standardization activities, in particular, the requirements for the security function described in Y.2701 discussed in ITU-T SG-13. In addition to the basic NGN security function, requirements for NGN authentication are also described from three aspects: security, deployability, and service. As examples of authentication implementation, three profiles-namely, fixed, nomadic, and mobile-are defined in this paper. That is, the “fixed profile” is typically for fixed-line subscribers, the “nomadic profile” basically utilizes WiFi access points, and the “mobile profile” provides ideal NGN mobility for mobile subscribers. All three of these profiles satisfy the requirements from security aspects. The three profiles are compared from the viewpoint of requirements for deployability and service. After showing that none of the three profiles can fulfill all of the requirements, we propose that multiple profiles should be used by NGN providers. As service and application examples, two promising NGN applications are proposed. The first is a strong authentication mechanism that makes Web applications more safe and secure even against password theft. It is based on NGN ID federation function. The second provides an easy peer-to-peer broadband virtual private network service aimed at safe and secure communication for personal/SOHO (small office, home office) users, based on NGN SIP (session initiation protocol) session control.

Is Private Production of Public Services Cheaper Than Public Production? A Meta-Regression Analysis of Solid Waste and Water Services

ERIC Educational Resources Information Center

Bel, Germa; Fageda, Xavier; Warner, Mildred E.

2010-01-01

Privatization of local government services is assumed to deliver cost savings, but empirical evidence for this from around the world is mixed. We conduct a meta-regression analysis of all econometric studies examining privatization of water distribution and solid waste collection services and find no systematic support for lower costs with private…

Utilization and expenditure at public and private facilities in 39 low-income countries.

PubMed

Saksena, Priyanka; Xu, Ke; Elovainio, Riku; Perrot, Jean

2012-01-01

To document the patterns of health service utilization and health payments at public and private facilities across countries. We used data from the World Health Surveys from 39 low- and low-middle income countries to examine differences between public and private sectors. Utilization of outpatient and inpatient services, out-of-pocket payments (OOP) at public and private facilities, and transportation costs were compared. Utilization and payments to public and private sectors differ widely. Public facilities dominated in most countries for both outpatient and inpatient services. But, whereas use of private facilities is more common among the rich, poor people also use them, to a considerable extent and in almost all the countries in the study. The majority of OOP were incurred at public providers for inpatient services. On average, this was not the case for outpatient services. Medicines accounted for the largest share of OOP for all services except inpatient services at private facilities, where consultation fees did. Transportation costs were considerable. Price competition is certainly not the only factor that guides choice of provider. The results support continued efforts by the governments to engage strategically with the private sector. However, they also highlight the importance of not generalizing conditions across countries. Governments may need to reconsider simplistic user-fee abolition strategies at public providers if they simply focus on consultation fees. Policies to make health services more accessible need to consider a comprehensive benefit package that includes a wider scope of costs related to care such as expenditures on medicines and transportation. © 2011 Blackwell Publishing Ltd.

HPCC and the National Information Infrastructure: an overview.

PubMed Central

Lindberg, D A

1995-01-01

The National Information Infrastructure (NII) or "information superhighway" is a high-priority federal initiative to combine communications networks, computers, databases, and consumer electronics to deliver information services to all U.S. citizens. The NII will be used to improve government and social services while cutting administrative costs. Operated by the private sector, the NII will rely on advanced technologies developed under the direction of the federal High Performance Computing and Communications (HPCC) Program. These include computing systems capable of performing trillions of operations (teraops) per second and networks capable of transmitting billions of bits (gigabits) per second. Among other activities, the HPCC Program supports the national supercomputer research centers, the federal portion of the Internet, and the development of interface software, such as Mosaic, that facilitates access to network information services. Health care has been identified as a critical demonstration area for HPCC technology and an important application area for the NII. As an HPCC participant, the National Library of Medicine (NLM) assists hospitals and medical centers to connect to the Internet through projects directed by the Regional Medical Libraries and through an Internet Connections Program cosponsored by the National Science Foundation. In addition to using the Internet to provide enhanced access to its own information services, NLM sponsors health-related applications of HPCC technology. Examples include the "Visible Human" project and recently awarded contracts for test-bed networks to share patient data and medical images, telemedicine projects to provide consultation and medical care to patients in rural areas, and advanced computer simulations of human anatomy for training in "virtual surgery." PMID:7703935

The Medicaid School Program: An Effective Public School and Private Sector Partnership

ERIC Educational Resources Information Center

Mallett, Christopher A.

2013-01-01

Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…

Guidelines for Contracting with Private Providers for Educational Services. NSBA Series on School Board Governance.

ERIC Educational Resources Information Center

McLaughlin, John M.

Among the most rapidly progressing issues in American public education is that of contracting with private companies for teaching or administrative services. This booklet neither encourages nor discourages school boards from considering or entering into relationships with private companies for educational services. School districts usually enter…

Linking research to practice: the organisation and implementation of The Netherlands health and social care improvement programmes.

PubMed

Ovretveit, John; Klazinga, Niek

2013-02-01

Both public and private health and social care services are facing increased and changing demands to improve quality and reduce costs. To enable local services to respond to these demands, governments and other organisations have established large scale improvement programmes. These usually seek to enable many services to make changes to apply proven improvements and to make use of quality improvement methods. The purpose of this paper is to provide an empirical description of how one organisation coordinated ten national improvement programmes between 2004 and 2010. It provides details which may be useful to others seeking to plan and implement such programmes, and also contributes to the understanding of knowledge translation and of network governance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The JASMIN Cloud: specialised and hybrid to meet the needs of the Environmental Sciences Community

NASA Astrophysics Data System (ADS)

Kershaw, Philip; Lawrence, Bryan; Churchill, Jonathan; Pritchard, Matt

2014-05-01

Cloud computing provides enormous opportunities for the research community. The large public cloud providers provide near-limitless scaling capability. However, adapting Cloud to scientific workloads is not without its problems. The commodity nature of the public cloud infrastructure can be at odds with the specialist requirements of the research community. Issues such as trust, ownership of data, WAN bandwidth and costing models make additional barriers to more widespread adoption. Alongside the application of public cloud for scientific applications, a number of private cloud initiatives are underway in the research community of which the JASMIN Cloud is one example. Here, cloud service models are being effectively super-imposed over more established services such as data centres, compute cluster facilities and Grids. These have the potential to deliver the specialist infrastructure needed for the science community coupled with the benefits of a Cloud service model. The JASMIN facility based at the Rutherford Appleton Laboratory was established in 2012 to support the data analysis requirements of the climate and Earth Observation community. In its first year of operation, the 5PB of available storage capacity was filled and the hosted compute capability used extensively. JASMIN has modelled the concept of a centralised large-volume data analysis facility. Key characteristics have enabled success: peta-scale fast disk connected via low latency networks to compute resources and the use of virtualisation for effective management of the resources for a range of users. A second phase is now underway funded through NERC's (Natural Environment Research Council) Big Data initiative. This will see significant expansion to the resources available with a doubling of disk-based storage to 12PB and an increase of compute capacity by a factor of ten to over 3000 processing cores. This expansion is accompanied by a broadening in the scope for JASMIN, as a service available to the entire UK environmental science community. Experience with the first phase demonstrated the range of user needs. A trade-off is needed between access privileges to resources, flexibility of use and security. This has influenced the form and types of service under development for the new phase. JASMIN will deploy a specialised private cloud organised into "Managed" and "Unmanaged" components. In the Managed Cloud, users have direct access to the storage and compute resources for optimal performance but for reasons of security, via a more restrictive PaaS (Platform-as-a-Service) interface. The Unmanaged Cloud is deployed in an isolated part of the network but co-located with the rest of the infrastructure. This enables greater liberty to tenants - full IaaS (Infrastructure-as-a-Service) capability to provision customised infrastructure - whilst at the same time protecting more sensitive parts of the system from direct access using these elevated privileges. The private cloud will be augmented with cloud-bursting capability so that it can exploit the resources available from public clouds, making it effectively a hybrid solution. A single interface will overlay the functionality of both the private cloud and external interfaces to public cloud providers giving users the flexibility to migrate resources between infrastructures as requirements dictate.

Laboratory medicine in France. A jeopardized situation.

PubMed

Valdiguié, P M; de Graeve, J S; Guerre, J P

1997-11-06

The expenses for health care in France have risen considerably during the present decade, ranking third after USA and Canada in the Western world. In spite of the very low cost of laboratory medicine (2.4% of the total expenditure in 1995), clinical laboratories have undergone a severe squeeze, due to two limiting factors; a decrease in the ordering of laboratory tests from private physicians and a reduction in the total expenses for laboratory services from the Social Security. Consequently, there has been unemployment of technical and secretarial staff and severe restriction in investment for buying new equipment. However, hospital laboratories will manage to assume their challenge in developing robotics, automation, molecular pathology techniques and expert systems. Private laboratories, in spite of their efforts to follow the technological advances in automation, will survive thanks to consolidation of regional networks that operate in a cooperative rather than competitive mode. Therefore, the challenge will be not in the adaptation of clinical laboratories, but in the limitation of overspending at the national level and in modification of the behaviour of irresponsible citizens accustomed to spending freely on health care services.

The Virtual Xenbase: transitioning an online bioinformatics resource to a private cloud

PubMed Central

Karimi, Kamran; Vize, Peter D.

2014-01-01

As a model organism database, Xenbase has been providing informatics and genomic data on Xenopus (Silurana) tropicalis and Xenopus laevis frogs for more than a decade. The Xenbase database contains curated, as well as community-contributed and automatically harvested literature, gene and genomic data. A GBrowse genome browser, a BLAST+ server and stock center support are available on the site. When this resource was first built, all software services and components in Xenbase ran on a single physical server, with inherent reliability, scalability and inter-dependence issues. Recent advances in networking and virtualization techniques allowed us to move Xenbase to a virtual environment, and more specifically to a private cloud. To do so we decoupled the different software services and components, such that each would run on a different virtual machine. In the process, we also upgraded many of the components. The resulting system is faster and more reliable. System maintenance is easier, as individual virtual machines can now be updated, backed up and changed independently. We are also experiencing more effective resource allocation and utilization. Database URL: www.xenbase.org PMID:25380782

Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

PubMed

Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

2013-10-01

How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms.

Benefits and Costs of Privatized Public Services: Lessons from the Dutch Educational System.

ERIC Educational Resources Information Center

James, Estelle

1984-01-01

Examines the possibility of "privitizing" education (a government policy, such as a voucher or tax credit system, which combines public financing with private production of the service). Describes the Dutch system of publicly funded private education. Suggests that private organizations and local governments find themselves competing to…

A Surgical Business Composite Score for Army Medicine.

PubMed

Stoddard, Douglas R; Robinson, Andrew B; Comer, Tracy A; Meno, Jenifer A; Welder, Matthew D

2016-06-01

Measuring surgical business performance for Army military treatment facilities is currently done through 6 business metrics developed by the Army Medical Command (MEDCOM) Surgical Services Service Line (3SL). Development of a composite score for business performance has the potential to simplify and synthesize measurement, improving focus for strategic goal setting and implementation. However, several considerations, ranging from data availability to submetric selection, must be addressed to ensure the score is accurate and representative. This article presents the methodology used in the composite score's creation and presents a metric based on return on investment and a measure of cases recaptured from private networks. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Ubiquitous Virtual Private Network: A Solution for WSN Seamless Integration

PubMed Central

Villa, David; Moya, Francisco; Villanueva, Félix Jesús; Aceña, Óscar; López, Juan Carlos

2014-01-01

Sensor networks are becoming an essential part of ubiquitous systems and applications. However, there are no well-defined protocols or mechanisms to access the sensor network from the enterprise information system. We consider this issue as a heterogeneous network interconnection problem, and as a result, the same concepts may be applied. Specifically, we propose the use of object-oriented middlewares to provide a virtual private network in which all involved elements (sensor nodes or computer applications) will be able to communicate as if all of them were in a single and uniform network. PMID:24399154

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar

PubMed Central

2013-01-01

Introduction This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar’s social franchise operations from 2007 to 2009. Methods The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. Results In 2009 PSI Myanmar’s social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. Conclusion In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO’s, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers’ cost structures as well as strategic objectives in maintaining the network and its portfolio of services. PMID:23826743

The cost of service quality improvements: tracking the flow of funds in social franchise networks in Myanmar.

PubMed

Bishai, David; LeFevre, Amnesty; Theuss, Marc; Boxshall, Matt; Hetherington, John D; Zaw, Min; Montagu, Dominic

2013-01-01

This paper examines the cost of quality improvements in Population Services International (PSI) Myanmar's social franchise operations from 2007 to 2009. The social franchise commodities studied were products for reproductive health, malaria, STIs, pneumonia, and diarrhea. This project applied ingredients based costing for labor, supplies, transport, and overhead. Data were gathered seven during key informant interviews with staff in the central Yangon office, examination of 3 years of payroll data, examination of a time motion study conducted by PSI, and spreadsheets recording the costs of acquiring and transporting supplies. In 2009 PSI Myanmar's social franchise devoted $2.02 million towards a 94% reduction in commodity prices offered to its network of over 1700 primary care providers. These providers retained 1/3 of the subsidy as revenue and passed along the other 2/3 to their patients in the course of offering subsidized care for 1.5 million health episodes. In addition, PSI Myanmar devoted $2.09 million to support a team of franchise officers who conducted quality assurance for the private providers overseeing service quality and to distributing medical commodities. In Myanmar, the social franchise operated by PSI spends roughly $1.00 in quality management and retailing for every $1.00 spent subsidizing medical commodities. Some services are free, but patients also pay fees for other lines of service. Overall patients contribute 1/6 as much as PSI does. Unlike other NGO's, health services in social franchises like PSI are not all free to the patients, nor are the discounts uniformly applied. Discounts and subsidies evolve in response to public health concerns, market demand, providers' cost structures as well as strategic objectives in maintaining the network and its portfolio of services.

Experiences of selected countries in the use of public-private partnership in hospital services provision.

PubMed

Sadeghi, Ahmad; Barati, Omid; Bastani, Peivand; Jafari, Davood Danesh; Etemadian, Masoud

2016-11-01

To review the experiences of selected countries in the use of public-private partnership in the provision of hospital services. This comparative study was conducted in 2015 in Iran. To collect data, valid databases as well as articles, theses, reports and related books in the field of private-sector partnership in hospital services were employed. Using purposive sampling, countries such as the United Kingdom, Spain, Canada, Turkey, Australia and Lesotho, which had successful experiences in the field of application of the public-private partnership in hospital services, were included. Likewise, the only experience in Iran in this field was also reviewed. Studies done between 1980 and 2015 were examined. The results obtained from each country were compared. Implementing public-private partnership had great and valuable outcomes and achievements for governmental hospitals. Moreover, clinical and nonclinical service delivery, hospital utilisation and management along with building, repairing and supportive operations through public-private partnership contracts can be differently divided among the partners. Furthermore, duration of the projects ranged from 12 to 40 years in different countries, depending on the type of the model used. A successful experience in the use of the public-private partnership in the provision of hospital services was observed.

42 CFR 422.216 - Special rules for MA private fee-for-service plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Special rules for MA private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

42 CFR 422.216 - Special rules for MA private fee-for-service plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules for MA private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

42 CFR 422.216 - Special rules for MA private fee-for-service plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules for MA private fee-for-service plans... With Providers § 422.216 Special rules for MA private fee-for-service plans. (a) Payment to providers—(1) Payment rate. (i) The MA organization must establish payment rates for plan covered items and...

49 CFR 37.169 - Interim requirements for over-the-road bus service operated by private entities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Interim requirements for over-the-road bus service... Interim requirements for over-the-road bus service operated by private entities. (a) Private entities operating over-the-road buses, in addition to compliance with other applicable provisions of this part...

Chilean geo client application for disasters

NASA Astrophysics Data System (ADS)

Suárez, Rodrigo F.; Lovison, Lucia; Potters, Martinus

2018-05-01

The global network of the Group on Earth Observation, GEO, connects all kinds of professionals from public and private institutions with data providers, sharing information to face the challenges of global changes and human development and they are creating a Global Earth Observation System of Systems (GEOSS) to connect existing data infrastructures. A GEOSS Architecture Implementation Pilot Project for Disasters in Chile (AIP-8) was created as part of a capacity building initiative and representatives of different national agencies in Chile, along with international experts, formed a GEOSS Capacity Building Working Group (Lovison et al, 2016). Consistent with the objectives of GEOSS AIP-8 Chile, we developed and implemented a prototype service based on web services, mobile applications and other communication channels, which allows connecting different sources of information, aiming to reduce population vulnerability to natural disasters such as: earthquakes, flooding, wild fires and tsunamis, which is presented here. The GEO Chile client application is a JavaScript application using GEODAB brokering services, GIS technology and disaster information provided by national and international disaster services, including public and private organizations, where cartography becomes fundamental as a tool to provide realism and ubiquity to the information. Seven hotpots are targeted: Calbuco, Copahue and Villarrica volcanoes areas, Valparaíso city, which is frequently a victim of wildfires in the zone where population meets forest and Iquique, Illapel and Talcahuano, areas frequently struck by earthquakes and tsunamis.

Private Graphs - Access Rights on Graphs for Seamless Navigation

NASA Astrophysics Data System (ADS)

Dorner, W.; Hau, F.; Pagany, R.

2016-06-01

After the success of GNSS (Global Navigational Satellite Systems) and navigation services for public streets, indoor seems to be the next big development in navigational services, relying on RTLS - Real Time Locating Services (e.g. WIFI) and allowing seamless navigation. In contrast to navigation and routing services on public streets, seamless navigation will cause an additional challenge: how to make routing data accessible to defined users or restrict access rights for defined areas or only to parts of the graph to a defined user group? The paper will present case studies and data from literature, where seamless and especially indoor navigation solutions are presented (hospitals, industrial complexes, building sites), but the problem of restricted access rights was only touched from a real world, but not a technical perspective. The analysis of case studies will show, that the objective of navigation and the different target groups for navigation solutions will demand well defined access rights and require solutions, how to make only parts of a graph to a user or application available to solve a navigational task. The paper will therefore introduce the concept of private graphs, which is defined as a graph for navigational purposes covering the street, road or floor network of an area behind a public street and suggest different approaches how to make graph data for navigational purposes available considering access rights and data protection, privacy and security issues as well.

[Ambulance in emergency medicine].

PubMed

Aksoy, Fikret; Ergun, Alper

2002-07-01

The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

Comparison of public and private care management agencies under public long-term care insurance in Japan: a cross-sectional study.

PubMed

Yoshioka, Yoji; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Okubo, Ichiro

2010-01-01

Long-Term Care Insurance (LTCI), which started in April 2000, allowed private business corporations to provide long-term care services which had been provided by social welfare corporations or public agencies in the previous long-term care scheme. This study compared differences in care management plans for community-dwelling frail elderly people between public care management agencies and private care management agencies. The subjects were 309 community-dwelling frail elderly people living in a suburban city with a population of approximately 55,000 and who had been using community-based long-term care services of the LTCI for 6 months from April 2000. The characteristics of the care management agencies (public/private) were identified using a claims database. After comparing profiles of users and their care mix between those managed by public agencies and by private agencies, the effect of the characteristics of care management agencies on LTCI service use was examined. Public care management agencies favored younger subjects (P = 0.003), male subjects (P = 0.006) and people with a higher need for care (P = 0.02) than private agencies. The number of service items used was significantly larger in public agencies than in their private counterparts. In multivariate regression analysis, the utilization of community-based long-term care service was significantly greater among beneficiaries managed by private agencies than those managed by public agencies (P = 0.02). Private care management agencies play an important role in promoting the use of care services, but their quality of care plans might be questionable.

Vouchers for primary healthcare services in an ageing world? The perspectives of elderly voucher recipients in Hong Kong.

PubMed

Lai, Angel Hor-Yan; Kuang, Zoey; Yam, Carrie Ho-Kwan; Ayub, Shereen; Yeoh, Eng-Kiong

2018-05-01

Considering the ageing population in economically advanced regions across the world, measures are necessary to enhance the health of the older population as well as contain public healthcare spending. Hong Kong implements the Elderly Health Care Voucher Scheme (EHCVS), providing older people aged 65 or above an annual subsidy of visiting private healthcare service providers for chronic disease prevention and management. The services also aim at reallocating demand from the public to private sector as well as improve quality of services. This qualitative study explored the experiences of EHCVS recipients (n = 55, aged 61-94) with eight focus group interviews in Hong Kong in the year 2016. Convenience sampling was used. Research questions were: (1) Why do older people choose not to use EHCVS for preventive as well as disease management services among older people in Hong Kong? (2) What are the barriers to reallocating demand from the public to private sector? (3) In what ways did EHCVS improve the quality of primary care services for older people? Using a deductive and inductive approach, eight qualitative themes were identified. Findings suggested that the non-targeted services and inadequate knowledge on EHCVS deterred older people from using the vouchers for disease management and prevention. The relatively expensive private services, lack of trust in the private sector, low public clinic fees and good services quality of the public sector, together with inadequate private practitioners in the healthcare market were barriers that hinder demand reallocation. Nevertheless, the quality of primary care services had been improved after the implementation of EHCVS with shortened wait times and opportunities to discuss health-related issues with private practitioners. Findings were discussed with practice, policy and research implications. © 2017 John Wiley & Sons Ltd.

Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

PubMed

Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth

2018-01-01

Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78-1.03). These three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB.

Analysis of Fast Charging Station Network for Electrified Ride-Hailing Services

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

Wood, Eric W; Rames, Clement L; Kontou, Eleftheria

Today's electric vehicle (EV) owners charge their vehicles mostly at home and seldom use public direct current fast charger (DCFCs), reducing the need for a large deployment of DCFCs for private EV owners. However, due to the emerging interest among transportation network companies to operate EVs in their fleet, there is great potential for DCFCs to be highly utilized and become economically feasible in the future. This paper describes a heuristic algorithm to emulate operation of EVs within a hypothetical transportation network company fleet using a large global positioning system data set from Columbus, Ohio. DCFC requirements supporting operation ofmore » EVs are estimated using the Electric Vehicle Infrastructure Projection tool. Operation and installation costs were estimated using real-world data to assess the economic feasibility of the recommended fast charging stations. Results suggest that the hypothetical transportation network company fleet increases daily vehicle miles traveled per EV with less overall down time, resulting in increased demand for DCFC. Sites with overhead service lines are recommended for hosting DCFC stations to minimize the need for trenching underground service lines. A negative relationship was found between cost per unit of energy and fast charging utilization, underscoring the importance of prioritizing utilization over installation costs when siting DCFC stations. Although this preliminary analysis of the impacts of new mobility paradigms on alternative fueling infrastructure requirements has produced several key results, the complexity of the problem warrants further investigation.« less

78 FR 27339 - Private Attorney Involvement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... LEGAL SERVICES CORPORATION 45 CFR Part 1614 Private Attorney Involvement AGENCY: Legal Services... in the rulemaking workshops. SUMMARY: The Legal Services Corporation (LSC) is conducting two... to Mark Freedman, Senior Assistant General Counsel, Legal Services Corporation, 3333 K St NW...

Is U.S. climatic diversity well represented within the existing federal protection network?

PubMed

Batllori, Enric; Miller, Carol; Parisien, Marc-Andre; Parks, Sean A; Moritz, Max A

Establishing protection networks to ensure that biodiversity and associated ecosystem services persist under changing environments is a major challenge for conservation planning. The potential consequences of altered climates for the structure and function of ecosystems necessitates new and complementary approaches be incorporated into traditional conservation plans. The conterminous United States of America (CONUS) has an extensive system of protected areas managed by federal agencies, but a comprehensive assessment of how this network represents CONUS climate is lacking. We present a quantitative classification of the climate space that is independent from the geographic locations to evaluate the climatic representation of the existing protected area network. We use this classification to evaluate the coverage of each agency's jurisdiction and to identify current conservation deficits. Our findings reveal that the existing network poorly represents CONUS climatic diversity. Although rare climates are generally well represented by the network, the most common climates are particularly underrepresented. Overall, 83% of the area of the CONUS corresponds to climates underrepresented by the network. The addition of some currently unprotected federal lands to the network would enhance the coverage of CONUS climates. However, to fully palliate current conservation deficits, large-scale private-land conservation initiatives will be critical.

The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients.

PubMed

Hernandez, Julie H; Mbadu, Muanda Fidèle; Garcia, Mélissa; Glover, Annie

2018-01-01

Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives. The objective of this study is to explore selected pharmacies' readiness to serve women seeking emergency contraception (EC). This study used a mystery client (MC) methodology to visit 73 pharmacies in Kinshasa, Democratic Republic of Congo (DRC). Trained interviewers posed as novice EC users and asked specific questions to evaluate the pharmacy staff's technical knowledge of EC and their attitudes towards EC clients. The results of the MC visit were recorded immediately after the MC left the pharmacy. Findings indicate that more than two-thirds of EC providers were knowledgeable about EC dosage, timeframe, and side effects, and 90% were deemed helpful towards novice EC users. Rare but glaring misconceptions about EC timeframe (20% of providers) and long-term side effects (4% of providers), as well as frequent stock-out (22%) and cost issues highlight priorities for programmatic improvements. As new service delivery strategies are explored to complement the uneven network of health structures in DRC, this study suggests that, given proper training and integration in FP programming, private-sector pharmacies have the potential to meet specific contraceptive needs for women living in Kinshasa. Private pharmacies included in study sample in Kinshasa (DRC) have adequate family planning (FP) service skills to provide clients with emergency contraceptive pills. These higher-end outlets constitute an opportunity for expanding access to FP, although, under total market approaches, a more diverse range of drugs shops should be investigated. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Shift work to balance everyday life - a salutogenic nursing perspective in home help service in Sweden.

PubMed

Agosti, Madelaine Törnquist; Andersson, Ingemar; Ejlertsson, Göran; Janlöv, Ann-Christin

2015-01-01

Nurses in Sweden have a high absence due to illness and many retire before the age of sixty. Factors at work as well as in private life may contribute to health problems. To maintain a healthy work-force there is a need for actions on work-life balance in a salutogenic perspective. The aim of this study was to explore perceptions of resources in everyday life to balance work and private life among nurses in home help service. Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden. A qualitative content analysis was used for the analyses. In the analyses, six themes of perceptions of recourses in everyday life emerged; (i) Reflecting on life. (ii) Being healthy and taking care of yourself. (iii) Having a meaningful job and a supportive work climate. (iv) Working shifts and part time. (v) Having a family and a supporting network. (vi) Making your home your castle. The result points out the complexity of work-life balance and support that the need for nurses to balance everyday life differs during different phases and transitions in life. In this salutogenic study, the result differs from studies with a pathogenic approach. Shift work and part time work were seen as two resources that contributed to flexibility and a prerequisite to work-life balance. To have time and energy for both private life and work was seen as essential. To reflect on and discuss life gave inner strength to set boundaries and to prioritize both in private life and in work life. Managers in nursing contexts have a great challenge to maintain and strengthen resources which enhance the work-life balance and health of nurses. Salutogenic research is needed to gain an understanding of resources that enhance work-life balance and health in nursing contexts.

Northeastern Area State and Private Forestry At a Glance

Treesearch

Northeastern Area, State & Private Forestry USDA Forest Service

2006-01-01

The State and Private Forestry branch of the USDA Forest Service promotes sustainable management of non-Federal forest lands, which make up two-thirds of the forests in the United States. This work supports the Forest Service?s role as steward of the Nation?s forests and ensures that private forests yield public benefits. Among these benefits are clean air, drinking...

Field testing of a remote controlled robotic tele-echo system in an ambulance using broadband mobile communication technology.

PubMed

Takeuchi, Ryohei; Harada, Hiroshi; Masuda, Kohji; Ota, Gen-ichiro; Yokoi, Masaki; Teramura, Nobuyasu; Saito, Tomoyuki

2008-06-01

We report the testing of a mobile Robotic Tele-echo system that was placed in an ambulance and successfully transmitted clear real time echo imaging of a patient's abdomen to the destination hospital from where this device was being remotely operated. Two-way communication between the paramedics in this vehicle and a doctor standing by at the hospital was undertaken. The robot was equipped with an ultrasound probe which was remotely controlled by the clinician at the hospital and ultrasound images of the patient were transmitted wirelessly. The quality of the ultrasound images that were transmitted over the public mobile telephone networks and those transmitted over the Multimedia Wireless Access Network (a private networks) were compared. The transmission rate over the public networks and the private networks was approximately 256 Kbps, 3 Mbps respectively. Our results indicate that ultrasound images of far higher definition could be obtained through the private networks.

Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

PubMed

Peters, David H; Mirchandani, Gita G; Hansen, Peter M

2004-10-01

The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research designs, key questions regarding their feasibility and impact remain unanswered. Copyright 2004 Oxford University Press

Private sector approaches to workforce enhancement.

PubMed

Wendling, Wayne R

2010-06-01

This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as one example of how dental services to Medicaid insured children were effectively expanded using the private practice model.

Second Line of Defense Virtual Private Network Guidance for Deployed and New CAS Systems

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

Singh, Surya V.; Thronas, Aaron I.

2010-01-01

This paper discusses the importance of remote access via virtual private network (VPN) for the Second Line of Defense (SLD) Central Alarm System (CAS) sites, the requirements for maintaining secure channels while using VPN and implementation requirements for current and future sites.

Geospatial Authentication

NASA Technical Reports Server (NTRS)

Lyle, Stacey D.

2009-01-01

A software package that has been designed to allow authentication for determining if the rover(s) is/are within a set of boundaries or a specific area to access critical geospatial information by using GPS signal structures as a means to authenticate mobile devices into a network wirelessly and in real-time has been developed. The advantage lies in that the system only allows those with designated geospatial boundaries or areas into the server. The Geospatial Authentication software has two parts Server and Client. The server software is a virtual private network (VPN) developed in Linux operating system using Perl programming language. The server can be a stand-alone VPN server or can be combined with other applications and services. The client software is a GUI Windows CE software, or Mobile Graphical Software, that allows users to authenticate into a network. The purpose of the client software is to pass the needed satellite information to the server for authentication.

Exploring mobile health in a private online social network.

PubMed

Memon, Qurban A; Mustafa, Asma Fayes

2015-01-01

Health information is very vulnerable. Certain individuals or corporate organisations will continue to steal it similar to bank account data once data is on wireless channels. Once health information is part of a social network, corresponding privacy issues also surface. Insufficiently trained employees at hospitals that pay less attention to creating a privacy-aware culture will suffer loss when mobile devices containing health information are lost, stolen or sniffed. In this work, a social network system is explored as a m-health system from a privacy perspective. A model is developed within a framework of data-driven privacy and implemented on Android operating system. In order to check feasibility of the proposed model, a prototype application is developed on Facebook for different services, including: i) sharing user location; ii) showing nearby friends; iii) calculating and sharing distance moved, and calories burned; iv) calculating, tracking and sharing user heart rate; etc.

Shifts in the architecture of the Nationwide Health Information Network.

PubMed

Lenert, Leslie; Sundwall, David; Lenert, Michael Edward

2012-01-01

In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services. These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC's proposed changes in its strategy for the NwHIN.

A performance study of live VM migration technologies: VMotion vs XenMotion

NASA Astrophysics Data System (ADS)

Feng, Xiujie; Tang, Jianxiong; Luo, Xuan; Jin, Yaohui

2011-12-01

Due to the growing demand of flexible resource management for cloud computing services, researches on live virtual machine migration have attained more and more attention. Live migration of virtual machine across different hosts has been a powerful tool to facilitate system maintenance, load balancing, fault tolerance and so on. In this paper, we use a measurement-based approach to compare the performance of two major live migration technologies under certain network conditions, i.e., VMotion and XenMotion. The results show that VMotion generates much less data transferred than XenMotion when migrating identical VMs. However, in network with moderate packet loss and delay, which are typical in a VPN (virtual private network) scenario used to connect the data centers, XenMotion outperforms VMotion in total migration time. We hope that this study can be helpful in choosing suitable virtualization environments for data center administrators and optimizing existing live migration mechanisms.

Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

PubMed Central

Oluoha, Chukwuemeka; Ahaneku, Hycienth

2014-01-01

The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

Nephrology around Europe: organization models and management strategies: Spain.

PubMed

de Francisco, Angel L M; Piñera, Celestino

2011-01-01

The main aim of this report is to present a picture of the current organization of nephrology in Spain. The Spanish health system offers almost universal coverage, a wide variety of services and a high-quality network of hospitals and primary care centers. Spain has a specialized health care training system that is highly developed, highly regulated, with the capacity to provide high-quality training in 54 different specialties. Nephrology is basically a hospital-based specialty. There are no private dialysis patients in Spain. Hemodialysis centers are 40% public, 15% private and 45% run by companies. The National Health System covers 95% of the population, and there is no cost to patients for treatment of renal disease (dialysis and transplant). We observed a clear decrease of nephrology in residents' election rankings, with position 29 out of 47 specialties in 2007. Some of the reasons for this are the complexity of the subject, no clear information at the university, reduction of professional posts and a very good public service with minimal private practice. In Spain, a model of organization for transplantation was adopted based on a decentralized transplant coordinating network. For cadaveric donors, it compares favorably with rates in other Western countries. Living donor transplantation is very low in Spain--just 10% of total renal transplantation activity. New programs due to financial constraints need to include reduced dialysis costs, greater cost-effectiveness of prescriptions, better handling of ethical issues related to the need for using a clinical score of chronic kidney disease patients to make decisions about conservative or renal replacement therapy and an action plan for improvement of organ donation and transplantation. Recovery of skills (acute kidney injury, biopsies, vascular access, etc.), research and advances in autonomous activities (imaging, surgical and medical vascular training, etc.) are some of the future educational paths needed in nephrology. Adequate decisions in the context of economic restrictions need to be discussed for the sustainability of nephrological care.

Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India.

PubMed

Brown, Heather A; Douglass, Katherine A; Ejas, Shafi; Poovathumparambil, Venugopalan

2016-12-01

Most low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings. Brown HA , Douglass KA , Ejas S , Poovathumparambil V . Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663-666.

Strengthening the Tuberculosis Specimen Referral Network in Uganda: The Role of Public-Private Partnerships.

PubMed

Joloba, Moses; Mwangi, Christina; Alexander, Heather; Nadunga, Diana; Bwanga, Freddie; Modi, Nelson; Downing, Robert; Nabasirye, Agnes; Adatu, Francis E; Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N

2016-04-15

Diagnosis of multidrug-resistant tuberculosis and prompt initiation of effective treatment rely on access to rapid and reliable drug-susceptibility testing. Efficient specimen transport systems and appropriate training on specimen referral contribute to optimal and timely access to tuberculosis diagnostic services. With support and technical assistance from a public-private partnership (PPP) between Becton Dickinson and the US President's Emergency Plan for AIDS Relief, the Uganda National TB Reference Laboratory (NTRL) and National TB and Leprosy Program redesigned the tuberculosis specimen transport network and trained healthcare workers with the goal of improving multidrug-resistant tuberculosis detection. Between 2008 and 2011, the PPP mapped 93% of health facilities and trained 724 healthcare and postal staff members covering 72% of districts. Strengthening the tuberculosis specimen referral system increased referrals from presumptive multidrug-resistant tuberculosis cases by >10-fold, with 94% of specimens reaching the NTRL within the established target transport time. This study demonstrates the potential of PPP collaborations with ministries of health to positively influence patient care by strengthening laboratory systems through increased access to drug-susceptibility testing in Uganda. Ongoing efforts to integrate specimen transport networks will maximize resources and improve patient management. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

An Agent-Based Model of Private Woodland Owner Management Behavior Using Social Interactions, Information Flow, and Peer-To-Peer Networks

PubMed Central

Huff, Emily Silver; Leahy, Jessica E.; Hiebeler, David; Weiskittel, Aaron R.; Noblet, Caroline L.

2015-01-01

Privately owned woodlands are an important source of timber and ecosystem services in North America and worldwide. Impacts of management on these ecosystems and timber supply from these woodlands are difficult to estimate because complex behavioral theory informs the owner’s management decisions. The decision-making environment consists of exogenous market factors, internal cognitive processes, and social interactions with fellow landowners, foresters, and other rural community members. This study seeks to understand how social interactions, information flow, and peer-to-peer networks influence timber harvesting behavior using an agent-based model. This theoretical model includes forested polygons in various states of ‘harvest readiness’ and three types of agents: forest landowners, foresters, and peer leaders (individuals trained in conservation who use peer-to-peer networking). Agent rules, interactions, and characteristics were parameterized with values from existing literature and an empirical survey of forest landowner attitudes, intentions, and demographics. The model demonstrates that as trust in foresters and peer leaders increases, the percentage of the forest that is harvested sustainably increases. Furthermore, peer leaders can serve to increase landowner trust in foresters. Model output and equations will inform forest policy and extension/outreach efforts. The model also serves as an important testing ground for new theories of landowner decision making and behavior. PMID:26562429

Importance of Public-Private Partnerships: Strengthening Laboratory Medicine Systems and Clinical Practice in Africa.

PubMed

Shrivastava, Ritu; Gadde, Renuka; Nkengasong, John N

2016-04-15

After the launch of the US President's Emergency Plan for AIDS Relief in 2003, it became evident that inadequate laboratory systems and services would severely limit the scale-up of human immunodeficiency virus infection prevention, care, and treatment programs. Thus, the Office of the US Global AIDS Coordinator, Centers for Disease Control and Prevention, and Becton, Dickinson and Company developed a public-private partnership (PPP). Between October 2007 and July 2012, the PPP combined the competencies of the public and private sectors to boost sustainable laboratory systems and develop workforce skills in 4 African countries. Key accomplishments of the initiative include measurable and scalable outcomes to strengthen national capacities to build technical skills, develop sample referral networks, map disease prevalence, support evidence-based health programming, and drive continuous quality improvement in laboratories. This report details lessons learned from our experience and a series of recommendations on how to achieve successful PPPs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Athletic Trainer Services in US Private Secondary Schools.

PubMed

Pike, Alicia; Pryor, Riana R; Mazerolle, Stephanie M; Stearns, Rebecca L; Casa, Douglas J

2016-09-01

Availability of athletic trainer (AT) services in US secondary schools has recently been reported to be as high as 70%, but this only describes the public sector. The extent of AT coverage in private secondary school settings has yet to be investigated and may differ from the public secondary school setting for several reasons, including differences in funding sources. To determine the level of AT services in US private secondary schools and identify the reasons why some schools did not employ ATs. Concurrent mixed-methods study. Private secondary schools in the United States. Of 5414 private secondary schools, 2044 (38%) responded to the survey. School administrators responded to the survey via telephone or e-mail. This instrument was previously used in a study examining AT services among public secondary schools. Descriptive statistics provided national data. Open-ended questions were evaluated through content analysis. Of the 2044 schools that responded, 58% (1176/2044) offered AT services, including 28% (574/2040) full time, 25% (501/2042) part time, 4% (78/1918) per diem, and 20% (409/2042) from a hospital or clinic. A total of 84% (281 285/336 165) of athletes had access to AT services. Larger private secondary schools were more likely to have AT services available. Barriers to providing AT services in the private sector were budgetary constraints, school size and sports, and lack of awareness of the role of an AT. More than half of the surveyed private secondary schools in the United States had AT services available; however, only 28% had a full-time AT. This demonstrates the need for increased medical coverage to provide athletes in this setting the appropriate level of care. Budgetary concerns, size of the school and sport offerings, and lack of awareness of the role of the AT continued to be barriers in the secondary school setting.

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

PubMed

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

2015-11-01

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

Athletic Trainer Services in US Private Secondary Schools

PubMed Central

Pike, Alicia; Pryor, Riana R.; Mazerolle, Stephanie M.; Stearns, Rebecca L.; Casa, Douglas J.

2016-01-01

Context: Availability of athletic trainer (AT) services in US secondary schools has recently been reported to be as high as 70%, but this only describes the public sector. The extent of AT coverage in private secondary school settings has yet to be investigated and may differ from the public secondary school setting for several reasons, including differences in funding sources. Objective: To determine the level of AT services in US private secondary schools and identify the reasons why some schools did not employ ATs. Design: Concurrent mixed-methods study. Setting: Private secondary schools in the United States. Patients or Other Participants: Of 5414 private secondary schools, 2044 (38%) responded to the survey. Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. This instrument was previously used in a study examining AT services among public secondary schools. Descriptive statistics provided national data. Open-ended questions were evaluated through content analysis. Results: Of the 2044 schools that responded, 58% (1176/2044) offered AT services, including 28% (574/2040) full time, 25% (501/2042) part time, 4% (78/1918) per diem, and 20% (409/2042) from a hospital or clinic. A total of 84% (281 285/336 165) of athletes had access to AT services. Larger private secondary schools were more likely to have AT services available. Barriers to providing AT services in the private sector were budgetary constraints, school size and sports, and lack of awareness of the role of an AT. Conclusions: More than half of the surveyed private secondary schools in the United States had AT services available; however, only 28% had a full-time AT. This demonstrates the need for increased medical coverage to provide athletes in this setting the appropriate level of care. Budgetary concerns, size of the school and sport offerings, and lack of awareness of the role of the AT continued to be barriers in the secondary school setting. PMID:27749083

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…

Assessment of public vs private MSW management: a case study.

PubMed

Massoud, M A; El-Fadel, M; Abdel Malak, A

2003-09-01

Public-private partnerships in urban environmental services have witnessed increased interest in recent years primarily to reform the weak performance of the public sector, reduce cost, improve efficiency, and ensure environmental protection. In this context, successful public-private partnerships require a thorough analysis of opportunities, a deliberate attention to process details, and a continuous examination of services to determine whether they are more effectively performed by the private sector. A comparative assessment of municipal solid waste collection services in the two largest cities in Lebanon where until recently municipal solid waste collection is private in one and public in the other is conducted. While quality of municipal solid waste collection improved, due to private sector participation, the corresponding cost did not, due to monopoly and an inadequate organizational plan defining a proper division of responsibilities between the private and the public sector.

Network Upgrade for the SLC: PEP II Network

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

Crane, M.; Call, M.; Clark, S.

2011-09-09

The PEP-II control system required a new network to support the system functions. This network, called CTLnet, is an FDDI/Ethernet based network using only TCP/IP protocols. An upgrade of the SLC Control System micro communications to use TCP/IP and SLCNET would allow all PEP-II control system nodes to use TCP/IP. CTLnet is private and separate from the SLAC public network. Access to nodes and control system functions is provided by multi-homed application servers with connections to both the private CTLnet and the SLAC public network. Monitoring and diagnostics are provided using a dedicated system. Future plans and current status informationmore » is included.« less

Mental health services at selected private schools.

PubMed

Van Hoof, Thomas J; Sherwin, Tierney E; Baggish, Rosemary C; Tacy, Peter B; Meehan, Thomas P

2004-04-01

Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.

47 CFR 101.137 - Interconnection of private operational fixed point-to-point microwave stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... point-to-point microwave stations. 101.137 Section 101.137 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.137 Interconnection of private operational fixed point-to-point microwave stations. Private...

47 CFR 101.137 - Interconnection of private operational fixed point-to-point microwave stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... point-to-point microwave stations. 101.137 Section 101.137 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.137 Interconnection of private operational fixed point-to-point microwave stations. Private...

47 CFR 101.137 - Interconnection of private operational fixed point-to-point microwave stations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... point-to-point microwave stations. 101.137 Section 101.137 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.137 Interconnection of private operational fixed point-to-point microwave stations. Private...

47 CFR 101.137 - Interconnection of private operational fixed point-to-point microwave stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... point-to-point microwave stations. 101.137 Section 101.137 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.137 Interconnection of private operational fixed point-to-point microwave stations. Private...

47 CFR 101.137 - Interconnection of private operational fixed point-to-point microwave stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... point-to-point microwave stations. 101.137 Section 101.137 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Technical Standards § 101.137 Interconnection of private operational fixed point-to-point microwave stations. Private...

Education Management Organisations and the Privatisation of Public Education: A Cross-National Comparison of the USA and Britain.

ERIC Educational Resources Information Center

Fitz, John; Beers, Bryan

2002-01-01

British government policies promoting public-private partnerships enabled the privatization of failing schools. In the U.S., the private sector has drawn upon a political network of well-financed institutions to advance privatized education, most recently among charter schools. Privatization has not yet been very successful, but promises to be…

Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

PubMed

Petratos, Pythagoras

2005-12-01

The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System.

Distributed generation of shared RSA keys in mobile ad hoc networks

NASA Astrophysics Data System (ADS)

Liu, Yi-Liang; Huang, Qin; Shen, Ying

2005-12-01

Mobile Ad Hoc Networks is a totally new concept in which mobile nodes are able to communicate together over wireless links in an independent manner, independent of fixed physical infrastructure and centralized administrative infrastructure. However, the nature of Ad Hoc Networks makes them very vulnerable to security threats. Generation and distribution of shared keys for CA (Certification Authority) is challenging for security solution based on distributed PKI(Public-Key Infrastructure)/CA. The solutions that have been proposed in the literature and some related issues are discussed in this paper. The solution of a distributed generation of shared threshold RSA keys for CA is proposed in the present paper. During the process of creating an RSA private key share, every CA node only has its own private security. Distributed arithmetic is used to create the CA's private share locally, and that the requirement of centralized management institution is eliminated. Based on fully considering the Mobile Ad Hoc network's characteristic of self-organization, it avoids the security hidden trouble that comes by holding an all private security share of CA, with which the security and robustness of system is enhanced.

Evaluation of Workload and its Impact on Satisfaction Among Pharmacy Academicians in Southern India

PubMed Central

Khan, Muhammad Umair; Srikanth, Akshaya B.; Patel, Isha; Nagappa, Anantha Naik; Jamshed, Shazia Qasim

2015-01-01

Objective The purpose of this study was to determine the level of workload among pharmacy academicians working in public and private sector universities in India. The study also aimed to assess the satisfaction of academicians towards their workload. Materials and Methods A cross-sectional study was conducted for a period of 2 months among pharmacy academicians in Karnataka state of Southern India. Convenience sampling was used to select a sample and was contacted via email and/or social networking sites. Questionnaire designed by thorough review literature was used as a tool to collect data on workload (teaching, research, extracurricular services) and satisfaction. Results Of 214 participants, 95 returned the filled questionnaire giving the response rate of 44.39%. Private sector academicians had more load of teaching (p=0.046) and they appeared to be less involved in research activities (p=0.046) as compared to public sector academicians. More than half of the respondents (57.9%) were satisfied with their workload with Assistant Professors were least satisfied as compared to Professors (p=0.01). Conclusion Overall, private sector academicians are more burdened by teaching load and also are less satisfied of their workload. Revision of private universities policies may aid in addressing this issue. PMID:26266133

Private healthcare quality: applying a SERVQUAL model.

PubMed

Butt, Mohsin Muhammad; de Run, Ernest Cyril

2010-01-01

This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality. The study consists of 340 randomly selected participants visiting a private healthcare facility during a three-month data collection period. Data were analyzed using means, correlations, principal component and confirmatory factor analysis to establish the modified SERVQUAL scale's reliability, underlying dimensionality and convergent, discriminant validity. Results indicate a moderate negative quality gap for overall Malaysian private healthcare service quality. Results also indicate a moderate negative quality gap on each service quality scale dimension. However, scale development analysis yielded excellent results, which can be used in wider healthcare policy and practice. Respondents were skewed towards a younger population, causing concern that the results might not represent all Malaysian age groups. The study's major contribution is that it offers a way to assess private healthcare service quality. Second, it successfully develops a scale that can be used to measure health service quality in Malaysian contexts.

The Limits of Privatization.

ERIC Educational Resources Information Center

Starr, Paul

Transferring public services and public assets to private ownership is not an entirely new idea. Governments at all levels in the United States have for years contracted out many services. However, under the recently coined label "privatization," such policies now come recommended as a more comprehensive approach to the problems of…

Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review

PubMed Central

Hudson, Mollie; Rutherford, George W.; Weiser, Sheri; Fair, Elizabeth

2018-01-01

Background Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. Methods We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. Results We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88–2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78–1.03). Conclusion These three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB. PMID:29634772

Lynx: a database and knowledge extraction engine for integrative medicine.

PubMed

Sulakhe, Dinanath; Balasubramanian, Sandhya; Xie, Bingqing; Feng, Bo; Taylor, Andrew; Wang, Sheng; Berrocal, Eduardo; Dave, Utpal; Xu, Jinbo; Börnigen, Daniela; Gilliam, T Conrad; Maltsev, Natalia

2014-01-01

We have developed Lynx (http://lynx.ci.uchicago.edu)--a web-based database and a knowledge extraction engine, supporting annotation and analysis of experimental data and generation of weighted hypotheses on molecular mechanisms contributing to human phenotypes and disorders of interest. Its underlying knowledge base (LynxKB) integrates various classes of information from >35 public databases and private collections, as well as manually curated data from our group and collaborators. Lynx provides advanced search capabilities and a variety of algorithms for enrichment analysis and network-based gene prioritization to assist the user in extracting meaningful knowledge from LynxKB and experimental data, whereas its service-oriented architecture provides public access to LynxKB and its analytical tools via user-friendly web services and interfaces.

Differentially Private Distributed Sensing

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

Fink, Glenn A.

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

Insights Into Collaborative Networks Of Nonprofit, Private, And Public Organizations That Address Complex Health Issues.

PubMed

Hogg, Rachel A; Varda, Danielle

2016-11-01

Community networks that include nonprofit, public, and private organizations have formed around many health issues, such as chronic disease management and healthy living and eating. Despite the increases in the numbers of and funding for cross-sector networks, and the growing literature about them, there are limited data and methods that can be used to assess their effectiveness and analyze their designs. We addressed this gap in knowledge by analyzing the characteristics of 260 cross-sector community health networks that collectively consisted of 7,816 organizations during the period 2008-15. We found that nonprofit organizations were more prevalent than private firms or government agencies in these networks. Traditional types of partners in community health networks such as hospitals, community health centers, and public health agencies were the most trusted and valued by other members of their networks. However, nontraditional partners, such as employer or business groups and colleges or universities, reported contributing relatively high numbers of resources to their networks. Further evidence is needed to inform collaborative management processes and policies as a mechanism for building what the Robert Wood Johnson Foundation describes as a culture of health. Project HOPE—The People-to-People Health Foundation, Inc.

Private health care in Nigeria: walking the tightrope.

PubMed

Ogunbekun, I; Ogunbekun, A; Orobaton, N

1999-06-01

The persistently low quality and inadequacy of health services provided in public facilities has made the private sector an unavoidable choice for consumers of health care in Nigeria. Ineffective state regulation, however, has meant little control over the clinical activities of private sector providers while the price of medical services has, in recent years, grown faster than the average rate of inflation. Reforms that are targeted at reorganizing the private sector, with a view to enhancing efficiency in the supply of services, are urgently required if costs are to be contained and consumers assured of good value for money.

All-optical virtual private network system in OFDM based long-reach PON using RSOA re-modulation technique

NASA Astrophysics Data System (ADS)

Kim, Chang-Hun; Jung, Sang-Min; Kang, Su-Min; Han, Sang-Kook

2015-01-01

We propose an all-optical virtual private network (VPN) system in an orthogonal frequency division multiplexing (OFDM) based long reach PON (LR-PON). In the optical access network field, technologies based on fundamental upstream (U/S) and downstream (D/S) have been actively researched to accommodate explosion of data capacity. However, data transmission among the end users which is arisen from cloud computing, file-sharing and interactive game takes a large weight inside of internet traffic. Moreover, this traffic is predicted to increase more if Internet of Things (IoT) services are activated. In a conventional PON, VPN data is transmitted through ONU-OLT-ONU via U/S and D/S carriers. It leads to waste of bandwidth and energy due to O-E-O conversion in the OLT and round-trip propagation between OLT and remote node (RN). Also, it causes inevitable load to the OLT for electrical buffer, scheduling and routing. The network inefficiency becomes more critical in a LR-PON which has been researched as an effort to reduce CAPEX and OPEX through metro-access consolidation. In the proposed system, the VPN data is separated from conventional U/S and re-modulated on the D/S carrier by using RSOA in the ONUs to avoid bandwidth consumption of U/S and D/S unlike in previously reported system. Moreover, the transmitted VPN data is re-directed to the ONUs by wavelength selective reflector device in the RN without passing through the OLT. Experimental demonstration for the VPN communication system in an OFDM based LR-PON has been verified.

Working with the private sector for child health.

PubMed

Waters, Hugh; Hatt, Laurel; Peters, David

2003-06-01

Private sector providers are the most commonly consulted source of care for child illnesses in many countries, offering significant opportunities to expand the reach of essential child health services and products. Yet collaboration with private providers presents major challenges - the suitability and quality of the services they provide is often questionable and governments' capacity to regulate them is limited. This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors. Governments and international organizations can use a variety of strategies to collaborate with and influence private sector actors to improve child health - including contracting, regulating, financing and social marketing, training, coordinating and informing the public. These mutually reinforcing strategies can both improve the quality of services currently delivered in the private sector, and expand and rationalize the coverage of these services. One lesson from this review is that the private sector is very heterogeneous. At the country level, feasible strategies depend on the potential of the different components of the private sector and the capacity of governments and their partners for collaboration. To date, experience with private sector strategies offers considerable promise for children's health, but also raises many questions about the feasibility and impact of these strategies. Where possible, future interventions should be designed as experiments, with careful assessment of the intervention design and the environment in which they are implemented.

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh.

PubMed

Roy, Lumbini; Biswas, Taposh Kumar; Chowdhury, Mahbub Elahi

2017-01-01

Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh.

Patient satisfaction in Turkey: differences between public and private hospitals.

PubMed

Tengilimoglu, D; Kisa, A; Dziegielewski, S F

1999-02-01

This article reports the results of a patient-satisfaction survey administered by interview to 2045 adults discharged from several major public and private hospitals in Turkey. The direct measurement of patient-satisfaction is a new phenomenon for this country. An instrument was designed similar to those available in the United States and administered during exit interviews. Two primary areas of analyses were determined in comparing services provided by these public and private hospitals: demographic factors with regard to accessibility and consumer perceptions of the quality of service provided. Relationships and percentages within and among the five public and two private hospitals are reported. Several statistically significant differences were found between the hospitals, with the private hospitals achieving the greatest satisfaction on most of the quality of services issues examined. Future recommendations outline the need to take into account the public's perception of these hospitals and enhancing customer satisfaction as a means of increasing service utilization.

42 CFR 405.415 - Requirements of the private contract.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements of the private contract. 405.415 Section 405.415 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Private Contracts § 405.415...

Michigan School Privatization Survey 2008

ERIC Educational Resources Information Center

Hohman, James M.; Freeland, William L. E.

2008-01-01

Privatization of school support services is a time-tested means for lowering educational costs. The three major services that school districts in Michigan contract out for are food, custodial and transportation. The Mackinac Center for Public Policy's survey of privatization is the longest running and most comprehensive source of school support…

Public Schools, Private Markets: A Reporter's Guide to Privatization

ERIC Educational Resources Information Center

Elliott, Scott

2005-01-01

More and more, private for-profit and non-profit organizations are involved in schools. No longer limited to support services like transportation and food services, companies are providing tutoring, directing classroom instruction and managing public and charter schools. School reform has raised the stakes for schools and students, asking for…

Michigan School Privatization Survey 2010

ERIC Educational Resources Information Center

Hohman, James M.; Anderson, Dustin D.

2010-01-01

Privatization of support services has been a method that Michigan school districts have used for several years to lower costs. More than ever before, Michigan school districts are privatizing the three main support services they offer--food, custodial and transportation. The annual survey finds that 48.8 percent of Michigan school districts are…

Private vs. Public Care for Juvenile Offenders: A Qualitative Examination.

ERIC Educational Resources Information Center

Kronick, Robert F.

1993-01-01

Examined effectiveness of methods used by public and private institutions' handling of incarcerated delinquents. Concluded that organizational culture is key concept in delivery of services to incarcerated children and youth; that private sector provides alternative to public in delivery of services; that alcohol and drug treatment programs are…

The potentials and problems of private sector transportation services : activities in the New York region

DOT National Transportation Integrated Search

1987-01-01

This project explored the problems and potentials of new forms of private urban transportation that have evolved in the Metropolitan New York region in the last 20 years, as well as the problems and potentials of private urban bus service that has ex...

45 CFR 2516.310 - May private school students participate?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false May private school students participate? 2516.310... NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2516.310 May private school students participate? (a) Yes. To the extent consistent with the number of students...

Health Resources in a 200,000 Urban Indian Population Argues the Need for a Policy on Private Sector Health Services

PubMed Central

Furtado, Kheya Melo; Kar, Anita

2014-01-01

Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals. PMID:24963226

Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

PubMed

Furtado, Kheya Melo; Kar, Anita

2014-04-01

There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

PubMed

Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

2010-11-01

Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions.

42 CFR 422.220 - Exclusion of services furnished under a private contract.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Exclusion of services furnished under a private contract. 422.220 Section 422.220 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With...

The Process of Privatization of Health Care Provision in Poland.

PubMed

Kaczmarek, Krzysztof; Flynn, Hannah; Letka-Paralusz, Edyta; Krajewski-Siuda, Krzysztof; Gericke, Christian A

In January 1999, a new institutional structure for Poland's health care system was laid out, instigated by the dramatic change in both the political and economic system. Following the dissolution of state socialism, private financing of health care services was encouraged to fill an important role in meeting rising consumer demand and to encourage a more efficient use of resources through competition and private initiative. However, from the outset of the intended transformations, systemic limitations to the privatization process hindered progression, resulting in varying rates of privatization amongst the distinct health care sectors. The aim of this paper is to describe the privatization process and to analyze its pace and differences in strategic approach in all major health care sectors. Policy analysis of legislation, government directives, and published national and international scientific literature on Polish health reforms between 1999 and 2012 was conducted. The analysis demonstrates a clear disparity in privatization rates in different sectors. The pharmaceutical industry is fully privatized in 2012, and the ambulatory and dental sectors both systematically increased their private market shares to around 70% of all services provided. However, despite a steady increase in the number of private hospitals in Poland since 1999, their overall role in the health care system is comparatively limited. Unclear legal regulations have resulted in a gray area between public and private health care, where informal payments impede the intended function of the system. If left unchanged, official health care in Poland is likely to become an increasingly residual service for the worst-off population segments that are unable to afford the legal private sector or the informal payments which guarantee a higher quality service in the public sector. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Outsourcing in private healthcare organisations: a Greek perspective.

PubMed

Moschuris, Socrates J; Kondylis, Michael N

2007-01-01

The purpose of this paper is to present a study carried out to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in private healthcare organisations in Greece. A survey instrument was designed and mailed to a random sample of 100 private healthcare organisations in Greece. A total of 25 usable questionnaires were received, representing a response rate of 25 percent. The survey instrument focused on the extent to which private healthcare organisations outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing. Private healthcare organisations in Greece outsource a variety of activities. Cost savings, customisation, and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to an improvement in customer satisfaction and to a cost reduction. Most users are highly satisfied with the performance of these companies and believe that there will be a future increase in the usage of these services. The paper provides a framework regarding outsourcing in private healthcare organisations. This research fills the gap in the area of outsourcing in private healthcare organisations in Greece.

[On the issues of private-public partnership in health care: the case of organization of optometric service)].

PubMed

2011-01-01

The article deals with the issue of private-public partnership in health care. It is demonstrated that in many countries health care system condition is characterized by increase of problems in organization, financing and provision of medical sanitary care. The exponent up growth of aggregate costs of health care, medical services financing occurs. The system of public and municipal health care has no adequate resources to efficiently function without interaction with private organizations. The reason is that most of the suppliers of medical services are not public or municipal belonging. It is necessary to provide inter-financing of curative preventive care at the expense of funds of public and private economic sectors within a framework of full-scale implementation health care the mechanisms of private-public partnership. The studies in this field are to be organized on the example of organizational specificity of optometric service which is positioned concurrently in public and private sectors. This approach makes it possible to reveal feasible ways of implementation of the private-public partnership institution to enhance quality and accessibility of medical care to population in the conditions of concurrent model of health care and globalization challenges.

Does ownership matter for the provision of professionalized services? Hip operations at publicly and privately owned clinics in Denmark.

PubMed

Andersen, Lotte Bøgh; Jakobsen, Mads Leth Felsager

2011-01-01

In terms of clinical procedures (to take the example used in this article, hip operations), both public and private organizations provide highly professionalized services. For this service type, our knowledge about ownership differences is sparse. To begin to fill this gap, we investigate how the ownership of hip clinics affects professional behaviour, treatment quality and patient satisfaction. The comparison of private and public hip clinics is based on data from the Danish Hip Arthroplasty Register and the Danish Central Patient Register combined with 20 semi-structured interviews. We find that private clinics employ stronger individual financial incentives and try harder to increase the income/costs ratio than do public clinics. Private clinics optimize non-clinical factors such as waiting time much more than public clinics and have fewer complication-prone patients than public clinics. However, the clinical procedures are very similar in the two types of clinics. Private clinics do not achieve better clinical results, but patient satisfaction is nevertheless higher with private clinics. The implication is that ownership matters for highly professionalized services, but professionalism neutralizes some – but not all – ownership differences.

An interim prosthesis program for lower limb amputees: comparison of public and private models of service.

PubMed

Gordon, Robert; Magee, Christopher; Frazer, Anna; Evans, Craig; McCosker, Kathryn

2010-06-01

This study compared the outcomes of an interim mechanical prosthesis program for lower limb amputees operated under a public and private model of service. Over a two-year period, 60 transtibial amputees were fitted with an interim prosthesis as part of their early amputee care. Thirty-four patients received early amputee care under a public model of service, whereby a prosthetist was employed to provide the interim mechanical prosthesis service. The remaining 26 patients received early amputee care under a private model of service, where an external company was contracted to provide the interim mechanical prosthesis service. The results suggested comparable clinical outcomes between the two patient groups. However, the public model appeared to be less expensive with the average labour cost per patient being 29.0% lower compared with the private model. The results suggest that a public model of service may provide a more comprehensive and less expensive interim prosthesis program for lower limb amputees.

A private-sector preferred provider network model for public health screening of newly resettled refugees.

PubMed

Geltman, Paul L; Cochran, Jennifer

2005-02-01

US law and regulations stipulate a process for the health screening of refugees. The responsibility of caring for refugees resettled in the United States rests, in part, with public health or welfare departments. Massachusetts has met its screening responsibilities through the innovative creation of a network of private preferred providers. We explore the Massachusetts model of public-private collaboration within the context of federal refugee health priorities and current state fiscal restraints affecting public health programs, and demonstrate the model's accomplishments.

Optimization of turbine positioning in water distribution networks. A Sicilian case study

NASA Astrophysics Data System (ADS)

Milici, Barbara; Messineo, Simona; Messineo, Antonio

2017-11-01

The potential energy of water in Water Distribution Networks (WDNs), is usually dissipated by Pressure Reduction Valves (PRVs), thanks to which water utilities manage the pressure level in selected nodes of the network. The present study explores the use of economic hydraulic machines, pumps as turbines (PATs), to produce energy in a small network with the aim to avoid dissipation in favour of renewable energy production. The proposed study is applied to a WDN located in a town close to Palermo (Sicily), where users often install private tanks, to collect water during the period of water scarcity conditions. As expected, the economic benefit of PATs installation in WDNs is affected by the presence of private tanks, whose presence deeply modifies the network from designed condition. The analysis is carried out by means of a mathematical model, which is able to simulate dynamically water distribution networks with private tanks and PATs. As expected, the advantage of PATs' installation in terms of renewable energy recovery is strictly conditioned by their placement in the WDN.

``Planetário e Teatro Digital Johannes Kepler'' and its Institutional Pedagogical Project

NASA Astrophysics Data System (ADS)

Faria, R. Z.; Calil, M. R.; Perez, E. R.; Kanashiro, M.; Silva, L. C. P.; Calipo, F.

2014-10-01

This work relates the reception of schools, started on August 2012, in the astronomic laboratory of the "Planetário e Teatro Digital Johannes Kepler", located in the "Sabina - Escola Parque do Conhecimento" in Santo André, São Paulo. The idealization of this project, authorship of Marcos Calil, PhD, consists in four apprenticeship environments disposed around the planetary dome. They make reference to the System Sun - Earth - Moon (Tellurium), Solar System, Astronautic and Stars. On Tuesdays and Wednesdays the astronomic laboratory is used by Santo André municipal schools for focused lessons, being possible on Thursdays scheduling for private and public schools. On weekends and holidays is opened for the visitors. Since the inauguration to the beginning of activities with students, the monitor team was guided and trained on contents of Astronomy and Aeronautic to execute the schools service. This is done in four stages, which are: reception, course trough the astronomic laboratory, dome session and activities closure. During the reception the acquaintance rules are passed on for a better visit. Before starting the course the monitors do a survey about the previous knowledge of the students. On the astronomic laboratory resources of the environment are used to explain the contents of Astronomy and Astronautic, always considering the age group and the curriculum developed in classroom. After the course the students watch a planetary session supporting the contents seen on the astronomic laboratory. At the end a feedback is done with the students about the subject discussed. During the visit the teachers fulfill an evaluation about the place and the service. From August 2012 to November 2012 were attended between municipal, public and private schools. From the 4932 students attended, 92% belonged to the municipal network, 5% to the private network and 3% to the public network. From the 189 evaluations done by the teachers, 97.8% were satisfied, 2.1% partially satisfied e 0.1% unsatisfied with the reception promoted by the team of the planetary. Meantime the satisfaction presented on the evaluation is thought that the use of non-formal places is an ally of apprenticeship. The ``Planetário e Teatro Digital Johannes Kepler'' by its team collaborates for an education and divulgation of the Astronomy and Astronautic make part of the reality and quotidian of the students of the city of Santo André.

Investigating Factors Related to Virtual Private Network Adoption in Small Businesses

ERIC Educational Resources Information Center

Lederer, Karen

2012-01-01

The purpose of this quantitative study was to investigate six factors that may influence adoption of virtual private network (VPN) technologies in small businesses with fewer than 100 employees. Prior research indicated small businesses employing fewer than 100 workers do not adopt VPN technology at the same rate as larger competitors, and the…

Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership

PubMed Central

Kebede, Yenew; Fonjungo, Peter N.; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N.; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

2016-01-01

Background. Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)–US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). Methods. In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. Results. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2–14 days) to 2 days (range, 1–3 days) in Addis Ababa and from 10 days (range, 6–21 days) to 5 days (range, 2–6 days) in Amhara Region. Conclusions. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. PMID:27025700

Child outpatient mental health service use: why doesn't insurance matter?

PubMed

Glied, Sherry; Bowen Garrett, A.; Hoven, Christina; Rubio-Stipec, Maritza; Regier, Darrel; Moore, Robert E.; Goodman, Sherryl; Wu, Ping; Bird, Hector

1998-12-01

BACKGROUND: Several recent studies of child outpatient mental health service use in the US have shown that having private insurance has no effect on the propensity to use services. Some studies also find that public coverage has no beneficial effect relative to no insurance. AIMS: This study explores several potential explanations, including inadequate measurement of mental health status, bandwagon effects, unobservable heterogeneity and public sector substitution for private services, for the lack of an effect of private insurance on service use. METHODS: We use secondary analysis of data from the three mainland US sites of NIMH's 1992 field trial of the Cooperative Agreement for Methodological Research for Multi-Site Surveys of Mental Disorders in Child and Adolescent Populations (MECA) Study. We examine whether or not a subject used any mental health service, school-based mental health services or outpatient mental health services, and the number of outpatient visits among users. We also examine use of general medical services as a check on our results. We conduct regression analysis; instrumental variables analysis, using instruments based on employment and parental history of mental health problems to identify insurance choice, and bivariate probit analysis to examine multiservice use. RESULTS: We find evidence that children with private health insurance have fewer observable (measured) mental health problems. They also appear to have a lower unobservable (latent) propensity to use mental health services than do children without coverage and those with Medicaid coverage. Unobserved differences in mental health status that relate to insurance choice are found to contribute to the absence of a positive effect for private insurance relative to no coverage in service use regressions. We find no evidence to suggest that differences in attitudes or differences in service availability in children's census tracts of residence explain the non-effect of insurance. Finally, we find that the lack of a difference is not a consequence of substitution of school-based for office-based services. School-based and office-based specialty mental health services are complements rather than substitutes. School-based services are used by the same children who use office-based services, even after controlling for mental health status. DISCUSSION: Our results are consistent with at least two explanations. First, limits on coverage under private insurance may discourage families who anticipate a need for child mental health services from purchasing such insurance. Second, publicly funded services may be readily available substitutes for private services, so that lack of insurance is not a barrier to adequate care. Despite the richness of data in the MECA dataset, cross-sectional data based on epidemiological surveys do not appear to be sufficient to fully understand the surprising result that insurance does not enable access to care. IMPLICATIONS FOR POLICY AND RESEARCH: Limits on coverage under private mental health insurance combined with a relatively extensive system of public mental health coverage have apparently generated a situation where there is no observed advantage to the marginal family of obtaining private mental health insurance coverage. Further research using longitudinal data is needed to better understand the nature of selection in the child mental health insurance market. Further research using better measures of the nature of treatment provided in different settings is needed to better understand how the private and public mental health systems operate.

The Virtual Xenbase: transitioning an online bioinformatics resource to a private cloud.

PubMed

Karimi, Kamran; Vize, Peter D

2014-01-01

As a model organism database, Xenbase has been providing informatics and genomic data on Xenopus (Silurana) tropicalis and Xenopus laevis frogs for more than a decade. The Xenbase database contains curated, as well as community-contributed and automatically harvested literature, gene and genomic data. A GBrowse genome browser, a BLAST+ server and stock center support are available on the site. When this resource was first built, all software services and components in Xenbase ran on a single physical server, with inherent reliability, scalability and inter-dependence issues. Recent advances in networking and virtualization techniques allowed us to move Xenbase to a virtual environment, and more specifically to a private cloud. To do so we decoupled the different software services and components, such that each would run on a different virtual machine. In the process, we also upgraded many of the components. The resulting system is faster and more reliable. System maintenance is easier, as individual virtual machines can now be updated, backed up and changed independently. We are also experiencing more effective resource allocation and utilization. Database URL: www.xenbase.org. © The Author(s) 2014. Published by Oxford University Press.

Using Patient Pathway Analysis to Design Patient-centered Referral Networks for Diagnosis and Treatment of Tuberculosis: The Case of the Philippines

PubMed Central

Garfin, Celine; Mantala, Mariquita; Yadav, Rajendra; Hanson, Christy L; Osberg, Mike; Hymoff, Aaron; Makayova, Julia

2017-01-01

Abstract Background Tuberculosis (TB) is the 8th leading cause of death in the Philippines. A recent prevalence survey found that there were nearly 70% more cases of tuberculosis than previously estimated. Given these new data, the National TB Program (NTP), operating through a decentralized health system, identified about 58% of the estimated new drug-sensitive (DS) TB patients in 2016. However, the NTP only identified and commenced treatment for around 17% of estimated new drug-resistant patients. In order to reach the remaining 42% of drug-sensitive patients and 83% of drug-resistant patients, it is necessary to develop a better understanding of where patients seek care. Methods National and regional patient pathway analyses (PPAs) were undertaken using existing national survey and NTP data. The PPA assessed the alignment between patient care seeking and the availability of TB diagnostic and treatment services. Results Systemic referral networks from the community-level Barangay Health Stations (BHSs) to diagnostic facilities have enabled more efficient detection of drug-sensitive tuberculosis in the public sector. Approximately 36% of patients initiated care in the private sector, where there is limited coverage of appropriate diagnostic technologies. Important differences in the alignment between care seeking patterns and diagnostic and treatment availability were found between regions. Conclusions The PPA identified opportunities for strengthening access to care for all forms of tuberculosis and for accelerating the time to diagnosis by aligning services to where patients initiate care. Geographic variations in care seeking may guide prioritization of some regions for intensified engagement with the private sector. PMID:29117352

Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

PubMed

Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

2015-01-01

In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001). Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both private and public sector facilities, and a greater emphasis on tracking access to and quality of care in private sector facilities.

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

9 CFR 130.5 - User fees for services at privately owned permanent and temporary import quarantine facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... owned permanent and temporary import quarantine facilities. 130.5 Section 130.5 Animals and Animal... User fees for services at privately owned permanent and temporary import quarantine facilities. (a... privately operated permanent or temporary import quarantine facility will be calculated at the hourly user...

Impact of telepharmacy in a multihospital health system.

PubMed

Garrelts, James C; Gagnon, Mark; Eisenberg, Charlese; Moerer, Janell; Carrithers, Joe

2010-09-01

The impact of telepharmacy in a multihospital health system was evaluated. Telepharmacy services were implemented at five hospitals within a Catholic, nonprofit, integrated delivery network health system. Telepharmacy services were provided by seven pharmacists employed by the health system. Using a virtual private network or terminal server, pharmacists directly accessed hospital servers and information systems to conduct their work. Telephone calls were automatically routed to the telepharmacist so that handling of nursing and other calls would be transparent to staff. Hours of telepharmacy service were 5 p.m. to 2 a.m. Monday through Friday evenings at four of the hospitals and 8 p.m. to 10 p.m. at the rural hospital. Order-processing time for routine orders was reduced from 26.8 to 14 minutes (p < 0.0001), while stat order processing was shortened from 11.6 to 8.8 minutes (p = 0.007). For routine orders, turnaround times greater than 60 minutes became almost nonexistent after telepharmacy services were implemented. The number of clinical interventions documented increased by 42%, from 619 to 881, equivalent to a net annualized saving of $1,132,144. A significant improvement in nurses' global satisfaction with pharmacist availability for unit consultations was reported (3.0 versus 4.0 on a 5.0 Likert scale; p = 0.028). The implementation of telepharmacy services in a multihospital health system expanded hours of service, improved the speed of processing of physician medication orders, and increased clinical pharmacy services and cost avoidance. Surveys of health care staff found that telepharmacy services were well received.

Out-of-pocket expenses for maternity care in rural Bangladesh: a public-private comparison.

PubMed

Rahman, Moshiur; Rob, Ubaidur; Noor, Forhana Rahman; Bellows, Benjamin

Out-of-pocket expenses incurred by women for availing maternal healthcare services at public and private health facilities in Bangladesh were examined using a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal healthcare. The survey was conducted in 2010 among 3,300 women who gave birth in the previous 12 months from the start of data collection. Information on costs incurred to receive antenatal, delivery, and postnatal care services was collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal healthcare services both at public and private health facilities. Out-of-pocket expenses include registration, consultation, laboratory examination, medicine, transportation, and other associated costs incurred for receiving maternal healthcare services. On average, women paid US$3.60 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.40 at private health facilities. Similarly, women paid one and half times more for normal (US$42.30) and cesarean deliveries (US$136.20) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care services did not vary significantly between public and private health facilities. Utilization of maternal healthcare services can be improved if out-of-pocket expenses can be minimized. At the same time, effective demand generation strategies are necessary to encourage women to utilize health facilities.

The consequences of health service privatisation for equality and equity in health care in South Africa.

PubMed

Price, M

1988-01-01

The trend towards the privatisation of health services in South Africa reflects a growing use of private sources of finance and the growing proportion of privately owned fee-for-service providers and facilities. Fee-for-service methods of reimbursement aggravate the geographical maldistribution of personnel and facilities, and the competition for scarce personnel resources aggravates the difference in the quality of the public and private services. Thus the growth in demand for these types of providers may be expected to increase inequality of access in these two respects. The potential expansion of medical scheme coverage is shown to be limited to well under 50% of the population, leaving the majority of the population without access to private sector health care. Even for members of the medical schemes, benefits are linked to income, thus clashing with the principle of equal care for equal need. The public funds needed to overcome financial obstacles to access to private providers could be more efficiently deployed by financing publicly owned and controlled health services directly. Taxation also offers the most equitable method of financing health services. Finally, attention is drawn to the dilemma resulting from the strengthening of the private health sector; while in the short term this can offer better care to more people on a racially non-discriminatory basis, in the long term, health care for the population as a whole may become more unequal and for those dependent on the public sector it may even deteriorate.

Expanding malaria diagnosis and treatment in Lao PDR: lessons learned from a public-private mix initiative.

PubMed

Simmalavong, Nouannipha; Phommixay, Sengkham; Kongmanivong, Phoudaliphone; Sichanthongthip, Odai; Hongvangthong, Bouasy; Gopinath, Deyer; Sintasath, David M

2017-11-13

As in other countries of the Greater Mekong Sub-region (GMS), the private health sector constitutes a significant avenue where malaria services are provided and presents a unique opportunity for public-private collaboration. In September 2008, a public-private mix (PPM) strategy was launched initially in four northern and southern provinces in Lao PDR to increase access to rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT), improve quality of care, and collect routine malaria data from the private sector. Throughout the process, key stakeholders were involved in the planning, monitoring and supervision of project sites. Following an initial assessment in 2009, the PPM initiative expanded to an additional 14 district sites to a total of 245 private pharmacies and 16 clinics covering 8 provinces and 22 districts. By June 2016, a total of 317 pharmacies, 30 clinics in 32 districts of the 8 provinces were participating in the PPM network and reported monthly malaria case data. This descriptive study documented the process of initiating and maintaining the PPM network in Lao PDR. Epidemiological data reported through the routine surveillance system from January 2009 to June 2016 were analyzed to illustrate the contribution of case reporting from the private sector. A total of 2,301,676 malaria tests were performed in the PPM districts, which included all the PPM pharmacies and clinics (176,224, 7.7%), proportion of patients tested from 14,102 (4.6%) in 2009 to 29,554 (10.4%) in 2015. Over the same period of 90 months, a total of 246,091 positive cases (10.7%) were detected in PPM pharmacies and clinics (33,565; 13.6%), in the same districts as the PPM sites. The results suggest that the PPM sites contributed to a significant increasing proportion of patients positive for malaria from 1687 (7.4%) in 2009 to 5697 (15.8%) in 2015. Ensuring adequate and timely supplies of RDTs and ACT to PPM sites is critical. Frequent refresher training is necessary to maintain data quality, motivation and feedback. In the context of malaria elimination, the PPM initiative should be expanded further to ensure that all febrile cases seen through the private sector in malaria transmission areas are tested for malaria and treated appropriately. Results from the PPM must be integrated into a centralized registry of malaria cases that should prompt required case and foci investigations and responses to be conducted as part of elimination efforts.

Reaching youth through franchise clinics: assessment of Kenyan private sector involvement in youth services.

PubMed

Decker, Martha; Montagu, Dominic

2007-03-01

This paper evaluates the ability of social franchise programs, which use private providers to offer reproductive health services, to provide services to youth in western Kenya. Although franchise clinics have rarely targeted youth, they appear to offer a viable alternative for providing reproductive health services to this age group.

Community Services Landscape in Canada: Survey of Developmental Disability Agencies.

ERIC Educational Resources Information Center

Pedlar, Alison; Hutchison, Peggy; Arai, Susan; Dunn, Peter

2000-01-01

A survey of 801 support services for adults with developmental disabilities living in community settings in Canada found a diminution of government's role in funding and guiding service provision and the emergence of private-for-profit services. Differences between nonprofit and private sectors include a greater propensity in nonprofit agencies to…

47 CFR 90.415 - Prohibited uses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND...) Render a communications common carrier service, except for stations in the Public Safety Pool providing..., private carrier paging, Industrial/Business Pool, or 220-222 MHz services. [43 FR 54791, Nov. 22, 1978, as...

47 CFR 90.415 - Prohibited uses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND...) Render a communications common carrier service, except for stations in the Public Safety Pool providing..., private carrier paging, Industrial/Business Pool, or 220-222 MHz services. [43 FR 54791, Nov. 22, 1978, as...

47 CFR 90.415 - Prohibited uses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND...) Render a communications common carrier service, except for stations in the Public Safety Pool providing..., private carrier paging, Industrial/Business Pool, or 220-222 MHz services. [43 FR 54791, Nov. 22, 1978, as...

47 CFR 90.415 - Prohibited uses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND...) Render a communications common carrier service, except for stations in the Public Safety Pool providing..., private carrier paging, Industrial/Business Pool, or 220-222 MHz services. [43 FR 54791, Nov. 22, 1978, as...

47 CFR 101.1305 - Private internal service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... business purposes or public safety communications and not on a for-hire or for-profit basis. ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Private internal service. 101.1305 Section 101.1305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES...

Expanding mental health services through novel models of intervention delivery.

PubMed

Kazdin, Alan E

2018-06-13

Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one-to-one, in-person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health-care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research. © 2018 Association for Child and Adolescent Mental Health.

Public vs. Private Insurance: Cost, Use, Accessibility, and Outcomes of Services for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Young, April; Ruble, Lisa; McGrew, John

2009-01-01

Very little research has been conducted on insurance type (private vs. public funded) and costs, accessibility, and use of services of children with autism. Analysis of five parent reported outcomes: (a) out-of-pocket expenditures, (b) variety of services used, (c) access to services, (d) child and family service outcomes, and (e) satisfaction…

Customer perceived service quality, satisfaction and loyalty in Indian private healthcare.

PubMed

Kondasani, Rama Koteswara Rao; Panda, Rajeev Kumar

2015-01-01

The purpose of this paper is to analyse how perceived service quality and customer satisfaction lead to loyalty towards healthcare service providers. In total, 475 hospital patients participated in a questionnaire survey in five Indian private hospitals. Descriptive statistics, factor analysis, regression and correlation statistics were employed to analyse customer perceived service quality and how it leads to loyalty towards service providers. Results indicate that the service seeker-service provider relationship, quality of facilities and the interaction with supporting staff have a positive effect on customer perception. Findings help healthcare managers to formulate effective strategies to ensure a better quality of services to the customers. This study helps healthcare managers to build customer loyalty towards healthcare services, thereby attracting and gaining more customers. This paper will help healthcare managers and service providers to analyse customer perceptions and their loyalty towards Indian private healthcare services.

A Community-based Partnership for a Sustainable GNSS Geodetic Network

NASA Astrophysics Data System (ADS)

Dokka, R. K.

2009-12-01

Geodetic networks offer unparalleled opportunities to monitor and understand many of the rhythms of the Earth most vital to the sustainability of modern and future societies, i.e., crustal motions, sea-level, and the weather. For crustal deformation studies, the advantage is clear. Modern measurements allow us to document not only the permanent strains incurred over a seismic cycle, for example, but also the ephemeral strains that are critical for understanding the underlying physical mechanism. To be effective for science, however, geodetic networks must be properly designed, capitalized, and maintained over sufficient time intervals to fully capture the processes in action. Unfortunately, most networks lack interoperability and lack a business plan to ensure long term sustainability. The USA, for example, lacks a unified nation-wide GNSS network that can sustain its self over the coming years, decades, and century. Current federal priorities do not yet envision such a singular network. Publicly and privately funded regional networks exist, but tend to be parochial in scope, and optimized for a special user community, e.g., surveying, crustal motions, etc. Data sharing is common, but the lack of input at the beginning limits the functionality of the system for non-primary users. Funding for private networks depend heavily on the user demand, business cycle, and regulatory requirements. Agencies funding science networks offer no guarantee of sustained support. An alternative model (GULFNet) developed in Louisiana is meeting user needs, is sustainable, and is helping engineers, surveyors, and geologists become more spatially enabled. The common denominator among all participants is the view that accurate, precise, and timely geodetic data have tangible value for all segments of society. Although operated by a university (LSU), GULFNet is a community-based partnership between public and private sectors. GULFNet simultaneously achieves scientific goals by providing data to multiple user communities, supports National Spatial Reference System needs through NGS CORS, and serves the private sector by helping to make it become more profitable. The private sector participates through direct support that sustains operations, but most importantly by raising awareness among policy makers and federal and state appropriators.

Family planning, antenatal and delivery care: cross-sectional survey evidence on levels of coverage and inequalities by public and private sector in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; MacLeod, David; Baggaley, Rebecca F; Rodrigues, Laura C; Hanson, Kara; Powell-Jackson, Timothy; Penn-Kekana, Loveday; Polonsky, Reen; Footman, Katharine; Vahanian, Alice; Pereira, Shreya K; Santos, Andreia Costa; Filippi, Veronique G A; Lynch, Caroline A; Goodman, Catherine

2016-04-01

The objective of this study was to assess the role of the private sector in low- and middle-income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000-2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio-economic position. We used data from 865 547 women aged 15-49, representing a total of 3 billion people. We defined 'met and unmet need for services' and 'use of appropriate service types' clearly and developed explicit classifications of source and sector of provision. Across the four regions (sub-Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private-sector share among users of family planning services was 37-39% across regions (overall mean: 37%; median across countries: 41%). The private-sector market share among users of ANC was 13-61% across regions (overall mean: 44%; median across countries: 15%). The private-sector share among appropriate deliveries was 9-56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care. The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision. © 2016 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Utilization of HIV-related services from the private health sector: A multi-country analysis.

PubMed

Wang, Wenjuan; Sulzbach, Sara; De, Susna

2011-01-01

Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

PubMed

Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

2015-10-01

To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

Financialisation in health care: An analysis of private equity fund investments in Turkey.

PubMed

Eren Vural, Ipek

2017-08-01

The 2007-2008 global financial crisis revived interest in the impacts of financial markets and actors on our social and economic life. Nevertheless, research on health care financialisation remains scant. This article presents findings from research on one modality of financial investments in health care: global private equity funds' investments in private hospitals. Adopting a political economy approach, it analyses the drivers and impacts of the upsurge of global private equity investments in the Turkish private hospital sector amid the global financial crisis. The analysis derives from review of research and archival literature, as well as six in-depth interviews held with owners/executive board directors/general managers of the largest private hospital chains in Turkey and the general partners of their PE investors. The interviewing process took place between January and November 2016. All interviews were conducted by the author in Istanbul. The findings point to a mutually reinforcing relationship between neoliberal policies and financialisation processes in health care. The article shows that neoliberal healthcare reforms, introduced under consecutive Justice and Development Party (JDP) governments in Turkey, have been important precursors of private equity investments in healthcare services. These private equity investments, in turn, intensified and broadened the process of marketisation in health care services. Four impacts are identified, through which private equity investments hasten the marketisation of health care services. These relate to the impacts of private equity investments on a) advancing the process of chain formation by large hospital groups, b) spreading financial imperatives into the operations of private hospitals c) fostering internationalisation of capital, and d) augmenting inequities in access to health care services and standards. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health insurance and use of medical services by men infected with HIV.

PubMed

Katz, M H; Chang, S W; Buchbinder, S P; Hessol, N A; O'Malley, P; Doll, L S

1995-01-01

Among 178 HIV-infected men from the San Francisco City Clinic Cohort (SFCCC), we examined the association between health insurance and use of outpatient services and treatment. For men with private insurance, we also assessed the frequency of avoiding the use of health insurance. Men without private insurance reported fewer outpatient visits than men with fee-for-service or managed-care plans. Use of zidovudine for eligible men was similar for those with fee-for-service plans (74%), managed-care plans (77%), or no insurance (61%). Use of Pneumocytstis carinii pneumonia prophylaxis was similar for those with fee-for-service (93%) and managed-care plans (83%) but lower for those with no insurance (63%). Of 149 men with private insurance, 31 (21%) reported that they had avoided using their health insurance for medical expenses in the previous year. In multivariate analysis, the independent predictors of avoiding the use of insurance were working for a small company and living outside the San Francisco Bay Area. Having private insurance resulted in higher use of outpatient services, but the type of private insurance did not appear to affect the use of service or treatment. Fears of loss of coverage and confidentiality may negate some benefits of health insurance for HIV-infected persons.

Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

PubMed

Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

2016-01-01

A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

Remote Asynchronous Message Service Gateway

NASA Technical Reports Server (NTRS)

Wang, Shin-Ywan; Burleigh, Scott C.

2011-01-01

The Remote Asynchronous Message Service (RAMS) gateway is a special-purpose AMS application node that enables exchange of AMS messages between nodes residing in different AMS "continua," notionally in different geographical locations. JPL s implementation of RAMS gateway functionality is integrated with the ION (Interplanetary Overlay Network) implementation of the DTN (Delay-Tolerant Networking) bundle protocol, and with JPL s implementation of AMS itself. RAMS protocol data units are encapsulated in ION bundles and are forwarded to the neighboring RAMS gateways identified in the source gateway s AMS management information base. Each RAMS gateway has interfaces in two communication environments: the AMS message space it serves, and the RAMS network - the grid or tree of mutually aware RAMS gateways - that enables AMS messages produced in one message space to be forwarded to other message spaces of the same venture. Each gateway opens persistent, private RAMS network communication channels to the RAMS gateways of other message spaces for the same venture, in other continua. The interconnected RAMS gateways use these communication channels to forward message petition assertions and cancellations among themselves. Each RAMS gateway subscribes locally to all subjects that are of interest in any of the linked message spaces. On receiving its copy of a message on any of these subjects, the RAMS gateway node uses the RAMS network to forward the message to every other RAMS gateway whose message space contains at least one node that has subscribed to messages on that subject. On receiving a message via the RAMS network from some other RAMS gateway, the RAMS gateway node forwards the message to all subscribers in its own message space.

Transnational health care: from a global terminology towards transnational health region development.

PubMed

Mainil, Tomas; Van Loon, Francis; Dinnie, Keith; Botterill, David; Platenkamp, Vincent; Meulemans, Herman

2012-11-01

Within European cross-border health care, recent studies have identified several types of international patients. Within the Anglo-Saxon setting, the specific terminology of medical tourism is used. The analytical purpose of the paper is to resolve this semantic difference by suggesting an alternative terminology, 'transnational health care' that is understood as a 'context-controlled and coordinated network of health services'. For demand-driven trans-border access seekers and cross-border access searchers, there is a need to opt for regional health-policy strategies. For supply-driven sending context actors and receiving context actors, there would be organizational benefits to these strategies. Applying the terminology of trans-border access seekers, cross-border access searchers, sending context and receiving context actors results in a transnational patient mobility typology of twelve types of international patients, based on the criteria of geographical distance, cultural distance and searching efforts, public/private/no cover and private/public provision of health services. Finally, the normative purpose of the paper is to encourage the use of this terminology to promote a policy route for transnational health regions. It is suggested that the development of transnational health regions, each with their own medical and supportive service characteristics, could enhance governmental context-controlled decision power in applying sustainable health destination management. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Growth in spending on substance use disorder treatment services for the privately insured population.

PubMed

Thomas, Cindy Parks; Hodgkin, Dominic; Levit, Katharine; Mark, Tami L

2016-03-01

Approximately 8% of individuals with private health insurance in the United States have substance use disorders (SUDs), but in 2009 only 0.4% of all private insurance spending was on SUDs. The objective of this study was to determine if changes that occurred between 2009 and 2012 - such as more generous SUD benefits, an epidemic of opioid use disorders, and slow recovery from a recession - were associated with greater use of SUD treatment. Data were from the 2004-2012 Truven Health Analytics MarketScan(®) Commercial Claims and Encounters Database. This database is representative of individuals with private insurance in the United States. Per enrollee use of and spending on SUD treatment was determined and compared with spending on all health care services. Trends were examined for inpatient care, outpatient care, and prescription medications. During the 2009-2012 time period, use of and spending on SUD services increased compared with all diagnoses. Two-thirds of the increase was driven by higher growth rates in outpatient use and prices. Despite the high growth rates, SUD treatment penetration rates remained low. As of 2012, only 0.6% of individuals with private insurance used SUD outpatient services, 0.2% filled SUD medication prescriptions, and 0.1% used inpatient SUD services. In 2012, SUD services accounted for less than 0.7% of all private insurance spending. Despite recent coverage improvements, individuals with private health insurance still may not receive adequate levels of treatment for SUDs, as evidenced by the small proportion of individuals who access treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

PubMed

Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

2015-08-20

Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

Privatization and Education

ERIC Educational Resources Information Center

Dash, Neena

2009-01-01

This paper highlights emerging trends, programmes and policies in privatization of education in Western countries. These trends are educational vouchers, choice of private schools, private school liberalization, private contracting of specific services, tuition tax credits and deductions for parents ,subsidies and assistance grants to private…

International, private-public, multi-mission, next-generation Lunar/Martian laser retroreflectors

NASA Astrophysics Data System (ADS)

Dellagnello, S.

2017-09-01

We describe an international, private-public, multi-mission effort to deploy on the Moon next-generation lunar laser retroreflectors to extend (also to the far side) the existing passive Lunar Geophysical Network (LNG) consisting of the three Apollo and the two Lunokhod payloads. We also describe important applications and extension of this program to Mars Geophysical Network (MGN).

Addiction to Social Networks and Social Skills in Students from a Private Educational Institution

ERIC Educational Resources Information Center

Domínguez-Vergara, Julio A.; Ybañez-Carranza, Jessenia

2016-01-01

This research aims to determine the relationship between addiction to social networks and social skills in students of a private educational centre. A correlational descriptive study where the sample was represented by 205 students from 1st to 5th grade of junior high school was conducted. Two instruments were used: "Goldstein Social Skills…

Group-multicast capable optical virtual private ring with contention avoidance

NASA Astrophysics Data System (ADS)

Peng, Yunfeng; Du, Shu; Long, Keping

2008-11-01

A ring based optical virtual private network (OVPN) employing contention sensing and avoidance is proposed to deliver multiple-to-multiple group-multicast traffic. The network architecture is presented and its operation principles as well as performance are investigated. The main contribution of this article is the presentation of an innovative group-multicast capable OVPN architecture with technologies available today.

Climate Services - Innovation for Smart Solutions

NASA Astrophysics Data System (ADS)

Jacob, Daniela

2015-04-01

Living in a changing climate is becoming an increasing challenge for all kinds of human activities. Mitigation of global warming is of utmost importance to avoid further and stronger changes in our climate. At the same time, adaptation to today's and future changes is needed. To address both, a new field of activity developed within the last couple of years: climate services. They develop and deliver easy understandable and useful information for decision makers in public and private business and society as a whole. The German Climate Service Center 2.0 was one of the first institutions worldwide bridging the gap between scientific climate change knowledge and user needs. Developing prototype products and services, the Climate Service Center 2.0 orients its activities toward consultation of climate change topics and adaptation to climate change impacts. It prepares high quality and state of the art information for decision makers. What have we learned and where are we heading to? What are the roles of partners and networks? And how might a new field of expertise like climate services develop and stimulate the job market? These questions will be discussed and examples will be given.

Consumer, physician, and payer perspectives on primary care medication management services with a shared resource pharmacists network.

PubMed

Smith, Marie; Cannon-Breland, Michelle L; Spiggle, Susan

2014-01-01

Health care reform initiatives are examining new care delivery models and payment reform alternatives such as medical homes, health homes, community-based care transitions teams, medical neighborhoods and accountable care organizations (ACOs). Of particular interest is the extent to which pharmacists are integrated in team-based health care reform initiatives and the related perspectives of consumers, physicians, and payers. To assess the current knowledge of consumers and physicians about pharmacist training/expertise and capacity to provide primary care medication management services in a shared resource network; determine factors that will facilitate/limit consumer interest in having pharmacists as a member of a community-based "health care team;" determine factors that will facilitate/limit physician utilization of pharmacists for medication management services; and determine factors that will facilitate/limit payer reimbursement models for medication management services using a shared resource pharmacist network model. This project used qualitative research methods to assess the perceptions of consumers, primary care physicians, and payers on pharmacist-provided medication management services using a shared resource network of pharmacists. Focus groups were conducted with primary care physicians and consumers, while semi-structured discussions were conducted with a public and private payer. Most consumers viewed pharmacists in traditional dispensing roles and were unaware of the direct patient care responsibilities of pharmacists as part of community-based health teams. Physicians noted several chronic disease states where clinically-trained pharmacists could collaborate as health care team members yet had uncertainties about integrating pharmacists into their practice workflow and payment sources for pharmacist services. Payers were interested in having credentialed pharmacists provide medication management services if the services improved quality of patient care and/or prevented adverse drug events, and the services were cost neutral (at a minimum). It was difficult for most consumers and physicians to envision pharmacists practicing in non-dispensing roles. The pharmacy profession must disseminate the existing body of evidence on pharmacists as care providers of medication management services and the related impact on clinical outcomes, patient safety, and cost savings to external audiences. Without such, new pharmacist practice models may have limited acceptance by consumers, primary care physicians, and payers. Copyright © 2014 Elsevier Inc. All rights reserved.

34 CFR 300.137 - Equitable services determined.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in Private Schools § 300.137 Equitable services determined. (a) No individual right to special education and related services. No parentally-placed private school child with a disability has an individual right to...

Small City Transit : Bremerton, Washington : Privately Operated Subscription Bus Service to an Industrial Site

DOT National Transportation Integrated Search

1976-03-01

Bremerton, Washington, is an illustration of a privately operated, profitmaking subscription bus service. This case study is one of thirteen examples of a transit service in a small community. The background of the community is discussed along with a...

Forest Land Ownership in the Conterminous United States [map

Treesearch

Mark D. Nelson; Greg C. Liknes

2007-01-01

Patterns of public and private forestland ownership vary across the United States. For example, two-thirds of western forestland is publicly owned, mostly by federal agencies such as the U.S. Forest Service (USFS), Bureau of Land Management, and National Park Service. However, more than 80 percent of eastern forestland is privately owned. Private forestland is further...

From Public to Private Care The Historical Trajectory of Medical Services in a New York City Jail

PubMed Central

2009-01-01

Over the past 25 years, incarceration rates in the United States have more than tripled. Providing health care services for this growing number of inmates poses immense medical and public health challenges. Focusing on the administrative and financial shifts in health care delivery, I examined the history of medical services in one of the nation's largest correctional facilities, Rikers Island in New York City. Over time, medical services at Rikers have become increasingly privatized. This trend toward privatization is mirrored nationwide and coincides with the rising prevalence of incarceration. PMID:19372534

From public to private care the historical trajectory of medical services in a New York city jail.

PubMed

Shalev, Noga

2009-06-01

Over the past 25 years, incarceration rates in the United States have more than tripled. Providing health care services for this growing number of inmates poses immense medical and public health challenges. Focusing on the administrative and financial shifts in health care delivery, I examined the history of medical services in one of the nation's largest correctional facilities, Rikers Island in New York City. Over time, medical services at Rikers have become increasingly privatized. This trend toward privatization is mirrored nationwide and coincides with the rising prevalence of incarceration.

Privatization of municipal waste management services in Virginia

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

Arner, R.

As the cost of waste management has increased dramatically in recent years, public works and environmental services officials in Virginia responsible for waste management are exploring how various delivery systems can enhance the efficiency and effectiveness of these services. Shifting some service delivery from the public to the private sector, or vice versa, are approaches that may have the potential to improve efficiency. However, each jurisdiction's waste management requirements differ, and there is no cookie-cutter approach. The following discusses various privatization/publicization opportunities and under what conditions these strategies may be developed to the benefit of localities.

Establishment of a Spaceport Network Architecture

NASA Technical Reports Server (NTRS)

Larson, Wiley J.; Gill, Tracy R.; Mueller, Robert P.; Brink, Jeffrey S.

2012-01-01

Since the beginning of the space age, the main actors in space exploration have been governmental agencies, enabling a privileged access to space, but with very restricted and rare missions. The last decade has seen the rise of space tourism, and the founding of ambitious private space mining companies, showing the beginnings of a new exploration era, that is based on a more generalized and regular access to space and which is not limited to the Earth's vicinity. However, the cost of launching sufficient mass into orbit to sustain these inspiring challenges is prohibitive, and the necessary infrastructures to support these missions is still lacking. To provide easy and affordable access into orbital and deep space destinations, there is the need to create a network of spaceports via specific waypoint locations coupled with the use of natural resources, or In Situ Resource Utilization (ISRU), to provide a more economical solution. As part of the International Space University Space Studies Program 2012, the international and intercultural team of Operations and Service Infrastructure for Space (OASIS) proposes an interdisciplinary answer to the problem of economical space access and transportation. This paper presents a summary of a detailed report [1] of the different phases of a project for developing a network of spaceports throughout the Solar System in a timeframe of 50 years. The requirements, functions, critical technologies and mission architecture of this network of spaceports are outlined in a roadmap of the important steps and phases. The economic and financial aspects are emphasized in order to allow a sustainable development of the network in a public-private partnership via the formation of an International Spaceport Authority (ISPA). The approach includes engineering, scientific, financial, legal, policy, and societal aspects. Team OASIS intends to provide guidelines to make the development of space transportation via a spaceports logistics network feasible, and believes that this pioneering effort will revolutionize space exploration, science and commerce, ultimately contributing to permanently expand humanity into space.

Privatized managed care and forensic mental health services.

PubMed

Packer, I K

1998-01-01

Managed care for mental health services, which began in the private, commercial sector, has spread over the past few years to the public mental health sector as well. Recently, states have begun considering whether to include the forensic population within their privatized managed care systems. This article explores some of the complexities and special challenges unique to forensic services and notes some of the problems that might be incurred if the forensic population were included in a managed care system.

Fee-for-Service Medicare in a Competitive Market Environment

PubMed Central

Dowd, Bryan E.; Coulam, Robert F.; Feldman, Roger; Pizer, Steven D.

2005-01-01

Since its inception, the Medicare Program has allowed for the participation of private health plans, but the relationship of private plans to the government-sponsored fee-for-service (FFS) plan has been the subject of debate. Increased payments to private plans, the introduction of regional preferred provider organizations (PPOs), and a mandated demonstration of price competition that includes FFS Medicare reflect an ongoing attempt to define the role of private plans. The purpose of this article is to explore the roles of private plans and FFS Medicare and to attempt to identify the advantages and disadvantages of each. PMID:17290642

Performance reporting for consumers: issues for the Australian private hospital sector.

PubMed

Sheahan, Margo; Little, Russ; Leggat, Sandra G

2007-05-30

A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia.

Privatization of solid waste collection services: Lessons from Gaborone.

PubMed

Bolaane, Benjamin; Isaac, Emmanuel

2015-06-01

Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Performance reporting for consumers: issues for the Australian private hospital sector

PubMed Central

Sheahan, Margo; Little, Russ; Leggat, Sandra G

2007-01-01

A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia. PMID:17537238

Clients' satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya.

PubMed

Okumu, Clarice; Oyugi, Boniface

2018-01-01

This study intended to compare the clients' satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients' satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15-49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. A higher proportion of clients from private facility 98.1% were attended within 0-30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001) while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission till discharge in both public and private facilities and were willing to recommend other to come and deliver in the respective facilities.

The trust-commitment challenge in service quality-loyalty relationships.

PubMed

Moreira, Antonio Carrizo; Silva, Pedro Miguel

2015-01-01

The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.

Out of place: mediating health and social care in Ontario's long-term care sector.

PubMed

Daly, Tamara

2007-01-01

The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which types of home care and home support services receive public funding. It addresses the effects of these reforms on the state–non-profit relationship, and the shifting balance between public funding of health and social care. At a program level, and with few exceptions, homemaking services have been cut from home care, and home support services are more medicalized. With these changes, growing numbers of people no longer eligible to receive publicly funded home care services look for other alternatives: they draw available resources from home support, they draw on family and friend networks, they hire privately and pay out of pocket, they leave home and enter an institution, or they do without.

Design of real-time encryption module for secure data protection of wearable healthcare devices.

PubMed

Kim, Jungchae; Lee, Byuck Jin; Yoo, Sun K

2013-01-01

Wearable devices for biomedical instrumentation could generate the medical data and transmit to a repository on cloud service through wireless networks. In this process, the private medical data will be disclosed by man in the middle attack. Thus, the archived data for healthcare services would be protected by non-standardized security policy by healthcare service provider (HSP) because HIPAA only defines the security rules. In this paper, we adopted the Advanced Encryption Standard (AES) for security framework on wearable devices, so healthcare applications using this framework could support the confidentiality easily. The framework developed as dynamic loadable module targeted for lightweight microcontroller such as msp430 within embedded operating system. The performance was shown that the module can support the real-time encryption using electrocardiogram and photoplethysmogram. In this regard, the processing load for enabling security is distributed to wearable devices, and the customized data protection method could be composed by HSP for a trusted healthcare service.

Service Quality and Student/Customer Satisfaction in the Private Tertiary Education Sector in Singapore

ERIC Educational Resources Information Center

Khoo, Susie; Ha, Huong; McGregor, Sue L. T.

2017-01-01

Purpose: This paper focuses on students' perceptions of the quality of non-academic services received in higher education. While the important role played by expectations and perceptions in students' evaluations of such services has been discussed in much of the service quality literature, there is insufficient work in the private tertiary…

43 CFR 4.909 - How do I request an extension of time?

Code of Federal Regulations, 2010 CFR

2010-10-01

... purpose, you may obtain an extension of time under this section. (b) You must submit a written request for... Service, a private delivery or courier service, hand delivery or telefax to (703) 235-8349; (2) If you.... Postal Service, a private delivery or courier service or hand delivery so that it is received within 5...

Effectiveness and Efficiencies of Private Military Corporations

DTIC Science & Technology

2008-06-01

generalize. While some private military corporations provide direct combat services , others provide ancillary services —such as laundry and food...collection of information, including suggestions for reducing this burden, to Washington headquarters Services , Directorate for Information...for traditional military forces. The PMC consists of a for profit firm that provides military services that range from combat operations to training

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh

PubMed Central

2017-01-01

Background Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. Methods An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Results Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. Conclusions In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh. PMID:29091965

The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

PubMed Central

2010-01-01

Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions. PMID:21040539

Who serves the urban poor? A geospatial and descriptive analysis of health services in slum settlements in Dhaka, Bangladesh

PubMed Central

Adams, Alayne M; Islam, Rubana; Ahmed, Tanvir

2015-01-01

In Bangladesh, the health risks of unplanned urbanization are disproportionately shouldered by the urban poor. At the same time, affordable formal primary care services are scarce, and what exists is almost exclusively provided by non-government organizations (NGOs) working on a project basis. So where do the poor go for health care? A health facility mapping of six urban slum settlements in Dhaka was undertaken to explore the configuration of healthcare services proximate to where the poor reside. Three methods were employed: (1) Social mapping and listing of all Health Service Delivery Points (HSDPs); (2) Creation of a geospatial map including Global Positioning System (GPS) co-ordinates of all HSPDs in the six study areas and (3) Implementation of a facility survey of all HSDPs within six study areas. Descriptive statistics are used to examine the number, type and concentration of service provider types, as well as indicators of their accessibility in terms of location and hours of service. A total of 1041 HSDPs were mapped, of which 80% are privately operated and the rest by NGOs and the public sector. Phamacies and non-formal or traditional doctors make up 75% of the private sector while consultation chambers account for 20%. Most NGO and Urban Primary Health Care Project (UPHCP) static clinics are open 5–6 days/week, but close by 4–5 pm in the afternoon. Evening services are almost exclusively offered by private HSDPs; however, only 37% of private sector health staff possess some kind of formal medical qualification. This spatial analysis of health service supply in poor urban settlements emphasizes the importance of taking the informal private sector into account in efforts to increase effective coverage of quality services. Features of informal private sector service provision that have facilitated market penetration may be relevant in designing formal services that better meet the needs of the urban poor. PMID:25759453

Lynx: a database and knowledge extraction engine for integrative medicine

PubMed Central

Sulakhe, Dinanath; Balasubramanian, Sandhya; Xie, Bingqing; Feng, Bo; Taylor, Andrew; Wang, Sheng; Berrocal, Eduardo; Dave, Utpal; Xu, Jinbo; Börnigen, Daniela; Gilliam, T. Conrad; Maltsev, Natalia

2014-01-01

We have developed Lynx (http://lynx.ci.uchicago.edu)—a web-based database and a knowledge extraction engine, supporting annotation and analysis of experimental data and generation of weighted hypotheses on molecular mechanisms contributing to human phenotypes and disorders of interest. Its underlying knowledge base (LynxKB) integrates various classes of information from >35 public databases and private collections, as well as manually curated data from our group and collaborators. Lynx provides advanced search capabilities and a variety of algorithms for enrichment analysis and network-based gene prioritization to assist the user in extracting meaningful knowledge from LynxKB and experimental data, whereas its service-oriented architecture provides public access to LynxKB and its analytical tools via user-friendly web services and interfaces. PMID:24270788

Advanced reflector materials for solar concentrators

NASA Astrophysics Data System (ADS)

Jorgensen, Gary; Williams, Tom; Wendelin, Tim

1994-10-01

This paper describes the research and development at the US National Renewable Energy Laboratory (NREL) in advanced reflector materials for solar concentrators. NREL's research thrust is to develop solar reflector materials that maintain high specular reflectance for extended lifetimes under outdoor service conditions and whose cost is significantly lower than existing products. Much of this work has been in collaboration with private-sector companies that have extensive expertise in vacuum-coating and polymer-film technologies. Significant progress and other promising developments will be discussed. These are expected to lead to additional improvements needed to commercialize solar thermal concentration systems and make them economically attractive to the solar manufacturing industry. To explicitly demonstrate the optical durability of candidate reflector materials in real-world service conditions, a network of instrumented outdoor exposure sites has been activated.

Moving into the 'patient-centred medical home': reforming Australian general practice.

PubMed

Hayes, Paul; Lynch, Anthony; Stiffe, Jenni

2016-09-01

The Australian healthcare system is a complex network of services and providers funded and administered by federal, state and territory governments, supplemented by private health insurance and patient contributions. The broad geographical range, complexity and increasing demand within the Australian healthcare sector mean health expenditure is high. Aspects of current funding for the healthcare system have attracted criticism from medical practitioners, patients, representative organisations and independent statutory agencies. In response to the problems in primary care funding in Australia, The Royal Australian College of General Practitioners developed the Vision for general practice and a sustainable healthcare system (the Vision). The Vision presents a plan to improve healthcare delivery in Australia through greater quality, access and efficiency by reorienting how general practice services are funded based on the 'patient-centred medical home' model.

49 CFR 604.13 - Registration of private charter operators.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Procedures for Registration and Notification § 604..., if available, state motor carrier identifying number; (3) The geographic service areas of public... intends to provide charter service; (4) The number of buses or vans the private charter operator owns; (5...

76 FR 27296 - Private Land Mobile Radio Service Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-11

... copies for each additional docket or rulemaking number. Filings can be sent by hand or messenger delivery, by commercial overnight courier, or by first-class or overnight U.S. Postal Service mail. All filings... 11-63] Private Land Mobile Radio Service Regulations AGENCY: Federal Communications Commission...

An overview of the DII-HEP OpenStack based CMS data analysis

NASA Astrophysics Data System (ADS)

Osmani, L.; Tarkoma, S.; Eerola, P.; Komu, M.; Kortelainen, M. J.; Kraemer, O.; Lindén, T.; Toor, S.; White, J.

2015-05-01

An OpenStack based private cloud with the Cluster File System has been built and used with both CMS analysis and Monte Carlo simulation jobs in the Datacenter Indirection Infrastructure for Secure High Energy Physics (DII-HEP) project. On the cloud we run the ARC middleware that allows running CMS applications without changes on the job submission side. Our test results indicate that the adopted approach provides a scalable and resilient solution for managing resources without compromising on performance and high availability. To manage the virtual machines (VM) dynamically in an elastic fasion, we are testing the EMI authorization service (Argus) and the Execution Environment Service (Argus-EES). An OpenStackplugin has been developed for Argus-EES. The Host Identity Protocol (HIP) has been designed for mobile networks and it provides a secure method for IP multihoming. HIP separates the end-point identifier and locator role for IP address which increases the network availability for the applications. Our solution leverages HIP for traffic management. This presentation gives an update on the status of the work and our lessons learned in creating an OpenStackbased cloud for HEP.

Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong.

PubMed

Yam, Carrie H K; Liu, Su; Huang, Olivia H Y; Yeoh, E K; Griffiths, Sian M

2011-10-07

As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary.

Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong

PubMed Central

2011-01-01

Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary. PMID:21978140

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria.

PubMed

Chukwu, Emeka; Garg, Lalit; Eze, Godson

2016-05-17

Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas-antenatal care, routine immunization, and birth attendance for 1 year-showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead.

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

PubMed Central

Garg, Lalit; Eze, Godson

2016-01-01

Background Nigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. Objective The purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme. Methods This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. Results All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas—antenatal care, routine immunization, and birth attendance for 1 year—showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted. Conclusions This study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead. PMID:27189312

Growth of private medicine in Sweden: the new diversity and the new challenge.

PubMed

Rosenthal, M M

1992-01-01

The growth of private medical care in Sweden has occurred despite the lack of overt encouragement by the long-term Social Democrat government. This can be documented from official government statistics, private insurance sales, media sources, membership growth in the private doctors association, purchase of private risk insurance, growth of private health care organizations and services, and particularly an increase in public sector private contracting. While the percent of the population with private insurance is close to 1%, it is probable that over 20% of physicians engage in some form of private practice. Explanations range from increasing criticism of poor service orientation in the public system, long waiting lists and the reduced rate of public spending, to a general atmosphere that asserts more individual choice. With the Social Democrats now out of power, it is likely that the Moderate coalition will officially promote some forms of privatization. What will be the impact on the long-cherished Swedish principle of equity?

Network security vulnerabilities and personal privacy issues in Healthcare Information Systems: a case study in a private hospital in Turkey.

PubMed

Namoğlu, Nihan; Ulgen, Yekta

2013-01-01

Healthcare industry has become widely dependent on information technology and internet as it moves from paper to electronic records. Healthcare Information System has to provide a high quality service to patients and a productive knowledge share between healthcare staff by means of patient data. With the internet being commonly used across hospitals, healthcare industry got its own share from cyber threats like other industries in the world. The challenge is allowing knowledge transfer to hospital staff while still ensuring compliance with security mandates. Working in collaboration with a private hospital in Turkey; this study aims to reveal the essential elements of a 21st century business continuity plan for hospitals while presenting the security vulnerabilities in the current hospital information systems and personal privacy auditing standards proposed by regulations and laws. We will survey the accreditation criteria in Turkey and counterparts in US and EU. We will also interview with medical staff in the hospital to understand the needs for personal privacy and the technical staff to perceive the technical requirements in terms of network security configuration and deployment. As hospitals are adopting electronic transactions, it should be considered a must to protect these electronic health records in terms of personal privacy aspects.

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

PubMed Central

2010-01-01

Background Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. Methods We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Results Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Conclusion Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals. PMID:20626904

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan.

PubMed

Waning, Brenda; Maddix, Jason; Soucy, Lyne

2010-07-13

Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals.

European health telematics networks for positron emission tomography

NASA Astrophysics Data System (ADS)

Kontaxakis, George; Pozo, Miguel Angel; Ohl, Roland; Visvikis, Dimitris; Sachpazidis, Ilias; Ortega, Fernando; Guerra, Pedro; Cheze-Le Rest, Catherine; Selby, Peter; Pan, Leyun; Diaz, Javier; Dimitrakopoulou-Strauss, Antonia; Santos, Andres; Strauss, Ludwig; Sakas, Georgios

2006-12-01

A pilot network of positron emission tomography centers across Europe has been setup employing telemedicine services. The primary aim is to bring all PET centers in Europe (and beyond) closer, by integrating advanced medical imaging technology and health telematics networks applications into a single, easy to operate health telematics platform, which allows secure transmission of medical data via a variety of telecommunications channels and fosters the cooperation between professionals in the field. The platform runs on PCs with Windows 2000/XP and incorporates advanced techniques for image visualization, analysis and fusion. The communication between two connected workstations is based on a TCP/IP connection secured by secure socket layers and virtual private network or jabber protocols. A teleconsultation can be online (with both physicians physically present) or offline (via transmission of messages which contain image data and other information). An interface sharing protocol enables online teleconsultations even over low bandwidth connections. This initiative promotes the cooperation and improved communication between nuclear medicine professionals, offering options for second opinion and training. It permits physicians to remotely consult patient data, even if they are away from the physical examination site.

A Comparison of SERVQUAL and I-P Analysis: Measuring and Improving Service Quality in Egyptian Private Universities

ERIC Educational Resources Information Center

Mostafa, Mohamed M.

2006-01-01

The overall purpose of this research is to further our understanding of how students perceive service quality in Egypt's private universities. The paper also tests the SERVQUAL dimensions in higher education within an Arab, non-Western context. A sample of 508 students from four private universities in Egypt participated in the study. Student…

Water for Life: The Impact of the Privatization of Water Services on Child Mortality.

ERIC Educational Resources Information Center

Galiani, Sebastian; Gertler, Paul; Schargrodsky, Ernesto

2005-01-01

While most countries are committed to increasing access to safe water and thereby reducing child mortality, there is little consensus on how to actually improve water services. One important proposal under discussion is whether to privatize water provision. In the 1990s Argentina embarked on one of the largest privatization campaigns in the world,…

Will Ohio Always Have an Antioch,...Rio Grande,...Wilberforce,...Xavier? Private Schools and Public Policy in Higher Education in Ohio.

ERIC Educational Resources Information Center

Frueh, Lloyd, II; Treacy, John J.

This document details the effects of various state programs and proposals which seek to aid the private schools including contracting by the Ohio Board of Regents for instructional services with private institutions, grants for capital improvements and special services, direct payments to students and long-term loans to students to recover…

An Examination of a Virtual Private Network Implementation to Support a Teleworking Initiative: The Marcus Food Company Inc. Case Study

ERIC Educational Resources Information Center

Ferguson, Jason W.

2010-01-01

In this dissertation, the author examined the capabilities of virtual private networks (VPNs) in supporting teleworking environments for small businesses in the food marketing sector. The goal of this research was to develop an implementation model for small businesses in the food marketing sector that use a VPN solution to support teleworker…

49 CFR 604.26 - Complaints and decisions regarding removal of private charter operators or qualified human...

Code of Federal Regulations, 2010 CFR

2010-10-01

... human service organization should not be listed on the FTA charter registration Web site; (3) Files... private charter operators or qualified human service organizations from registration list. 604.26 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Complaints § 604.26 Complaints and decisions...

22 CFR 228.53 - Suppliers of services-privately owned commercial suppliers and nonprofit organizations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Suppliers of services-privately owned commercial suppliers and nonprofit organizations. 228.53 Section 228.53 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND SERVICES FINANCED BY USAID...

Comparison Quality of Health Services between Public and Private Providers: The Iranian People's Perspective.

PubMed

Alijanzadeh, Mehran; Zare, Seyed Ali Moosaniaye; Rajaee, Roya; Fard, Seyed Mohammad Ali Mousavi; Asefzadeh, Saeed; Alijanzadeh, Mahnaz; Gholami, Soheyla

2016-09-01

Health services quality has been the most important criteria of judging, and its improvement causes people's satisfaction of health systems. In a health system, public and private sectors provide services and typically have been effective in promoting health services quality of community. The aim of this study was to compare the quality of health services in both public and private sectors from the perspective of residents in Qazvin (Iran). This cross-sectional study was conducted in 2014. The study population included all residents of Qazvin Province, and the sample size was estimated to 1002. The research tool was a perceptions of services quality standard questionnaire. Data were collected by trained interviewers visiting homes and were analyzed by IBM-SPSS software version 22 and t-test and linear regression. Cronbach's alpha coefficient was 0.91 and test-re-test coefficient was 83%. 741 people (74%) in their last visit to receive services were referred to the public sector. Between the perception of people participating in the study about medical equipment and supplies, welfare facilities, competence and experience of doctor, waiting time, rapid reception, and access to doctor in public and private sectors, significant differences were observed (p < 0.05). In the tangible realm in perception of health services, there was a significant difference in quality between the public and private sectors (p < 0.05). In addition, place of receiving services, waiting time, education, occupation, and type of received services were affecting factors in regards to perceptions of health services from the perspective of Iran's population (p < 0.05). The results showed the importance of a tangible realm on people's satisfaction of health services. It seems that the public sector should pay more attention to this issue.

Integrating multiple scientific computing needs via a Private Cloud infrastructure

NASA Astrophysics Data System (ADS)

Bagnasco, S.; Berzano, D.; Brunetti, R.; Lusso, S.; Vallero, S.

2014-06-01

In a typical scientific computing centre, diverse applications coexist and share a single physical infrastructure. An underlying Private Cloud facility eases the management and maintenance of heterogeneous use cases such as multipurpose or application-specific batch farms, Grid sites catering to different communities, parallel interactive data analysis facilities and others. It allows to dynamically and efficiently allocate resources to any application and to tailor the virtual machines according to the applications' requirements. Furthermore, the maintenance of large deployments of complex and rapidly evolving middleware and application software is eased by the use of virtual images and contextualization techniques; for example, rolling updates can be performed easily and minimizing the downtime. In this contribution we describe the Private Cloud infrastructure at the INFN-Torino Computer Centre, that hosts a full-fledged WLCG Tier-2 site and a dynamically expandable PROOF-based Interactive Analysis Facility for the ALICE experiment at the CERN LHC and several smaller scientific computing applications. The Private Cloud building blocks include the OpenNebula software stack, the GlusterFS filesystem (used in two different configurations for worker- and service-class hypervisors) and the OpenWRT Linux distribution (used for network virtualization). A future integration into a federated higher-level infrastructure is made possible by exposing commonly used APIs like EC2 and by using mainstream contextualization tools like CloudInit.

CE: Original Research: Primary Care Providers and Screening for Military Service and PTSD.

PubMed

Mohler, Kristin Michelle; Sankey-Deemer, Cydnee

2017-11-01

: Background: Most veterans have the option of receiving their health care from the Veterans Health Administration or through primary care providers in the private sector. However, there is some evidence that fewer than half of community-based, private sector primary care and mental health providers screen their patients for military service, particularly in rural areas, leaving these veterans less likely to be screened for posttraumatic stress disorder (PTSD) and other military service-related conditions. To determine whether primary care providers in the private sector are screening patients for military service and subsequent PTSD. We designed and piloted a survey to determine whether primary care providers in a rural Pennsylvania region routinely screen for military service and service-related PTSD. We distributed the survey to a convenience sample of more than 250 primary care providers in central and western Pennsylvania through the U.S. Postal Service, via Facebook, and via work e-mails for those who worked in a local health system. Among 50 eligible respondents, only four (8%) said they screen all their patients for military service, and 20 (40%) reported screening none; only two respondents (4%) screened all their patients who have served in the military for PTSD, and 30 (60%) screened none. Veterans who rely on private sector providers may not receive evidence-based care for military service-related health problems, including PTSD. To improve care for these patients, providers in the private sector should be educated on why all patients should be screened for military service, how to conduct such screening properly, and veterans' general health concerns.

Enhanced networked server management with random remote backups

NASA Astrophysics Data System (ADS)

Kim, Song-Kyoo

2003-08-01

In this paper, the model is focused on available server management in network environments. The (remote) backup servers are hooked up by VPN (Virtual Private Network) and replace broken main severs immediately. A virtual private network (VPN) is a way to use a public network infrastructure and hooks up long-distance servers within a single network infrastructure. The servers can be represent as "machines" and then the system deals with main unreliable and random auxiliary spare (remote backup) machines. When the system performs a mandatory routine maintenance, auxiliary machines are being used for backups during idle periods. Unlike other existing models, the availability of auxiliary machines is changed for each activation in this enhanced model. Analytically tractable results are obtained by using several mathematical techniques and the results are demonstrated in the framework of optimized networked server allocation problems.

Increasing access to prevention of mother-to-child transmission of HIV services through the private sector in Uganda.

PubMed

Mbonye, A K; Hansen, K S; Wamono, F; Magnussen, P

2009-12-01

To explore whether private midwives can perform HIV counselling and testing, provide antiretroviral treatment and contraceptives, and how this affects access to services especially among young and HIV-positive women. A formative study was conducted between January and April 2009 to assess care-seeking practices and perceptions on the prevention of mother-to-child transmission (PMTCT) and family planning services in Wakiso district, central Uganda. A household survey supplemented by 12 focus group discussions and 66 key informant interviews was carried out between January and April 2009. 10,706 women, mean age 25.8 years (14-49 years) were interviewed. The majority of women, 4786 (57%) were in the lowest wealth quintile; 62.0% were not using family planning (p<0.000); 56.2% did not access HIV counselling and testing because they feared knowing their HIV status (p<0.013), while 66.5% feared spouses knowing their HIV status (p<0.013). Access to these services among the young women and those with no education was also poor. Private midwives provide HIV testing to 7.8% of their clients; 5.9% received antiretroviral drugs and 8.6% received contraceptives. Client satisfaction with services at private midwifery practices was high. Private midwives are trusted and many clients confide in them. An intervention through private midwives was perceived to improve access because of short distances and no transport costs. Adolescents prioritized confidentiality, while subsidizing costs, community sensitisation and focusing on male spouses were overwhelmingly recommended. Private midwives clinics are potential delivery outlets for PMTCT in Uganda. A well-designed intervention linking them to the public sector and the community could increase access to services.

Comparison of thromboprophylaxis patterns in arthroplasty in public and private hospitals

PubMed Central

Cortada, Aline Pinheiro dos Santos; da Silva, Telma Gomes; da Silva, André Campos; Golmia, Ricardo Prado; Guerra, Renata Leborato; Takemoto, Maíra Libertad Soligo; Monteiro, Roberta Dyonisio Canaveira; Scheinberg, Morton Aaron

2015-01-01

Objective To compare therapy for prophylaxis of venous thromboembolism and costs related to hospitalization of patients undergoing total knee and hip replacement within the context of the Brazilian health system. Methods A retrospective study of patients undergoing arthroplasty in 2010 in a public hospital and two private hospitals in the state of São Paulo, conducted by means of medical record review. Costs were estimated based on the use of health care resources during hospitalization. A descriptive analysis was performed using frequency and mean (standard deviation) according to the type of care delivered (by public or private organization). Results A total of 215 patients were evaluated, and 56.3% were submitted to knee surgery and 43.7%, to hip replacement. Approximately 88% and 98% of patients from public and private health services, respectively, received some form of venous thromboembolism prophylaxis, and enoxaparin was the drug most widely used in both systems. The total cost of prophylaxis was R$ 1,873.01 (R$ 26.38 per patient) in the public service and R$ 21,559.73 (R$ 163.33 per patient) in the private service. For the individuals who presented with thromboembolism, the average cost of hospitalization was R$ 6,210.80 and R$ 43,792.59 per patient in public and private health services, respectively. Conclusion Thromboembolism prophylaxis in patients undergoing arthroplasty is most commonly used in the private health services than public organizations, despite its high costs in both services. The cost per patient with thrombosis during hospitalization was higher than the total cost of prophylaxis, suggesting that prevention is associated to better cost-benefit ratio. PMID:26313439

A correlation study of social network usage among health care students.

PubMed

Suit, Louise; Winkler, Patricia; Campbell, Linda; Pennington, Karen; Szutenbach, Mary Pat; Haight, Robert; Roybal, Deborah; McCollum, Marianne

2015-04-01

Due to anecdotal concerns about adequacy of health professions students' communication skills, health professions faculty at a private university formed an interprofessional research team. The study was designed to explore whether the use of social networking services (SNS) influenced health care students' written and oral communication skills. One hundred thirty-two students participated in the study. Communication skills were assessed by using assignments from a health care ethics course required of all students. Use of SNS was measured with an information technology questionnaire. Contrary to expected findings, this exploratory correlation study found no meaningful relationship between the frequency of SNS usage and oral and written communication skills in health professions students. Future studies of SNS would benefit from a younger and more homogeneous study population to assess the use of SNS for learning versus leisure. Copyright 2015, SLACK Incorporated.

Measuring what we manage - the importance of hydrological data to water resources management

NASA Astrophysics Data System (ADS)

Stewart, B.

2015-04-01

Water resources cannot be managed, unless we know where they are, in what quantity and quality, and how variable they are likely to be in the foreseeable future. Data from hydrological networks are used by public and private sectors for a variety of different applications. This paper discusses the value proposition behind the collection, analysis and use of hydrological data in support of these applications. The need for hydrological data and the requirements for the data are outlined, and information is provided on topics such as status of networks and data access and sharing. This paper outlines elements of the contribution by the World Meteorological Organization (WMO) to hydrological data collection and covers aspects related to quality management in the collection of hydrological data, especially regarding streamflow gauging, network design and capacity building for services delivery. It should be noted that the applications which make use of hydrological data may also be significantly impacted by climate change.

Privacy-preserving self-helped medical diagnosis scheme based on secure two-party computation in wireless sensor networks.

PubMed

Sun, Yi; Wen, Qiaoyan; Zhang, Yudong; Li, Wenmin

2014-01-01

With the continuing growth of wireless sensor networks in pervasive medical care, people pay more and more attention to privacy in medical monitoring, diagnosis, treatment, and patient care. On one hand, we expect the public health institutions to provide us with better service. On the other hand, we would not like to leak our personal health information to them. In order to balance this contradiction, in this paper we design a privacy-preserving self-helped medical diagnosis scheme based on secure two-party computation in wireless sensor networks so that patients can privately diagnose themselves by inputting a health card into a self-helped medical diagnosis ATM to obtain a diagnostic report just like drawing money from a bank ATM without revealing patients' health information and doctors' diagnostic skill. It makes secure self-helped disease diagnosis feasible and greatly benefits patients as well as relieving the heavy pressure of public health institutions.

Privacy-Preserving Self-Helped Medical Diagnosis Scheme Based on Secure Two-Party Computation in Wireless Sensor Networks

PubMed Central

Wen, Qiaoyan; Zhang, Yudong; Li, Wenmin

2014-01-01

With the continuing growth of wireless sensor networks in pervasive medical care, people pay more and more attention to privacy in medical monitoring, diagnosis, treatment, and patient care. On one hand, we expect the public health institutions to provide us with better service. On the other hand, we would not like to leak our personal health information to them. In order to balance this contradiction, in this paper we design a privacy-preserving self-helped medical diagnosis scheme based on secure two-party computation in wireless sensor networks so that patients can privately diagnose themselves by inputting a health card into a self-helped medical diagnosis ATM to obtain a diagnostic report just like drawing money from a bank ATM without revealing patients' health information and doctors' diagnostic skill. It makes secure self-helped disease diagnosis feasible and greatly benefits patients as well as relieving the heavy pressure of public health institutions. PMID:25126107

Control Systems Cyber Security:Defense in Depth Strategies

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

David Kuipers; Mark Fabro

2006-05-01

Information infrastructures across many public and private domains share several common attributes regarding IT deployments and data communications. This is particularly true in the control systems domain. A majority of the systems use robust architectures to enhance business and reduce costs by increasing the integration of external, business, and control system networks. However, multi-network integration strategies often lead to vulnerabilities that greatly reduce the security of an organization, and can expose mission-critical control systems to cyber threats. This document provides guidance and direction for developing ‘defense-in-depth’ strategies for organizations that use control system networks while maintaining a multi-tier information architecturemore » that requires: Maintenance of various field devices, telemetry collection, and/or industrial-level process systems Access to facilities via remote data link or modem Public facing services for customer or corporate operations A robust business environment that requires connections among the control system domain, the external Internet, and other peer organizations.« less

Control Systems Cyber Security: Defense-in-Depth Strategies

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

Mark Fabro

2007-10-01

Information infrastructures across many public and private domains share several common attributes regarding IT deployments and data communications. This is particularly true in the control systems domain. A majority of the systems use robust architectures to enhance business and reduce costs by increasing the integration of external, business, and control system networks. However, multi-network integration strategies often lead to vulnerabilities that greatly reduce the security of an organization, and can expose mission-critical control systems to cyber threats. This document provides guidance and direction for developing ‘defense-in-depth’ strategies for organizations that use control system networks while maintaining a multi-tier information architecturemore » that requires: • Maintenance of various field devices, telemetry collection, and/or industrial-level process systems • Access to facilities via remote data link or modem • Public facing services for customer or corporate operations • A robust business environment that requires connections among the control system domain, the external Internet, and other peer organizations.« less

Relations that affect the probability and prediction of nitrate concentration in private wells in the glacial aquifer system in the United States

USGS Publications Warehouse

Warner, Kelly L.; Arnold, Terri L.

2010-01-01

Nitrate in private wells in the glacial aquifer system is a concern for an estimated 17 million people using private wells because of the proximity of many private wells to nitrogen sources. Yet, less than 5 percent of private wells sampled in this study contained nitrate in concentrations that exceeded the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level (MCL) of 10 mg/L (milligrams per liter) as N (nitrogen). However, this small group with nitrate concentrations above the USEPA MCL includes some of the highest nitrate concentrations detected in groundwater from private wells (77 mg/L). Median nitrate concentration measured in groundwater from private wells in the glacial aquifer system (0.11 mg/L as N) is lower than that in water from other unconsolidated aquifers and is not strongly related to surface sources of nitrate. Background concentration of nitrate is less than 1 mg/L as N. Although overall nitrate concentration in private wells was low relative to the MCL, concentrations were highly variable over short distances and at various depths below land surface. Groundwater from wells in the glacial aquifer system at all depths was a mixture of old and young water. Oxidation and reduction potential changes with depth and groundwater age were important influences on nitrate concentrations in private wells. A series of 10 logistic regression models was developed to estimate the probability of nitrate concentration above various thresholds. The threshold concentration (1 to 10 mg/L) affected the number of variables in the model. Fewer explanatory variables are needed to predict nitrate at higher threshold concentrations. The variables that were identified as significant predictors for nitrate concentration above 4 mg/L as N included well characteristics such as open-interval diameter, open-interval length, and depth to top of open interval. Environmental variables in the models were mean percent silt in soil, soil type, and mean depth to saturated soil. The 10-year mean (1992-2001) application rate of nitrogen fertilizer applied to farms was included as the potential source variable. A linear regression model also was developed to predict mean nitrate concentrations in well networks. The model is based on network averages because nitrate concentrations are highly variable over short distances. Using values for each of the predictor variables averaged by network (network mean value) from the logistic regression models, the linear regression model developed in this study predicted the mean nitrate concentration in well networks with a 95 percent confidence in predictions.

How size matters: exploring the association between quality of mental health services and catchment area size.

PubMed

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

2016-08-12

The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others. The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size. To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors. The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units. Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units. Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system.

Public-private partnerships in China's urban water sector.

PubMed

Zhong, Lijin; Mol, Arthur P J; Fu, Tao

2008-06-01

During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China's water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China.

Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership.

PubMed

Kebede, Yenew; Fonjungo, Peter N; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

2016-04-15

Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)-US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2-14 days) to 2 days (range, 1-3 days) in Addis Ababa and from 10 days (range, 6-21 days) to 5 days (range, 2-6 days) in Amhara Region. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Lost in Cloud

NASA Technical Reports Server (NTRS)

Maluf, David A.; Shetye, Sandeep D.; Chilukuri, Sri; Sturken, Ian

2012-01-01

Cloud computing can reduce cost significantly because businesses can share computing resources. In recent years Small and Medium Businesses (SMB) have used Cloud effectively for cost saving and for sharing IT expenses. With the success of SMBs, many perceive that the larger enterprises ought to move into Cloud environment as well. Government agency s stove-piped environments are being considered as candidates for potential use of Cloud either as an enterprise entity or pockets of small communities. Cloud Computing is the delivery of computing as a service rather than as a product, whereby shared resources, software, and information are provided to computers and other devices as a utility over a network. Underneath the offered services, there exists a modern infrastructure cost of which is often spread across its services or its investors. As NASA is considered as an Enterprise class organization, like other enterprises, a shift has been occurring in perceiving its IT services as candidates for Cloud services. This paper discusses market trends in cloud computing from an enterprise angle and then addresses the topic of Cloud Computing for NASA in two possible forms. First, in the form of a public Cloud to support it as an enterprise, as well as to share it with the commercial and public at large. Second, as a private Cloud wherein the infrastructure is operated solely for NASA, whether managed internally or by a third-party and hosted internally or externally. The paper addresses the strengths and weaknesses of both paradigms of public and private Clouds, in both internally and externally operated settings. The content of the paper is from a NASA perspective but is applicable to any large enterprise with thousands of employees and contractors.

[Loan of services developing palliative care skills based on the apprentice model].

PubMed

Dallaire, Clémence; Audet, Geneviève; L'Heureux, Michel; Saint-Laurent, Louise; Fillion, Lise; Morin, Diane; Dubé, Nathalie

2008-01-01

For over 25 years, the Maison Michel-Sarrazin, a private palliative care institution in the Quebec City region, has had an original agreement with other establishments in the healthcare network (hospitals, long-term residential centres and CLSCs), in the form of the loan of nursing services. Based on the findings of a study as part of a research program, this article describes the loan of nursing services and qualitatively assesses its effects on the development of nurses' palliative care skills. An evaluative descriptive approach based on two conceptual frameworks (Giddens; Patton) was used to compile the views of 79 players. The findings demonstrate the innovative nature of the loan of nursing services and its considerable influence on the development of nursing skills, thanks to training based on the apprenticeship model (learning through observation and imitation), and on nursing practice at the Maison Michel-Sarrazin. Nevertheless, the controversy surrounding training using the apprenticeship model and the lack of recognition of this training on the part of the lending institutions raise questions despite the general satisfaction with the loan of nursing services.

Publicly Funded Services to Private Elementary and Secondary Schools and Students, 1983-84. OERI Historical Report.

ERIC Educational Resources Information Center

Center for Education Statistics (ED/OERI), Washington, DC.

During the 1983-84 school year, 58 percent of the 27,700 private schools in the United States reported benefiting from publicly funded services. The source of these data is the National Survey of Private Schools, fall 1983, carried out by Westat, Inc., under contract with the Center for Education Statistics (CES). The survey supplemented the CES…

Public Sector/Private Sector Interaction in Providing Information Services. Report to the NCLIS from the Public Sector/Private Sector Task Force.

ERIC Educational Resources Information Center

National Commission on Libraries and Information Science, Washington, DC.

The results of a 2-year study on the interactions between government and private sector information activities are presented in terms of principles and guidelines for federal policy to support the development and use of information resources, products, and services, and to implement the principles. Discussions address sources of conflict between…

China in International Institutions: Challenges and Opportunities for Singapore

DTIC Science & Technology

2011-12-16

Thornton points out that the Chinese civil service is facing increasing competition from the private sector in attracting top graduates. 78 In...demographics and education system, Thornton highlights that China’s civil service faces challenges from the private sector in recruiting and retaining the... private and unofficial” 25 visit to Taiwan, China “expressed strong dissatisfaction with and protest against the visit” and threatened that

Geographically distributed Batch System as a Service: the INDIGO-DataCloud approach exploiting HTCondor

NASA Astrophysics Data System (ADS)

Aiftimiei, D. C.; Antonacci, M.; Bagnasco, S.; Boccali, T.; Bucchi, R.; Caballer, M.; Costantini, A.; Donvito, G.; Gaido, L.; Italiano, A.; Michelotto, D.; Panella, M.; Salomoni, D.; Vallero, S.

2017-10-01

One of the challenges a scientific computing center has to face is to keep delivering well consolidated computational frameworks (i.e. the batch computing farm), while conforming to modern computing paradigms. The aim is to ease system administration at all levels (from hardware to applications) and to provide a smooth end-user experience. Within the INDIGO- DataCloud project, we adopt two different approaches to implement a PaaS-level, on-demand Batch Farm Service based on HTCondor and Mesos. In the first approach, described in this paper, the various HTCondor daemons are packaged inside pre-configured Docker images and deployed as Long Running Services through Marathon, profiting from its health checks and failover capabilities. In the second approach, we are going to implement an ad-hoc HTCondor framework for Mesos. Container-to-container communication and isolation have been addressed exploring a solution based on overlay networks (based on the Calico Project). Finally, we have studied the possibility to deploy an HTCondor cluster that spans over different sites, exploiting the Condor Connection Broker component, that allows communication across a private network boundary or firewall as in case of multi-site deployments. In this paper, we are going to describe and motivate our implementation choices and to show the results of the first tests performed.

A New User Interface for On-Demand Customizable Data Products for Sensors in a SensorWeb

NASA Technical Reports Server (NTRS)

Mandl, Daniel; Cappelaere, Pat; Frye, Stuart; Sohlberg, Rob; Ly, Vuong; Chien, Steve; Sullivan, Don

2011-01-01

A SensorWeb is a set of sensors, which can consist of ground, airborne and space-based sensors interoperating in an automated or autonomous collaborative manner. The NASA SensorWeb toolbox, developed at NASA/GSFC in collaboration with NASA/JPL, NASA/Ames and other partners, is a set of software and standards that (1) enables users to create virtual private networks of sensors over open networks; (2) provides the capability to orchestrate their actions; (3) provides the capability to customize the output data products and (4) enables automated delivery of the data products to the users desktop. A recent addition to the SensorWeb Toolbox is a new user interface, together with web services co-resident with the sensors, to enable rapid creation, loading and execution of new algorithms for processing sensor data. The web service along with the user interface follows the Open Geospatial Consortium (OGC) standard called Web Coverage Processing Service (WCPS). This presentation will detail the prototype that was built and how the WCPS was tested against a HyspIRI flight testbed and an elastic computation cloud on the ground with EO-1 data. HyspIRI is a future NASA decadal mission. The elastic computation cloud stores EO-1 data and runs software similar to Amazon online shopping.

Are tax subsidies for private medical insurance self-financing? Evidence from a microsimulation model.

PubMed

López Nicolás, Angel; Vera-Hernández, Marcos

2008-09-01

This paper develops an empirical strategy to estimate whether subsidies to private medical insurance are self-financing in countries where public and private insurance coexist and the latter covers the same treatments as the former. We construct a simulation routine based on a micro-econometric discrete choice model that allows us to evaluate the impact of premium changes on the utilization of outpatient and inpatient health care services. As an application, we estimate the budgetary effects of scrapping a subsidy from the purchase of individual private policies, using micro-data from Catalonia. Our results suggest that the subsidy is not self-financing. This result is driven by the fact that private medical insurance holders make concurrent use of public and private services, and by the price inelasticity of the demand for private policies.

Private sector joins family planning effort.

PubMed

1989-12-01

Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.

An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

PubMed Central

Tynkkynen, Liina-Kaisa; Lehto, Juhani

2009-01-01

Background We studied the prerequisites for Public-Private Partnership (PPP) in the context of the Finnish health care system and more specifically in the field of ophthalmology. PPP can be defined as a more or less permanent cooperation between public and private actors, through which the joint products or services are developed and in which the risks, costs and profits are shared. The Finnish eye care services system is heterogeneous with several different providers and can be regarded as sub-optimal in terms of overall resource use. What is more, the public sector is suffering from a shortage of ophthalmologists, which further decreases its possibilities to meet the present needs. As ophthalmology has traditionally been a medical specialty with a substantial private sector involvement in service provision, PPP could be a feasible policy to be used in the field. We thus ask the following research question: Is there, and to what extent, an open window of opportunity for PPP? Methods In addition to the previously published literature, the research data consisted of 17 thematic interviews with public and private experts in the field of ophthalmology. The analysis was conducted in two stages. First, a literature-based content analysis was used to explore the prerequisites for PPP. Second, Kingdon's (1995) multiple streams theory was used to study the opening of the window of opportunity for PPP. Results Public and private parties reported similar problems in the current situation but defined them differently. Also, there is no consensus on policy alternatives. Public opinion seems to be somewhat uncertain as to the attitudes towards private service providers. The analysis thus showed that although there are prerequisites for PPP, the time has not yet come for a Public-Private Partnership. Conclusion Should the window open fully, the emergence of policy entrepreneurs and an opportunity for a win-win situation between public and private organizations are required. PMID:19900293

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

PubMed

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-06-22

Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

PubMed Central

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-01-01

Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public–private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. PMID:28645984

Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.

PubMed

Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel

2017-11-06

In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Twenty Years of Successful Private Management. The Debate over Private vs. Public Management of Food Service.

ERIC Educational Resources Information Center

Riegel, Ronald B.

1994-01-01

Companies such as ARA Services provide lunch every day to more than 1 million students in over 280 school districts nationwide. An Illinois superintendent lists several reasons for school districts to consider "outsourcing" their food-service operations, including cost-saving opportunities, capacity for offering comprehensive services…

Quality of the ophthalmological service to outpatients of the public and private healthcare systems.

PubMed

Hercos, Benigno Vicente Santos; Berezovsky, Adriana

2017-01-01

To compare perceptions of the quality of ophthalmological services offered to outpatients from the public healthcare system to those from the private healthcare system, and to determine which measures are seen as necessary and a priority for improving the quality of care. This was a prospective observational study on 200 patients, 101 and 99 of whom were from the public and private healthcare systems, respectively. All patients underwent an ophthalmological examination at an ophthalmology hospital in Belo Horizonte, Minas Gerais, Brazil. Personal interviews were conducted using two structured questionnaires adapted from the modified SERVQUAL scale. Overall, patients from the private healthcare system were significantly more dissatisfied than those from the public healthcare system. In both systems, reliability was considered to be the most important determinant of quality, and it presented the highest level of dissatisfaction. Satisfaction with the public healthcare system was significantly greater than that with the private healthcare system in terms of the tangibles, reliability, responsiveness, and assurance determinants of the SERVQUAL scale. Institutions must plan, execute, evaluate, and monitor measures that seek to improve the overall patient satisfaction with the quality of services provided, particularly in the private healthcare system, and special attention must be paid to reliability in both healthcare systems. The identification and monitoring of the quality of healthcare services through the periodic use of the SERVQUAL scale may provide healthcare managers with information so that they can identify, plan, and monitor necessary and priority measures. This could be a key strategy for improving the quality of outpatient health services in the public and private systems.

The effects of the Norwegian Coordination Reform on the use of rehabilitation services: panel data analyses of service use, 2010 to 2013.

PubMed

Monkerud, Lars C; Tjerbo, Trond

2016-08-05

In 2012 the Norwegian Coordination Reform was implemented. The main motivation was to encourage municipalities to expand local, primary health care services. From 2012 to 2014, under the Municipal Co-Financing regime, municipalities were obliged to cover 20 % of the costs of health services provided at the specialist (hospital) level. Importantly, use of rehabilitation services in private institutions was not part of the cost-sharing mechanism of Municipal Co-Financing. Rehabilitation services may be seen as quite similar in nature whether they be provided by municipalities, hospitals or private institutions. Thus, with rehabilitation patients readily "transferrable" between levels, the question is whether the reform brought with it a sought after shift towards more municipal rehabilitation and less specialist rehabilitation. Data from the Norwegian Patient Register and from Statistics Norway/KOSTRA were utilized to gauge annual expenditures and inputs in specialist, municipal and private institution rehabilitation services respectively. Fixed effects and first difference regression analyses for the period 2010-2013 were carried out to account for certain time-invariant traits of municipalities and/or hospital regions, and results were adjusted for contemporaneous trends in local needs. Expenditures in specialist rehabilitation services declined sharply (typically by 8-10 %) from 2011 (pre-reform) to 2012 (post-reform), while expenditures in private rehabilitation services rose markedly in the same period (typically by 42-44 %). The results do not suggest any general expansion of municipal rehabilitation services. The results of the analyses suggest that municipalities shift away from the use of specialist rehabilitation services and towards the use of rehabilitation services in private institutions since the latter becomes relatively cheaper (free-of charge) than both municipal and specialist services in post-reform periods (as specialist services come at a cost to municipalities post-reform). While the main goal of the reform has not materialized the results nevertheless suggest that incentives (of cost-shifting) do play a significant role in rehabilitation service use.

Design of a high-speed high-resolution teleradiology system

NASA Astrophysics Data System (ADS)

Stewart, Brent K.; Dwyer, Samuel J., III; Huang, H. K.; Kangarloo, Hooshang

1992-07-01

A teleradiology system acquires radiographic images from one location and transmits them to one or more distant sites where they are displayed and/or converted to hardcopy film recordings. The long term goal of this research is to demonstrate that teleradiology systems can provide diagnostically equivalent results when compared to conventional radiographic film interpretation. If this hypothesis is proven, the following radiology tasks will be improved: (1) providing for primary interpretation of radiological images for patients in under served areas as well as other medical facilities; (2) integration of radiological services for multi- hospital/clinic health care provides consortiums (HMOs); (3) improving emergency service and intensive care unit coverage; (4) offering consulting-at-a-distance with sub-speciality radiologists; and (5) providing radiologists in the community or in rural areas immediate access to large academic centers for help in the interpretation of difficult and problematic cases. We are designing a high-speed, high-resolution teleradiology system between our level I medical center and several outlying medical centers within the metropolitan area. CT, MR and screen-film examinations will be digitized to 2 K or 4 K at the remote sites, transmitted to the central referral facility and sent to a laser film printer, reproducing the original film. The film can then be used for primary diagnosis, overreading/consultative purposes or for emergency room preparation. Inherently digital modality data (e.g. MR and CT) can be sent without digitization of the multi-format film is desired. A teleradiology system using a Wide Area Network (WAN) is to be connected to the following sites: (1) Olive View Medical Center; (2) Harbor General Medical Center; (3) UCLA Department of Radiological Sciences; and (4) two radiologist''s private residences. The wide area network (WAN) consists of a local carrier (GTE California Incorporated) and an inter-exchange carrier (US Sprint). Each affiliated hospital site is equipped with: (1) a radiographic film digitizer; (2) an interactive grayscale display workstation; (3) a computer system with teleradiology application software; (4) a local area network (LAN); (5) a LAN-WAN router; and (6) and dial-up (multiple switched N X 56 kbps lines) DS-1 WAN interfaces. The UCLA site is equipped with a local area image management network (PACS) for archiving, displaying, laser printed film hardcopy recordings, and WAN interfaces. The radiologists private residence is equipped with a grayscale station and a DS-0 56 kbps modem. We estimate the hardware costs at each remote site to be DLR160,000, DLR200,000 for the central referring facility, and under $DLR20,000 for the radiologist private residence.

IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL.

PubMed

Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

2016-10-01

One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals.

Food Acquisition through Private and Public Social Networks and Its Relationship with Household Food Security among Various Socioeconomic Statuses in South Korea

PubMed Central

Park, Sohyun; Kim, Kirang

2018-01-01

This study was conducted to understand food acquisition practices from social networks and its relationship with household food security. In-depth interviews and a survey on food security were conducted with twenty-nine mothers and one father in metropolitan areas of South Korea. Many families acquired food from their extended families, mainly participants’ mothers. Between low-income and non-low-income households, there was a pattern of more active sharing of food through private networks among non-low-income households. Most of the low-income households received food support from public social networks, such as government and charity institutions. Despite the assistance, most of them perceived food insecurity. We hypothesized that the lack of private social support may exacerbate the food security status of low-income households, despite formal food assistance from government and social welfare institutions. Interviews revealed that certain food items were perceived as lacking, such as animal-based protein sources and fresh produce, which are relatively expensive in this setting. Future programs should consider what would alleviate food insecurity among low-income households and determine the right instruments and mode of resolving the unmet needs. Future research could evaluate the quantitative relationship between private resources and food insecurity in households with various income statuses. PMID:29370127

Food Acquisition through Private and Public Social Networks and Its Relationship with Household Food Security among Various Socioeconomic Statuses in South Korea.

PubMed

Park, Sohyun; Kim, Kirang

2018-01-25

This study was conducted to understand food acquisition practices from social networks and its relationship with household food security. In-depth interviews and a survey on food security were conducted with twenty-nine mothers and one father in metropolitan areas of South Korea. Many families acquired food from their extended families, mainly participants' mothers. Between low-income and non-low-income households, there was a pattern of more active sharing of food through private networks among non-low-income households. Most of the low-income households received food support from public social networks, such as government and charity institutions. Despite the assistance, most of them perceived food insecurity. We hypothesized that the lack of private social support may exacerbate the food security status of low-income households, despite formal food assistance from government and social welfare institutions. Interviews revealed that certain food items were perceived as lacking, such as animal-based protein sources and fresh produce, which are relatively expensive in this setting. Future programs should consider what would alleviate food insecurity among low-income households and determine the right instruments and mode of resolving the unmet needs. Future research could evaluate the quantitative relationship between private resources and food insecurity in households with various income statuses.

Studies in Ambulatory Care Quality Assessment in the Indian Health Service. Volume III: Comparison of Rural Private Practice, Health Maintenance Organizations, and the Indian Health Service.

ERIC Educational Resources Information Center

Nutting, Paul A.; And Others

Utilizing a quality assessment methodology for ambulatory patient care currently under development by the Indian Health Service's (IHS) Office of Research and Development, comparisons were made between results derived from a pilot test in IHS service units, 2 metropolitan Health Maintenance Organizations (HMO), and 3 rural private practices.…

Using Patient Pathway Analysis to Design Patient-centered Referral Networks for Diagnosis and Treatment of Tuberculosis: The Case of the Philippines.

PubMed

Garfin, Celine; Mantala, Mariquita; Yadav, Rajendra; Hanson, Christy L; Osberg, Mike; Hymoff, Aaron; Makayova, Julia

2017-11-06

Tuberculosis (TB) is the 8th leading cause of death in the Philippines. A recent prevalence survey found that there were nearly 70% more cases of tuberculosis than previously estimated. Given these new data, the National TB Program (NTP), operating through a decentralized health system, identified about 58% of the estimated new drug-sensitive (DS) TB patients in 2016. However, the NTP only identified and commenced treatment for around 17% of estimated new drug-resistant patients. In order to reach the remaining 42% of drug-sensitive patients and 83% of drug-resistant patients, it is necessary to develop a better understanding of where patients seek care. National and regional patient pathway analyses (PPAs) were undertaken using existing national survey and NTP data. The PPA assessed the alignment between patient care seeking and the availability of TB diagnostic and treatment services. Systemic referral networks from the community-level Barangay Health Stations (BHSs) to diagnostic facilities have enabled more efficient detection of drug-sensitive tuberculosis in the public sector. Approximately 36% of patients initiated care in the private sector, where there is limited coverage of appropriate diagnostic technologies. Important differences in the alignment between care seeking patterns and diagnostic and treatment availability were found between regions. The PPA identified opportunities for strengthening access to care for all forms of tuberculosis and for accelerating the time to diagnosis by aligning services to where patients initiate care. Geographic variations in care seeking may guide prioritization of some regions for intensified engagement with the private sector. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Name-Based Address Mapping for Virtual Private Networks

NASA Astrophysics Data System (ADS)

Surányi, Péter; Shinjo, Yasushi; Kato, Kazuhiko

IPv4 private addresses are commonly used in local area networks (LANs). With the increasing popularity of virtual private networks (VPNs), it has become common that a user connects to multiple LANs at the same time. However, private address ranges for LANs frequently overlap. In such cases, existing systems do not allow the user to access the resources on all LANs at the same time. In this paper, we propose name-based address mapping for VPNs, a novel method that allows connecting to hosts through multiple VPNs at the same time, even when the address ranges of the VPNs overlap. In name-based address mapping, rather than using the IP addresses used on the LANs (the real addresses), we assign a unique virtual address to each remote host based on its domain name. The local host uses the virtual addresses to communicate with remote hosts. We have implemented name-based address mapping for layer 3 OpenVPN connections on Linux and measured its performance. The communication overhead of our system is less than 1.5% for throughput and less than 0.2ms for each name resolution.

2010 Staff Organization for Optimum C2: A Private Sector Analysis

DTIC Science & Technology

1998-02-13

control over business operations. Warfighting CINCs can benefit from the lessons learned in the private sector by adapting those lessons to future military... private sector analysis. Through the use of a networked command and control system and a "matrix" staff structure, the model consolidates the JFC staff

Kootenai River Focus Watershed Coordination, 2003-2004 Annual Report.

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

Kootenai River Network,

2006-02-01

The Kootenai River Network (KRN) was contracted by the Bonneville Power Administration; PPA Project Number 96087200 for the period June 1, 2003 to May 31, 2004 to provide Kootenai River basin watershed coordination services. The prime focus of the KRN is coordinating activities and disseminating information related to watershed improvement and education and outreach with other interest groups in the Kootenai River basin. To this end, the KRN primarily focuses on maintaining communication networks among private and public watershed improvement groups in the Columbia River Basin. The KRN willing shares its resources with these groups. The 2003-2004 BPA contract extendedmore » the original Montana Fish, Wildlife and Parks contract, which was transferred to the Kootenai River Network through a Memorandum of Understanding in November 2001. The KRN objectives of this contract were carried out through Watershed Coordinator position. The highly successful Kootenai River Network Annual General Meeting in Bonners Ferry in May 2003 demonstrated the tremendous gains that the Kootenai River Network has made in trans-boundary networking of watershed issues and accomplishments. The Annual General Meeting included seventy five participants representing more than forty US and Canadian citizen groups, tribes, first nations, agencies, ministries, businesses and private land owners from Montana, British Columbia, Idaho and Alberta. The International Restoration Tour in July 2004 featured the Grave Creek and Therriault Wetlands restoration projects in Montana and the Sand Creek and Wolf Creek restoration projects in British Columbia. The tour was attended by more than thirty people representing US and Canadian Federal and State/Provincial agencies, schools, colleges, conservation groups, private land owners, consultants, tribes, first nations, and politicians. These exciting trans-boundary successes encouraged the KRN to establish half-time Watershed Coordinator positions in both the United States and Canada. In September 2004 Kim Laub was hired as US-Watershed Coordinator and Jim and Laura Duncan were hired as Canadian Watershed Coordinators. To rejuvenate and revitalize the KRN, the Board conducted a strategic thinking and planning meeting in November 2004. All Board, staff and Advisory members participated in a combined effort to clearly define the goals of the KRN and to design ways of achieving those goals. Affirming and integrating board policy was a primary focus and it included writing accurate job descriptions for all KRN positions. KRN committee goals, the BPA contract and the Statement of Work plan were reviewed to establish future directions for a complex organization.« less

Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

PubMed Central

Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

2016-01-01

Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102