Action Research and Teacher Leadership

ERIC Educational Resources Information Center

Smeets, Karel; Ponte, Petra

2009-01-01

The present article reports on a case study into the influence and impact of action research carried out by teachers in a special school. The action research was an important component of the two-year, post-initial, in-service course in special educational needs, provided by Fontys University of Applied Sciences, Department of Inclusive and…

25 CFR 175.11 - Procedures for setting service fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Area Director shall establish, and amend as needed, service fees to cover the expense of customer service. Service fees shall be set by unilateral action of the Area Director and remain in effect until amended by the Area Director pursuant to this section. At least 30 days prior to the effective date, a...

Defense Health Care Reform: Actions Needed to Help Realize Potential Cost Savings from Medical Education and Training

DTIC Science & Technology

2014-07-01

services in carrying out their medical missions, manage the military s health plan, oversee the medical operations within and provide 10 shared services , including...oversight of medical education and training. According to DOD, a shared services concept is a combination of common services performed across

The service blueprint as a tool for designing innovative pharmaceutical services.

PubMed

Holdford, D A; Kennedy, D T

1999-01-01

To describe service blueprints, discuss their need and design, and provide examples of their use in advancing pharmaceutical care. Service blueprints are pictures or maps of service processes that permit the people involved in designing, providing, managing, and using the service to better understand them and deal with them objectively. A service blueprint simultaneously depicts the service process and the roles of consumers, service providers, and supporting services. Service blueprints can be useful in pharmacy because many of the obstacles to pharmaceutical care are a result of insufficient planning by service designers and/or poor communication between those designing services and those implementing them. One consequence of this poor design and communication is that many consumers and third party payers are uninformed about pharmacist roles. Service blueprints can be used by pharmacists to promote the value of pharmaceutical care to consumers and other decision makers. They can also assist in designing better pharmaceutical services. Blueprints are designed by identifying and mapping a process from the consumer's point of view, mapping employee actions and support activities, and adding visible evidence of service at each consumer action step. Key components of service blueprints are consumer actions, "onstage" and "backstage" employee actions, and support processes. Blueprints can help pharmacy managers identify and correct problems with the service process, provide pharmacy employees an opportunity to offer feedback in the planning stages of services, and demonstrate the value of pharmaceutical services to consumers. Service blueprints can be a valuable tool for designing, implementing, and evaluating pharmacy services.

Essential Concepts in Modern Health Services

PubMed Central

El Taguri, A

2008-01-01

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

75 FR 51373 - Withholding of District of Columbia, State, City and County Income or Employment Taxes by Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-20

...: Financial Management Service, Fiscal Service, Treasury. ACTION: Technical amendment. SUMMARY: This document... addressing the request to: Assistant Commissioner, Payment Management, Financial Management Service... Management, as the recipient of the letters. II. Need for Correction As published, the final regulations...

Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

PubMed

Krumwiede, Kelly A; Van Gelderen, Stacey A; Krumwiede, Norma K

2015-01-01

The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources. © 2014 Wiley Periodicals, Inc.

Protocol for the End-of-Life Social Action Study (ELSA): a randomised wait-list controlled trial and embedded qualitative case study evaluation assessing the causal impact of social action befriending services on end of life experience.

PubMed

Walshe, Catherine; Algorta, Guillermo Perez; Dodd, Steven; Hill, Matthew; Ockenden, Nick; Payne, Sheila; Preston, Nancy

2016-07-13

Compassionate support at the end of life should not be the responsibility of health and social care professionals alone and requires a response from the wider community. Volunteers, as community members, are a critical part of many end-of-life care services. The impact of their services on important outcomes such as quality of life is currently poorly understood. The purpose of this study is to evaluate a series of social action initiatives which use volunteers to deliver befriending services to people anticipated to be in their last year of life. The aim is to determine if receiving care from a social action volunteer befriending service plus usual care significantly improves quality of life in the last year of life. The research questions will be addressed through a wait-list randomised controlled trial (WLRCT) and qualitative case study evaluation across 12 sites in England. Participants will be randomly allocated to either receive the social action volunteer befriending service straight away or receive the intervention after a four week wait (wait-list arm). The impact of the intervention on end-of-life experience (quality of life as primary outcome, loneliness, social support) will be measured. Repeated assessments will be carried out at baseline and weeks 4 and 8 for the intervention arm and weeks 4, 8 and 12 for the wait-list arm. For selected sites case study evaluation will include interviews, observation and documentary analysis to understand the mechanisms underpinning any found impact. This study will address the need to both provide services which use social action models to support end-of-life care in community settings, and to robustly evaluate these models to determine if they influence the experience of end-of-life care. Such services could work to reduce isolation, help meet emotional needs and maintain a sense of connectedness to the community. ISRCTN 12929812 Registered 20.5.15.

Library Service, A Statement of Policy and Proposed Action by the Regents of the University of the State of New York.

ERIC Educational Resources Information Center

New York State Education Dept., Albany.

A plan of action by which library service and development in New York State can respond to rapid and dynamic changes in society is outlined. The program is based on the principles that any state resident has a right to convenient access to local libraries to meet his needs, that statewide library networks constitute the most efficient means to…

Implementation of the systems approach to improve a pharmacist-managed vancomycin dosing service.

PubMed

Gagnon, David J; Roberts, Russel; Sylvia, Lynne

2014-12-01

Quality improvements achieved by applying the systems approach to assess the clinical effectiveness, operational efficiency, and financial feasibility of a pharmacist-managed vancomycin dosing service are described. Faced with increased patient volumes and resource demands, the pharmacy department at Tufts Medical Center conducted an evaluation of its adult inpatient vancomycin dosing service using the systems approach, which emphasizes multidisciplinary assessment of system inputs, processes, and outcomes and consensus-building methods to identify needed changes and recommended action steps. A multidisciplinary committee composed of representatives of the medical center's pharmacy, internal medicine, infectious diseases, nursing, phlebotomy, and clinical laboratory services was assembled; in a series of three moderated monthly sessions, committee members deliberated and ultimately reached consensus on a list of action items. Relative to a concurrent intradepartmental assessment of the vancomycin dosing service based solely on pharmacist feedback, the systems approach identified a greater number and wider array of needed improvements in key program areas. Quality improvements implemented as a direct result of the systems-based analysis included a policy change authorizing pharmacists to order serum vancomycin determinations without physician cosignature and inclusion of a vancomycin dosing algorithm in the institutional antibiotic dosing guide. Future changes based on deliverable action items will result in a structured process to help direct program resources toward the patients most in need of pharmacist-managed vancomycin dosing services. The systems approach allowed for a comprehensive multidisciplinary evaluation of the service, as indicated by the identification of process improvements not identified by the department of pharmacy alone. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Using action research to develop midwives' skills to support women with perinatal mental health needs.

PubMed

Madden, Deirdre; Sliney, Annmarie; O'Friel, Aoife; McMackin, Barbara; O'Callaghan, Bernie; Casey, Kate; Courtney, Lisa; Fleming, Valerie; Brady, Vivienne

2018-02-01

The aim of the research was to identify and develop midwives' skills to support women with mental health needs during pregnancy, using an action research approach. A review of perinatal mental health services in a large Dublin maternity unit revealed a high number of referred women who 'did not attend' the perinatal mental health service with few guidelines in place to support midwives in identifying and referring women for specialist help. Action research using cooperative inquiry involved a mental health nurse specialist and a team of midwives, who were drawn to each other in mutual concern about an area of practice. Data were gathered from three Cooperative Inquiry meetings, which incorporated one main Action Research Cycle of constructing, planning, taking and evaluating action. Data were analysed using a thematic content analysis framework. Participants experienced varying levels of uncertainty about how to support women with perinatal mental health needs. Cooperative inquiry supported participants in making sense of how they understood perinatal mental health and how they managed challenges experienced when caring for women with perinatal mental health issues. Participants developed a referral pathway, highlighted the significance of education to support women with perinatal mental health issues and identified the value of using open questions to promote conversation with pregnant women about mental health. Midwives value education and support to identify and refer women at risk of perinatal mental health issues. Cooperative inquiry, with a focus on action and shared reflection, facilitated the drawing together of two professional groups with diverse knowledge bases to work together to develop practice in an area of mutual concern. Perinatal mental health is a significant public health issue and midwives need support to make psychosocial assessments and to negotiate access to specialist services where available and when required. © 2017 John Wiley & Sons Ltd.

77 FR 5481 - Notice of Request for Extension of Approval of an Information Collection; Special Need Requests...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2011-0113... Plant Protection Act AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Extension of... Act of 1995, this notice announces the Animal and Plant Health Inspection Service's (APHIS) intention...

76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Development of...: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION... the Department of Health and Human Services (HHS), will hold a public forum from July 11-13, 2011 on...

Blending Ameliorative and Transformative Approaches in Human Service Organizations: A Case Study

ERIC Educational Resources Information Center

Evans, Scot D.; Hanlin, Carrie E.; Prilleltensky, Isaac

2007-01-01

This paper describes the challenges and benefits of an action-research project with a Nashville-based nonprofit human service organization. In our view, outmoded human service organizations are in serious need of innovation to promote psychological and physical wellness, prevention of social problems, empowerment, and social justice. This project…

Clear Purpose...Complete Commitment: A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1993-1997.

ERIC Educational Resources Information Center

Jaques, Thomas F.

This long range plan, which was prepared in compliance with the Library Services and Construction Act (LSCA), begins with an overview of the library public and the state library agency in Louisiana. Identification of needs and action plans are presented in the following goal areas: (1) improving state library administration; (2) extending services…

Mapping Ecological Processes and Ecosystem Services for Prioritizing Restoration Efforts in a Semi-arid Mediterranean River Basin

NASA Astrophysics Data System (ADS)

Trabucchi, Mattia; O'Farrell, Patrick J.; Notivol, Eduardo; Comín, Francisco A.

2014-06-01

Semi-arid Mediterranean regions are highly susceptible to desertification processes which can reduce the benefits that people obtain from healthy ecosystems and thus threaten human wellbeing. The European Union Biodiversity Strategy to 2020 recognizes the need to incorporate ecosystem services into land-use management, conservation, and restoration actions. The inclusion of ecosystem services into restoration actions and plans is an emerging area of research, and there are few documented approaches and guidelines on how to undertake such an exercise. This paper responds to this need, and we demonstrate an approach for identifying both key ecosystem services provisioning areas and the spatial relationship between ecological processes and services. A degraded semi-arid Mediterranean river basin in north east Spain was used as a case study area. We show that the quantification and mapping of services are the first step required for both optimizing and targeting of specific local areas for restoration. Additionally, we provide guidelines for restoration planning at a watershed scale; establishing priorities for improving the delivery of ecosystem services at this scale; and prioritizing the sub-watersheds for restoration based on their potential for delivering a combination of key ecosystem services for the entire basin.

Mapping ecological processes and ecosystem services for prioritizing restoration efforts in a semi-arid Mediterranean river basin.

PubMed

Trabucchi, Mattia; O'Farrell, Patrick J; Notivol, Eduardo; Comín, Francisco A

2014-06-01

Semi-arid Mediterranean regions are highly susceptible to desertification processes which can reduce the benefits that people obtain from healthy ecosystems and thus threaten human wellbeing. The European Union Biodiversity Strategy to 2020 recognizes the need to incorporate ecosystem services into land-use management, conservation, and restoration actions. The inclusion of ecosystem services into restoration actions and plans is an emerging area of research, and there are few documented approaches and guidelines on how to undertake such an exercise. This paper responds to this need, and we demonstrate an approach for identifying both key ecosystem services provisioning areas and the spatial relationship between ecological processes and services. A degraded semi-arid Mediterranean river basin in north east Spain was used as a case study area. We show that the quantification and mapping of services are the first step required for both optimizing and targeting of specific local areas for restoration. Additionally, we provide guidelines for restoration planning at a watershed scale; establishing priorities for improving the delivery of ecosystem services at this scale; and prioritizing the sub-watersheds for restoration based on their potential for delivering a combination of key ecosystem services for the entire basin.

Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

PubMed

Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

2014-01-01

To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

42 CFR 90.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... recommendations, and identify studies or actions needed to evaluate and mitigate or prevent human health effects. Health effects study means research, investigation, or study performed by ATSDR or other parties pursuant... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF...

42 CFR 90.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... recommendations, and identify studies or actions needed to evaluate and mitigate or prevent human health effects. Health effects study means research, investigation, or study performed by ATSDR or other parties pursuant... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF...

Supporting the education goals of post-9/11 veterans with self-reported PTSD symptoms: a needs assessment.

PubMed

Ellison, Marsha Langer; Mueller, Lisa; Smelson, David; Corrigan, Patrick W; Torres Stone, Rosalie A; Bokhour, Barbara G; Najavits, Lisa M; Vessella, Jennifer M; Drebing, Charles

2012-01-01

The influx of young adult veterans with mental health challenges from recent wars combined with newly expanded veteran education benefits has highlighted the need for a supported education service within the Veterans Administration. However, it is unknown how such a service should be designed to best respond to these needs. This study undertook a qualitative needs assessment for education supports among veterans with post-9/11 service with self-reported PTSD symptoms. Focus groups were held with 31 veterans, 54% of whom were under age 30. Transcripts were analyzed and interpreted using a thematic approach and a Participatory Action Research team. Findings indicate a need for age relevant services that assist with: education planning and access, counseling for the G.I. Bill, accommodations for PTSD symptoms, community and family re-integration, and outreach and support. The veterans recommended that supported education be integrated with the delivery of mental health services, that services have varied intensity, and there be linkages between colleges and the Veterans Health Administration.

Learning to Be Interdisciplinary: An Action Research Approach to Boundary Spanning

ERIC Educational Resources Information Center

Munoz, Karen; Jeris, Laurel

2005-01-01

Objective: This study explored challenges and barriers that need to be addressed in a preprofessional educational setting to provide opportunities for boundary spanning that leads to family-centred interdisciplinary service provision. Design: The design employed in this study was participatory action research, an inductive approach. Setting: The…

The modern crisis in health services--professional concerns and the public interest.

PubMed

Sheps, C G

1981-01-01

The modern crisis in the health service systems of developed nations is described. Six major issues are discussed. 1) The need for recognition of the wholeness of man and the implications of this for implementing the concept of essential unity in the development and organization of health services; 2) the creation of ample opportunity for health manpower to work effectively in team situations; 3) the need for community-wide epidemiologic intelligence that will allow for better identification of problems and solutions; 4) the need to move away from the entrepreneurial framework of health care and regionalize facilities; 5) the assessment of costs both in terms of actions and inactions; and 6) the need for the professionals and public to work together in order to improve health services.

Perceived Needs of Educational Administrators for Student Services Offices in a Chinese Context: School Counselling Programs Addressing the Needs of Children and Teachers

ERIC Educational Resources Information Center

Dwyer, Sonya Corbin; McNaughton, Kathryn

2004-01-01

Conditions in China today are calling for a more holistic approach to education. As a result of seminars held in Changchun, Jilin, senior administrators suggested the introduction of Student Services Offices in elementary schools. This study examined 19 action plans developed by educators in North East China which reveal their goals for these…

78 FR 21116 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

...-0472. Needs and Uses: Executive Order 12829, ``National Industrial Security Program (NISP)'' Section...; Comment Request AGENCY: Defense Security Service, DoD. ACTION: Notice. In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the Defense Security Service (DSS) announces the...

24 CFR 91.220 - Action plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... emergency shelter and transitional housing needs of homeless persons; and (iii) Helping homeless persons... were recently homeless from becoming homeless again; and (iv) Helping low-income individuals and... services, employment, education, or youth needs. (2) The jurisdiction must specify the activities that it...

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Balancing Work Responsibilities and Family Needs: The Federal Civil Service Response. A Report Concerning Significant Actions of the U.S. Office of Personnel Management. A Report to the President and the Congress of the United States.

ERIC Educational Resources Information Center

Merit Systems Protection Board, Washington, DC.

This report examines actions of the U.S. Office of Personnel Management in providing leadership to several of the government's human resource management programs in the work and family benefits area. It reviews employee benefit programs that help civilian federal workers balance their work responsibilities and personal needs. Programs reviewed are…

Electronic Warfare: Comprehensive Strategy Still Needed for Suppressing Enemy Air Defenses

NASA Astrophysics Data System (ADS)

2002-11-01

U.S. military aircraft are often at great risk from enemy air defenses, and the services use specialized aircraft to neutralize or destroy them. In January 2001, GAO reported that a gap existed between the services' suppression capabilities and their needs and recommended that a comprehensive strategy was needed to fix the situation. In response to GAO's report, DOD emphasized that a major study underway at the time would provide the basis for a Department-wide strategy and lead to a balanced set of acquisition programs between the services. This report updates our previous work and assesses actions that DOD has taken to improve its suppression capabilities.

DOD Inventory of Contracted Services: Timely Decisions and Further Actions Needed to Address Long Standing Issues

DTIC Science & Technology

2016-10-01

which contractors were providing services that are closely associated with inherently governmental functions, a key review objective to help ensure...or dinapolit@gao.gov. Why GAO Did This Study DOD is the government’s largest purchaser of contractor -provided services. In 2008, Congress...required DOD to compile and review an annual inventory of its contracted services to identify the number of contractors performing services and the

[Difficult teenagers: the challenges of interdisciplinarity].

PubMed

Saint-Andrté, Stéphane; Botbola, Michel

2013-01-01

The adolescents in great distress, because of ruptures in the course of their lives and of their chaotic family environment, need educational and social actions. The consensual point of view is that responding to the needs of the so called "difficult adolescents" implies the involvement of educational, therapeutic and judicial services. Nevertheless, the usual tendency to categorize the users with the idea it will permit to guide them to the appropriate skill field and the transgressive characteristic of these adolescents' behaviours lead all these services to reject them and send them to the two other services.

Systemic Action and Learning in Public Services

ERIC Educational Resources Information Center

Rigg, Clare

2011-01-01

Complex, systemic issues continue to challenge public services without respect for organisational and professional boundaries. In practice, collaborative working with others who have differing professional cultural norms and systems confront members with the need to learn about each other's values, priorities and practices. This paper explores the…

Ethical issues in hospital clients' satisfaction: a Brazilian perspective.

PubMed

Rocha, Elyrose S B; Ventura, Carla A A; de Godoy, Simone; Mendes, Isabel A C; Trevizan, Maria A

2015-03-01

Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care delivery based on competence, efficiency and ethics represents a challenge. This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses' actions involving patients' satisfaction with nursing care. This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients' education, in order to further their involvement and participation in decisions concerning the care planned for them. The adoption of this paradigm entails a change in the performance of nurses' management and care roles, which may have to observe attitudes previously disregarded in most services provided. © The Author(s) 2014.

The World Report on Disability as a blueprint for international, national, and local aphasia services.

PubMed

Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia

2013-02-01

This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.

Guide to Rebuilding Governance in Stability Operations: A Role for the Military?

DTIC Science & Technology

2009-06-01

departments to assess needs, develop a list of necessary parts and equipment, and prepare an action plan for restoration of services. With rapid...for drafting, reviewing, and voting on a new constitution was pursued. The Rwandan government’s action plan included: training and sensitization of...together to build collaborative relationships, share strategies for addressing obstacles, and develop joint action plans . Provide opportunities for CSOs to

Linking water quality and well-being for improved assessment and valuation of ecosystem services

PubMed Central

Keeler, Bonnie L.; Polasky, Stephen; Brauman, Kate A.; Johnson, Kris A.; Finlay, Jacques C.; O’Neill, Ann; Kovacs, Kent; Dalzell, Brent

2012-01-01

Despite broad recognition of the value of the goods and services provided by nature, existing tools for assessing and valuing ecosystem services often fall short of the needs and expectations of decision makers. Here we address one of the most important missing components in the current ecosystem services toolbox: a comprehensive and generalizable framework for describing and valuing water quality-related services. Water quality is often misrepresented as a final ecosystem service. We argue that it is actually an important contributor to many different services, from recreation to human health. We present a valuation approach for water quality-related services that is sensitive to different actions that affect water quality, identifies aquatic endpoints where the consequences of changing water quality on human well-being are realized, and recognizes the unique groups of beneficiaries affected by those changes. We describe the multiple biophysical and economic pathways that link actions to changes in water quality-related ecosystem goods and services and provide guidance to researchers interested in valuing these changes. Finally, we present a valuation template that integrates biophysical and economic models, links actions to changes in service provision and value estimates, and considers multiple sources of water quality-related ecosystem service values without double counting. PMID:23091018

Linking water quality and well-being for improved assessment and valuation of ecosystem services.

PubMed

Keeler, Bonnie L; Polasky, Stephen; Brauman, Kate A; Johnson, Kris A; Finlay, Jacques C; O'Neill, Ann; Kovacs, Kent; Dalzell, Brent

2012-11-06

Despite broad recognition of the value of the goods and services provided by nature, existing tools for assessing and valuing ecosystem services often fall short of the needs and expectations of decision makers. Here we address one of the most important missing components in the current ecosystem services toolbox: a comprehensive and generalizable framework for describing and valuing water quality-related services. Water quality is often misrepresented as a final ecosystem service. We argue that it is actually an important contributor to many different services, from recreation to human health. We present a valuation approach for water quality-related services that is sensitive to different actions that affect water quality, identifies aquatic endpoints where the consequences of changing water quality on human well-being are realized, and recognizes the unique groups of beneficiaries affected by those changes. We describe the multiple biophysical and economic pathways that link actions to changes in water quality-related ecosystem goods and services and provide guidance to researchers interested in valuing these changes. Finally, we present a valuation template that integrates biophysical and economic models, links actions to changes in service provision and value estimates, and considers multiple sources of water quality-related ecosystem service values without double counting.

Agricultural Extension, Collective Action and Innovation Systems: Lessons on Network Brokering from Peru and Mexico

ERIC Educational Resources Information Center

Hellin, Jon

2012-01-01

Purpose: New approaches to extension service delivery are needed that stimulate increased agricultural production, contribute to collective action and which also foster the emergence of agricultural innovation systems. Research in Peru and Mexico explores some of these new approaches. Design/methodology/approach: In both countries, a qualitative…

Learning from Our Own Lessons: Pre-Service Teachers' Narratives of Teaching as an Experiment

ERIC Educational Resources Information Center

Wickstrom, Megan H.; Wilm, Stephanie; Mills, Emily; Johnson, Alexis; Leonard, Nicole; Larberg, Raegan

2018-01-01

Pre-service teachers need to develop habits of mind that allow them to grow as new teachers. This article describes an elementary mathematics methods course in which teaching as an experiment was used a framework for pre-service teachers to participate in action research by developing learning goals, observing and analyzing student thinking,…

Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs

PubMed Central

Goldman, Eliot; Offord, David; Costello, Elizabeth J.; Friedman, Robert; Huff, Barbara; Crowe, Maura; Amsel, Lawrence; Bennett, Kathryn; Bird, Hector; Conger, Rand; Fisher, Prudence; Hoagwood, Kimberly; Kessler, Ronald C.; Roberts, Robert

2011-01-01

OBJECTIVE: The US Surgeon General has called for new approaches to close the mental health services gap for the large proportion of US children with significant mental health needs who have not received evaluation or services within the previous 6 to 12 months. In response, investigators sought to develop brief, easily understood, scientifically derived “warning signs” to help parents, teachers, and the lay public to more easily recognize children with unmet mental health needs and bring these children to health care providers' attention for evaluation and possible services. METHOD: Analyses of epidemiologic data sets from >6000 children and parents were conducted to (1) determine the frequency of common but severely impairing symptom profiles, (2) examine symptom profile frequencies according to age and gender, (3) evaluate positive predictive values of symptom profiles relative to Diagnostic and Statistical Manual of Mental Disorders diagnoses, and (4) examine whether children with 1 or more symptom profiles receive mental health services. RESULTS: Symptom-profile frequencies ranged from 0.5% to 2.0%, and 8% of the children had 1 or more symptom profile. Profiles generated moderate-to-high positive predictive values (52.7%–75.4%) for impairing psychiatric diagnoses, but fewer than 25% of children with 1 or more profiles had received services in the previous 6 months. CONCLUSIONS: Scientifically robust symptom profiles that reflect severe but largely untreated mental health problems were identified. Used as “action signs,” these profiles might help increase public awareness about children's mental health needs, facilitate communication and referral for specific children in need of evaluation, and narrow the child mental health services gap. PMID:22025589

Adopting a Sustainable Community of Practice Model when Developing a Service to Support Patients with Epidermolysis Bullosa (EB): A Stakeholder-Centered Approach.

PubMed

Gowran, Rosemary Joan; Kennan, Avril; Marshall, Siobhán; Mulcahy, Irene; Ní Mhaille, Sile; Beasley, Sarah; Devlin, Mark

2015-02-01

Epidermolysis bullosa (EB) is a rare, genetic skin condition that is complicated, distressing, and painful and permeates every aspect of patients' lives. Support services are essential for meeting the primary needs of patients and families living with EB; however, provision is challenged by many complex issues. In collaboration with the patient organization DEBRA Ireland, this research conducted an in-depth analysis of Irish healthcare support services for EB, with a view to moving towards an improved and sustainable care pathway. A sustainable community of practice model (SCOP), as a core construct provided a simplified framework when studying this complex system. The research utilized mixed methods, comprising individual interviews, questionnaires, and a participatory action research workshop based on a soft systems approach. The study engaged patients, family members, service providers, and policy developers. Findings emphasized that the complexities of life with EB are more than 'skin deep'. The lived experience of stakeholders revealed many levels of emotion, both positive and heart-rending. Despite the positive efforts of specialists in this field, inadequacies to meet the primary needs of people with EB, such as bandages-fundamental for survival-were highlighted. Participants reported challenges relating to understanding patients' needs, access to consistent services within hospitals and the community, time constraints, and the strong emotions evoked by this severe and rare disease. The study identified several areas that can be targeted to bring about improvements in meeting primary needs. Education and research at public, policy, and practice levels need to be prioritized. It is imperative that citizens move beyond an awareness that EB exists and demonstrate a consciousness about the importance of advocating and enabling seamless and sustainable support services through collective action.

Transportation and Children Who Have Disabilities. Alliance Action Information Sheets

ERIC Educational Resources Information Center

Technical Assistance ALLIANCE for Parent Centers, 2007

2007-01-01

The Individuals with Disabilities Education Act (IDEA) includes transportation within its definition of "related services." This means that students with Individualized Education Programs (IEPs) have the right to receive special transportation services if it is needed. Transportation and assistance may be provided to a child whose…

Chemical and Biological Terrorism: Improvements to Emergency Medical Response.

ERIC Educational Resources Information Center

DeGraffenreid, Jeff Gordon

The challenge facing many emergency medical services (EMS) is the implementation of a comprehensive educational strategy to address emergency responses to terrorism. One such service, Johnson County (Kansas) Medical Action, needed a strategy that would keep paramedics safe and offer the community an effective approach to mitigation. A…

75 FR 10809 - Outer Continental Shelf (OCS) Scientific Committee-Notice of Renewal

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... AGENCY: Minerals Management Service (MMS), Interior. ACTION: Notice of renewal of the Outer Continental... Minerals Management Service. The Committee reviews the relevance of the research and data being produced to meet MMS scientific information needs for decisionmaking and may recommend changes in scope, direction...

45 CFR 84.35 - Evaluation and placement.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., and Secondary Education § 84.35 Evaluation and placement. (a) Preplacement evaluation. A recipient that operates a public elementary or secondary education program or activity shall conduct an... handicap, needs or is believed to need special education or related services before taking any action with...

ELIXIR pilot action: Marine metagenomics - towards a domain specific set of sustainable services.

PubMed

Robertsen, Espen Mikal; Denise, Hubert; Mitchell, Alex; Finn, Robert D; Bongo, Lars Ailo; Willassen, Nils Peder

2017-01-01

Metagenomics, the study of genetic material recovered directly from environmental samples, has the potential to provide insight into the structure and function of heterogeneous microbial communities.  There has been an increased use of metagenomics to discover and understand the diverse biosynthetic capacities of marine microbes, thereby allowing them to be exploited for industrial, food, and health care products. This ELIXIR pilot action was motivated by the need to establish dedicated data resources and harmonized metagenomics pipelines for the marine domain, in order to enhance the exploration and exploitation of marine genetic resources. In this paper, we summarize some of the results from the ELIXIR pilot action "Marine metagenomics - towards user centric services".

The role of the Carer Support Needs Assessment Tool in palliative home care: A qualitative study of practitioners' perspectives of its impact and mechanisms of action.

PubMed

Ewing, Gail; Austin, Lynn; Grande, Gunn

2016-04-01

The importance of supporting family carers is well recognised in healthcare policy. The Carer Support Needs Assessment Tool is an evidence-based, comprehensive measure of carer support needs to facilitate carer support in palliative home care. To examine practitioner perspectives of the role of the Carer Support Needs Assessment Tool intervention in palliative home care to identify its impact and mechanisms of action. Qualitative - practitioner accounts of implementation (interviews, focus groups, reflective audio diaries) plus researcher field notes. A total of 29 staff members from two hospice home-care services - contrasting geographical locations, different service sizes and staff composition. A thematic analysis was conducted. Existing approaches to identification of carer needs were informal and unstructured. Practitioners expressed some concerns, pre-implementation, about negative impacts of the Carer Support Needs Assessment Tool on carers and expectations raised about support available. In contrast, post-implementation, the Carer Support Needs Assessment Tool provided positive impacts when used as part of a carer-led assessment and support process: it made support needs visible, legitimised support for carers and opened up different conversations with carers. The mechanisms of action that enabled the Carer Support Needs Assessment Tool to make a difference were creating space for the separate needs of carers, providing an opportunity for carers to express support needs and responding to carers' self-defined priorities. The Carer Support Needs Assessment Tool delivered benefits through a change in practice to an identifiable, separate assessment process for carers, facilitated by practitioners but carer-led. Used routinely with all carers, the Carer Support Needs Assessment Tool has the potential to normalise carer assessment and support, facilitate delivery of carer-identified support and enable effective targeting of resources. © The Author(s) 2015.

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis.

PubMed

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2017-07-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation's most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

PubMed Central

Krawczyk, Noa; Kerrigan, Deanna; Bastos, Francisco Inácio

2018-01-01

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care. PMID:27856941

Economic Analysis of Waterfront Area Services at Naval Station, Long Beach

DTIC Science & Technology

1991-06-01

the Gradall for waterfront area services, would result in improved responsiveness and timely service. Customer satisfaction and overall customer ...overall cost. Hence, both quality and efficiency will improve leading to greater customer satisfaction . 58 VII. RECOMMENDATIONS FOR ACTION RECOMMENDATION 1...prompting the need for improved efficiency. To ensure adequate future support can be provided to its customers , Naval Station Long Beach (Navsta) is

Using Participatory Action Research To Evaluate Programs Serving People with Severe Disabilities: Reflections from the Field.

ERIC Educational Resources Information Center

Stevens, Karen A.; Folchman, Ruth

1998-01-01

This article discusses challenges in using participatory action research (PAR) in the evaluation of programs that provide services and supports to people with severe disabilities. Challenges include the need for modification of the model, time constraints, issues around power and position, and inclusion of individuals with severe disabilities.…

TESF Methodology for Statistics Education Improvement

ERIC Educational Resources Information Center

Barone, Stefano; Lo Franco, Eva

2010-01-01

The need for universities to achieve excellence in the services they provide has been the subject of research for several decades. The idea of involving students and recognizing the importance of their opinions has led to the creation of various models and tools. This paper focuses on teaching, a central service from which improvement actions of…

Health Coordination Manual. Head Start Health Services.

ERIC Educational Resources Information Center

Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.

Part 1 of this manual on coordinating health care services for Head Start children provides an overview of what Head Start health staff should do to meet the medical, mental health, nutritional, and/or dental needs of Head Start children, staff, and family members. Offering examples, lists, action steps, and charts for clarification, part 2…

Making Canadian Schools Inclusive: A Call to Action

ERIC Educational Resources Information Center

Porter, Gordon L.

2008-01-01

How to best provide quality educational services to students with disabilities, and other special needs, is a flash point issue for education systems in Canada. The news stories are frequent and engaging. A family or parent demands one thing and a school district offers something else. Sometimes the demand is for more special services and…

Higher Education. Lifelong Learning and Community Service: A Profile of Action and Responsibility.

ERIC Educational Resources Information Center

Champagne, Joseph E.

Two projects, designed to serve as technical input to the developing Texas State Plan for Higher Continuing Education, focused on: (1) enrollment trends and needs, institutional activities, and statewide planning across the nation; and (2) higher education and community services. Both projects involved extensive survey work of institutional visits…

Guidelines for conducting TMDL consultations on selenium

Treesearch

Dennis A. Lemly

2000-01-01

This report was prepared to provide Environmental Contaminants Specialists in the U.S. Fish and Wildlife Service (Service) with a step-by-step procedure for consultations involving Total Maximum Daily Loads (TMDL's) for selenium. The need for this information stems from recent actions taken by the U.S. Environmental Protection Agency (EPA) that will involve the...

The Development of Youth Purpose through Community Service and Social Action

ERIC Educational Resources Information Center

Jones, Jeffrey N.

2017-01-01

"Purpose" has been identified as a fundamental need of adolescence, and there are a growing number of community service programs that may promote the development of a sense of purpose and meaning for youth participants. Understanding the transformative nature of contextual influences for the individual is critical, and this research…

[Planning by service organisation priorities. The process of preparing strategic service-organisation plans].

PubMed

Sampietro-Colom, Laura; Costa, Dolors; Busqué, Anna; Lacasa, Carme

2008-12-01

Strategic planning designs the general setting and the strategic principles of a healthcare system, as well as the general guidelines that govern the development of a health system. Strategic service-organisation plans deal with translating healthcare policies into service policies and respond, principally, to the need for services; these give rise to problems that require a solution. They are developed in line with advances in scientific knowledge, the implementation and current characteristics of the healthcare services and the evolution in the competences of professional teams. There are five stages for their development: identification of health/service requirements; prioritisation of needs in health/services; definition of and agreement on service organisation models (care model and service portfolio); the preparation of and agreement on territorial action plans; introduction and evaluation. A conceptual framework is presented along with practical applications carried out in Catalonia.

[Strengthening primary health care: a strategy to maximize coordination of care].

PubMed

de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

2011-02-01

To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

36 CFR 72.12 - Assessment of needs, problems and issues.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and issues. 72.12 Section 72.12 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT... Assessment of needs, problems and issues. The Action Program should begin with an Assessment describing the existing park and recreation system; issues and problems; goals and objectives. The Assessment should...

36 CFR 72.12 - Assessment of needs, problems and issues.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and issues. 72.12 Section 72.12 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT... Assessment of needs, problems and issues. The Action Program should begin with an Assessment describing the existing park and recreation system; issues and problems; goals and objectives. The Assessment should...

36 CFR 72.12 - Assessment of needs, problems and issues.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and issues. 72.12 Section 72.12 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT... Assessment of needs, problems and issues. The Action Program should begin with an Assessment describing the existing park and recreation system; issues and problems; goals and objectives. The Assessment should...

36 CFR 72.12 - Assessment of needs, problems and issues.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and issues. 72.12 Section 72.12 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT... Assessment of needs, problems and issues. The Action Program should begin with an Assessment describing the existing park and recreation system; issues and problems; goals and objectives. The Assessment should...

Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces.

PubMed

Meinck, Franziska; Cluver, Lucie; Loening-Voysey, Heidi; Bray, Rachel; Doubt, Jenny; Casale, Marisa; Sherr, Lorraine

2017-03-01

Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.

Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

PubMed

Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

2015-06-16

Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction

PubMed Central

Reyers, Belinda; Nel, Jeanne L.; O’Farrell, Patrick J.; Sitas, Nadia; Nel, Deon C.

2015-01-01

Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social–ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making. PMID:26082541

Actions to Empower Digital Competences in Healthcare Workforce: A Qualitative Approach.

PubMed

Konstantinidis, Stathis Th; Li, Sisi; Traver, Vicente; Zary, Nabil; Bamidis, Panagiotis D

2017-01-01

While healthcare systems are taking advantage of the ICT to improve healthcare services, healthcare workforce needs additional competencies in order to continue the provision of the best achievable care. In this paper emphasis is given to an active research effort taken during the MEI2015 Conference. Based on hands-on group-work, participants identified the actions needed to boost the acquisition of IT competences by healthcare workforce and collaboratively indicated the most important actions. The leading priority actions were integration of IT into Curriculum, continuous IT/eHealth training at the work place, raising awareness of IT competences, participatory decisions for actions, match healthcare applications to users' own context, inclusion of professionals in the development of eHealth projects. Interestingly, the proposed actions coupling the outcomes of another study following a different methodology, but also support the cooperation opportunities on IT skills for healthcare workforce. The latter formed a set of recommendations which were proposed within the CAMEI coordination and support action of EC-FP7.

Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland.

PubMed

Panzera, Annette June; Murray, Richard; Stewart, Ruth; Mills, Jane; Beaton, Neil; Larkins, Sarah

2016-01-01

Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services that meet the needs of the population and contribute to service and system improvement and innovation.

Analysis of the Salvation Army World Service Offices Disaster Relief Capabilities

DTIC Science & Technology

2017-03-01

AOR based primarily on their financial revenues, since revenue is a prerequisite enabling mechanism for the delivery of goods and services . The...are from government sources, whereas contributions include cash and dollar value of in-kind services and goods . Investment revenues largely consist of...taking action among those most in need of assistance offers a compelling and admirable example of the good a religious organization can accomplish

Military Compensation: Additional Actions Are Needed to Better Manage Special and Incentive Pay Programs

DTIC Science & Technology

2017-02-01

services largely applied key principles of effective human capital management in the design of their S&I pay programs for nuclear propulsion...aviation, and cybersecurity occupations. However, the application of these key principles varied by service and occupation. Only the Navy’s S&I pay...programs for nuclear propulsion and aviation fully addressed all seven principles ; programs for other occupations and services generally exhibited a

Using Action Research to Assess and Advocate for Innovative School Library Design

ERIC Educational Resources Information Center

Harper, Meghan; Deskins,Liz

2015-01-01

This article describes a collaborative project designed to use action research to assess and advocate for innovative design changes in a school library. The high school library was in its fifth year of service, and yet the layout of the library was not meeting the learning and technological needs of 21st-century high school students. The purpose…

Call to Action: Better Nutrition for Mothers, Children, and Families National Workshop Proceedings (Washington, D.C., December 6-8, 1990). Executive Summary.

ERIC Educational Resources Information Center

Sharbaugh, Carolyn S., Ed.

This report summarizes proceedings and recommendations of a workshop on trends, needs, and issues in maternal and child nutrition services and presents 28 major recommendations and associated action strategies which address general areas, women's nutrition for optimal reproductive health, infant nutrition, child nutrition, adolescent nutrition,…

Preventative maintenance program for bridges.

DOT National Transportation Integrated Search

2015-07-01

The Kentucky Transportation Cabinets (KYTC) bridge inventory is rapidly aging. As such, the Cabinet : needs to identify and implement relevant preventative maintenance (PM) actions to extend the useful : service lives of those structures. Maintena...

Improving Emergency Medical Services (EMS) in the United States Through Improved and Centralized Federal Coordination

DTIC Science & Technology

2011-03-01

guidance and actions towards that end service product . Also to be considered is that not only are the stakeholders independent in their needs for strategy...from http://www.firerescue1.com/fire- ems/articles/770081-Ex-DC-fire-chief-rerets- intergrating Doyle, J. (2008, April 13). San Francisco 911 misses

IEP Goals. Alliance Action Information Sheets

ERIC Educational Resources Information Center

Technical Assistance ALLIANCE for Parent Centers, 2007

2007-01-01

IDEA is the nation's special education law. Under IDEA if a child is found to be a "child with a disability," he or she is eligible for special education and related services. If your child has a disability, under IDEA, a team of people will gather to talk about what special instruction and services your child needs. This team includes…

75 FR 63141 - Apalachicola National Forest; Florida; City of Tallahassee 230kV Southwestern Transmission Line

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... INFORMATION CONTACT: Harold Shenk, U.S. Forest Service, 57 Taff Drive, Crawfordville, FL 32327. Telephone... Information Relay Service (FIRS) at 1-800-877-8339 between 8 a.m. and 8 p.m., Eastern Time, Monday through Friday. SUPPLEMENTARY INFORMATION: Purpose and Need for Action The North American Electric Reliability...

47 CFR 5.83 - Cancellation provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Services accepts the license with the express understanding: (a) that the authority to use the frequency or... Commission at any time without hearing if in its discretion the need for such action arises. However, a...

75 FR 47820 - Generic Drug User Fee; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381... fee program. The number of human generic drug applications awaiting FDA action and the median review... needed for presentations, FDA reserves the right to terminate the meeting early. If you need special...

Drug Abuse Assessment, Program Planning and Resource Development in the Black Community.

ERIC Educational Resources Information Center

Gunn, Karen S.

This paper presents a needs assessment project developed to establish drug-related services in a small black community. A literature review reveals the influence of social issues relevant to the population on research methodology, program planning, and social action. The convergent analysis approach used in the needs assessment is explained and…

Service Use and Unmet Needs in Youth Suicide: A Study of Trajectories

PubMed Central

Renaud, Johanne; Séguin, Monique; Lesage, Alain D; Marquette, Claude; Choo, Bettina; Turecki, Gustavo

2014-01-01

Objective: While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. Method: We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects’ psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. Results: Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. Conclusions: Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people. PMID:25565685

Service use and unmet needs in youth suicide: a study of trajectories.

PubMed

Renaud, Johanne; Séguin, Monique; Lesage, Alain D; Marquette, Claude; Choo, Bettina; Turecki, Gustavo

2014-10-01

While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects' psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people.

"Freedom to go where I want": improving access to sexual and reproductive health for women with disabilities in the Philippines.

PubMed

Devine, Alexandra; Ignacio, Raquel; Prenter, Krystle; Temminghoff, Lauren; Gill-Atkinson, Liz; Zayas, Jerome; Marco, Ma Jesusa; Vaughan, Cathy

2017-05-01

Women with disabilities experience a range of violations of their sexual and reproductive rights. The Philippines ratified the United Nations Convention on the Rights of Persons with Disabilities and have laws in place to promote the rights to sexual and reproductive health and protection from violence. However, limited resourcing, and opposition to such laws undermine access to these rights for all women. Inadequate disability inclusion within policy and programming, and limited disability awareness of services, further impedes women with disabilities from attaining these rights. The W-DARE project (Women with Disability taking Action on REproductive and sexual health) was a three-year participatory action research program designed to (1) understand the sexual and reproductive health experiences and needs of women with disabilities; and (2) improve access to quality sexual and reproductive health, including violence response services, for women with disabilities in the Philippines. In response to the highlighted need for more information about sexual and reproductive health and greater access to services, the W-DARE team developed and implemented a pilot intervention focused on peer-facilitated Participatory Action Groups (PAGs) for women with disabilities. This paper focuses on the qualitative findings from the evaluation of this PAG intervention.

EMERGING INFECTIOUS DISEASES. Actions Needed to Address the Challenges of Responding to Zika Virus Disease Outbreaks

DTIC Science & Technology

2017-05-01

Department of Health and Human Services 81 Appendix IV Zika Virus Case Definitions for National Notifiable Disease Reporting 86 Appendix V...Insecticide, Fungicide, and Rodenticide Act HHS Department of Health and Human Services IgG immunoglobulin G IgM immunoglobulin M IMM...Agency (EPA), and Department of Health and Human Services (HHS) including CDC, FDA and National Institutes of Health (NIH). We also convened, with

W-DARE: a three-year program of participatory action research to improve the sexual and reproductive health of women with disabilities in the Philippines.

PubMed

Vaughan, Cathy; Zayas, Jerome; Devine, Alexandra; Gill-Atkinson, Liz; Marella, Manjula; Garcia, Joy; Bisda, Krissy; Salgado, Joy; Sobritchea, Carolyn; Edmonds, Tanya; Baker, Sally; Marco, Ma Jesusa

2015-09-29

In many contexts, women with disability have less access to sexual and reproductive health information, screening, prevention, and care services than women without disability. Women with disability are also known to be more likely to experience physical and sexual violence than women without disability. In the Philippines, health service providers often have little awareness of the sexual and reproductive experiences of women with disability and limited capacity to provide services in response to their needs. Very limited data are available to inform development of disability-inclusive sexual and reproductive health, and violence prevention and response, services in the country. This paper presents the protocol for W-DARE (Women with Disability taking Action on REproductive and sexual health), a three-year program of participatory action research that aims to improve the sexual and reproductive health of women with disability in the Philippines. W-DARE is a disability-inclusive program that will use mixed methods to 1) increase understanding of factors influencing the sexual and reproductive health of women with disability, and 2) develop, implement and evaluate local interventions to increase supply of and demand for services. W-DARE will generate data on the prevalence of disability in two districts; the wellbeing and community participation of people with and without disability, and identify barriers to community; and describe the sexual and reproductive health needs and experiences, and service-related experiences of women with disability. These data will inform the development and evaluation of interventions aiming to improve access to sexual and reproductive health services, and violence prevention and response services, for women with disability. Local women with disabilities, their representative organisations, and SRH service providers will be involved as members of the research team across all stages of the research. This three-year study will provide evidence about factors undermining the sexual and reproductive health of women with disability in a lower-middle income country, and provide new insights about what may be effective in increasing access to services in settings of limited resources. Findings will be relevant across Asia and the Pacific. Analysis of the program will also provide evidence about disability-inclusion in participatory action research approaches.

Evaluating the Implementation of a Training Program for Improving Quality Service: An Action Research Study

ERIC Educational Resources Information Center

Pierre, Ketly Dieudonne

2014-01-01

There is a need to implement a comprehensive training program to build employees' knowledge, skills, and attitudes in order to improve quality service at ABC Restaurant because of a surge in customer complaints. The purpose of this study was to develop a training program that included an employee handbook as a training tool, a handbook designed…

School Accommodation and Modification Ideas for Students Who Receive Special Education Services. PACER Center ACTion Information Sheets: PHP-c49

ERIC Educational Resources Information Center

PACER Center, 2013

2013-01-01

Some students with disabilities who receive special education services need accommodations or modifications to their educational program in order to participate in the general curriculum and to be successful in school. While the Individuals with Disabilities Education Act (IDEA) and its regulations do not define accommodations or modifications,…

Meta-Reflective Service Learning Poster Fairs: Purposive Pedagogy for Pre-Service Teachers

ERIC Educational Resources Information Center

Stewart, Trae

2008-01-01

Given that teachers need to present information in a concise, understandable way, to reflect on their practices to inform future actions, and to know how to create and use a teaching artifact, this article reports the findings from a study conducted to examine the impacts from a class-based poster session in teacher education. First, a review of…

DOD Service Academies: More Changes Needed To Eliminate Hazing. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of National Security and International Affairs.

This study sought to review the extent of hazing at the three Department of Defense (DOD) service academies, the actions taken by the academies to control and eliminate hazing, and the impact of hazing on cadets and midshipmen. The three academies studied were the Naval Academy (Annapolis, Maryland), the Air Force Academy (Colorado Springs,…

Cultural sensitivity: a practical approach to improving services.

PubMed

Daddy, J; Clegg, A

Reports commissioned by the Department of Health (Acheson 1998, Alexander 1999) have highlighted the failure of the NHS to provide culturally sensitive services for black and Asian patients. Cultural sensitivity in nursing is the provision of care that is sensitive to the needs of clients from all cultures. The authors outline the action taken to improve cultural sensitivity in a community hospital.

Southern Research Station Global Change Research Strategy 2011-2019

Treesearch

Kier Klepzig; Zoe Hoyle; Stevin Westcott; Emrys Treasure

2012-01-01

In keeping with the goals of the Research and Development agenda of the Forest Service, U.S. Department of Agriculture (USDA), the Southern Research Station (SRS) provides the information and technology needed to develop best management practices for the forest lands of the Southern United States, where science-guided actions are needed to sustain ecosystem health,...

Elections: DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

DTIC Science & Technology

2016-04-01

Acknowledgments Contact Acknowledgments Related GAO Products Page 75 GAO-16-378 DOD Overseas Absentee Voting U.S. Postal Service: Actions... Products Page 76 GAO-16-378 DOD Overseas Absentee Voting Election Reform: Nine States’ Experiences Implementing Federal Requirements for...ELECTIONS DOD Needs More Comprehensive Planning to Address Military and Overseas Absentee Voting Challenges

Excerpts from Managing CQI in Radiology and Diagnostic Imaging Services: A CQI Handbook.

PubMed

Joseph, E D; Lesher, C; Zage, R

1994-01-01

Continuous quality improvement (CQI) is currently the most popular and influential quality management program used in healthcare organizations. It is an effective methodology for identifying and acting on opportunities to improve the efficiency, effectiveness and value of services provided to customers. CQI implementation can be broken down into four components: (1) achievement objectives and goal identification, (2) system process analysis, (3) action planning and implementation, and (4) performance measurement and follow-up. As the project team establishes goals, it should consider customer and staff needs, what constitutes "quality," existing guidelines and regulations, and how results will be measured. Many techniques can be used to analyze the procedure or function targeted for improvement, including charts and diagrams, formal monitoring, data collection and statistical analysis. After the project team has identified potential service improvements, they develop an action plan, which may include education, recruitment, reassignment or equipment acquisition. The team must consider the impact of proposed changes and the financial and logistical feasibility of various proposals. The dynamic challenges of radiology and diagnostic imaging cannot be addressed through single, isolated actions; efforts to improve quality should be continuous. Accordingly, the project team should measure and analyze results of the action plan, reappraise goals and look for opportunities to further improve service.

Transfusion service disaster planning.

PubMed

Bundy, K L; Foss, M L; Stubbs, J R

2008-01-01

The Mayo Clinic, in Rochester, Minnesota, recently set forth a directive to develop a Mayo Emergency Incident Command System (MEICS) plan to respond to major disasters. The MEICS plan that was developed interfaces with national response plans to ensure effective communication and coordination between our institution and local, state, and federal agencies to establish a common language and communication structure. The MEICS plan addresses multiple aspects of dealing with resource needs during a crisis, including the need for blood and transfusion medicine services. The MEICS plan was developed to supplement our current local emergency preparedness procedures and provide a mechanism for responding to the escalating severity of an emergency to deal with situations of a magnitude that is outside the normal experience. A plan was developed to interface the existing Transfusion Medicine disaster plan standard operating procedures (SOP) with the institutional and Department of Laboratory Medicine (DLMP) MEICS plans. The first step in developing this interface was defining MEICS. Other major steps were defining the chain of command, developing a method for visually indicating who is "in charge," planning communication, defining the actions to be taken, assessing resource needs, developing flowcharts and updating SOPs, and developing a blood rationing team to deal with anticipated blood shortages. Several key features of the interface and updated disaster plan that were developed are calling trees for response personnel, plans for relocating leadership to alternative command centers, and action sheets to assist with resource assessment. The action sheets also provide documentation of key actions by response personnel.

Obtaining Technical Support for Superfund, RCRA and Brownfields Site Issues Fact Sheet

EPA Pesticide Factsheets

EPA’s Technical Support Centers (TSCs) and other technical support services are available to Regional RemedialProject Managers, Corrective Action Staff, and On-Scene Coordinators needing specialized technical expertisefor specific tasks or projects.

From Framework to Practice: Person-Directed Planning in the Real World.

PubMed

Martin, Lynn; Grandia, Philip; Ouellette-Kuntz, Hélène; Cobigo, Virginie

2016-11-01

Person-directed planning (PDP) is an approach to planning supports that aims to redistribute power from the service system to individuals with intellectual and developmental disabilities (IDD) and natural supports, improve relationships and build community. To do this, the right people with the right attitudes engaging in the right actions are needed. This paper examines how key elements in PDP contribute to successes in planning. Researchers worked with three planning teams from different community service agencies using participatory action research techniques (i.e. free list and pile sort, Socratic wheel, whys/hows exercise). Most key elements of PDP were relevant to each team. Perceptions of which had most contributed to planning successes differed. The various elements of PDP are used by and useful to planning teams, although some may be more relevant to some successes than others because of specific goals, or the person's strengths and needs. © 2015 John Wiley & Sons Ltd.

Improving Community-Based Mental Health Care for Children: Translating Knowledge into Action

PubMed Central

Haine-Schlagel, Rachel; Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Trask, Emily; Fawley-King, Kya

2013-01-01

There is urgent need for improvement in community-based mental health care for children and families. Multiple studies have documented serious limitations in the effectiveness of “usual care.” Fortunately, many empirically-supported strategies to improve care have been developed, and thus there is now a great deal of knowledge available to address this significant public health problem. The goal of this selective review is to highlight and synthesize that empirically-supported knowledge to stimulate and facilitate the needed translation of knowledge into action. The review provides a sound foundation for constructing improved services by consolidating descriptive data on the status quo in children’s mental health care, as well as evidence for an array of promising strategies to improve (a) Service access and engagement; (b) Delivery of evidence-based practices; and (c) Outcome accountability. A multi-level framework is used to highlight recommended care improvement targets. PMID:23212902

Parents’ actions, challenges, and needs while enabling participation of children with a physical disability: a scoping review

PubMed Central

2012-01-01

Background Pediatric rehabilitation considers Family-centered service (FCS) as a way to increase participation of children with a physical disability in daily life. An important principal is that parents greatly contribute to their child’s participation at school, at home, and in the community. However, it is unclear what kind of information is available from literature about what parents actually do to support their child’s participation and what problems and needs they experience? Hence, the aim of this study was to provide an overview of the actions, challenges, and needs of parents in enabling participation of their child with a physical disability that is neurological and non-progressive in nature. Methods Scoping review with extensive literature search (September 2011) and a thematic analysis to synthesize findings. Results Fourteen relevant articles revealed two major themes: ‘parents enable and support performance of meaningful activities’ and ‘parents enable, change and use the environment’. Each theme holds a number of actions (e.g. choosing the right type of meaningful activities for facilitating social contacts) and challenges (e.g. negative attitudes of other people). Less information is available about the needs of parents. Conclusions This study indicates that parents apply a broad range of strategies to support participation of their children. They experience many challenges, especially as a result of constraints in the social and physical environments. However, this review also shows that little is known about needs of parents in facilitating participation. As Family-centered service (FCS) philosophy is all about the needs of the child and the family, it is essential to further investigate the needs of the parents and to understand if and to what extent they wish to be supported in enabling their child’s participation in daily life. PMID:23137074

[Health care units image development on the market of medical services].

PubMed

Kemicer-Chmielewska, Ewa; Karakiewicz, Beata

2010-01-01

The cause for this document is to present a deliberation on public health facility image development on the medical services market. Marketization of the health service, growing awareness of Polish citizens and their expectation of high service quality as well as increased competition in the healthcare system market is the reason why health unit managers need to put a lot of strength and effort in sustaining or improving the image of the facility they run. Such action gives a chance for obtaining a competitive advantage.

Utility of the Montreal assessment of need questionnaire for community mental health planning.

PubMed

Tremblay, Jacques; Bamvita, Jean-Marie; Grenier, Guy; Fleury, Marie-Josée

2014-09-01

Needs assessment facilitates mental health services planning, provision, and evaluation. This study aimed to (a) validate a new instrument, the Montreal Assessment of Needs Questionnaire (MANQ), and (b) use this to assess variations and predictors of need (number and seriousness) in 297 individuals with severe mental disorders for 18 months, during implementation of the Quebec Mental Health Action Plan. MANQ internal and external validations were adequate. Variables significantly associated with need number and seriousness variations were used to build multiple linear regression models. Autonomous housing, not receiving welfare, not having consulted a health educator, higher level of help from services, Alcohol Use Disorders Identification Test total score, and social support were associated with decreasing need number and seriousness over time. Having a higher education was also associated with decreasing need number. In a reform context, the MANQ's unique ability to detect rapid improvement in patient needs has usefulness for Quebec mental health planning.

Mass Transit: Actions Needed for the BART Airport Extension

DOT National Transportation Integrated Search

1996-05-31

The Bay Area Rapid Transit District (BART) intends to spend over $1.1 billion, including $750 million in federal funds, to extend mass transit service to the San Francisco International Airport. The project is controversial, encountering both widespr...

49 CFR 375.203 - What actions of an individual shipper may limit or reduce my normal liability?

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROTECTION REGULATIONS Before Offering Services to My Customers Liability Considerations § 375.203 What... includes perishable, dangerous, or hazardous articles in the shipment without your knowledge, you need not...

7 CFR 36.2 - Initiating action on grade standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the need for new or revised standards; (ii) Collect technical, marketing, or other appropriate data....2 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER...

An Examination of the Vocational Rehabilitation Needs of American Indians with Behavioral Health Diagnoses in New York State. Final Report.

ERIC Educational Resources Information Center

Marshall, Catherine A.; And Others

A participatory action research project examined vocational rehabilitation (VR) services provided in New York State to American Indians with behavioral health diagnoses, including dual diagnoses involving substance abuse. In 1991, the New York public VR system had 81 American Indians apply for VR services (only 2.8 percent of American Indians with…

An integrated health and social care organisation in Sweden: creation and structure of a unique local public health and social care system.

PubMed

Øvretveit, John; Hansson, Johan; Brommels, Mats

2010-10-01

Research and citizens have noted failures in coordinating health and social services and professionals, and the need to address this issue to realize benefits from increasing specialisation. Different methods have been proposed and one has been structural integration of separate services within one organisation. This paper reports an empirical longitudinal study of the development of an integrated health and social care organisation in Sweden combining service provision, purchasing and political governance for a defined population. The study found a combination of influences contributed to the development of this new organisation. The initial structural macro-integration facilitated, but did not of itself result in better clinical care coordination. Other actions were needed to modify the specialised systems and cultures which the organisation inherited. The study design was not able to establish with any degree of certainty whether better patient and cost outcomes resulted, but it did find structural and process changes which make improved outcomes likely. The study concludes that coordinated actions at different levels and of different types were needed to achieve care coordination for patients and that a phased approach was necessary where management capacity and outside expertise are limited. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

DOD Education Benefits: Further Actions Needed to Improve Oversight of Tuition Assistance Program. Testimony before the Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security, Committee on Homeland Security and Governmental Affairs, United States Senate. GAO-11-389T

ERIC Educational Resources Information Center

Scott, George A.

2011-01-01

This testimony discusses the Department of Defense's (DOD) oversight of its Military Tuition Assistance (TA) Program. In fiscal year 2010, the TA Program provided $531 million in tuition assistance to approximately 302,000 service members who elected to pursue off-duty postsecondary education. DOD offers these benefits to service members in order…

Additional Actions Needed to Mitigate Risks of Unsuitable Life Insurance Sales to Junior Enlisted Service Members

DTIC Science & Technology

2011-08-23

Service member has no formal banking relationship. 35 • Knowingly offering or giving anything of value to a Service member with a pay grade of E -4...provided briefing charts summarizing our tentative findings to the Committee on Banking , Housing, and Urban Affairs of the Senate and the Committee on...Inspector General of the DoD shall submit an initial report on the results of the study conducted under subsection (a) to the Committee on Banking

Seagrass ecosystem services - What's next?

PubMed

Nordlund, Lina Mtwana; Jackson, Emma L; Nakaoka, Masahiro; Samper-Villarreal, Jimena; Beca-Carretero, Pedro; Creed, Joel C

2017-09-20

Seagrasses, marine flowering plants, provide a wide range of ecosystem services, defined here as natural processes and components that directly or indirectly benefit human needs. Recent research has shown that there are still many gaps in our comprehension of seagrass ecosystem service provision. Furthermore, there seems to be little public knowledge of seagrasses in general and the benefits they provide. This begs the questions: how do we move forward with the information we have? What other information do we need and what actions do we need to take in order to improve the situation and appreciation for seagrass? Based on the outcomes from an international expert knowledge eliciting workshop, three key areas to advance seagrass ecosystem service research were identified: 1) Variability of ecosystem services within seagrass meadows and among different meadows; 2) Seagrass ecosystem services in relation to, and their connection with, other coastal habitats; and 3) Improvement in the communication of seagrass ecosystem services to the public. Here we present ways forward to advance seagrass ecosystem service research in order to raise the profile of seagrass globally, as a means to establish more effective conservation and restoration of these important coastal habitats around the world. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Energy Management Needs; A Project to Develop Solutions for Higher Education's Energy Problems in the 1980's.

ERIC Educational Resources Information Center

Coldren, Sharon L.; Mitchell, Cecilia

Current patterns of energy management within higher education institutions and energy-related information and services that are needed by senior administrators and others to develop and improve energy management and planning on campus were studied. The findings and recommendations will be used to help develop a new research and action program for…

Stand for Children: Pray, Speak Out, and Act. Multi-Faith Resource Materials 1996.

ERIC Educational Resources Information Center

duMond, Marge, Ed.

The primary goal of the Children's Sabbaths and Children's Days is to inspire new long-term actions to help children and families. During the Children's Sabbath, religious services and programs focus on the needs of children and ways in which the religious community can help meet those needs. This booklet is designed to provide religious…

Cut fossil fuel links and curb burden on the NHS.

PubMed

Munro, Alice

2017-06-21

At a time when the NHS is struggling to meet demand, it is easy to regard the health impact of climate change as less urgent than the immediate needs of patients. However, action now to limit the effects of climate change would also reduce demands on the health service and help us to meet the healthcare needs of future generations.

Gaining a Competitive Edge through Action Design Research

NASA Astrophysics Data System (ADS)

Alexa, L.; Alexa, M.; Avasilcăi, S.

2016-08-01

The current business environment is characterized by increased competition and highly innovative approach, in order to create products and services to better respond to the costumers’ needs and expectations. In this specific context, the research approaches need to be more flexible and business oriented and so, throughout the paper we have used a research method that combines design research and action research, named Action Design Research which is a research method used for generating prescriptive design knowledge through building and evaluating IT artifacts in an organizational setting [1]. Following the Action Design Research stages and principles: problem identification, building, intervention and evaluation, reflection and learning and formalization of learning, the research team has developed an online instrument used to actively involve the consumer in the product development process, in order to generate a better consumers insight regarding their needs and desires and to design and/or adjust the product accordingly. The customer engagement IT tool created and tested by using Action Design Research, E-PICUS, has been developed within the framework of the research project „E-solutions for innovation through customer pro-active involvement in value creation to increase organisational competitiveness (E-PICUS)”, PN- II-PT-PCCA-2013-4-1811, currently undergoing.

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications--part II.

PubMed

Woersching, Joanna C; Snyder, Audrey E

2004-01-01

Results reported in Part I of the Earthquakes in El Salvador series (see Disaster Management & Response 2003;1:105-9) indicated clinically relevant findings. The findings indicated a need for greater public health action within all five categories reviewed: healthcare, access to healthcare, housing, food, water and sanitation. Significant results between urban and rural communities indicated a need for broader community aid, public health and sanitation services to rural areas. Faster and more efficient disaster management and care services throughout the San Sebastian community were also necessary modifications.

Use-Inspired Data Information Services for NOAA's National Centers for Environmental Information

NASA Astrophysics Data System (ADS)

Owen, T.

2015-12-01

Leveraging environmental data and information to make specific, informed decisions is critical to the Nation's economy, environment, and public safety. The ability to successfully transform past and recent data into environmental intelligence is predicated on the articulation of use-inspired, actionable requirements for product and service development. With the formation of the National Centers for Environmental Information (NCEI), there is a unique opportunity to revolutionize the delivery of information services in support of customer requirements. Such delivery cuts across the disciplines of meteorology, geophysics, and oceanography, as well as regions and sectors for the United States. At NCEI, information services are based on a two-way dialogue that (i) raises awareness of environmental data products and services and (ii) captures user needs for product and services sustainment and development. To this end, NCEI information services has developed a formal process for collecting user needs and translating them into requirements. This process reflects economically-prevalent and regionally-focused sectors based on Census Bureau classifications.

Developing a vision and strategic action plan for future community-based residency training.

PubMed

Skelton, Jann B; Owen, James A

2016-01-01

The Community Pharmacy Residency Program (CPRP) Planning Committee convened to develop a vision and a strategic action plan for the advancement of community pharmacy residency training. Aligned with the profession's efforts to achieve provider status and expand access to care, the Future Vision and Action Plan for Community-based Residency Training will provide guidance, direction, and a strategic action plan for community-based residency training to ensure that the future needs of community-based pharmacist practitioners are met. National thought leaders, selected because of their leadership in pharmacy practice, academia, and residency training, served on the planning committee. The committee conducted a series of conference calls and an in-person strategic planning meeting held on January 13-14, 2015. Outcomes from the discussions were supplemented with related information from the literature. Results of a survey of CPRP directors and preceptors also informed the planning process. The vision and strategic action plan for community-based residency training is intended to advance training to meet the emerging needs of patients in communities that are served by the pharmacy profession. The group anticipated the advanced skills required of pharmacists serving as community-based pharmacist practitioners and the likely education, training and competencies required by future residency graduates in order to deliver these services. The vision reflects a transformation of community residency training, from CPRPs to community-based residency training, and embodies the concept that residency training should be primarily focused on training the individual pharmacist practitioner based on the needs of patients served within the community, and not on the physical location where pharmacy services are provided. The development of a vision statement, core values statements, and strategic action plan will provide support, guidance, and direction to the profession of pharmacy to continue the advancement and expansion of community-based residency training. Published by Elsevier Inc.

Using Photovoice, Latina Transgender Women Identify Priorities in a New Immigrant-Destination State

PubMed Central

Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Simán, Florence; Garcia, Manuel; Abraham, Claire; Sun, Christina J.

2016-01-01

Little is known about the immigrant Latino/a transgender community in the southeastern United States. This study used photovoice, a methodology aligned with community-based participatory research, to explore needs, assets, and priorities of Latina transgender women in North Carolina. Nine immigrant Latina male-to-female transgender women documented their daily experiences through photography, engaged in empowerment-based photo-discussions, and organized a bilingual community forum to move knowledge to action. From the participants’ photographs and words, 11 themes emerged in three domains: daily challenges (e.g., health risks, uncertainty about the future, discrimination, and anxiety about family reactions); needs and priorities (e.g., health and social services, emotional support, and collective action); and community strengths and assets (e.g., supportive individuals and institutions, wisdom through lived experiences, and personal and professional goals). At the community forum, 60 influential advocates, including Latina transgender women, representatives from community-based organizations, health and social service providers, and law enforcement, reviewed findings and identified ten recommended actions. Overall, photovoice served to obtain rich qualitative insight into the lived experiences of Latina transgender women that was then shared with local leaders and agencies to help address priorities. PMID:27110226

Empowering people to be healthier: public health nutrition through the Ottawa Charter.

PubMed

Flynn, Mary A T

2015-08-01

The WHO's Ottawa Charter highlights five priority areas for taking action in public health. Only one of them is at the individual level as action at more upstream intervention levels, such as community or policy levels, is critical for enabling individuals to succeed. The objective of the present paper is to give insight into the many complex processes involved in public health nutrition by describing the Ottawa Charter's five priority areas for taking action using public health nutrition initiatives I have been involved in. Evidence-based guidelines for healthy eating and infant feeding provide an essential basis for individuals to 'develop personal skills' (Action Area 1). 'Re-orienting health services' (Action Area 2) can address the needs of vulnerable population subgroups, such as the culturally sensitive diabetes prevention programme established for an Indo-Asian community in Canada. Identifying geographic areas at high risk of childhood obesity enables better strategic planning and targeting of resources to 'strengthen community action' (Action Area 3). Calorie menu labelling can 'create supportive environments' (Action Area 4) through encouraging a demand for less energy-dense, healthier food options. 'Building healthy public policy' (Action Area 5) to implement mandatory folic acid food fortification for prevention of birth defects has many advantages over a voluntary approach. In conclusion, evaluation and evidence-based decision-making needs to take account of different strategies used to take action in each of these priority areas. For this, the randomised control trial needs adaptation to determine the best practice in public health nutrition where interventions play out in real life with all its confounding factors.

A Toolkit to assess health needs for congenital disorders in low- and middle-income countries: an instrument for public health action.

PubMed

Nacul, L C; Stewart, A; Alberg, C; Chowdhury, S; Darlison, M W; Grollman, C; Hall, A; Modell, B; Moorthie, S; Sagoo, G S; Burton, H

2014-06-01

In 2010 the World Health Assembly called for action to improve the care and prevention of congenital disorders, noting that technical guidance would be required for this task, especially in low- and middle-income countries. Responding to this call, we have developed a freely available web-accessible Toolkit for assessing health needs for congenital disorders. Materials for the Toolkit website (http://toolkit.phgfoundation.org) were prepared by an iterative process of writing, discussion and modification by the project team, with advice from external experts. A customized database was developed using epidemiological, demographic, socio-economic and health-services data from a range of validated sources. Document-processing and data integration software combines data from the database with a template to generate topic- and country-specific Calculator documents for quantitative analysis. The Toolkit guides users through selection of topics (including both clinical conditions and relevant health services), assembly and evaluation of qualitative and quantitative information, assessment of the potential effects of selected interventions, and planning and prioritization of actions to reduce the risk or prevalence of congenital disorders. The Toolkit enables users without epidemiological or public health expertise to undertake health needs assessment as a prerequisite for strategic planning in relation to congenital disorders in their country or region. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

76 FR 31988 - Agency Information Collection Activities: Proposed Collection; Comments Requested

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... DEPARTMENT OF JUSTICE Office of Community Oriented Policing Services [OMB Number 1103-NEW] Agency Information Collection Activities: Proposed Collection; Comments Requested ACTION: 30-Day Notice of Information Collection under Review: COPS Police and Communities Together (PACT) 360 Needs Assessment Survey...

Understanding the dynamics of sustainable change: A 20-year case study of integrated health and social care.

PubMed

Klinga, Charlotte; Hasson, Henna; Andreen Sachs, Magna; Hansson, Johan

2018-06-04

Change initiatives face many challenges, and only a few lead to long-term sustainability. One area in which the challenge of achieving long-term sustainability is particularly noticeable is integrated health and social care. Service integration is crucial for a wide range of patients including people with complex mental health and social care needs. However, previous research has focused on the initiation, resistance and implementation of change, while longitudinal studies remain sparse. The objective of this study was therefore to gain insight into the dynamics of sustainable changes in integrated health and social care through an analysis of local actions that were triggered by a national policy. A retrospective and qualitative case-study research design was used, and data from the model organisation's steering-committee minutes covering 1995-2015 were gathered and analysed. The analysis generated a narrative case description, which was mirrored to the key elements of the Dynamic Sustainability Framework (DSF). The development of inter-sectoral cooperation was characterized by a participatory approach in which a shared structure was created to support cooperation and on-going quality improvement and learning based on the needs of the service user. A key management principle was cooperation, not only on all organisational levels, but also with service users, stakeholder associations and other partner organisations. It was shown that all these parts were interrelated and collectively contributed to the creation of a structure and a culture which supported the development of a dynamic sustainable health and social care. This study provides valuable insights into the dynamics of organizational sustainability and understanding of key managerial actions taken to establish, develop and support integration of health and social care for people with complex mental health needs. The service user involvement and regular reviews of service users' needs were essential in order to tailor services to the needs. Another major finding was the importance of continuously adapting the content of the change to suit its context. Hence, continuous refinement of the change content was found to be more important than designing the change at the pre-implementation stage.

The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study.

PubMed

O'Hara, Jane K; Lawton, Rebecca J; Armitage, Gerry; Sheard, Laura; Marsh, Claire; Cocks, Kim; McEachan, Rosie R C; Reynolds, Caroline; Watt, Ian; Wright, John

2016-11-28

There is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Here we describe the development and feasibility testing of an intervention that collects patient feedback on patient safety, brings together staff to consider this feedback and to plan improvement strategies. We address two research questions: i) to explore the feasibility of the process of systematically collecting feedback from patients about the safety of care as part of the PRASE intervention; and, ii) to explore the feasibility and acceptability of the PRASE intervention for staff, and to understand more about how staff use the patient feedback for service improvement. We conducted a feasibility study using a wait-list controlled design across six wards within an acute teaching hospital. Intervention wards were asked to participate in two cycles of the PRASE (Patient Reporting & Action for a Safe Environment) intervention across a six-month period. Participants were patients on participating wards. To explore the acceptability of the intervention for staff, observations of action planning meetings, interviews with a lead person for the intervention on each ward and recorded researcher reflections were analysed thematically and synthesised. Recruitment of patients using computer tablets at their bedside was straightforward, with the majority of patients willing and able to provide feedback. Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups. In general, ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, although engagement with the process was variable. Gathering a multidisciplinary team together for action planning was found to be challenging, and implementing action plans was sometimes hindered by the need to co-ordinate action across multiple services. The PRASE intervention was found to be acceptable to staff and patients. However, before proceeding to a full cluster randomised controlled trial, the intervention requires adaptation to account for the difficulties in implementing action plans within three months, the need for a facilitator to support the action planning meetings, and the provision of training and senior management support for participating ward teams. The PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.

The Needs of Tribal Men and the Social Service Providers on or Near the Nez Perce Indian Nation.

ERIC Educational Resources Information Center

High Eagle, Gordon; And Others

This report results from an action research project of the Nee Mee Poom Ha Hum (Men's Coalition), investigating the needs of tribal men in the Nez Perce Indian Nation, as part of planning to improve men's development. Research was directed toward interviewing a stratified random sample of tribal men and interviewing the directors and employees of…

[Strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine: basic modules and their components].

PubMed

Федосюк, Роман Н

In recent years, the problem of patient safety has become top-priority in further improvement of national healthcare systems in all developed countries. To develop a modular structure and a component composition of the strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine as a part of the National Action Plan. Major domestic priorities, substantiated and made public by the author in previous works, are taken as the basis for the modular structuring of the action plan. Existing foreign prototypes, evaluated for the patient safety effectiveness and the potential for the adaptation to domestic conditions, as well as author's own innovations are offered for a component filling-up of each module. Eight modules - infectious safety, surgical safety, pharmaceutical safety, infrastructural safety, incident monitoring and reporting, education and training, research and awards - have been proposed. Individual components for each of the modules are selected from a variety of foreign prototypes and author's own developments. Inter-modular stratification of the components into short-term perspective tools and long-term perspective tools, depending on the amount of resources needed for their implementation, is carried out. The strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine is the embodiment, within a particular specialty, of the wider National Action Plan developed by the First National Congress on Patient Safety (Kiev, 2012) on the initiative of the Council of Europe and aimed at the fulfillment of international obligations of Ukraine in the healthcare sector. Its implementation will contribute to enhancing the safety of anesthesia and intensive care services in Ukraine and further development of the specialty.

Library Service to the People of New York State. A Long-Range Program, October 1, 1987-September 30, 1992, for the Improvement of Library Services Utilizing Local, State and Federal Resources. Supplement 1: LSCA Program Purposes: Needs and Intended Actions. Supplement 2: Policy Guidelines on the Administration of LSCA funds, 1987-88.

ERIC Educational Resources Information Center

New York State Library, Albany.

This annual report on the comprehensive five-year program for the enhancement of libraries in New York State achieves the following: (1) provides a benchmark for the continuing planning, development, and evaluation of state library services; (2) summarizes the objectives, policies, and programs undertaken for the improvement of those services; (3)…

Trust the process: community health psychology after Occupy.

PubMed

Cornish, Flora; Montenegro, Cristian; van Reisen, Kirsten; Zaka, Flavia; Sevitt, James

2014-01-01

This article argues that community health psychology's core strategy of 'community mobilisation' is in need of renewal and proposes a new way of conceptualising community health action. Taking the Occupy movement as an example, we critique modernist understandings of community mobilisation, which are based on instrumental action in the service of a predetermined goal. Aiming to re-invigorate the 'process' tradition of community health psychology, we explore possibilities of an open-ended, anti-hierarchical and inclusive mode of community action, which we label 'trusting the process'. The gains to be made are unpredictable, but we suggest that the risk is worth taking.

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

PubMed

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

2005-10-01

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

Report of the Special Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care.

PubMed

Anderson, R J; Milburn, L T

1990-04-01

Texas not-for-profit hospitals recently received intense scrutiny regarding their involvement in charity-related contributions when Texas Attorney General Jim Mattox formed the Task Force to Study Not-for-Profit Hospitals and Unsponsored Charity Care. This article details the task force's recommendations concerning charity care obligations of Texas not-for-profit hospitals. Setting the stage for these recommendations was a broad definition of charitable services that included costs for delivering services to indigents and for providing community services to fulfill the hospital's charitable, religious, educational, research, or eleemosynary purposes. The task force unanimously agreed that a mandated level of charity care was incongruent with the hospitals' individual missions and specific community needs, but they supported the formation of standard accounting procedures for charitable services and the voluntary submission of their mission statements to the attorney general of Texas. While the hospitals' role in providing charitable services is very important, the task force emphasized that the overall need for adequate financing and reimbursement of health care is a societal problem that needs specific state and federal actions.

Decentralized energy systems for clean electricity access

NASA Astrophysics Data System (ADS)

Alstone, Peter; Gershenson, Dimitry; Kammen, Daniel M.

2015-04-01

Innovative approaches are needed to address the needs of the 1.3 billion people lacking electricity, while simultaneously transitioning to a decarbonized energy system. With particular focus on the energy needs of the underserved, we present an analytic and conceptual framework that clarifies the heterogeneous continuum of centralized on-grid electricity, autonomous mini- or community grids, and distributed, individual energy services. A historical analysis shows that the present day is a unique moment in the history of electrification where decentralized energy networks are rapidly spreading, based on super-efficient end-use appliances and low-cost photovoltaics. We document how this evolution is supported by critical and widely available information technologies, particularly mobile phones and virtual financial services. These disruptive technology systems can rapidly increase access to basic electricity services and directly inform the emerging Sustainable Development Goals for quality of life, while simultaneously driving action towards low-carbon, Earth-sustaining, inclusive energy systems.

Expressing the sense of Congress regarding the need to prevent the closure or consolidation of post offices.

THOMAS, 112th Congress

Rep. Emerson, Jo Ann [R-MO-8

2011-01-07

House - 02/08/2011 Referred to the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor Policy. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Health Services for Migrant Children.

ERIC Educational Resources Information Center

Bove, Beverly A.

Intended as a resource for administrators, teachers, nurses, paraprofessionals, health coordinators, and community action personnel who are interested in meeting the health needs of migrant children, this handbook offers suggestions for organizing community resources in providing health care to migrant children. Poor nutrition, the lack of dental…

ALA Meets at Ground-Zero, New York City Conference Report.

ERIC Educational Resources Information Center

Wilson Library Bulletin, 1986

1986-01-01

Description of 1986 American Library Association Conference summarizes significant organizational actions and presentations on upgrading automation systems, censorship, federal libraries, fees and public library services, black community information needs, Linked Systems Project, libraries and the homeless, new products exhibited, and 1994…

Early socialization of prosocial behavior: Patterns in parents' encouragement of toddlers' helping in an everyday household task.

PubMed

Waugh, Whitney; Brownell, Celia; Pollock, Brianna

2015-05-01

Patterns in parents' socialization of prosocial behavior in 18- and 24-month-olds (n=46) were investigated during an everyday household chore that parents were asked to complete with their toddlers. Two socialization approaches were distinguished, one focused on specific requests for concrete actions needed to complete an immediate, concrete goal ("action-oriented"), and a second focused on the more abstract needs and emotions of the parent and the child's role as a helper ("need-oriented'). Parents were equally active at both ages in trying to elicit children's help but used different strategies with younger and older toddlers. With 18-month-olds they used more action-oriented approaches, whereas with 24-month-olds they increased their use of need-oriented approaches. They also regulated the attention of younger toddlers more, and more often socially approved older toddlers' helping. Thus, how parents prompt, support, and encourage prosocial behavior changes over the second year from utilizing primarily concrete, goal-directed requests in the service of the immediate task, to increasingly emphasizing more abstract needs and emotions of the recipient and the child's role as a helper. Copyright © 2015 Elsevier Inc. All rights reserved.

[Environmental medicine in public health service--a social responsibility and its consequences].

PubMed

Thriene, B

2001-02-01

The special committee for "Environmental Medicine" established by the Federal Association of Doctors in the German Public Health Service presents its paper entitled "Environmental Medicine in the Public Health Service--A Social Responsibility and its Consequences: Propositions with regard to the situation, aims, strategies, and opportunities for action". The paper includes core ideas and responsibilities in the public health service. It aims at providing a number of guidelines for implementing "Environment and Health" ("Umwelt und Gesundheit"), an action programme by the Federal Ministry of Environmental Protection and the Ministry of Health, as well as "Health 21" ("Gesundheit 21"), the framework concept "Health for all" for the WHO's European Region. The paper also aims at initiating and facilitating steps for joint action by the Public Health Service. These theses were passed on to Mrs. Andrea Fischer, the Federal Minister of Health, during a meeting with the Board of the Association. In Germany, environment-related public health protection is well established in the Public Health Departments and state institutes/departments within the scope of public health provision and disease prevention. Typical responsibilities include environmental hygiene and environment-related medical services which have increased in importance. The range of responsibilities and its current political importance are a result of environment-related public health risks, the social situation of the population, also with regard to health issues, and the scope of responsibilities and competencies by doctors and staff in the public health departments. With the people's demands for health, quality of life and life expectancy, this need for action increases. In this paper, judicial, professional, and personal consequence are presented which arise as public health authorities assume these responsibilities.

Utility of the Montreal Assessment of Need Questionnaire for Community Mental Health Planning

PubMed Central

Tremblay, Jacques; Bamvita, Jean-Marie; Grenier, Guy; Fleury, Marie-Josée

2014-01-01

Abstract Needs assessment facilitates mental health services planning, provision, and evaluation. This study aimed to a) validate a new instrument, the Montreal Assessment of Needs Questionnaire (MANQ), and b) use this to assess variations and predictors of need (number and seriousness) in 297 individuals with severe mental disorders for 18 months, during implementation of the Quebec Mental Health Action Plan. MANQ internal and external validations were adequate. Variables significantly associated with need number and seriousness variations were used to build multiple linear regression models. Autonomous housing, not receiving welfare, not having consulted a health educator, higher level of help from services, Alcohol Use Disorders Identification Test total score, and social support were associated with decreasing need number and seriousness over time. Having a higher education was also associated with decreasing need number. In a reform context, the MANQ’s unique ability to detect rapid improvement in patient needs has usefulness for Quebec mental health planning. PMID:25099300

Using a cognitive architecture for general purpose service robot control

NASA Astrophysics Data System (ADS)

Puigbo, Jordi-Ysard; Pumarola, Albert; Angulo, Cecilio; Tellez, Ricardo

2015-04-01

A humanoid service robot equipped with a set of simple action skills including navigating, grasping, recognising objects or people, among others, is considered in this paper. By using those skills the robot should complete a voice command expressed in natural language encoding a complex task (defined as the concatenation of a number of those basic skills). As a main feature, no traditional planner has been used to decide skills to be activated, as well as in which sequence. Instead, the SOAR cognitive architecture acts as the reasoner by selecting which action the robot should complete, addressing it towards the goal. Our proposal allows to include new goals for the robot just by adding new skills (without the need to encode new plans). The proposed architecture has been tested on a human-sized humanoid robot, REEM, acting as a general purpose service robot.

Conference on European Co-operation in the Field of Vocational Guidance for Young People and Adults (Berlin, November 27-28, 1990). Summary Report.

ERIC Educational Resources Information Center

Watts, A. G.

1990-01-01

A conference set the stage for the development of European Community (EC) policy in the field of vocational guidance and possible action. Discussion focused on the need for trans-frontier guidance and the need for communication and cooperation between guidance services to support educational and occupational mobility across the EC as a whole. The…

The Library and the Economic Community; A Market Analysis of Information Needs of Business and Industry in the Communities of Pasadena and Pomona, California.

ERIC Educational Resources Information Center

Meyer, Robert S.; Rostvold, Gerhard N.

This study represents a market analysis of the needs, habits and desires of business firms concerning their acquisition and utilization of the information required in their work in order to improve public library services to business and industry through cooperative library action. The key recommendations were: the public library should be the…

Toward a Fifth Generation of Community Colleges: Seven Priorities for Action.

ERIC Educational Resources Information Center

Deegan, William L.; Tillery, Dale

1987-01-01

Proposes an agenda of community college priorities for the coming decade to guide policymakers in their deliberations. Highlights needs related to outcomes assessment, organizational and staff development, mission conflicts, governance structures, curriculum development, student service programs, and linkages with other educational providers. (AYC)

5 CFR 2429.17 - Reconsideration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... action of the Authority, unless so ordered by the Authority. A motion for reconsideration need not be... move for reconsideration of such final decision or order. The motion shall be filed within ten (10) days after service of the Authority's decision or order. A motion for reconsideration shall state with...

5 CFR 2429.17 - Reconsideration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... action of the Authority, unless so ordered by the Authority. A motion for reconsideration need not be... move for reconsideration of such final decision or order. The motion shall be filed within ten (10) days after service of the Authority's decision or order. A motion for reconsideration shall state with...

Creating a vision for the future: key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services.

PubMed

Fredriksen-Goldsen, Karen I; Hoy-Ellis, Charles P; Goldsen, Jayn; Emlet, Charles A; Hooyman, Nancy R

2014-01-01

Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities.

Creating a Vision for the Future: Key Competencies and Strategies for Culturally Competent Practice With Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults in the Health and Human Services

PubMed Central

FREDRIKSEN-GOLDSEN, KAREN I.; HOY-ELLIS, CHARLES P.; GOLDSEN, JAYN; EMLET, CHARLES A.; HOOYMAN, NANCY R.

2014-01-01

Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities. PMID:24571387

[Food and nutrition in primary care in Brazil].

PubMed

Nunes Pereira, Tatiane; Alves Monteiro, Renata; Pacheco Santos, Leonor Maria

To describe food and nutrition actions in primary health care in Brazil. Exploratory review of articles published between 2007 and 2016. Lilacs, PubMed, Scopus and Web of Science databases were consulted. 103 articles were included, mostly published between 2012 and 2016 and developed mainly in the Southeast region of Brazil. The most prevalent research topics were food behaviour or consumption, nutritional status and non-communicable diseases. Most research was led by universities and was focused on diagnosis. Few actions on health promotion, healthy eating, assistance, treatment, integral health care and prevention of diseases related to food and nutrition were found in the review. National interest in food and nutrition has increased, however academic production is still far from the actual needs for providing evidence that impacts health status. More research is needed to describe, propose and evaluate programmes and actions. Therefore, it is essential for closer relationships to be forged between universities, managers and health services in order to identify common interests and to develop research that meets the needs of the area and contribute to planning and improving programmes and actions. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Mobilizing cross-sector community partnerships to address the needs of criminal justice-involved older adults: a framework for action.

PubMed

Metzger, Lia; Ahalt, Cyrus; Kushel, Margot; Riker, Alissa; Williams, Brie

2017-09-11

Purpose The rapidly increasing number of older adults cycling through local criminal justice systems (jails, probation, and parole) suggests a need for greater collaboration among a diverse group of local stakeholders including professionals from healthcare delivery, public health, and criminal justice and directly affected individuals, their families, and advocates. The purpose of this paper is to develop a framework that local communities can use to understand and begin to address the needs of criminal justice-involved older adults. Design/methodology/approach The framework included solicit input from community stakeholders to identify pressing challenges facing criminal justice-involved older adults, conduct needs assessments of criminal justice-involved older adults and professionals working with them; implement quick-response interventions based on needs assessments; share findings with community stakeholders and generate public feedback; engage interdisciplinary group to develop an action plan to optimize services. Findings A five-step framework for creating an interdisciplinary community response is an effective approach to action planning and broad stakeholder engagement on behalf of older adults cycling through the criminal justice system. Originality/value This study proposes the Criminal Justice Involved Older Adults in Need of Treatment Initiative Framework for establishing an interdisciplinary community response to the growing population of medically and socially vulnerable criminal justice-involved older adults.

From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

PubMed

Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

2006-12-01

To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

Building Services and Systems To Support the Healthy Emotional Development of Young Children: An Action Guide for Policymakers. Promoting the Emotional Well-Being of Children and Families Policy Paper.

ERIC Educational Resources Information Center

Knitzer, Jane

Noting that there is a group of young children for whom emotional development does not proceed smoothly, placing the children at risk for poor cognitive, social, and behavioral outcomes, this policy paper paints a portrait of the kinds of young children and families who are in need of preventive, early intervention, or treatment services and…

Strategic Planning. Alliance Action Information Sheets

ERIC Educational Resources Information Center

Technical Assistance ALLIANCE for Parent Centers, 2005

2005-01-01

Executive Directors of parent centers have very challenging careers. For example, they need to ensure that high quality services are developed and provided; funds are raised; bills are paid on time; staff are hired, trained and supported; boards are recruited and effective; community awareness is high; and reports are accurate and submitted on…

76 FR 17400 - Proposed Priorities: Interventions To Promote Community Living Among Individuals With Disabilities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... and Rehabilitative Services proposes a funding priority for the Disability and Rehabilitation Research... action to focus research attention on areas of national need. We intend this priority to improve... disability and rehabilitation research; (2) foster an exchange of expertise, information, and [[Page 17401...

Adolescent Health Issues: State Actions 1995.

ERIC Educational Resources Information Center

Savage, Melissa Hough; Ourada, Joanne

Many adolescents need basic health care and other services that address risky behaviors such as sexual activity, violence, alcohol and other drug abuse, and the consequences of those behaviors. This publication summarizes approximately 250 laws and resolutions concerning adolescent health and related issues passed by the 50 states and the District…

Adolescent Health Issues: State Actions 1997.

ERIC Educational Resources Information Center

Kendell, Nicole

Many adolescents need basic health care and other services that address risky behaviors such as sexual activity, violence, alcohol and drug abuse, and the consequences of these behaviors. This publication summarizes laws and resolutions on adolescent health issues passed in 1997 state and territory legislative sessions. No 1997 legislative session…

38 CFR 61.43 - Rating criteria for special needs grant applications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... activities, physical activity, and plans for social engagement within the program and in the community; (3... of dying,” or activities of “getting things in order” or other therapeutic actions that help resolve... services that may optimize reintegration such as life-skills education, recreational activities, and follow...

Healthy Relationships and Building Developmental Assets in Middle School Students

ERIC Educational Resources Information Center

Carlisle, Mariko

2011-01-01

This action research project was designed to have the majority of middle school students engage in healthy relationships with their peers and teachers as the data suggested the need for improved interactions with others. Students contributed to team building lessons; implemented school community service learning projects; participated in an…

77 FR 19928 - Amendment of Class E Airspace; Hugo, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

.... Decommissioning of the Hugo Tactical Air Navigation System (TACAN) has made this action necessary for the safety... legal description is better clarified at the request of the National Aeronautical Navigation Services... to publication, it was discovered by NANS that the legal description needed editing by removing the...

Introduction

Treesearch

Theresa B. Jain

2010-01-01

Forests can play a role in carbon sequestration and mitigating CO2 emissions. However, what course of action needed to meet issues concerning carbon management and other ecosystem services for specific situations is not always clear. The National Silviculture Workshop, held in Boise, Idaho on June 15-18, 2009, focused on scientific information and management...

Is the Problem Cultural Incompetence or Racism?

PubMed

Rosenberg, Linda

2015-10-01

Clinical competence-including asking about and understanding the impact of a patient's culture-should be what we all expect when we seek treatment. Behavioral health organizations have opportunities to create culturally competent and responsive services. But we need to add another call to action-acknowledging and addressing the disparities caused by racism.

Expanding Collaboration for Literacy Promotion in Public and School Libraries.

ERIC Educational Resources Information Center

Callison, Daniel

1997-01-01

Explores mutual advantages for information literacy through public and school library partnerships. Highlights include different goals for the same audience, a shift in services and roles, exemplary national programs, and possibilities of joint collection development. Demonstrates the needs and actions to stimulate the opportunity for adolescents…

76 FR 30428 - Proposed Collection; Comment Request for Revenue Procedure 99-21

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... Revenue Procedure 99-21 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request for...: Disability Suspension. OMB Number: 1545-1649. Revenue Procedure Number: Revenue Procedure 99-21. Abstract: Revenue Procedure 99-21 describes the information that is needed to establish a claim that a taxpayer was...

76 FR 33744 - Final Priority; National Institute on Disability and Rehabilitation Research (NIDRR)-Disability...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... and Rehabilitation Research (NIDRR)--Disability Rehabilitation Research Project (DRRP)--Disability in... Rehabilitative Services announces a funding priority for the Disability and Rehabilitation Research Projects and...) 2011 and later years. We take this action to focus research attention on areas of national need. We...

78 FR 13376 - Chronic Wasting Disease Management Plan/Environmental Impact Statement, Shenandoah National Park

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

...] Chronic Wasting Disease Management Plan/Environmental Impact Statement, Shenandoah National Park AGENCY... National Park Service (NPS) is preparing a Chronic Wasting Disease Management Plan and Environmental Impact Statement (CWD Management Plan/EIS) for Shenandoah National Park, Virginia. Action is needed at this time...

Young Adults Deserve the Best: YALSA's Competencies in Action

ERIC Educational Resources Information Center

Flowers, Sarah

2010-01-01

As high school enrollment continues to rise, the need for effective librarianship serving young adults is greater than ever before. "Young Adults Deserve the Best: Competencies for Librarians Serving Youth," developed by Young Adult Library Services Association (YALSA), is a document outlining areas of focus for providing quality library service…

Consensus builds on population policy as ICPD PrepCom meetings conclude. Vatican objections firm and vocal.

PubMed

1994-04-29

In April, 1994, at UN headquarters in New York, delegates from almost 200 countries and nongovernmental organizations (NGOs) negotiated a Programme of Action to be ratified following more debate at the International Conference on Population and Development in Cairo in September. A sizable consensus emerged for this Preparatory Committee III (PrepCom) meeting. It has an expanded view of population policy that centers more on meeting individual needs and less on achieving strict demographic goals. Thus, it focuses on the unmet need for reproductive health services (family planning, basic women's health care, and services linked to sexually transmitted diseases). It considers women's status and female education as being important themselves as well as key determinants of fertility rates. Disagreement over access to abortion services and reproductive health services for adolescents remain. Unlike earlier world conferences, most of the world is working towards a consensus, while the Vatican and just a few small countries (Benin, Malta, Honduras, and Nicaragua) object to these services. Some topics that US National Conference of Catholic Bishops did not want in the Programme of Action were references to reducing the incidence of unsafe abortion, promoting condom use to prevent HIV/AIDS, and even safe motherhood. The US and Japan have committed sizable increases in population assistance. Some European countries are concerned about how their contributions would be allocated. US Undersecretary for Global Affairs and a mostly female 23-member US delegation attended PrepCom III. Most of the US delegates were from NGOs. Many country delegates were women. Many countries accepted recommendations of the women's caucus. The US's priorities are promotion of universal access to the full range of high quality family planning and reproductive health services; increasing women's status; child survival promotion; serving adolescent needs; augmenting the role and responsibility of men in reproductive health; strengthening the family; and sustainable development.

Quality maternity care for every woman, everywhere: a call to action.

PubMed

Koblinsky, Marjorie; Moyer, Cheryl A; Calvert, Clara; Campbell, James; Campbell, Oona M R; Feigl, Andrea B; Graham, Wendy J; Hatt, Laurel; Hodgins, Steve; Matthews, Zoe; McDougall, Lori; Moran, Allisyn C; Nandakumar, Allyala K; Langer, Ana

2016-11-05

To improve maternal health requires action to ensure quality maternal health care for all women and girls, and to guarantee access to care for those outside the system. In this paper, we highlight some of the most pressing issues in maternal health and ask: what steps can be taken in the next 5 years to catalyse action toward achieving the Sustainable Development Goal target of less than 70 maternal deaths per 100 000 livebirths by 2030, with no single country exceeding 140? What steps can be taken to ensure that high-quality maternal health care is prioritised for every woman and girl everywhere? We call on all stakeholders to work together in securing a healthy, prosperous future for all women. National and local governments must be supported by development partners, civil society, and the private sector in leading efforts to improve maternal-perinatal health. This effort means dedicating needed policies and resources, and sustaining implementation to address the many factors influencing maternal health-care provision and use. Five priority actions emerge for all partners: prioritise quality maternal health services that respond to the local specificities of need, and meet emerging challenges; promote equity through universal coverage of quality maternal health services, including for the most vulnerable women; increase the resilience and strength of health systems by optimising the health workforce, and improve facility capability; guarantee sustainable finances for maternal-perinatal health; and accelerate progress through evidence, advocacy, and accountability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Alcohol service provision for older people in an area experiencing high alcohol use and health inequalities.

PubMed

McCabe, Karen E; Ling, Jonathan; Wilson, Graeme B; Crosland, Ann; Kaner, Eileen F S; Haighton, Catherine A

2016-03-01

UK society is ageing. Older people who drink alcohol, drink more than those from previous generations, drink more frequently than other age groups and are more likely to drink at home and alone. Alcohol problems in later life however are often under-detected and under-reported meaning older people experiencing alcohol problems have high levels of unmet need. This study sought to identify existing services within South of Tyne, North East England to capture the extent of service provision for older drinkers and identify any gaps. The Age UK definition of 'older people' (aged 50 and over) was used. Services were contacted by telephone, managers or their deputy took part in semi-structured interviews. Forty six service providers were identified. Only one provided a specific intervention for older drinkers. Others typically provided services for age 18+. Among providers, there was no definitive definition of an older person. Data collection procedures within many organisations did not enable them to confirm whether older people were accessing services. Where alcohol was used alongside other drugs, alcohol use could remain unrecorded. To enable alcohol services to meet the needs of older people, greater understanding is needed of the patterns of drinking in later life, the experiences of older people, the scale and scope of the issue and guidance as to the most appropriate action to take. An awareness of the issues related to alcohol use in later life also needs to be integrated into commissioning of other services that impact upon older people. © Royal Society for Public Health 2015.

Development, empowerment and accountability of front line employees.

PubMed

Kaushik, Mradul; Mehta, Sanjay; Singh, Prashant; Gupta, Vivek; Singh, Ajay

2015-01-01

Facilitating patient-focused, cost-effective care throughout the continuum is a challenge that requires creativity of healthcare administrators. At BLK Super Specialty Hospital, a Guest Relationship Executive (GRE) and Patient Care Coordinator (PCC) role was developed to improve communication and linkage among clinical and non-clinical departments. Management also innovated various other processes which needed improvement for facilitating the improvement of services provided to the patients. Empowering PCC and GRE to take the initiative, make decisions and take actions to prevent and resolve service issues has elevated service levels and lead to an enhanced patient experience.

After-school enrichment and the activity theory: How can a management service organization assist schools with reducing the achievement gap among minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours?

NASA Astrophysics Data System (ADS)

Flowers, Reagan D.

The primary purpose of this study was to investigate how a management service organization can assist schools with reducing the achievement gap between minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours. Developing a strategic plan through creating a program that provides support services for the implementation of hands-on activities in STEM for children during the after-school hours was central to this purpose. This Project Demonstrating Excellence (PDE), a social action project, also presents historical and current after-school program developments in the nation. The study is quantitative and qualitative in nature. Surveys were utilized to quantitatively capture the opinions of participants in the social action project on three specific education related issues: (1) disparity in academic motivation of students to participate in after-school STEM enrichment programs; (2) whether teachers and school administrators saw a need for STEM after-school enrichment; and (3) developing STEM after-school programs that were centered on problem-solving and higher-order thinking skills to develop students' interest in STEM careers. The sample consisted of 50 participants comprised of students, teachers, and administrators. The focus groups and interviews provided the qualitative data for the study. The qualitative sample consisted of 14 participants comprised of students, parents and teachers, administrators, an education consultant, and a corporate sponsor. The empirical data obtained from the study survey, focus groups, and interviews provided a comprehensive profile on the current views and future expectations of STEM after-school enrichment, student and school needs, and community partnerships with STEM companies. Results of the study and review of the implementation of the social action project, C-STEM (communication, science, technology, engineering, and mathematics) Teacher and Student Support Services, Inc., revealed the need and focus for STEM after-school enrichment programs in Houston, Texas. This result, along with requirements of STEM Research and Special Programs Administrations and a multiyear and multilevel strategic plan inspired by this study, led to the conceptualization, development, and implementation of C-STEM Teacher and Student Support Services, Inc. at multiple schools in Houston, Texas. The purpose of C-STEM Teacher and Student Support Services, Inc. is to provide hands-on support services that encourage schools, organizations and families to improve academic achievement and socioemotional development through project-based learning in communication, science, technology, engineering, and mathematics (CSTEM) in grades 4-12.

Early socialization of prosocial behavior: Patterns in parents’ encouragement of toddlers’ helping in an everyday household task

PubMed Central

Waugh, Whitney; Brownell, Celia; Pollock, Brianna

2015-01-01

Patterns in parents’ socialization of prosocial behavior in 18- and 24-month-olds (n=46) were investigated during an everyday household chore that parents were asked to complete with their toddlers. Two socialization approaches were distinguished, one focused on specific requests for concrete actions needed to complete an immediate, concrete goal (“action-oriented”), and a second focused on the more abstract needs and emotions of the parent and the child's role as a helper (“need-oriented’). Parents were equally active at both ages in trying to elicit children's help but used different strategies with younger and older toddlers. With 18-month-olds they used more action-oriented approaches, whereas with 24-month-olds they increased their use of needoriented approaches. They also regulated the attention of younger toddlers more, and more often socially approved older toddlers’ helping. Thus, how parents prompt, support, and encourage prosocial behavior changes over the second year from utilizing primarily concrete, goal-directed requests in the service of the immediate task, to increasingly emphasizing more abstract needs and emotions of the recipient and the child's role as a helper. PMID:25682218

Final priority. Rehabilitation Training: Job-Driven Vocational Rehabilitation Technical Assistance Center. Final priority.

PubMed

2014-08-19

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program to establish a Job-Driven Vocational Rehabilitation Technical Assistance Center (JDVRTAC). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus on training in an area of national need. Specifically, this priority responds to the Presidential Memorandum to Federal agencies directing them to take action to address job-driven training for the Nation's workers. The JDVRTAC will provide technical assistance (TA) to State vocational rehabilitation (VR) agencies to help them develop for individuals with disabilities training and employment opportunities that meet the needs of today's employers.

Rural energy and development

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

Stern, R.

1997-12-01

The author discusses the worldwide problem and need for rural electrification to support development. He points out that rural areas will pay high rates to receive such services, but cannot afford the capital cost for conventional services. The author looks at this problem from the point of energy choices, subsides, initial costs, financing, investors, local involvement, and governmental actions. In particular he is concerned with ways to make better use of biofuels, to promote sustainable harvesting, and to encourage development of more modern fuels.

The Iraq Community Action Program: USAID’s Agreement with CHF Met Goals, but Greater Oversight Is Needed

DTIC Science & Technology

2011-04-28

communities are unable to contribute materials and services useful to technical infrastructure projects. CHF also reported that 867,070 Iraqis directly...may be in-kind, rather than cash, and can include donated materials and supplies, equipment and services, land and property, and volunteer time and...electrical materials N/A N/Ab 75,000 11 – Provide a water pump and transformer 143,145 3,550 68,740 Total $383,835 $934,744 $1,014,041 Notes: a

Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey.

PubMed

Ko, Naomi Yu; Battaglia, Tracy A; Gupta-Lawrence, Rebecca; Schiller, Jessica; Gunn, Christine; Festa, Kate; Nelson, Kerrie; Flacks, JoHanna; Morton, Samantha J; Rosen, Jennifer E

2016-06-14

Social and economic conditions that affect one's ability to satisfy life's most basic needs such as lack of affordable housing, restricted access to education and employment, or inadequate income are increasingly well-documented barriers to optimal health. The burden of these challenges among vulnerable patients accessing cancer care services is unknown. We conducted a cross-sectional survey of patients presenting for ambulatory cancer care services (screening and treatment) at an urban safety-net hospital to assess socio-legal concerns (social problems related to meeting life's basic needs supported by public policy or programming and potentially remedied through legal advocacy/action). Among 104 respondents, 80 (77 %) reported concerns with one or more socio-legal needs in the past month, with a mean of 5.75 concerns per participant. The most common socio-legal concerns related to income supports, housing, and employment/education. Our findings support the need for innovations in cancer care delivery to address socio-legal concerns of a vulnerable patient population.

An integrated outsourcing solution at York Central Hospital.

PubMed

Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

2011-01-01

Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

Female sterilization in Thailand: past, present and future.

PubMed

Intaraprasert, S; Chaturachinda, K

1993-01-01

Female sterilization is the most effective contraception and has a very high demographic effectiveness. In the past, there have been developments in technological aspects. At present, the minilaparotomy and laparoscopic sterilization have been well developed and widely used, but the number of new acceptors is declining, and there is still a large number of unmet demands. Social action rather than technological action is needed. In the future, steps to increase the number of acceptors, are, proper management of the sterilization services, including adequate monitoring and a good surveillance system.

The meaning of recovery in a regional mental health service: an action research study.

PubMed

Kidd, Susan; Kenny, Amanda; McKinstry, Carol

2015-01-01

To explore the meaning of the term recovery to people with experience providing and receiving mental health services. Internationally, governments have proposed recovery-oriented mental health policy. In practice, people managing mental health difficulties struggle to recover, self-manage, or improve their quality of life. Mental health services increasingly provide acutely focused and poorly coordinated services to people experiencing mental health difficulties, with self-management, wellness and recovery overlooked. A cooperative enquiry, action research design guided the study. Participants were people with experience of mental health difficulties from consumer, carer and clinician perspectives. Data were collected between August 2012-July 2013. Analysis was conducted using an iterative process for the duration of the study. A thematic network was developed that reflected key organizing themes. The overarching theme developed from the participants' group discussions, reflections, actions and observations was recovery as an ongoing quest in life. This global theme was constructed from five organizing themes: 'finding meaning', 'an invisible disability', 'empowerment and agency' 'connection' and 'the passage of time'. Participatory approaches support the inclusion of lived experience perspectives. Structured processes are needed to bring different perspectives together to find solutions, through dialogue, and acknowledge the barriers to participation that people who use mental health services experience. The lack of integration of lived experience perspectives demonstrates forms of discrimination that inhibit consumer participation and prevent the recovery-oriented transformation required in mental health systems. © 2014 John Wiley & Sons Ltd.

Rural Reflections. Occasional Paper No. 2. Fall 1995.

ERIC Educational Resources Information Center

Literacy Field Research Group, Dundas (Ontario).

This document contains six papers describing program-based research from rural literacy program in Ontario, Canada. Some of the reports describe action research from pilot projects. The papers raise questions about responding to the special challenges of rural needs, such as whether there is an additional expense to providing service of equal…

77 FR 70413 - Information Collection; Flathead and McKenzie Rivers and McKenzie National Recreational Trail...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... McKenzie National Recreational Trail Visitor Surveys AGENCY: Forest Service, USDA. ACTION: Notice; request... Recreational Trail. Because of the differences in the issues on each River and the need for different... Rivers and McKenzie National Recreational Trail by in-person, written surveys which will be administered...

The Impact of Faculty-Student Interactions on Teaching Behavior: An Investigation of Perceived Student Encounter Orientation, Interactive Confidence, and Interactive Practice.

ERIC Educational Resources Information Center

Frankel, Robert; Swanson, Scott R.

2002-01-01

Data from 221 marketing professors were used to classify critical student incidents as service system failures, response to student needs, or unprompted instructor actions. Resulting behavior changes included methods and materials changes, requirement clarification, reinforcement, student praise, and authoritativeness. Influential factors were…

Promoting Positive Citizenship: Priming Youth for Action. CIRCLE Working Paper 05

ERIC Educational Resources Information Center

Zaff, Jonathon F.; Malanchuk, Oksana; Michelsen, Erik; Eccles, Jacquelynne

2003-01-01

Researchers have theorized that programs to promote positive citizenship should begin with an opportunity for adolescents to participate in civic activities, such as community service or political volunteering. In this report, authors expand this theoretical perspective by arguing that programs to promote positive citizenship may need to begin by…

77 FR 70467 - Agency Information Collection Activities: Proposed Collection; Comments Requested; Revision of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... Training and Technical Assistance Center (OVC TTAC) Feedback Form Package ACTION: 30-day notice. The...: The Office for Victims of Crime Training and Technical Assistance Center (OVC TTAC) Feedback Form... needs of the victim services field. OVC TTAC will give these forms to recipients of training and...

New Neighbors: The Retarded Citizen in Quest of a Home.

ERIC Educational Resources Information Center

Cherington, Carolyn, Ed.; Dybwad, Gunnar, Ed.

The philosophical and practical aspects of the retarded citizen's need for a home in the community are discussed in 14 author contributed chapters dealing with people and communities, rights and independence, home and community, services and communities, and action and advocacy. Chapters cover the following topics: "Community Life and Individual…

Adolescent Health Issues: State Actions 1996.

ERIC Educational Resources Information Center

Stroud, Joanne; Rollins, Kathy

Many adolescents need basic health care and other services that address risky behaviors such as sexual activity, violence, alcohol and other drug abuse, and the consequences of those behaviors. This publication summarizes approximately 200 child health-related laws and resolutions passed in the 50 states, Puerto Rico, American Samoa, and the U.S.…

78 FR 15017 - Guidance for Industry: What You Need To Know About Administrative Detention of Foods; Small...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0643... Compliance Guide; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled...

78 FR 13662 - Kansas Gas Service, a Division of ONEOK, Inc.; Notice of Petition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

....214). Protests will be considered by the Commission in determining the appropriate action to be taken... must file a notice of intervention or motion to intervene, as appropriate. Such notices, motions, or... before the intervention or protest date need not serve motions to intervene or protests on persons other...

Expressing the sense of Congress regarding the need for the continued availability of religious services to members of the Armed Forces and their families during a lapse in appropriations.

THOMAS, 113th Congress

Rep. Collins, Doug [R-GA-9

2013-10-05

House - 10/16/2013 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker: This bill has the status Resolving DifferencesHere are the steps for Status of Legislation:

Analysis of Patient’s Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement

PubMed Central

Dwivedi, Tanima; Sadhana; Chaudhary, Raju

2017-01-01

Introduction Patient’s satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine. Aim To assess the patient’s satisfaction with phlebotomy services in a neuropsychiatric hospital by a structured questionnaire with grading scale. Also, identify the problems causing dissatisfactions and to undertake necessary Corrective and Preventative Action (CAPA). Materials and Methods Total 1200 patients were randomly selected over a period of two months (June and July 2016). A structured self designed questionnaire (feedback form) was devised in both Hindi and English languages containing ten questions with a grading scale for each question. It also included suggestions from the users. All the selected patients or their attendants filled up this questionnaire. At the same time, they were also interviewed by phlebotomy staff. A statistical analysis was conducted using SPSS version 16.0 software and Likert scale. Results A total of 94% of the patients were satisfied with the phlebotomy services. Almost 30.0% patients found the phlebotomy services to be very good, but the majority of them (40.5%) found it to be good and another 23.5% found it to be satisfactory while, 4% found the services to be poor and 2% found it to be very poor. The highest rate of satisfaction (4.21) was noted in case of parameter-ease to find collection sample room and lowest rate of satisfaction (3.92) was scored by the parameter-staff’s wearing proper uniform. Depending upon the deficient areas some corrective actions were suggested such as strict compliance of personal protective equipments, regular training to improve technical skill, knowledge and behaviour with emphasis on cleanliness of work area. Conclusion Even though the overall patient’s satisfaction was high, there were areas which needed our attention such as waiting time for phlebotomy procedure, lack of proper sitting arrangement, techniques of sample collection, knowledge of universal precautions etc. Appropriate corrective and preventive actions were taken to solve the problems. Thereby, feedback proved effective in maintenance and improvement of phlebotomy services. PMID:29207713

Analysis of Patient's Satisfaction with Phlebotomy Services in NABH Accredited Neuropsychiatric Hospital: An Effective Tool for Improvement.

PubMed

Gupta, Anshu; Dwivedi, Tanima; Sadhana; Chaudhary, Raju

2017-09-01

Patient's satisfaction is the need of the hour and one of the most important quality indicators in the laboratory medicine. To assess the patient's satisfaction with phlebotomy services in a neuropsychiatric hospital by a structured questionnaire with grading scale. Also, identify the problems causing dissatisfactions and to undertake necessary Corrective and Preventative Action (CAPA). Total 1200 patients were randomly selected over a period of two months (June and July 2016). A structured self designed questionnaire (feedback form) was devised in both Hindi and English languages containing ten questions with a grading scale for each question. It also included suggestions from the users. All the selected patients or their attendants filled up this questionnaire. At the same time, they were also interviewed by phlebotomy staff. A statistical analysis was conducted using SPSS version 16.0 software and Likert scale. A total of 94% of the patients were satisfied with the phlebotomy services. Almost 30.0% patients found the phlebotomy services to be very good, but the majority of them (40.5%) found it to be good and another 23.5% found it to be satisfactory while, 4% found the services to be poor and 2% found it to be very poor. The highest rate of satisfaction (4.21) was noted in case of parameter-ease to find collection sample room and lowest rate of satisfaction (3.92) was scored by the parameter-staff's wearing proper uniform. Depending upon the deficient areas some corrective actions were suggested such as strict compliance of personal protective equipments, regular training to improve technical skill, knowledge and behaviour with emphasis on cleanliness of work area. Even though the overall patient's satisfaction was high, there were areas which needed our attention such as waiting time for phlebotomy procedure, lack of proper sitting arrangement, techniques of sample collection, knowledge of universal precautions etc. Appropriate corrective and preventive actions were taken to solve the problems. Thereby, feedback proved effective in maintenance and improvement of phlebotomy services.

Ecosystem Services: a Framework for Environmental Management of the Deep Sea

NASA Astrophysics Data System (ADS)

Le, J. T.; Levin, L. A.; Carson, R. T.

2016-02-01

As demand for deep-sea resources rapidly expands in the food, energy, mineral, and pharmaceutical sectors, it has become increasingly clear that a regulatory structure for extracting these resources is not yet in place. There are jurisdictional gaps and a lack of regulatory consistency regarding what aspects of the deep sea need protection and what requirements might help guarantee that protection. Given the mining sector's intent to exploit seafloor massive sulphides, Mn nodules, cobalt crusts, and phosphorites in the coming years, there is an urgent need for deep-ocean environmental management. Here, we propose an ecosystem services-based framework to inform decisions and best practices regarding resource exploitation, and to guide baseline studies, preventative actions, monitoring, and remediation. With policy in early stages of development, an ecosystem services approach has the potential to serve as an overarching framework that takes protection of natural capital provided by the environment into account during the decision-making process. We show how an ecosystem services approach combined with economic tools, such as benefit transfer techniques, should help illuminate issues where there are direct conflicts among different industries, and between industry and conservation. We argue for baseline and monitoring measurements and metrics that inform about deep-sea ecosystem services that would be impaired by mining, and discuss ways to incorporate the value of those losses into decision making, mitigation measures, and ultimately product costs. This proposal is considered relative to current International Seabed Authority recommendations and contractor practices, and new actions are proposed. An ecosystem services-based understanding of how these systems work and their value to society can improve sustainability and stewardship of the deep ocean.

Obesity and what we need do about it- an interview with John Wass.

PubMed

Wass, John

2014-08-26

In this podcast we talk to Professor John Wass, co-author of the 'Action on obesity: Comprehensive care for all' report, and Chair of the Working Party for Action on Obesity in the UK. In this interview Prof Wass discusses the gaps in care for obese patients in current UK healthcare services, and outlines his recommendations on what actions should be taken to tackle these issues, including how education about nutrition and obesity should be offered to the public as well as within the formal medical education system.The podcast for this interview is available at: http://media.biomedcentral.com/content/movies/supplementary/johnwass-audio-v1.mp3.

Strengthening rehabilitation services in Indonesia: A brief situation analysis.

PubMed

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

2018-04-18

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

[Effectiveness of a quality control program in mammography for the Brazilian National Health System].

PubMed

Corrêa, Rosangela da Silveira; Freitas-Junior, Ruffo; Peixoto, João Emílio; Rodrigues, Danielle Cristina Netto; Lemos, Maria Eugênia Fonseca; Dias, Cíntia Melazo; Ferreira, Rubemar de Souza; Rahal, Rosemar Macedo Souza

2012-10-01

To assess the effectiveness of a quality control program in mammography services of the Brazilian National Health System (SUS). A prospective study using temporal analysis of a health surveillance action was conducted. A total of 35 service providers that had mammography equipment in operation and regularly performed exams between 2007 and 2009 in the state of Goiás, Central-Western Brazil, participated in this study. Services were assessed during three site visits by performance testing of mammography equipment, film processors, and other materials, and image quality and entrance surface dose in a phantom were also assessed. Each service was scored according to the percentage of tests that conformed to standards. The mean percentage for compliance among the participating service providers were 64.1% (± 13.3%) in the first visit, 68.4% (± 15.9%) in the second, and 77.1% (± 13.3%) in the third (p < 0.001). The main improvements resulted from adjustments to the breast compression force, the automatic exposure control system, and the alignment of the compression paddle. The doses measured were within the conformity range in 80% of the services assessed. The implementation of this program in the mammography services was effective at improving the operational parameters of the mammography machines, although 40% of the services did not reach the acceptable level of 70%. This result indicates the need to continue this health surveillance action.

Regional input to joint European space weather service

NASA Astrophysics Data System (ADS)

Stanislawska, I.; Belehaki, A.; Jansen, F.; Heynderickx, D.; Lilensten, J.; Candidi, M.

The basis for elaborating within COST 724 Action Developing the scientific basis for monitoring modeling and predicting Space Weather European space weather service is rich by many national and international activities which provide instruments and tools for global as well as regional monitoring and modeling COST 724 stimulates coordinates and supports Europe s goals of development and global cooperation by providing standards for timely and high quality information and knowledge in space weather Existing local capabilities are taken into account to develop synergies and avoid duplication The enhancement of environment monitoring networks and associated instruments technology yields mutual advantages for European service and regional services specialized for local users needs It structurally increases the integration of limited-area services generates a platform employing the same approach to each task differing mostly in input and output data In doing so it also provides complementary description of the environmental state within issued information A general scheme of regional services concept within COST 724 activity can be the processing chain from measurements trough algorithms to operational knowledge It provides the platform for interaction among the local end users who define what kind of information they need system providers who elaborate tools necessary to obtain required information and local service providers who do the actual processing of data and tailor it to specific user s needs Such initiative creates a unique possibility for small

Health Care Transformation: A Strategy Rooted in Data and Analytics.

PubMed

Koster, John; Stewart, Elizabeth; Kolker, Eugene

2016-02-01

Today's consumers purchasing any product or service are armed with information and have high expectations. They expect service providers and payers to know about their unique needs. Data-driven decisions can help organizations meet those expectations and fulfill those needs.Health care, however, is not strictly a retail relationship-the sacred trust between patient and doctor, the clinician-patient relationship, must be preserved. The opportunities and challenges created by the digitization of health care are at the crux of the most crucial strategic decisions for academic medicine. A transformational vision grounded in data and analytics must guide health care decisions and actions.In this Commentary, the authors describe three examples of the transformational force of data and analytics to improve health care in order to focus attention on academic medicine's vital role in guiding the needed changes.

Assisting persons living with HIV/AIDS to return to work: programmatic steps for AIDS service organizations.

PubMed

Brooks, R A; Klosinski, L E

1999-06-01

The objective of this study was to develop a comprehensive picture of the concerns and needs of persons living with HIV/AIDS who are interested in returning to work. To collect information in this new area, a series of focus groups was conducted with a random sample of clients from AIDS Project Los Angeles who were currently unemployed and expressed a desire to return to work. The results indicate a range of concerns among individuals with HIV/AIDS about returning to work, such as a loss of or change in medical benefits, the need for flexibility in employment to address ongoing medical needs, concerns regarding disclosure of their HIV/AIDS status, the possibility of job related discrimination, and the need to address the practical aspects of reentering the labor market after a prolonged absence. The findings suggest a series of action steps for AIDS service organizations and others to address the needs of persons with HIV/AIDS in this new area.

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

PubMed Central

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

Background There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Results Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges. PMID:28579793

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project.

PubMed

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Three categories emerged from the analysis: "Balancing complex situations" clarified the complexity regarding senior employees; "Working with a proactive approach" indicated the need for working with a new proactive approach supporting sustainable health; and "Collaborate internally and externally" showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

PubMed

Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

2014-01-01

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

DOD Education Benefits: Action Is Needed to Ensure Evaluations of Postsecondary Schools Are Useful

DTIC Science & Technology

2014-09-01

Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a...This program accommodates service members, who may regularly be reassigned to another location (including overseas), by allowing them to take classes...schools, but does not yet have a plan to guide future efforts. Absent a plan, it will be difficult for DOD to have all of the information it needs to

DIRAC distributed secure framework

NASA Astrophysics Data System (ADS)

Casajus, A.; Graciani, R.; LHCb DIRAC Team

2010-04-01

DIRAC, the LHCb community Grid solution, provides access to a vast amount of computing and storage resources to a large number of users. In DIRAC users are organized in groups with different needs and permissions. In order to ensure that only allowed users can access the resources and to enforce that there are no abuses, security is mandatory. All DIRAC services and clients use secure connections that are authenticated using certificates and grid proxies. Once a client has been authenticated, authorization rules are applied to the requested action based on the presented credentials. These authorization rules and the list of users and groups are centrally managed in the DIRAC Configuration Service. Users submit jobs to DIRAC using their local credentials. From then on, DIRAC has to interact with different Grid services on behalf of this user. DIRAC has a proxy management service where users upload short-lived proxies to be used when DIRAC needs to act on behalf of them. Long duration proxies are uploaded by users to a MyProxy service, and DIRAC retrieves new short delegated proxies when necessary. This contribution discusses the details of the implementation of this security infrastructure in DIRAC.

5 CFR 831.114 - Voluntary early retirement-substantial delayering, reorganization, reduction in force, transfer...

Code of Federal Regulations, 2013 CFR

2013-01-01

... that agencies treat employees on military duty, for all practical purposes, as though they were still on the job. Further, employees are not to be disadvantaged because of their military service. In... description of the types of personnel actions anticipated as a result of the agency's need for voluntary early...

5 CFR 831.114 - Voluntary early retirement-substantial delayering, reorganization, reduction in force, transfer...

Code of Federal Regulations, 2014 CFR

2014-01-01

... that agencies treat employees on military duty, for all practical purposes, as though they were still on the job. Further, employees are not to be disadvantaged because of their military service. In... description of the types of personnel actions anticipated as a result of the agency's need for voluntary early...

5 CFR 831.114 - Voluntary early retirement-substantial delayering, reorganization, reduction in force, transfer...

Code of Federal Regulations, 2012 CFR

2012-01-01

... that agencies treat employees on military duty, for all practical purposes, as though they were still on the job. Further, employees are not to be disadvantaged because of their military service. In... description of the types of personnel actions anticipated as a result of the agency's need for voluntary early...

The Use of Demonstration Lessons to Support Curriculum Implementation: Invitation or Intrusion?

ERIC Educational Resources Information Center

de Paor, Cathal

2015-01-01

Lesson demonstration within the context of school-based coaching can give teachers practical examples of a new curriculum in action, thereby reinforcing the key messages introduced in initial in-service training. At the same time, the demonstration needs to be sufficiently invitational so that teachers feel positively about the new programme and…

America's Youth Are at Risk: Developing Models for Action in the Nation's Public Libraries.

ERIC Educational Resources Information Center

Flum, Judith G.; Weisner, Stan

1993-01-01

Discussion of public library support systems for at-risk teens focuses on the Bay Area Library and Information System (BALIS) that was developed to improve library services to at-risk teenagers in the San Francisco Bay area. Highlights include needs assessment; staff training; intervention models; and project evaluation. (10 references) (LRW)

Management of Inclusive Education in Oman: A Framework for Action

ERIC Educational Resources Information Center

Mohamed Emam, Mahmoud

2016-01-01

Inclusive education (IE) and the special education services related to it are relatively new in Oman. Efforts to manage special/inclusive education face many challenges due to a number of culturally rooted factors. Further, empirical research on IE in Oman is scarce and there is a need to advance IE discourse based on empirically validated…

HEALTH CONDITIONS AND SERVICES FOR DOMESTIC SEASONAL AGRICULTURAL WORKERS AND THEIR FAMILIES IN CALIFORNIA.

ERIC Educational Resources Information Center

California State Dept. of Public Health, Berkeley.

FIELD INTERVIEWS WERE HELD WITH COMMUNITY LEADERS AND WITH SEVERAL HUNDRED WORKERS' FAMILIES. THE ACQUIRED INFORMATION SUPPLEMENTED A SURVEY OF PAST AND PRESENT CONDITIONS AND ASSISTED IN FORMULATING RECOMMENDATIONS FOR ACTION TO MEET THE ACUTE HEALTH NEEDS OF CALIFORNIA'S SEASONAL AGRICULTURAL WORKERS. THE HEALTH PROBLEM CAN BE MET BY LOCAL…

New roles for old.

PubMed

Edmonstone, J; Chisnell, C

1992-01-01

The creation of clinical directorates in acute hospital services has directed attention towards the clinical director role. The two "support" roles of clinical nurse manager and business manager have received less attention. Reports on an action research study into these roles, examining recruitment and selection, monitoring of performance, training needs and succession planning. Deals with the clinical nurse manager role.

We Think You Need a Vacation...: The Discipline Model at Fresh Youth Initiatives

ERIC Educational Resources Information Center

Afterschool Matters, 2003

2003-01-01

Fresh Youth Initiative (FYI) is a youth development organization based in the Washington Heights-Inwood section of Manhattan. The group's mission is to support and encourage the efforts of neighborhood young people and their families to design and carry out community service and social action projects, develop leadership skills, fulfill their…

World Health Organization Global Disability Action Plan: The Mongolian Perspective.

PubMed

Khan, Fary; Amatya, Bhasker; Avirmed, Baljnnyam; Yi, Yoon Kyoung; Shirmen, Batchimeg; Abbott, Geoff; Galea, Mary P

2018-04-18

To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO) Global Disability Action Plan (GDAP). A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n = 77) from medical rehabilitation facilities (urban/rural, public/private) and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement) identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure/human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.

42 CFR 136.42 - Appointment actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Appointment actions. 136.42 Section 136.42 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Preference in Employment § 136.42 Appointment actions. (a...

[Measurement of customer satisfaction and participation of citizens in improving the quality of healthcare services.].

PubMed

Degrassi, Flori; Sopranzi, Cristina; Leto, Antonella; Amato, Simona; D'Urso, Antonio

2009-01-01

Managing quality in health care whilst ensuring equity is a fundamental aspect of the provision of services by healthcare organizations. Measuring perceived quality of care is an important tool for evaluating the quality of healthcare delivery in that it allows the implementation of corrective actions to meet the healthcare needs of patients. The Rome B (ASL RMB) local health authority adopted the UNI EN 10006:2006 norms as a management tool, therefore introducing the evaluation of customer satisfaction as an opportunity to involve users in the creation of quality healthcare services with and for the citizens. This paper presents the activities implemented and the results achieved with regards to shared and integrated continuous improvement of services.

Transforming children’s palliative care—from ideas to action: highlights from the first ICPCN conference on children’s palliative care

PubMed Central

Downing, J; Marston, J; Muckaden, MA; Boucher, S; Cardoz, M; Nkosi, B; Steel, B; Talawadekar, P; Tilve, P

2014-01-01

The International Children’s Palliative Care Network (ICPCN) held its first international conference on children’s palliative care, in conjunction with Tata Memorial Centre, in Mumbai, India, from 10–12 February 2014. The theme of the conference, Transforming children’s palliative care—from ideas to action, reflected the vision of the ICPCN to live in a world where every child who needs it, can access palliative care, regardless of where they live. Key to this is action, to develop service provision and advocate for children’s palliative care. Three pre-conference workshops were held on 9 February, aimed at doctors, nurses, social workers, and volunteers, and focused around the principles of children’s palliative care, and in particular pain and symptom management. The conference brought together 235 participants representing 38 countries. Key themes identified throughout the conference included: the need for advocacy and leadership; for education and research, with great strides having been taken in the development of an evidence base for children’s palliative care, along with the provision of education; the importance of communication and attention to spirituality in children, and issues around clinical care, in particular for neonates. Delegates were continually challenged to transform children’s palliative care in their parts of the world and the conference culminated in the signing of the ICPCN Mumbai Declaration. The Declaration calls upon governments around the world to improve access to quality children’s palliative care services and made a call on the Belgian government not to pass a bill allowing children to be euthanised in that country. The conference highlighted many of the ongoing developments in children’s palliative care around the world, and as she closed the conference, Joan Marston (ICPCN CEO) challenged participants to take positive action and be the champions that the children need, thus transforming children’s palliative care. PMID:24761156

Ancillary-service costs for 12 US electric utilities

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

Kirby, B.; Hirst, E.

1996-03-01

Ancillary services are those functions performed by electrical generating, transmission, system-control, and distribution-system equipment and people to support the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission defined ancillary services as ``those services necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.`` FERC divided these services into three categories: ``actions taken to effect the transaction (such as scheduling and dispatching services) , services that are necessary to maintainmore » the integrity of the transmission system [and] services needed to correct for the effects associated with undertaking a transaction.`` In March 1995, FERC published a proposed rule to ensure open and comparable access to transmission networks throughout the country. The rule defined six ancillary services and developed pro forma tariffs for these services: scheduling and dispatch, load following, system protection, energy imbalance, loss compensation, and reactive power/voltage control.« less

Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery.

PubMed

Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Bergeron, Sophie; Lambert, Carole

2013-05-01

This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to improve the quality of services provided to children with disabilities, their families, and their communities.

Space assets for demining assistance

NASA Astrophysics Data System (ADS)

Kruijff, Michiel; Eriksson, Daniel; Bouvet, Thomas; Griffiths, Alexander; Craig, Matthew; Sahli, Hichem; González-Rosón, Fernando Valcarce; Willekens, Philippe; Ginati, Amnon

2013-02-01

Populations emerging from armed conflicts often remain threatened by landmines and explosive remnants of war. The international mine action community is concerned with the relief of this threat. The Space Assets for Demining Assistance (SADA) undertaking is a set of activities that aim at developing new services to improve the socio-economic impact of mine action activities, primarily focused on the release of land thought to be contaminated, a process described as land release. SADA was originally initiated by the International Astronautical Federation (IAF). It has been implemented under the Integrated Applications Promotion (IAP) program of the European Space Agency (ESA). Land release in mine action is the process whereby the demining community identifies, surveys and prioritizes suspected hazardous areas for more detailed investigation, which eventually results in the clearance of landmines and other explosives, thereby releasing land to the local population. SADA has a broad scope, covering activities, such as planning (risk and impact analysis, prioritization, and resource management), field operations and reporting. SADA services are developed in two phases: feasibility studies followed by demonstration projects. Three parallel feasibility studies have been performed. They aimed at defining an integrated set of space enabled services to support the land release process in mine action, and at analyzing their added value, viability and sustainability. The needs of the mine action sector have been assessed and the potential contribution of space assets has been identified. Support services have been formulated. To test their fieldability, proofs of concept involving mine action end users in various operational field settings have been performed by each of the study teams. The economic viability has also been assessed. Whenever relevant and cost-effective, SADA aims at integrating Earth observation data, GNSS navigation and SatCom technologies with existing mine action tools and procedures, as well as with novel aerial survey technologies. Such conformity with existing user processes, as well as available budgets and appropriateness of technology based solutions given the field level operational setting are important conditions for success. The studies have demonstrated that Earth observation data, satellite navigation solutions and in some cases, satellite communication, indeed can provide added value to mine action activities if properly tailored based on close user interaction and provided through a suitable channel. Such added value for example includes easy and sustained access to Earth observation data for general purpose mapping, land use assessment for post-release progress reporting, and multi-source data fusion algorithms to help quantify risks and socio-economic impact for prioritization and planning purposes. The environment and boundaries of a hazardous area can also be better specified to support the land release process including detailed survey and clearance operations. Satellite communication can help to provide relevant data to remote locations, but is not regarded as strongly user driven. Finally, satellite navigation can support more precise non-technical surveys, as well as aerial observation with small planes or hand-launched UAV's. To ensure the activity is genuinely user driven, the Geneva International Center for Humanitarian Demining (GICHD) plays an important role as ESA's external advisor. ESA is furthermore supported by a representative field operator, the Swiss Foundation of Mine Action (FSD), providing ESA with a direct connection to the field level end users. Specifically FSD has provided a shared user needs baseline to the three study teams. To ensure solutions meet with end user requirements, the study teams themselves include mine action representatives and have interacted closely with their pre-existing and newly established contacts within the mine action community.

ELIXIR pilot action: Marine metagenomics – towards a domain specific set of sustainable services

PubMed Central

Robertsen, Espen Mikal; Denise, Hubert; Mitchell, Alex; Finn, Robert D.; Bongo, Lars Ailo; Willassen, Nils Peder

2017-01-01

Metagenomics, the study of genetic material recovered directly from environmental samples, has the potential to provide insight into the structure and function of heterogeneous microbial communities.  There has been an increased use of metagenomics to discover and understand the diverse biosynthetic capacities of marine microbes, thereby allowing them to be exploited for industrial, food, and health care products. This ELIXIR pilot action was motivated by the need to establish dedicated data resources and harmonized metagenomics pipelines for the marine domain, in order to enhance the exploration and exploitation of marine genetic resources. In this paper, we summarize some of the results from the ELIXIR pilot action “Marine metagenomics – towards user centric services”. PMID:28620454

42 CFR 136a.42 - Appointment actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Appointment actions. 136a.42 Section 136a.42 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Preference in Employment § 136a.42 Appointment actions. (a...

Priorities for Action in a Rural Older Adults Study

PubMed Central

Averill, Jennifer B.

2013-01-01

This article reports the findings from a recent study of older adults in the rural southwestern United States and discusses practice and research implications. The aim of the study was to analyze health disparities and strengths in the contexts of rurality, aging, a depressed economy, and limited health resources. Identified themes needing action included sustained access to prescriptions, transportation solutions for older adults in isolated communities, inadequate access to care, poor infrastructure and coordination of services, scarce assisted living and in-home care for frail older adults, and barriers related to culture, language, and economics. PMID:22929381

DCoE in Action. Volume 4, Number 6, June 2011. Community Partnerships: Working Together to Support Service Members, Veterans, Families

DTIC Science & Technology

2011-06-01

worldwide in the war on terrorism. U.S. Air Force photo by Staff Sgt. Bennie J. Davis III DCoE Real Warriors Campaign DCoE Real Warriors Campaign DCoE...resilience, recovery and reintegration, it can often be hard for them to choose what best fits their needs,” said Dr. Lolita O’Donnell, deputy director...Force photo by Airman 1st Class Clayton Lenhardt See INITIATIVE on Page 5 new s R esilience  R ecovery  R eintegration 3 DCoE in ActionVol. 4 No

Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

PubMed

Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

2014-07-27

Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

[Perceptions and experiences of access to health services and their utilization among the immigrant population].

PubMed

Bas-Sarmiento, Pilar; Fernández-Gutiérrez, Martina; Albar-Marín, M A Jesús; García-Ramírez, Manuel

2015-01-01

To identify and describe the needs and problems of the immigrant population related to access and utilization of health services. A descriptive, qualitative, phenomenological study was conducted using focus groups. The study area was the county of Campo de Gibraltar (Spain), which represents the gateway to Europe for immigration from Africa. The final sample size (51 immigrants from 11 countries) was determined by theoretical saturation. A narrative analysis was conducted with QSR NVivo9 software. Immigrants' discourse showed four categories of analysis: response to a health problem, system access, knowledge of social and health resources, and health literacy needs. Responses to health problems and the route of access to the health care system differed according to some sociodemographic characteristics (nationality/culture of origin, length of residence, and economic status). In general, immigrants primarily used emergency services, hampering health promotion and prevention. The health literacy needs identified concerned language proficiency and the functioning of the health system. There is a need to promote interventions to enhance health literacy among immigrants. These interventions should take into account diversity and length of residence, and should be based on an action-participation methodology. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Barriers to HIV testing among male clients of female sex workers in Indonesia.

PubMed

Fauk, Nelsensius Klau; Sukmawati, Anastasia Suci; Berek, Pius Almindu Leki; Ernawati; Kristanti, Elisabeth; Wardojo, Sri Sunaringsih Ika; Cahaya, Isaias Budi; Mwanri, Lillian

2018-05-30

Frequent engagement of men in sexual encounters with female sex workers (FSWs) without using condoms places them at a high risk for HIV infection. HIV testing has been noted to be among important strategies to prevent HIV transmission and acquisition. However, it is known that not all men willingly undertake an HIV test as a way to prevent HIV transmission and/or acquisition. This study aimed to identify barriers to accessing HIV testing services among men who are clients of FSWs (clients) in Belu and Malaka districts, Indonesia. A qualitative inquiry employing face to face open ended interviews was conducted from January to April 2017. The participants (n = 42) were clients of FSWs recruited using purposive and snowball sampling techniques. Data were analysed using a qualitative data analysis framework. Findings indicated three main barriers of accessing HIV testing services by clients. These included: (1) personal barriers (lack of knowledge of HIV/AIDS and HIV testing availability, and unwillingness to undergo HIV testing due to low self-perceived risk of HIV and fear of the test result); (2) health care service provision barriers (lack of trust in health professionals and limited availability of medication including antiretroviral (ARV)); and (3) social barriers (stigma and discrimination, and the lack of social supports). These findings indicated multilevelled barriers to accessing HIV testing services among participants, who are known to be among key population groups in HIV care. Actions to improve HIV/AIDS-related health services accessibility are required. The dissemination of the knowledge and information on HIV/AIDS and improved available of HIV/AIDS-related services are necessary actions to improve the personal levelled barriers. System wide barriers will need improved practices and health policies to provide patients friendly and accessible services. The societal levelled barriers will need a more broad societal approach including raising awareness in the community and enhanced discussions about HIV/AIDS issues in order to normalise HIV in the society.

The US Forest Service Framework for Climate Adaptation (Invited)

NASA Astrophysics Data System (ADS)

Cleaves, D.

2013-12-01

Public lands are changing in response to climate change and related stressors such that resilience-based management plans that integrate climate-smart adaptation are needed. The goal of these plans is to facilitate land managers' consideration of a range of potential futures while simplifying the complex array of choices and assumptions in a rigorous, defensible manner. The foundation for climate response has been built into recent Forest Service policies, guidance, and strategies like the climate change Roadmap and Scorecard; 2012 Planning Rule; Cohesive Wildland Fire Management strategy; and Inventory, Monitoring & Assessment strategy. This has driven the need for information that is relevant, timely, and accessible to support vulnerability assessments and risk management to aid in designing and choosing alternatives and ranking actions. Managers must also consider carbon and greenhouse gas implications as well as understand the nature and level of uncertainties. The major adjustments that need to be made involve: improving risk-based decision making and working with predictive models and information; evaluating underlying assumptions against new realities and possibilities being revealed by climate science; integrating carbon cycle science and a new ethic of carbon stewardship into management practices; and preparing systems for inevitable changes to ameliorate negative effects, capture opportunities, or accept different and perhaps novel ecosystem configurations. We need to avoid waiting for complete science that never arrives and take actions that blend science and experience to boost learning, reduce costs and irreversible losses, and buy lead time.

[Mental health of undocumented migrants in transit at the southern border of Mexico].

PubMed

Temores-Alcántara, Guadalupe; Infante, César; Caballero, Marta; Flores-Palacios, Fátima; Santillanes-Allande, Nadia

2015-01-01

To identify the perception and needs in mental health of Central American migrants in transit through Tapachula, Chiapas. Qualitative study in a migrant shelter in Tapachula, Chiapas. In 20 semi-structured interviews with migrant men and women, we explored their perceptions on mental health and expectations on care. We used basic notions of phenomenology to guide the analysis. Migrants had several mental health problems related to the conditions at their country of origin and due to their initial transit through Mexico.Their perception on mental health problems was heavily influenced by the biomedical health paradigm. The expectations they had on the provision of services were related to the satisfaction of basic needs. It is necessary to strengthen the governmental response to mental health needs through collaborative strategies. Also, actions are needed to further the understanding of mental health in order to transcend the biomedical notions that stigmatize, segregate and create a barrier to accessing services.

Scoping the context of programs and services for maintaining wellness of older people in rural areas of Indonesia.

PubMed

Kadar, K S; McKenna, L; Francis, K

2014-09-01

Ageing and problems concerning the aged are an increasing and concerning reality in developing and underdeveloped countries such as Indonesia. Improving service quality is important to promote and maintain wellness of older persons, especially in rural areas. To explore programs and services offered to the elderly in a rural area of Indonesia to support them in promoting and maintaining their wellness. To describe roles and practices of health professionals and teams responsible for delivering services to older people. Action research was used with mixed method data collection (interview and survey). Results demonstrated that activities related to the elderly health programs were limited due to budget and facilities. Practices of health staff for elderly in the community focused on intervention tasks, rather than prevention. Lack of available information on the range of programs and services implemented in Indonesia for the elderly in community settings was a limitation of this study. Programs and services for older people have been implemented in Indonesia. However, these do not yet meet their needs, especially in rural areas. There is a need for greater focus on health promotion and illness prevention. Findings contribute to development of international knowledge in community health nursing, as these issues may not be only relevant to Indonesia. It is timely for governments, including in Indonesia, to evaluate health workforce needs in the community and appropriate educational qualifications for delivering optimal health services for older people. © 2014 International Council of Nurses.

'We have got the tools': Qualitative evaluation of a mental health Wellness Recovery Action Planning (WRAP) education programme in Ireland.

PubMed

Keogh, B; Higgins, A; Devries, J; Morrissey, J; Callaghan, P; Ryan, D; Gijbels, H; Nash, M

2014-04-01

In recent years, there has been a consistent drive to incorporate Recovery principles into the Irish mental health services. A group of Irish mental health service providers came together and delivered a 5-day Wellness Recovery Action Planning (WRAP) facilitator's programme. The programme was developed and delivered by key stakeholders including people with self-experience of mental health problem. This paper presents the qualitative findings from an evaluation of these facilitator's programmes. Three focus groups were held with 22 people, the majority of who described themselves as mental health professionals and/or people with self-experience of mental health problems. Data were analysed using a thematic approach and yielded four themes. Although the participants were positive about the programme and felt that their knowledge of Recovery and WRAP had improved, they felt that they still lacked confidence in terms of the presentation skills required for facilitating Recovery and WRAP programmes. The findings suggest that mental health service providers who wish to develop service users and clinicians as WRAP facilitators need to put more emphasis on the provision of facilitation and presentation skills in the programmes they develop. © 2013 John Wiley & Sons Ltd.

7 CFR 1942.122 - Actions prior to loan closing and start of construction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Actions prior to loan closing and start of...) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE... Rescue and Other Small Community Facilities Projects § 1942.122 Actions prior to loan closing and start...

Delivering modern, high-quality, affordable pathology and laboratory medicine to low-income and middle-income countries: a call to action.

PubMed

Horton, Susan; Sullivan, Richard; Flanigan, John; Fleming, Kenneth A; Kuti, Modupe A; Looi, Lai Meng; Pai, Sanjay A; Lawler, Mark

2018-05-12

Modern, affordable pathology and laboratory medicine (PALM) systems are essential to achieve the 2030 Sustainable Development Goals for health in low-income and middle-income countries (LMICs). In this last in a Series of three papers about PALM in LMICs, we discuss the policy environment and emphasise three crucial high-level actions that are needed to deliver universal health coverage. First, nations need national strategic laboratory plans; second, these plans require adequate financing for implementation; and last, pathologists themselves need to take on leadership roles to advocate for the centrality of PALM to achieve the Sustainable Development Goals for health. The national strategic laboratory plan should deliver a tiered, networked laboratory system as a central element. Appropriate financing should be provided, at a level of at least 4% of health expenditure. Financing of new technologies such as molecular diagnostics is challenging for LMICs, even though many of these tests are cost-effective. Point-of-care testing can substantially reduce test-reporting time, but this benefit must be balanced with higher costs. Our research analysis highlights a considerable deficiency in advocacy for PALM; pathologists have been invisible in national and international health discourse and leadership. Embedding PALM in LMICs can only be achieved if pathologists advocate for these services, and undertake leadership roles, both nationally and internationally. We articulate eight key recommendations to address the current barriers identified in this Series and issue a call to action for all stakeholders to come together in a global alliance to ensure the effective provision of PALM services in resource-limited settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Strategic Science for Coral Ecosystems 2007-2011

USGS Publications Warehouse

,

2010-01-01

Shallow and deep coral ecosystems are being imperiled by a combination of stressors. Climate change, unsustainable fishing practices, and disease are transforming coral communities at regional to global scales. At local levels, excessive amounts of sediments, nutrients, and contaminants are also impacting the many benefits that healthy coral ecosystems provide. This Plan, Strategic Science for Coral Ecosystems, describes the information needs of resource managers and summarizes current research being conducted by U.S. Geological Survey (USGS) scientists and partners. It outlines important research actions that need to be undertaken over the next five years to achieve more accurate forecasting of future conditions and develop more effective decision-support tools to adaptively manage coral ecosystems. The overarching outcome of this Plan, if fully implemented, would be in transferring relevant knowledge to decision-makers, enabling them to better protect and sustain coral ecosystem services. These services include sources of food, essential habitat for fisheries and protected species, protection of coastlines from wave damage and erosion, recreation, and cultural values for indigenous communities. The USGS has a long history of research and monitoring experience in studying ancient and living coral communities and serving many stakeholders. The research actions in this Plan build on the USGS legacy of conducting integrated multidisciplinary science to address complex environmental issues. This Plan is responsive to Federal legislation and authorities and a variety of external and internal drivers that include the President's Ocean Action Plan, the recommendations of the Coral Reef Task Force, the information needs of Bureaus in the Department of Interior, the USGS Bureau Science Strategy (USGS 2007) and the formal plans of several USGS Programs. To achieve this Plan's desired outcomes will require increased funding and more effective coordination and collaboration among USGS managers and scientists within a national and international framework of partnerships in coral ecosystem science.

Health services for children in western Europe.

PubMed

Wolfe, Ingrid; Thompson, Matthew; Gill, Peter; Tamburlini, Giorgio; Blair, Mitch; van den Bruel, Ann; Ehrich, Jochen; Pettoello-Mantovani, Massimo; Janson, Staffan; Karanikolos, Marina; McKee, Martin

2013-04-06

Western European health systems are not keeping pace with changes in child health needs. Non-communicable diseases are increasingly common causes of childhood illness and death. Countries are responding to changing needs by adapting child health services in different ways and useful insights can be gained through comparison, especially because some have better outcomes, or have made more progress, than others. Although overall child health has improved throughout Europe, wide inequities remain. Health services and social and cultural determinants contribute to differences in health outcomes. Improvement of child health and reduction of suffering are achievable goals. Development of systems more responsive to evolving child health needs is likely to necessitate reconfiguring of health services as part of a whole-systems approach to improvement of health. Chronic care services and first-contact care systems are important aspects. The Swedish and Dutch experiences of development of integrated systems emphasise the importance of supportive policies backed by adequate funding. France, the UK, Italy, and Germany offer further insights into chronic care services in different health systems. First-contact care models and the outcomes they deliver are highly variable. Comparisons between systems are challenging. Important issues emerging include the organisation of first-contact models, professional training, arrangements for provision of out-of-hours services, and task-sharing between doctors and nurses. Flexible first-contact models in which child health professionals work closely together could offer a way to balance the need to provide expertise with ready access. Strategies to improve child health and health services in Europe necessitate a whole-systems approach in three interdependent systems-practice (chronic care models, first-contact care, competency standards for child health professionals), plans (child health indicator sets, reliable systems for capture and analysis of data, scale-up of child health research, anticipation of future child health needs), and policy (translation of high-level goals into actionable policies, open and transparent accountability structures, political commitment to delivery of improvements in child health and equity throughout Europe). Copyright © 2013 Elsevier Ltd. All rights reserved.

DOD Service Academies. More Actions Needed To Eliminate Sexual Harassment. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of National Security and International Affairs.

The General Accounting Office reviewed sexual harassment of students at the Naval Academy in Annapolis, Maryland; the Air Force Academy in Colorado Springs, Colorado; and the Military Academy in West Point, New York. At the core of the review were surveys of academy students, faculty, and staff conducted in late 1990 and early 1991 and focus…

CoCAR: An Online Synchronous Training Model for Empowering ICT Capacity of Teachers of Chinese as a Foreign Language

ERIC Educational Resources Information Center

Lan, Yu-Ju; Chang, Kuo-En; Chen, Nian-Shing

2012-01-01

In response to the need to cultivate pre-service Chinese as a foreign language (CFL) teachers' information and communication technology (ICT) competency in online synchronous environments, this research adopted a three-stage cyclical model named "cooperation-based cognition, action, and reflection" (CoCAR). The model was implemented in an 18-week…

Missile Defense: Actions Needed to Improve Transparency and Accountability

DTIC Science & Technology

2011-04-13

suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway...Established resource, schedule, test, operational capacity, technical, and contract baselines for several missile defense systems. It reported...Europe as well as the Ground-based Midcourse Defense system. View GAO-11-555T or key components. For more information, contact Cristina T

Mandating Education of Dental Graduates to Provide Care to Individuals with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Waldman, H. Barry; Perlman, Steven P.

2006-01-01

In 2004, The Commission on Dental Accreditation adopted new standards for dental and dental hygiene education programs to ensure the preparation of practitioners to provide oral health services for persons with special health care needs. The course of action leading to the adoption of the new standards, together with the continuing obstacles of…

Supporting the mission and goals of 2014 National Crime Victims' Rights Week, which include increasing public awareness of the rights, needs, and concerns of, and services available to assist, victims of crime in the United States.

THOMAS, 113th Congress

Rep. Costa, Jim [D-CA-16

2014-04-10

House - 06/09/2014 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Banners for Books: "Mighty-Hearted" Kindergartners Take Action through Arts-Based Service Learning

ERIC Educational Resources Information Center

Montgomery, Sarah E.; Miller, Wendy; Foss, Page; Tallakson, Denise; Howard, Maria

2017-01-01

Teaching about the Universal Declaration of Human Rights, which was adopted by the United Nations General Assembly in 1948, is one way to support students' learning about issues of fairness. However, learning about this document is not enough. Students need to have experiences where they explore issues of justice and equity in order to learn about…

Paid Support Workers for Adults with Intellectual Disabilities; Their Current Knowledge of Hearing Loss and Future Training Needs

ERIC Educational Resources Information Center

McShea, Lynzee; Fulton, John; Hayes, Catherine

2016-01-01

Background: People with intellectual disabilities are more likely to have hearing loss than the general population. For those unable to self-advocate, the responsibility of detection and management falls to their caregivers. Methods: This is the first cycle of a project using action research methodology to improve services. Twenty care workers…

Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

PubMed

Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M

2015-11-01

Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.

Commentary: Prevention of violence against children: a framework for progress in low- and middle-income countries.

PubMed

Chandran, Aruna; Puvanachandra, Prasanthi; Hyder, Adnan A

2011-02-01

Violence against children has been the least reported, studied, and understood area of child injuries. Initial awareness emerged from international conferences and resolutions, followed by national policies and statements. More effective responses around the world will require action. Although previous calls for action have pointed to important activities (gathering of baseline data, passing of legal reforms, and providing services to those who experience violence), the agenda is limited. Data collection needs to be continuous, systematic, and sustainable, and should enable ongoing evaluation of intervention programs. An inter-sectoral approach to violence against children incorporating public health, criminal justice, social services, education, non-governmental organizations, media, and businesses is imperative if the growing burden is to be mitigated. Thus we offer a framework, building on earlier recommendations, to focus on four domains: national surveillance, intervention research, legislation and policy, and partnerships and collaboration.

Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice.

PubMed

Tempest, Stephanie; Jefferson, Richard

2015-01-01

Although deemed a globally accepted framework, there remains scare evidence on the process and outcome of implementing the International Classification of Functioning, Disability and Health (ICF) within neurorehabilitation. This review briefly explores the existing, broader literature and then reports on two action research projects, undertaken in England, specifically within stroke and neurorehabilitation. Working with participants, including clinicians from in-patient and community settings, there are now 35 different ways identified for the use of the ICF. The outcome of the first project highlights that using the ICF enhances communication within and beyond the acute stroke service, fosters holistic thinking and clarifies team roles. To adopt it into clinical practice, the ICF must be adapted to meet local service needs. The use of action research has facilitated the knowledge translation process which has enabled the ICF to become a clinical reality in neurorehabilitation, with clinicians identifying a range of potential uses.

A qualitative study of clinical reasoning in physiotherapy with preterm infants and their parents: Action and interaction.

PubMed

Håkstad, Ragnhild B; Obstfelder, Aud; Øberg, Gunn Kristin

2018-09-01

Physiotherapists (PTs) in primary health care provide services to preterm infants and their parents after hospital discharge. The service should be collaborative and individualized to meet the family's needs. In this study, we analyze pediatric PTs' collaborative work in the clinical setting and investigate the PTs' emerging clinical reasoning (CR) in interaction with the infant and parent(s). The study is based on observations of 20 physical therapy sessions and 20 interviews with PTs. We performed a systematic content analysis informed by enactive theory regarding the interactions and co-creation of meaning. CR emerged in reciprocity with the PTs' interaction with the infant and parent(s). Based on the sensitivity to the infant's motor abilities and signs of engagement as well as the parents' need of support and education, the PTs individualized and reasoned about their therapeutic approach. This interactional CR was vulnerable: infant disengagement, parent expectations, and PT preoccupations could obfuscate interactions and hamper CR. Through mutuality and engagement with the infant and parent(s), the PTs allow the autonomy of interaction to emerge and shape the translation of CR into successful therapeutic actions and learning together with the infant and parent(s).

[Development of human resources and the Plan of Action].

PubMed

Vidal, C

1984-01-01

This article (whose first part was published in the previous issue of Educación Médica y Salud) concludes an exhaustive review of manpower development in the Americas. This part considers the specific measures in this field enunciated in the Plan of Action; these measures pertain to four main areas: planning and programming of human resources, training in priority areas, utilization of human resources, and educational technology. The author discusses the present and future possibilities and obstacles of each of these activities and the steps to be taken to bring needs into line with real situations. It is of paramount importance that the national health authorities clearly spell out their policies for the development of human resources in the health field within the framework of general development policies. Another point to be insisted upon is the multiprofessional and multidisciplinary training of the health team and the importance of the education-service-supervision function, which usually results in permanent and continuing education, which in turn optimizes the utilization of personnel. However, none of this will be possible without an appropriate education technology with which to innovate, analyze and refine the entire education process and so meet the needs of both society and the health services.

Putting program evaluation to work: a framework for creating actionable knowledge for suicide prevention practice.

PubMed

Wilkins, Natalie; Thigpen, Sally; Lockman, Jennifer; Mackin, Juliette; Madden, Mary; Perkins, Tamara; Schut, James; Van Regenmorter, Christina; Williams, Lygia; Donovan, John

2013-06-01

The economic and human cost of suicidal behavior to individuals, families, communities, and society makes suicide a serious public health concern, both in the US and around the world. As research and evaluation continue to identify strategies that have the potential to reduce or ultimately prevent suicidal behavior, the need for translating these findings into practice grows. The development of actionable knowledge is an emerging process for translating important research and evaluation findings into action to benefit practice settings. In an effort to apply evaluation findings to strengthen suicide prevention practice, the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) supported the development of three actionable knowledge products that make key findings and lessons learned from youth suicide prevention program evaluations accessible and useable for action. This paper describes the actionable knowledge framework (adapted from the knowledge transfer literature), the three products that resulted, and recommendations for further research into this emerging method for translating research and evaluation findings and bridging the knowledge-action gap.

The Willingness of Military Members to Seek Help: The Role of Social Involvement and Social Responsibility.

PubMed

Bowen, Gary L; Jensen, Todd M; Martin, James A; Mancini, Jay A

2016-03-01

Anchored in the social organization theory of action and change, we use data from a large sample of active-duty Air Force members to examine the direct and indirect influence of social involvement and social responsibility on willingness to seek help in times of need via trust in formal systems and informal supports. Group comparisons are conducted between junior male, junior female, senior male, and senior female service members. The key mediational path in the model for all groups is the connection between social involvement and willingness to seek help via trust in formal systems. These results can inform both unit- and community-level interventions intended to increase the likelihood that active-duty AF members will seek help in times of need. © Society for Community Research and Action 2016.

Social and Emotional Wellbeing Screening for Aboriginal and Torres Strait Islanders within Primary Health Care: A Series of Missed Opportunities?

PubMed

Langham, Erika; McCalman, Janya; Matthews, Veronica; Bainbridge, Roxanne Gwendalyn; Nattabi, Barbara; Kinchin, Irina; Bailie, Ross

2017-01-01

Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS. Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening. The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6%, ranging from 13.7 to 37.1%. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13% across the sample, ranging from 9 to 45.1%. For the clients where SEWB concern was noted, 25.4% had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7% of cases; and six-monthly follow up of referrals to external services occurred in 50.9% of cases. Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4% of clients were not screened and no further action was taken for 25.4% for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.

Psychologists in Academic Administration: A Call to Action and Service.

PubMed

Schmaling, Karen B; Linton, John C

2017-06-01

Academic psychologists' backgrounds may prepare them for many aspects of academic administration such as: understanding and working with people; prioritizing others' needs and institutional needs; and managing projects and budgets, e.g., for research grants or training programs. Contemporary academic health centers also may provide opportunities for psychologists to serve in academic health administration. This article encourages psychologists to consider preparing for and seeking administrative and higher-level leadership roles. Six psychologists serving diverse administrative roles-from vice chairs in medical school departments to presidents of universities with academic health centers-reflected on: their paths to administration; their preparation for administrative roles; and the commonalities and differences between the work and skills sets of psychologist health service providers and the work and skill sets required for higher level administrative and leadership roles.

Teaching community oriented primary care in a traditional medical school: a two year progress report.

PubMed

Klevens, J; Valderrama, C; Restrepo, O; Vargas, P; Casasbuenas, M; Avella, M M

1992-08-01

Efforts are being made to extend the practice of Community Oriented Primary Care by reorienting existing health services or restructuring medical education curricula. Nevertheless, changes in education must be simultaneous to changes in health services so that health professionals trained in COPC will find areas to practice COPC. The experience described in this article presents an effort in these two directions. A teaching program was introduced in a traditional medical school curriculum and was extended to six health services by training the directors of the health service as teaching instructors of COPC or closely coordinating actions with the director of the health service. The results of the program show fulfillment of learning objectives and student satisfaction with the program. Evaluations of the development of COPC in the health services involved show modifications in health programs to meet community needs and stronger community leadership and organization.

The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

PubMed

Leggio, William Joseph

2014-10-01

This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

Beyond Cairo: changing directions for population policies in the Asia-Pacific region.

PubMed

Jones, G W

1998-01-01

This article reviews post-Cairo thinking about population policies, program strategies by governments in the Asia-Pacific region, and the prospects for implementing reproductive health (RH) services. Cairo's action plan emphasizes development of broad social policy, sustainability, and RH. There is no mechanism of enforcement. Asia is very diverse in population size, trends in fertility and mortality, rates of economic development, patterns of migration, and development approaches. RH approaches are not controversial in Asian countries that are below, have, or are approaching replacement level fertility. Economic crises have occurred since the 1994 Cairo Plan. The region needs the Cairo focus on women's empowerment and a humane attitude to women in family planning (FP) implementation. The Cairo approach to human rights, equitable gender relations, RH and rights, and poverty alleviation is needed. It is not possible to specify what kind of FP program inputs will produce specific impacts, without considering broader policy and program contexts. Satisfaction of unmet need would more than exceed targets for fertility decline in 13 of 17 Asian countries. A focus on unmet need could take 10 years. All approaches require an expansion of service outreach. Research can determine cost effectiveness of essential RH services. RH requires institutional structures that promote a holistic view, gender sensitive quality care, and community participation. There is a need to retrain, upgrade skills, and reorient attitudes. Available financial services must be effectively used. RH must not dilute scarce FP resources.

7 CFR 1951.16 - Other servicing actions on real estate type loan accounts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 14 2014-01-01 2014-01-01 false Other servicing actions on real estate type loan... Account Servicing Policies § 1951.16 Other servicing actions on real estate type loan accounts. (a... smaller, respectively, than the sum of such installments on the note and other charges. (c) Real estate...

7 CFR 1951.16 - Other servicing actions on real estate type loan accounts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 14 2011-01-01 2011-01-01 false Other servicing actions on real estate type loan... Account Servicing Policies § 1951.16 Other servicing actions on real estate type loan accounts. (a... smaller, respectively, than the sum of such installments on the note and other charges. (c) Real estate...

7 CFR 1951.16 - Other servicing actions on real estate type loan accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Other servicing actions on real estate type loan... Account Servicing Policies § 1951.16 Other servicing actions on real estate type loan accounts. (a... smaller, respectively, than the sum of such installments on the note and other charges. (c) Real estate...

7 CFR 1951.16 - Other servicing actions on real estate type loan accounts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 14 2012-01-01 2012-01-01 false Other servicing actions on real estate type loan... Account Servicing Policies § 1951.16 Other servicing actions on real estate type loan accounts. (a... smaller, respectively, than the sum of such installments on the note and other charges. (c) Real estate...

7 CFR 1951.16 - Other servicing actions on real estate type loan accounts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 14 2013-01-01 2013-01-01 false Other servicing actions on real estate type loan... Account Servicing Policies § 1951.16 Other servicing actions on real estate type loan accounts. (a... smaller, respectively, than the sum of such installments on the note and other charges. (c) Real estate...

Coming of Age on the Margins: Mental Health and Wellbeing Among Latino Immigrant Young Adults Eligible for Deferred Action for Childhood Arrivals (DACA).

PubMed

Siemons, Rachel; Raymond-Flesch, Marissa; Auerswald, Colette L; Brindis, Claire D

2017-06-01

Undocumented immigrant young adults growing up in the United States face significant challenges. For those qualified, the Deferred Action for Childhood Arrivals (DACA) program's protections may alleviate stressors, with implications for their mental health and wellbeing (MHWB). We conducted nine focus groups with 61 DACA-eligible Latinos (ages 18-31) in California to investigate their health needs. Participants reported MHWB as their greatest health concern and viewed DACA as beneficial through increasing access to opportunities and promoting belonging and peer support. Participants found that DACA also introduced unanticipated challenges, including greater adult responsibilities and a new precarious identity. Thus, immigration policies such as DACA may influence undocumented young adults' MHWB in expected and unexpected ways. Research into the impacts of policy changes on young immigrants' MHWB can guide stakeholders to better address this population's health needs. MHWB implications include the need to reduce fear of deportation and increase access to services.

Influenza sentinel surveillance network: a public health-primary care collaborative action to assess influenza A(H1N1)pmd09 in Catalonia, Spain.

PubMed

Torner, Nuria; Baricot, Maretva; Martínez, Ana; Toledo, Diana; Godoy, Pere; Dominguez, Ángela

2013-03-01

The aim of this study was to evaluate the outcome of a collaborative action between Public Health services and Primary Care in the context of a case-control study on effectiveness of pharmaceutical and non-pharmaceutical measures to prevent hospitalization in a pandemic situation. To carry out this research the collaborative action of the primary care physicians members of the Influenza surveillance network was needed, they had to recall clinical information from influenza A(H1N1)pmd09 confirmed outpatient cases and negative outpatient controls matching their corresponding hospitalized confirmed case.   A survey questionnaire to assess involvement of Influenza Sentinel Surveillance Primary care physicians' Network of Catalonia (PIDIRAC) regarding the outpatient case and control outreach during the pandemic influenza season was performed. A total of 71,1% of completed surveys were received. Perception of pandemic activity was considered to be similar to seasonal influenza activity in 43.8% or higher but not unbearable in 37.5% of the replies. There was no nuisance reported from patients regarding neither the questions nor the surveyor. Collaborative research between Public Health services and Primary Care physicians enhances Public Health actions and research.

Industrial action by nurses: the Italian situation.

PubMed

Sala, R; Usai, M

1997-07-01

Those who want to know anything about strike action by Italian nurses will find very little written about it. This contribution intends to show that, whatever they are prepared to admit, Italian nurses are not used to strike action because they mostly think of their profession as a form of mission. Even if we could agree with the idea of nursing as a profession subscribing to an ideal of service, we have to distinguish between a real profession and philanthropic work; vocational motivation is not enough to make a good professional. Historically, nurses perceived strikes as contradictory to human need and action; patients must never be left alone. However, Italian nurses are now interested in a dramatic transformation of many aspects of their professional life, becoming conscious of the duty to protect themselves from every kind of exploitation, even if the typical idealism and dedication of nurses makes them vulnerable.

Better management of Irish hospitals.

PubMed

Brugha, C M

1991-08-01

The establishment of the Dublin Hospitals Initiative and the Efficiency Review Group as first steps in an "action" plan was based on the report in 1989 of the Commission of Health Funding which suggested that "the solution to the problem facing the Irish health services...(lies) primarily...in the way that services are planned, organised and delivered". Our health service is in transition from the phase of facility management into that of functional management. This will involve facing the fact of the limit on resources, introducing information systems and getting the co-operation of hospital doctors. The most senior executive in a hospital must firstly be a good general manager with sufficient power to manage. Hospitals should be divided into centres of responsibility made up of one or more centres of activity. Formal education for hospital administrators should be extended. There is a need for training at all levels, particularly of those administrative and medical staff who have direct interaction with the computer-based system. There should be a commitment to management development particularly by means of teamwork and action learning.

Impact of Affirmative Action on Quality of Service Delivery in the Public Service Sector of Kenya: A Comparative Case Study of the Ministry of State in the Office of the President and Ministry of Higher Education

ERIC Educational Resources Information Center

Kilonzo, Evans Mbuthi; Ikamari, Lawrence

2015-01-01

This study was carried out to determine the impact of affirmative action policy on the quality service delivery in the public service sector of Kenya. The study was carried out on the premise that there is a relationship between affirmative Action implementation and the quality of service delivery in the public service sector of Kenya. A lot of…

Prevention and control of noncommunicable diseases through evidence-based public health: implementing the NCD 2020 action plan.

PubMed

Diem, Günter; Brownson, Ross C; Grabauskas, Vilius; Shatchkute, Aushra; Stachenko, Sylvie

2016-09-01

The control of noncommunicable diseases (NCDs) was addressed by the declaration of the 66th United Nations (UN) General Assembly followed by the World Health Organization's (WHO) NCD 2020 action plan. There is a clear need to better apply evidence in public health settings to tackle both behaviour-related factors and the underlying social and economic conditions. This article describes concepts of evidence-based public health (EBPH) and outlines a set of actions that are essential for successful global NCD prevention. The authors describe the importance of knowledge translation with the goal of increasing the effectiveness of public health services, relying on both quantitative and qualitative evidence. In particular, the role of capacity building is highlighted because it is fundamental to progress in controlling NCDs. Important challenges for capacity building include the need to bridge diverse disciplines, build the evidence base across countries and the lack of formal training in public health sciences. As brief case examples, several successful capacity-building efforts are highlighted to address challenges and further evidence-based decision making. The need for a more comprehensive public health approach, addressing social, environmental and cultural conditions, has led to government-wide and society-wide strategies that are now on the agenda due to efforts such as the WHO's NCD 2020 action plan and Health 2020: the European Policy for Health and Wellbeing. These efforts need research to generate evidence in new areas (e.g. equity and sustainability), training to build public health capacity and a continuous process of improvement and knowledge generation and translation. © The Author(s) 2015.

"They treat us like we're not there": Queer bodies and the social production of healthcare spaces.

PubMed

Meer, Talia; Müller, Alex

2017-05-01

There is significant literature demonstrating the interpenetrability of identity and space, yet there is almost no work that explores the co-production of queer identities and healthcare spaces. We use Lefebvre's triad of (social) space to explore how the social spaces of South African healthcare facilities shape and are shaped by queer service-users, drawing on data from interviews and focus group discussions with 29 queer service-users and 14 representatives of organisations. Findings reveal that healthcare spaces are produced by the spatial ordering of health policy inattentive to queer health needs; the enduring symbolic representations of queerness as pathological or 'un-African'; and various identity assertions and practices of individuals, including queer service-users and healthcare providers. As a result, healthcare spaces are overwhelmingly heteronormative, although queer service-users' subversive practices suggest alternative spatial configurations. However, such resistance relies on individual empowered action and risks disciplining responses. Wider efforts are needed to transform the material and ideological space of healthcare facilities through law and policy reform and continuing professional training for healthcare providers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Action Research on Development and Application of Internet of Things Services in Hospital.

PubMed

Park, Arum; Chang, Hyejung; Lee, Kyoung Jun

2017-01-01

Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.

Action Research on Development and Application of Internet of Things Services in Hospital

PubMed Central

Park, Arum; Chang, Hyejung

2017-01-01

Objectives Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Methods Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. Results During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. Conclusions From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital. PMID:28261528

78 FR 18966 - Publication of Fiscal Year 2012 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... Year 2012 Service Contract Inventory AGENCY: Court Services and Offender Supervision Agency for the District of Columbia. ACTION: Notice of Public Availability of FY 2012 Service Contract Inventory. SUMMARY... 2012 Service Contract Inventory. This inventory provides information on service contract actions over...

The GEOSS User Requirement Registry (URR): A Cross-Cutting Service-Oriented Infrastructure Linking Science, Society and GEOSS

NASA Astrophysics Data System (ADS)

Plag, H.-P.; Foley, G.; Jules-Plag, S.; Ondich, G.; Kaufman, J.

2012-04-01

The Group on Earth Observations (GEO) is implementing the Global Earth Observation System of Systems (GEOSS) as a user-driven service infrastructure responding to the needs of users in nine interdependent Societal Benefit Areas (SBAs) of Earth observations (EOs). GEOSS applies an interdisciplinary scientific approach integrating observations, research, and knowledge in these SBAs in order to enable scientific interpretation of the collected observations and the extraction of actionable information. Using EOs to actually produce these societal benefits means getting the data and information to users, i.e., decision-makers. Thus, GEO needs to know what the users need and how they would use the information. The GEOSS User Requirements Registry (URR) is developed as a service-oriented infrastructure enabling a wide range of users, including science and technology (S&T) users, to express their needs in terms of EOs and to understand the benefits of GEOSS for their fields. S&T communities need to be involved in both the development and the use of GEOSS, and the development of the URR accounts for the special needs of these communities. The GEOSS Common Infrastructure (GCI) at the core of GEOSS includes system-oriented registries enabling users to discover, access, and use EOs and derived products and services available through GEOSS. In addition, the user-oriented URR is a place for the collection, sharing, and analysis of user needs and EO requirements, and it provides means for an efficient dialog between users and providers. The URR is a community-based infrastructure for the publishing, viewing, and analyzing of user-need related information. The data model of the URR has a core of seven relations for User Types, Applications, Requirements, Research Needs, Infrastructure Needs, Technology Needs, and Capacity Building Needs. The URR also includes a Lexicon, a number of controlled vocabularies, and

Application of a Multimedia Service and Resource Management Architecture for Fault Diagnosis

PubMed Central

Castro, Alfonso; Sedano, Andrés A.; García, Fco. Javier; Villoslada, Eduardo

2017-01-01

Nowadays, the complexity of global video products has substantially increased. They are composed of several associated services whose functionalities need to adapt across heterogeneous networks with different technologies and administrative domains. Each of these domains has different operational procedures; therefore, the comprehensive management of multi-domain services presents serious challenges. This paper discusses an approach to service management linking fault diagnosis system and Business Processes for Telefónica’s global video service. The main contribution of this paper is the proposal of an extended service management architecture based on Multi Agent Systems able to integrate the fault diagnosis with other different service management functionalities. This architecture includes a distributed set of agents able to coordinate their actions under the umbrella of a Shared Knowledge Plane, inferring and sharing their knowledge with semantic techniques and three types of automatic reasoning: heterogeneous, ontology-based and Bayesian reasoning. This proposal has been deployed and validated in a real scenario in the video service offered by Telefónica Latam. PMID:29283398

Application of a Multimedia Service and Resource Management Architecture for Fault Diagnosis.

PubMed

Castro, Alfonso; Sedano, Andrés A; García, Fco Javier; Villoslada, Eduardo; Villagrá, Víctor A

2017-12-28

Nowadays, the complexity of global video products has substantially increased. They are composed of several associated services whose functionalities need to adapt across heterogeneous networks with different technologies and administrative domains. Each of these domains has different operational procedures; therefore, the comprehensive management of multi-domain services presents serious challenges. This paper discusses an approach to service management linking fault diagnosis system and Business Processes for Telefónica's global video service. The main contribution of this paper is the proposal of an extended service management architecture based on Multi Agent Systems able to integrate the fault diagnosis with other different service management functionalities. This architecture includes a distributed set of agents able to coordinate their actions under the umbrella of a Shared Knowledge Plane, inferring and sharing their knowledge with semantic techniques and three types of automatic reasoning: heterogeneous, ontology-based and Bayesian reasoning. This proposal has been deployed and validated in a real scenario in the video service offered by Telefónica Latam.

Implementation of secondary fracture prevention services after hip fracture: a qualitative study using extended Normalization Process Theory.

PubMed

Drew, Sarah; Judge, Andrew; May, Carl; Farmer, Andrew; Cooper, Cyrus; Javaid, M Kassim; Gooberman-Hill, Rachael

2015-04-23

National and international guidance emphasizes the need for hospitals to have effective secondary fracture prevention services, to reduce the risk of future fractures in hip fracture patients. Variation exists in how hospitals organize these services, and there remain significant gaps in care. No research has systematically explored reasons for this to understand how to successfully implement these services. The objective of this study was to use extended Normalization Process Theory to understand how secondary fracture prevention services can be successfully implemented. Forty-three semi-structured interviews were conducted with healthcare professionals involved in delivering secondary fracture prevention within 11 hospitals that receive patients with acute hip fracture in one region in England. These included orthogeriatricians, fracture prevention nurses and service managers. Extended Normalization Process Theory was used to inform study design and analysis. Extended Normalization Process Theory specifies four constructs relating to collective action in service implementation: capacity, potential, capability and contribution. The capacity of healthcare professionals to co-operate and co-ordinate their actions was achieved using dedicated fracture prevention co-ordinators to organize important processes of care. However, participants described effective communication with GPs as challenging. Individual potential and commitment to operationalize services was generally high. Shared commitments were promoted through multi-disciplinary team working, facilitated by fracture prevention co-ordinators. Healthcare professionals had capacity to deliver multiple components of services when co-ordinators 'freed up' time. As key agents in its intervention, fracture prevention coordinators were therefore indispensable to effective implementation. Aside from difficulty of co-ordination with primary care, the intervention was highly workable and easily integrated into practice. Nevertheless, implementation was threatened by under-staffed and under-resourced services, lack of capacity to administer scans and poor patient access. To ensure ongoing service delivery, the contributions of healthcare professionals were shaped by planning, in multi-disciplinary team meetings, the use of clinical databases to identify patients and define the composition of clinical work and monitoring to improve clinical practice. Findings identify and describe elements needed to implement secondary fracture prevention services successfully. The study highlights the value of Normalization Process Theory to achieve comprehensive understanding of healthcare professionals' experiences in enacting a complex intervention.

Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda.

PubMed

Atuyambe, Lynn M; Kibira, Simon P S; Bukenya, Justine; Muhumuza, Christine; Apolot, Rebecca R; Mulogo, Edgar

2015-04-22

Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available. A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software. Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase. Adolescents in Uganda have multiple sexual and reproductive health needs that require special focus through adolescent friendly services. This calls for resource support in terms of health provider training, information education and communication materials as well as involvement of key stakeholders that include parents, teachers and legislators.

Primary Care Behavioral Health (PCBH) Model Research: Current State of the Science and a Call to Action.

PubMed

Hunter, Christopher L; Funderburk, Jennifer S; Polaha, Jodi; Bauman, David; Goodie, Jeffrey L; Hunter, Christine M

2018-06-01

The Primary Care Behavioral Health (PCBH) model of service delivery is being used increasingly as an effective way to integrate behavioral health services into primary care. Despite its growing popularity, scientifically robust research on the model is lacking. In this article, we provide a qualitative review of published PCBH model research on patient and implementation outcomes. We review common barriers and potential solutions for improving the quantity and quality of PCBH model research, the vital data that need to be collected over the next 10 years, and how to collect those data.

The need of a multi-actor perspective to understand expectations from virtual presence: managing elderly homecare informatics.

PubMed

Mettler, Tobias; Vimarlund, Vivian

2011-12-01

Different studies have analysed a wide range of use cases and scenarios for using IT-based services in homecare settings for elderly people. In most instances, the impact of such services has been studied using a one-dimensional approach, either focusing on the benefits for the patient or health service provider. The objective of this contribution is to explore a model for identifying and understanding outcomes of IT-based homecare services from a multi-actor perspective. In order to better understand the state of the art in homecare informatics, we conducted a literature review. We use experiences from previous research in the area of informatics to develop the proposed model. The proposed model consists of four core activities 'identify involved actors', 'understand consequences', 'clarify contingencies', 'take corrective actions', and one additional activity 'brainstorming IT use'. The primary goal of innovating organisations, processes and services in homecare informatics today, is to offer continued care, better decision support both to practitioners and patients, as well as effective distribution of resources. A multi-actor analysis perspective is needed to understand utility determination for the involved stakeholders.

34 CFR 668.83 - Emergency action.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Emergency action. 668.83 Section 668.83 Education... Proceedings § 668.83 Emergency action. (a) Under an emergency action, the Secretary may— (1) Withhold Title IV... action against an institution or third-party servicer by sending the institution or servicer a notice by...

34 CFR 668.83 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Emergency action. 668.83 Section 668.83 Education... Proceedings § 668.83 Emergency action. (a) Under an emergency action, the Secretary may— (1) Withhold Title IV... action against an institution or third-party servicer by sending the institution or servicer a notice by...

How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.

PubMed

Hill, Sophie J; Sofra, Tanya A

2017-03-07

Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy. Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee. Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity. Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and governments have taken a critical interest in improving health literacy. What does this paper add? This article presents the findings of the Victorian Consultation on Health Literacy as they relate to needs, priorities and potential actions for improving health information. In the context of the National Statement for Health Literacy, health information should be a priority, given its centrality to the public's management of its own health and effective, standards-based, patient-centred clinical care. A framework to improve health information would underpin the efforts of government, services and consumer organisations to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What are the implications for practitioners? The development and provision of health information materials needs to be systematised and supported by infrastructure, requiring leadership, cultural change, standards and skills development.

Managing bay and estuarine ecosystems for multiple services

USGS Publications Warehouse

Needles, Lisa A.; Lester, Sarah E.; Ambrose, Richard; Andren, Anders; Beyeler, Marc; Connor, Michael S.; Eckman, James E.; Costa-Pierce, Barry A.; Gaines, Steven D.; Lafferty, Kevin D.; Lenihan, Junter S.; Parrish, Julia; Peterson, Mark S.; Scaroni, Amy E.; Weis, Judith S.; Wendt, Dean E.

2013-01-01

Managers are moving from a model of managing individual sectors, human activities, or ecosystem services to an ecosystem-based management (EBM) approach which attempts to balance the range of services provided by ecosystems. Applying EBM is often difficult due to inherent tradeoffs in managing for different services. This challenge particularly holds for estuarine systems, which have been heavily altered in most regions and are often subject to intense management interventions. Estuarine managers can often choose among a range of management tactics to enhance a particular service; although some management actions will result in strong tradeoffs, others may enhance multiple services simultaneously. Management of estuarine ecosystems could be improved by distinguishing between optimal management actions for enhancing multiple services and those that have severe tradeoffs. This requires a framework that evaluates tradeoff scenarios and identifies management actions likely to benefit multiple services. We created a management action-services matrix as a first step towards assessing tradeoffs and providing managers with a decision support tool. We found that management actions that restored or enhanced natural vegetation (e.g., salt marsh and mangroves) and some shellfish (particularly oysters and oyster reef habitat) benefited multiple services. In contrast, management actions such as desalination, salt pond creation, sand mining, and large container shipping had large net negative effects on several of the other services considered in the matrix. Our framework provides resource managers a simple way to inform EBM decisions and can also be used as a first step in more sophisticated approaches that model service delivery.

78 FR 44307 - Semiannual Agenda

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-23

... Service--Completed Actions Regulation Sequence No. Title Identifier No. 233 Indoor Tanning Services; 1545... TREASURY (TREAS) Internal Revenue Service (IRS) Completed Actions 233. Indoor Tanning Services; Cosmetic...: Proposed regulations provide guidance on the indoor tanning services tax made by the Patient Protection and...

An analysis of potential stream fish and fish habitat monitoring procedures for the Inland Northwest: Annual Report 1999

Treesearch

James T. Peterson; Sherry P. Wollrab

1999-01-01

Natural resource managers in the Inland Northwest need tools for assessing the success or failure of conservation policies and the impacts of management actions on fish and fish habitats. Effectiveness monitoring is one such potential tool, but there are currently no established monitoring protocols. Since 1991, U.S. Forest Service biologists have used the standardized...

Defense Logistics: DOD Needs to Take Additional Actions to Address Challenges in Supply Chain Management

DTIC Science & Technology

2011-07-01

Jack E. Edwa appendix III. t rds Director, Defense Capabilities and Managemen Page 36 GAO-11-569 Defense Logistics List of Committees...Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302... operations . DOD faces asset visibility challenges due, in part, to a lack of interoperability among information technology

Schools and Libraries Corporation: Actions Needed To Strengthen Program Integrity Operations before Committing Funds. Testimony before the Committee on Commerce, Science, and Transportation, U.S. Senate.

ERIC Educational Resources Information Center

England-Joseph, Judy A.

The Telecommunications Act of 1996 expanded universal support to eligible schools and libraries. To administer the universal service program for schools and libraries, the Federal Communications Commission (FCC) directed the creation of the Schools and Libraries Corporation (Corporation). As a start-up operation, the Corporation has had to develop…

Image-based change estimation (ICE): monitoring land use, land cover and agent of change information for all lands

Treesearch

Kevin Megown; Andy Lister; Paul Patterson; Tracey Frescino; Dennis Jacobs; Jeremy Webb; Nicholas Daniels; Mark Finco

2015-01-01

The Image-based Change Estimation (ICE) protocols have been designed to respond to several Agency and Department information requirements. These include provisions set forth by the 2014 Farm Bill, the Forest Service Action Plan and Strategic Plan, the 2012 Planning Rule, and the 2015 Planning Directives. ICE outputs support the information needs by providing estimates...

Debt Collection: More Aggressive Action Needed To Collect Debts Owed by Health Professionals. United States General Accounting Office Report to the Honorable John R. Kasich, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The General Accounting Office (GAO) reviewed and evaluated debt collection activities of five programs of the Health Resources and Services Administration (HRSA) that provide financial assistance to health professions students and medical facilities. The principal findings include: (1) HRSA changes have improved delinquency rates; however, large…

Predictors of Ethical Stress, Moral Action and Job Satisfaction in Health Care Social Workers

PubMed Central

O'Donnell, Patricia; Farrar, Adrienne; BrintzenhofeSzoc, Karlynn; Conrad, Ann Patrick; Danis, Marion; Grady, Christine; Taylor, Carol; Ulrich, Connie M.

2016-01-01

Value conflicts can be a source of ethical stress for social workers in health care settings. That stress, unless mediated by the availability of ethical resource services, can lead to social workers' dissatisfaction with their positions and careers, and possibly result in needed professionals leaving the field. This study explored social workers' experiences in dealing with ethical issues in health care settings. Findings showed the inter-relationship between selected individual and organizational factors and overall ethical stress, the ability to take moral actions, the impact of ethical stress on job satisfaction, and the intent to leave position. PMID:18551828

Using service data: tools for taking action.

PubMed

1992-01-01

Program performance can be improved through use of a simple information system. The focus of the discussion is on analysis of service data, decision making, and program improvement. Clinic managers must collect and analyze their own data and not wait for supervisors from central or district offices to conduct thorough examination. Local decision making has the advantage of providing monitoring and modification of services in a timely way and in a way responsive to client needs. Information can be shared throughout all levels of local and central administration. The model for decision making is based on data collection, data analysis, decision making, action, evaluation, information dissemination, and feedback. Data need to be collected on types of clients (new acceptor or continuing user), type of contraceptive method and quantity dispensed, and how the client learned about the clinic. Supply data also needs to be collected on methods of contraceptives on hand, number dispensed by method to clients, and projected supplies; requests for additional supplies can thus be made in a timely and appropriate way. The basic clinic forms are the family planning (FP), client record, the client referral card, an appointment card, a complication card, a daily FP activity register, a FP activities worksheet, a monthly summary of FP activities, and a commodities request/receipt form. A suggestion sheet from users addresses issues about performance targets, continuing users, dropouts, staff motivation, and setting up a system. Suggestions are also provided on the importance of staff training in data collection and analysis and in creating awareness of the program's objectives. Discussion is directed to how to interpret new acceptor data and to look for patterns. A sample chart is provided of a summary of FP activities, possible interpretations, and possible actions to take. Analysis is given for new acceptor trends, contraceptive method mix, and sources of information. A short example illustrates how client card data and bar graphs of method mix by desire for no more children or for more children revealed that couples childbearing desires did not affect method choice.

Achieving the World Health Organization's vision for clinical pharmacology

PubMed Central

Henry, David; Gray, Jean; Day, Richard; Bochner, Felix; Ferro, Albert; Pirmohamed, Munir; Mörike, Klaus; Schwab, Matthias

2015-01-01

Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence‐based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co‐morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need. PMID:26466826

Resettlement of individuals with learning disabilities into community care: a risk audit.

PubMed

Ellis, Roger; Hogard, Elaine; Sines, David

2013-09-01

This article describes a risk audit carried out on the support provided for 36 people with profound learning disabilities who had been resettled from hospital care to supported housing. The risks were those factors identified in the literature as associated with deleterious effects on quality of life. The audit was carried out with a specially designed tool that covered 24 possible risks and involved a support worker familiar with the service user choosing the most appropriate statement regarding each risk. Their judgements were verified by care managers and social needs assessors. Whilst one or more risks were identified for 32 of the 36 service users, the overall result showed relatively low risks for the group as a whole with 62 incidences (7%) from a possible 864, which nevertheless highlighted several areas that needed attention. The results of the audit have led to action plans for the provision and for the individual service users for whom risks were identified.

Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

PubMed Central

2014-01-01

Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

75 FR 82066 - Status Report of Water Service, Repayment, and Other Water-Related Contract Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Status Report of Water Service, Repayment, and Other Water- Related Contract Actions AGENCY: Bureau of Reclamation, Interior. ACTION: Notice. SUMMARY... CONTACT: Michelle Kelly, Water and Environmental Services Division, Bureau of Reclamation, P.O. Box 25007...

13 CFR 120.1716 - Required SBA approval of servicing actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Required SBA approval of servicing actions. 120.1716 Section 120.1716 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS... § 120.1716 Required SBA approval of servicing actions. Seller shall not, without prior written consent...

OTF CCSDS Mission Operations Prototype. Directory and Action Service. Phase I: Exit Presentation

NASA Technical Reports Server (NTRS)

Reynolds, Walter F.; Lucord, Steven A.; Stevens, John E.

2009-01-01

This slide presentation describes the phase I directory and action service prototype for the CCSDS system. The project goals are to: (1) Demonstrate the use of Mission Operations standards to implement Directory and Action Services (2) Investigate Mission Operations language neutrality (3) Investigate C3I XML interoperability concepts (4) Integrate applicable open source technologies in a Service Oriented Architecture

The Cairo conference: feminists vs. the Pope.

PubMed

Grant, L

1994-07-01

The draft Programme of Action to be discussed at the UN International Conference on Population and Development (ICPD) in Cairo is not about population and development, but about women and related agendas, supporting the various family forms (which promote population growth), and incalculable amounts of funding to increase the breadth of goals (e.g., more funding to improve the quality of life in cities). It does little to link those goals with global population growth. The US Department of State supports the militant feminists' agenda, which is for money to be directed to women's advancement activities rather than to direct population programs. Their reasoning is that women will achieve the socially desirable fertility level if they have unimpeded freedom of choice. The Vatican, which opposes birth control and abortion, is chastising the women's groups and the population movement. The US government has shifted its position to accommodate the militant feminists. It is not listening to bioscientists, demographers, and others who might have mellowed the advocacy approach. The draft Programme of Action has no population goals, which are needed to operate a population program. The US government should call for meeting unmet needs for contraception, expansion of family planning facilities and services in developing countries, and reinstatement of goals in the international population dialogue. It should also continue efforts to persuade developing country leaders of the importance of the population issue and of incentives and disincentives. Its first priority should be population, followed by development assistance to maternal and child health services coordinated with family planning services.

Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review.

PubMed

Haberlen, Sabina A; Narasimhan, Manjulaa; Beres, Laura K; Kennedy, Caitlin E

2017-06-01

Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care. © 2017 The Population Council, Inc.

Strategy to combat obesity and to promote physical activity in Arab countries.

PubMed

Musaiger, Abdulrahman O; Al Hazzaa, Hazzaa M; Al-Qahtani, Aayed; Elati, Jalila; Ramadan, Jasem; Aboulella, Nebal A; Mokhtar, Najat; Kilani, Hashem A

2011-01-01

Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries' government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included.

Strategy to combat obesity and to promote physical activity in Arab countries

PubMed Central

Musaiger, Abdulrahman O; Al Hazzaa, Hazzaa M; Al-Qahtani, Aayed; Elati, Jalila; Ramadan, Jasem; AboulElla, Nebal A; Mokhtar, Najat; Kilani, Hashem A

2011-01-01

Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries’ government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included. PMID:21660292

An operational model for mainstreaming ecosystem services for implementation

PubMed Central

Cowling, Richard M.; Egoh, Benis; Knight, Andrew T.; O'Farrell, Patrick J.; Reyers, Belinda; Rouget, Mathieu; Roux, Dirk J.; Welz, Adam; Wilhelm-Rechman, Angelika

2008-01-01

Research on ecosystem services has grown markedly in recent years. However, few studies are embedded in a social process designed to ensure effective management of ecosystem services. Most research has focused only on biophysical and valuation assessments of putative services. As a mission-oriented discipline, ecosystem service research should be user-inspired and user-useful, which will require that researchers respond to stakeholder needs from the outset and collaborate with them in strategy development and implementation. Here we provide a pragmatic operational model for achieving the safeguarding of ecosystem services. The model comprises three phases: assessment, planning, and management. Outcomes of social, biophysical, and valuation assessments are used to identify opportunities and constraints for implementation. The latter then are transformed into user-friendly products to identify, with stakeholders, strategic objectives for implementation (the planning phase). The management phase undertakes and coordinates actions that achieve the protection of ecosystem services and ensure the flow of these services to beneficiaries. This outcome is achieved via mainstreaming, or incorporating the safeguarding of ecosystem services into the policies and practices of sectors that deal with land- and water-use planning. Management needs to be adaptive and should be institutionalized in a suite of learning organizations that are representative of the sectors that are concerned with decision-making and planning. By following the phases of our operational model, projects for safeguarding ecosystem services are likely to empower stakeholders to implement effective on-the-ground management that will achieve resilience of the corresponding social-ecological systems. PMID:18621695

Building a National Culture of Health

PubMed Central

Chandra, Anita; Acosta, Joie; Carman, Katherine Grace; Dubowitz, Tamara; Leviton, Laura; Martin, Laurie T.; Miller, Carolyn; Nelson, Christopher; Orleans, Tracy; Tait, Margaret; Trujillo, Matthew; Towe, Vivian; Yeung, Douglas; Plough, Alonzo L.

2017-01-01

Abstract Because health is a function of more than medical care, solutions to U.S. health problems must encompass more than reforms to health care systems. But those working to improve health, well-being, and equity still too often find themselves traveling on parallel paths that rarely intersect. In 2013, the Robert Wood Johnson Foundation (RWJF) embarked on a pioneering effort to advance a Culture of Health initiative. A Culture of Health places well-being at the center of every aspect of life, with the goal of enabling everyone in our diverse society to lead healthier lives, now and for generations to come. To put this vision into action, RWJF worked with RAND to develop an action framework that identifies how the nation will work toward achieving these outcomes. This article provides background on the development of this action framework. The Culture of Health action framework is designed around four action areas and one outcome area. Action areas are the core areas in which investment and activity are needed: (1) making health a shared value; (2) fostering cross-sector collaboration to improve well-being; (3) creating healthier, more equitable communities; and (4) strengthening integration of health services and systems. Each action area contains a set of drivers indicating where the United States needs to accelerate change and a set of measures illustrating places for progress. Within the primary Culture of Health outcome---improved population health, well-being, and equity---the authors identified three outcome areas: enhanced individual and community well-being, managed chronic disease and reduced toxic stress, and reduced health care costs. PMID:28845341

[Emergency service utilization and athletic injuries--data collection from the Fulda district].

PubMed

Raschka, C; Witzel, K

1996-06-01

Throughout the period of one year all sports accidents, which implied the need of medical services (n = 59), in the district of Fulda with 195,000 inhabitants were analysed. The bulk of the accidents took place during soccer matches (37.3%). The share of women was 25.4%. A repeated trauma was registered in 69.5% of the cases. 16% of the casualties received outpatient treatment. The ambulance was already at the site of the accident in 35.6% of the cases. The greater part of the accidents happened in the afternoon (57.6%). The accident was caused due to another athlete in 44.1% of the accidents. An ambulance with a doctor on board was needed four times, because the injury demanded treatment by an internist. The principle measure of first aid, taken by the ambulance men, was the positioning of the injured limb on a splint (n = 44). The incidence of sports accidents with need for medical service is 30/100,000 inhabitants. The part of sports accidents in relation to all ambulance actions is 2.3% (internal medicine only 0.18% and surgery only 15.3%). The percentage of sports accidents demanding a doctor in relation to all rescues with the need for a doctor is 0.3%.

Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

PubMed

Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

2016-09-01

Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Expected Impact of Health Care Reform on the Organization and Service Delivery of Publicly Funded Addiction Health Services.

PubMed

Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence

2017-07-01

Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.

Expected Impact of Health Care Reform on the Organization and Service Delivery of Publicly Funded Addiction Health Services

PubMed Central

Harris, Lesley; Padwa, Howard; Vega, William A.; Palinkas, Lawrence

2015-01-01

Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs’ strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities. PMID:26008902

76 FR 14969 - Public Availability of Environmental Protection Agency FY 2010 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Environmental Protection Agency FY 2010 Service Contract Inventory AGENCY: Environmental Protection Agency. ACTION: Notice of public availability of FY 2010 Service Contract inventories. SUMMARY: In accordance... 2010 Service Contract inventory. This inventory provides information on service contract actions over...

77 FR 5513 - Public Availability of Environmental Protection Agency FY 2011 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... Environmental Protection Agency FY 2011 Service Contract Inventory AGENCY: Environmental Protection Agency. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance... 2011 Service Contract Inventory. This inventory provides information on service contract actions over...

78 FR 7858 - Publication of Fiscal Year 2012 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... DEPARTMENT OF THE TREASURY Publication of Fiscal Year 2012 Service Contract Inventory AGENCY: Departmental Offices, Treasury. ACTION: Notice of publication of Fiscal Year 2012 Service Contract Inventory... Fiscal Year (FY) 2012 Service Contract Inventory. The Inventory lists all service contract actions over...

Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects.

PubMed

Jasso-Aguilar, Rebeca; Waitzkin, Howard; Landwehr, Angela

2004-01-01

In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector

Multinational Corporations and Health Care in the United States and Latin America: Strategies, Actions, and Effects*

PubMed Central

JASSO-AGUILAR, REBECA; WAITZKIN, HOWARD; LANDWEHR, ANGELA

2010-01-01

In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations’ access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector. PMID:15779471

Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands

PubMed Central

2013-01-01

Background A mental health needs assessment in the Irish prison population confirmed findings from other jurisdictions showing high prevalence of severe mental illness, including psychosis amongst those newly committed. We implemented a participatory action research approach in order to provide an integrated mental health prison in-reach and court liaison service for this population. Results Following extensive consultation, a two stage screening process was developed which was supplemented by an inter-agency referral management system. During the six years 2006–2011, all 20,084 new remands to the main remand prison serving 58% of the national population were screened. Following the first stage screen, 3,195 received a comprehensive psychiatric assessment. Of these 561 (2.8%) had symptoms of psychosis – corresponding to the prior research finding – and 572 were diverted from the criminal justice system to mental health services (89 to a secure forensic hospital, 164 to community mental health hospitals and 319 to other community mental health services). Conclusions We have shown that it is possible to match research findings in clinical practice by systematic screening, to sustain this over a long period and to achieve consistent levels of diversion from the criminal justice system to appropriate mental health services. The sustained and consistent performance of the model used is likely to reflect the use of participatory action research both to find the most effective model and to achieve wide ownership and cooperation with the model of care. PMID:23800103

Professionalizing action research--a meaningful strategy for modernizing services?

PubMed

Hall, Julie E

2006-04-01

This paper outlines how a specific action research approach can be used to secure practice development in services which have found sustained change difficult. For the purpose of this paper discussion focuses upon using professionalizing action research (a form of action research) to secure transformation in acute inpatient mental health services. This speciality has experienced long-term difficultly in meaningful practice change. Not limited to this context parallels can be made with other health and social care services requiring significant modernization. The aim is to critically discuss the use of professionalizing action research as an approach to sustainable change. clarifies whether this method is a suitable vehicle for change, which is ideally suited to services which have a poor record of practice development. A review of action research and practice development literature forms the basis of this paper. The literature is sourced through bulletin boards, electronic databases and the British Library Classification Scheme. Keywords searched are action research, team learning, managing change and practice development. Following definition; the components of professionalizing action research are analysed using the themes of educative base, problem focus, improvement and involvement. The educative base of professionalizing action research is collaborative reflective practice which is used to initiate meaningful change, rooted in everyday practice. The benefit of this is that change actions are based in real-time situations. The problem focus component of professionalizing action research is used to emphasize the views of service users and carers. This is positive in terms of the patient and public involvement agenda although this theme does emphasize limitations of the approach. The final components are involvement and improvement, these are debated as pluralistic notions and the implications of this are acknowledged. Reviewing the literature and theoretical application indicates the value of professionalizing action research as a process for modernization. The strength of the approach lies in the opportunity for team learning and change which is grounded in the context of services and pursued through collaboration.

Who is in Your Waiting Room? Health Care Professionals as Culturally Responsive and Trauma-Informed First Responders to Human Trafficking.

PubMed

Rollins, Rochelle; Gribble, Anna; Barrett, Sharon E; Powell, Clydette

2017-01-01

Evidence-based practice standards are not yet well defined for assisting potential victims of human trafficking. Nonetheless, health care professionals are learning to be first responders in identifying, treating, and referring potential victims. As more public and private sector resources are used to train health care professionals about human trafficking, more evaluation and research are needed to develop an effective standard of care. Adopting a public health lens and using the "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care" can guide critical decision making and actions. Through collaboration between researchers and policymakers, lessons learned in health care settings can inform future evidence-based standards of care so that all patients receive the services that they need. © 2017 American Medical Association. All Rights Reserved.

Protection of sexual and reproductive health rights: addressing violence against women.

PubMed

García-Moreno, Claudia; Stöckl, Heidi

2009-08-01

Violence against women is recognized as a global public health and human rights problem in need of urgent attention. It affects women's health, including their sexual and reproductive health, and their human rights. While progress has been made in the last 15 years, there is still a long way to go. International human rights law and public health provide tools to governments and non-governmental actors to ensure women a life free from violence and its consequences. Health policies and services need to address violence more systematically and health providers must take action. At a minimum, they should be informed and able to respond appropriately to violence, providing appropriate care and referral to other services. Equally, if not more important, is to provide support to interventions that prevent violence against women from happening in the first place.

Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

PubMed

Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

2011-11-01

In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.

A Scotland-wide pilot programme of smoking cessation services for young people: process and outcome evaluation.

PubMed

Gnich, Wendy; Sheehy, Christine; Amos, Amanda; Bitel, Mark; Platt, Stephen

2008-11-01

To conduct an independent, external evaluation of a Scotland-wide youth cessation pilot programme, focusing upon service uptake and effectiveness. National Health Service (NHS) Health Scotland and Action on Smoking and Health (ASH) Scotland funded a 3-year (2002-2005) national pilot programme comprising eight projects which aimed to engage with and support young smokers (aged 12-25 years) to quit. Process evaluation was undertaken via detailed case studies comprising qualitative interviews, observation and documentary analysis. Outcomes were assessed by following project participants (n=470 at baseline) at 3 and 12 months and measuring changes in smoking behaviour, including carbon monoxide (CO)-validated quit status. Recruitment proved difficult. Considerable time and effort were needed to attract young smokers. Advertising and recruitment had to be tailored to project settings and educational activities proved essential to raise the profile of smoking as an issue. Thirty-nine participants [8.6%, 95% confidence interval (CI) 5.0-11.2%] were CO-validated quitters at 3 months and 11 of these (2.4%, 95% CI 1.90-3.8%) were also validated quitters at 12 months. Older participants were more likely to be abstinent at 3 months. The overall quit rate was disappointing. As a result of low participant numbers, it was impossible to draw conclusions about the relative effectiveness of different project approaches. These findings give little support to the case for developing dedicated youth cessation services in Scotland. They also highlight the difficulties of undertaking 'real-world' evaluations of pilot youth cessation projects. More action is needed to develop environments which enhance young smokers' motivation to quit and their ability to sustain quit attempts.

78 FR 14298 - Public Availability of Environmental Protection Agency FY 2012 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... Environmental Protection Agency FY 2012 Service Contract Inventory AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of public availability of FY 2012 Service Contract Inventories. SUMMARY: In accordance... 2012 Service Contract Inventory. This inventory provides information on service contract actions over...

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

PubMed

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

National audit of continence care for older people: management of urinary incontinence.

PubMed

Wagg, Adrian; Potter, Jonathan; Peel, Penny; Irwin, Penny; Lowe, Derek; Pearson, Michael

2008-01-01

the Department of Health report 'Good practice in continence services' highlights the need for proper assessment and management of urinary incontinence. The National Service Framework for Older People required service providers to establish integrated continence services by April 2004. A national audit was conducted to assess the quality of continence care for older people and whether these requirements have been met. the audit studied incontinent individuals of 65 years and over. Each site returned data on organisational structure and the process of 20 patients' care. Data were submitted via the internet, and all were anonymous. the national audit was conducted across England, Wales and Northern Ireland. Data on the care of patients/residents with bladder problems were returned by 141/326 (43%) of primary care trusts (PCT), by 159/196 (81%) of secondary care trusts (involving 198 hospitals) and by 29/309 (9%) of invited care homes. In all 58% of PCT, 48% of hospitals and 74% of care homes reported that integrated continence services existed in their area. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services, and in the assessment and management of urinary incontinence in the elderly. the results of this audit indicate that the requirement for integrated continence services has not yet been met. Assessment and care by professionals directly looking after the older person were often lacking. There is an urgent need to re-establish the fundamentals of continence care into the practice of medical and nursing staff and action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.

HIV scale-up in Mozambique: Exceptionalism, normalisation and global health

PubMed Central

Høg, Erling

2014-01-01

The large-scale introduction of HIV and AIDS services in Mozambique from 2000 onwards occurred in the context of deep political commitment to sovereign nation-building and an important transition in the nation's health system. Simultaneously, the international community encountered a willing state partner that recognised the need to take action against the HIV epidemic. This article examines two critical policy shifts: sustained international funding and public health system integration (the move from parallel to integrated HIV services). The Mozambican government struggles to support its national health system against privatisation, NGO competition and internal brain drain. This is a sovereignty issue. However, the dominant discourse on self-determination shows a contradictory twist: it is part of the political rhetoric to keep the sovereignty discourse alive, while the real challenge is coordination, not partnerships. Nevertheless, we need more anthropological studies to understand the political implications of global health funding and governance. Other studies need to examine the consequences of public health system integration for the quality of access to health care. PMID:24499102

HIV scale-up in Mozambique: exceptionalism, normalisation and global health.

PubMed

Høg, Erling

2014-01-01

The large-scale introduction of HIV and AIDS services in Mozambique from 2000 onwards occurred in the context of deep political commitment to sovereign nation-building and an important transition in the nation's health system. Simultaneously, the international community encountered a willing state partner that recognised the need to take action against the HIV epidemic. This article examines two critical policy shifts: sustained international funding and public health system integration (the move from parallel to integrated HIV services). The Mozambican government struggles to support its national health system against privatisation, NGO competition and internal brain drain. This is a sovereignty issue. However, the dominant discourse on self-determination shows a contradictory twist: it is part of the political rhetoric to keep the sovereignty discourse alive, while the real challenge is coordination, not partnerships. Nevertheless, we need more anthropological studies to understand the political implications of global health funding and governance. Other studies need to examine the consequences of public health system integration for the quality of access to health care.

The experiences and needs of individuals with disabilities exposed to chronic political violence.

PubMed

Shpigelman, Carmit-Noa; Gelkopf, Marc

2017-01-01

Purpose The main objective of this study was to understand, describe and map the experiences, challenges and needs of individuals with lifelong disabilities, who have been exposed to chronic politically violent events (terror, war or continuous missile attacks) in Israel. Method The study was conducted within the qualitative-constructivist paradigm. Three focus groups consisting of 18 individuals with lifelong disabilities were conducted; each focus group included a specific disability type (physical, visual and hearing impairment). Results The participants reported encountering environmental barriers, such as inaccessibly of the physical environment and information as well as dependency on others. These barriers limited the participants' functioning during emergency period and thus increased their level of distress. The participants also emphasized their physical, social and psychological needs. Conclusions The needs of individuals with disabilities in emergency situations can be met if they have a safe place to stay in, are with someone else, and plan every daily action in advance. It is also imperative to provide accessible services and information. Furthermore, it is recommended to develop training sessions for individuals with disabilities and for service providers regarding how to locate, communicate with and assist individuals with disabilities during security threat situations. Implications for Rehabilitation Successful coping of individuals with lifelong disabilities with chronic politically violent events depends on personal and organizational accommodations. Besides an accessible physical environment, the information provided should be available and accessible through mass media and assistive technologies. A comprehensive emergency service for various disabilities is needed. Service providers should be trained on how to locate, communicate with, and assist individuals with disabilities during security threat situations.

78 FR 54201 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and... further possible actions necessary to improve internet protocol captioned telephone relay service (IP CTS... for calculating the compensation rate paid to IP CTS providers. This action is necessary to ensure...

75 FR 6700 - National Park Service Concessions Management Advisory Board Reestablishment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

... DEPARTMENT OF THE INTERIOR National Park Service Concessions Management Advisory Board Reestablishment AGENCY: National Park Service, Interior. ACTION: Notice of reestablishment of the National Park... administratively reestablish the National Park Service Concessions Management Advisory Board. This action is...

The need for social support provided by the non-profit cancer societies throughout different phases in the cancer trajectory and its integration into public healthcare.

PubMed

Yli-Uotila, Tiina; Kaunonen, Marja; Pylkkänen, Liisa; Suominen, Tarja

2016-04-01

To describe the phases of the cancer trajectory when social support, in the form of electronic counselling services, as provided by the non-profit cancer societies, is needed, as well as how these services are integrated into the cancer care in public healthcare. In this descriptive qualitative study a purposive sample of patients with cancer (n = 12) were interviewed. The data were content analysed inductively. Social support was needed when emotional well-being was weakened, when the body broke, when the care pathway induced unawareness, and when empowerment needed strengthening. There was no need for social support when well-being was considered in balance. The electronic counselling services were integrated into cancer care by supporting the patient with cancer emotionally, developing the informational expertise of the patient with cancer, expanding the opportunities for support, and supporting public healthcare. Integration required improvements to the actions of the patients and various actors involved in the healthcare system. There was no integration due to the health status of the patient and the sufficiency of the primary support sources. The received social support was not integrated into the actual cancer treatment process of the patient with cancer in the public healthcare system. The phases of support needed in the cancer trajectory as defined by the patient differ from the traditional biomedical phases of treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Marginal Man and Military Service, A Review

DTIC Science & Technology

1965-12-01

of Research and Development , Department of the Army. Members of the group were Dr. Robert Vineberg of the Human Resources Research Office of the...careful analysis of the situation; in others, research may be necessary to supply an unambiguous answer as to the best course of action. Development ...attempt to provide? Experience—and research - will be needed to develop guidelines for the instructor who undertakes to train marginal adults in a

INSA Hand Puppet Training Manual: Involving U.S. Citizens in a Puppetmaking Project To Enhance the Use of Educational Puppet Theater in Developing Nations.

ERIC Educational Resources Information Center

Carter, David A.

Designed to help U.S. citizens become aware of the needs of people living in developing countries, this puppet project is an action oriented education program implemented by the International Service Association for Health, Inc. (INSA). The program's primary purpose is to inform citizens about global concerns and issues while enlisting public…

To require the Forest Service to accommodate, to the extent consistent with the management objectives and limitations applicable to the National Forest System lands at issue, individuals with mobility disabilities who need to use a power-driven mobility device for reasonable access to such lands.

THOMAS, 111th Congress

Rep. Alexander, Rodney [R-LA-5

2009-12-08

House - 03/29/2010 Referred to the Subcommittee on Department Operations, Oversight, Nutrition and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Learning from the implementation of inter-organisational web-based care planning and coordination.

PubMed

Walker, Rae; Blacker, Vivian; Pandita, Linda; Close, Jacky; Mason, Wendy; Watson, Julie

2013-01-01

In Victoria, despite strong policy support, e-care planning and coordination is poorly developed. The action research project discussed here was developed to overcome organisational and worker-level barriers to change. The project outcomes highlighted the need for work on the building blocks of e-care coordination that enhance workers' knowledge and skills, and provide permission and support for appropriate collaborative system and services coordination practices.

Migration and AIDS.

PubMed

1998-01-01

This article presents the perspectives of UNAIDS and the International Organization for Migration (IOM) on migration and HIV/AIDS. It identifies research and action priorities and policy issues, and describes the current situation in major regions of the world. Migration is a process. Movement is enhanced by air transport, rising international trade, deregulation of trade practices, and opening of borders. Movements are restricted by laws and statutes. Denial to freely circulate and obtain asylum is associated with vulnerability to HIV infections. A UNAIDS policy paper in 1997 and IOM policy guidelines in 1988 affirm that refugees and asylum seekers should not be targeted for special measures due to HIV/AIDS. There is an urgent need to provide primary health services for migrants, voluntary counseling and testing, and more favorable conditions. Research is needed on the role of migration in the spread of HIV, the extent of migration, availability of health services, and options for HIV prevention. Research must be action-oriented and focused on vulnerability to HIV and risk taking behavior. There is substantial mobility in West and Central Africa, economic migration in South Africa, and nonvoluntary migration in Angola. Sex workers in southeast Asia contribute to the spread. The breakup of the USSR led to population shifts. Migrants in Central America and Mexico move north to the US where HIV prevalence is higher.

Coral Reef Remote Sensing: Helping Managers Protect Reefs in a Changing Climate

NASA Astrophysics Data System (ADS)

Eakin, C.; Liu, G.; Li, J.; Muller-Karger, F. E.; Heron, S. F.; Gledhill, D. K.; Christensen, T.; Rauenzahn, J.; Morgan, J.; Parker, B. A.; Skirving, W. J.; Nim, C.; Burgess, T.; Strong, A. E.

2010-12-01

Climate change and ocean acidification are already having severe impacts on coral reef ecosystems. Warming oceans have caused corals to bleach, or expel their symbiotic algae (zooxanthellae) with alarming frequency and severity and have contributed to a rise in coral infectious diseases. Ocean acidification is reducing the availability of carbonate ions needed by corals and many other marine organisms to build structural components like skeletons and shells and may already be slowing the coral growth. These two impacts are already killing corals and slowing reef growth, reducing biodiversity and the structure needed to provide crucial ecosystem services. NOAA’s Coral Reef Watch (CRW) uses a combination of satellite data, in situ observations, and models to provide coral reef managers, scientists, and others with information needed to monitor threats to coral reefs. The advance notice provided by remote sensing and models allows resource managers to protect corals, coral reefs, and the services they provide, although managers often encounter barriers to implementation of adaptation strategies. This talk will focus on application of NOAA’s satellite and model-based tools that monitor the risk of mass coral bleaching on a global scale, ocean acidification in the Caribbean, and coral disease outbreaks in selected regions, as well as CRW work to train managers in their use, and barriers to taking action to adapt to climate change. As both anthropogenic CO2 and temperatures will continue to rise, local actions to protect reefs are becoming even more important.

New perspectives on population: lessons from Cairo.

PubMed

Ashford, L S

1995-03-01

The lessons from the 1994 World Population Conference in Cairo, Egypt, are summarized in this publication. The topics of discussion include the evolution of population policies, the changing policy environment, demographic trends, and solutions in the form of gender equity, provision of reproductive health services, and sustainable social and economic development. The program of action supported by 180 governments and targeted for 2015 articulated the goals of universal access to a full range of safe and reliable family planning methods and reproductive health services, a specified level of reduction in infant and child mortality, a specified level of reduction in maternal mortality, an increase in life expectancy to 70-75 years or more, and universal access to and completion of primary education. Other features include goals for improving women's status and equity in gender relations, expansion of educational and job opportunities for women and girls, and involvement of men in childrearing responsibilities and family planning. Steps should be taken to eliminate poverty and reduce or eliminate unsustainable patterns of production and consumption. Population policy must be integrated within social and economic development policies. About $22 billion will be needed for provision of family planning and reproductive health services by the year 2015. Costs will increase over the 10-year period due to the increased population to be served. Per person user costs for family planning alone are higher in countries without infrastructure and technical skills. Actual costs vary with the cost of contraceptive supplies, patterns of use, and efficiency of delivery systems. Although the plan offers 16 chapters worth of advice and recommends 243 specific actions, countries will have to be selective due to cost limitations. The 20/20 Initiative is proposed for sharing social service costs between international donors (20%) and host countries (20%). A separate UN projection of need is for 33% of support from international donors for family planning and related programs. The constraints to the implementation of the action plan are identified as the rate of demographic change, the extent of public support for population limitation and provision of family planning services, and potential conflicts of interests and funding between cooperating agencies. The World Bank has developed guidelines for policy development according to a country's identification as an emergent, transitional, or advanced country.

Assessment without action; a randomised evaluation of the interRAI home care compared to a national assessment tool on identification of needs and service provision for older people in New Zealand.

PubMed

Parsons, Matthew; Senior, Hugh; Mei-Hu Chen, Xenia; Jacobs, Stephen; Parsons, John; Sheridan, Nicolette; Kenealy, Timothy

2013-09-01

Comprehensive geriatric assessment (CGA) is considered the cornerstone of good practice, as it identifies need across multiple domains such as social, physical and psychological. The interRAI home care (interRAI-HC), probably the most well-researched and supported community-based CGA has been implemented globally, often at considerable expense. Policy-makers, managers and clinicians anticipate significant gains in health outcomes following such investment; however, the implementation of CGA is often undertaken in the absence of community service development. This study sought to compare the interRAI-HC with an existing CGA [the Support Needs Assessment (SNA)] in community-dwelling older people. A randomised controlled trial was undertaken from January 2006 to January 2007 comparing the interRAI-HC and the SNA in 316 people (65+) referred for assessment of needs with follow-up at 1 and 4 months. Outcomes included health-related quality of life, physical function, social support, cognitive status, mood and health service usage as well as identified need. The study found that significantly more support needs were identified using the interRAI-HC compared to the SNA. More social and carer support were recommended by SNA and more rehabilitation and preventive health screens were recommended by interRAI-HC. Despite these differences, the mean healthcare use was similar at 4 months, although interRAI-HC participants had more Emergency Department presentations and hospital admissions. No statistically significant differences between groups were reported in terms of outcomes. In conclusion, the interRAI-HC was found to identify more unmet support needs than the SNA though resulted in no favourable outcomes for the older person or their carer. The study highlights the need to invest attention around the service context to maximise outcomes based on identified needs. © 2013 John Wiley & Sons Ltd.

Mozambican midwives' views on barriers to quality perinatal care.

PubMed

Pettersson, Karen Odberg; Johansson, Eva; Pelembe, Maria de Fatima M; Dgedge, Clemencia; Christensson, Kyllike

2006-02-01

Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures.

Towards a Global MAP Data Base

NASA Technical Reports Server (NTRS)

Hartmann, G. K.

1985-01-01

Scientific and ecological needs call for the generation of a global data base of measured data from the Earth's atmosphere, similar but complementary to the data of the meteorological service. Right now there is a large gap between these needs and the available financial means. If this prevails, it might be prohibitive for the generation of such a data base. There must be a compromise between the needs and the means. Priorities must be set. Thus, discussions should be started on which data can be or should be stored. Newly generated data for storage in such a data base is recommended to be handled by the World Data Centers (WDCs). This brief report should help to stimulate discussions and ubsequent actions.

Women's descriptions of childbirth trauma relating to care provider actions and interactions.

PubMed

Reed, Rachel; Sharman, Rachael; Inglis, Christian

2017-01-10

Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women's experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes. As part of a large mixed methods study, 748 women completed an online survey and answered the question 'describe the birth trauma experience, and what you found traumatising'. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process. Four themes were identified in the data: 'prioritising the care provider's agenda'; 'disregarding embodied knowledge'; 'lies and threats'; and 'violation'. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women's own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider's clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault. Care provider actions and interactions can influence women's experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.

Understanding the parents of children with special needs: collaboration between health, social and education networks.

PubMed

Tétreault, S; Freeman, A; Carrière, M; Beaupré, P; Gascon, H; Marier Deschênes, P

2014-11-01

In 2003, Quebec's Ministry of Health and Social Services (MSSS) and the Ministry of Education, Recreation and Sports (MELS) concluded the Agreement for the complementarity of services between the health and social services network and the education network. The objectives of the current investigation were to evaluate the implementation of this Agreement and its impact upon renewal of practices and services, and to investigate the consequences for children with special needs and their families. The specific focus of this article is to describe parents' perspectives regarding the impact of this Agreement upon them and their children. Interviews were conducted with 56 parents of children with disabilities, social maladjustment or learning difficulties across the province of Quebec. Data were analysed using content analysis. Most parents were not directly aware of any contact between school staff and health or social professionals, although discussions might have been held without their knowledge. The intervention plans seemed to be the main vehicle through which some parents perceived collaboration to be occurring. For parents, the impact upon actual practices or collaborative work is either minimal or non-existent. School inclusion of children with special needs is a challenge for all societies. The Agreement illustrates the Quebec government's intent to promote an alliance between two complex networks and has the potential to greatly benefit children and their families. However, more concrete action is required in order to realize specific changes regarding work cohesion and service organization for these groups. © 2013 John Wiley & Sons Ltd.

Development of a Web-based tool to collect and display water system customer service areas for public health action.

PubMed

Wong, Michelle; Wolff, Craig; Collins, Natalie; Guo, Liang; Meltzer, Dan; English, Paul

2015-01-01

Significant illness is associated with biological contaminants in drinking water, but little is known about health effects from low levels of chemical contamination in drinking water. To examine these effects in epidemiological studies, the sources of drinking water of study populations need to be known. The California Environmental Health Tracking Program developed an online application that would collect data on the geographic location of public water system (PWS) customer service areas in California, which then could be linked to demographic and drinking water quality data. We deployed the Water Boundary Tool (WBT), a Web-based geospatial crowdsourcing application that can manage customer service boundary data for each PWS in California and can track changes over time. We also conducted a needs assessment for expansion to other states. The WBT was designed for water system operators, local and state regulatory agencies, and government entities. Since its public launch in 2012, the WBT has collected service area boundaries for about 2300 individual PWS, serving more than 90% of the California population. Results of the needs assessment suggest interest and utility for deploying such a tool among states lacking statewide PWS service area boundary data. Although the WBT data set is incomplete, it has already been used for a variety of applications, including fulfilling legislatively mandated reporting requirements and linking customer service areas to drinking water quality data to better understand local water quality issues. Development of this tool holds promise to assist with outbreak investigations and prevention, environmental health monitoring, and emergency preparedness and response.

Community participation for transformative action on women's, children's and adolescents' health.

PubMed

Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda

2016-05-01

The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.

Strengthening the Health System to Better Confront Noncommunicable Diseases in India

PubMed Central

Duran, Antonio; Khot, Anagha

2011-01-01

The paper emphasizes the vital need to address the rising burden of noncommunicable diseases (NCDs) in India with a health systems approach. The authors argue that adoption of such approach may soon be imperative. Applying the health systems framework developed by the WHO in 2000 to NCDs means in summary re-examining the planning and organization of the entire health system, from service provision to financing, from information generation to ensuring adequate supply of pharmaceuticals/technologies or human resources, from improving facility management to performance monitoring. Using this framework the authors seek to highlight core issues and identify possible policy actions required. The challenge is to ensure the best implementation of what works, aligning the service provision function with the financial incentives, ensuring leadership/stewardship by the government across local/municipal, state or regional and national level while involving stakeholders. A health system perspective would also ensure that action against NCD goes hand in hand with tackling the remaining burden from communicable diseases, maternal, child health and nutrition issues. PMID:22628908

Elder abuse: The role of general practitioners in community-based screening and multidisciplinary action

PubMed

Ries, Nola M; Mansfield, Elise

2018-04-01

There are growing calls for elder abuse screening to be conducted by a range of community-based service providers, including general practitioners (GPs), practice nurses, home care workers and lawyers. Improved screening may be a valuable first step towards improving elder abuse detection and response; however, practitioners need evidence-based strategies for screening and follow-up. This article summarises several brief screening tools for various forms of elder abuse. Screening tool properties and evidence gaps are noted. As elder abuse often requires multidisciplinary responses, initiatives to connect health, legal and other service providers are highlighted. GPs are trusted professionals who are well placed to identify older patients at risk of, or experiencing, various forms of abuse. They should be aware of available screening tools and consider how best to incorporate them into their own practice. They also play an important role in multidisciplinary action to address elder abuse.

Developing a strategic marketing plan for hospitals.

PubMed

Dychtwald, K; Zitter, M

1988-09-01

The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market.

A comparative study of the knowledge, beliefs, and practices of diabetic patients cared for at a teaching hospital (free service) and those cared for by private practitioners (paid service).

PubMed

Sivagnanam, G; Namasivayam, K; Rajasekaran, M; Thirumalaikolundusubramanian, P; Ravindranath, C

2002-04-01

The aim of this study was to determine and compare the knowledge, beliefs, and practices of diabetics receiving free medical care and those paying for medical care in Tamilnadu, India. A questionnaire was administered to elicit diabetic patients' knowledge regarding diet, exercise, adverse effects, habits, and other matters; their beliefs about diabetes; and their practices regarding diet, medication, and self-monitoring. The results showed a large gap between knowledge and action in both groups and a need for increased efforts toward patient education regarding diabetes.

Omani Pre-Service Science Teachers' Views about Global Warming: Beliefs about Actions and Willingness to Act

ERIC Educational Resources Information Center

Ambusaidi, Abdullah; Boyes, Edward; Stanisstreet, Martin; Taylor, Neil

2012-01-01

A 44-item questionnaire was employed to determine pre-service teachers' beliefs about how useful various specific actions might be in helping to reduce global warming, their willingness to undertake these same actions, and the extent to which these two might be related. The instrument was administered to pre-service science teachers (n = 104) at…

Enabling health systems transformation: what progress has been made in re-orienting health services?

PubMed

Wise, Marilyn; Nutbeam, Don

2007-01-01

The Ottawa Charter has been remarkably influential in guiding the development of the goals and concepts of health promotion, and in shaping global public health practice in the past 20 years. However, of the five action areas identified in the Ottawa Charter, it appears that there has been little systematic attention to the challenge of re-orienting health services, and less than optimal progress in practice. The purposes of re-orienting health services as proposed in the Ottawa Charter were to achieve a better balance in investment between prevention and treatment, and to include a focus on population health outcomes alongside the focus on individual health outcomes. However, there is little evidence that a re-orientation of health services in these terms has occurred systematically anywhere in the world. This is in spite of the fact that direct evidence of the need to re-orient health services and of the potential benefits of doing so has grown substantially since 1986. Patient education, preventive care (screening, immunisation), and organisational and environmental changes by health organisations have all been found to have positive health and environmental outcomes. However, evidence of effectiveness has not been sufficient, on its own, to sway community preferences and political decisions. The lack of progress points to the need for significant re-thinking of the approaches we have adopted to date. The paper proposes a number of ways forward. These include working effectively in partnership with the communities we want to serve to mobilise support for change, and to reinforce this by working more effectively at influencing broader public opinion through the media. The active engagement of clinical health professionals is also identified as crucial to achieving sustainable change. Finally we recognize that by working in partnership with like-minded advocacy organizations, the IUHPE could put its significant knowledge and experience to work in leading action to transform health care systems to make a major contribution to the improvement of public health.

Preliminary assessment of appropriateness of emergency care service use: actions taken and consultations obtained before emergency care presentation.

PubMed

Tzeng, Huey-Ming

2011-01-01

Inappropriate use of emergency care services can increase hospital readmissions and related costs. This pilot, cross-sectional survey project determined whether home health care patients who receive emergency care services during a Medicare-approved home care episode sought consultation from health care professionals before they made the emergency care visit. The two research questions were: (a) What actions were taken by the patient before making an emergency care visit?; (b) If prior consultation was obtained, what were the suggestions? Preliminary data were obtained from a Michigan-based, Medicare-certified, not-for-profit home health agency affiliated with a university health system. A two-page questionnaire recorded up to three emergency care visits. Volunteer participants were Medicare patients who had no cognitive deficits and were able to communicate with home health care providers (HHCPs) by themselves. Thirty-five emergency care visits were reported; 31 (88.6%) Medicare patients participated and 4 (11.4%) of them had two emergency care visits. Before the patients made an emergency care visit, they most often called their primary care physicians (PCPs; N = 20, 57.1%), followed by the HHCPs (N = 10, 28.6%). All 20 patients who contacted their PCPs and 7 patients who contacted their HHCPs were advised to seek emergency care services. In 20 emergency care visits the patient was admitted for an acute hospital stay; the other 15 patients went home. Most patients contacted their PCPs or HHCPs before they went to an emergency department or urgent care facility. These results implied that PCPs and HHCPs seemed to perceive that the need for emergency care should be determined at an emergency room or urgent care facility. This study was unable to differentiate the need for emergency care services or the appropriateness of the advice given by PCPs or HHCPs when the home care patients were under the care of a medical team.

How can the rehabilitation planning process at the workplace be improved? A qualitative study from employers' perspective.

PubMed

Larsson, Agneta; Gard, Gunvor

2003-09-01

Employers in Sweden are by law responsible for planning and controlling the working environment situation in their companies and for ensuring that any need for rehabilitation is noted as soon as possible and that action is taken. This includes developing a plan for rehabilitation. The aim of this study is to describe employers' experiences of the work rehabilitation planning process at the workplace, and how it can be improved with a focus on quality and cost-effectiveness. Qualitative interviews were performed with 10 employers of employee/s that had participated in vocational rehabilitation at a rehabilitation center in the North of Sweden. The results showed that employers were interested in detecting work rehabilitation needs and in taking action early. Rehabilitation at the workplace could be improved by development of routines, improved work relations and work technique, and environment in-service training at the workplace. Prevention was perceived as a prerequisite for a good result of rehabilitation. Attention to social and geographic conditions is needed. Organizational and financial limitations exist.

Problems that mothers' with epilepsy experience when caring for their children.

PubMed

Bagshaw, Jan; Crawford, Pamela; Chappell, Brian

2008-01-01

Women with epilepsy who were service users of Epilepsy Action in the United Kingdom (UK) completed a questionnaire on the risks of caring for their baby and whether they were provided with useful information on fulfilling their caring role (Epilepsy Action is the trading name of the British Epilepsy Association a major UK charity for those with epilepsy). The cohort of 84 all reported some problems. The following were rated as being the most problematic; caring for their baby outside the home and bathing, whereas breastfeeding was rated as much less problematic. Some problems were rated as severe, which meant some babies were put at undue risk. Approximately 50% had been provided with information about caring and managing risk. Eighty-six percent found this information useful. The main conclusion is that more extensive, well-planned research is needed on this topic. There is virtually nothing in the academic literature to guide practice and this is needed. Present guidelines tend only to cover what the women rate as less problematic, e.g. breastfeeding, whereas what they rate highly problematic is often not covered. This needs attention in updates.

Caring Across the Continuum: A Call to Nurse Leaders to Manifest Values Through Action With Community Outreach.

PubMed

Dyess, Susan MacLeod; Opalinski, Andra; Saiswick, Kim; Fox, Valerie

2016-01-01

As health reform continues to advance, there is a need for nurse leaders to broaden their perspective related to possible nursing practice models and potential community partners in order to successfully address caring, accomplish the triple aim mandate, and achieve suitable metrics for maximum reimbursement. Intentional efforts must be made by nurse leaders to maximize caring and ensure that professional nurses are responding to the key drivers shifting health care delivery in the 21st century. Academic-practice collaboration (APC) and community-based participatory action research (CBPAR) align well. Together, they provide an ideal mechanism to pursue endeavors that extend evidence for caring services across the health care continuum. One APC/CBPAR model for community outreach that can maximize individual and population health outcomes is highlighted in this article. Furthermore, useful action steps are offered that could be taken by a nurse leader to develop and maintain any form of APC/CBPAR in order to manifest values through caring action across the health care continuum.

Meeting the needs of people with AIDS: local initiatives and Federal support.

PubMed Central

Sundwall, D N; Bailey, D

1988-01-01

The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

Nature as capital: Advancing and incorporating ecosystem services in United States federal policies and programs.

PubMed

Schaefer, Mark; Goldman, Erica; Bartuska, Ann M; Sutton-Grier, Ariana; Lubchenco, Jane

2015-06-16

The concept of nature as capital is gaining visibility in policies and practices in both the public and private sectors. This change is due to an improved ability to assess and value ecosystem services, as well as to a growing recognition of the potential of an ecosystem services approach to make tradeoffs in decision making more transparent, inform efficient use of resources, enhance resilience and sustainability, and avoid unintended negative consequences of policy actions. Globally, governments, financial institutions, and corporations have begun to incorporate natural capital accounting in their policies and practices. In the United States, universities, nongovernmental organizations, and federal agencies are actively collaborating to develop and apply ecosystem services concepts to further national environmental and economic objectives. Numerous federal agencies have begun incorporating these concepts into land use planning, water resources management, and preparations for, and responses to, climate change. Going forward, well-defined policy direction will be necessary to institutionalize ecosystem services approaches in federal agencies, as well as to guide intersector and interdisciplinary collaborative research and development efforts. In addition, a new generation of decision support tools are needed to further the practical application of ecosystem services principles in policymaking and commercial activities. Improved performance metrics are needed, as are mechanisms to monitor the status of ecosystem services and assess the environmental and economic impacts of policies and programs. A greater national and international financial commitment to advancing ecosystem services and natural capital accounting would likely have broad, long-term economic and environmental benefits.

Violent media exposure, aggression and CU traits in adolescence: Testing the selection and socialization hypotheses.

PubMed

Rydell, Ann-Margret

2016-10-01

We investigated the role of exposure to violent action for later aggression and for later callous-unemotional traits in a sample of Swedish adolescents (N = 77-85), testing the selection and socialization hypotheses. Adolescents reported on violent delinquency and on callous-unemotional (CU) traits at age 15, on their media habits at age 16 and on reactive and proactive aggression and CU traits at age 18. The socialization hypothesis was supported with regard to aggression, that is, violent delinquency did not affect consumption of violent action, but controlling for violent delinquency, consumption of violent action added to proactive aggression and, marginally, to reactive aggression. The selection hypothesis was supported with regard to CU traits, that is, high levels of CU traits predicted frequent consumption of violent action, but consumption of violent action did not affect later levels of CU traits. Frequent violent media use was associated with later aggression. The associations between CU traits and violent media need further study. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Community mental health nursing: keeping pace with care delivery?

PubMed

Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa

2008-06-01

The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.

An evaluation of governance capacity of the specialized component of pharmaceutical services in Brazil.

PubMed

Rover, Marina Raijche Mattozo; Peláez, Claudia Marcela Vargas; Faraco, Emília Baierle; Farias, Mareni Rocha; Leite, Silvana Nair

2017-08-01

This paper presents application of an indicator protocol to assessment of current levels of governance capacity of the Specialized Component of Pharmaceutical Services (CEAF) in a state of the South of Brazil. We chose the theoretical referential of 'governance capacity' proposed by Carlos Matus, which reflects in the concepts of management capacity and pharmaceutical service management, due to the perception of a need to overcome the fragmentation and technicist reductionism that we believe has been imposed on the area of pharmaceutical services. Data was collected using the protocol in 74 municipal or state units. The results of the analysis indicate that the currently existing governance capacity needs improvement in all three dimensions that were evaluated, principally in relation to the aspects that seek sustainability of the governance. The model and the protocol used indicate a way forward for governance of pharmaceutical service by proposing a change from the technicist-logistical focus to an emphasis on strategic and political actions, or ones which foster greater participation and autonomy. With these results in hand, it will be possible to develop strategies for improvement of access to medicines in the SUS, in the sense that the CEAF becomes able to guarantee integrality of medicines treatments.

When health services researchers and policy makers interact: tales from the tectonic plates.

PubMed

Martens, Patricia J; Roos, Noralou P

2005-09-01

There has been a strong push over the last decade for health services researchers to become "relevant," to work with policy makers to translate evidence into action. What has been learned from this interaction? The pooled experiences of health services researchers across the country, including those at the Manitoba Centre for Health Policy (MCHP), suggest five key lessons. First, policy makers pay more attention to research findings if they have invested their own funds and time. Second, researchers must make major investments in building relationships with policy makers, because there are inevitable tensions between what the two parties need and do. Third, researchers must be able to figure out and communicate the real meaning of their results. Fourth, health services researchers need a "back-pocket" mindset, as they cannot count on immediate uptake of results; because the issues never go away, evidence, if known and easily retrievable, is likely to have an eventual impact. Finally, getting evidence into the policy process does not come cheaply or easily, but it can be done. The overriding lesson learned by health services researchers is the importance of relationship-building, whether in formalizing contractual relationships, building and maintaining personal trust, having a communications strategy or increasing the involvement of users in the research process.

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

NASA Astrophysics Data System (ADS)

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

2013-04-01

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

Quality improvement activities associated with organisational capacity in general practice.

PubMed

Amoroso, Cheryl; Proudfoot, Judy; Bubner, Tanya; Swan, Edward; Espinel, Paola; Barton, Christopher; Beilby, Justin; Harris, Mark

2007-01-01

Clinical audit is recognised worldwide as a useful tool for quality improvement. A feedback report profiling capacity for chronic disease care was sent to 97 general practices. These practices were invited to complete a clinical audit activity based on that feedback. Data were analysed quantitatively and case studies were developed based on the free text responses. Eighty-two (33%) of 247 general practitioners participated in the clinical audit process, representing 57 (59%) of 97 general practices. From the data in their feedback report, 37 (65%) of the 57 practices recognised the area most in need of improvement. This was most likely where the need related to clinical practice or teamwork, and least likely where the need related to linkages with other services, and business and finance. Only 25 practices (46%) developed an action plan related to their recognised area for improvement, and 22 (39%) practices implemented their chosen activity. Participating GPs judged that change activity focused on teamwork was most successful. The clinical audit process offered participating GPs and practices an opportunity to reflect on their performance across a number of key areas and to implement change to enhance the practice's capacity for quality chronic disease care. The relationship between need and action was weak, suggesting a need for greater support to overcome barriers.

Multiple barriers to participation for people with psychosocial disability in Dehradun district, North India: a cross-sectional study.

PubMed

Mathias, Kaaren; Pant, Hira; Marella, Manjula; Singh, Lawrence; Murthy, Gvs; Grills, Nathan

2018-02-27

This study used a population-based cross-sectional survey to describe the prevalence of psychosocial disability and unmet need for access to services in North India. This study was conducted in Dehradun district, Uttarakhand, in 2014. A population-based sample of 2441 people over the age of 18 years. The Rapid Assessment of Disability survey tool identified people with disability and used an adapted version of the Kessler scale to identify those with psychosocial disability. It additionally collected information on socioeconomic variables, access to community services and barriers to participation. Prevalence of psychosocial disability and unmet needs and descriptions of barriers to services were calculated, and multivariable logistic regression was used to assess associations between risk factors and psychosocial disability. Prevalence of psychosocial disability was 4.8% and 75% of participants with psychological distress also reported comorbid functional impairments. Adjusted ORs for depression of more than two were found for people who were unschooled, unemployed and of moderate or poor socioeconomic status. The unmet need for access to services was significantly higher in every domain for people with psychosocial disability and was more than 25% in the areas of employment, health service access and community consultation. People with psychosocial disability encountered greater barriers in each domain compared with controls. People who are poor, uneducated and unemployed are two to four times more likely to have psychosocial disability in Dehradun district. They face unmet needs in accessing community services and perceive negative social attitudes, lack of physical accessibility and lack of information as barriers limiting their participation. Social policy must increase access to education and reduce poverty but additionally ensure action is taken in all community services to increase information, physical accessibility and social inclusion of people with psychosocial and other forms of disability. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

How action researchers use anxiety to facilitate change in health care.

PubMed

Evans, Nicola; Hopkinson, Jane

2016-06-01

The aim of this paper is to report on the role of an action researcher in a study investigating the change process in a health service context where a new assessment clinic was developed to manage the excessive waiting list for that service. For effective organisational change in health, there is a suggestion that change agents need to be emotionally intelligent; recognising the emotional state of individuals, reconciling that with the organisational drivers and making an assessment of readiness for organisational change. Anxiety features throughout this literature and there is a suggestion that being aware of anxiety and managing anxiety is within the emotionally intelligent change agent's repertoire, but there is a gap in the literature that explains this relationship in detail. Data were generated to investigate the discrete nature of the role of the action researcher during this organisational change that spanned two years, through three methods: participant observations in the field captured in field notes (n = 72); observations of team meetings that had been recorded and transcribed (n = 13); interviews with key informants pre- and postintervention (n = 14); a reflexive diary one document of 8920 words (n = 1). The data illuminating the interaction between the action researcher and participants were synthesised into two broad themes: how the action researcher introduced anxiety into the system; how the action researcher facilitated the participants to tolerate change anxiety. The findings from this study can be applied in clinical practice where change in practice is planned. Part of the requirement of a change agent in the NHS might be to be sufficiently emotionally literate to understand anxiety in the participant system and manage it to effect change. © 2016 John Wiley & Sons Ltd.

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

PubMed

Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

2015-09-28

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

Libyan National Health Services The Need to Move to Management-by-Objectives

PubMed Central

El Taguri, A; Elkhammas, EA; Bakoush, O; Ashammakhi, N; Baccoush, M; Betilmal, I

2008-01-01

In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude. PMID:21499467

Water Saving for Development

NASA Astrophysics Data System (ADS)

Zacharias, Ierotheos

2013-04-01

The project "Water Saving for Development (WaS4D)" is financed by European Territorial Cooperational Programme, Greece-Italy 2007-2013, and aims at developing issues on water saving related to improvement of individual behaviors and implementing innovative actions and facilities in order to harmonize policies and start concrete actions for a sustainable water management, making also people and stakeholders awake to water as a vital resource, strategic for quality of life and territory competitiveness. Drinkable water saving culture & behavior, limited water resources, water supply optimization, water resources and demand management, water e-service & educational e-tools are the key words of WaS4D. In this frame the project objectives are: • Definition of water need for domestic and other than domestic purposes: regional and territorial hydro-balance; • promotion of locally available resources not currently being used - water recycling or reuse and rainwater harvesting; • scientific data implementation into Informative Territorial System and publication of geo-referred maps into the institutional web sites, to share information for water protection; • participated review of the regulatory framework for the promotion of water-efficient devices and practices by means of the definition of Action Plans, with defined targets up to brief (2015) and medium (2020) term; • building up water e-services, front-office for all the water issues in building agricultural, industrial and touristic sectors, to share information, procedures and instruments for the water management; • creation and publication of a user friendly software, a game, to promote sustainability for houses also addressed to young people; • creation of water info point into physical spaces called "Water House" to promote education, training, events and new advisory services to assist professionals involved in water uses and consumers; • implementation of participatory approach & networking for a permanent cooperation among Public Bodies and Institutions, with the creation of a transferable model of best practices. WaS4D will carry out initiatives and advisory services aimed to encourage a behavior change, influencing citizens' demand and support consumers who wish to take action to reduce drinking water use: for the civil use, from literature, it's possible to reduce drinkable water consumption up to 50% using simple and economic tools, with a large environmental positive impact. WaS4D mainly focuses on the needs to define a participatory approach to enhance water-saving culture at urban level, encouraging a shift from supply-driven policies to management policies and from a sectorial to an integrated approach. The innovative character of the project is referred to the integrated approach as well as to the creation of new web services & tools.

Student Perceptions of Academic Service Learning: Using Mixed Content Analysis to Examine the Effectiveness of the International Baccalaureate Creativity, Action, Service Programme

ERIC Educational Resources Information Center

Hatziconstantis, Christos; Kolympari, Tania

2016-01-01

The International Baccalaureate Diploma Programme for secondary education students requires the successful completion of the Creativity, Action, Service (CAS) component (more recently renamed Creativity, Activity, Service) which is based on the philosophy of experiential learning and Academic Service Learning. In this article, the technique of…

Focus groups for allied health professionals and professions allied to technical services in the NHS--marketing opportunities, lessons learnt and recommendations.

PubMed

Chamberlain, David; Brook, Richard

2011-09-01

Worcestershire Health Libraries provides services to all NHS and social care staff in Worcestershire. Despite intensive marketing, statistics showed low usage of the library service for professions allied to technical services and allied health professionals. To discover why there was low usage of the library services using qualitative techniques and to use focus groups as a marketing opportunity. This article also aims to outline the processes involved in delivering focus groups, the results gained, and the actions taken in response to the results. Focus groups were conducted in two departments, Pathology and Occupational Therapy. The Biochemistry department (part of Pathology) had two focus groups. An additional focus group was conducted for all the Pathology education leads. Occupational Therapy had two meetings, one for hospital based staff, and the other for community staff. Issues centred on registration, inductions, time, library ambience, multi-disciplinary service and resources. The findings raised marketing opportunities and the process identified potential candidates for the role of team knowledge officer, to act as library champions within departments. It also identified areas in which the library service was not meeting user needs and expectations, and helped focus service development. Focus groups allowed an opportunity to speak to non-users face to face and to discover, and where appropriate challenge both their, and library staff's pre-conceived ideas about the service. The information revealed gave an opportunity to market services based on user needs. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice.

PubMed

Silva, Ezequiel; Breslau, Jonathan; Barr, Robert M; Liebscher, Lawrence A; Bohl, Michael; Hoffman, Thomas; Boland, Giles W L; Sherry, Cynthia; Kim, Woojin; Shah, Samir S; Tilkin, Mike

2013-08-01

Teleradiology services are now embedded into the workflow of many radiology practices in the United States, driven largely by an expanding corporate model of services. This has brought opportunities and challenges to both providers and recipients of teleradiology services and has heightened the need to create best-practice guidelines for teleradiology to ensure patient primacy. To this end, the ACR Task Force on Teleradiology Practice has created this white paper to update the prior ACR communication on teleradiology and discuss the current and possible future state of teleradiology in the United States. This white paper proposes comprehensive best-practice guidelines for the practice of teleradiology, with recommendations offered regarding future actions. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Look Who's Talking. Explaining Water-Related Information Sharing and Demand for Action Among Ugandan Villagers

NASA Astrophysics Data System (ADS)

Holvoet, Nathalie; Dewachter, Sara; Molenaers, Nadia

2016-11-01

Many national water policies propagate community-based participatory approaches to overcome weaknesses in supply-driven rural water provision, operation, and maintenance. Citizen involvement is thought to stimulate bottom-up accountability and broaden the information base, which may enrich design and implementation processes and foster improved water accessibility and sustainability. Practices on the ground, however, are embedded in socio-political realities which mediate possible beneficial effects of participatory approaches. This paper builds on full social network data collected in a Ugandan village to study the social and political reality of two distinct levels of participation, i.e. local information sharing among citizens and a more active appeal to fellow citizens to improve water services. We use Logistic Regression Quadratic Assignment Procedure to explore what type of actor and network traits influence information sharing and whether the same factors are in play in the demand for action to remedy water-related problems. Whereas social aspects (social support relations) and homophily (using the same water source, the same gender) play an important role in information sharing, it is the educational level, in particular, of the villager who is called upon that is important when villagers demand action. Our findings also demonstrate that those most in need of safe water do not mobilize their information sharing ties to demand for action. This indicates that building local water policies and practice exclusively on locally existing demand for action may fail to capture the needs of the most deprived citizens.

'That red flag on your file': misinterpreting physical symptoms as mental illness.

PubMed

Happell, Brenda; Ewart, Stephanie B; Bocking, Julia; Platania-Phung, Chris; Stanton, Robert

2016-10-01

To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs. People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers. Exploratory qualitative. Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed. The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation. Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously. Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care. © 2016 John Wiley & Sons Ltd.

77 FR 24990 - Public Availability of the Department of Labor FY 2011 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... Inventory AGENCY: Office of Assistant Secretary for Administration and Management, Department of Labor. ACTION: Notice of Public Availability of FY 2011 Service Contract Inventories. SUMMARY: In accordance... Service Contract Inventory. This inventory provides information on service contract actions over $25,000...

39 CFR 281.2 - Action required by processing postal officials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... center director of customer services at the office of mailing. The notification should include, but not... 39 Postal Service 1 2010-07-01 2010-07-01 false Action required by processing postal officials. 281.2 Section 281.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION FIRM...

42 CFR 137.136 - What happens if the agency takes no action within the 45 day review period (or any extensions...

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer § 137.136 What happens if the agency takes no action... operation of law. ...

Migrants' access to healthcare services within the European Union: a content analysis of policy documents in Ireland, Portugal and Spain.

PubMed

Ledoux, Céline; Pilot, Eva; Diaz, Esperanza; Krafft, Thomas

2018-06-15

The current migration flow into Europe is leading to a growing ethnically diverse population in many European countries. Now more than ever, those populations have different healthcare needs, languages, traditions, and previous level of care. This higher level of diversity is likely to increase health inequalities that might challenge healthcare systems if not addressed. In this context, this study aims at reviewing the policy framework for migrants' access to healthcare in Spain, Portugal and Ireland, countries with a long history of immigration, to identify lessons to be learned for policies on migrants' health. A content analysis of official policy documents was undertaken and the conceptual framework developed by Mladowsky was adapted to classify the actions indicated in the policies. The content analysis revealed that the policy aim for all three analysed countries is the improvement of the health status of the immigrant population based on equity and equality principles. The main strategies are the adaptation of services through actions targeting patients and providers, such as the implementation of cultural mediators and trainings for health professionals. The three countries propose a great range of policies aiming at improving access to healthcare services for immigrants that can inspire other European countries currently welcoming refugees. Developing inclusive policies, however does not necessarily mean they will be implemented or felt on the ground. Inclusive policies are indeed under threat due to the economic and social crises and due to the respective nationalistic attitudes towards integration. The European Union is challenged to take a more proactive leadership and ensure that countries effectively implement inclusive actions to improve migrant's access to health services.

Time, timing, talking and training: findings from an exploratory action research study to improve quality of end of life care for minority ethnic kidney patients.

PubMed

Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina; Da Silva Gane, Maria; Stoves, John; Warwick, Graham; Mir, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken

2017-06-01

Background. With an ageing and increasingly diverse population at risk from rising levels of obesity, diabetes and cardiovascular disease, including kidney complications, there is a need to provide quality care at all stages in the care pathway including at the end of life and to all patients. Aim . This study purposively explored South Asian patients' experiences of kidney end of life care to understand how services can be delivered in a way that meets diverse patient needs. Methods. Within an action research design 14 focus groups (45 care providers) of kidney care providers discussed the recruitment and analysis of individual interviews with 16 South Asian kidney patients (eight men, eight women). Emergent themes from the focus groups were analysed thematically. The research took place at four UK centres providing kidney care to diverse populations: West London, Luton, Leicester and Bradford. Results. Key themes related to time and the timing of discussions about end of life care and the factors that place limitations on patients and providers in talking about end of life care. Lack of time and confidence of nurses in areas of kidney care, individual attitudes and workforce composition influence whether and how patients have access to end of life care through kidney services. Conclusion. Training, team work and time to discuss overarching issues (including timing and communication about end of life) with colleagues could support service providers to facilitate access and delivery of end of life care to this group of patients.

Customer service: developing a new mindset for today's instant gratification society.

PubMed

Stockburger, W T

1998-01-01

Today's society expects and demands immediate service, results and access to information. Can those of us in leadership positions say that the service we provide is equal to or exceeds what our customers expect? How can we redesign our services so they are better than those we currently provide? Some people look to advances in technology as one means to improve services and access to information, but this should not be the only means. If we are to develop a philosophy of exceptional service, we must develop a vision of those services. We must gain an understanding of our customers, plus a knowledge of products, the availability of resources and any industry constraints. In healthcare, we must look to leadership to achieve our goals. A goal of exceptional customer service must be communicated to all levels of service providers from management. Top-down action by management--leadership by example--is critical. Leadership must gain the trust of both customers and employees by actively listening to both verbal and nonverbal comments at all points of service. Without an understanding of our customers' needs, it won't be possible to deliver services at or above their expectations.

DOD Inventory of Contracted Services: Actions Needed to Help Ensure Inventory Data Are Complete and Accurate

DTIC Science & Technology

2015-11-01

for Personnel and Readiness NAVSEA Naval Sea Systems Command OFPP Office of Federal Procurement Policy OMB Office of Management and Budget PDC ...Documentation of Contractors ( PDC ) process is delegated to the manpower and programing functions at the commands. The PDC process collects information from...review results. Army’s PDC tool, used to inform the inventory review, tracks by location and functional requirement—such as administrative or

Military Personnel: DOD Needs to Take Further Actions to Prevent Sexual Assault During Initial Military Training

DTIC Science & Technology

2014-09-01

health care providers affected whether servicemembers who are victims of sexual assault can or do access mental health services. We made nine...victims’ access to mental health care ; and evaluate appropriate staffing levels of certain sexual assault response-related positions. DOD concurred with...Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD’s Plans and Enhance Accountability, GAO-14-49 (Washington

A Review of the Historical Development and Contemporary Management Structure of Military Club Systems.

DTIC Science & Technology

1980-06-01

representatives from each service would provide that their specific needs receive appropriate attention . Such an action will require extensive...supplemented by gratuities 4; 56 -. -I~---.- (e.g., waiters and waitresses) are subject to prevailing state and federal minimum wage laws. With double-digit in... attention has been focused on the management and operation of military clubs from a Depart- ment of Defense (DOD) perspective rather than from the

Defense Health Care Reform: Actions Needed to Help Ensure Defense Health Agency Maintains Implementation Progress

DTIC Science & Technology

2015-09-01

business case analyses, and performance measures for the DHA’s shared services. GAO compared this information with key management practices and DOD...headquarters personnel within the MHS in annual budget documents. • Approach to help achieve cost savings - The DHA has developed a business case...comprehensive business case analyses for 2 shared services— Public Health, and Medical Education and Training. Specifically, the DHA has proposed the

A resolution supporting the mission and goals of 2013 National Crime Victims' Rights Week to increase public awareness of the rights, needs, and concerns of, and services available to assist, victims and survivors of crime in the United States.

THOMAS, 113th Congress

Sen. Wicker, Roger F. [R-MS

2013-04-25

Senate - 04/25/2013 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Resources for the Aging--An Action Handbook, a Catalogue of Federal Programs, Foundations and Trusts, and Voluntary Agencies that Assist Communities and Individuals to Meet the Needs of the Aging.

ERIC Educational Resources Information Center

Office of Economic Opportunity, Washington, DC. Community Action Program.

Published to stimulate local, state, and national groups to develop programs to assist the aged, this catalog presents information about federal grants-in-aid and basic service programs that serve the old, and about foundations and trusts, and national voluntary agencies supporting programs for the aged or willing to assist local groups organizing…

The Need to Ensure Training Readiness in the Total Force

DTIC Science & Technology

2012-05-31

MacArthur, who was in charge of the War Department’s Bureau of Information convinced the Secretary of the War, Newton Baker, and President Wilson to...Representative Richard S . Schweiker, (R-PA), of the House Armed Services Committee assailed the Navy’s action as a “disgraceful and outrageous injustice...with former Eisenhower Administration Defense Secretary Thomas S . Gates, Jr. as the chairman. The committee delivered its final report after eleven

Marketing service guarantees for health care.

PubMed

Levy, J S

1999-01-01

The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America.

PubMed

Na, Sumin; Ryder, Andrew G; Kirmayer, Laurence J

2016-09-01

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified. © Society for Community Research and Action 2016.

Classification of processes involved in sharing individual participant data from clinical trials.

PubMed

Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

2018-01-01

Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods : Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing.

Classification of processes involved in sharing individual participant data from clinical trials

PubMed Central

Ohmann, Christian; Canham, Steve; Banzi, Rita; Kuchinke, Wolfgang; Battaglia, Serena

2018-01-01

Background: In recent years, a cultural change in the handling of data from research has resulted in the strong promotion of a culture of openness and increased sharing of data. In the area of clinical trials, sharing of individual participant data involves a complex set of processes and the interaction of many actors and actions. Individual services/tools to support data sharing are available, but what is missing is a detailed, structured and comprehensive list of processes/subprocesses involved and tools/services needed. Methods: Principles and recommendations from a published data sharing consensus document are analysed in detail by a small expert group. Processes/subprocesses involved in data sharing are identified and linked to actors and possible services/tools. Definitions are adapted from the business process model and notation (BPMN) and applied in the analysis. Results: A detailed and comprehensive list of individual processes/subprocesses involved in data sharing, structured according to 9 main processes, is provided. Possible tools/services to support these processes/subprocesses are identified and grouped according to major type of support. Conclusions: The list of individual processes/subprocesses and tools/services identified is a first step towards development of a generic framework or architecture for sharing of data from clinical trials. Such a framework is strongly needed to give an overview of how various actors, research processes and services could form an interoperable system for data sharing. PMID:29623192

Digital Storytelling Experiences of Pre-Service Teachers: An Action Research

ERIC Educational Resources Information Center

Göçen Kabaran, Güler; Aldan Karademir, Çigdem

2017-01-01

The purpose of this research is to examine the digital storytelling experiences of preschool pre-service teachers. In the study, an action research from qualitative research designs was used. Furthermore, collaborative action research from the types of action research in the research was used. The research group of the study was formed in the…

The status of health librarianship and libraries in the Republic of Ireland (SHELLI): a mixed methods review to inform future strategy and sustainability.

PubMed

Harrison, Janet; Creaser, Claire; Greenwood, Helen

2013-06-01

This paper summarises the main points of a review of the Status of Health Librarianship & Libraries in Ireland (SHELLI). The review was commissioned to gain a broad understanding of what was happening in practice in Ireland; acquire knowledge about international best practice, and to inform strategic plans to develop and sustain health libraries and librarianship in Ireland. A Mixed Methods approach was used: a literature review; an online survey distributed to health librarians; Semi structured interviews with key stakeholders; a focus group drawing participants from the survey. All evidence was triangulated. New roles for health librarians needed development and the changing educational needs of health librarians warranted attention. Increased collaboration across institutional boundaries needed more consideration, especially in relation to access to e-resources. Marketing of library services was crucial. Irish health library standards, needed to be updated and enforced and a proper evidence base established. The literature provided a number of examples of potentially useful initiatives. A strategic plan of action was drawn up in three areas: (i) to identify champions and promote visibility of health service libraries, (ii) to establish a body of evidence and (iii) to support service development and staff mentoring. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Postwar City: Importance of Recycling Construction and Demolition Waste

NASA Astrophysics Data System (ADS)

Al-Qaraghuli, Hanan; Alsayed, Yaman; Almoghazy, Ali

2017-10-01

Wars and armed conflicts have heavy tolls on the built environment when they take place in cities. It is not only restricted to the actually fighting which destroys or damages buildings and infrastructure, but the damage and destruction inflicts its impacts way beyond the cessation of military actions. They can even have another impact through physical segregation of city quarters through walls and checkpoints that complicates, or even terminates, mobility of citizens, goods, and services in the post-war scenario. The accumulation of debris in the streets often impedes the processes of rescue, distribution of aid and services, and other forms of city life as well. Also, the amount of effort and energy needed to remove those residual materials to their final dumping sites divert a lot of urgently needed resources. In this paper, the components of construction and demolition waste found in post-war cities are to be discussed, relating each one to its origins and potential reuses. Then the issues related to the management of construction waste and demolition debris resulting from military actions are to be discussed. First, an outlook is to be given on the historical example of Berlin and how the city was severely damaged during World War II, and how the reconstruction of the city was aided in part by the reuse of demolition debris. Then two more recent examples will be given, the cities of Baghdad in Iraq, and Homs in Syria. In Baghdad, though major military actions have ceased but not all rubble is cleared out, some security structures in the form of concrete walls separate the cities into quarters and impede city life and lie around as poorly allocated resource needed for reconstruction. While in the case of Homs, and the wider Syrian context, major military operations are still raging, making more pressure on the resources needed for reconstruction. This recycling of demolition debris can bring economic and social stability through the conservation of resources, creation of jobs, and - eventually - the stabilization of the society in the midst of an atrocious war. Suggestions for relevant solutions will be given in both cities.

Landscape management challenges on the California Channel Islands

USGS Publications Warehouse

Halvorson, William L.

1997-01-01

Managing for sustained biodiversity and restoration of natural habitat has become increasingly important over the last two decades, first as mitigation for development (especially in wetlands), and , more recently in natural areas. The latter has come about as land managing agencies like the Department of Defense and Bureau of Land Management have seen the need to reverse the impact of past land uses and agencies like the National Park Service and The Nature Conservancy have taken on the responsibility for less-than-pristine lands.On the California Channel Islands, the need for restoring and managing biodiversity is great, but this restoration and management needs to be based on a sound ecological understanding. By conducting surveys, implementing long-term research and monitoring, and by conducting population and community dynamics research, the necessary data to arrive at such an understanding can be obtained. Once management actions have been taken to effect restoration, monitoring needs to be conducted to determine the success of those actions. The need is to gain enough of an understanding of the islands' ecosystems that we can manage to restore, not just populations of native plants and animals, but also the processes of a naturally functioning ecosystem. The challenges that confront this goal are many and include ecology and popUlation biology, conservation ecology, information management, agency mandates and regulations, the need to build constituencies and consensus among disparate groups, financing, and political pressures.

42 CFR 137.155 - What constitutes a final agency action?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What constitutes a final agency action? 137.155 Section 137.155 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer Decision Maker § 137...

42 CFR 137.155 - What constitutes a final agency action?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false What constitutes a final agency action? 137.155 Section 137.155 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Final Offer Decision Maker § 137...

75 FR 8108 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... DEPARTMENT OF THE INTERIOR National Park Service National Register of Historic Places... considered for listing or related actions in the National Register were received by the National Park Service... States Postal Service, to the National Register of Historic Places, National Park Service, 1849 C St. NW...

Strengthening health-related rehabilitation services at national levels.

PubMed

Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

2018-04-18

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

An urgent need to improve life conditions of seniors.

PubMed

Hebert, R

2010-10-01

In the fall of 2007, the Government of Quebec set up a Public Consultation on Living Conditions of Seniors. Fifty sessions were held in 26 cities across all 17 regions of the province. More than 4000 seniors attended the sessions and 275 briefs were received from scientists and associations. Three themes were identified in the report published in 2008: supporting seniors and their caregivers, reinforcing the place of seniors in society, and preventing problems associated with aging (suicide, abuse, addictions). The main actions that I recommended included: Increasing the Guaranteed Income Supplement to prevent poverty; Modifying pension plans and working conditions to allow for progressive retirement; Making a major investment in home care to provide access to services regardless of place of residence; Introducing an Autonomy Support Benefit and autonomy insurance program for financing services to support people with disabilities; Generalizing an Integrated Service Delivery Network providing services to frail older people; Better training for professionals in gerontology. I also recommended setting up a National Policy on Seniors to align all government departments and agencies, municipalities and the private sector around a vision, objectives and a set of actions for improving the integration of seniors in an aging society. This would contribute to a more equitable, interdependent and wiser society. Unfortunately, the Government did not support these recommendations. It is now time for scientists to get involved in leading policy on seniors and in the political arena.

Admiral nursing competency project: practice development and action research.

PubMed

Dewing, Jan; Traynor, Victoria

2005-07-01

Admiral Nurses are specialist dementia care nurses working in the community with carers of those who have a dementia. The aim of the competency project (2000-2003) was threefold. Firstly to work collaboratively with these specialist nurses to facilitate the development a competency framework that reflects the needs of the Admiral Nursing Service. Secondly, to provide a way to structure evidence demonstrating evolving competency. Thirdly, to specifically enable the nurses to demonstrate evidence of achieving the UK Nursing and Midwifery Council's Higher Level Practice standard. The two complementary approaches of emancipatory action research and systematic practice development were adopted. Methods were taken from action research and systematic practice development approaches with an emphasis on promoting and enabling enlightenment, critical reflection, ownership and creating the best conditions for long-term commitment to the competency framework. The main outcome from this project was the development of a specialist nursing competency framework. The Admiral Nurses' Competency Framework is made up of a set of eight core competencies with three levels of competency statements, loosely structured around the Higher Level Practice standard, and guidance documentation to illustrate how work-based evidence can be generated to demonstrate competence. There were also process-derived outcomes associated with combining systematic practice development with emancipatory action research that had an impact on the culture. The main outcomes here were that practitioners engaged in and experienced learning about how to research their own practice and the consequences of doing this. They also learnt about specialist nursing practice more widely than Admiral Nursing. Finally, there was some increase in awareness about the culture within their teams and organizations. The final competency framework reflects the needs of the service, is owned by the majority of practitioners and project commissioners and this has had a positive impact on implementation. In this paper, we report on combining systematic practice development with action research to achieve immediate project aims. In addition we show how a project of this nature can contribute to developing skills in practitioners necessary for cultural changes in practice and contributes to wider issues of modernization within nursing and health care. This competency framework will enable Admiral Nurses to demonstrate their level of specialist practice, as individuals and collectively as a service and it also promotes the principles of nurses as life long learners. This may have relevance to other groups of specialist nurses. The project has widespread relevance for two reasons. Firstly, it shows that nurses can be involved in designing and testing a competency framework as collaborators. Secondly, that to achieve this within the spirit of approaches, such as systematic practice development and action research, can be testing for all collaborators even were there is a shared or espoused aim.

42 CFR 493.1846 - Civil action.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Civil action. 493.1846 Section 493.1846 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1846 Civil action. If CMS...

42 CFR 493.1846 - Civil action.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Civil action. 493.1846 Section 493.1846 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1846 Civil action. If CMS...

42 CFR 493.1846 - Civil action.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Civil action. 493.1846 Section 493.1846 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1846 Civil action. If CMS...

42 CFR 493.1846 - Civil action.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Civil action. 493.1846 Section 493.1846 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1846 Civil action. If CMS...

42 CFR 493.1846 - Civil action.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Civil action. 493.1846 Section 493.1846 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Enforcement Procedures § 493.1846 Civil action. If CMS...

Beyond Criminalization: Toward a Criminologically Informed Framework for Mental Health Policy and Services Research

PubMed Central

Silver, Eric; Wolff, Nancy

2010-01-01

The problems posed by persons with mental illness involved with the criminal justice system are vexing ones that have received attention at the local, state and national levels. The conceptual model currently guiding research and social action around these problems is shaped by the “criminalization” perspective and the associated belief that reconnecting individuals with mental health services will by itself reduce risk for arrest. This paper argues that such efforts are necessary but possibly not sufficient to achieve that reduction. Arguing for the need to develop a services research framework that identifies a broader range of risk factors for arrest, we describe three potentially useful criminological frameworks—the “life course,” “local life circumstances” and “routine activities” perspectives. Their utility as platforms for research in a population of persons with mental illness is discussed and suggestions are provided with regard to how services research guided by these perspectives might inform the development of community-based services aimed at reducing risk of arrest. PMID:16791518

Study of the Cherokee Nuclear Station: projected impacts, monitoring plan, and mitigation options for Cherokee County, South Carolina

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

Peelle, E.; Schweitzer, M.; Scharre, P.

1979-07-01

This report inventories Cherokee County's capabilities and CNS project characteristics, projects expected impacts from the interaction of the two defines four options for Cherokee County decision makers, and presents a range of possible mitigation and monitoring plans for dealing with the problems identified. The four options and general implementation guidelines for each are presented after reviewing pertinent features of other mitigation and monitoring plans. The four options include (1) no action, (2) preventing impacts by preventing growth, (3) selective growth in designated areas as services can be supplied, and (4) maximum growth designed to attract as many in-movers as possiblemore » through a major program of capital investiments in public and private services. With the exception of the no action option, all plans deal with impacts according to some strategy determined by how the County wishes to manage growth. Solutions for impact problems depend on which growth strategy is selected and what additional resources are secured during the impact period. A monitoring program deals with the problems of data and projections uncertainty, while direct action is proposed to deal with the institutional problems of delay of the needed access road, timeing and location problems from the tax base mismatch, and lack of local planning capability.« less

[On the health sector crisis].

PubMed

Lopez Sarmiento, A

1997-09-01

The chronic crisis in Ecuador's health sector is an indication of the general deterioration of the country, whose multiple unmet needs signify a condition of underdevelopment. Theorizing on health problems should not be allowed to substitute for action. Developing a health policy giving priority to the most disadvantaged sectors will require a development model with a participatory character that promotes equity and solidarity and does not benefit the macroeconomy exclusively. The political will of all sectors must be committed to development of a national health system. A well-coordinated regional system of services, comprising integrated levels of care with functioning referral systems, is needed. The existing network of services must be made to function effectively, without strikes or suspension of activities. The government has a constitutional, legal, and moral obligation to provide health care. Ecuador directs about 6% of the gross national product to health, with 1.6% financing the Ministry of Public Health, which attends to at least 60% of the population. A country like Ecuador--with a very poor population--should not require copayment for services. Ecuador needs an environmental policy to guarantee a healthy food supply, treat sewage, and control use of pesticides--measures which will reduce health care costs in the long run. Finally, it is necessary to improve attention to the human values of medical practice.

Cross-border reproductive care: market forces in action or market failure? An economic perspective.

PubMed

Connolly, Mark

2011-12-01

From an economist's perspective, cross-border reproductive care (CBRC) reflects a global market economy bringing together the needs of patients and skills of doctors at an agreed price. From this perspective CBRC is neither wrong nor right, rather it reflects rational economic behaviour of couples to maximize their wellbeing. The major economic criticism of CBRC relates to the costs and risks of multiple pregnancies, as couples paying out-of-pocket may have more embryos transferred than is desirable to optimize their chances of having a live birth. This criticism is valid, suggesting a need to communicate the hidden costs of failing to adequately fund fertility services. However, under some circumstances health authorities may be willing to bear these additional costs if the savings from not providing fertility services are sufficiently large enough to warrant a no-funding policy. Because infertility is often viewed as a low health priority, the likelihood of CBRC persisting is real, particularly as many health services adjust to the challenges of ageing populations and decreased public financing. To counter funding challenges, there is a need to communicate the medical benefits of assisted reproduction and the economic benefits that these children will offer in an era of austerity and ageing populations. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Priority strategies for India's family planning programme

PubMed Central

Pachauri, Saroj

2014-01-01

Strategies to accelerate progress of India's family planning programme are discussed and the importance of improving the quality and reach of services to address unmet contraceptive need by providing method choice is emphasized. Although there is a growing demand for both limiting and spacing births, female sterilisation, is the dominant method in the national programme and use of spacing methods remains very limited. Fertility decline has been slower in the empowered action group (EAG) States which contribute about 40 per cent of population growth to the country and also depict gloomy statistics for other socio-development indicators. It is, therefore, important to intensify efforts to reduce both fertility and mortality in these States. A rationale has been provided for implementing integrated programmes using a gender lens because the lack of women's autonomy in reproductive decision-making, compounded by poor male involvement in sexual and reproductive health matters, is a fundamental issue yet to be addressed. The need for collaboration between scientists developing contraceptive technologies and those implementing family planning services is underscored. If contraceptive technologies are developed with an understanding of the contexts in which they will be delivered and an appreciation of end-users’ needs and perspectives, they are more likely to be accepted by service providers and used by clients. PMID:25673535

Twenty years after International Conference on Population and Development: where are we with adolescent sexual and reproductive health and rights?

PubMed

Chandra-Mouli, Venkatraman; Svanemyr, Joar; Amin, Avni; Fogstad, Helga; Say, Lale; Girard, Françoise; Temmerman, Marleen

2015-01-01

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in addressing adolescent sexual and reproductive health and rights. The key recommendations are to link the provision of sexuality education and sexual and reproductive health (SRH) services; build awareness, acceptance, and support for youth-friendly SRH education and services; address gender inequality in terms of beliefs, attitudes, and norms; and target the early adolescent period (10-14 years). The many knowledge gaps, however, point to the pressing need for further research on how to best design effective adolescent SRH intervention packages and how best to deliver them. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Dengue expansion in Africa-not recognized or not happening?

PubMed

Jaenisch, Thomas; Junghanss, Thomas; Wills, Bridget; Brady, Oliver J; Eckerle, Isabella; Farlow, Andrew; Hay, Simon I; McCall, Philip J; Messina, Jane P; Ofula, Victor; Sall, Amadou A; Sakuntabhai, Anavaj; Velayudhan, Raman; Wint, G R William; Zeller, Herve; Margolis, Harold S; Sankoh, Osman

2014-10-01

An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the healthcare setting in Africa. Second, representative data need to be collected across Africa to uncover the true burden of dengue. Third, established networks should collaborate to produce these types of data. Fourth, policy needs to be informed so the necessary steps can be taken to provide dengue vector control and health services.

Dengue Expansion in Africa—Not Recognized or Not Happening?

PubMed Central

Junghanss, Thomas; Wills, Bridget; Brady, Oliver J.; Eckerle, Isabella; Farlow, Andrew; Hay, Simon I.; McCall, Philip J.; Messina, Jane P.; Ofula, Victor; Sall, Amadou A.; Sakuntabhai, Anavaj; Velayudhan, Raman; Wint, G.R. William; Zeller, Herve; Margolis, Harold S.; Sankoh, Osman

2014-01-01

An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the healthcare setting in Africa. Second, representative data need to be collected across Africa to uncover the true burden of dengue. Third, established networks should collaborate to produce these types of data. Fourth, policy needs to be informed so the necessary steps can be taken to provide dengue vector control and health services. PMID:25271370

Assessment of the health system and policy environment as a critical complement to tracking intervention coverage for maternal, newborn, and child health.

PubMed

Cavagnero, Eleonora; Daelmans, Bernadette; Gupta, Neeru; Scherpbier, Robert; Shankar, Anuraj

2008-04-12

In 2008, the Countdown to 2015 initiative identified 68 priority countries for action on maternal, newborn, and child health. Much attention was paid to monitoring country-level progress in achieving high and equitable coverage with interventions effective in reducing mortality of mothers, newborn infants, and children up to 5 years of age. To have a broader understanding of the environment in which health services are delivered and health outcomes are produced is essential to increase intervention coverage. Programmes to address MNCH rely on health systems to generate information needed for effective decisions and to achieve the expected outcomes. Governance and leadership are needed throughout the process not only to create policies and implement them but also to assure quality and efficiency of care, to finance health services sufficiently and in an equitable way, and to manage the health workforce. We present a systematic approach to assess the wider health system and policy environment needed to achieve positive outcomes for maternal, newborn, and child health. We report on results from 13 indicators and show gaps in policy adoption as well as weaknesses in other health system building blocks. We identify areas for future action in measurement of key indicators and their use to support decision making. We hope that this information will provide an additional dimension to the discussions on feasible and sustainable solutions to accelerate progress towards Millennium Development Goals 4 and 5, both at the global level but most importantly in individual countries.

A consensus action agenda for achieving the national health information infrastructure.

PubMed

Yasnoff, William A; Humphreys, Betsy L; Overhage, J Marc; Detmer, Don E; Brennan, Patricia Flatley; Morris, Richard W; Middleton, Blackford; Bates, David W; Fanning, John P

2004-01-01

Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Attendees favored a public-private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.

HELPing older people with very severe chronic obstructive pulmonary disease (HELP-COPD): mixed-method feasibility pilot randomised controlled trial of a novel intervention.

PubMed

Buckingham, Susan; Kendall, Marilyn; Ferguson, Susie; MacNee, William; Sheikh, Aziz; White, Patrick; Worth, Allison; Boyd, Kirsty; Murray, Scott A; Pinnock, Hilary

2015-04-16

Extending palliative care to those with advanced non-malignant disease is advocated, but the implications in specific conditions are poorly understood. We piloted a novel nurse-led intervention, HELPing older people with very severe chronic obstructive pulmonary disease (HELP-COPD), undertaken 4 weeks after discharge from hospital, which sought to identify and address the holistic care needs of people with severe COPD. This 6-month mixed-method feasibility pilot trial randomised (ratio 3:1) patients to HELP-COPD or usual care. We assessed the feasibility of using validated questionnaires as outcome measures and analysed the needs/actions recorded in the HELP-COPD records. Semi-structured interviews with a purposive sample of patients, carers and professionals explored the perceptions of HELP-COPD. Verbatim transcriptions and field notes were analysed using Normalisation Process Theory as a framework. We randomised 32 patients (24 to HELP-COPD); 19 completed the study (death=3, ill-health=4, declined=6). The HELP-COPD record noted a mean of 1.6 actions/assessment, mostly provision of information or self-help actions: only five referrals were made. Most patients were positive about HELP-COPD, discussing their concerns and coping strategies in all domains, but the questionnaires were burdensome for some patients. Adaptation to their slowly progressive disability and a strong preference to rely on family support was reflected in limited acceptance of formal services. Professionals perceived HELP-COPD as addressing an important aspect of care, although timing overlapped with discharge planning. The HELP-COPD intervention was well received by patients and the concept resonated with professionals, although delivery post discharge overlapped with existing services. Integration of brief holistic care assessments in the routine primary care management of COPD may be more appropriate.

76 FR 44948 - Status Report of Water Service, Repayment, and Other Water-Related Contract Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-27

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Status Report of Water Service, Repayment, and Other Water- Related Contract Actions AGENCY: Bureau of Reclamation, Interior. ACTION: Notice. SUMMARY... SUPPLEMENTARY INFORMATION section. FOR FURTHER INFORMATION CONTACT: Michelle Kelly, Water and Environmental...

76 FR 61090 - Endangered and Threatened Species; Counterpart Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

...), Interior. ACTION: Notice of availability. SUMMARY: The U.S. Forest Service and Bureau of Land Management..., National Fire Plan Counterpart Regulation Alternative Consultation Agreements (ACAs). DATES: This is... actions that support the National Fire Plan. Upon entering into an ACA with the Services, action agencies...

To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England.

PubMed

Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

2012-01-01

The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

Assisting the U.S. Forest Service in monitoring and managing the Pacific pine marten

NASA Astrophysics Data System (ADS)

Force, A.; Hadley, N.; Howell, B. L.; Holsinger, K.

2017-12-01

Innovative partnerships that bridge institutional sectors may be key in seizing many opportunities for highly effective projects. Adventure Scientists is a nonprofit organization that works in partnership with governments, universities, businesses and other nonprofits to support their need for actionable, research-grade data. In every partnership, it is critical that responsible decision-makers are involved and in place to use the data collected, such as to inform new resource management strategies or regulatory policies. In this presentation, we will highlight our experience working on one such partnership. In 2013, the U.S. Forest Service and Adventure Scientists collaborated on a two-year project to better understand Pacific pine marten (Martes caurina), a small native carnivore, in the Olympic National Forest. In response to the species' recent disappearance, Forest managers needed to gather more accurate data on martens' presence and abundance to support species management. Adventure Scientists was in a unique position to provide the agency this needed data-collection capacity. Volunteers collected data about the marten populations by positioning and monitoring camera traps throughout the area. Utilizing our volunteer-collected data, the U.S. Forest Service was able to inform the management and protection of these threatened species in U.S Forest Service Region 6. This project was also successful in establishing the foundation for an expanded, long-term relationship with the agency, where both parties continue to explore partnership opportunities for Adventure Scientists to collect data system-wide in support of U.S. Forest Service improved land management and policy decisions.

An Efficient Workflow Environment to Support the Collaborative Development of Actionable Climate Information Using the NCAR Climate Risk Management Engine (CRMe)

NASA Astrophysics Data System (ADS)

Ammann, C. M.; Vigh, J. L.; Lee, J. A.

2016-12-01

Society's growing needs for robust and relevant climate information have fostered an explosion in tools and frameworks for processing climate projections. Many top-down workflows might be employed to generate sets of pre-computed data and plots, frequently served in a "loading-dock style" through a metadata-enabled search and discovery engine. Despite these increasing resources, the diverse needs of applications-driven projects often result in data processing workflow requirements that cannot be fully satisfied using past approaches. In parallel to the data processing challenges, the provision of climate information to users in a form that is also usable represents a formidable challenge of its own. Finally, many users do not have the time nor the desire to synthesize and distill massive volumes of climate information to find the relevant information for their particular application. All of these considerations call for new approaches to developing actionable climate information. CRMe seeks to bridge the gap between the diversity and richness of bottom-up needs of practitioners, with discrete, structured top-down workflows typically implemented for rapid delivery. Additionally, CRMe has implemented web-based data services capable of providing focused climate information in usable form for a given location, or as spatially aggregated information for entire regions or countries following the needs of users and sectors. Making climate data actionable also involves summarizing and presenting it in concise and approachable ways. CRMe is developing the concept of dashboards, co-developed with the users, to condense the key information into a quick summary of the most relevant, curated climate data for a given discipline, application, or location, while still enabling users to efficiently conduct deeper discovery into rich datasets on an as-needed basis.

7 CFR 1940.313 - Actions that normally require the preparation of an Environmental Impact Statement (EIS).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Actions that normally require the preparation of an Environmental Impact Statement (EIS). 1940.313 Section 1940.313 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMEN...

Developing Library GIS Services for Humanities and Social Science: An Action Research Approach

ERIC Educational Resources Information Center

Kong, Ningning; Fosmire, Michael; Branch, Benjamin Dewayne

2017-01-01

In the academic libraries' efforts to support digital humanities and social science, GIS service plays an important role. However, there is no general service model existing about how libraries can develop GIS services to best engage with digital humanities and social science. In this study, we adopted the action research method to develop and…

Consider long-term care as service alternative.

PubMed

Loria, L S

1987-04-01

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

Children at the Front: A Different View of the War on Alcohol and Drugs. The CWLA North American Commission on Chemical Dependency and Child Welfare. Final Report and Recommendations.

ERIC Educational Resources Information Center

Child Welfare League of America, Inc., Washington, DC.

This report explores the impact of alcohol and drug problems on the children and families served by the child welfare system and outlines a comprehensive strategy to better respond to their needs. It contains more than 100 policy and action recommendations to enhance services to children and families affected by alcohol and other drugs (AOD), to…

Defense Inventory: Services Generally Have Reduced Excess Inventory, but Additional Actions Are Needed

DTIC Science & Technology

2015-04-01

MICAP Mission Impaired Capability Awaiting Parts OSD Office of the Secretary of Defense S & OP Sales and Operations Planning This is a work of...January 2013, the Army began to implement a Sales and Operations Planning ( S & OP ) process to improve its supply chain and inventory management...According to the Army Materiel Command officials, the Army’s decision to implement S & OP was recommended by an Integrated Project Team that concluded the

The infant food industry and international child health.

PubMed

Jelliffe, D B; Jelliffe, E F

1977-01-01

Declining breast-feeding, with accompanying increased marasmus and diarrhea, has occurred in developing countries because of many factors, including inappropriate health services, new urban life styles, and so forth. The infant food industry must bear a considerable burden of blame as a result of "unethical" advertising. Responses have most recently included various journalistic and legal actions. There is a need for revised roles for the infant food industry, and for mechanisms to monitor intrinsically harmful practices.

Integrating Agriculture and Conservation

USGS Publications Warehouse

Vandever, Mark W.

2010-01-01

The USGS produces the needed science-based information to guide management actions and policy decisions that support wildlife habitat and other environmental services compatible with USDA conservation goals and farm operations. The Policy Analysis and Science Assistance Branch of the Fort Collins Science Center (FORT) has conducted research involving a national landowner survey and numerous short- and long-term evaluations regarding vegetation responses to land management practices. This research helps land and resource managers to make informed decisions and resolve resource management conflicts.

Reauthorization of Demonstration Partnership Agreements Addressing the Needs of the Poor. Hearing before the Subcommittee on Human Resources of the Committee on Education and Labor. House of Representatives, One Hundred First Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and Labor.

This document presents the record of a hearing on the reauthorization of the Demonstration Partnership Program (DPP), part of the Community Services Block Grant Act. The program offers community action agencies the opportunity to test new methods for reducing dependency and fostering self-sufficiency among the poor. Six agency representatives…

Health Workforce Planning

PubMed Central

Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.

2015-01-01

In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381

Challenges and barriers for implementation of the World Health Organization Global Disability Action Plan in low- and middle- income countries.

PubMed

Khan, Fary; Owolabi, Mayowa Ojo; Amatya, Bhasker; Hamzat, Talhatu Kolapo; Ogunniyi, Adesola; Oshinowo, Helen; Elmalik, Alaeldin; Galea, Mary P

2018-04-18

To identify potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Nigeria and compare these with other low- and middle-income countries. A rehabilitation team from the Royal Melbourne Hospital, Parkville, Australia, conducted intensive workshops at medical/academic institutions in Nigeria for healthcare professionals from various local Physical Medicine and Rehabilitation facilities. A modified Delphi method identified challenges for person with disability, using 3 GDAP objectives. Findings were compared with similar exercises in Madagascar, Pakistan and Mongolia. Despite differences in the healthcare system and practice, the challenges reported in Nigeria were similar to those in other 3 low- and middle-income countries, at both macro (governmental/policymakers) and micro levels (community/social/individual). Common challenges identified were: limited knowledge of disability services, limited Physical Medicine and Rehabilitation workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Common potential facilitators included: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research. Disability care is an emerging priority in low- and middle-income countries to address the needs of people with disability. The challenges identified in Nigeria are common to most low- and middle-income countries. The GDAP framework can facilitate access and strengthen Physical Medicine and Rehabilitation services.

Fracture liaison services for osteoporosis in the Asia-Pacific region: current unmet needs and systematic literature review.

PubMed

Chang, Y -F; Huang, C -F; Hwang, J -S; Kuo, J -F; Lin, K -M; Huang, H -C; Bagga, S; Kumar, A; Chen, F -P; Wu, C -H

2018-04-01

The analysis aimed to identify the treatment gaps in current fracture liaison services (FLS) and to provide recommendations for best practice establishment of future FLS across the Asia-Pacific region. The findings emphasize the unmet need for the implementation of new programs and provide recommendations for the refinement of existing ones. The study's objectives were to evaluate fracture liaison service (FLS) programs in the Asia-Pacific region and provide recommendations for establishment of future FLS programs. A systematic literature review (SLR) of Medline, PubMed, EMBASE, and Cochrane Library (2000-2017 inclusive) was performed using the following keywords: osteoporosis, fractures, liaison, and service. Inclusion criteria included the following: patients ≥ 50 years with osteoporosis-related fractures; randomized controlled trials or observational studies with control groups (prospective or retrospective), pre-post, cross-sectional and economic evaluation studies. Success of direct or indirect interventions was assessed based on patients' understanding of risk, bone mineral density assessment, calcium intake, osteoporosis treatment, re-fracture rates, adherence, and mortality, in addition to cost-effectiveness. Overall, 5663 unique citations were identified and the SLR identified 159 publications, reporting 37 studies in Asia-Pacific. These studies revealed the unmet need for public health education, adequate funding, and staff resourcing, along with greater cooperation between departments and physicians. These actions can help to overcome therapeutic inertia with sufficient follow-up to ensure adherence to recommendations and compliance with treatment. The findings also emphasize the importance of primary care physicians continuing to prescribe treatment and ensure service remains convenient. These findings highlight the limited evidence supporting FLS across the Asia-Pacific region, emphasizing the unmet need for new programs and/or refinement of existing ones to improve outcomes. With the continued increase in burden of fractures in Asia-Pacific, establishment of new FLS and assessment of existing services are warranted to determine the impact of FLS for healthcare professionals, patients, family/caregivers, and society.

Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

PubMed Central

2012-01-01

Introduction In recent years, the country of Mongolia (population 2.8 million) has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy) to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons from Mongolia mirror other international studies which point to the need to measure and take action on the social determinants of health at the local area level in order to adequately reduce persistent inequities in health care access for the urban poor. PMID:22429615

76 FR 73674 - Status Report of Water Service, Repayment, and Other Water-Related Contract Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-29

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Status Report of Water Service, Repayment, and Other Water- Related Contract Actions AGENCY: Bureau of Reclamation, Interior. ACTION: Notice. SUMMARY... INFORMATION CONTACT: Michelle Kelly, Water and Environmental Resources Division, Bureau of Reclamation, P.O...

76 FR 60527 - Status Report of Water Service, Repayment, and Other Water-Related Contract Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Status Report of Water Service, Repayment, and Other Water- Related Contract Actions AGENCY: Bureau of Reclamation, Interior. ACTION: Notice. SUMMARY... CONTACT: Michelle Kelly, Water and Environmental Resources Division, Bureau of Reclamation, P.O. Box 25007...

42 CFR 93.501 - Opportunity to contest findings of research misconduct and administrative actions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... misconduct and administrative actions. 93.501 Section 93.501 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General Information § 93.501 Opportunity to...

42 CFR 93.501 - Opportunity to contest findings of research misconduct and administrative actions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... misconduct and administrative actions. 93.501 Section 93.501 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General Information § 93.501 Opportunity to...

42 CFR 93.501 - Opportunity to contest findings of research misconduct and administrative actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... misconduct and administrative actions. 93.501 Section 93.501 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General Information § 93.501 Opportunity to...

42 CFR 93.501 - Opportunity to contest findings of research misconduct and administrative actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... misconduct and administrative actions. 93.501 Section 93.501 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General Information § 93.501 Opportunity to...

42 CFR 93.501 - Opportunity to contest findings of research misconduct and administrative actions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... misconduct and administrative actions. 93.501 Section 93.501 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions General Information § 93.501 Opportunity to...

20 CFR 658.416 - Action on JS-related complaints.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Action on JS-related complaints. 658.416... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.416 Action on JS-related complaints. (a) The appropriate State agency official handling an...

Nature as capital: Advancing and incorporating ecosystem services in United States federal policies and programs

PubMed Central

Schaefer, Mark; Goldman, Erica; Bartuska, Ann M.; Sutton-Grier, Ariana; Lubchenco, Jane

2015-01-01

The concept of nature as capital is gaining visibility in policies and practices in both the public and private sectors. This change is due to an improved ability to assess and value ecosystem services, as well as to a growing recognition of the potential of an ecosystem services approach to make tradeoffs in decision making more transparent, inform efficient use of resources, enhance resilience and sustainability, and avoid unintended negative consequences of policy actions. Globally, governments, financial institutions, and corporations have begun to incorporate natural capital accounting in their policies and practices. In the United States, universities, nongovernmental organizations, and federal agencies are actively collaborating to develop and apply ecosystem services concepts to further national environmental and economic objectives. Numerous federal agencies have begun incorporating these concepts into land use planning, water resources management, and preparations for, and responses to, climate change. Going forward, well-defined policy direction will be necessary to institutionalize ecosystem services approaches in federal agencies, as well as to guide intersector and interdisciplinary collaborative research and development efforts. In addition, a new generation of decision support tools are needed to further the practical application of ecosystem services principles in policymaking and commercial activities. Improved performance metrics are needed, as are mechanisms to monitor the status of ecosystem services and assess the environmental and economic impacts of policies and programs. A greater national and international financial commitment to advancing ecosystem services and natural capital accounting would likely have broad, long-term economic and environmental benefits. PMID:26082544

Climate Change Boot Camps: Targeting Policy Makers and Outreach Trainers in Arizona to Improve Climate Literacy

NASA Astrophysics Data System (ADS)

Ferguson, D. B.; Guido, Z. S.; Buizer, J.; Roy, M.

2010-12-01

Bringing climate change issues into focus for decision makers is a growing challenge. Decision makers are often confronted with unique informational needs, a lack of useable information, and needs for customized climate change training, among other issues. Despite significant progress in improving climate literacy among certain stakeholders such as water managers, recent reports have highlighted the growing demand for climate-change information in regions and sectors across the US. In recent years many ventures have sprung up to address these gaps and have predominantly focused on K-12 education and resource management agencies such as the National Park Service and National Weather Service. However, two groups that are critical for integrating climate information into actions have received less attention: (1) policy makers and (2) outreach experts, such as Cooperative Extension agents. Climate Change Boot Camps (CCBC) is a joint effort between the Climate Assessment for the Southwest (CLIMAS)—a NOAA Regionally Integrated Sciences and Assessments (RISA) program—and researchers at Arizona State University to diagnose climate literacy and training gaps in Arizona and develop a process that converts these deficiencies into actionable knowledge among the two aforementioned groups. This presentation will highlight the initial phases of the CCBC process, which has as its outcomes the identification of effective strategies for reaching legislators, climate literacy and training needs for both policy makers and trainers, and effective metrics to evaluate the success of these efforts. Specific attention is given to evaluating the process from initial needs assessment to the effectiveness of the workshops. Web curriculum and training models made available on the internet will also be developed, drawing on extensive existing Web resources for other training efforts and converted to meet the needs of these two groups. CCBC will also leverage CLIMAS’ long history of engaging with stakeholders in the Southwest to facilitate to use of climate information in the decision process.

Social support needs for equity in health and social care: a thematic analysis of experiences of people with chronic fatigue syndrome/myalgic encephalomyelitis

PubMed Central

2011-01-01

Background Needs-based resource allocation is fundamental to equitable care provision, which can meet the often-complex, fluctuating needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This has posed challenges both for those providing and those seeking support providers, in building shared understanding of the condition and of actions to address it. This qualitative study reports on needs for equity in health and social care expressed by adults living with CFS/ME. Methods The participants were 35 adults with CFS/ME in England, purposively selected to provide variation in clinical presentations, social backgrounds and illness experiences. Accounts of experienced needs and needs-related encounters with health and social services were obtained through a focus group (n = 6) and semi-structured interviews (n = 35). These were transcribed and needs related topics identified through data-led thematic analysis. Findings Participants emphasised needs for personalised, timely and sustained support to alleviate CFS/ME impacts and regain life control, in three thematic areas: (1) Illness symptoms, functional limitations and illness management; (2) practical support and social care; (3) financial support. Access of people with CFS/ME to support from health and social services was seen to be constrained by barriers stemming from social, cultural, organisational and professional norms and practices, further heightened for disadvantaged groups including some ethnic minorities. These reduced opportunities for their illness to be explained or associated functional limitations and social disadvantages to be addressed through social support. Participants sought more understanding of bio-psycho-social aspects of CFS/ME, of felt needs of people with CFS/ME and of human rights and disability rights, for providing person-centred, equitable care. Conclusions Changes in attitudes of health practitioners, policy makers and general public and more flexibly organised health and social care provision are needed to address equity issues in support needs expressed by people with CFS/ME, to be underpinned by research-based knowledge and communication, for public and professional education. Policy development should include shared decision-making and coordinated action across organizations working for people with CFS/ME, human rights and disadvantaged groups. Experiences of people with CFS/ME can usefully inform an understanding of equity in their health and social care. PMID:22044797

Quick-Reaction Report on the Audit of ReCoupment Actions on Medicine Payments to Uniformed Services Treatment Facilities.

DTIC Science & Technology

1993-07-21

OFFICE OF THE INSPECTOR GENERAL QUICK-REACTION REPORT ON THE AUDIT OF RECOUPMENT ACTIONS ON MEDICARE PAYMENTS TO UNIFORMED SERVICES TREATMENT...Quick-Reaction Report on the Audit of Recoupment Actions on Medicare Payments to Uniformed Services Treatment Facilities (Report No. 93-150) We are...Inspectors General will provide a joint report to the congressional committees that requested the audit . The courtesies extended to the audit staff

Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an 'evidence-based climatic health' transfrontier training program.

PubMed

Lapaige, Véronique; Essiembre, Hélène

2010-01-01

It has become increasingly clear to the international scientific community that climate change is real and has important consequences for human health. To meet these new challenges, the World Health Organization recommends reinforcing the adaptive capacity of health systems. One of the possible avenues in this respect is to promote awareness and knowledge translation in climatic health, at both the local and global scales. Within such perspective, two major themes have emerged in the field of public health research: 1) the development of advanced training adapted to 'global environment' change and to the specific needs of various groups of actors (doctors, nurses, public health practitioners, health care managers, public service managers, local communities, etc) and 2) the development of strategies for implementing research results and applying various types of evidence to the management of public health issues affected by climate change. Progress on these two fronts will depend on maximum innovation in transdisciplinary and transsectoral collaborations. The general purpose of this article is to present the program of a new research and learning chair designed for this double set of developmental objectives - a chair that emphasizes 'innoversity' (the dynamic relationship between innovation and diversity) and 'transfrontier ecolearning for adaptive actions'. The Écoapprentissages, santé mentale et climat collaborative research chair (University of Montreal and Quebec National Public Health Institute) based in Montreal is a center for 'transdisciplinary research' on the transfrontier knowledge-for-action that can aid adaptation of the public health sector, the public mental health sector, and the public service sector to climate change, as well as a center for complex collaborations on evidence-based climatic health 'training'. This program-focused article comprises two main sections. The first section presents the 'general' and 'specific contexts' in which the chair emerged. The 'general context' pertains to the health-related challenge of finding ways to integrate, transfer, and implement knowledge, a particularly pointed challenge in Canada. The 'specific context' refers to the emerging research field of adaptation of public health to climate change. In the second section, the characteristics of the research chair are more extensively detailed (the vision of 'innoversity' and ' transfrontier knowledge-for-action,' the approach of shared responsibility and complex collaboration, objectives, and major axes of research). We conclude with a call for complex collaboration toward knowledge-for-action in public health services/mental health services/public services' adaptation to climate change: this call is aimed at individual and institutional actors in the North and South/West and East concerned by these issues.

Unfulfilled expectations to services offered at primary health care facilities: experiences of caretakers of underfive children in rural Tanzania.

PubMed

Kahabuka, Catherine; Moland, Karen Marie; Kvåle, Gunnar; Hinderaker, Sven Gudmund

2012-06-14

There is growing evidence that patients frequently bypass primary health care (PHC) facilities in favour of higher level hospitals regardless of substantial additional time and costs. Among the reasons given for bypassing are poor services (including lack of drugs and diagnostic facilities) and lack of trust in health workers. The World Health Report 2008 "PHC now more than ever" pointed to the importance of organizing health services around people's needs and expectations as one of the four main issues of PHC reforms. There is limited documentation of user's expectations to services offered at PHC facilities. The current study is a community extension of a hospital-based survey that showed a high bypassing frequency of PHC facilities among caretakers seeking care for their underfive children at two district hospitals. We aimed to explore caretakers' perceptions and expectations to services offered at PHC facilities in their area with reference to their experiences seeking care at such facilities. We conducted four community-based focus group discussions (FGD's) with 47 caretakers of underfive children in Muheza district of Tanga region, Tanzania in October 2009. Lack of clinical examinations and laboratory tests, combined with shortage of drugs and health workers, were common experiences. Across all the focus group discussions, unpleasant health workers' behaviors, lack of urgency and unnecessary delays were major complaints. In some places, unauthorized fees reduced access to services. The study revealed significant disappointments among caretakers with regard to the quality of services offered at PHC facilities in their areas, with implications for their utilization and proper functioning of the referral system. Practices regarding partial drugs administrations, skipping of injections, unofficial payments and consultations by unskilled health care providers need urgent action. There is also a need for proper accountability mechanisms to govern appropriate allocation and monitoring of health care resources and services in Tanzania.

42 CFR 93.413 - HHS compliance actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false HHS compliance actions. 93.413 Section 93.413 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

42 CFR 93.413 - HHS compliance actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false HHS compliance actions. 93.413 Section 93.413 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

Service Learning: An Action Oriented Program Evaluation

ERIC Educational Resources Information Center

Kelley, George

2013-01-01

Service learning is an academic discipline that provides students with "hands-on" opportunities for developing skills in real-world, community-based projects that serve and benefit community members. This dissertation reflects an action-oriented process for improving the quality of the Service Learning Program at City University of…

[E-health--challenge for health care system].

PubMed

Buczak-Stec, Elzbieta; Lemanowicz, Katarzyna; Mazurek, Marcin

2011-01-01

E-health and systems related to the electronic patient record (EPR) are seen as important factors in the development of the health care System. In 2004 European Commission had adopted e-Health Action Plan, which indicated the development directions of European e-Health. In Poland, the main development trends and Government course of actions in this regard, are contained in the document Computerization plan "e-Health Poland" 2009-2015. The European Commission defines e-Health as an application of tools and services, information and communication technologies in healthcare. EPR is a collection of patient data that are stored in a certain place and it is possible to access them. E-health and EPR are closely related to the concept of interoperability. Denmark is one of the countries in which the information services and information technology in healthcare is mostly used. The introduction of ERP involves a lot of positive effects. Using the ERP, stored data can be optimally used by both physicians and patients. However, also risks associated with data security need to be considered. Furthermore, the Polish law defines in great detail the issues associated with creating, storing and sharing medical records (1). According to the Act from 17 February 2005, concerning the computerization of public service activities, it possible to keep medical documentation in electronically form.

Involving migrants in the development of guidelines for communication in cross-cultural general practice consultations: a participatory learning and action research project

PubMed Central

O'Reilly-de Brún, Mary; MacFarlane, Anne; de Brún, Tomas; Okonkwo, Ekaterina; Bonsenge Bokanga, Jean Samuel; Manuela De Almeida Silva, Maria; Ogbebor, Florence; Mierzejewska, Aga; Nnadi, Lovina; van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; van Weel, Chris

2015-01-01

Objective The aim of this research was to involve migrants and other key stakeholders in a participatory dialogue to develop a guideline for enhancing communication in cross-cultural general practice consultations. In this paper, we focus on findings about the use of formal versus informal interpreters because dialogues about these issues emerged as central to the identification of recommendations for best practice. Design This qualitative case study involved a Participatory Learning and Action (PLA) research methodology. Participants The sample comprised 80 stakeholders: 51 from migrant communities; 15 general practitioners (GPs) and general practice staff; 7 established migrants as peer researchers; 5 formal, trained interpreters; and 2 service planners from the national health authority. Setting Galway, Ireland. Results There was 100% consensus across stakeholder groups that while informal interpreters have uses for migrants and general practice staff, they are not considered acceptable as best practice. There was also 100% consensus that formal interpreters who are trained and working as per a professional code of practice are acceptable as best practice. Conclusions Policymakers and service planners need to work in partnership with service providers and migrants to progress the implementation of professional, trained interpreters as a routine way of working in general practice. PMID:26391628

Development and evaluation of a wheelchair service provision training of trainers programme

PubMed Central

2017-01-01

Background In many countries, availability of basic training and continued professional development programmes in wheelchair services is limited. Therefore, many health professionals lack access to formal training opportunities and new approaches to improve wheelchair service provision. To address this need, the World Health Organization (WHO) developed the WHO Wheelchair Service Training of Trainers Programme (WSTPt), aiming to increase the number of trainers who are well prepared to deliver the WHO Wheelchair Service Training Packages. Despite these efforts, there was no recognised method to prepare trainers to facilitate these training programmes in a standardised manner. Objectives To understand if the WSTPt is an effective mechanism to train aspiring wheelchair service provision trainers. Method An action research study was conducted using a mixed-methods approach to data collection and analysis to integrate feedback from questionnaires and focus groups from three WHO WSTPt pilots. Results Trainees were satisfied with the WHO WSTPt and the iterative process appears to have helped to improve each subsequent pilot and the final training package. Conclusion The WHO WSTPt is an effective mechanism to train wheelchair service provision trainers. This programme has potential to increase the number of trainees and may increase the number of qualified service providers. PMID:28936423

78 FR 72111 - Quarterly Status Report of Water Service, Repayment, and Other Water-Related Contract Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... Status Report of Water Service, Repayment, and Other Water-Related Contract Actions AGENCY: Bureau of... Kelly, Water and Environmental Resources Division, Bureau of Reclamation, P.O. Box 25007, [[Page 72112... actions for any contract for the delivery of project water for authorized uses in newspapers of general...

Introducing Pre-Service Teachers to Action Research

ERIC Educational Resources Information Center

Stephens, Dianne; Kitchen, Julian

2004-01-01

Action Research is used in many teacher education programs to promote reflection, inquiry, and a sense of efficacy in pre-service teachers. As teacher educators working with a cohort of thirty-two teachers in a nine-month program, we decided to incorporate action research into the Teacher Education Seminar, a foundational course addressing general…

42 CFR 93.406 - Final HHS actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues... 42 Public Health 1 2011-10-01 2011-10-01 false Final HHS actions. 93.406 Section 93.406 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH...

39 CFR 501.13 - False representations of Postal Service actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MANUFACTURE AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.13 False representations of Postal Service actions... Evidencing Systems. The Postal Service reserves the right to suspend and/or revoke the authorization to manufacture or distribute Postage Evidencing Systems throughout the United States or any part thereof pursuant...

An action agenda for HIV and sex workers.

PubMed

Beyrer, Chris; Crago, Anna-Louise; Bekker, Linda-Gail; Butler, Jenny; Shannon, Kate; Kerrigan, Deanna; Decker, Michele R; Baral, Stefan D; Poteat, Tonia; Wirtz, Andrea L; Weir, Brian W; Barré-Sinoussi, Françoise; Kazatchkine, Michel; Sidibé, Michel; Dehne, Karl-Lorenz; Boily, Marie-Claude; Strathdee, Steffanie A

2015-01-17

The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

Insights from Australian parents into educational experiences in the early postnatal period.

PubMed

McKellar, Lois V; Pincombe, Jan I; Henderson, Ann M

2006-12-01

to investigate the provision of parent education during the early postnatal period in order to gain insight that, through stakeholder collaboration, will contribute to the development of innovative strategies to enhance the provision of postnatal education in a contemporary health-care environment. the study comprises the first stage of an action-research project. The first stage of research sought to explore the experiences of mothers and fathers in the early postnatal period by conducting a questionnaire within 4 weeks of the birth of their baby. The data obtained from the questionnaire is to inform an action-research group for stage two of the project. The Children, Youth and Women's Health Service, a large city maternity hospital in South Australia, covering a range of socio-economic strata. 85 parents completed and returned the questionnaire, comprising 52 mothers and 33 fathers. an anonymous self-report questionnaire was purpose designed to provide each parent with an opportunity to reflect on their own experience, with particular emphasis given to the provision of education and support during the early postnatal period. a number of themes emerged, including a window of opportunity during the postnatal hospital stay to provide education and support, despite the reduction in the length of stay; the need for a family-centred approach to maternity services; and the significance of self and social network in the early transition to parenthood. The findings from this stage of the research, combined with a review of the literature, provide insight that will contribute to stage two of the study. At this stage, an action-research group will continue planning to develop specific actions to enhance the provision of education to parents in the early postnatal period. These actions will subsequently be implemented and assessed.

What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs.

PubMed

Forman, Lisa; Ooms, Gorik; Chapman, Audrey; Friedman, Eric; Waris, Attiya; Lamprea, Everaldo; Mulumba, Moses

2013-12-01

Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health's contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable "minimum core" obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of scarcity and inadequate international assistance, and empowering civil society to claim fulfillment of their essential health needs from domestic and global decision-makers.

What could a strengthened right to health bring to the post-2015 health development agenda?: interrogating the role of the minimum core concept in advancing essential global health needs

PubMed Central

2013-01-01

Background Global health institutions increasingly recognize that the right to health should guide the formulation of replacement goals for the Millennium Development Goals, which expire in 2015. However, the right to health’s contribution is undercut by the principle of progressive realization, which links provision of health services to available resources, permitting states to deny even basic levels of health coverage domestically and allowing international assistance for health to remain entirely discretionary. Discussion To prevent progressive realization from undermining both domestic and international responsibilities towards health, international human rights law institutions developed the idea of non-derogable “minimum core” obligations to provide essential health services. While minimum core obligations have enjoyed some uptake in human rights practice and scholarship, their definition in international law fails to specify which health services should fall within their scope, or to specify wealthy country obligations to assist poorer countries. These definitional gaps undercut the capacity of minimum core obligations to protect essential health needs against inaction, austerity and illegitimate trade-offs in both domestic and global action. If the right to health is to effectively advance essential global health needs in these contexts, weaknesses within the minimum core concept must be resolved through innovative research on social, political and legal conceptualizations of essential health needs. Summary We believe that if the minimum core concept is strengthened in these ways, it will produce a more feasible and grounded conception of legally prioritized health needs that could assist in advancing health equity, including by providing a framework rooted in legal obligations to guide the formulation of new health development goals, providing a baseline of essential health services to be protected as a matter of right against governmental claims of scarcity and inadequate international assistance, and empowering civil society to claim fulfillment of their essential health needs from domestic and global decision-makers. PMID:24289096

Allowing variance may enlarge the safe operating space for exploited ecosystems.

PubMed

Carpenter, Stephen R; Brock, William A; Folke, Carl; van Nes, Egbert H; Scheffer, Marten

2015-11-17

Variable flows of food, water, or other ecosystem services complicate planning. Management strategies that decrease variability and increase predictability may therefore be preferred. However, actions to decrease variance over short timescales (2-4 y), when applied continuously, may lead to long-term ecosystem changes with adverse consequences. We investigated the effects of managing short-term variance in three well-understood models of ecosystem services: lake eutrophication, harvest of a wild population, and yield of domestic herbivores on a rangeland. In all cases, actions to decrease variance can increase the risk of crossing critical ecosystem thresholds, resulting in less desirable ecosystem states. Managing to decrease short-term variance creates ecosystem fragility by changing the boundaries of safe operating spaces, suppressing information needed for adaptive management, cancelling signals of declining resilience, and removing pressures that may build tolerance of stress. Thus, the management of variance interacts strongly and inseparably with the management of resilience. By allowing for variation, learning, and flexibility while observing change, managers can detect opportunities and problems as they develop while sustaining the capacity to deal with them.

Mental health system and services in Albania.

PubMed

Keste, Dévora; Lazeri, Ledia; Demi, Neli; Severoni, Santino; Lora, Antonio; Saxena, Shekhar

2006-01-01

To describe the mental health system in Albania. Data were gathered in 2003 and in 2004 using a new WHO instrument, World Health Organization Assessment Instrument for Mental health Systems (WHO-AIMS), designed for collecting essential information on the mental health system of low and middle income countries. It consists of 6 domains, 28 facets and 156 items. The information collected through WHO AIMS covered the key aspects of mental health system in Albania: the mental health policy and the legislative framework, the network of mental health services and the characteristics of the users, the role of the primary health care, the human resources, the public education and the links with other governmental sectors, monitoring and research. The data collection through WHO AIMS represented a needed step for a better in-depth knowledge of the system and for implementing actions to strengthen the system. Examples of planned actions were the improvement of the mental health component in primary care, a clear shift of resources from mental hospitals to community facilities, an increase of the outpatient care and an expansion of the mental health information system.

Allowing variance may enlarge the safe operating space for exploited ecosystems

PubMed Central

Carpenter, Stephen R.; Brock, William A.; Folke, Carl; van Nes, Egbert H.; Scheffer, Marten

2015-01-01

Variable flows of food, water, or other ecosystem services complicate planning. Management strategies that decrease variability and increase predictability may therefore be preferred. However, actions to decrease variance over short timescales (2–4 y), when applied continuously, may lead to long-term ecosystem changes with adverse consequences. We investigated the effects of managing short-term variance in three well-understood models of ecosystem services: lake eutrophication, harvest of a wild population, and yield of domestic herbivores on a rangeland. In all cases, actions to decrease variance can increase the risk of crossing critical ecosystem thresholds, resulting in less desirable ecosystem states. Managing to decrease short-term variance creates ecosystem fragility by changing the boundaries of safe operating spaces, suppressing information needed for adaptive management, cancelling signals of declining resilience, and removing pressures that may build tolerance of stress. Thus, the management of variance interacts strongly and inseparably with the management of resilience. By allowing for variation, learning, and flexibility while observing change, managers can detect opportunities and problems as they develop while sustaining the capacity to deal with them. PMID:26438857

Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services.

PubMed

Nieuwsma, Jason A; Jackson, George L; DeKraai, Mark B; Bulling, Denise J; Cantrell, William C; Rhodes, Jeffrey E; Bates, Mark J; Ethridge, Keith; Lane, Marian E; Tenhula, Wendy N; Batten, Sonja V; Meador, Keith G

2014-12-01

Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

The WHO UNESCO FIP Pharmacy Education Taskforce

PubMed Central

Anderson, Claire; Bates, Ian; Beck, Diane; Brock, Tina Penick; Futter, Billy; Mercer, Hugo; Rouse, Mike; Whitmarsh, Sarah; Wuliji, Tana; Yonemura, Akemi

2009-01-01

Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services. Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles. Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008–2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope. PMID:19500351

Impact of telephone triage on medical service use: implications for rural and remote areas.

PubMed

Hogenbirk, J C; Pong, R W; Lemieux, S K

2005-05-01

Lack of ready access to health services is a continuing problem for the one-quarter of northern Ontario residents who live in non-urban areas. Teletriage has been proposed to help reduce medically unnecessary visits and thus free-up available resources. A mail survey obtained information about patients' use of teletriage and other health care services, as well as socioeconomic and demographic characteristics. Survey data (n = 2389) were used to determine the impact of teletriage on health service use by asking about the patient's intended use of health care service (intent), the service advised by the nurse (advice), and the actual health service used by the patient (action). Responses were compared among geographic categories based on commuter flows to urban areas in northern Ontario. Survey responses suggest that teletriage may have decreased visits to emergency departments relative to patient intent, and this effect appears to be stronger in communities with weak or no commuter flows (intent = 54%, action = 41%) than in urban areas (intent = 39%, action = 33%). Visits to physicians' offices or clinics may have increased relative to patient intent, but only for non-urban areas (intent = 16%, action = 21% to 23%) with strong, moderate, weak, or no commuter flows. Very little difference was found among geographic categories for calls or visits to other health care providers (overall: intent = 17%, action = 11%) or for informal care (self-care and care for others) (overall: intent = 16%, action = 29%). Results should be interpreted carefully, as there was evidence of selection and social desirability bias.

Massachusetts Institute of Technology Lincoln Laboratory Facilities Replacement on Hanscom Air Force Base Phase 1 Final Environmental Assessment

DTIC Science & Technology

2014-07-24

Service UST Underground Storage Tank VC Vitrified Clay VOCs Volatile Organic Compounds W Watts 1 1.0 PURPOSE AND NEED FOR ACTION 1.1 INTRODUCTION The...discharged to sanitary drain and the solids slurry is hauled off site for disposal Fluoride drain: welded stainless steel drain piping from wet...diameter vitrified clay (VC) gravity sewer collection pipe, flowing north/northeast to the upper pumping station at Building 1306, is located within the

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

Physician, heal thyself

PubMed Central

Blais, Régis; Safianyk, Catherine; Magnan, Anne; Lapierre, André

2010-01-01

ABSTRACT OBJECTIVE To document the opinions of the users of the Quebec Physicians Health Program (QPHP) about the services they received. DESIGN Mailed questionnaire. SETTING Quebec. PARTICIPANTS A total of 126 physicians who used QPHP services between 1999 and 2004. MAIN OUTCOME MEASURES Users’ overall rating of the QPHP services, their opinions about the program, and whether their situations improved as a result of accessing QPHP services. RESULTS Ninety-two of the 126 physicians surveyed returned their completed questionnaires, providing a response rate of 73%. Most respondents thought that the QPHP services were good or excellent (90%), most would use the program again (86%) or recommend it (96%), and most thought the Quebec physician associations and the Collège des médecins du Québec should continue funding the QPHP (97%). Most respondents thought the service confidentiality was excellent (84%), as was staff professionalism (82%), and 62% thought the quality of the services they were referred to was excellent. However, only 57% believed their situations had improved with the help of the QPHP. CONCLUSION The QPHP received good marks from its users. Given the effects of physician burnout on patients and on the health care system, it is not only a personal problem, but also a collective problem. Thus, actions are needed not only to set up programs like the QPHP for those suffering from burnout, but also to prevent these types of problems. Because family physicians are likely to be the first ones consulted by their physician patients in distress, they play a key role in acknowledging these problems and referring those colleagues to the appropriate help programs when needed. PMID:20944027

Physician, heal thyself: Survey of users of the Quebec Physicians Health Program.

PubMed

Blais, Régis; Safianyk, Catherine; Magnan, Anne; Lapierre, André

2010-10-01

To document the opinions of the users of the Quebec Physicians Health Program (QPHP) about the services they received. Mailed questionnaire. Quebec. A total of 126 physicians who used QPHP services between 1999 and 2004. Users' overall rating of the QPHP services, their opinions about the program, and whether their situations improved as a result of accessing QPHP services. Ninety-two of the 126 physicians surveyed returned their completed questionnaires, providing a response rate of 73%. Most respondents thought that the QPHP services were good or excellent (90%), most would use the program again (86%) or recommend it (96%), and most thought the Quebec physician associations and the Collège des médecins du Québec should continue funding the QPHP (97%). Most respondents thought the service confidentiality was excellent (84%), as was staff professionalism (82%), and 62% thought the quality of the services they were referred to was excellent. However, only 57% believed their situations had improved with the help of the QPHP. The QPHP received good marks from its users. Given the effects of physician burnout on patients and on the health care system, it is not only a personal problem, but also a collective problem. Thus, actions are needed not only to set up programs like the QPHP for those suffering from burnout, but also to prevent these types of problems. Because family physicians are likely to be the first ones consulted by their physician patients in distress, they play a key role in acknowledging these problems and referring those colleagues to the appropriate help programs when needed.

Manipulation Action Understanding for Observation and Execution

ERIC Educational Resources Information Center

Yang, Yezhou

2015-01-01

Modern intelligent agents will need to learn the actions that humans perform. They will need to recognize these actions when they see them and they will need to perform these actions themselves. We want to propose a cognitive system that interprets human manipulation actions from perceptual information (image and depth data) and consists of…

Trade in health services.

PubMed Central

Chanda, Rupa

2002-01-01

In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

77 FR 1722 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-11

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-WASO-NRNHL-1212-9138; 2200-3200-665] National Register of Historic Places; Notification of Pending Nominations and Related Actions Nominations for the following properties being considered for listing or related actions in the National Register were received by the National Park Service befor...

10 CFR 10.33 - Action by the Deputy Executive Director for Information Services and Administration and Chief...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Action by the Deputy Executive Director for Information Services and Administration and Chief Information Officer. 10.33 Section 10.33 Energy NUCLEAR REGULATORY... SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.33 Action by the Deputy Executive Director...

10 CFR 10.33 - Action by the Deputy Executive Director for Information Services and Administration and Chief...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Action by the Deputy Executive Director for Information Services and Administration and Chief Information Officer. 10.33 Section 10.33 Energy NUCLEAR REGULATORY... SECURITY INFORMATION OR AN EMPLOYMENT CLEARANCE Procedures § 10.33 Action by the Deputy Executive Director...

Actionable Data Projects: Social Science and Service-Learning in General Education Courses

ERIC Educational Resources Information Center

Maloyed, Christie L.

2016-01-01

The use of service-learning pedagogies in general education courses is often limited to increasing volunteerism or civic literacy with problem-based or research-based projects reserved for upper level courses. This article examines the implementation of an "actionable data" service-learning project in an introductory, general studies…

42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

42 CFR 93.410 - Final HHS action with no settlement or finding of research misconduct.

Code of Federal Regulations, 2014 CFR

2014-10-01

... research misconduct. 93.410 Section 93.410 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.410 Final HHS action with no settlement or...

42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

42 CFR 93.410 - Final HHS action with no settlement or finding of research misconduct.

Code of Federal Regulations, 2012 CFR

2012-10-01

... research misconduct. 93.410 Section 93.410 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.410 Final HHS action with no settlement or...

42 CFR 93.411 - Final HHS action with settlement or finding of research misconduct.

Code of Federal Regulations, 2014 CFR

2014-10-01

... research misconduct. 93.411 Section 93.411 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.411 Final HHS action with settlement or finding...

42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

42 CFR 93.411 - Final HHS action with settlement or finding of research misconduct.

Code of Federal Regulations, 2013 CFR

2013-10-01

... research misconduct. 93.411 Section 93.411 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.411 Final HHS action with settlement or finding...

42 CFR 93.410 - Final HHS action with no settlement or finding of research misconduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... research misconduct. 93.410 Section 93.410 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.410 Final HHS action with no settlement or...

42 CFR 93.411 - Final HHS action with settlement or finding of research misconduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... research misconduct. 93.411 Section 93.411 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.411 Final HHS action with settlement or finding...

42 CFR 93.411 - Final HHS action with settlement or finding of research misconduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... research misconduct. 93.411 Section 93.411 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.411 Final HHS action with settlement or finding...

42 CFR 93.405 - Notifying the respondent of findings of research misconduct and HHS administrative actions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... misconduct and HHS administrative actions. 93.405 Section 93.405 Public Health PUBLIC HEALTH SERVICE... RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.405 Notifying the respondent of...

42 CFR 93.410 - Final HHS action with no settlement or finding of research misconduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... research misconduct. 93.410 Section 93.410 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.410 Final HHS action with no settlement or...

42 CFR 93.411 - Final HHS action with settlement or finding of research misconduct.

Code of Federal Regulations, 2012 CFR

2012-10-01

... research misconduct. 93.411 Section 93.411 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.411 Final HHS action with settlement or finding...

42 CFR 93.410 - Final HHS action with no settlement or finding of research misconduct.

Code of Federal Regulations, 2013 CFR

2013-10-01

... research misconduct. 93.410 Section 93.410 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.410 Final HHS action with no settlement or...

29 CFR 1471.635 - May the Federal Mediation and Conciliation Service settle a debarment or suspension action?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false May the Federal Mediation and Conciliation Service settle a...) FEDERAL MEDIATION AND CONCILIATION SERVICE GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General Principles Relating to Suspension and Debarment Actions § 1471.635 May the Federal Mediation and...

75 FR 28817 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... DEPARTMENT OF THE INTERIOR National Park Service National Register of Historic Places... considered for listing or related actions in the National Register were received by the National Park Service... CFR 60.15. Comments may be forwarded by United States Postal Service, to the National Register of...

75 FR 44281 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... DEPARTMENT OF THE INTERIOR National Park Service National Register of Historic Places... considered for listing or related actions in the National Register were received by the National Park Service.... Comments may be forwarded by United States Postal Service, to the National Register of Historic Places...