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Sample records for service integration affect

  1. Integrative Review of Factors That Affect the Use of Postpartum Care Services in Developing Countries.

    PubMed

    Adams, Yenupini Joyce; Smith, Barbara

    2018-03-07

    To identify factors that affect the use of postpartum care services in developing countries. PubMed, CINAHL, Global Health, EMBASE, and grey literature were searched for relevant articles in 2015 and 2016 with no publication date limit imposed. Thirteen studies met inclusion criteria and were assessed for quality with the use of a checklist developed by Fowkes and Fulton (1991) and a checklist developed by the Critical Appraisal Skills Programme (2017). The integrative review framework of Whittemore and Knafl (2005) guided the conduct of the review. Results were synthesized based on the three delays model of Thaddeus and Maine (1994). Factors that negatively affected women's decisions to seek postpartum care (Phase I delays) included lack of women's autonomy, lack of exposure to mass media, no pregnancy/birth/postpartum complications, lack of awareness of postpartum care, negative provider attitude, lower levels of women's and husbands' education, women's and husbands' farming occupations, increasing number of children, and lower level of household income. Perceived easy access to a health care facility was associated with lesser odds of using postpartum care (Phase II delay). Hospitals, public health care facilities, and long queuing at a health care facility were associated with decreased postpartum care use (Phase III delays). The most common determinants of how women used postpartum care were complications and the education levels and occupations of the women and their husbands. Further research is needed to identify health facility and accessibility factors that affect postpartum care use to develop effective interventions to improve the use of postpartum care. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  2. The ECE Pre-Service Teachers' Perception on Factors Affecting the Integration of Educational Computer Games in Two Conditions: Selecting versus Redesigning

    ERIC Educational Resources Information Center

    Sancar Tokmak, Hatice; Ozgelen, Sinan

    2013-01-01

    This case study aimed to examine early childhood education (ECE) pre-service teachers' perception on the factors affecting integration of educational computer games to their instruction in two areas: selecting and redesigning. Twenty-six ECE pre-service teachers participated in the study. The data was collected through open-ended questionnaires,…

  3. CopperCore Service Integration

    ERIC Educational Resources Information Center

    Vogten, Hubert; Martens, Harrie; Nadolski, Rob; Tattersall, Colin; van Rosmalen, Peter; Koper, Rob

    2007-01-01

    In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will…

  4. INTEGRAL burst alert service

    NASA Technical Reports Server (NTRS)

    Pedersen, H.; Jennings, D.; Mereghetti, S.; Teegarden, B.

    1997-01-01

    The detection, accurate positioning, and spectral analysis of cosmic gamma ray bursts is an objective of the International Gamma Ray Astrophysics Laboratory (INTEGRAL) mission. Due to their unpredictable nature, gamma ray bursts can only be observed in serendipity mode. In order to allow and promote multiwavelength follow-up observations of such events, it is desirable to make the information available to the astrophysics community with a minimum delay through the use of Internet. Ideally, the data dissemination should occur within a few seconds of the start of the burst event so that follow up observations can proceed while gamma rays are still being emitted. The technical feasibility of building such a system to disseminate INTEGRAL burst alerts in real time is currently under consideration, the preliminary results of which are presented. It is concluded that such an alert service is technically feasible.

  5. 'It is not a quick fix' structural and contextual issues that affect implementation of integrated health and well-being services: a qualitative study from North East England.

    PubMed

    Cheetham, M; Visram, S; Rushmer, R; Greig, G; Gibson, E; Khazaeli, B; Wiseman, A

    2017-11-01

    The objective of this article is to examine the factors affecting the design, commissioning and delivery of integrated health and well-being services (IHWSs), which seek to address multiple health-related behaviours, improve well-being and tackle health inequalities using holistic approaches. Qualitative studies embedded within iterative process evaluations. Semi-structured interviews conducted with 16 key informants as part of two separate evaluations of IHWSs in North East England, supplemented by informal observations of service delivery. Transcripts and fieldnotes were analysed thematically. The study findings identify a challenging organisational context in which to implement innovative service redesign, as a result of budget cuts and changes in NHS and local authority capacity. Pressures to demonstrate outcomes affected the ability to negotiate the practicalities of joint working. Progress is at risk of being undermined by pressures to disinvest before the long-term benefits to population health and well-being are realised. The findings raise important questions about contract management and relationships between commissioners and providers involved in implementing these new ways of working. These findings provide useful learning in terms of the delivery and commissioning of similar IHWSs, contributing to understanding of the benefits and challenges of this model of working. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. How Deployments Affect Service Members

    DTIC Science & Technology

    2006-01-01

    health effects , in- cluding post-traumatic stress disorder and other mental health problems, both of which have affected veteran populations in the...she receives from deployment. Furthermore, this literature can offer insight into how deployment-related stressors influence the effectiveness of...as well. For example, stress can affect an indi- vidual’s decisionmaking process and ability to make effective judgments. Easterbrook (1959), Janis

  7. Application Agreement and Integration Services

    NASA Technical Reports Server (NTRS)

    Driscoll, Kevin R.; Hall, Brendan; Schweiker, Kevin

    2013-01-01

    Application agreement and integration services are required by distributed, fault-tolerant, safety critical systems to assure required performance. An analysis of distributed and hierarchical agreement strategies are developed against the backdrop of observed agreement failures in fielded systems. The documented work was performed under NASA Task Order NNL10AB32T, Validation And Verification of Safety-Critical Integrated Distributed Systems Area 2. This document is intended to satisfy the requirements for deliverable 5.2.11 under Task 4.2.2.3. This report discusses the challenges of maintaining application agreement and integration services. A literature search is presented that documents previous work in the area of replica determinism. Sources of non-deterministic behavior are identified and examples are presented where system level agreement failed to be achieved. We then explore how TTEthernet services can be extended to supply some interesting application agreement frameworks. This document assumes that the reader is familiar with the TTEthernet protocol. The reader is advised to read the TTEthernet protocol standard [1] before reading this document. This document does not re-iterate the content of the standard.

  8. Service integration: something old and something new.

    PubMed

    Hassett, S; Austin, M J

    1997-01-01

    The authors trace the definition and challenges of "service integration," variously known over time as "collaboration," "coordination," "human services integration," and "one-stop shopping." While the common use of service integration terminology currently may seem to indicate a consensus in favor of a broad systemic reform, motivations and expectations for service integration differ significantly among different players in the service system. The authors conclude that service integration cannot be defined by a particular service model or outcome, but instead should be conceived of as an ongoing reform process. This process, when well-designed and implemented with long-term vision, can reduce duplication, strengthen communities, and improve client outcomes.

  9. Integration initiatives for forensic services

    PubMed Central

    ARBOLEDA-FLÓREZ, JULIO

    2003-01-01

    Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends. PMID:16946932

  10. Integrating services involves cost issues.

    PubMed

    Blaney, C L

    1998-01-01

    This article discusses the integration of sexually transmitted disease (STD) care within family planning (FP) programs and the cost effectiveness of integrated services in development countries. Examples are taken from experiences in Colombia, India, the US, and Kenya. The 1994 International Conference on Population and Development urged the integration of reproductive health care within FP. The more than 330 million annual new STD cases increase HIV transmission and cause pain and infertility. Women are biologically more susceptible to STDs, are more likely to be asymptomatic, and face harsher consequences, including death. Women with STDs should avoid the IUD and use barrier methods. Maintaining laboratories, training staff, and supplying drugs can overburden strained health budgets, but may lower long-term medical costs, increase productivity in employment, and decrease pain and suffering. STDs are viewed by some US health professionals as a "best buy" for being one of the least expensive of the reproductive health options. A Kenyan study found that treating STDs and providing oral contraceptives saved money by collapsing treatment into one instead of two visits. The savings were in overhead and staff costs. Evaluations of cost effectiveness should consider local STD prevalence, cultural setting, client needs, and available resources. In some cases, referral of cases to STD clinics may be the most cost-effective. A US study found that chlamydia screening for all FP clients was more cost-effective than screening selectively. Another US study found that universal screening for chlamydia would provide long-term medical savings even if prevalence was only 2%. Developing countries have the lower-cost option of offering syndromic management of STDs for symptomatic women rather than lab tests. A program in India cut costs by educating and encouraging barrier methods.

  11. Healthcare resource allocation decisions affecting uninsured services.

    PubMed

    Harrison, Krista Lyn; Taylor, Holly A

    2016-11-21

    Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services.

  12. Healthcare resource allocation decisions affecting uninsured services

    PubMed Central

    Harrison, Krista Lyn; Taylor, Holly A.

    2017-01-01

    Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services. PMID:27934550

  13. Integrated Distributed Directory Service for KSC

    NASA Technical Reports Server (NTRS)

    Ghansah, Isaac

    1997-01-01

    This paper describes an integrated distributed directory services (DDS) architecture as a fundamental component of KSC distributed computing systems. Specifically, an architecture for an integrated directory service based on DNS and X.500/LDAP has been suggested. The architecture supports using DNS in its traditional role as a name service and X.500 for other services. Specific designs were made in the integration of X.500 DDS for Public Key Certificates, Kerberos Security Services, Network-wide Login, Electronic Mail, WWW URLS, Servers, and other diverse network objects. Issues involved in incorporating the emerging Microsoft Active Directory Service MADS in KSC's X.500 were discussed.

  14. The EPOS Integrated Core Services

    NASA Astrophysics Data System (ADS)

    Jeffery, Keith; Michelini, Alberto; Bailo, Daniele

    2013-04-01

    The European Plate Observing System (EPOS) is integrating the diverse, but advanced Research Infrastructures in Europe for solid Earth Science, and will build on new e-science opportunities to monitor and understand the dynamic and complex solid-Earth System. This integration requires a significant coordination between, among others, disciplinary (thematic) communities, national RIs policies and initiatives, and geo- and IT-scientists. The RIs that EPOS will coordinate include at least, but not only: regionally-distributed geophysical observing systems (seismological and geodetic networks), local observatories (including geomagnetic, permanent in-situ and volcano observatories), experimental & analogue laboratories in Europe, integrated satellite data and geological information. EPOS is promoting open access to geophysical and geological data as well as modelling/processing tools, enabling a step change in multidisciplinary scientific research for Earth Sciences The EPOS e-infrastructure is developed through strawman (initial design / architecture), woodman (refined design/architecture) and ironman (final design/architecture) phases. Midway in the project we are in the woodman phase based on extensive primary requirements from users and secondary requirements for interoperation with other geoscience systems, other European environmental research infrastructure projects and e-infrastructure projects (e.g. EUDAT). The EPOS e-infrastructure is being developed along 3 parallel tracks: (a) an inventory of assets offered by organisations within the EPOS community. The RIDE (Research Infrastructure Database for EPOS) system from the strawman phase is being extended in the woodman phase to the metadata catalog describing computing and scientific resources, data, services (software), and users which will drive the EPOS e-infrastructure; (b) refining an architecture to meet the requirements. This is an iterative process with the working groups (organised thematically) within

  15. Affect integration in dreams and dreaming.

    PubMed

    Grenell, Gary

    2008-03-01

    The processes by which dreaming aids in the ongoing integration of affects into the mind are approached here from complementary psychoanalytic and nonpsychoanalytic perspectives. One relevant notion is that the dream provides a psychological space wherein overwhelming, contradictory, or highly complex affects that under waking conditions are subject to dissociation, splitting, or disavowal may be brought together for observation by the dreaming ego. This process serves the need for psychological balance and equilibrium. A brief discussion of how the mind processes information during dreaming is followed by a consideration of four component aspects of the integrative process: the nature and use of the dream-space, the oscillating "me / not me" quality of the dream, the apparent reality of the dream, and the use of nonpathological projective identification in dreaming. Three clinical illustrations are offered and discussed.

  16. [Integration of the delivery of health services].

    PubMed

    Frenk, J

    1992-01-01

    In Mexico the Constitution defines the right to health care as a social right and, as such, confers to the state the guiding role in the access of the population to health services. Unfortunately, this constitutional principle has not been fully met. One of the reasons for this is the fragmentation of public action in health and the continuous postponement of the integration of health services. In this paper the conceptual and practical limits of integration of health services are discussed, using as starting point a brief diagnosis of inequity and fragmentation of the health system in Mexico. The doctrinaire principles of integration are also described, as well as its practical advantages and disadvantages. Finally, a typology of forms of integration and previous integration experiences in Mexico are discussed. In the concluding remarks the integration prospects for Mexico are analyzed.

  17. Integrating nutrition services into primary care

    PubMed Central

    Crustolo, Anne Marie; Kates, Nick; Ackerman, Sari; Schamehorn, Sherri

    2005-01-01

    PROBLEM BEING ADDRESSED Nutrition services can have an important role in prevention and management of many conditions seen by family physicians, but access to these services in primary care is limited. OBJECTIVE OF PROGRAM To integrate specialized nutrition services into the offices of family physicians in Hamilton, Ont, in order to improve patient access to those services, to expand the range of problems seen in primary care, and to increase collaboration between family physicians and registered dietitians. PROGRAM DESCRIPTION Registered dietitians were integrated into the offices of 80 family physicians. In collaboration with physicians, they assessed, treated, and consulted on a variety of nutrition-related problems. A central management team coordinated the dietitians’ activities. CONCLUSION Registered dietitians can augment and complement family physicians’ activities in preventing, assessing, and treating nutrition-related problems. This model of shared care can be applied to integrating other specialized services into primary care practices. PMID:16805083

  18. Fire Service Integration for Fusion Centers

    DTIC Science & Technology

    2010-04-01

    Facility, and Physical Infrastructure 13 F. Funding 14 Available Resources 15 Fire Service Integration for Fusion Centers 1 Introduction...Information Technology/Communications Infrastructure, Systems, Equipment, Facility, and Physical Infrastructure F. Funding Fire Service...Technology/Communications Infrastructure, Systems, Equipment, Facility, and Physical Infrastructure o Information Exchange Within the Center—Fusion centers

  19. Supporting Theory Building in Integrated Services Research

    ERIC Educational Resources Information Center

    Robinson, Mark; Atkinson, Mary; Downing, Dick

    2008-01-01

    This literature review was commissioned by the National Foundation for Educational Research (NFER) to draw together current and recent studies of integrated working, in order to build an overview of the theories and models of such working. The review is important for current work on evaluating the early impact of integrated children's services and…

  20. Measuring the degree of integration for an integrated service network

    PubMed Central

    Ye, Chenglin; Browne, Gina; Grdisa, Valerie S; Beyene, Joseph; Thabane, Lehana

    2012-01-01

    Background Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies’ perception and expectation. We propose a method for quantifying the agencies’ service integration. Using the data from the Children’s Treatment Network (CTN), we aimed to measure the degree of integration for the CTN agencies in York and Simcoe. Theory and methods We quantified the integration by the agreement between perceived and expected levels of involvement and calculated four scores from different perspectives for each agency. We used the average score to measure the global network integration and examined the sensitivity of the global score. Results Most agencies’ integration scores were <65%. As measured by the agreement between every other agency’s perception and expectation, the overall integration of CTN in Simcoe and York was 44% (95% CI: 39%–49%) and 52% (95% CI: 48%–56%), respectively. The sensitivity analysis showed that the global scores were robust. Conclusion Our method extends existing measures of integration and possesses a good extent of validity. We can also apply the method in monitoring improvement and linking integration with other outcomes. PMID:23593050

  1. Knowledge exchange and integrated services: experiences from an integrated community intellectual (learning) disability service for adults.

    PubMed

    Farrington, C; Clare, I C H; Holland, A J; Barrett, M; Oborn, E

    2015-03-01

    This paper examines knowledge exchange dynamics in a specialist integrated intellectual (learning) disability service, comprising specialist healthcare provision with social care commissioning and management, and considers their significance in terms of integrated service delivery. A qualitative study focusing on knowledge exchange and integrated services. Semi-structured interviews (n = 25) were conducted with members of an integrated intellectual disability service in England regarding their perceptions of knowledge exchange within the service and the way in which knowledge exchange impinges on the operation of the integrated service. Exchange of 'explicit' (codifiable) knowledge between health and care management components of the service is problematic because of a lack of integrated clinical governance and related factors such as IT and care record systems and office arrangements. Team meetings and workplace interactions allowed for informal exchange of explicit and 'tacit' (non-codifiable) knowledge, but presented challenges in terms of knowledge exchange completeness and sustainability. Knowledge exchange processes play an important role in the functioning of integrated services incorporating health and care management components. Managers need to ensure that knowledge exchange processes facilitate both explicit and tacit knowledge exchange and do not rely excessively on informal, 'ad hoc' interactions. Research on integrated services should take account of micro-scale knowledge exchange dynamics and relationships between social dynamics and physical factors. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. Streamlining Data Access Services and Data Analysis Services Integration

    NASA Astrophysics Data System (ADS)

    Del Rio, N.; Pennington, D. D.; Pinheiro da Silva, P.; Benedict, K. K.

    2012-12-01

    There are few data analysis services capable of understanding and consuming data coming from multiple data access services. This lack of interoperability between data access services and data analysis services is indeed a major roadblock for science because it prevents the reuse and repurposing of both data and analytical software to support new scientific discoveries. In this presentation, we discuss this problem in light of the Earth, Life, and Semantic Web (ELSEWEB) project funded through NASA's ACCESS Program. The project uses the University of Kansas' Lifemapper system as its analytical Web Service platform, which models potential future species distributions under scenarios of climate change. In an effort to broaden the range of scenarios to include land cover/land use change, ELSEWEB aims to streamline the flow of highly heterogeneous geographic, social, and geological data hosted at UNM's Earth Data Analysis Center (EDAC) through a collection of OGC Web Coverage Services into Lifemapper. In turn, this integration will enable new modeling of complex factors associated with biotic change such as health and infectious disease, that depend not only on climate change and species distributions, but also on other human/environmental interactions. In this presentation we discuss the integration of Lifemapper and EDAC data and model services, provided by a third party semantic system, known as VisKo, that (1) translates Lifemapper data requirements to EDAC service invocations and (2) pipes the data output from EDAC into Lifemapper. VisKo is supported by a knowledge base of web service descriptions that contains information about interface requirements as well as invocation details, including service parameters. VisKo ontologies are designed to capture the knowledge required by the system to orchestrate and execute service pipelines that perform scientist's required computation. The ELSEWEB project also aims to expand VisKo's original goal of building visualization

  3. Multidisciplinary management--an opportunity for service integration.

    PubMed

    Cameron, M

    1997-01-01

    The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble.

  4. Military Base Closures and Affected Defense Department Civil Service Employees

    DTIC Science & Technology

    2006-03-07

    be several implications and options for affected DoD civil service employees relating to reductions in force (RIFs) and several types of transition...DoD employees are affected by the BRAC process. This report will be updated if major changes occur in the BRAC process regarding DoD civil service employees

  5. Strengthening Integration Of Health Services And Systems.

    PubMed

    Martin, Laurie T; Plough, Alonzo; Carman, Katherine G; Leviton, Laura; Bogdan, Olena; Miller, Carolyn E

    2016-11-01

    New care delivery models that hold providers more accountable for coordinated, high-quality care and the overall health of their patients have appeared in the US health care system, spurred by recent legislation such as the Affordable Care Act. These models support the integration of health care systems, but maximizing health and well-being for all individuals will require a broader conceptualization of health and more explicit connections between diverse partners. Integration of health services and systems constitutes the fourth Action Area in the Robert Wood Johnson Foundation's Culture of Health Action Framework, which is the subject of this article. This Action Area conceives of a strengthened health care system as one in which medical care, public health, and social services interact to produce a more effective, equitable, higher-value whole that maximizes the production of health and well-being for all individuals. Three critical drivers help define and advance this Action Area and identify gaps and needs that must be addressed to move forward. These drivers are access, balance and integration, and consumer experience and quality. This article discusses each driver and summarizes practice gaps that, if addressed, will help move the nation toward a stronger and more integrated health system. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Pediatric traumatic brain injury affects multisensory integration.

    PubMed

    Königs, Marsh; Weeda, Wouter D; van Heurn, L W Ernest; Vermeulen, R Jeroen; Goslings, J Carel; Luitse, Jan S K; Poll-The, Bwee Tien; Beelen, Anita; van der Wees, Marleen; Kemps, Rachèl J J K; Catsman-Berrevoets, Coriene E; Oosterlaan, Jaap

    2017-02-01

    To investigate the impact of pediatric traumatic brain injury (TBI) on multisensory integration in relation to general neurocognitive functioning. Children with a hospital admission for TBI aged between 6 and 13 years (n = 94) were compared with children with trauma control (TC) injuries (n = 39), while differentiating between mild TBI without risk factors for complicated TBI (mild RF- ; n = 19), mild TBI with ≥1 risk factor (mild RF+ ; n = 45), and moderate/severe TBI (n = 30). We measured set-shifting performance based on visual information (visual shift condition) and set-shifting performance based on audiovisual information, requiring multisensory integration (audiovisual shift condition). Effects of TBI on set-shifting performance were traced back to task strategy (i.e., boundary separation), processing efficiency (i.e., drift rate), or extradecisional processes (i.e., nondecision time) using diffusion model analysis. General neurocognitive functioning was measured using estimated full-scale IQ (FSIQ). The TBI group showed selectively reduced performance in the audiovisual shift condition (p = .009, Cohen's d = -0.51). Follow-up analyses in the audiovisual shift condition revealed reduced performance in the mildRF+ TBI group and moderate/severe TBI group (ps ≤ .025, ds ≤ -0.61). These effects were traced back to lower drift rate (ps ≤ .048, ds ≤ -0.44), reflecting reduced multisensory integration efficiency. Notably, accuracy and drift rate in the audiovisual shift condition partially mediated the relation between TBI and FSIQ. Children with mildRF+ or moderate/severe TBI are at risk for reduced multisensory integration efficiency, possibly contributing to decreased general neurocognitive functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Possible Determinants Affecting the Use of Mobile Tourism Services

    NASA Astrophysics Data System (ADS)

    Eriksson, Niklas; Strandvik, Peter

    For this study a field trial was conducted to identify possible determinants affecting tourists’ intended or actual use of mobile tourism services. Three trial services targeting tourists on tour were set up, in this case on the Åland Islands in Finland. We identified that the major barrier for the non usage of the trial services was linked to the value aspect of the packaged tour that the trial group participated in. Also price transparency and ease of use especially ease to take new mobile services temporary into use should be highlighted in mobile tourism service development.

  8. Integrating services for patients with mental and substance use disorders: What matters?

    PubMed Central

    Brousselle, Astrid; Lamothe, Lise; Sylvain, Chantal; Foro, Anne; Perreault, Michel

    2012-01-01

    Background Over the past decade, practice standards have recommended that people suffering from both mental and substance use disorders receive integrated treatment. Yet, few institutions offer integrated services, and patients are too often turned away from psychiatric and addiction rehabilitation services. Purpose The purpose of this study was to identify key factors in integrating services for patients with co-occurring disorders. Methodology We conducted a process evaluation with the aim of identifying factors that enhance or impede service integration. First, we elaborated a sound conceptual framework of service integration. We then conducted in-depth case studies analysis using socioanthropological methods (interviews with managers and professionals, focus groups with patients, nonparticipant observation, and document analysis). We analyzed two contrasted forms of services integration, a joint venture and a strategic alliance, separately and then compared them. Findings The integrations achieved in the two cases were of different intensities. However, from our study, we were able to identify various levers and characteristics that affect the development of an integrated approach. Reflecting on the dynamics of these two cases, we formulated six propositions to identify what matters when integrating services for persons with mental and substance use disorders. Practice Implications The integration of services transcends debates on care models and must be focused on the patients’ experience of care. The process should stimulate a learning experience that helps to align practices (normative integration) and to integrate teams and care. In this study, we identified a number of key conditions and levers for success. PMID:20551769

  9. Integrative Health Services in School Health Clinics

    PubMed Central

    Milosavljevic, Nada

    2015-01-01

    Objective: Mental health treatment today incorporates neurobiology, genetics, neuro-imaging, and pharmacologic mechanisms, offering more options to patients. For some, these modern approaches are not viable choices due to reasons such as limited access to care, cost, intolerable side effects, and, in the pediatric population, fears of potential long-term effects. With the growing prevalence of chronic health conditions, concerns for age of onset, (McGorry, Purcell, Goldstone, & Amminger, 2011) and a growing population of mental health patients, cost-effective and evidence-based treatment options should be evaluated. Integrative treatments, also known as complementary and alternative medicine (CAM), may offer interventions that meet today’s clinical needs. Method: To evaluate evidence-based treatment options, we initiated the school-based integrative health program (IHP) in January 2011 at three high schools located in Massachusetts. Our goal was two-fold: first, to design a holistic treatment program and evaluate several integrative modalities, and; second, to determine the feasibility of providing a CAM health program through school clinics. Our protocol utilized three integrative treatments that addressed stress and anxiety conditions. Anxiety disorders are the most common mental illness affecting over 40 million adults in the US (Anxiety and Depression Association of America). Results: The program has been successfully implemented. Preliminary results indicate that this intervention decreased anxiety in these youth. Conclusion: Providing integrative techniques to students in the school setting has the potential to decrease barriers to accessing care, lowering treatment costs and decreasing school absenteeism by instituting care on-site. Offering a holistic approach to treatment in schools is feasible. Because utilizing these approaches involves their active participation, adolescents can acquire life-long skills that improve their ability to cope and confront

  10. The Arithmetic of Emotion: Integration of Incidental and Integral Affect in Judgments and Decisions

    PubMed Central

    Västfjäll, Daniel; Slovic, Paul; Burns, William J.; Erlandsson, Arvid; Koppel, Lina; Asutay, Erkin; Tinghög, Gustav

    2016-01-01

    Research has demonstrated that two types of affect have an influence on judgment and decision making: incidental affect (affect unrelated to a judgment or decision such as a mood) and integral affect (affect that is part of the perceiver’s internal representation of the option or target under consideration). So far, these two lines of research have seldom crossed so that knowledge concerning their combined effects is largely missing. To fill this gap, the present review highlights differences and similarities between integral and incidental affect. Further, common and unique mechanisms that enable these two types of affect to influence judgment and choices are identified. Finally, some basic principles for affect integration when the two sources co-occur are outlined. These mechanisms are discussed in relation to existing work that has focused on incidental or integral affect but not both. PMID:27014136

  11. The Arithmetic of Emotion: Integration of Incidental and Integral Affect in Judgments and Decisions.

    PubMed

    Västfjäll, Daniel; Slovic, Paul; Burns, William J; Erlandsson, Arvid; Koppel, Lina; Asutay, Erkin; Tinghög, Gustav

    2016-01-01

    Research has demonstrated that two types of affect have an influence on judgment and decision making: incidental affect (affect unrelated to a judgment or decision such as a mood) and integral affect (affect that is part of the perceiver's internal representation of the option or target under consideration). So far, these two lines of research have seldom crossed so that knowledge concerning their combined effects is largely missing. To fill this gap, the present review highlights differences and similarities between integral and incidental affect. Further, common and unique mechanisms that enable these two types of affect to influence judgment and choices are identified. Finally, some basic principles for affect integration when the two sources co-occur are outlined. These mechanisms are discussed in relation to existing work that has focused on incidental or integral affect but not both.

  12. Considering Affective Responses towards Environments for Enhancing Location Based Services

    NASA Astrophysics Data System (ADS)

    Huang, H.; Gartner, G.; Klettner, S.; Schmidt, M.

    2014-04-01

    A number of studies in the field of environmental psychology show that humans perceive and evaluate their surroundings affectively. Some places are experienced as unsafe, while some others as attractive and interesting. Experiences from daily life show that many of our daily behaviours and decision-making are often influenced by this kind of affective responses towards environments. Location based services (LBS) are often designed to assist and support people's behaviours and decision-making in space. In order to provide services with high usefulness (usability and utility), LBS should consider these kinds of affective responses towards environments. This paper reports on the results of a research project, which studies how people's affective responses towards environments can be modelled and acquired, as well as how LBS can benefit by considering these affective responses. As one of the most popular LBS applications, mobile pedestrian navigation systems are used as an example for illustration.

  13. Teleradiology for Veterans Integrated Service Networks

    NASA Astrophysics Data System (ADS)

    Duerinckx, Andre J.; Hayrapetian, Alek S.; Kenagy, John J.; Grant, Edward G.

    1997-05-01

    Veterans Affairs Health Care has become more decentralized with the creation of local Veteran Integrated Service Networks (VISN). The purpose of this study was to analyze the design and cost of a wide-area-network (WAN) for teleradiology in a local VISN. The Southern California VISN includes 4 large and 3 small medical centers. Only one of the 7 medical centers has an operational PACS. Data were collected on the radiologist workloads and patient and image flow within and between the 7 medical centers. This was used to estimate the size and cost of local PACS at each medical center and the need for teleradiology services. A simplified cost-analysis model was used to estimate potential cost- savings by gong filmless. Asynchronous transfer mode (ATM) technology was selected for the WAN between the medical centers. A realistic cost-savings model was developed. Cost- effectiveness of a PACS/Teleradiology system was established. Based on this model, a PACS/Teleradiology configuration for the VISN was successfully designed and partially implemented. The ATM-based WAN provides instantaneous access to PACS at each centers. Cost-analysis of the design and implementation of a PACS/teleradiology network in a VISN is possible and important when planning such system. The experience gained will serve a model for future similar projects nationwide.

  14. Variables affecting the academic and social integration of nursing students.

    PubMed

    Zeitlin-Ophir, Iris; Melitz, Osnat; Miller, Rina; Podoshin, Pia; Mesh, Gustavo

    2004-07-01

    This study attempted to analyze the variables that influence the academic integration of nursing students. The theoretical model presented by Leigler was adapted to the existing conditions in a school of nursing in northern Israel. The independent variables included the student's background; amount of support received in the course of studies; extent of outside family and social commitments; satisfaction with the school's facilities and services; and level of social integration. The dependent variable was the student's level of academic integration. The findings substantiated four central hypotheses, with the study model explaining approximately 45% of the variance in the dependent variable. Academic integration is influenced by a number of variables, the most prominent of which is the social integration of the student with colleagues and educational staff. Among the background variables, country of origin was found to be significant to both social and academic integration for two main groups in the sample: Israeli-born students (both Jewish and Arab) and immigrant students.

  15. Factors affecting rural volunteering in palliative care - an integrated review.

    PubMed

    Whittall, Dawn; Lee, Susan; O'Connor, Margaret

    2016-12-01

    To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment

  16. Semi-automated software service integration in virtual organisations

    NASA Astrophysics Data System (ADS)

    Afsarmanesh, Hamideh; Sargolzaei, Mahdi; Shadi, Mahdieh

    2015-08-01

    To enhance their business opportunities, organisations involved in many service industries are increasingly active in pursuit of both online provision of their business services (BSs) and collaborating with others. Collaborative Networks (CNs) in service industry sector, however, face many challenges related to sharing and integration of their collection of provided BSs and their corresponding software services. Therefore, the topic of service interoperability for which this article introduces a framework is gaining momentum in research for supporting CNs. It contributes to generation of formal machine readable specification for business processes, aimed at providing their unambiguous definitions, as needed for developing their equivalent software services. The framework provides a model and implementation architecture for discovery and composition of shared services, to support the semi-automated development of integrated value-added services. In support of service discovery, a main contribution of this research is the formal representation of services' behaviour and applying desired service behaviour specified by users for automated matchmaking with other existing services. Furthermore, to support service integration, mechanisms are developed for automated selection of the most suitable service(s) according to a number of service quality aspects. Two scenario cases are presented, which exemplify several specific features related to service discovery and service integration aspects.

  17. Integration of multimodal transportation services : final report.

    DOT National Transportation Integrated Search

    2016-03-08

    Flexible route paratransit services may complement as well as compete with conventional public transportation services (that : have fixed routes and schedules). Flexible routes are especially suitable for service areas or time periods with low demand...

  18. Factors Affecting Use of Environmental Services by the Elderly.

    ERIC Educational Resources Information Center

    Hartwigsen, Gail

    The ability to function independently in the later years has been defined as a combination of capability and support. To examine factors affecting older adults' use of services provided in an accommodating environment, 52 physically independent residents of an Arizona apartment complex for the elderly were surveyed. Time spent living in the…

  19. Services for mentally ill homeless persons: street-level integration.

    PubMed

    Rowe, M; Hoge, M A; Fisk, D

    1998-07-01

    The key elements of a systems integration approach to delivery of human services are reviewed in terms of their application to services for mentally ill homeless persons. The example of a mental health outreach project illustrates the service- and systems-integrating influences of clinical case management with this population, and the ability of a "bottom-up" street-level approach to improve coordination and service accessibility for clients in general is discussed.

  20. Europlanet Integrated and Distributed Information Service

    NASA Astrophysics Data System (ADS)

    Schmidt, W.; Capria, M. T.; Chanteur, G.

    2009-04-01

    During the past decades the various disciplines in planetary sciences have developed to a very high international standard. But the collaboration between the different fields should be improved. To overcome the current fragmentation of the EU Planetary Science community and thereby to increase the scientific return of the related investment, the EU commission is funding via its Framework Program 7 the development of the "Europlanet Research Infrastructure -Europlanet RI". The Europlanet RI will consolidate the integration of the European Planetary Science community which started with Europlanet's FP6 project and will integrate major parts of the related distributed European infrastructure to be shared, fed and expanded by all planetary scientists. This infrastructure encompasses as diverse components as space exploration, ground-based observations, laboratory experiments and numerical modeling teams. Europlanet RI aims at bringing scientists from Europe and beyond together who are working in these fields, support the exchange of experts and ideas and make as many resources and data as possible available to the research community. A central part of Europlanet RI is the "Integrated and Distributed Information Service" or Europlanet-IDIS. The task of IDIS as central part of Europlanet is to provide an easy-to-use Web-based platform to locate teams and laboratories with special knowledge needed to support the own research activities, give access to the wealth of already available data, initiate new research activities needed to interpret accumulated data or to solve open questions, and to exploit synergies between space-based missions and capabilities of ground based observatories. It also offers to a wide range of teams and laboratories the possibility to share their data, advertise their capabilities and increase the scientific return by cooperation. IDIS is organized as an EU FP7 Support Activity, consisting of different access nodes which are connected by

  1. How In-Service Science Teachers Integrate History and Nature of Science in Elementary Science Courses

    ERIC Educational Resources Information Center

    Hacieminoglu, Esme

    2014-01-01

    The purpose of this study is to investigate how the in-service science teachers' (IST) perceptions and practices about curriculum and integration of the history of science (HOS) and the nature of science (NOS) affect their science courses. For this aim, how ISTs integrated the NOS and HOS in their elementary science courses for understanding of…

  2. Jordanian Pre-Service Teachers' and Technology Integration: A Human Resource Development Approach

    ERIC Educational Resources Information Center

    Al-Ruz, Jamal Abu; Khasawneh, Samer

    2011-01-01

    The purpose of this study was to test a model in which technology integration of pre-service teachers was predicted by a number of university-based and school-based factors. Initially, factors affecting technology integration were identified, and a research-based path model was developed to explain causal relationships between these factors. The…

  3. Elements affecting food waste in the food service sector.

    PubMed

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

    2016-10-01

    Avoidable food waste is produced in the food service sector, with significant ecological and economical impacts. In order to understand and explain better the complex issue of food waste a qualitative study was conducted on the reasons for its generation in restaurants and catering businesses. Research data were collected during three participatory workshops for personnel from three different catering sector companies in Finland. Based on synthesized qualitative content analysis, eight elements influencing production and reduction of food waste were identified. Results revealed the diversity of managing food waste in the food service sector and how a holistic approach is required to prevent and reduce it. It is crucial to understand that food waste is manageable and should be an integral component of the management system. The model of eight factors provides a framework for recognition and management of food waste in the food service sector. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. How Do Volcanoes Affect Human Life? Integrated Unit.

    ERIC Educational Resources Information Center

    Dayton, Rebecca; Edwards, Carrie; Sisler, Michelle

    This packet contains a unit on teaching about volcanoes. The following question is addressed: How do volcanoes affect human life? The unit covers approximately three weeks of instruction and strives to present volcanoes in an holistic form. The five subject areas of art, language arts, mathematics, science, and social studies are integrated into…

  5. An Integrated View of Service Innovation in Service Networks

    NASA Astrophysics Data System (ADS)

    Agarwal, Renu; Selen, Willem

    This chapter provides an insight into how service innovation may be enabled in service systems. In particular, we look at the ability of the organizational networks to collaboratively generate the capacity to adapt to changing circumstances rather than as individual firms on their own, using the RARE (Resources, Activities and Routines configured and reconfigured through Entrepreneurial actions) strategic framework. This leads into unraveling the complexity of strategic decision making in service networks through co-evolutionary adaptation, or the learning of organizations over time and the resulting virtuous process of experience, learning, and dynamic capabilities enabling them to respond to and launch a variety of competitive actions. Finally, we report on how service networks can address the duality of dynamic control capacity and responsiveness, known as the Paradox of Flexibility, through linking strategic and operational capabilities, as well as customer-supplier duality capabilities, in real time. This in the end results in innovation in services or our notion of "elevated" service offerings.

  6. The Complexity of Health Service Integration: A Review of Reviews.

    PubMed

    Heyeres, Marion; McCalman, Janya; Tsey, Komla; Kinchin, Irina

    2016-01-01

    The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. The review was developed by systematically searching nine electronic databases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized. Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low. There is no "one size fits all" approach to

  7. Publications of the School-Linked Services Integration Research Project.

    ERIC Educational Resources Information Center

    Kansas Univ., Lawrence.

    This compilation of publications from the School-Linked Service Integration Research Project focuses on integrated services and includes the following papers: (1) "New Community Schools: Issues for Families in Three Streams of Reform" (Wayne Sailor), describes issues in special education reform, general education reform, and school/health services…

  8. Technology Integration Support Levels for In-Service Teachers

    ERIC Educational Resources Information Center

    Williams, Mable Evans

    2017-01-01

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

  9. Affective state and community integration after traumatic brain injury.

    PubMed

    Juengst, Shannon B; Arenth, Patricia M; Raina, Ketki D; McCue, Michael; Skidmore, Elizabeth R

    2014-12-01

    Previous studies investigating the relationship between affective state and community integration have focused primarily on the influence of depression and anxiety. In addition, they have focused on frequency of participation in various activities, failing to address an individual's subjective satisfaction with participation. The purpose of this study was to examine how affective state contributes to frequency of participation and satisfaction with participation after traumatic brain injury among participants with and without a current major depressive episode. Sixty-four community-dwelling participants with a history of complicated mild-to-severe traumatic brain injury participated in this cross-sectional cohort study. High positive affect contributed significantly to frequency of participation (β = 0.401, P = 0.001), and both high positive affect and low negative affect significantly contributed to better satisfaction with participation (F2,61 = 13.63, P < 0.001). Further investigation to assess the direction of these relationships may better inform effective targets for intervention. These findings highlight the importance of assessing affective state after traumatic brain injury and incorporating a subjective measure of participation when considering community integration outcomes.

  10. Integrating HIV and substance use services: a systematic review

    PubMed Central

    Haldane, Victoria; Cervero-Liceras, Francisco; Chuah, Fiona LH; Ong, Suan Ee; Murphy, Georgina; Sigfrid, Louise; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; Piot, Peter; McKee, Martin; Perel, Pablo; Legido-Quigley, Helena

    2017-01-01

    Abstract Introduction: Substance use is an important risk factor for HIV, with both concentrated in certain vulnerable and marginalized populations. Although their management differs, there may be opportunities to integrate services for substance use and HIV. In this paper we systematically review evidence from studies that sought to integrate care for people living with HIV and substance use problems. Methods: Studies were included if they evaluated service integration for substance use and HIV. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. Results and discussion: 11,057 records were identified, with 7616 after removal of duplicates. After screening titles and abstracts, 51 met the inclusion criteria. Integration models were categorized by location (HIV, substance use and other facilities), level of integration from mirco (integrated care delivered to individuals) to macro (system level integrations) and degree of integration from least (screening and counselling only) to most (care for HIV, substance use and/or other illnesses at the same facility). Most reported descriptive or cohort studies; in four randomized control trials integrated activities improved patient outcomes. There is potential for integrating services at all facility types, including mobile health services. While services offering screening only can achieve synergies, there are benefits from delivering integrated treatment for HIV and substance use, including ease of referral to other mental health and social services. Conclusions: Our review used a wide range of databases and conference archives to increase representation of papers from low- and middle-income countries. Limitations include the overrepresentation of studies from the United States, and the descriptive nature of the majority of papers. The evidence reviewed shows that greater integration offers important benefits in both

  11. Integration of Library Services in the System of Digital Libraries

    NASA Astrophysics Data System (ADS)

    Bezdushnyj, A. N.; Kalenov, N. E.; Kouriv, P. M.; Serebryakov, V. A.

    The article is devoted to the functional extension of the Integrated System of Information Resources of RAS (ISIR RAS - RFBR 99-07-90139 project). This extension (Library Subsystem) provides integration of library services in ISIR RAS electronic libraries system. Library Subsystem implements standard library services such as information about free and ordered copies of editions, creation of the library orders for edition etc. The Library Subsystem is an integrated solution; it's based on ISIR data model and technologies.

  12. Integrating HIV and substance use services: a systematic review.

    PubMed

    Haldane, Victoria; Cervero-Liceras, Francisco; Chuah, Fiona Lh; Ong, Suan Ee; Murphy, Georgina; Sigfrid, Louise; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Buse, Kent; Piot, Peter; McKee, Martin; Perel, Pablo; Legido-Quigley, Helena

    2017-05-30

    Substance use is an important risk factor for HIV, with both concentrated in certain vulnerable and marginalized populations. Although their management differs, there may be opportunities to integrate services for substance use and HIV. In this paper we systematically review evidence from studies that sought to integrate care for people living with HIV and substance use problems. Studies were included if they evaluated service integration for substance use and HIV. We searched multiple databases from inception until October 2015. Articles were screened independently by two reviewers and assessed for risk of bias. 11,057 records were identified, with 7616 after removal of duplicates. After screening titles and abstracts, 51 met the inclusion criteria. Integration models were categorized by location (HIV, substance use and other facilities), level of integration from mirco (integrated care delivered to individuals) to macro (system level integrations) and degree of integration from least (screening and counselling only) to most (care for HIV, substance use and/or other illnesses at the same facility). Most reported descriptive or cohort studies; in four randomized control trials integrated activities improved patient outcomes. There is potential for integrating services at all facility types, including mobile health services. While services offering screening only can achieve synergies, there are benefits from delivering integrated treatment for HIV and substance use, including ease of referral to other mental health and social services. Our review used a wide range of databases and conference archives to increase representation of papers from low- and middle-income countries. Limitations include the overrepresentation of studies from the United States, and the descriptive nature of the majority of papers. The evidence reviewed shows that greater integration offers important benefits in both patient and service outcomes but further research and outcome reporting is

  13. Southern Appalachian Settlement Schools as Early Initiators of Integrated Services.

    ERIC Educational Resources Information Center

    Jurgens, Eloise; West, Russ

    The integration of health and social services with schools promises to be an effective means of delivering services to children and families in the face of increasing social problems and needs. Beginning in 1886, urban settlement houses provided education and a wide variety of services to aid the assimilation of new immigrants. Similarly,…

  14. Successful outsourcing: improving quality of life through integrated support services.

    PubMed

    Bates, Jason; Sharratt, Martin; King, John

    2014-01-01

    This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.

  15. Virtual Enterprises for Integrated Energy Service Provision

    NASA Astrophysics Data System (ADS)

    Allan, Luke; Menzel, Karsten

    Holistic Energy Service Provision has the potential to provide new business opportunities for Facility Management Companies, Building Managers, Energy Providers, Maintenance Providers and many other stakeholders currently working in the area of building design, construction, building operation, energy management, maintenance, etc. since customers wish to get access to all services related to energy supply, energy consumption and building services maintenance through a “one-stop-shop”.

  16. Integrated Children's Services: Enablers, Challenges and Impact. Research Briefing

    ERIC Educational Resources Information Center

    Robinson, Mark; Atkinson, Mary; Downing, Dick

    2008-01-01

    This summary provides background information about the enablers, challenges and impact of integration, based on a thorough literature review of thirty-five sources. The review findings are presented under thematic headings that reflect the: (1) extent of integration: the "stage" or depth of the collaborative activity in integrated services; (2)…

  17. Microblogging for Class: An Analysis of Affective, Cognitive, Personal Integrative, and Social Integrative Gratifications

    ERIC Educational Resources Information Center

    Gant, Camilla; Hadley, Patrick D.

    2014-01-01

    This study shows that undergraduate students can gratify cognitive, affective, social integrative, and personal integrative needs microblogging via a learning management system discussion tool. Moreover, the researchers find that microblogging about news regarding mass media events and issues via Blackboard heightened engagement, expanded…

  18. Integrating ecosystem services into national Forest Service policy and operations

    Treesearch

    Robert Deal; Lisa Fong; Erin Phelps; Emily Weidner; Jonas Epstein; Tommie Herbert; Mary Snieckus; Nikola Smith; Tania Ellersick; Greg Arthaud

    2017-01-01

    The ecosystem services concept describes the many benefits people receive from nature. It highlights the importance of managing public and private lands sustainably to ensure these benefits continue into the future, and it closely aligns with the U.S. Forest Service (USFS) mission to “sustain the health, diversity, and productivity of the Nation’s forests and...

  19. An Integrated Approach to Forest Ecosystem Services

    Treesearch

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

    2005-01-01

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

  20. Integrating Reproductive Health Services Into Intimate Partner and Sexual Violence Victim Service Programs.

    PubMed

    Gmelin, Theresa; Raible, Claire A; Dick, Rebecca; Kukke, Surabhi; Miller, Elizabeth

    2017-12-01

    This study assessed the feasibility of integrating reproductive health services into intimate partner violence/sexual violence (IPV/SV) programs. After a training for victim service agencies on integration of health services, we conducted semistructured interviews with IPV/SV program leadership. Leadership reported advocates were more likely to recognize the need to refer clients to health services, and revealed challenges operationalizing partnerships with health care centers. Training to integrate basic health assessment into victim services may be one way to address women's urgent health needs. Formal partnership agreements, protocols to facilitate referrals, and opportunities to cross-train are needed to nurture these cross-sector collaborations.

  1. An Integrated Approach for Creating Service-Based Interactive Applications

    NASA Astrophysics Data System (ADS)

    Feldmann, Marius; Janeiro, Jordan; Nestler, Tobias; Hübsch, Gerald; Jugel, Uwe; Preussner, André; Schill, Alexander

    While the implementation of business logic and business processes based on service-oriented architectures is well-understood and covered by existing development approaches, integrated concepts that empower users to exploit the Internet of Services to create complex interactive applications are missing. In this paper, we present an integrated approach that fills this gap. Our approach builds upon service annotations that add meta-information related to user interface generation, service dependencies, and service composition to existing service descriptions. Services can be composed visually to complex interactive applications based on these annotations without the need to write any code. The application code is generated completely from the service composition description. Our approach is able to support heterogeneous target environments ranging from client/server architectures to mobile platforms.

  2. Integrated Services for the Severely Physically Disabled

    ERIC Educational Resources Information Center

    Patrick, Donald

    1975-01-01

    Describes cooperative planning among a non-profit metropolitan tuberculosis sanitorium, a state vocational rehabilitation service and a medical center to provide a comprehensive rehabilitation program at Lakeshore Hospital, Birmingham, Alabama. (Author/EJT)

  3. Integrating High School Chemistry and Service Learning.

    ERIC Educational Resources Information Center

    Schlenker, Richard M.; Schlenker, Karl R.

    2001-01-01

    Describes students' activities in introductory chemistry to fulfill their requirement for service learning. Explains the investigation of the causes for the foul taste of drinking water coming from a specific fountain. (YDS)

  4. Web Services Integration on the Fly

    DTIC Science & Technology

    2008-12-01

    Service (WMS) displays geographic data as raster images . Web Feature Service (WFS) communicates real geographic data to and from the user in the form of...collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources...gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or

  5. Integrating ecosystem services in terrestrial conservation planning.

    PubMed

    Yuan, Mei-Hua; Lo, Shang-Lien; Yang, Chih-Kai

    2017-05-01

    The purpose of this study is to estimate the benefits of ecosystem services for prioritization of land use conservation and to highlight the importance of ecosystem services by comparison between ecosystem service value and green GDP accounting. Based on land use pattern and benefit transfer method, this research estimated value of ecosystem services in Taiwan. Scientific information of land use and land cover change is accessed through multi-year satellite imagery moderate resolution imaging spectroradiometer (MODIS), and geographic information system (GIS) technology. Combined with benefit transfer method, this research estimated the ecosystem service valuation of forest, grassland, cropland, wetland, water, and urban for the period of 2000 to 2015 in Taiwan. It is found that forest made the greatest contribution and the significant increasing area of wetland has huge potential benefit for environmental conservation in Taiwan. We recommend placing maintaining wetland ecosystem in Taiwan with higher priority. This research also compared ecosystem service value with natural capital consumption which would essentially facilitate policy makers to understand the relationship between benefits gained from natural capital and the loss from human-made capital.

  6. Employee health services integration: meeting the challenge. Successful program.

    PubMed

    Lang, Y C

    1998-02-01

    1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.

  7. [Is merging organizations the solution to service integration?].

    PubMed

    Demers, Louis; Dupuis, Alain; Poirier, Mario

    2002-01-01

    Organizational models inherited from the time when institutionalizing patients was common practice are now obsolete. Service coordination, undergone earlier within a same institution, is now governed by professionnals linked to various organizations and different settings. One of the difficulties of integration of these services is that contributing organizations often continue to operate individually, consequently going against the pursued goal. The solution most often proposed to counter this compartimentalization consists in reinforcing integration of organizations, which will in time favor integration of various services. One of the ways to realize this organizational integration is to reduce the number of existing organizations, by merging for example, a certain number of them. It is this path of hierarchical organization that the Québec health care system has taken during the 1990. Other paths that of networking have also been experienced during the same period. To judge of the relevance of these options, the authors propose a reversal of the dominating perspective according to which service integration necessarily pass through installing mecanisms of organizational integration. Withought minimizing the importance of such mecanisms, the authors put forth that integration of services commands first and foremost collaboration between professional health workers. Through this angle, the relevance of an organizational integration model depends on the impact it will have on the capacity and willingness of health workers to work in a concerted way. The authors submit that the fact of giving to a sole authority the govern of existing organizations is not the panacea some would like to believe.

  8. Integrate FP with community-based health service: Xuanwu, Beijing.

    PubMed

    Guo, X

    1999-10-01

    In response to the demands for high-quality health care service, the family planning (FP) and public health departments collaborated to provide such health services in Xuanwu, Beijing. As a pilot district for reforming the urban public health service system, Xuanwu established 28 community-based health service stations in 1997. These service stations focused on households in the neighborhood, providing information on prevention of diseases, treatment of common diseases, medical care, rehabilitation, health education and FP technical service. An average of 7-10 staff and workers were employed for every station, responsible for some 20,000 residents. The Public Health Bureau and Family Planning Committee of the district developed a set of program standards. The integrated community-based health service program has produced encouraging results. Community service stations are more capable of providing expedient, considerate, careful and quality services than hospitals. In addition, it has indirectly benefited the economy and society of the district.

  9. Integrating Service Learning into a Business School Curriculum.

    ERIC Educational Resources Information Center

    Lamb, Christine H.; Swinth, Robert L.; Vinton, Karen L.; Lee, James B.

    1998-01-01

    Service learning was integrated into a business curriculum through phases of exploration, clarification, realization, activation, and internalization. The objective was to promote students' personal (moral) and professional (ethical) development. (SK)

  10. Academic Service-Learning and Integrative Complexity

    ERIC Educational Resources Information Center

    Koch-Patterson, Penelope

    2012-01-01

    Society is more and more interconnected and interdependent. This results in a plethora of complex social problems and thereby creates the need for individuals with strong decision-making skills. This quantitative study examined the relationship between undergraduate students' participation in academic service-learning and their levels of…

  11. Bringing ecosystem services into integrated water resources management.

    PubMed

    Liu, Shuang; Crossman, Neville D; Nolan, Martin; Ghirmay, Hiyoba

    2013-11-15

    In this paper we propose an ecosystem service framework to support integrated water resource management and apply it to the Murray-Darling Basin in Australia. Water resources in the Murray-Darling Basin have been over-allocated for irrigation use with the consequent degradation of freshwater ecosystems. In line with integrated water resource management principles, Australian Government reforms are reducing the amount of water diverted for irrigation to improve ecosystem health. However, limited understanding of the broader benefits and trade-offs associated with reducing irrigation diversions has hampered the planning process supporting this reform. Ecosystem services offer an integrative framework to identify the broader benefits associated with integrated water resource management in the Murray-Darling Basin, thereby providing support for the Government to reform decision-making. We conducted a multi-criteria decision analysis for ranking regional potentials to provide ecosystem services at river basin scale. We surveyed the wider public about their understanding of, and priorities for, managing ecosystem services and then integrated the results with spatially explicit indicators of ecosystem service provision. The preliminary results of this work identified the sub-catchments with the greatest potential synergies and trade-offs of ecosystem service provision under the integrated water resources management reform process. With future development, our framework could be used as a decision support tool by those grappling with the challenge of the sustainable allocation of water between irrigation and the environment. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  12. Evolution of Women's Trauma-Integrated Services at the Substance Abuse and Mental Health Services Administration

    ERIC Educational Resources Information Center

    Salasin, Susan E.

    2005-01-01

    In this article a historical overview of the evolution of the Women's Trauma Integrated Services model at the Substance Abuse and Mental Health Services Administration (SAMHSA) is presented. Milestones in women's services policy development at SAMHSA (1992-1998) and in trauma treatment development for four different trauma populations (1960-1998)…

  13. Improving Acceptance, Integration, and Health Among LGBT Service Members

    DTIC Science & Technology

    2016-10-01

    Military, LGBT, health disparities, minority stress, social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...members’ social networks. c) Measure differences in health disparities relative to LGBT service members’ heterosexual counterparts. d) Develop...Calendar 12 b. Social Network Interview 13 Improving Acceptance, Integration and Health among LGBT Service Members Draft Social

  14. Improving Acceptance, Integration, and Health Among LGBT Service Members

    DTIC Science & Technology

    2016-10-01

    Military, LGBT, health disparities, minority stress, social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a... social networks. c) Measure differences in health disparities relative to LGBT service members’ heterosexual counterparts. d) Develop actionable...Calendar 12 b. Social Network Interview 13 Improving Acceptance, Integration and Health among LGBT Service Members Draft Social

  15. Integration of an Online Search Service into the Reference Department.

    ERIC Educational Resources Information Center

    Belanger, Sandra E.; Thorne, Rosemary

    In academic libraries, online searching services and reference departments often have to compete for a share of financial and personnel resources. This paper examines how San Jose State University Library solved the problems of shrinking budgets, space constraints, and loss of trained searchers by integrating the online search service into the…

  16. Zooming In on Copyright with Integrated Library Software Services

    ERIC Educational Resources Information Center

    Oye, Karen

    2007-01-01

    Over the last decade, many of Kelvin Smith Library's (KSL) content delivery services have gone digital, and some, such as enhanced course reserves products, are new to the market. The best digital library services have given KSL options and integrated solutions that allow it to do more than it thought possible just a few years ago. As with many…

  17. Integrated Services Digital Network (ISDN): Telecommunications in the Future.

    ERIC Educational Resources Information Center

    Miller, Ralph

    1987-01-01

    This discussion of the Integrated Services Digital Network (ISDN) telecommunications system compares it to existing telephone networks and describes international efforts at standardization, proposed services to business and residential customers, technological developments, and cost considerations. The effects of ISDN developments on the role of…

  18. Let's Talk about School: Collaboration and Integrated Service Delivery.

    ERIC Educational Resources Information Center

    Brewer, Dee

    This report summarizes recent research on collaboration and integrated service delivery for schools and communities in North Carolina. The North Carolina Department of Public Instruction commissioned three research projects to determine the general state of affairs in service delivery for school-age children and their families and to identify ways…

  19. Colleges' Experiences: Integrating Support Services for Military Veterans

    ERIC Educational Resources Information Center

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  20. Teaching Service Modelling to a Mixed Class: An Integrated Approach

    ERIC Educational Resources Information Center

    Deng, Jeremiah D.; Purvis, Martin K.

    2015-01-01

    Service modelling has become an increasingly important area in today's telecommunications and information systems practice. We have adapted a Network Design course in order to teach service modelling to a mixed class of both the telecommunication engineering and information systems backgrounds. An integrated approach engaging mathematics teaching…

  1. Integration of Information Services in the Parliament of Zimbabwe.

    ERIC Educational Resources Information Center

    Chiwandamira, Lyn

    This paper discusses the integration of information services in the Parliament of Zimbabwe (PoZ). An organizational chart of the information systems at PoZ in 1999 is provided, and each of the four departments managing information services are described, i.e., the library, the research department, public relations, and information technology. An…

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

    PubMed

    Singer, Judy; Adams, Jon

    2014-05-22

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

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

    PubMed Central

    2014-01-01

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

  4. Integrating Oral Health Care Services Within Medicare.

    PubMed

    Moss, Mark E

    2017-01-01

    The idea of a Medicare oral health benefit is attracting attention. Models for care that focus on screening, prevention, and early intervention have been developed. East Carolina University's Community Service Learning Centers are well-positioned to work with community partners to extend care to older adults in rural areas. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  5. Integrating Workforce Planning, Human Resources, and Service Planning.

    ERIC Educational Resources Information Center

    O'Brien-Pallas, Linda; Birch, Stephen; Baumann, Andrea; Murphy, Gail Tomblin

    The feasibility of integrated health human resources planning (IHHRP) was examined. The analysis focused on the following topics: ways of integrating labor market indicators into service planning; whether planning is sufficiently responsive and flexible to retain relevance and validity in rapidly changing health systems; different models and…

  6. Biofilm Affecting the Mechanical Integrity of Implant-Abutment Joints.

    PubMed

    Prado, Abraão M; Pereira, Jorge; Henriques, Bruno; Benfatti, César Am; Magini, Ricardo S; López-López, José; Souza, Júlio Cm

    2016-01-01

    This in vitro study evaluated the effect of biofilms on abutment torque loss and wear of implant internal connection surfaces. Morse taper abutments were torqued to corresponding implants and then the implant-abutment assemblies were immersed in a biofilm medium for 72 hours. After detorque evaluation, the abutments were removed and the inner implant surfaces were observed via scanning electron microscopy and profilometry. The removal torque values and the implant damaged areas decreased after contact with biofilms. The lubricating effect of biofilms decreased the friction between contacting surfaces, negatively affecting the mechanical integrity of the implant-abutment connection.

  7. From NHS Choices to the integrated customer service platform.

    PubMed

    Gann, Bob; Grant, Maria J

    2013-03-01

    In 2013 the NHS Commissioning Board launches its new integrated customer service platform. The new service utilises the full range of channels (web, telephone, apps etc) to provide access to information to support transparency, participation and transactions. Digital health services have proven benefits in informed choice, shared decision making and patient participation. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

  8. Affect Consciousness in children with internalizing problems: Assessment of affect integration.

    PubMed

    Taarvig, Eva; Solbakken, Ole André; Grova, Bjørg; Monsen, Jon T

    2015-10-01

    Affect integration was operationalized through the Affect Consciousness (AC) construct as degrees of awareness, tolerance, nonverbal expression and conceptual expression of 11 affects. These aspects are assessed through a semi-structured Affect Consciousness Interview (ACI) and separate rating scales (Affect Consciousness Scales (ACSs)) developed for use in research and clinical work with adults with psychopathological disorders. Age-adjusted changes were made in the interview and rating system. This study explored the applicability of the adjusted ACI to a sample of 11-year-old children with internalizing problems through examining inter-rater reliability of the adjusted ACI, along with relationships between the AC aspects and aspects of mental health as symptoms of depression, symptoms of anxiety, social competence, besides general intelligence. Satisfactory inter-rater reliability was found, as well as consistent relationships between the AC aspects and the various aspects of mental health, a finding which coincides with previous research. The finding indicates that the attainment of the capacity to deal adaptively with affect is probably an important contributor to the development of adequate social competence and maybe in the prevention of psychopathology in children. The results indicate that the adjusted ACI and rating scales are useful tools in treatment planning with children at least from the age of 11 years. © The Author(s) 2014.

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

    PubMed

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

    2016-05-10

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

  10. A novel virtual hub approach for multisource downstream service integration

    NASA Astrophysics Data System (ADS)

    Previtali, Mattia; Cuca, Branka; Barazzetti, Luigi

    2016-08-01

    A large development of downstream services is expected to be stimulated starting from earth observations (EO) datasets acquired by Copernicus satellites. An important challenge connected with the availability of downstream services is the possibility for their integration in order to create innovative applications with added values for users of different categories level. At the moment, the world of geo-information (GI) is extremely heterogeneous in terms of standards and formats used, thus preventing a facilitated access and integration of downstream services. Indeed, different users and data providers have also different requirements in terms of communication protocols and technology advancement. In recent years, many important programs and initiatives have tried to address this issue even on trans-regional and international level (e.g. INSPIRE Directive, GEOSS, Eye on Earth and SEIS). However, a lack of interoperability between systems and services still exists. In order to facilitate the interaction between different downstream services, a new architectural approach (developed within the European project ENERGIC OD) is proposed in this paper. The brokering-oriented architecture introduces a new mediation layer (the Virtual Hub) which works as an intermediary to bridge the gaps linked to interoperability issues. This intermediation layer de-couples the server and the client allowing a facilitated access to multiple downstream services and also Open Data provided by national and local SDIs. In particular, in this paper an application is presented integrating four services on the topic of agriculture: (i) the service given by Space4Agri (providing services based on MODIS and Landsat data); (ii) Gicarus Lab (providing sample services based on Landsat datasets) and (iii) FRESHMON (providing sample services for water quality) and services from a several regional SDIs.

  11. Mobile agent based online integration modeling for traffic information services

    NASA Astrophysics Data System (ADS)

    Li, Qingquan; Gao, Dequan; Fang, Zhixiang; Li, Lianying

    2007-06-01

    With the rapid development of urban economy and urbanization construction in China, traffic load rises sharply because of the larger vehicle occupancy within many urban areas, which has already led to serious traffic congestion problem. GIS-T is an efficient technological solution and core information infrastructure for solving modern urban transportation problems. High-level traffic systems must integrate real-time traffic information and spatial data of road to supply timely and efficient public services and guarantee a better orderly transportation. However, for traffic information is multisource, complex and massive, traffic information service must have fast, powerful capabilities for online integration processing. Online integration of traffic information emphasizes the traffic resources share and services optimization, and solve assignment, scheduling, monitoring and feedback of integration computing tasks in dynamic and distributed network. This paper firstly analyzes traffic data and existing problems of online integration, and then discusses mobile agent technology, and finally proposes a mobile agent based unified online integration model of traffic information. This model will achieve cooperative computing and more accessible, flexible and reliable traffic information services.

  12. Qualitative Assessment of the Integration of HIV Services With Infant Routine Immunization Visits in Tanzania

    PubMed Central

    Wallace, Aaron; Kimambo, Sajida; Dafrossa, Lyimo; Rusibamayila, Neema; Rwebembera, Anath; Songoro, Juma; Arthur, Gilly; Luman, Elizabeth; Finkbeiner, Thomas; Goodson, James L.

    2015-01-01

    Background In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits. Methods We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation. Findings Mothers’ perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers’ perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers’ fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations. Interpretation Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term. PMID:24326602

  13. Qualitative assessment of the integration of HIV services with infant routine immunization visits in Tanzania.

    PubMed

    Wallace, Aaron; Kimambo, Sajida; Dafrossa, Lyimo; Rusibamayila, Neema; Rwebembera, Anath; Songoro, Juma; Arthur, Gilly; Luman, Elizabeth; Finkbeiner, Thomas; Goodson, James L

    2014-05-01

    In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits. We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation. Mothers' perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers' perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers' fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations. Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term.

  14. Landscape structure affects the provision of multiple ecosystem services

    NASA Astrophysics Data System (ADS)

    Lamy, T.; Liss, K. N.; Gonzalez, A.; Bennett, E. M.

    2016-12-01

    Understanding how landscape structure, the composition and configuration of land use/land cover (LULC) types, affects the relative supply of ecosystem services (ES), is critical to improving landscape management. While there is a long history of studies on landscape composition, the importance of landscape configuration has only recently become apparent. To understand the role of landscape structure in the provision of multiple ES, we must understand how ES respond to different measures of both composition and configuration of LULC. We used a multivariate framework to quantify the role of landscape configuration and composition in the provision of ten ES in 130 municipalities in an agricultural region in Southern Québec. We identified the relative influence of composition and configuration in the provision of these ES using multiple regression, and on bundles of ES using canonical redundancy analysis. We found that both configuration and composition play a role in explaining variation in the supply of ES, but the relative contribution of composition and configuration varies significantly among ES. We also identified three distinct ES bundles (sets of ES that regularly appear together on the landscape) and found that each bundle was associated with a unique area in the landscape, that mapped to a gradient in the composition and configuration of forest and agricultural LULC. These results show that the distribution of ES on the landscape depends upon both the overall composition of LULC types and their configuration on the landscape. As ES become more widely used to steer land use decision-making, quantifying the roles of configuration and composition in the provision of ES bundles can improve landscape management by helping us understand when and where the spatial pattern of land cover is important for multiple services.

  15. Exploration mode affects visuohaptic integration of surface orientation.

    PubMed

    Plaisier, Myrthe A; van Dam, Loes C J; Glowania, Catharina; Ernst, Marc O

    2014-11-20

    We experience the world mostly in a multisensory fashion using a combination of all of our senses. Depending on the modality we can select different exploration strategies for extracting perceptual information. For instance, using touch we can enclose an object in our hand to explore parts of the object in parallel. Alternatively, we can trace the object with a single finger to explore its parts in a serial fashion. In this study we investigated whether the exploration mode (parallel vs. serial) affects the way sensory signals are combined. To this end, participants visually and haptically explored surfaces that varied in roll angle and indicated which side of the surface was perceived as higher. In Experiment 1, the exploration mode was the same for both modalities (i.e., both parallel or both serial). In Experiment 2, we introduced a difference in exploration mode between the two modalities (visual exploration was parallel while haptic exploration was serial or vice versa). The results showed that visual and haptic signals were combined in a statistically optimal fashion only when the exploration modes were the same. In case of an asymmetry in the exploration modes across modalities, integration was suboptimal. This indicates that spatial-temporal discrepancies in the acquisition of information in the two senses (i.e., haptic and visual) can lead to the breakdown of sensory integration. © 2014 ARVO.

  16. Do thawing and warming affect the integrity of human milk?

    PubMed

    Handa, D; Ahrabi, A F; Codipilly, C N; Shah, S; Ruff, S; Potak, D; Williams, J E; McGuire, M A; Schanler, R J

    2014-11-01

    To evaluate the integrity of the human milk (pH, bacterial counts, host defense factors and nutrients) subjected to thawing, warming, refrigeration and maintenance at room temperature. Mothers in the neonatal intensive care unit donated freshly expressed milk. A baseline sample was stored at -80 °C and the remainder of the milk was divided and stored for 7 days at -20 °C. The milk was then subjected to two methods of thawing and warming: tepid water and waterless warmer. Thawed milk also was refrigerated for 24 h prior to warming. Lastly, warmed milk was maintained at room temperature for 4 h to simulate a feeding session. Samples were analyzed for pH, bacterial colony counts, total fat and free fatty acids, and the content of protein, secretory IgA and lactoferrin. Data were analyzed by repeated-measures analysis of variance and paired t test. There were no differences between processing methods and no changes in fat, protein, lactoferrin and secretory immunoglobulin A with processing steps. Milk pH and bacterial colony counts declined while free fatty acids rose with processing. Refrigeration of thawed milk resulted in greater declines in pH and bacteria and increases in free fatty acids. Bacterial colony counts and free fatty acids increased with maintenance at room temperature. The integrity of the milk was affected similarly by the two thawing and warming methods. Thawing and warming change the integrity of previously frozen human milk, but not adversely. Concerns about maintaining warmed milk at room temperature need to be explored.

  17. Affective neuroimaging in generalized anxiety disorder: an integrated review

    PubMed Central

    Fonzo, Gregory A.; Etkin, Amit

    2017-01-01

    Affective neuroimaging has contributed to our knowledge of generalized anxiety disorder (GAD) through measurement of blood oxygenation level-dependent (BOLD) responses, which facilitate inference on neural responses to emotional stimuli during task-based functional magnetic resonance imaging (fMRI). In this article, the authors provide an integrated review of the task-based affective fMRI literature in GAD. Studies provide evidence for variable presence and directionality of BOLD abnormalities in limbic and prefrontal regions during reactivity to, regulation of, and learning from emotional cues. We conclude that understanding the sources of this variability is key to accelerating progress in this area. We propose that the cardinal symptom of GAD—worry—predominantly reflects stimulus-independent mental processes that impose abnormal, inflexible functional brain configurations, ie, the overall pattern of information transfer among behaviorally relevant neural circuits at a given point in time. These configurations that are inflexible to change from the incoming flux of environmental stimuli may underlie inconsistent task-based findings. PMID:28867941

  18. Orion European Service Module (ESM) Development, Integration and Qualification Status

    NASA Technical Reports Server (NTRS)

    Berthe, Philippe; Over, Ann P.; Picardo, Michelle; Byers, Anthony W.

    2017-01-01

    ESA and the European Industry are supplying the European Service Module for Orion. An overview of the system and subsystem configuration of the Orion European Service Module (ESM) as designed and built for the EM-1 mission is provided as well as an outline of its development, assembly, integration and verification process performed by ESA and NASA in coordination with their respective Industrial prime contractors, Airbus Defence and Space and Lockheed Martin.

  19. Technical and economic feasibility of integrated video service by satellite

    NASA Technical Reports Server (NTRS)

    Price, K. M.; Kwan, R. K.; White, L. W.; Garlow, R. K.; Henderson, T. R.

    1992-01-01

    A feasibility study is presented of utilizing modern satellite technology, or more advanced technology, to create a cost-effective, user-friendly, integrated video service, which can provide videophone, video conference, or other equivalent wideband service on demand. A system is described that permits a user to select a desired audience and establish the required links similar to arranging a teleconference by phone. Attention is given to video standards, video traffic scenarios, satellite system architecture, and user costs.

  20. Building Better Human Service Systems: Integrating Services for Income Support and Related Programs.

    ERIC Educational Resources Information Center

    Ragan, Mark

    Service integration attempts to provide coordinated service delivery systems for the uncoordinated mix of programs such as income support programs (food stamps, Medicaid, and Temporary Assistance for Needy Families) and employment, child care, child welfare, and training programs that exist at the local level throughout the United States by…

  1. Integrating geo web services for a user driven exploratory analysis

    NASA Astrophysics Data System (ADS)

    Moncrieff, Simon; Turdukulov, Ulanbek; Gulland, Elizabeth-Kate

    2016-04-01

    In data exploration, several online data sources may need to be dynamically aggregated or summarised over spatial region, time interval, or set of attributes. With respect to thematic data, web services are mainly used to present results leading to a supplier driven service model limiting the exploration of the data. In this paper we propose a user need driven service model based on geo web processing services. The aim of the framework is to provide a method for the scalable and interactive access to various geographic data sources on the web. The architecture combines a data query, processing technique and visualisation methodology to rapidly integrate and visually summarise properties of a dataset. We illustrate the environment on a health related use case that derives Age Standardised Rate - a dynamic index that needs integration of the existing interoperable web services of demographic data in conjunction with standalone non-spatial secure database servers used in health research. Although the example is specific to the health field, the architecture and the proposed approach are relevant and applicable to other fields that require integration and visualisation of geo datasets from various web services and thus, we believe is generic in its approach.

  2. From Biloxi to Cape Town: curricular integration of service learning.

    PubMed

    Richards, Elizabeth A Libby; Novak, Julie Cowan

    2010-01-01

    Team Reach Out started as a student-initiated service-learning project with the goal of providing on-going assistance to the victims of Hurricane Katrina. Four years after Hurricane Katrina, Team Reach Out refocused efforts to Cape Town, South Africa, where 4 senior nursing students and 1 science student integrated their leadership skills with the application of public health knowledge, compassion, and concern to work in partnership with several international health agencies. This article reviews the service-learning framework, course planning, and implementation of a recent service-learning project.

  3. Integrated network management framework for ATM-over-ADSL service

    NASA Astrophysics Data System (ADS)

    Hong, Won-Kyu; Yoon, Sung-Sook; Hong, Seong-Ik; Kim, Dong-Il; Jung, Mun-Jo; Song, Joong-Goo

    2001-11-01

    In this paper, we describe an integrated network management system for ATM over ADSL service provisioning. There are two distinct networks of ATM and Internet. Most of routers in Internet connected with WDM. The Network Access Server (NAS) in the Internet provides the Internet access service for the ATM over ADSL subscriber. The ATM network takes the roles of backbone network for the pure ATM PVC and SVC services and the access network for the ATM over ADSL service. In order to define the generic network model that can be commonly applicable for the backbone network for pure ATM service and the access network for ATM over ADSL service taking into account the scalability, we suggest two fragments of the topological fragment and connectivity fragment to maximize the scalability in accordance with the ITU-T G.805 layering and partitioning concepts and the RM-ODP information viewpoint. In addition, we propose the distributed computational model of the ATM over ADSL network management system using the RM-ODP computational viewpoint and TMN functional decomposition of FCAPS taking into account the functional distribution and the modularity. Lastly, we describe the scenario for providing the integrated ADSL service.

  4. 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.

  5. Integrated Early Years Services: A Thematic Literature Review

    ERIC Educational Resources Information Center

    Wong, Sandie; Sumsion, Jennifer

    2013-01-01

    This article reports on the findings of a thematic review of research literature about integrated early years services (IEYS) [1995-2012]. Four themes are discussed: broad support for IEYS; critiques of claims about IEYS; a focus on inter-professional practice; and the challenge of evaluating IEYS. The article concludes with reflections concerning…

  6. A Community Approach to an Integrated Service System: A Digest.

    ERIC Educational Resources Information Center

    Roberts, Sally

    This digest summarizes the underlying structure, concepts, and ideology of the Project NEXUS manual, "A Community Approach to an Integrated Service System" (CAISS). Project NEXUS is a 3-year project charged with the development and field-testing of a technical assistance manual to aid communities in the development and/or improvement of…

  7. Integrating Technology into Service Delivery (ITSD) Project: Final Report.

    ERIC Educational Resources Information Center

    Schoech, Dick; And Others

    The emerging field of assistive technology offers employment and independent living for people with disabilities. However, agency staff, people with disabilities, and their guardians often spend substantial time finding appropriate technological solutions. The integration of technology into the existing service system is needed to maximize scarce…

  8. California Integrated Service Delivery Evaluation Report. Phase I

    ERIC Educational Resources Information Center

    Moore, Richard W.; Rossy, Gerard; Roberts, William; Chapman, Kenneth; Sanchez, Urte; Hanley, Chris

    2010-01-01

    This study is a formative evaluation of the OneStop Career Center Integrated Service Delivery (ISD) Model within the California Workforce System. The study was sponsored by the California Workforce Investment Board. The study completed four in-depth case studies of California OneStops to describe how they implemented the ISD model which brings…

  9. Development of Integrated Public Administration Custom Services in Hungary.

    PubMed

    Laki, Tamas

    2015-01-01

    The paper is a case-study introducing a national project in Hungary establishing a countrywide public administration customer service system where accessibility was a key issue. Starting from the concept the paper describes the methods and organisational background how accessible design was integrated in the planning method and gives a feedback of site experiences.

  10. Evaluation of the Integrated Services Pilot Program from Western Australia

    ERIC Educational Resources Information Center

    Hancock, Peter; Cooper, Trudi; Bahn, Susanne

    2009-01-01

    Independent evaluation of refugee-focused programs in developed nations is increasingly a mandatory requirement of funding bodies and government agencies. This paper presents an evaluation of the Integrated Services Centre (ISC) Pilot Project that was conducted in Australia in 2007 and early 2008. The purpose of the ISC program was to provide…

  11. Integrative Review of Service-Learning Assessment in Nursing Education.

    PubMed

    Taylor, Susan L; Leffers, Jeanne M

    The aim of the research is to review all qualitative research studies related to service-learning assessment in nursing education. Recent literature reviews have examined quantitative but not qualitative research studies on service-learning assessment in nursing education. An integrative review analyzed the results of published qualitative research of service-learning assessment. Articles included in this review were published in English in peer-reviewed journals from 1997 to 2014 and encompassed information on outcomes, assessment or evaluation, nursing education, and service-learning. Nine articles containing thematic analysis were included in the final review. Findings were synthesized into a higher order of analysis. Eight categories from that analysis were created: professional competency development, integration of knowledge for the professional nursing role, greater understanding of community strengths and needs, collaboration and teamwork, transformation and personal growth, civic engagement, emotions and adjustment, and culture awareness and competency. The integrative review will aid in the development of measurement categories for further nursing service-learning assessment work.

  12. Implicit Affective Cues and Attentional Tuning: An Integrative Review

    PubMed Central

    Friedman, Ronald S.; Förster, Jens

    2010-01-01

    A large and growing number of studies support the notion that arousing positive emotional states expand, and that arousing negative states constrict, the scope of attention on both the perceptual and conceptual levels. However, these studies have predominantly involved the manipulation or measurement of conscious emotional experiences (e.g., subjective feelings of happiness or anxiety). This raises the question: Do cues that are merely associated with benign versus threatening situations, but that do not elicit conscious feelings of positive or negative emotional arousal, independently expand or contract attentional scope? Integrating theoretical advances in affective neuroscience, positive psychology, and social cognition, it is proposed that rudimentary intero- and exteroceptive stimuli may indeed become associated with the onset of arousing positive or negative emotional states and/or with appraisals that the environment is benign or threatening and thereby come to moderate the scope of attention in the absence of conscious emotional experience. Specifically, implicit “benign situation” cues are posited to broaden, and implicit “threatening situation” cues to narrow, the range of both perceptual as well as conceptual attentional selection. An extensive array of research findings involving a diverse set of such implicit affective cues (e.g., enactment of approach and avoidance behaviors, incidental exposure to colors signaling safety versus danger) is marshaled in support of this proposition. Potential alternative explanations for and moderators of these attentional tuning effects, as well as their higher-level neuropsychological underpinnings, are also discussed along with prospective extensions to a range of other situational cues and domains of social cognitive processing. PMID:20804240

  13. Risk of affective and stress related disorders among employees in human service professions.

    PubMed

    Wieclaw, J; Agerbo, E; Mortensen, P B; Bonde, J P

    2006-05-01

    To examine the risk of affective and stress related disorders among men and women employed in human service professions. Population based case-control study using data from national registers. Cases (n = 28 971) were identified in the Danish Psychiatric Central Research Register among all hospitalised patients and outpatients aged 18-65 who received a first time ever diagnosis of affective (ICD-10, F30-39) or stress related (ICD-10, F40-48) disorder from 1 January 1995 to 31 December 1998. Each case was assigned five never admitted referents (n = 144 855) of the same gender and age, randomly drawn from a 5% sample of the Danish population obtained from Statistics Denmark's Integrated Database for Labour Market Research. Occupation held the year before matching was classified according to the Danish version of the International Classification of Occupation. Health care, education, social work, and customer services were defined as human service professions and constituted 21% of all employed in the study. Adjusted risks (hazard ratios) relative to all other occupations were calculated for 24 human service occupations. The relative risk of depression in human service professions was 1.35 (95% CI 1.24 to 1.47) for women and 1.49 (95% CI 1.29 to 1.73) for men. The risk of stress was 1.18 (95% CI 1.11 to 1.26) for women and 1.49 (95% CI 1.32 to 1.67) for men. Specific professions contributed differentially to the magnitude of risk, with education and social services displaying the highest risks. No increase in risks was found in customer service occupations. Gender was a significant modifying factor with the highest risk levels in men. There was a consistent association between employment in human service occupations and the risk of affective and stress related disorders. Risks were highest for men working in these typically female professions. More work is needed to distinguish work hazards from effects attributable to selection mechanisms and personality

  14. Costs and efficiency of integrating HIV/AIDS services with other health services: a systematic review of evidence and experience.

    PubMed

    Sweeney, Sedona; Obure, Carol Dayo; Maier, Claudia B; Greener, Robert; Dehne, Karl; Vassall, Anna

    2012-03-01

    To review the literature on the potential efficiency gains of integrating HIV services with other health services. Systematic literature review. Search of electronic databases, manual searching and snowball sampling. Studies that presented results on cost, efficiency or cost-effectiveness of integrated HIV services were included, focusing on low- and middle-income countries. Evidence was analysed and synthesised through a narrative approach and the quality of studies assessed. Of 666 citations retrieved, 46 were included (35 peer reviewed and 11 from grey literature). A range of integrated HIV services were found to be cost-effective compared with 'do-nothing' alternatives, including HIV services integrated into sexual and reproductive health services, integrated tuberculosis/HIV services and HIV services integrated into primary healthcare. The cost of integrated HIV counselling and testing is likely to be lower than that of stand-alone counselling and testing provision; however, evidence is limited on the comparative costs of other services, particularly HIV care and treatment. There is also little known about the most efficient model of integration, the efficiency gain from integration beyond the service level and any economic benefit to HIV service users. In the context of increasing political commitment and previous reviews suggesting a strong public health argument for the integration of HIV services, the authors found the evidence on efficiency broadly supports further efforts to integrate HIV services. However, key evidence gaps remain, and there is an urgent need for further research in this area.

  15. The role of affect in consumer evaluation of health care services.

    PubMed

    Ng, Sandy; Russell-Bennett, Rebekah

    2015-01-01

    Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes.

  16. Integrated Cancer System: a perspective on developing an integrated system for cancer services in London

    PubMed Central

    Haire, K; Burton, C; Park, R; Reynolds, J; Stewart, D

    2012-01-01

    This article explores the potential for integrated cancer systems to improve the quality of care and deliver cost efficiencies and improve outcomes for cancer patients. Currently, patients in the UK still have poorer survival rates than comparable countries such as Canada, Sweden, Norway and Australia. Improving the quality of cancer services is a key policy objective and cancer is a priority outcome measure in both the NHS and Public Health Outcomes Framework. Evidence suggests that better integrated delivery has the potential to improve the quality and reduce the cost of healthcare, and ultimately improve health outcomes. One of the key themes from the Model of Care for Cancer Services1 was that cancer services should be commissioned along pathways and that provider networks should be established to deliver care. London has two integrated cancer systems; one covering north central and east London (London Cancer) and the other covering west and south London (London Cancer Alliance). There a number of areas in cancer care that the current model of service provision has failed to adequately address and which have the potential to improve significantly though implementation of integrated services. These include improving early diagnosis, reducing inequalities in access to treatment and outcomes and maximising research and training across the system. Important drivers for the integration of cancer services are strong clinical leadership, shared informatics systems, focusing on quality of services and improving patient experience. Emerging needs of integrated cancer in London are around strengthening the involvement of primary care, public health and the third sector; working to develop sufficient capacity and expertise in primary care and collaborating more closely with commissioners to develop integrated systems. PMID:25949664

  17. The politics of tuberculosis and HIV service integration in Ghana.

    PubMed

    Amo-Adjei, Joshua; Kumi-Kyereme, Akwasi; Fosuah Amo, Hannah; Awusabo-Asare, Kofi

    2014-09-01

    The need to integrate TB/HIV control programmes has become critical due to the comorbidity regarding these diseases and the need to optimise the use of resources. In developing countries such as Ghana, where public health interventions depend on donor funds, the integration of the two programmes has become more urgent. This paper explores stakeholders' views on the integration of TB/HIV control programmes in Ghana within the remits of contingency theory. With 31 purposively selected informants from four regions, semi-structured interviews and observations were conducted between March and May 2012, and the data collected were analysed using the inductive approach. The results showed both support for and opposition to integration, as well as some of the avoidable challenges inherent in combining TB/HIV control. While those who supported integration based their arguments on clinical synergies and the need to promote the efficient use of resources, those who opposed integration cited the potential increase in workload, the clinical complications associated with joint management, the potential for a leadership crisis, and the "smaller the better" propositions to support their stance. Although a policy on TB/HIV integration exists, inadequate 'political will' from the top management of both programmes has trickled down to lower levels, which has stifled progress towards the comprehensive management of TB/HIV and particularly leading to weak data collection and management structures and unsatisfactory administration of co-trimoxazole for co-infected patients. It is our view that the leadership of both programmes show an increased commitment to protocols involving the integration of TB/HIV, followed by a commitment to addressing the 'fears' of frontline service providers to encourage confidence in the process of service integration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Integration in stroke services: the challenges for primary and community care services

    PubMed Central

    Fraser, Alec; Boaz, Dr Annette

    2012-01-01

    Objectives A number of evidence-based interventions are now available for stroke patients. Good quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of healthcare workers involved in stroke care in two different English case study sites on the integration challenges stroke care presents. Methods Two qualitative case studies were carried out, including 45 semi-structured interviews with clinicians and managers associated with two different hospitals providing specialised stroke services. Findings High levels of organisational, functional, service and clinical integration amongst clinicians that deliver emergency and acute stroke care were identified. This is frequently lacking amongst professionals delivering post-acute care. These findings are linked to the prevalence or lack of normative and systemic integration in each respective stage of care. Conclusions Emphasis on the need to treat stroke as an emergency condition in England over recent years has created a context in which normative and systemic integration often occurs amongst clinicians that deliver emergency and acute stroke care, aiding the development of organisational, functional, service and clinical integration across the case study sites. In contrast, integration between hospital and community (rehabilitation and general practice) care is frequently less successful. PMID:25949663

  19. GMFS Service Integration and Know How Transfer to Africa

    NASA Astrophysics Data System (ADS)

    Haub, Carsten; Gilliams, Sven

    2010-12-01

    The Global Monitoring for Food Security (GMFS) project aims to provide earth observation based services for, and encourage partnerships in, monitoring Food Security and related environmental processes. This is done, by concerting efforts to bring data and information providers together, in order to assist stakeholders, nations and international organizations to better implement their policies towards sustainable development. GMFS is an ESA Earth Watch GMES Service Element (GSE) and is part of the ESA contribution to the EU/ESA Global Monitoring for Environment and Security (GMES) framework. Service lines and user network had been established and consolidated during the first two stages of the project, which ran from 2003 until 2009. The aim of the recently kicked off 3rd stage of GMFS is the sustainable transfer and integration of ESA data and the GMFS service portfolio into operational contexts at the relevant African stakeholders networks.

  20. Integrated Behavioral Health Services: Improving Access to Mental Health Care

    ERIC Educational Resources Information Center

    Sturm, Lynne A.; Perry, Deborah F.

    2007-01-01

    This article describes innovative service delivery models and clinical strategies that support the social-emotional development of young children and their families in the pediatric primary care setting. By understanding the trends affecting well-child care, early childhood providers will be better equipped to partner with their pediatric…

  1. Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

    PubMed Central

    2014-01-01

    Background Based on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter. Methods We have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process. Results We have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties. Conclusions This first exploratory study into the enablers of the effective development and implementation was based on a single

  2. Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study.

    PubMed

    Thomassen, Jean-Pierre; Ahaus, Kees; Van de Walle, Steven

    2014-03-29

    Based on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter. We have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser's approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process. We have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project's organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties. This first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the

  3. The zeamine antibiotics affect the integrity of bacterial membranes.

    PubMed

    Masschelein, Joleen; Clauwers, Charlien; Stalmans, Karen; Nuyts, Koen; De Borggraeve, Wim; Briers, Yves; Aertsen, Abram; Michiels, Chris W; Lavigne, Rob

    2015-02-01

    The zeamines (zeamine, zeamine I, and zeamine II) constitute an unusual class of cationic polyamine-polyketide-nonribosomal peptide antibiotics produced by Serratia plymuthica RVH1. They exhibit potent bactericidal activity, killing a broad range of Gram-negative and Gram-positive bacteria, including multidrug-resistant pathogens. Examination of their specific mode of action and molecular target revealed that the zeamines affect the integrity of cell membranes. The zeamines provoke rapid release of carboxyfluorescein from unilamellar vesicles with different phospholipid compositions, demonstrating that they can interact directly with the lipid bilayer in the absence of a specific target. DNA, RNA, fatty acid, and protein biosynthetic processes ceased simultaneously at subinhibitory levels of the antibiotics, presumably as a direct consequence of membrane disruption. The zeamine antibiotics also facilitated the uptake of small molecules, such as 1-N-phenylnaphtylamine, indicating their ability to permeabilize the Gram-negative outer membrane (OM). The valine-linked polyketide moiety present in zeamine and zeamine I was found to increase the efficiency of this process. In contrast, translocation of the large hydrophilic fluorescent peptidoglycan binding protein PBDKZ-GFP was not facilitated, suggesting that the zeamines cause subtle perturbation of the OM rather than drastic alterations or defined pore formation. At zeamine concentrations above those required for growth inhibition, membrane lysis occurred as indicated by time-lapse microscopy. Together, these findings show that the bactericidal activity of the zeamines derives from generalized membrane permeabilization, which likely is initiated by electrostatic interactions with negatively charged membrane components. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. Occupational Health Services Integrated in Primary Health Care in Iran.

    PubMed

    Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio

    2015-01-01

    A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health

  5. Space Mission Operations Ground Systems Integration Customer Service

    NASA Technical Reports Server (NTRS)

    Roth, Karl

    2014-01-01

    , and cultural differences, to ensure an efficient response to customer issues using a small Customer Service Team (CST) and adaptability, constant communication with customers, technical expertise and knowledge of services, and dedication to customer service. The HOSC Customer Support Team has implemented a variety of processes, and procedures that help to mitigate the potential problems that arise when integrating ground system services for a variety of complex missions and the lessons learned from this experience will lead the future of customer service in the space operations industry.

  6. Home care: from adequate funding to integration of services.

    PubMed

    Hébert, Réjean

    2009-01-01

    With the aging of the population, the healthcare system needs to shift from the actual hospital-centred system developed in the past century for dealing with acute diseases and a young population toward a home-centred system, more appropriate for serving older people with chronic diseases. Funding of home care should not only be significantly increased but also be managed differently. We propose the introduction of an autonomy support benefit (ASB) to cover costs related to disabilities, irrespective of living environment, and to set up a public universal autonomy insurance program that will cover the ASB. This insurance should be at least partly capitalized to provide for the aging of the population and to ensure intergenerational equity. Also, since the home is a much more complicated service-delivery environment than the hospital, these services must be coordinated and integrated. The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) is a coordination-type model of integration that was implemented and evaluated in three areas (one urban and two rural) in and around Sherbrooke, Quebec. A four-year longitudinal quasi-experimental study with over 1,500 participants demonstrated its efficiency in improving system effectiveness at no extra cost.

  7. Satellite and terrestrial integrated services digital networks in Japan

    NASA Astrophysics Data System (ADS)

    Yamamoto, Heiichi; Kato, Shuzo

    1991-10-01

    Satellite and terrestrial Integrated Services Digital Networks (ISDN) to provide cost effective ISDN services and to enhance installation of ISDN services all over the nation are proposed. The proposed networks are based on the traffic sharing between satellite and terrestrial networks for traffic transmission among telephone offices and provide satellite subscriber lines for ISDN customers in rural areas. The former DYANET (dynamic channel assigning routing satellite aided digital networks) (1) takes the advantage of high transmission efficiency of terrestrial networks for steady traffic and the advantage of high transmission efficiency of satellite communications for light and dynamically varying traffic. By employing demand assignment and transponder hopping (for both transmission and reception) techniques, effective satellite transmission capacity is encreased to five to six times higher than that of preassignment systems. Moreover, earth station cost was significantly reduced by Large Scale Integrated Circuits (LSIC) and Monolithic Integrated Circuit (MIC) implementation and by the development of dual beam antennas. DYANET 1 has been in perfect operation employing 64 Time Division Multiple Access (TDMA) earth stations since 1988 and the latter (DYANET 2) will be put into commercial use from mid 1991.

  8. Health and social services integration: a review of concepts and models.

    PubMed

    Fisher, Michael P; Elnitsky, Christine

    2012-01-01

    Health and social services integration is particularly relevant for populations whose needs span physical health, mental health, housing, and disability services, along with others. Veterans, homeless, chronically ill, and aging are among those populations. This review examines recent peer-reviewed literature about different approaches to services integration, rationales behind those approaches, and successes of those approaches, including factors that make them succeed or fail. The focus here is on services that cross disciplinary boundaries; that is, those that integrate health services with social services, health services with mental health services, or one social service with a categorically different social service.

  9. Work in progress. Integrating physicians' services in the home.

    PubMed Central

    McWilliam, C. L.; Stewart, M.; Sangster, J.; Cohen, I.; Mitchell, J.; Sutherland, C.; Ryan, B.

    2001-01-01

    OBJECTIVE: While increasing acuity levels and the concomitant complexity of service demand that physicians be involved in in-home care, conflicting evidence and opinions do not show how this can best be achieved. DESIGN: A phenomenologic research design was used to obtain insights into the challenges and opportunities of integrating physicians' services into the usual in-home services in London, Ont. SETTING: Home care in London, Ont. PARTICIPANTS: Twelve participants included three patients, two family caregivers, two family physicians, the program's nurse practitioner, two case managers, and two community nurses. METHOD: In-depth interviews with a maximally varied purposeful sample of patients, caregivers, and providers were analyzed using immersion and crystallization techniques. MAIN FINDINGS: Findings revealed the potential for enhanced continuity of care and interdisciplinary team functioning. Having a nurse practitioner, interdisciplinary team-building exercises and meetings, regular face-to-face contact among all providers, support for family caregivers, and 24-hour coverage for physicians were found to be essential for success. CONCLUSION: Integration of services takes time, money, and sustained commitment, particularly when undertaken in geographically isolated communities. Informed choice and a fair remuneration system remain important considerations for family physicians. PMID:11785281

  10. Hydra: a service oriented architecture for scientific simulation integration

    SciTech Connect

    Bent, Russell; Djidjev, Tatiana; Hayes, Birch P

    2008-01-01

    One of the current major challenges in scientific modeling and simulation, in particular in the infrastructure-analysis community, is the development of techniques for efficiently and automatically coupling disparate tools that exist in separate locations on different platforms, implemented in a variety of languages and designed to be standalone. Recent advances in web-based platforms for integrating systems such as SOA provide an opportunity to address these challenges in a systematic fashion. This paper describes Hydra, an integrating architecture for infrastructure modeling and simulation that defines geography-based schemas that, when used to wrap existing tools as web services, allow for seamless plug-and-playmore » composability. Existing users of these tools can enhance the value of their analysis by assessing how the simulations of one tool impact the behavior of another tool and can automate existing ad hoc processes and work flows for integrating tools together.« less

  11. Service Integration in Colorado: Connecting Programs To Provide Better Services in Mesa and El Paso Counties.

    ERIC Educational Resources Information Center

    Ragan, Mark

    Efforts to integrate the delivery of human service programs (HSP) in Colorado's El Paso County and Mesa County were examined through site visits and meetings with 34 members of HSP staff in both counties. The site visits confirmed that staff and management of HSP in both counties have implemented a series of client-centered processes to provide…

  12. How Military Service Affects Student Veteran Success at Community Colleges

    ERIC Educational Resources Information Center

    O'Rourke, Patrick C., Jr.

    2013-01-01

    Increasingly more service members are separating from the military as the United States draws down the force and moves towards a post-war era. Tens of thousands of these veterans will leverage their GI Bill tuition and housing benefits in an attempt to access Southern California community colleges and bolster their transition into mainstream…

  13. Integrated modelling of ecosystem services and energy systems research

    NASA Astrophysics Data System (ADS)

    Agarwala, Matthew; Lovett, Andrew; Bateman, Ian; Day, Brett; Agnolucci, Paolo; Ziv, Guy

    2016-04-01

    The UK Government is formally committed to reducing carbon emissions and protecting and improving natural capital and the environment. However, actually delivering on these objectives requires an integrated approach to addressing two parallel challenges: de-carbonising future energy system pathways; and safeguarding natural capital to ensure the continued flow of ecosystem services. Although both emphasise benefiting from natural resources, efforts to connect natural capital and energy systems research have been limited, meaning opportunities to improve management of natural resources and meet society's energy needs could be missed. The ecosystem services paradigm provides a consistent conceptual framework that applies in multiple disciplines across the natural and economic sciences, and facilitates collaboration between them. At the forefront of the field, integrated ecosystem service - economy models have guided public- and private-sector decision making at all levels. Models vary in sophistication from simple spreadsheet tools to complex software packages integrating biophysical, GIS and economic models and draw upon many fields, including ecology, hydrology, geography, systems theory, economics and the social sciences. They also differ in their ability to value changes in natural capital and ecosystem services at various spatial and temporal scales. Despite these differences, current models share a common feature: their treatment of energy systems is superficial at best. In contrast, energy systems research has no widely adopted, unifying conceptual framework that organises thinking about key system components and interactions. Instead, the literature is organised around modelling approaches, including life cycle analyses, econometric investigations, linear programming and computable general equilibrium models. However, some consistencies do emerge. First, often contain a linear set of steps, from exploration to resource supply, fuel processing, conversion

  14. Including Affective and Social Education in the Integrated Curriculum.

    ERIC Educational Resources Information Center

    Sheldon, Kenneth L.

    Today's social and demographic changes demand that elementary and secondary education incorporate social skills and affective education in the curriculum. One way for this to be accomplished is through an interdisciplinary approach. Numerous curriculum resources which use an interdisciplinary approach and address affective skills are available for…

  15. 47 CFR 73.4157 - Network signals which adversely affect affiliate broadcast service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Network signals which adversely affect affiliate broadcast service. 73.4157 Section 73.4157 Telecommunication FEDERAL COMMUNICATIONS COMMISSION....4157 Network signals which adversely affect affiliate broadcast service. See Public Notice, FCC 79-387...

  16. 47 CFR 73.4157 - Network signals which adversely affect affiliate broadcast service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Network signals which adversely affect affiliate broadcast service. 73.4157 Section 73.4157 Telecommunication FEDERAL COMMUNICATIONS COMMISSION....4157 Network signals which adversely affect affiliate broadcast service. See Public Notice, FCC 79-387...

  17. Interoperability of Volcano Observation Thematic Core Services with the EPOS Integrated Core Services

    NASA Astrophysics Data System (ADS)

    Vogfjord, Kristin; Sigurdsson, Sigurdur F.; Reitano, Danilo

    2017-04-01

    The volcano observations community, represented by Volcano Observatories (VO) and Volcano Research Institutions (VRI) participating in The European Plate Observing System (EPOS), will implement services to enable open access to data, data products, software and services (DDSS) from the community. Technical implementation of these services is established within the Volcano Observations Thematic Core Service (VO-TCS), which will coordinate activities among the contributing VOs and VRIs to ensure their interoperability with the EPOS Integrated Core services (ICS). The goal is to implement a service-oriented architecture (SOA) to guarantee interoperability among the different components of the VO-TCS and the EPOS-ICS architecture. This entails linking and harmonizing the technical implementation of the VO-TCS with the EPOS-ICS, defining standards for TCS-ICS interaction and implementing a prototype for a RESTful service (REpresentational State Transfer). The VO-TCS services will also coordinate with services and platforms already developed and implemented within the two Volcano Supersite projects, FUTUREVOLC and MED-SUV and will utilize some of their already established services to enable initial access to the community's products. To prepare for initial implementation in the fall of 2017, a survey among the VO-TCS participants was carried out to evaluate the maturity level of their different products (DDSSs). The specific goal was to obtain a report for each participating institution describing the real cross-reference between each DDSS status and the TCS requirements, as well as to determine the availability of data and metadata for each DDSS and their level of maturity. Data and metadata similarities between the participants highlighted by the survey results are used to reorganize and simplify the list of products to be made available in the VO-TCS. The presentation will give an overview of the planned services in the Volcano Observations TCS and outline the roadmap

  18. Innovation in Evaluating the Impact of Integrated Service-Delivery: The Integra Indexes of HIV and Reproductive Health Integration.

    PubMed

    Mayhew, Susannah H; Ploubidis, George B; Sloggett, Andy; Church, Kathryn; Obure, Carol D; Birdthistle, Isolde; Sweeney, Sedona; Warren, Charlotte E; Watts, Charlotte; Vassall, Anna

    2016-01-01

    The body of knowledge on evaluating complex interventions for integrated healthcare lacks both common definitions of 'integrated service delivery' and standard measures of impact. Using multiple data sources in combination with statistical modelling the aim of this study is to develop a measure of HIV-reproductive health (HIV-RH) service integration that can be used to assess the degree of service integration, and the degree to which integration may have health benefits to clients, or reduce service costs. Data were drawn from the Integra Initiative's client flow (8,263 clients in Swaziland and 25,539 in Kenya) and costing tools implemented between 2008-2012 in 40 clinics providing RH services in Kenya and Swaziland. We used latent variable measurement models to derive dimensions of HIV-RH integration using these data, which quantified the extent and type of integration between HIV and RH services in Kenya and Swaziland. The modelling produced two clear and uncorrelated dimensions of integration at facility level leading to the development of two sub-indexes: a Structural Integration Index (integrated physical and human resource infrastructure) and a Functional Integration Index (integrated delivery of services to clients). The findings highlight the importance of multi-dimensional assessments of integration, suggesting that structural integration is not sufficient to achieve the integrated delivery of care to clients--i.e. "functional integration". These Indexes are an important methodological contribution for evaluating complex multi-service interventions. They help address the need to broaden traditional evaluations of integrated HIV-RH care through the incorporation of a functional integration measure, to avoid misleading conclusions on its 'impact' on health outcomes. This is particularly important for decision-makers seeking to promote integration in resource constrained environments.

  19. Interconnected operations services in a vertically integrated utility

    SciTech Connect

    Hoffman, S.P.

    1999-11-01

    The North American electric industry has historically been composed of regulated Vertically Integrated Utilities (VIU). Vertical integration means that the same company owns generation, transmission, and distribution facilities. Regulated utilities were ensured cost recovery for all justifiable expenses. The entire industry is in the process of deregulation. The industry-wide trend is to competitive generation, while transmission and distribution remain regulated. Many variations, in both timing and structure, exist in states that have enacted deregulation and retail choice legislation. Some have combined retail choice with an ISO and power exchange; others have opted for retail choice without either. In the past,more » Interconnected Operations Services (IOS) were obtained by informal means within the same company. Generation is now being actively bought and sold as companies align their strategic direction with different sectors of the emerging electric industry. In the future, these IOS will have to be obtained by formal arrangements. The formal arrangements will need to encompass parameters including service definitions, compensation, performance measurement, and performance incentives. These formal arrangements are presently taking different forms in the industry depending on the stage of deregulation in each area, and on the particular agreements made by each Control Area. This paper describes how VIUs obtained and dispatched the IOS needed for reliability, and what challenges will be faced with respect to these services.« less

  20. IRLT: Integrating Reputation and Local Trust for Trustworthy Service Recommendation in Service-Oriented Social Networks

    PubMed Central

    Liu, Zhiquan; Ma, Jianfeng; Jiang, Zhongyuan; Miao, Yinbin; Gao, Cong

    2016-01-01

    With the prevalence of Social Networks (SNs) and services, plenty of trust models for Trustworthy Service Recommendation (TSR) in Service-oriented SNs (S-SNs) have been proposed. The reputation-based schemes usually do not contain user preferences and are vulnerable to unfair rating attacks. Meanwhile, the local trust-based schemes generally have low reliability or even fail to work when the trust path is too long or does not exist. Thus it is beneficial to integrate them for TSR in S-SNs. This work improves the state-of-the-art Combining Global and Local Trust (CGLT) scheme and proposes a novel Integrating Reputation and Local Trust (IRLT) model which mainly includes four modules, namely Service Recommendation Interface (SRI) module, Local Trust-based Trust Evaluation (LTTE) module, Reputation-based Trust Evaluation (RTE) module and Aggregation Trust Evaluation (ATE) module. Besides, a synthetic S-SN based on the famous Advogato dataset is deployed and the well-known Discount Cumulative Gain (DCG) metric is employed to measure the service recommendation performance of our IRLT model with comparing to that of the excellent CGLT model. The results illustrate that our IRLT model is slightly superior to the CGLT model in honest environment and significantly outperforms the CGLT model in terms of the robustness against unfair rating attacks. PMID:26963089

  1. IRLT: Integrating Reputation and Local Trust for Trustworthy Service Recommendation in Service-Oriented Social Networks.

    PubMed

    Liu, Zhiquan; Ma, Jianfeng; Jiang, Zhongyuan; Miao, Yinbin; Gao, Cong

    2016-01-01

    With the prevalence of Social Networks (SNs) and services, plenty of trust models for Trustworthy Service Recommendation (TSR) in Service-oriented SNs (S-SNs) have been proposed. The reputation-based schemes usually do not contain user preferences and are vulnerable to unfair rating attacks. Meanwhile, the local trust-based schemes generally have low reliability or even fail to work when the trust path is too long or does not exist. Thus it is beneficial to integrate them for TSR in S-SNs. This work improves the state-of-the-art Combining Global and Local Trust (CGLT) scheme and proposes a novel Integrating Reputation and Local Trust (IRLT) model which mainly includes four modules, namely Service Recommendation Interface (SRI) module, Local Trust-based Trust Evaluation (LTTE) module, Reputation-based Trust Evaluation (RTE) module and Aggregation Trust Evaluation (ATE) module. Besides, a synthetic S-SN based on the famous Advogato dataset is deployed and the well-known Discount Cumulative Gain (DCG) metric is employed to measure the service recommendation performance of our IRLT model with comparing to that of the excellent CGLT model. The results illustrate that our IRLT model is slightly superior to the CGLT model in honest environment and significantly outperforms the CGLT model in terms of the robustness against unfair rating attacks.

  2. Advancing Integrated African Early Warning Science and Climate Services

    NASA Astrophysics Data System (ADS)

    Funk, C. C.; Verdin, J. P.; Galu, G.; Macharia, D.; Shukla, S.; Harrison, L.; McNally, A.; Peters-Lidard, C. D.; Robertson, F. R.; Roberts, J. B.; Pedreros, D. H.; Husak, G. J.; Peterson, P.; Peterson, S.; Ederer, G.; Landsfeld, M. F.

    2016-12-01

    In this talk we summarize new research and strategies for enhancing climate services to support better climate adaptation, drought monitoring and drought prediction in food insecure East Africa. With support from USAID and NASA, scientists in the United States and Africa are developing new data sets, such as the gridded 1981-present Climate Hazards Group Infrared Precipitation with Stations (CHIRPS) and Climate Hazards Group Infrared Temperature with Stations (CHIRTS), and then using these data sets to drive 1981-present crop water balance and land surface models. We describe how these data and modeling systems provide unprecedented early warning capabilities. We then go on to describe new research focused on i) developing integrated downscaled weather and climate forecasts suitable for driving crop and land surface models, and ii) strategies for enhancing climate service distribution capacities at the Regional Centre for Mapping and Resource Development (RCMRD) and national meteorological agencies in Eastern and Southern Africa.

  3. Integrating Grid Services into the Cray XT4 Environment

    SciTech Connect

    NERSC; Cholia, Shreyas; Lin, Hwa-Chun Wendy

    2009-05-01

    The 38640 core Cray XT4"Franklin" system at the National Energy Research Scientific Computing Center (NERSC) is a massively parallel resource available to Department of Energy researchers that also provides on-demand grid computing to the Open Science Grid. The integration of grid services on Franklin presented various challenges, including fundamental differences between the interactive and compute nodes, a stripped down compute-node operating system without dynamic library support, a shared-root environment and idiosyncratic application launching. Inour work, we describe how we resolved these challenges on a running, general-purpose production system to provide on-demand compute, storage, accounting and monitoring services through generic gridmore » interfaces that mask the underlying system-specific details for the end user.« less

  4. PNAUM: integrated approach to Pharmaceutical Services, Science, Technology and Innovation

    PubMed Central

    Gadelha, Carlos Augusto Grabois; Costa, Karen Sarmento; do Nascimento, José Miguel; Soeiro, Orlando Mário; Mengue, Sotero Serrate; da Motta, Márcia Luz; de Carvalho, Antônio Carlos Campos

    2016-01-01

    ABSTRACT This paper describes the development process of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines) based on an integrated approach to pharmaceutical services, science, technology and innovation. It starts by contextualizing health and development in Brazil and features elements of the National Policy for Science, Technology and Innovation in Health in Brazil and the National Policy for Pharmaceutical Services. On presenting pharmaceutical policy guidelines, it stresses the lack of nationwide data. This survey, commissioned by the Brazilian Ministry of Health, has two components: household survey and evaluation of pharmaceutical services in primary care. The findings point to perspectives that represent, besides the enhancement of public policy for pharmaceutical services and public health, results of government action aimed at developing the economic and industrial health care complex to improve the health conditions of the Brazilian population. PMID:27982379

  5. Delivering high-quality family planning services in crisis-affected settings I: program implementation.

    PubMed

    Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh

    2015-02-04

    In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization

  6. Integrating Affective Learning in the Classroom: A Heuristic Approach.

    ERIC Educational Resources Information Center

    Figley, Charles R.

    This paper describes a structured three-hour program in the area of interpersonal relations designed to supplement classroom instruction. The program, called the Discovery Session, is designed primarily to meet specific affective educational objectives associated with a college undergraduate course in intimate interpersonal relationships.…

  7. An Integrated Model for Identifying Linkages Between the Management of Fuel Treatments, Fire and Ecosystem Services

    NASA Astrophysics Data System (ADS)

    Bart, R. R.; Anderson, S.; Moritz, M.; Plantinga, A.; Tague, C.

    2015-12-01

    Vegetation fuel treatments (e.g. thinning, prescribed burning) are a frequent tool for managing fire-prone landscapes. However, predicting how fuel treatments may affect future wildfire risk and associated ecosystem services, such as forest water availability and streamflow, remains a challenge. This challenge is in part due to the large range of conditions under which fuel treatments may be implemented, as response is likely to vary with species type, rates of vegetation regrowth, meteorological conditions and physiographic properties of the treated site. It is also due to insufficient understanding of how social factors such as political pressure, public demands and economic constraints affect fuel management decisions. To examine the feedbacks between ecological and social dimensions of fuel treatments, we present an integrated model that links a biophysical model that simulates vegetation and hydrology (RHESSys), a fire spread model (WMFire) and an empirical fuel treatment model that accounts for agency decision-making. We use this model to investigate how management decisions affect landscape fuel loads, which in turn affect fire severity and ecosystem services, which feedback to management decisions on fuel treatments. We hypothesize that this latter effect will be driven by salience theory, which predicts that fuel treatments are more likely to occur following major wildfire events. The integrated model provides a flexible framework for answering novel questions about fuel treatments that span social and ecological domains, areas that have previously been treated separately.

  8. Organizational Capacity for Service Integration in Community-Based Addiction Health Services

    PubMed Central

    Guerrero, Erick G.; Aarons, Gregory A.; Palinkas, Lawrence A.

    2014-01-01

    Objectives. We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. Methods. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Results. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. Conclusions. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care. PMID:24524525

  9. Organizational capacity for service integration in community-based addiction health services.

    PubMed

    Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

    2014-04-01

    We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

  10. Modelling a radiology department service using a VDL integrated approach.

    PubMed

    Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

    2009-01-01

    The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

  11. Engineering management consideration for an integrated aeronautical mobile satellite service

    NASA Astrophysics Data System (ADS)

    Belcher, John M.

    In order to meet local air traffic control terminal requirements as well as national and transborder requirements, countries have developed communications, navigation, and surveillance (CNS) systems having little systems integration and a solely ground-based solution to air traffic control problems. It is believed that the application of satellite technology is the only currently viable solution that will enable international civil aviation to overcome the shortcomings of the presently available CNS systems. If properly implemented, available satellite system technology integrated with avionics and ground based capabilities, can be used to meet new global aviation demands. A clear transition plan has to be implemented so as to ensure continuity of service, recognize user-borne costs, and satisfy institutional and national objectives in the progress toward a universal air traffic management (ATM) system. ATM systems design should rely on a modular approach for flexibility and upgrading. An aeronautical mobile satellite service is intended to provide a worldwide satellite data link and direct air/ground voice communication. Institutional and financial roadblocks for implemetation of a global based approach will likely be far greater than technical constraints.

  12. Sharing Service Resource Information for Application Integration in a Virtual Enterprise - Modeling the Communication Protocol for Exchanging Service Resource Information

    NASA Astrophysics Data System (ADS)

    Yamada, Hiroshi; Kawaguchi, Akira

    Grid computing and web service technologies enable us to use networked resources in a coordinated manner. An integrated service is made of individual services running on coordinated resources. In order to achieve such coordinated services autonomously, the initiator of a coordinated service needs to know detailed service resource information. This information ranges from static attributes like the IP address of the application server to highly dynamic ones like the CPU load. The most famous wide-area service discovery mechanism based on names is DNS. Its hierarchical tree organization and caching methods take advantage of the static information managed. However, in order to integrate business applications in a virtual enterprise, we need a discovery mechanism to search for the optimal resources based on the given a set of criteria (search keys). In this paper, we propose a communication protocol for exchanging service resource information among wide-area systems. We introduce the concept of the service domain that consists of service providers managed under the same management policy. This concept of the service domain is similar to that for autonomous systems (ASs). In each service domain, the service information provider manages the service resource information of service providers that exist in this service domain. The service resource information provider exchanges this information with other service resource information providers that belong to the different service domains. We also verified the protocol's behavior and effectiveness using a simulation model developed for proposed protocol.

  13. Integrating Open Grid Services Architecture Data Access and Integration with computational Grid workflows.

    PubMed

    Kukla, Tamas; Kiss, Tamas; Kacsuk, Peter; Terstyanszky, Gabor

    2009-06-28

    Although many scientific applications rely on data stored in databases, most workflow management systems are not capable of establishing database connections during workflow execution. For this reason, e-Scientists have to use different tools before workflow submission to access their datasets and gather the required data on which they want to carry out computational experiments. Open Grid Services Architecture Data Access and Integration (OGSA-DAI) is a good candidate to use as middleware providing access to several structured and semi-structured database products through Web/Grid services. The integration technique and its reference implementation described in this paper enable e-Scientists to reach databases via OGSA-DAI within their scientific workflows at run-time and give a general solution that can be adopted by any workflow management system.

  14. Service line assessment and performance management through information integration: the case for cardiovascular services.

    PubMed

    Salaway, T; Burris, C

    2001-11-01

    Understanding the performance of clinically sophisticated services has become increasingly vital to ensuring the success of a health care organization. Health care delivery systems and providers will require well-designed performance management systems, which is underscored by an operating environment of declining margins, increased capacity issues, and labor shortages in key areas. This article reviews the case for cardiovascular service line assessment and performance management, specifically as a case study example of strategic, focused, and actionable measurement and assessment of clinical and financial performance for both clinical and administrative leaders. The integration of administrative data for comprehensive and strategic assessment of clinically sophisticated services is explored in depth, along with product line definition and positioning.

  15. Organizational change for services integration in public human service organizations: experiences in seven counties.

    PubMed

    Packard, Thomas; Patti, Rino; Daly, Donna; Tucker-Tatlow, Jennifer

    2012-01-01

    This is a study of organizational change strategies employed in seven county human service agencies to improve the coordination of services through the structural integration of previously free standing organizations or the development of voluntary interagency collaborative service delivery systems. The central question involves the identification of organizational change tactics which contributed to the success of the organizational change initiatives. The literature on organizational change is reviewed, with particular attention to a framework developed by Fernandez and Rainey based on their extensive review and synthesis of the research on successful change strategies in the public and business sectors. Qualitative and quantitative data were gathered from over 250 individuals and from agency documents. Findings are compared with the success factors identified by Fernandez and Rainey, and refinements to their propositions are suggested. More precise methods for measuring successful and unsuccessful change initiatives are suggested. Implications for practice and research are presented.

  16. Closing service system gaps for homeless clients with a dual diagnosis: integrated teams and interagency cooperation.

    PubMed

    Rosenheck, Robert A; Resnick, Sandra G; Morrissey, Joseph P

    2003-06-01

    There is great concern about fragmentation of mental health service delivery, especially for dually diagnosed homeless people, and apprehension that such fragmentation adversely affects service access and outcomes. This study first seeks to articulate two alternative approaches to the integration of psychiatric and substance abuse services, one involving an integrated team model and the other a collaborative relationship between agencies. It then applies this conceptualization to a sample of dually diagnosed homeless people who participated in the ACCESS demonstration. Longitudinal outcome data were obtained through interviews at baseline, 3 months, and 12 months with homeless clients with a dual diagnosis (N = 1074) who received ACT-like case management services through the ACCESS demonstration. A survey of ACCESS case managers was conducted to obtain information on: (i) the proportion of clients who received substance abuse services directly from ACCESS case management teams, and the proportion who received services from other agencies; and (ii) the perceived quality of the relationship (i.e. communication, cooperation and trust) between providers--both within the same teams and between agencies. Hierarchical linear modeling was then used to examine the relationship of these two factors to service use and outcome with mixed-model regression analysis. Significant (p<.05) and positive relationships were observed in 4 of the 20 analyses of the association of service use and measures of communication, cooperation, and trust (either intrateam or inter-agency) while none were significant and negative. At 12 months, receipt of a higher proportion of services from agencies other than the ACCESS team was associated with fewer days homeless, and greater reduction of psychiatric symptoms, contradicting the hypothesis that integrated team care is more effective than interagency collaborations. This study broadens the conceptual framework for addressing service system

  17. Need for integration of gender equity in family planning services

    PubMed Central

    Garg, Suneela; Singh, Ritesh

    2014-01-01

    The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services available through the public health facilities in India. Failure to adopt the latest technology is one of these. But the most serious drawback of the programme is that it has never been able to bridge the gap between the two genders related to contraceptives. The programme gave emphasis to women-centric contraceptive and thus women were seen as their clients. The choice to adopt a contraceptive though is ‘cafeteria approach’ in family planning lexicon; it is the choice of the husband that is ultimately practiced. There is not enough dialogue between husband and wife and husband and health worker to discuss the use of one contraceptive over another. The male gender needs to be taken in confidence while promoting the family planning practice. The integration of gender equity is to be done carefully so as not to make dominant gender more powerful. Only when there is equity between genders while using family planning services the programme will achieve success. PMID:25673536

  18. Need for integration of gender equity in family planning services.

    PubMed

    Garg, Suneela; Singh, Ritesh

    2014-11-01

    The family planning programme of India has shown many significant changes since its inception five decades back. The programme has made the contraceptives easily accessible and affordable to the people. Devices with very low failure rate are provided free of cost to those who need it. Despite these significant improvements in service delivery related to family planning the programme cannot be said to achieve success at all levels. There are many issues with the family planning services available through the public health facilities in India. Failure to adopt the latest technology is one of these. But the most serious drawback of the programme is that it has never been able to bridge the gap between the two genders related to contraceptives. The programme gave emphasis to women-centric contraceptive and thus women were seen as their clients. The choice to adopt a contraceptive though is 'cafeteria approach' in family planning lexicon; it is the choice of the husband that is ultimately practiced. There is not enough dialogue between husband and wife and husband and health worker to discuss the use of one contraceptive over another. The male gender needs to be taken in confidence while promoting the family planning practice. The integration of gender equity is to be done carefully so as not to make dominant gender more powerful. Only when there is equity between genders while using family planning services the programme will achieve success.

  19. Academic-Service Partnerships in Nursing: An Integrative Review

    PubMed Central

    Beal, Judy A.

    2012-01-01

    This integrative review summarizes currently available evidence on academic-service partnerships in the profession of nursing. More than 300 articles, published primarily in refereed journals, were accessed. Articles (110) were included in this review as they presented detailed and substantive information about any aspect of a nursing academic-service partnership. The majority were anecdotal in nature. Topics clustered around the following categories: pre-requisites for successful partnerships, benefits of partnerships, types of partnerships, and workforce development with its themes of academic-practice progression and educational re-design. Many examples of partnerships between academic and service settings were thoroughly described and best practices suggested, most often, however, without formal evaluation of outcomes. Nursing leaders in both settings have a long tradition of partnering with very little replicable evidence to support their efforts. It is critical that future initiatives evaluate the effectiveness of these partnerships, not only to ensure quality of patient outcomes but also to maximize efforts at building capacity for tomorrow's workforce. PMID:22548160

  20. The myth of patient centrality in integrated care: the case of back pain services

    PubMed Central

    Louise Howarth, Michelle; Haigh, Carol

    2007-01-01

    Purpose The purpose of this paper is to critically examine the extent of patient centrality within integrated chronic back pain management services and compare policy rhetoric with practice reality. Context Integrated chronic back pain management services. Data sources We have drawn on theories of integration and context specific journals related to integration and pain management between 1966 and 2006 to identify evidence of patient centrality within integrated chronic pain management services. Discussions Despite policy rhetoric and guidelines which promote ‘patient centrality’ within multidisciplinary services, we argue that evaluations of these services are scant. Many papers have focussed on the assessment of pain in multidisciplinary services as opposed to the patients' experience of these services. Conclusions A latent measure of the reality of its magnitude needs to be captured through analysis of the patient's perspectives. Capturing patients' thoughts about integrated services will promote patient centrality and support the reality rather than endorse the rhetoric. PMID:17786176

  1. Integrating service user participation in mental health care: what will it take?

    PubMed Central

    Lawn, Sharon

    2015-01-01

    Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective. PMID:25759608

  2. Multisensory integration affects visuo-spatial working memory.

    PubMed

    Botta, Fabiano; Santangelo, Valerio; Raffone, Antonino; Sanabria, Daniel; Lupiáñez, Juan; Belardinelli, Marta Olivetti

    2011-08-01

    In the present study, we investigate how spatial attention, driven by unisensory and multisensory cues, can bias the access of information into visuo-spatial working memory (VSWM). In a series of four experiments, we compared the effectiveness of spatially-nonpredictive visual, auditory, or audiovisual cues in capturing participants' spatial attention towards a location where to-be-remembered visual stimuli were or were not presented (cued/uncued trials, respectively). The results suggest that the effect of peripheral visual cues in biasing the access of information into VSWM depend on the size of the attentional focus, while auditory cues did not have direct effects in biasing VSWM. Finally, spatially congruent multisensory cues showed an enlarged attentional effect in VSWM as compared to unimodal visual cues, as a likely consequence of multisensory integration. This latter result sheds new light on the interplay between spatial attention and VSWM, pointing to the special role exerted by multisensory (audiovisual) cues.

  3. Development of an Integrated Subspecialist Multidisciplinary Neuro-oncology Service

    PubMed Central

    Price, Stephen J; Guilfoyle, Mathew; J Jefferies, Sarah; Harris, Fiona; Oberg, Ingela; G Burnet, Neil; Santarius, Thomas; Watts, Colin

    2013-01-01

    Traditionally, the poor outcome for patients with malignant brain tumours led to therapeutic nihilism. In turn, this resulted in lack of interest in neurosurgical oncology subspecialisation, and less than ideal patient pathways. One problem of concern was the low rate of tumour resection. Between 1997 and 2006, 685 treated glioblastomas were identified. In the first four years only 40% of patients underwent tumour resection, rising to 55% in the last four years. Before revision of the pathway, the median length of hospital stay was 8 days, and 35% of patients received the results of their histology outside of a clinic setting. A pathway of care was established, in which all patients were discussed pre-operatively in an MDT meeting and then directed into a new surgical neuro-oncology clinic providing first point of contact. This limited the number of surgeons operating on adult glioma patients and aided recruitment into research studies. Now, three consultant neurosurgeons run this service, easily fulfilling IOG requirement to spend >50% of programmed activities in neuro-oncology. Nursing support has been critical to provide an integrated service. This model has allowed increased recruitment to clinical trials. The introduction of this service led to an increase in patients discussed pre-operatively in an MDT (66% rising to 87%; P=0.027), an increase in the rate of surgical resection (from 40% to 80%) and more patients being admitted electively (from 25% to 80%; P<0.001). There was a reduction in the median length of stay (8 days reduced to 4.5 days; P<0.001). For the cohort of GBM patients that went on to have chemoradiotherapy we improved median survival to 18 months, with 35% of patients alive at two years, comparable to international outcomes. Implementing a specialist neurosurgical oncology service begins with understanding the patient care pathway. Our patients have benefitted from the culture of subspecialisation and the excellent inter-disciplinary working

  4. Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya

    PubMed Central

    Mayhew, Susannah H; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

    2017-01-01

    Abstract Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers. Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as

  5. Building thematic and integrated services for solid Earth sciences: the EPOS integrated approach

    NASA Astrophysics Data System (ADS)

    Cocco, Massimo; Consortium, Epos

    2016-04-01

    EPOS has been designed with the vision of creating a pan-European infrastructure for solid Earth science to support a safe and sustainable society. In accordance with this scientific vision, the EPOS mission is to integrate the diverse and advanced European Research Infrastructures for solid Earth science relying on new e-science opportunities to monitor and unravel the dynamic and complex Earth System. EPOS will enable innovative multidisciplinary research for a better understanding of the Earth's physical and chemical processes that control earthquakes, volcanic eruptions, ground instability and tsunami as well as the processes driving tectonics and Earth's surface dynamics. To accomplish its mission, EPOS is engaging different stakeholders, not limited to scientists, to allow the Earth sciences to open new horizons in our understanding of the planet. EPOS also aims at contributing to prepare society for geo-hazards and to responsibly manage the exploitation of geo-resources. Through integration of data, models and facilities, EPOS will allow the Earth science community to make a step change in developing new concepts and tools for key answers to scientific and socio-economic questions concerning geo-hazards and geo-resources as well as Earth sciences applications to the environment and human welfare. A long-term integration plan is necessary to accomplish the EPOS mission. EPOS is presently in its implementation phase further extending its pan-European dimension. The EPOS Implementation Phase builds on the achievements of the successful EPOS Preparatory Phase project and consists of two key activities: the legal establishment of the EPOS-ERIC and the EPOS IP project. The EPOS implementation phase will last from 2015 to 2019. Key objectives of the project are: implementing Thematic Core Services (TCS), the domain-specific service hubs for coordinating and harmonizing national resources/plans with the European dimension of EPOS; building the Integrated Core

  6. Elementary Education Pre-Service Teachers' Development of Mathematics Technology Integration Skills in a Technology Integration Course

    ERIC Educational Resources Information Center

    Polly, Drew

    2015-01-01

    Preparing pre-service teachers to effectively integrate technology in the classroom requires rich experiences that deepen their knowledge of technology, pedagogy, and content and the intersection of these aspects. This study examined elementary education pre-service teachers' development of skills and knowledge in a technology integration course…

  7. Unserved, Unseen, and Unheard: Integrating Programs for HIV-Infected and HIV-Affected Older Adults

    ERIC Educational Resources Information Center

    Emlet, Charles A.; Poindexter, Cynthia Cannon

    2004-01-01

    This article explores the parallel structures and service delivery systems of the Older Americans' Act and the Ryan White CARE Act, argues that social workers should have a working knowledge of both pieces of public policy, and suggests integration or coordination of aging and HIV services. Two vignettes illuminate the issues and implications for…

  8. Some aspects of powerplant airframe integration affecting fuel conservation

    NASA Technical Reports Server (NTRS)

    Farbridge, J. E.

    1978-01-01

    The performance criteria for STOL transport aircraft place many constraints on engineering design, which, in turn, may have a direct bearing on fuel efficiency: these constraints become even more severe with the introduction of powered-lift for turbofan aircraft. Consideration is given to some aspects of performance and design which arise as a result of powerplant/airframe integration and an attempt is made to assess these factors in terms of transport fuel efficiency. The drag polars of various powered lift concepts are analyzed to determine the installed thrust/weight required and a simple method of relating this to fuel efficiency is suggested. Some other factors have been identified as being important to this aspect of design and these are discussed in more general terms. Finally, special consideration is given to recent Canadian research in the realm of supercritical airfoil technology as applied to an multi-foil section which could be utilized both for the STOL regime of flight and for cruise at transonic speeds.

  9. Integrative Review of the Supportive Care Needs of Arab People Affected by Cancer

    PubMed Central

    Alananzeh, Ibrahim; Levesque, Janelle; Kwok, Cannas; Everett, Bronwyn

    2016-01-01

    This review aimed to identify the unmet supportive care needs to conduct an integrative review of the literature, to identify the unmet supportive care needs of Arab people affected by cancer (patients and caregivers), and the impact of these needs on quality of life and psychosocial well-being. In July 2015 databases, search engines and electronic list servers were searched, with no limit on the year of publication. Reference lists of included articles and published reviews were also hand searched. Six studies met the inclusion criteria. Most studies examined the supportive care/unmet needs of Arab cancer patients and their family caregivers. Language, communication, information, and the need to get relief from dependency were the most frequently reported unmet needs among Arab cancer patients. For immigrant Arab patients, physical unmet needs were higher than other migrant groups and native Anglo-Australians. Arab caregivers’ unmet needs included concerns about providing suitable care for their family member, sharing their experience with other caregivers, obtaining information, and, in the case of pediatric cancers, dealing with siblings’ emotional reactions. The existing literature exploring the unmet supportive care needs of Arab people affected by cancer is limited suggesting that comprehensive studies are needed to enhance our understanding of these needs and to inform service planning. PMID:27981153

  10. Integration of Tactical EMS in the National Park Service.

    PubMed

    Smith, William Will R

    2017-06-01

    The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers. The NPS developed a Tactical EMS (TEMS) program that closely integrated many principles from: 1) Tactical Combat Casualty Care (TCCC); 2) Tactical Emergency Casualty Care (TECC); 3) and other established federal and civilian TEMS programs. Combining these best practices into the NPS TEMS Program allowed for standardized training and implementation across not only the NPS, but also paralleled other military/federal/civilian TEMS programs. This synchronization is critical when an injury occurs in a joint tactical operation, either planned (drug interdiction) or unplanned (active shooter response), so that patient care can be uniform and efficient. The components identified for a sustainable TEMS program began with strong medical oversight, protocol development with defined phases of care, identifying specialized equipment, and organized implementation with trained TEMS instructors. Ongoing TEMS program management is continuously improving situationally appropriate training and integrating current best practices as new research, equipment, and tactics are developed. The NPS TEMS Program continues to provide ongoing training to ensure optimal patient care in tactical and other NPS settings. Copyright © 2017 Wilderness Medical Society. All rights reserved.

  11. Employees' organizational identification and affective organizational commitment: an integrative approach.

    PubMed

    Stinglhamber, Florence; Marique, Géraldine; Caesens, Gaëtane; Desmette, Donatienne; Hansez, Isabelle; Hanin, Dorothée; Bertrand, Françoise

    2015-01-01

    Although several studies have empirically supported the distinction between organizational identification (OI) and affective commitment (AC), there is still disagreement regarding how they are related. Precisely, little attention has been given to the direction of causality between these two constructs and as to why they have common antecedents and outcomes. This research was designed to fill these gaps. Using a cross-lagged panel design with two measurement times, Study 1 examined the directionality of the relationship between OI and AC, and showed that OI is positively related to temporal change in AC, confirming the antecedence of OI on AC. Using a cross-sectional design, Study 2 investigated the mediating role of OI in the relationship between three work experiences (i.e., perceived organizational support, leader-member exchange, and job autonomy) and AC, and found that OI partially mediates the influence of work experiences on AC. Finally, Study 3 examined longitudinally how OI and AC combine in the prediction of actual turnover, and showed that AC totally mediates the relationship between OI and turnover. Overall, these findings suggest that favorable work experiences operate via OI to increase employees' AC that, in turn, decreases employee turnover.

  12. Employees’ Organizational Identification and Affective Organizational Commitment: An Integrative Approach

    PubMed Central

    Stinglhamber, Florence; Marique, Géraldine; Caesens, Gaëtane; Desmette, Donatienne; Hansez, Isabelle; Hanin, Dorothée; Bertrand, Françoise

    2015-01-01

    Although several studies have empirically supported the distinction between organizational identification (OI) and affective commitment (AC), there is still disagreement regarding how they are related. Precisely, little attention has been given to the direction of causality between these two constructs and as to why they have common antecedents and outcomes. This research was designed to fill these gaps. Using a cross-lagged panel design with two measurement times, Study 1 examined the directionality of the relationship between OI and AC, and showed that OI is positively related to temporal change in AC, confirming the antecedence of OI on AC. Using a cross-sectional design, Study 2 investigated the mediating role of OI in the relationship between three work experiences (i.e., perceived organizational support, leader-member exchange, and job autonomy) and AC, and found that OI partially mediates the influence of work experiences on AC. Finally, Study 3 examined longitudinally how OI and AC combine in the prediction of actual turnover, and showed that AC totally mediates the relationship between OI and turnover. Overall, these findings suggest that favorable work experiences operate via OI to increase employees' AC that, in turn, decreases employee turnover. PMID:25875086

  13. Integrating leprosy control into general health service in a war situation: the level after 5 years in eastern Congo.

    PubMed

    Byamungu, Denis C; Ogbeiwi, Osahon I

    2003-03-01

    South Kivu Province of the Democratic Republic of Congo, plagued by a turbulent civil war, started a process of integrating leprosy into general health services in 1995. A questionnaire survey was carried out in September 2000 to assess the level of structural and functional integration, after 5 years of the integration process, in nine of its 14 health districts. The survey revealed that a total of 76 clinic nurses remained of those trained in leprosy since 1993. In all, 33-6% of the total 226 health facilities had a trained nurse, but according to the district supervisors who filled the questionnaires, nurses in only 28.3% of health facilities could diagnose leprosy. Less than 40% of the total 226 health facilities were structurally integrated with MDT and other leprosy services. Functionally, the clinic nurses were involved in dispensing MDT drugs and keeping leprosy records in 90.8 and 81.6%, respectively, of the integrated facilities, and diagnostic activities in 43.7%. The degree of involvement put health facilities into four grades of functional integration: 1) fully-functional integrated, 2) semi-functional integrated, 3) semi-integrated (structural but not functional), 4) not integrated (vertical). On this scale, 80% of 107 health facilities reported by the supervisors had some form of integration and 20% were not integrated. Treatment activities were significantly more functionally integrated than the diagnostic and POD activities, which require more skills. The presence of a trained nurse in a health facility made no significant difference to the involvement of clinic nurses in dispensing MDT drugs and performing POD activities, but significantly affected their performance of diagnostic activities and records keeping. The endemic districts had higher levels of structural integration, were not more likely to be functionally integrated. The levels of structural integration after 5 years are considered low in South Kivu Province, and reflect the significant

  14. Promoting autistic children's peer interaction in an integrated early childhood setting using affection activities.

    PubMed Central

    McEvoy, M A; Nordquist, V M; Twardosz, S; Heckaman, K A; Wehby, J H; Denny, R K

    1988-01-01

    Group affection activities were used to increase the interaction of three autistic children with their nonhandicapped peers in an integrated early childhood setting. Peer interaction increased during free play when the affection activities were conducted, but not when similar activities without the affection component were used. This interaction included initiations by both the autistic and nonhandicapped children, with reciprocal interactions occurring more frequently with nonhandicapped peers who had participated in the affection activities. PMID:3417581

  15. Maritime health in Spain: integrated services are the key.

    PubMed

    Canals, M L; Gómez, F; Herrador, J

    2001-01-01

    The maritime occupational health services in Spain are overviewed, and their coordination for seafarers and fishermen within the integrated governmental "Maritime Health Programme", which as from 1984 has been supervised by the Labour and Social Affairs Ministry. The institution in charge is the "Instituto Social de la Marina" (ISM) in Madrid (Mariners' Social Institute) established in 1919, which has organised a network of specialised health institutions in ports. They provide medical assistance on board ships and coastal preventive services for maritime workers. There is the Radio Medical Advice Centre in Madrid, local centres in ports, centres abroad, hospital ships and a repatriation centre. All of them are connected in a centralised database net of shared medical records in a confidential computerised system. Another institution is "Sanidad Exterior" which is related to vaccinations and hygienic problems in harbours. There is also a non profit national scientific medical organisation, the Spanish Society of Maritime Medicine (SEMM) established in 1989, and another society of Naval Medicine founded in 1995. There are also groups of specialists in underwater medicine and health problems of divers. A separate article is published on the SEMM and its activities.

  16. Sustainable Watersheds: Integrating Ecosystem Services and Public Health

    PubMed Central

    Jordan, Stephen J; Benson, William H

    2015-01-01

    Sustainable management of aquatic ecosystems is a worldwide priority; the integrity of these systems depends, in turn, on the integrity of the watersheds (catchments) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health, and socioeconomic values in the context of water quality, water quantity, landscapes, the condition of watersheds, and the connectivity of waters, from headwaters to estuaries and the coastal ocean. These assessments will be a foundation for what we have termed “watershed epidemiology,” through which the connections between ecosystems and human health can be explored over broad spatial and temporal scales. Understanding and communicating these relationships should lead to greater awareness of the roles watersheds play in human well-being, and hence to better management and stewardship of water resources. The U.S. Environmental Protection Agency is developing the research, models, and planning tools to support operational national assessments of watershed sustainability, building upon ongoing assessments of aquatic resources in streams, rivers, lakes, wetlands and estuaries. PMID:25987844

  17. Small Payload Launch Integrated Testing Services (SPLITS) - SPSDL

    NASA Technical Reports Server (NTRS)

    Plotner, Benjamin

    2013-01-01

    My experience working on the Small Payload Launch Integrated Testing Services project has been both educational and rewarding. I have been given the opportunity to work on and experiment with a number of exciting projects and initiatives, each offering different challenges and opportunities for teamwork and collaboration. One of my assignments is to aid in the design and construction of a small-scale two stage rocket as part of a Rocket University initiative. My duties include programming a microcontroller to control the various sensors on the rocket as well as process and transmit data. Additionally, I am writing a graphical user interface application for the ground station that will receive the transmitted data from the rocket and display the information on screen along with a 3D rendering displaying the rocket orientation. Another project I am working on is to design and develop the avionics that will be used to control a high altitude balloon flight that will test a sensor called a Micro Dosimeter that will measure the total ionizing dose absorbed by electrical components during a flight. This includes assembling and soldering the various sensors and components, programming a microcontroller to input and process data from the Micro Dosimeter, and transmitting the data down to a ground station as well as save the data to an on-board SD card. Additionally, I am aiding in the setup and development of ITOS (Integrated Test and Operations System) capability in the SPSDL (Spaceport Processing System Development Lab).

  18. Cognitive and Affective Outcomes of Short-Term Service-Learning Experiences: An Exploratory Study

    ERIC Educational Resources Information Center

    Davis, Darrel R.

    2013-01-01

    This study examined the performance differences in cognitive and affective outcomes between students who completed a short-term service-learning experience and students who watched a video exemplar of the task. Performance measures were obtained via a written reflection paper that contained both cognitive and affective components. Results revealed…

  19. THE TSUNAMI SERVICE BUS, AN INTEGRATION PLATFORM FOR HETEROGENEOUS SENSOR SYSTEMS

    NASA Astrophysics Data System (ADS)

    Fleischer, J.; Häner, R.; Herrnkind, S.; Kriegel, U.; Schwarting, H.; Wächter, J.

    2009-12-01

    The Tsunami Service Bus (TSB) is the sensor integration platform of the German Indonesian Tsunami Early Warning System (GITEWS) [1]. The primary goal of GITEWS is to deliver reliable tsunami warnings as fast as possible. This is achieved on basis of various sensor systems like seismometers, ocean instrumentation, and GPS stations, all providing fundamental data to support prediction of tsunami wave propagation by the GITEWS warning center. However, all these sensors come with their own proprietary data formats and specific behavior. Also new sensor types might be added, old sensors will be replaced. To keep GITEWS flexible the TSB was developed in order to access and control sensors in a uniform way. To meet these requirements the TSB follows the architectural blueprint of a Service Oriented Architecture (SOA). The integration platform implements dedicated services communicating via a service infrastructure. The functionality required for early warnings is provided by loosely coupled services replacing the "hard-wired" coupling at data level. Changes in the sensor specification are confined to the data level without affecting the warning center. Great emphasis was laid on following the Sensor Web Enablement (SWE) standard [2], specified by the Open Geospatial Consortium (OGC) [3]. As a result the full functionality needed in GITEWS could be achieved by implementing the four SWE services: The Sensor Observation Service for retrieving sensor measurements, the Sensor Alert Service in order to deliver sensor alerts, the Sensor Planning Service for tasking sensors, and the Web Notification Service for conduction messages to various media channels. Beyond these services the TSB also follows SWE Observation & Measurements specifications (O&M) for data encoding and Sensor Model Language (SensorML) for meta information. Moreover, accessing sensors via the TSB is not restricted to GITEWS. Multiple instances of the TSB can be composed to realize federate warning system

  20. [Integration of STD services. "All are part of the same service"].

    PubMed

    Jana, S; Bailey, M

    1995-07-01

    Two projects have succeeded at integrating sexually transmitted disease (STD) services at the primary health care level. The first operates in Mwanza district in Tanzania. Nurses use the syndromic approach to diagnose STDs and prescribe treatment. They provide health education to STD patients while also distributing condoms and cards for partner contacts. Health workers attend a three-week seminar on diagnosing and treating the most common STDs. The first week is in a classroom. The remaining two weeks consist of practical training in a health center providing STD services. The project began at the main hospital in Mwanza and has since expanded to rural areas. Monthly supervisory visits to each health center ensure the drug supply. The project focuses on the symptoms of urethral infection, vaginal infection, and genital ulcers. Education programs and public awareness promote and popularize risk reduction sex behavior and improve utilization of health services. The other project (Sonagachi) serves sex workers and their clients in Calcutta, India. It integrates STD services with a primary health center. Since its inception in 1992, STDs have fallen and HIV prevalence has not changed. Sex workers involved in the Sonagachi project are more likely to use condoms with clients than those not involved in the project (50% vs. 20%). Community participation is the key to the success of the Sonagachi project. More than 65 former or current sex workers serve as peer educators. They have attended a six-week training program. They make home visits to sex workers to talk about sexual health, to distribute condoms, to show them how to use condoms, and to encourage them to attend the health center. Peer educators are proud of their work and say that their work gives them confidence and dignity. The peer educators with the most experience become peer educator trainers.

  1. Technology Integration Coursework and Finding Meaning in Pre-Service Teachers' Reflective Practice

    ERIC Educational Resources Information Center

    Kimmons, Royce; Miller, Brant G.; Amador, Julie; Desjardins, Christopher David; Hall, Cassidy

    2015-01-01

    This study seeks to inform teacher preparation programs regarding technology integration by understanding (1) relationships between tasks with specific technologies and pre-service teachers' critical thinking about technology integration and (2) relationships between how pre-service teachers are critically thinking about technology integration and…

  2. Building Thematic and Integrated Services for European Solid Earth Sciences: the EPOS Integrated Approach

    NASA Astrophysics Data System (ADS)

    Harrison, M.; Cocco, M.

    2017-12-01

    EPOS (European Plate Observing System) has been designed with the vision of creating a pan-European infrastructure for solid Earth science to support a safe and sustainable society. In accordance with this scientific vision, the EPOS mission is to integrate the diverse and advanced European Research Infrastructures for solid Earth science relying on new e-science opportunities to monitor and unravel the dynamic and complex Earth System. EPOS will enable innovative multidisciplinary research for a better understanding of the Earth's physical and chemical processes that control earthquakes, volcanic eruptions, ground instability and tsunami as well as the processes driving tectonics and Earth's surface dynamics. To accomplish its mission, EPOS is engaging different stakeholders, to allow the Earth sciences to open new horizons in our understanding of the planet. EPOS also aims at contributing to prepare society for geo-hazards and to responsibly manage the exploitation of geo-resources. Through integration of data, models and facilities, EPOS will allow the Earth science community to make a step change in developing new concepts and tools for key answers to scientific and socio-economic questions concerning geo-hazards and geo-resources as well as Earth sciences applications to the environment and human welfare. The research infrastructures (RIs) that EPOS is coordinating include: i) distributed geophysical observing systems (seismological and geodetic networks); ii) local observatories (including geomagnetic, near-fault and volcano observatories); iii) analytical and experimental laboratories; iv) integrated satellite data and geological information services; v) new services for natural and anthropogenic hazards; vi) access to geo-energy test beds. Here we present the activities planned for the implementation phase focusing on the TCS, the ICS and on their interoperability. We will discuss the data, data-products, software and services (DDSS) presently under

  3. PNAUM: integrated approach to Pharmaceutical Services, Science, Technology and Innovation.

    PubMed

    Gadelha, Carlos Augusto Grabois; Costa, Karen Sarmento; Nascimento, José Miguel do; Soeiro, Orlando Mário; Mengue, Sotero Serrate; Motta, Márcia Luz da; Carvalho, Antônio Carlos Campos de

    2016-12-01

    This paper describes the development process of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines) based on an integrated approach to pharmaceutical services, science, technology and innovation. It starts by contextualizing health and development in Brazil and features elements of the National Policy for Science, Technology and Innovation in Health in Brazil and the National Policy for Pharmaceutical Services. On presenting pharmaceutical policy guidelines, it stresses the lack of nationwide data. This survey, commissioned by the Brazilian Ministry of Health, has two components: household survey and evaluation of pharmaceutical services in primary care. The findings point to perspectives that represent, besides the enhancement of public policy for pharmaceutical services and public health, results of government action aimed at developing the economic and industrial health care complex to improve the health conditions of the Brazilian population. RESUMO O artigo apresenta o processo de construção da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamento a partir de uma concepção integradora da Assistência Farmacêutica, Ciência, Tecnologia e Inovação. Inicia-se contextualizando a saúde e o desenvolvimento no País e apresenta elementos da Política Nacional de Ciência Tecnologia e Inovação em Saúde no Brasil e da Política Nacional de Assistência Farmacêutica. Ao apresentar as diretrizes das Políticas Farmacêuticas, destaca-se a carência de dados de abrangência nacional. A presente pesquisa, encomendada pelo Ministério da Saúde, foi estruturada em dois componentes: inquérito domiciliar e avaliação dos serviços de assistência farmacêutica na atenção básica. As perspectivas dos resultados representam, além do incremento das políticas públicas farmacêuticas e de saúde p

  4. Factors affecting mental health service utilization among Latino Americans with mental health issues.

    PubMed

    Chang, Ching-Wen; Biegel, David E

    2017-10-05

    In contrast to their white counterparts, Latino Americans are less likely to utilize mental health services. Guided by the Behavioral Model of Health Service Utilization, this study examined factors affecting use of mental health services and dropouts from mental health services among Latino Americans with mental health issues. This is a secondary analysis utilizing data from the National Latino and Asian American Study. Seven hundred 88 Latinos with mental health issues were included in this study. Logistic regression analyses were conducted. Being older, having health insurance, having self-perceived need for mental health services, having mental health service need perceived by others and a greater number of probable psychiatric disorders were associated with the use of mental health services among Latinos with mental health issues. Among 194 Latino mental health service users, being younger, not having health insurance, and having a lower level of family support were associated with dropouts from mental health services. The findings suggest that education is needed to help Latino Americans recognize the need for mental health services. In addition, policies are needed to address financial difficulties in accessing mental health services.

  5. Integrating ecosystem-service tradeoffs into land-use decisions

    PubMed Central

    Goldstein, Joshua H.; Caldarone, Giorgio; Duarte, Thomas Kaeo; Ennaanay, Driss; Hannahs, Neil; Mendoza, Guillermo; Polasky, Stephen; Wolny, Stacie; Daily, Gretchen C.

    2012-01-01

    Recent high-profile efforts have called for integrating ecosystem-service values into important societal decisions, but there are few demonstrations of this approach in practice. We quantified ecosystem-service values to help the largest private landowner in Hawaii, Kamehameha Schools, design a land-use development plan that balances multiple private and public values on its North Shore land holdings (Island of O’ahu) of ∼10,600 ha. We used the InVEST software tool to evaluate the environmental and financial implications of seven planning scenarios encompassing contrasting land-use combinations including biofuel feedstocks, food crops, forestry, livestock, and residential development. All scenarios had positive financial return relative to the status quo of negative return. However, tradeoffs existed between carbon storage and water quality as well as between environmental improvement and financial return. Based on this analysis and community input, Kamehameha Schools is implementing a plan to support diversified agriculture and forestry. This plan generates a positive financial return ($10.9 million) and improved carbon storage (0.5% increase relative to status quo) with negative relative effects on water quality (15.4% increase in potential nitrogen export relative to status quo). The effects on water quality could be mitigated partially (reduced to a 4.9% increase in potential nitrogen export) by establishing vegetation buffers on agricultural fields. This plan contributes to policy goals for climate change mitigation, food security, and diversifying rural economic opportunities. More broadly, our approach illustrates how information can help guide local land-use decisions that involve tradeoffs between private and public interests. PMID:22529388

  6. Program Integration: An Alternative for Improving County Rural Human Services Delivery. Technical Paper No. 13.

    ERIC Educational Resources Information Center

    Center for Rural Pennsylvania, Harrisburg.

    This report examines program integration as a way to improve the delivery of rural human services in Pennsylvania. A panel of policymakers, human services providers, and representatives of state agencies identified barriers to effective rural human services delivery and generated policy recommendations. Most county-based human services in…

  7. Service Design Attributes Affecting Diabetic Patient Preferences of Telemedicine in South Korea

    PubMed Central

    Chon, YuCheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

    2011-01-01

    Abstract Objective Attempts to introduce telemedicine in South Korea have failed mostly, leaving critical questions for service developers and providers about whether patients would be willing to pay for the service and how the service should be designed to encourage patient buy-in. In this study, we explore patients' valuations and preferences for each attribute of telemedicine service for diabetes management and evaluate patient willingness to pay for specific service attributes. Materials and Methods We conducted a conjoint survey to collect data on patients' stated preferences among telemedicine service alternatives. The alternatives for diabetes-related service differed in 10 attributes, including those related to price, type of service provider, and service scope. To estimate the relative importance of attributes, patients' willingness to pay for each attribute, and their probable choice of specific alternatives, we used a rank-ordered logit model. A total of 118 respondents participated in the survey. Results All 10 attributes significantly affected patients' valuations and preferences, and demographic and disease characteristics, such as existence of complications and comorbidities, significantly affected patients' valuations of the attributes. Price was the most important attribute, followed by comprehensive scope of service, the availability of mobile phone-based delivery, and large general-hospital provided services. Conclusions The study findings have significant implications for adoption policy and strategy of telemedicine in diabetes management care. Further, the methodology presented in this study can be used to draw knowledge needed to formulate effective policy for adoption of the necessary technology and for the design of services that attract potential beneficiaries. PMID:21631382

  8. Virtual Observatory Integration of OGC geospatial data and services.

    NASA Astrophysics Data System (ADS)

    Minin, M.; Rossi, A. P.; Marmo, C.; Cecconi, B.; Le Sidaner, P.; Erard, S.

    2016-12-01

    Planetary exploration missions produce a wealth of geospatial data, largely from imaging experiments. Data discovery and access can rely on Terrestrial geospatial standards [1], or Virtual Observatory (VO) approach of EuroPlanet-RI H2020 VESPA [2]. Integrating the two is the aim of VESPA Surface Task. VO-GIS interoperability facilitates discovery, display, access and use of geospatial data. In combination with non-surface imaging datasets, it has a potential for interdisciplinary science. We provide geospatial data through VO (Virtual Observatory) TAP (Table Access Protocol) on a dedicated server. Our service runs GAVO DaCHS (Data Center Helper Suite) and is registered with the IVOA (International Virtual Observatory Alliance). Currently exposed tables are: (a) usgs_wms - VO/GIS access to USGS-served WMS (Web Map Service) [3]; (b) crism - CRISM data on [4], with a JavaScript viewer where a spectrum selected on a preview can be visualized in a browser or broadcasted to VO tools; (c) mars_craters - Mars Crater Catalog [5]. Footprint polygons in crism and mars_craters can be sent to the VO viewing tool Aladin. Support from the latter for complex polygons will allow for improved, GIS-like search and data access capabilities. The exposure of additional planetary OGC services is planned. Current work involves the development of a Desktop GIS (QGIS) plugin to enable VO-access and expanding the range of datasets suitable for surface mapping and analysis. All of our developments are Open Source and our code and tools are available on the VESPA GitHub organization page and repositories therein [6]. References[1] Hare et al. (2015) LPSC XLVI, #2476. [2] Erard, S., et al., (2014), Astronomy and Computing 7, 52-61. [3] Hare, T. M., et al. (2014) LPSC 45. MTSTC4-2014-135. [4] Rossi A. P., et al., (2016) Geophysical Research Abstracts, 18, EGU2016-3996 [5] Robbins, S.J., and B.M. Hynek (2012) JGR 117, E06001. [6] https://github.com/epn-vespa/DaCHS-for-VESPA

  9. Factors affecting the extent of utilization of physiotherapy services by physicians in Saudi Arabia

    PubMed Central

    Alshehri, Mansour Abdullah; Alhasan, Hammad; Alayat, Mohamed; Al-subahi, Moayad; Yaseen, Khalid; Ismail, Ayah; Tobaigy, Abdullah; Almalki, Obaid; Alqahtani, Abdulfattah; Fallata, Basmah

    2018-01-01

    [Purpose] To investigate physicians’ attitudes, opinions and experiences towards physiotherapy services as well as to identify the potential factors that may affect the extent of utilization of physiotherapy services (based on physicians’ beliefs) in Saudi Arabia (SA). [Subjects and Methods] A cross-sectional study was conducted. [Results] A total of 108 respondents met the inclusion criteria. The respondents’ attitude towards physiotherapy was slightly low (53.5%), while their opinions and experiences of physiotherapy indicated some important issues. For example, 50% of them believed that physiotherapists did not create a good awareness about physiotherapy services and 55.5% admitted that they did not have enough information about physiotherapy services. The most potential factor reported by physicians that may affect the extent of utilization of physiotherapy services was the lack of physiotherapist’s skills and knowledge to assess and treat patients (55.3%), followed by the limited knowledge of physicians regarding the types of physiotherapy services (44.5%) and the lack of cooperation between physicians and physiotherapists (40.7%). [Conclusion] There were some factors that limited the extent of utilization of physiotherapy services in SA. Physiotherapy academics and clinicians should attempt to change physicians’ negative attitudes, promoting awareness to provide them with a better understanding of physiotherapy services. PMID:29545681

  10. How services for children with disabilities in Serbia affect the quality of life of their families.

    PubMed

    Ignjatovic, Tamara Dzamonja; Milanovic, Marko; Zegarac, Nevenka

    2017-09-01

    Families that have children with disabilities face numerous difficulties related to the lack of services support, social isolation and poverty in Serbia. Mostly due to the prolonged effect of social and economic crisis, there are insufficient adequate and diverse community-based services for those families. The aim of the study was to examine the effect of newly introduced services on the quality of families' life. A pretest/posttest study was conducted at the beginning of service and one year later to evaluate the effect of services measured by Family Quality of Life Scale (Hoffman et al., 2006). The sample consists of 153 families of children with disabilities from 35 different places in Serbia. The results show that the services generally improved the families' quality of life, particularly in the aspects targeted by services, but also had significant positive effect on family interaction and parenting. The services had the highest impact on the families that perceived the lowest life quality before using them. The life quality was improved, regardless of the type of services, but the effectiveness is affected by the severity of child disability. The results might be useful for further steps in developing and evaluating individually and flexible tailored service that support families' needs and suits them the best. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. SCALEUS: Semantic Web Services Integration for Biomedical Applications.

    PubMed

    Sernadela, Pedro; González-Castro, Lorena; Oliveira, José Luís

    2017-04-01

    In recent years, we have witnessed an explosion of biological data resulting largely from the demands of life science research. The vast majority of these data are freely available via diverse bioinformatics platforms, including relational databases and conventional keyword search applications. This type of approach has achieved great results in the last few years, but proved to be unfeasible when information needs to be combined or shared among different and scattered sources. During recent years, many of these data distribution challenges have been solved with the adoption of semantic web. Despite the evident benefits of this technology, its adoption introduced new challenges related with the migration process, from existent systems to the semantic level. To facilitate this transition, we have developed Scaleus, a semantic web migration tool that can be deployed on top of traditional systems in order to bring knowledge, inference rules, and query federation to the existent data. Targeted at the biomedical domain, this web-based platform offers, in a single package, straightforward data integration and semantic web services that help developers and researchers in the creation process of new semantically enhanced information systems. SCALEUS is available as open source at http://bioinformatics-ua.github.io/scaleus/ .

  12. Spiking Phineas Gage: a neurocomputational theory of cognitive-affective integration in decision making.

    PubMed

    Wagar, Brandon M; Thagard, Paul

    2004-01-01

    The authors present a neurological theory of how cognitive information and emotional information are integrated in the nucleus accumbens during effective decision making. They describe how the nucleus accumbens acts as a gateway to integrate cognitive information from the ventromedial prefrontal cortex and the hippocampus with emotional information from the amygdala. The authors have modeled this integration by a network of spiking artificial neurons organized into separate areas and used this computational model to simulate 2 kinds of cognitive-affective integration. The model simulates successful performance by people with normal cognitive-affective integration. The model also simulates the historical case of Phineas Gage as well as subsequent patients whose ability to make decisions became impeded by damage to the ventromedial prefrontal cortex.

  13. Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

    PubMed

    Hannah, Chona T; Lê, Quynh

    2012-10-01

    Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

  14. Non-communicable diseases and HIV care and treatment: models of integrated service delivery.

    PubMed

    Duffy, Malia; Ojikutu, Bisola; Andrian, Soa; Sohng, Elaine; Minior, Thomas; Hirschhorn, Lisa R

    2017-08-01

    Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunodeficiency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. We describe models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identified integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. © 2017 John Wiley & Sons Ltd.

  15. Integration of service providers into supply chain services and waste disposal transports

    NASA Astrophysics Data System (ADS)

    Wedekind, Saskia; Haasis, Hans-Dietrich

    2004-02-01

    An increasing number of manufacturers is responsible for the complete lifecycle of their products and they must create efficient and effective circular flow economic systems. The quality of these material and product cycles depend on the logistical processes and the development of logistic concepts, which have to suffer economic and ecological aims. The complexity of the different circular economic systems need the co-operation of the different participants in order to integrate the different core abilities. The aim of this contribution is to describe the possibilities of the service providers in combining services and transports of supply and waste disposal. As well as to represent their advantages, disadvantages and possible barriers. It was possible to refer to conclusions of the research project "Konfiguration von kooperativen Kreislaufwirtschaftssystemen unter besonderer Ber'cksichtigung von Logistikdienstleistern" within the scope of the Research Center of Logistics at the University of Bremen (FoLo). The research work was carried out in a closed collaboration of the following institutes and enterprises: University of Bremen, the Institute of Shipping Economics and Logistics (ISL) and the BLG International Logistics GmbH & Co.

  16. A self-evaluation tool for integrated care services: the Development Model for Integrated Care applied in practice

    PubMed Central

    Minkman, Mirella; Vat, Lidewij

    2012-01-01

    Purpose The purpose of the workshop is to show the applications of the Development Model for Integrated Care (DMIC) in practice. This relatively new and validated model, can be used by integrated care practices to evaluate their integrated care, to assess their phase of development and reveal improvement areas. In the workshop the results of the use of the model in three types of integrated care settings in the Netherlands will be presented. Participants are offered practical instruments based on the validated DMIC to use in their own setting and will be introduced to the webbased tool. Context To integrate care from multiple providers into a coherent and streamlined client-focused service, a large number of activities and agreements have to be implemented like streamlining information flows and adequate transfers of clients. In the large range of possible activities it is often not clear what essential activities are and where to start or continue. Also, knowledge about how to further develop integrated care services is needed. The Development Model for Integrated Care (DMIC), based on PhD research of Mirella Minkman, describes nine clusters containing in total 89 elements that contribute to the integration of care. The clusters are named: ‘client-centeredness’, ‘delivery system’, ‘performance management’, ‘quality of care’, ‘result-focused learning’, ‘interprofessional teamwork’, ‘roles and tasks’, ‘commitment’, and ‘transparant entrepreneurship’ [1–3]. In 2011 a new digital webbased self-evolution tool which contains the 89 elements grouped in nine clusters was developed. The DMIC also describes four phases of development [4]. The model is empirically validated in practice by assessing the relevance and implementation of the elements and development phases in 84 integrated care services in The Netherlands: in stroke, acute myocardial infarct (AMI), and dementia services. The validation studies are recently published [5, 6

  17. Improving Acceptance, Integration, and Health Among LGBT Service Members

    DTIC Science & Technology

    2016-10-01

    TERMS Military, LGBT, health disparities, minority stress, social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF...service members’ social networks. c) Measure differences in health disparities relative to LGBT service members’ heterosexual counterparts. d) Develop... social networks; (c) 6 determine if there are differences in behavioral health patterns among LGBT service members compared to their heterosexual

  18. Integrating Service-Learning into the Mainstream: A Case Study.

    ERIC Educational Resources Information Center

    Buchanan, Renee L.

    1998-01-01

    Describes an effort to institutionalize service learning within the academic departments of the University of Utah. A community service center at the university, through its faculty advisory committee, developed campus-wide support for incorporating service learning into the core offerings of 14 academic units. Models developed by the academic…

  19. Duke Energy Photovoltaic Integration Study: Carolinas Service Areas

    SciTech Connect

    Lu, Shuai; Samaan, Nader A.; Meng, Da

    2014-03-01

    Solar energy collected using photovoltaic (PV) technology is a clean and renewable energy source that offers multiple benefits to the electric utility industry and its customers, such as cost predictability, reduced emissions, and loss reduction by distributed installations. Renewable energy goals established in North Carolina Senate Bill 3 (SB3), in combination with the state tax credit and decreases in the cost of energy from PV panels, have resulted in rapid solar power penetration within the Carolinas services areas of Duke Energy. Continued decreases in PV prices are expected to lead to greater PV penetration rates than currently required in SB3.more » Despite the potential benefits, significant penetration of PV energy is of concern to the utility industry because of its impact on operating reliability and integration cost to customers, and equally important, how any additional costs may be allocated to different customer groups. Some of these impacts might become limiting factors for PV energy, especially growing distributed generation installed at customer sites. Recognizing the importance of renewable energy developments for a sustainable energy future and economic growth, Duke Energy has commissioned this study to simulate the effects of high-PV penetration rates and to initiate the process of quantifying the impacts. The objective of the study is to inform resource plans, guide operation improvements, and drive infrastructure investments for a steady and smooth transition to a new energy mix that provides optimal values to customers. The study team consists of experts from Pacific Northwest National Laboratory (PNNL), Power Costs, Inc. (PCI), Clean Power Research (CPR), Alstom Grid, and Duke Energy. PNNL, PCI, and CPR performed the study on generation impacts; Duke Energy modeled the transmission cases; and distribution simulations were conducted by Alstom Grid. PNNL analyzed the results from each work stream and produced the report.« less

  20. Enhancing Mobility: Integrating New Services into Your Library's Mobile Platform to Increase Traffic

    ERIC Educational Resources Information Center

    Felts, John W., Jr.

    2014-01-01

    Kimbel Library launched its mobile environment and ran it in full production for several months yet usage patterns were quite low and flat. The library only saw a substantial increase in usage when new, value-added services were integrated into this platform. Upon implementing and integrating discovery services, chat and SMS capabilities, and…

  1. Integrating Writing, Academic Discourses, and Service Learning: Project Renaissance and School/College Literacy Collaborations

    ERIC Educational Resources Information Center

    Mastrangelo, Lisa S.; Tischio, Victoria

    2005-01-01

    "Integrating Writing, Academic Discourses, and Service Learning: Project Renaissance and School/College Literacy Collaborations" discusses a year-long general education program for first-year students that integrated disciplinary learning with a pen pal project in light of the goals of critical pedagogy and service-learning. The program aimed at…

  2. Integrating Information Services in an Academic Setting: The Organizational and Technical Challenge.

    ERIC Educational Resources Information Center

    Branin, Joseph J.; And Others

    1993-01-01

    Describes a project to integrate the support and delivery of information services to faculty and staff at the University of Minnesota from the planning phase to implementation of a new organizational entity. Topics addressed include technical and organizational integration, control and delivery of services, and networking and organizational fit.…

  3. Integrating Child Welfare, Juvenile Justice, and Other Agencies in a Continuum of Services

    ERIC Educational Resources Information Center

    Howell, James C.; Kelly, Marion R.; Palmer, James; Mangum, Ronald L.

    2004-01-01

    This article presents a comprehensive strategy framework for integrating mental health, child welfare, education, substance abuse, and juvenile justice system services. It proposes an infrastructure of information exchange, cross-agency client referrals, a networking protocol, interagency councils, and service integration models. This…

  4. Integrating Business Communication Instruction and Career Services: Activities and Assessment Tools

    ERIC Educational Resources Information Center

    Crews, Moody E.; Hemby, K. Virginia

    2009-01-01

    This paper is an extension of an earlier JARBI article, "Integrating University and College Career Services Programs into the Business Communication Curriculum" (Hemby & Crews, 2005). The original article provided business communication instructors with ideas for integrating career services' programs into the business communication curriculum,…

  5. Teaching for Application: A Model for Assisting Pre-Service Teachers with Technology Integration

    ERIC Educational Resources Information Center

    Hur, Jung Won; Cullen, Theresa; Brush, Thomas

    2010-01-01

    The purpose of this paper is to introduce a technology integration model designed to assist pre-service teachers to learn meaningful uses of technology in K-12 classrooms. Based on studies in teacher education, learning theory, and technology integration, the authors define five essential characteristics necessary for pre-service teacher…

  6. Cloud Applications in Language Teaching: Examining Pre-Service Teachers' Expertise, Perceptions and Integration

    ERIC Educational Resources Information Center

    Aburezeq, Ibtehal Mahmoud; Dweikat, Fawzi Fayez Ishtaiwa

    2017-01-01

    This study examined pre-service teachers' expertise, perceptions and integration of cloud applications in teaching of Arabic and English. Questionnaires and semi-structured interviews were used as data collection methods. The findings of the study specified that pre-service teachers did not own sufficient expertise for effective integration of…

  7. Factors Affecting Early Services for Children Who Are Hard of Hearing

    ERIC Educational Resources Information Center

    Harrison, Melody; Page, Thomas A.; Oleson, Jacob; Spratford, Meredith; Berry, Lauren Unflat; Peterson, Barbara; Welhaven, Anne; Arenas, Richard M.; Moeller, Mary Pat

    2016-01-01

    Purpose: To describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for…

  8. In-Home Continuing Care Services for Substance-Affected Families: The Bridges Program.

    ERIC Educational Resources Information Center

    Gruber, Kenneth J.; Fleetwood, Thomas W.; Herring, Michael W.

    2001-01-01

    Presents a preliminary view of a continuing care substance abuse recovery services program designed to assist the substance-affected family. The program focuses on helping substance abusers and their families achieve relapse prevention by addressing functioning in four domains: individual actions and cognitions; individual recovery actions; family…

  9. A Modeling Study about the Factors Affecting Assessment Preferences of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Dogan, C. Deha

    2013-01-01

    This is a correlation study which aims to assess the theoretical model about the factors affecting assessment preferences of pre-service teachers. In the model the relations among the "alternative assessment methods", "critical thinking learning strategy", "Elaboration learning strategy", "self-efficacy about…

  10. Legal Issues and Constraints Affecting Finance Reform for Education and Related Services.

    ERIC Educational Resources Information Center

    Triplett, Tom

    This paper examines the federal and state constitutional and statutory issues that affect the capacity of governments to raise revenue for education and other children's services, including mandates and key legislation that limit revenues, expenditures, and borrowing. The paper is divided into three major sections: (1) legal issues affecting…

  11. Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

    PubMed

    Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

    2016-03-22

    While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. The Current Status of Research on the Integration of Sexual and Reproductive Health and HIV Services

    PubMed Central

    Warren, Charlotte E.; Mayhew, Susannah H.; Hopkins, Jonathan

    2017-01-01

    Integration of services for sexual and reproductive health (SRH) and HIV has been widely promoted globally in the belief that both clients and health providers benefit through improvements in quality, efficient use of resources, and lower costs, helping to maximize limited health resources and provide comprehensive client‐centered care. This article builds on the growing body of research on integrated sexual SRH and HIV services. It brings together critical reviews on issues within the wider SRH and rights agenda and synthesizes recent research on integrated services, drawing on the Integra Initiative and other major research. Unintended pregnancy and HIV are intrinsically interrelated SRH issues, however broadening the constellation of services, scaling up, and mainstreaming integration continue to be challenging. Overcoming stigma, reducing gender‐based violence, and meeting key populations’ SRH needs are critical. Health systems research using SRH as the entry point for integrated services and interaction with communities and clients is needed to realize universal health coverage. PMID:28493283

  13. What about Us? Economic and Policy Changes Affecting Rural HIV/AIDS Services and Care.

    PubMed

    Albritton, Tashuna; Martinez, Isabel; Gibson, Crystal; Angley, Meghan; Grandelski, Valen R

    2017-01-01

    Health care budgets and policies are chief drivers in the delivery and access to health services. Place is also a factor that affects patient and provider experiences within the health care system. We examine the impact of policy changes and subsequent budget cuts on rural HIV/AIDS care, support services, and prevention. We interviewed 11 social workers, case managers, and outreach workers who serve rural people living with HIV/AIDS. We conducted telephone interviews inquiring about the effect of economics and policies on direct practice with rural clients. We analyzed data using a content analysis approach. We found several themes from the data. Ryan White funding and policy changes shifted direct practice to a medical case management model. Changes in federal and state poverty levels affected client eligibility for the AIDS Drugs Assistance Program. Policy banning financial support for syringe service programs hindered prevention efforts to reduce HIV/AIDS transmission. Ancillary services were reduced, such as housing assistance, transportation, and emergency financial assistance. In conclusion, we highlight the importance of place-based policies to improve access to healthcare and services. We also provide recommendations for greater inclusion in HIV/AIDS-related policy development, care, and service planning for rural workers.

  14. Service delivery and community: social capital, service systems integration, and outcomes among homeless persons with severe mental illness.

    PubMed Central

    Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Stolar, M; Johnsen, M; Randolph, F; Blasinsky, M; Goldman, H

    2001-01-01

    OBJECTIVES: This study evaluated the influence of features of community social environment and service system integration on service use, housing, and clinical outcomes among homeless people with serious mental illness. STUDY SETTING: A one-year observational outcome study was conducted of homeless people with serious mental illness at 18 sites. DATA SOURCES: Measures of community social environment (e.g., social capital) were based on local surveys and voting records. Housing affordability was assessed with housing survey data. Service system integration was assessed through interviews with key informants at each site to document interorganizational transactions. Standardized clinical measures were used to assess clinical and housing outcomes in face-to-face interviews. RESEARCH DESIGN: Structural equation modeling was used to determine the relationship between (1) characteristics of the social environment (social capital, housing affordability); (2) the level of integration of the service system for persons who are homeless in each community; (3) access to and use of services by individual clients; and (4) successful exit from homelessness or clinical improvement. PRINCIPAL FINDINGS: Social capital was associated with greater service systems integration, which was associated in turn with greater access to assistance from a public housing agency and to a greater probability of exiting from homelessness at 12 months. Housing affordability also predicted exit from homelessness. Neither environmental factors nor systems integration predicted outcomes for psychiatric problems, substance abuse, employment, physical health, or income support. CONCLUSION: Community social capital and service system integration are related through a series of direct and indirect pathways with better housing outcomes but not with superior clinical outcomes for homeless people with mental illness. Implications for designing improved service systems are discussed. PMID:11508635

  15. Does Adolescent Affect Impact Adult Social Integration? Evidence from the British 1946 Birth Cohort

    PubMed Central

    Hatch, Stephani L.; Wadsworth, Michael EJ

    2012-01-01

    Using data from the MRC National Survey of Health and Development (the British 1946 birth cohort), we take a life course approach with a sociology of mental health framework to examine the relationship between adolescent affect and adult social integration. The results suggest that being observed as anxious or sad in adolescence has long-term effect on adult social integration. These associations are not explained by adult mental health or socioeconomic status, for the most part. The results demonstrate support for social selection processes between adolescent mental health and adult social outcomes and suggest a disparate effect of type of adolescent affect on adult social outcomes. PMID:22723717

  16. Memphis City Schools Mental Health Center: A Comprehensive Integrated Service Program.

    ERIC Educational Resources Information Center

    Faris, Judy; Nichol, Gerry T.

    1996-01-01

    Describes a nationally recognized service program that delivers integrated mental health and substance abuse services to children and youth with a wide range of problems. The model incorporates elements of primary and secondary prevention and community outreach into service delivery. Program components are discussed in detail. (RJM)

  17. Pre-Service Teachers' Use of a Technology Integration Planning Cycle: A Case Study

    ERIC Educational Resources Information Center

    Beschorner, Beth; Kruse, Jerrid

    2016-01-01

    This study explored pre-service teachers' use of Hutchison and Woodward's (2014) Technology Integration Planning Cycle for instructional lesson planning in literacy. Ten pre-service teachers enrolled in a course entitled Literacy Assessment and Instruction II participated. As part of the course, each pre-service teacher developed and delivered…

  18. Pre-Service Physics and Chemistry Teachers' Conceptual Integration of Physics and Chemistry Concepts

    ERIC Educational Resources Information Center

    Tuysuz, Mustafa; Bektas, Oktay; Geban, Omer; Ozturk, Gokhan; Yalvac, Bugrahan

    2016-01-01

    This study examines the pre-service teachers' opinions about conceptual integration (CI) and their understanding of it. A qualitative phenomenology design was used in the study. Data was collected through in-depth semi-structured interviews comprising ten guiding questions. Three pre-service physics and three pre-service chemistry teachers…

  19. Schools and Achieving Integrated Services: Facilitating Utilization of the Knowledge Base.

    ERIC Educational Resources Information Center

    Lugg, Catherine A.

    Coordinated social services may be one of the most promising aspects of the current era of systemic educational reform. However, moving from a policy that calls for coordinated service integration into the actual practice of providing services requires the resolution of a host of complex, interacting issues. This paper provides an overview of what…

  20. Toward Integrated Family Services in Rural Settings: A Summary of Research and Practice. Program Report.

    ERIC Educational Resources Information Center

    Stoops, Jack W.; Hull, Janis L.

    This report synthesizes research findings with observations of three Pacific Northwest sites attempting service integration in rural settings. At case-study sites in Washington and Oregon, rural schools, communities, and service providers collaborate to deliver services to students and community members suffering from high unemployment, alcohol…

  1. Improving Acceptance, Integration and Health among LGBT Service Members

    DTIC Science & Technology

    2017-10-01

    phases. In Phase I we (a) convened an expert panel to advise the study and (b) interview a diverse set of military service members ( n =42) using a...completion of formative processes, we are recruiting a sample of LGBT ( n =240) and heterosexual/cisgender ( n =240) service-members for participation in a...interviewed a diverse set of military service members ( n =42) using a semi- structured Life History Calendar approach to inform a set of culturally

  2. Technical and economic feasibility of integrated video service by satellite

    NASA Technical Reports Server (NTRS)

    Price, Kent M.; Garlow, R. K.; Henderson, T. R.; Kwan, Robert K.; White, L. W.

    1992-01-01

    The trends and roles of satellite based video services in the year 2010 time frame are examined based on an overall network and service model for that period. Emphasis is placed on point to point and multipoint service, but broadcast could also be accommodated. An estimate of the video traffic is made and the service and general network requirements are identified. User charges are then estimated based on several usage scenarios. In order to accommodate these traffic needs, a 28 spot beam satellite architecture with on-board processing and signal mixing is suggested.

  3. Integrating Diversity Education and Service Learning: A 15+ Year Journey Continues

    ERIC Educational Resources Information Center

    Womble, Myra N.; Adams, Elaine

    2016-01-01

    This paper reports the 15+ year journey undertaken by university faculty to integrate service learning with diversity education. It has taken the faculty from its initial integration of academic community learning and diversity education in 1999 to its current course offering in 2015. The purpose of this integration has remained the same, to…

  4. Preservice and In-Service Teachers' Perceptions toward Technology Benefits and Integration

    ERIC Educational Resources Information Center

    Spaulding, Michael

    2013-01-01

    This study examined preservice teacher attitudes toward and expected technology integration practices as compared to in-service teachers' attitudes toward and actual (self-reported) practice of technology integration. The preservice teachers revealed a greater level of confidence in their ability to integrate technology and more positive beliefs…

  5. Barriers to Integrating Mental Health Services in Community-Based Primary Care Settings in Mexico City: A Qualitative Analysis.

    PubMed

    Martinez, William; Galván, Jorge; Saavedra, Nayelhi; Berenzon, Shoshana

    2017-05-01

    Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.

  6. Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study

    PubMed Central

    Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

    2016-01-01

    Objective While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. Design We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. Setting We interviewed participants at Japan Clubs and their offices. Participants 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. Results We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. Conclusions The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. PMID:27006344

  7. Factors affecting employment outcomes for people with disabilities who received Disability Employment Services in Taiwan.

    PubMed

    Jang, Yuh; Wang, Yun-Tung; Lin, Meng-Hsiu

    2014-03-01

    One of the most important rehabilitation goals is to return people with disabilities to paid employment. The purposes of this study were (1) to explore employment status and (2) to identify factors that may affect the employment outcomes of people with disabilities who received Disability Employment Services (DES). A retrospective study was conducted on clients who commenced and closed DES between January 2008 and December 2010 in a metropolitan city in Taiwan, using the files from the National Vocational Rehabilitation Services Documentary System. Sixty-nine percent (1,684 out of 2,452) of the clients in this study were engaged in paid employment after receiving DES. Logistic regression analyses indicated that clients with no psychiatric disability or mild impairment and with useful vocational qualifications, typical work experience, more post-employment services, and less pre-employment services were associated with a higher rate of successful employment outcomes. This study provides empirical evidence of the association between person- and DES-related factors and the employment outcomes of people with disabilities. Future improvements in health, school-to-work transition services, and vocational rehabilitation for people with disabilities should place more emphasis on providing work-based work experience, professional vocational training, access to college/professional education, career exploration, effective supported employment services, and other post-employment services.

  8. Digital Library and Digital Reference Service: Integration and Mutual Complementarity

    ERIC Educational Resources Information Center

    Liu, Jia

    2008-01-01

    Both the digital library and the digital reference service were invented and have been developed under the networked environment. Among their intersections, the fundamental thing is their symbiotic interest--serving the user in a more efficient way. The article starts by discussing the digital library and its service and the digital reference…

  9. Integrating Service Learning Into the Research Methods Course.

    ERIC Educational Resources Information Center

    Potter, Sharyn J.; Caffrey, Elizabeth M.; Plante, Elizabethe G.

    2003-01-01

    Discusses a service learning research methods project to engage students in a sociology course. Parsed in four sections: (1) reviews service learning/research and its effect on students and community; (2) provides a detailed project description; (3) discusses student contributions to the organization served; and (4) examines evaluation methods of…

  10. Integrated Modeling Approach for Verifying Water Storage Services for a Payment for Environmental Service Programs

    NASA Astrophysics Data System (ADS)

    Hendricks, G.; Shukla, S.; Guzha, A. C.

    2013-12-01

    Hydrologic models have been used for improved understanding of how an ecosystem's hydrologic response to human intervention and may provide substantial insight into the viability of payment for environmental services (PES) programs. Little is currently known about how hydrologic models can contribute to the design and evaluation of PES programs. Increased water storage is a desired environmental service (ES) for the Florida Everglades' watershed to reduce nutrient loads and excessive flows to lakes and estuaries in the region. We present monitoring and modeling results to verify the water storage PES for two ranch sites (wetland and watershed scales) located in the Northern Everglades region located north of the Lake Okeechobee (LO). Verification of the water storage PES using at least 3 years of hydrologic data was inconclusive due to variable rainfall during pre- and post-PES periods. An integrated surface and groundwater model, MIKE-SHE/MIKE11, was used to help verify the water storage service as well as predict ecological responses for different water storage scenarios (different levels of storage). The hydrological model was calibrated and validated using field measurements and was able to effectively simulate the surface and groundwater levels for the watershed (Nash Sutcliffe Efficiency, NSE = 0.54 to 0.82) and for surface water levels within wetlands (NSE = 0.54 to 0.84). Scenario analyses for storage levels showed an inverse relationship between board heights for water control structures and flows at the watershed outlet. Changes in flow were marginal when board heights approached a maximum indicating movement of water into subsurface storage. Combining simulation results with field measurements showed reduced flows and increased subsurface storage (2 cm/yr.), a desired outcome for protecting LO and estuarine systems from excessive flows. Simulated wetland water levels were combined with LIDAR-based topography to predict inundation for wetlands at the two

  11. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia

    PubMed Central

    Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-01-01

    Background Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. Methodology A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. Results A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). Conclusion In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system. PMID:29075171

  12. Factors Affecting Quality of Laboratory Services in Public and Private Health Facilities in Addis Ababa, Ethiopia.

    PubMed

    Mesfin, Eyob Abera; Taye, Binyam; Belay, Getachew; Ashenafi, Aytenew; Girma, Veronica

    2017-10-01

    Quality laboratory service is an essential component of health care system but in Sub-Saharan Africa such as Ethiopia, laboratories quality system remains weak due to several factors and it needs more attention to strengthen its capacity and quality system. A cross sectional study was conducted using a questionnaire to assess factors affecting the quality of laboratory service at private and public health institutions in Addis Ababa. A total of 213 laboratory professionals participated in the study and 131 (61.5%) participants had bachelor degree. Majority, 133 (62.4%), of the professionals did not attend any work related training. Seventy five (35.2%) respondents believed that their laboratories did not provide quality laboratory services and the major reported factors affecting provision of quality services were shortage of resources (64.3%), poor management support (57.3%), poor equipment quality (53.4%), high workload (41.1%), lack of equipment calibration (38.3%) and lack of knowledge (23.3%). Moreover logistic regression analysis showed that provision of quality laboratory service was significantly associated with result verification (AOR=9.21, 95% CI=2.26, 37.48), internal quality control (AOR= 6.11, 95% CI=2.11, 17.70), turnaround time (AOR=5.11, 95% CI=1.94, 13.46), shortage of equipment (AOR=7.76, 95% CI=2.55, 23.66), communication with clinicians (AOR=3.24, 95% CI=1.25, 8.41) and lack of job description (AOR=3.67, 95% CI=1.319, 10.22). In conclusion, the major factors that affecting the quality of laboratory service were associated with poor human resource management, poor resources provision, poor management commitment, ineffective communication system and lack of well-established quality management system.

  13. Emotional Language Processing: How Mood Affects Integration Processes during Discourse Comprehension

    ERIC Educational Resources Information Center

    Egidi, Giovanna; Nusbaum, Howard C.

    2012-01-01

    This research tests whether mood affects semantic processing during discourse comprehension by facilitating integration of information congruent with moods' valence. Participants in happy, sad, or neutral moods listened to stories with positive or negative endings during EEG recording. N400 peak amplitudes showed mood congruence for happy and sad…

  14. An Analysis of How Proctoring Exams in Online Mathematics Offerings Affects Student Learning and Course Integrity

    ERIC Educational Resources Information Center

    Flesch, Michael; Ostler, Elliott

    2011-01-01

    This paper presents the results of a study focused on the issue of how proctored testing affects the learning outcomes and integrity in an Intermediate Algebra course setting. The study follows a model of assessment where students in one group have taken two of their five unit exams as proctored tests along with a proctored Comprehensive Final…

  15. An Investigation of Relationships between Internal and External Factors Affecting Technology Integration in Classrooms

    ERIC Educational Resources Information Center

    Hur, Jung Won; Shannon, David; Wolf, Sara

    2016-01-01

    Various factors affecting technology integration have been identified, but little research has examined the relationships between factors, especially internal and external ones, and whether they directly or indirectly influenced each other. To fill this research gap, this study examined the significance and relationships of five factors…

  16. The Views of Mathematics Teachers on the Factors Affecting the Integration of Technology in Mathematics Courses

    ERIC Educational Resources Information Center

    Kaleli-Yilmaz, Gül

    2015-01-01

    The aim of this study was to determine the views of mathematics teachers on the factors that affect the integration of technology in mathematic courses. It is a qualitative case study. The sample size of the study is 10 teachers who are receiving postgraduate education in a university in Turkey. The current study was conducted in three stages. At…

  17. Pedagogical Factors Affecting Integration of Computers in Mathematics Instruction in Secondary Schools in Kenya

    ERIC Educational Resources Information Center

    Wanjala, Martin M. S.; Aurah, Catherine M.; Symon, Koros C.

    2015-01-01

    The paper reports findings of a study which sought to examine the pedagogical factors that affect the integration of computers in mathematics instruction as perceived by teachers in secondary schools in Kenya. This study was based on the Technology Acceptance Model (TAM). A descriptive survey design was used for this study. Stratified and simple…

  18. Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya.

    PubMed

    Mayhew, Susannah H; Sweeney, Sedona; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

    2017-11-01

    Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers.Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as health

  19. Integrating mental health services into primary HIV care for women: the Whole Life project.

    PubMed

    Dodds, Sally; Nuehring, Elane M; Blaney, Nancy T; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E; O'Sullivan, Mary J

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, implementation strategies, effects of the service integration, and lessons learned. Funded by the Health Resources and Services Administration (HRSA) as a Special Program of National Significance (SPNS), Whole Life efforts have been sustained beyond the demonstration funding period as a result of the changes brought about in organizational structures, service delivery, and the providers' conceptualization of health for HIV-infected women.

  20. Primary Care and Public Health Services Integration in Brazil’s Unified Health System

    PubMed Central

    Wall, Melanie; Yu, Gary; Penido, Cláudia; Schmidt, Clecy

    2012-01-01

    Objectives. We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice. Methods. We collected cross-sectional data from community health workers, nurses, and physicians (n = 262). We used structural equation modeling to assess providers’ service integration and evidence-based practice engagement operationalized as latent factors. Predictors included endorsement of team meetings, access to and consultations with colleagues, familiarity with community, and previous research experience. Results. Providers’ familiarity with community and team meetings positively influenced evidence-based practice engagement and service integration. More experienced providers reported more integration and engagement. Physicians reported less integration than did community health workers. Black providers reported less evidence-based practice engagement than did Pardo (mixed races) providers. After accounting for all variables, evidence-based practice engagement and service integration were moderately correlated. Conclusions. Age and race of providers, transdisciplinary collaboration, and familiarity with the community are significant variables that should inform design and implementation of provider training. Promising practices that facilitate service integration in Brazil may be used in other countries. PMID:22994254

  1. Decision analytic strategies for integrating ecosystem services and risk assessment.

    PubMed

    von Stackelberg, Katherine E

    2013-04-01

    Ecosystem services as a concept and guiding principle are enjoying wide popularity and endorsement from high-level policy thinkers to industry as support for sustainability goals continue to grow. However, explicit incorporation of ecosystem services into decision making still lacks practical implementation at more local scales and faces significant regulatory and technical constraints. Risk assessment represents an example of a regulatory process for which guidance exists that makes it challenging to incorporate ecosystem service endpoints. Technical constraints exist in the quantification of the relationships between ecological functions and services and endpoints valued by humans, and the complexity of those interactions with respect to bundling and stacking. In addition, ecosystem services, by their very definition, represent an anthropogenic construct with no inherent ecological value, which, in practical terms, requires a far more inclusionary decision making process explicitly incorporating a greater diversity of stakeholder values. Despite these constraints, it is possible, given a commitment to sustainable decision making, to simplify the process based on strategic outcomes (e.g., identifying desired end-states in general terms). Decision analytic techniques provide a mechanism for evaluating tradeoffs across key ecosystem services valued by stakeholders and to develop criteria drawn from the entire spectrum of stakeholders in evaluating potential alternatives. This article highlights several examples of ways in which ecosystem service endpoints can be incorporated into the decision-making process. Copyright © 2013 SETAC.

  2. Integrating Health and Mental Health Services: A Past and Future History.

    PubMed

    Druss, Benjamin G; Goldman, Howard H

    2018-04-25

    The authors trace the modern history, current landscape, and future prospects for integration between mental health and general medical care in the United States. Research and new treatment models developed in the 1980s and early 1990s helped inform federal legislation, including the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act, which in turn are creating new opportunities to further integrate services. Future efforts should build on this foundation to develop clinical, service-level, and public health approaches that more fully integrate mental, medical, substance use, and social services.

  3. Improving Acceptance, Integration and Health among LGBT Service Members

    DTIC Science & Technology

    2017-10-01

    interview a diverse set of military service members ( n =42) using a semi- structured Life History Calendar approach to develop a set of culturally...appropriate measures for use in Phase II. In Phase II, following completion of formative processes, we are recruiting a sample of LGBT ( n =240) and...heterosexual/cisgender ( n =240) service-members for participation in a quantitative survey using respondent driven sampling (RDS). To date, 47 LGBT and 31 non

  4. Integrating Communication and Navigation: Next Generation Broadcast Service (NGBS)

    NASA Technical Reports Server (NTRS)

    Donaldson, Jennifer

    2017-01-01

    NASA Goddard has been investing in technology demonstrations of a beacon service, now called Next Generation Broadcast Services (NGBS). NGBS is a global, space-based, communications and navigation service for users of Global Navigation Satellite Systems (GNSS) and the Tracking and Data Relay Satellite System (TDRSS). NGBS will provide an S-band beacon messaging source and radio navigation available to users at orbital altitudes 1400 km and below, increasing the autonomy and resiliency of onboard communication and navigation. NGBS will deliver both one-way radiometric (Doppler and pseudorange) and fast forward data transport services to users. Portions of the overall forward data volume will be allocated for fixed message types while the remaining data volume will be left for user forward command data. The NGBS signal will reside within the 2106.43 MHz spectrum currently allocated for the Space Networks multiple access forward (MAF) service and a live service demonstration is currently being planned via the 2nd and 3rd generation TDRS satellites.

  5. Integrated Modeling for Environmental Assessment of Ecosystem Services

    EPA Science Inventory

    The U.S. Environmental Protection Agency uses environmental models to inform rulemaking and policy decisions at multiple spatial and temporal scales. In this study, several sophisticated modeling technologies are seamlessly integrated to facilitate a baseline assessment of the re...

  6. Customer Decision Making in Web Services with an Integrated P6 Model

    NASA Astrophysics Data System (ADS)

    Sun, Zhaohao; Sun, Junqing; Meredith, Grant

    Customer decision making (CDM) is an indispensable factor for web services. This article examines CDM in web services with a novel P6 model, which consists of the 6 Ps: privacy, perception, propensity, preference, personalization and promised experience. This model integrates the existing 6 P elements of marketing mix as the system environment of CDM in web services. The new integrated P6 model deals with the inner world of the customer and incorporates what the customer think during the DM process. The proposed approach will facilitate the research and development of web services and decision support systems.

  7. How vertical integration affects the quantity and cost of care for Medicare beneficiaries.

    PubMed

    Koch, Thomas G; Wendling, Brett W; Wilson, Nathan E

    2017-03-01

    Health systems are employing physicians in growing numbers. The implications of this trend are poorly understood and controversial. We use rich data from the Centers for Medicare and Medicaid Services to examine the effects of a set of physician acquisitions by hospital systems on outpatient utilization and spending. We find that financial integration systematically produces economically large changes in the acquired physicians' behavior, but has less consistent effects at the acquiring system level. Published by Elsevier B.V.

  8. Risk management for optimal land use planning integrating ecosystem services values: A case study in Changsha, Middle China.

    PubMed

    Liang, Jie; Zhong, Minzhou; Zeng, Guangming; Chen, Gaojie; Hua, Shanshan; Li, Xiaodong; Yuan, Yujie; Wu, Haipeng; Gao, Xiang

    2017-02-01

    Land-use change has direct impact on ecosystem services and alters ecosystem services values (ESVs). Ecosystem services analysis is beneficial for land management and decisions. However, the application of ESVs for decision-making in land use decisions is scarce. In this paper, a method, integrating ESVs to balance future ecosystem-service benefit and risk, is developed to optimize investment in land for ecological conservation in land use planning. Using ecological conservation in land use planning in Changsha as an example, ESVs is regarded as the expected ecosystem-service benefit. And uncertainty of land use change is regarded as risk. This method can optimize allocation of investment in land to improve ecological benefit. The result shows that investment should be partial to Liuyang City to get higher benefit. The investment should also be shifted from Liuyang City to other regions to reduce risk. In practice, lower limit and upper limit for weight distribution, which affects optimal outcome and selection of investment allocation, should be set in investment. This method can reveal the optimal spatial allocation of investment to maximize the expected ecosystem-service benefit at a given level of risk or minimize risk at a given level of expected ecosystem-service benefit. Our results of optimal analyses highlight tradeoffs between future ecosystem-service benefit and uncertainty of land use change in land use decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Challenges in researching violence affecting health service delivery in complex security environments.

    PubMed

    Foghammar, Ludvig; Jang, Suyoun; Kyzy, Gulzhan Asylbek; Weiss, Nerina; Sullivan, Katherine A; Gibson-Fall, Fawzia; Irwin, Rachel

    2016-08-01

    Complex security environments are characterized by violence (including, but not limited to "armed conflict" in the legal sense), poverty, environmental disasters and poor governance. Violence directly affecting health service delivery in complex security environments includes attacks on individuals (e.g. doctors, nurses, administrators, security guards, ambulance drivers and translators), obstructions (e.g. ambulances being stopped at checkpoints), discrimination (e.g. staff being pressured to treat one patient instead of another), attacks on and misappropriation of health facilities and property (e.g. vandalism, theft and ambulance theft by armed groups), and the criminalization of health workers. This paper examines the challenges associated with researching the context, scope and nature of violence directly affecting health service delivery in these environments. With a focus on data collection, it considers how these challenges affect researchers' ability to analyze the drivers of violence and impact of violence. This paper presents key findings from two research workshops organized in 2014 and 2015 which convened researchers and practitioners in the fields of health and humanitarian aid delivery and policy, and draws upon an analysis of organizational efforts to address violence affecting healthcare delivery and eleven in-depth interviews with representatives of organizations working in complex security environments. Despite the urgency and impact of violence affecting healthcare delivery, there is an overall lack of research that is of health-specific, publically accessible and comparable, as well as a lack of gender-disaggregated data, data on perpetrator motives and an assessment of the 'knock-on' effects of violence. These gaps limit analysis and, by extension, the ability of organizations operating in complex security environments to effectively manage the security of their staff and facilities and to deliver health services. Increased research

  10. The Allegheny Initiative for Mental Health Integration for the Homeless: Integrating Heterogeneous Health Services for Homeless Persons

    PubMed Central

    Gordon, Adam J.; Montlack, Melissa L.; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

    2007-01-01

    The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment. PMID:17267708

  11. The Allegheny initiative for mental health integration for the homeless: integrating heterogeneous health services for homeless persons.

    PubMed

    Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer

    2007-03-01

    The Allegheny Initiative for Mental Health Integration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioral health agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioral health care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioral health services for homeless persons can occur in a large urban environment.

  12. Bottlenecks and opportunities for delivering integrated pediatric HIV services in Nepal.

    PubMed

    Diese, Mulamba; Shrestha, Lexman; Pradhan, Birendra; Singh, Dipendra; Raaijmakers, Hendrikus; Kisesa, Annefrida; Chamla, Dick; Ntambue, Mukengeshayi Abel

    2016-03-01

    In children, integration of HIV in MNCH services has been shown to incr. ease uptake of early infant diagnosis. This article examines bottlenecks and opportunities for scaling up integrated pediatric HIV services in Nepal. This is a descriptive study using both mixed qualitative and quantitative methods, conducted in January 2015 in 19 facilities in five regions of Nepal most affected by HIV epidemic. The qualitative methods comprised in-depth structured interviews with key informants (leadership of The National Center for AIDS and STD Control and National Public Health Laboratory, district management teams, medical officers in charge of health facilities and HIV clinics, frontline staff at antenatal care and HIV clinics and laboratory). The quantitative methods were used to abstract data of HIV-infected pregnant women seen between January and December 2014, HIV-exposed infants aged less than 12 months, and HIV infected children aged less than 15 years who were initiated HIV treatment from 2010 to 2014. Structured tools were used to collect data which were analysed using IBM SPSS. Of the 19 facilities assessed, 18(98%), 18(98%), 14(75%), and 11(58%) provided prevention of mother-to-child transmission (PMTCT), Expanded Program on Immunization (EPI), pediatric ART and nutrition rehabilitation services, respectively. However, only 1(5%) facility collected onsite dried blood spots (DBS) for PCR HIV testing and 6(32%) facilities provided counselling and referral for DBS. In 2014, of the 121 HIV-exposed infants recorded, only 21(17%) received PCR test. The median turnaround time of the PCR test results was 54 days. Of the 21 records with PCR test, 11(52.5%) were from PMTCT clinics, 7(33%) from Nutritional rehabilitation clinics, and 3(14.5%) from pediatric outpatient clinic.Conversely, 934 children were initiated ART between 2010 and 2014, of which 5% were infants and 29% aged between 1 and 5 years. 298(32%) had comorbidities of which 64% had malnutrition. A total of 534

  13. Integrating home-based medication therapy management (MTM) services in a health system.

    PubMed

    Reidt, Shannon; Holtan, Haley; Stender, Jennifer; Salvatore, Toni; Thompson, Bruce

    2016-01-01

    To describe the integration of home-based Medication Therapy Management (MTM) into the ambulatory care infrastructure of a large urban health system and to discuss the outcomes of this service. Minnesota from September 2012 to December 2013. The health system has more than 50 primary care and specialty clinics. Eighteen credentialed MTM pharmacists are located in 16 different primary care and specialty settings, with the greatest number of pharmacists providing services in the internal medicine clinic. Home-based MTM was promoted throughout the clinics within the health system. Physicians, advanced practice providers, nurses, and pharmacists could refer patients to receive MTM in their homes. A home visit had the components of a clinic-based visit and was documented in the electronic health record (EHR); however, providing the service in the home allowed for a more direct assessment of environmental factors affecting medication use. Number of home MTM referrals, reason for referral and type of referring provider, number and type of medication-related problems (MRPs). In the first 15 months, 74 home visits were provided to 53 patients. Sixty-six percent of the patients were referred from the Internal Medicine Clinic. Referrals were also received from the senior care, coordinated care, and psychiatry clinics. Approximately 50% of referrals were made by physicians. More referrals (23%) were made by pharmacists compared with advanced practice providers, who made 21% of referrals. The top 3 reasons for referral were: nonadherence, transportation barriers, and the need for medication reconciliation with a home care nurse. Patients had a median of 3 MRPs with the most common (40%) MRP related to compliance. Home-based MTM is feasibly delivered within the ambulatory care infrastructure of a health system with sufficient provider engagement as demonstrated by referrals to the service. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All

  14. Patterns of HIV and mental health service integration in New York State.

    PubMed

    Kim, Sunhee; Ades, Marc; Pinho, Veronica; Cournos, Francine; McKinnon, Karen

    2014-01-01

    The Affordable Care Act (ACA) creates incentives to coordinate primary care, mental health (MH) care, and addiction services. Integration of clinical HIV and MH services has been shown to improve quality of life and physical and MH of people living with HIV/AIDS. However, few studies have investigated the practice of service integration systematically. We examined the practice patterns of 515 direct service providers in New York State who received training about HIV MH between May 2010 and July 2012. We sought to identify provider and treatment setting characteristics associated with an integrated spectrum of care. Using factor analysis and linear modeling, we found that patterns of service integration varied by type of health-care setting, service setting location, providers' HIV caseload, and the discipline of the provider describing the direct services. Understanding the existing capacities of clinicians providing care in a variety of settings throughout New York will help to guide staffing and linkage to enhance HIV MH service integration as significant shifts in the organization of health care occur.

  15. One stop shop versus collaborative integration: what is the best way of delivering sexual health services?

    PubMed

    French, R S; Coope, C M; Graham, A; Gerressu, M; Salisbury, C; Stephenson, J M

    2006-06-01

    To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people's services) and explore their relative strengths and weaknesses. Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having "integrated" services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over-centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach.

  16. Early life trauma is associated with altered white matter integrity and affective control.

    PubMed

    Corbo, Vincent; Amick, Melissa A; Milberg, William P; McGlinchey, Regina E; Salat, David H

    2016-08-01

    Early life trauma (ELT) has been shown to impair affective control and attention well into adulthood. Neuroimaging studies have further shown that ELT was associated with decreased white matter integrity in the prefrontal areas in children and adults. However, no study to date has looked at the relationship between white matter integrity and affective control in individuals with and without a history of ELT. To examine this, we tested 240 Veterans with (ELT N = 80) and without (NoELT N = 160) a history of childhood sexual abuse, physical abuse or family violence. Affective control was measured with the Affective Go/No-Go (AGN) and attention was indexed with the Test of Variable Attention (TOVA). White matter integrity was measured using fractional anisotropy (FA). Results showed greater number of errors on the AGN in ELT compared to NoELT. There was no difference on the TOVA. While there were no mean differences in FA, there was an interaction between FA and reaction time to positive stimuli on the AGN where the ELT group showed a positive relationship between FA and reaction time in right frontal and prefrontal areas, whereas the NoELT group showed a negative or no association between FA and reaction time. This suggests that ELT may be associated with a distinct brain-behavior relationship that could be related to other determinants of FA than those present in healthy adults. Published by Elsevier Ltd.

  17. The Impact of Affect on Out-Group Judgments Depends on Dominant Information-Processing Styles: Evidence From Incidental and Integral Affect Paradigms.

    PubMed

    Isbell, Linda M; Lair, Elicia C; Rovenpor, Daniel R

    2016-04-01

    Two studies tested the affect-as-cognitive-feedback model, in which positive and negative affective states are not uniquely associated with particular processing styles, but rather serve as feedback about currently accessible processing styles. The studies extend existing work by investigating (a) both incidental and integral affect, (b) out-group judgments, and (c) downstream consequences. We manipulated processing styles and either incidental (Study 1) or integral (Study 2) affect and measured perceptions of out-group homogeneity. Positive (relative to negative) affect increased out-group homogeneity judgments when global processing was primed, but under local priming, the effect reversed (Studies 1 and 2). A similar interactive effect emerged on attributions, which had downstream consequences for behavioral intentions (Study 2). These results demonstrate that both incidental and integral affect do not directly produce specific processing styles, but rather influence thinking by providing feedback about currently accessible processing styles. © 2016 by the Society for Personality and Social Psychology, Inc.

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

    PubMed

    Coelho, Carla Faustino; O'Farrell, Catherine Commander

    2011-01-01

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

  19. Medicus Deus: a review of factors affecting hospital library services to patients between 1790-1950.

    PubMed

    Perryman, Carol

    2006-07-01

    What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved.

  20. Medicus Deus: a review of factors affecting hospital library services to patients between 1790–1950

    PubMed Central

    Perryman, Carol

    2006-01-01

    Question: What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Data Sources: Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. Study Selection: The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. Data Extraction: An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Main Results: Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. Conclusion: This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved. PMID:16888658

  1. Factors affecting behavior and welfare of service dogs for children with autism spectrum disorder.

    PubMed

    Burrows, Kristen E; Adams, Cindy L; Millman, Suzanne T

    2008-01-01

    The use of service dogs for children with autism spectrum disorder is a relatively new and growing assistance-dog application. The objectives of this article were to identify and describe the factors influencing an autism service dog's performance and the impact of this type of placement on the dog's welfare. A qualitative approach uses interview and observational data to characterize the dogs' behaviors and welfare with relevancy to the dogs' home environments. Identification of potential physical stressors included lack of rest or recovery time after working, unintentional maltreatment and prodding by children with autism, lack of predictability in daily routines, and insufficient opportunities for recreational activities. Results revealed that these dogs formed social relationships primarily with the parents and second with the children with autism. Failure to recognize and respond to the identified physical, emotional, and social needs can have serious impacts on the behavior, welfare, and performance of these autism service dogs, as well as parental satisfaction. As applications of service dogs expand to new domains, there is a need to assess and understand factors and variables affecting the relationship between family and service dog to ensure continued success of these programs.

  2. CAD/CAE Integration Enhanced by New CAD Services Standard

    NASA Technical Reports Server (NTRS)

    Claus, Russell W.

    2002-01-01

    A Government-industry team led by the NASA Glenn Research Center has developed a computer interface standard for accessing data from computer-aided design (CAD) systems. The Object Management Group, an international computer standards organization, has adopted this CAD services standard. The new standard allows software (e.g., computer-aided engineering (CAE) and computer-aided manufacturing software to access multiple CAD systems through one programming interface. The interface is built on top of a distributed computing system called the Common Object Request Broker Architecture (CORBA). CORBA allows the CAD services software to operate in a distributed, heterogeneous computing environment.

  3. Integrating Learning Styles and Personality Traits into an Affective Model to Support Learner's Learning

    NASA Astrophysics Data System (ADS)

    Leontidis, Makis; Halatsis, Constantin

    The aim of this paper is to present a model in order to integrate the learning style and the personality traits of a learner into an enhanced Affective Style which is stored in the learner’s model. This model which can deal with the cognitive abilities as well as the affective preferences of the learner is called Learner Affective Model (LAM). The LAM is used to retain learner’s knowledge and activities during his interaction with a Web-based learning environment and also to provide him with the appropriate pedagogical guidance. The proposed model makes use of an ontological approach in combination with the Bayesian Network model and contributes to the efficient management of the LAM in an Affective Module.

  4. Integrating Different Modes of Inquiry for Pre-Service Teachers

    NASA Astrophysics Data System (ADS)

    Augsburg, Tanya; Acacio de Barros, J.

    At San Francisco State, about half of the students enrolled in Liberal Studies (LS) plan to be elementary school teachers. The LS faculty consists of an anthropologist, a physicist, a geographer, a performance scholar, and a writing composition specialist. Between 2007-2009 the five faculty members developed a curriculum that integrated our areas of expertise and attempted to make students aware of different disciplinary approaches. In this paper, the authors will discuss the changes of curriculum at the Liberal Studies program at San Francisco State University, how we integrated the disciplines, and how we addressed the needs of our students planning to be elementary school teachers.

  5. Applying Semantic Web Services and Wireless Sensor Networks for System Integration

    NASA Astrophysics Data System (ADS)

    Berkenbrock, Gian Ricardo; Hirata, Celso Massaki; de Oliveira Júnior, Frederico Guilherme Álvares; de Oliveira, José Maria Parente

    In environments like factories, buildings, and homes automation services tend to often change during their lifetime. Changes are concerned to business rules, process optimization, cost reduction, and so on. It is important to provide a smooth and straightforward way to deal with these changes so that could be handled in a faster and low cost manner. Some prominent solutions use the flexibility of Wireless Sensor Networks and the meaningful description of Semantic Web Services to provide service integration. In this work, we give an overview of current solutions for machinery integration that combine both technologies as well as a discussion about some perspectives and open issues when applying Wireless Sensor Networks and Semantic Web Services for automation services integration.

  6. LARC2: Integrated Children's Services and the CAF Process

    ERIC Educational Resources Information Center

    Easton, Claire; Morris, Marian; Gee, Geoff

    2010-01-01

    The local authority research consortium (LARC), established in 2007, supports children's service authorities in using and conducting research to evaluate progress, to inform practice, share findings and make recommendations locally and nationally. This summary reports the collective findings of the 24 authorities involved in the LARC2 project…

  7. Integrated Modeling for Watershed Ecosystem Services Assessment and Forecasting

    EPA Science Inventory

    Regional scale watershed management decisions must be informed by the science-based relationship between anthropogenic activities on the landscape and the change in ecosystem structure, function, and services that occur as a result. We applied process-based models that represent...

  8. Incorporating Integrative Health Services in Social Work Education

    ERIC Educational Resources Information Center

    Gant, Larry; Benn, Rita; Gioia, Deborah; Seabury, Brett

    2009-01-01

    More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are…

  9. Integrating forest products with ecosystem services: a global perspective

    Treesearch

    Robert L. Deal; Rachel. White

    2012-01-01

    Around the world forests provide a broad range of vital ecosystem services. Sustainable forest management and forest products play an important role in global carbon management, but one of the major forestry concerns worldwide is reducing the loss of forestland from development. Currently, deforestation accounts for approximately 20% of total greenhouse gas emissions....

  10. OhioLINK: Implementing Integrated Library Services across Institutional Boundaries.

    ERIC Educational Resources Information Center

    Hawks, Carol Pitts

    1995-01-01

    Discusses the implementation of the OhioLINK (Ohio Library and Information Network) system, an integrated library system linking 23 public and private academic institutions and the Ohio State Library. Topics include a history of OhioLINK; organizational structure; decision-making procedures; public relations strategies; cooperative circulation;…

  11. Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

    PubMed

    Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

    2013-10-01

    To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

  12. Can service integration work for universal health coverage? Evidence from around the globe.

    PubMed

    Lê, Gillian; Morgan, Rosemary; Bestall, Janine; Featherstone, Imogen; Veale, Thomas; Ensor, Tim

    2016-04-01

    Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact. We conducted a global review in a systematic manner searching for empirical outcomes of service integration experiments in UHC countries and those on the path to UHC. Sixty-seven articles and reports were found. We grouped results into a unique integration typology with six categories - medical staff from different disciplines; patients and medical staff; care package for one medical condition; care package for two or more medical conditions; specialist stand-alone services with GP services; community locations. We showed that it is possible to integrate services in different human development contexts delivering positive outcomes for patients and clinicians without incurring additional costs. However, the improved outcomes shown were incremental rather than radical and suggest that integration is likely to enhance already well established systems rather than fundamentally changing the outcomes of care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Should violence services be integrated within abortion care? A UK situation analysis.

    PubMed

    Kekana, Loveday Penn; Hall, Megan; Motta, Silvia; Bewley, Susan

    2016-05-01

    The prevalence of violence against women worldwide raises the question of the desirability and feasibility of integrating interpersonal violence (IPV) services within abortion care. By examining present services and context in an Inner London borough in the UK, this situation analysis explored the hypothesis that an established, integrated, health-based service (comprising raised awareness, staff training in routine IPV enquiry and referral to a community-based in-reach IPV service) would be transferable into abortion services. Four sources of qualitative data investigated views on integrating services: key stakeholder in-depth interviews including with providers of abortion and IPV services and commissioners and IPV survivors with past abortion service use (3 user, 15 provider); qualitative analysis of the open-ended part of a survey of current abortion service users with and without experience of IPV; feedback from an interactive workshop and data from field observations. While there was consensus among all informants that women experiencing IPV and seeking abortion have unidentified, unaddressed needs, how any intervention might be organised to address these needs was contested; thus questions remain about whether, when and how to raise the topic of IPV and what to offer. Two major anxieties surfaced: a practical concern in terms of interrupting a streamlined abortion service that suits the majority of staff and patients, and a conceptual concern about risk of stigmatising abortion seekers as 'victims in crisis'. Thus, our findings indicate: when integrating IPV interventions into abortion services, local context, the integrity of separate pathways, and women's safety and agency must be considered, especially when abortion rights are under attack. Novel approaches are required and should be researched. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Integrative Processing of Touch and Affect in Social Perception: An fMRI Study

    PubMed Central

    Ebisch, Sjoerd J. H.; Salone, Anatolia; Martinotti, Giovanni; Carlucci, Leonardo; Mantini, Dante; Perrucci, Mauro G.; Saggino, Aristide; Romani, Gian Luca; Di Giannantonio, Massimo; Northoff, Georg; Gallese, Vittorio

    2016-01-01

    Social perception commonly employs multiple sources of information. The present study aimed at investigating the integrative processing of affective social signals. Task-related and task-free functional magnetic resonance imaging was performed in 26 healthy adult participants during a social perception task concerning dynamic visual stimuli simultaneously depicting facial expressions of emotion and tactile sensations that could be either congruent or incongruent. Confounding effects due to affective valence, inhibitory top–down influences, cross-modal integration, and conflict processing were minimized. The results showed that the perception of congruent, compared to incongruent stimuli, elicited enhanced neural activity in a set of brain regions including left amygdala, bilateral posterior cingulate cortex (PCC), and left superior parietal cortex. These congruency effects did not differ as a function of emotion or sensation. A complementary task-related functional interaction analysis preliminarily suggested that amygdala activity depended on previous processing stages in fusiform gyrus and PCC. The findings provide support for the integrative processing of social information about others’ feelings from manifold bodily sources (sensory-affective information) in amygdala and PCC. Given that the congruent stimuli were also judged as being more self-related and more familiar in terms of personal experience in an independent sample of participants, we speculate that such integrative processing might be mediated by the linking of external stimuli with self-experience. Finally, the prediction of task-related responses in amygdala by intrinsic functional connectivity between amygdala and PCC during a task-free state implies a neuro-functional basis for an individual predisposition for the integrative processing of social stimulus content. PMID:27242474

  15. Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

    PubMed

    Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

    2014-01-01

    We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

  16. Program Collaboration and Service Integration Activities Among HIV Programs in 59 U.S. Health Departments

    PubMed Central

    Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A.; Nesheim, Steven R.

    2014-01-01

    Objectives We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Methods Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. Results HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. Conclusions HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs. PMID:24385647

  17. Beyond "One-Stop" Shopping: An Integrated Service Delivery System for Job Seekers and Employers.

    ERIC Educational Resources Information Center

    Anderson, Richard T.

    The Workforce Development Center (WDC), in Waukesha County, Wisconsin, is a cooperative effort of nine public and private agencies, including the Wisconsin Job Service, the Private Industry Council, and Waukesha County Technical College (WCTC), to provide integrated employment services to area citizens and employers. Located on the WCTC campus,…

  18. Creating a Successful Training Program for Frontline Staff: The University of Minnesota's Integrated Student Services Model

    ERIC Educational Resources Information Center

    Peterson, Heather L.; Otto, Carrie L.

    2011-01-01

    Successfully preparing frontline counseling staff in an integrated student services model is a challenge--one that management staff in One Stop Student Services at the University of Minnesota, Twin Cities (UMTC) have been fine-tuning for almost ten years. The effort has required collaboration across units in a series of trial and error attempts…

  19. Early Childhood Professionals and Inter-Professional Work in Integrated Early Childhood Services in Australia

    ERIC Educational Resources Information Center

    Wong, Sandie; Sumsion, Jennifer; Press, Frances

    2012-01-01

    A growing body of literature argues that integrated services, where a range of professionals including early childhood professionals work together in teams, offer a potentially highly effective strategy for providing families with access to a range of services in a seamless "joined-up" way. Some have cautioned, however, that early…

  20. One stop shop versus collaborative integration: what is the best way of delivering sexual health services?

    PubMed Central

    French, R S; Coope, C M; Graham, A; Gerressu, M; Salisbury, C; Stephenson, J M; Team, and the One‐Stop Shop Evaluation

    2006-01-01

    Objectives To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people's services) and explore their relative strengths and weaknesses. Methods Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). Results The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having “integrated” services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over‐centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. Conclusion Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach. PMID:16731668

  1. Pre-Service Teachers' Self-Efficacy Beliefs towards Educational Technologies Integration in Tanzania

    ERIC Educational Resources Information Center

    Raphael, Christina; Mtebe, Joel S.

    2017-01-01

    This study examines pre-service teachers' (N = 386) self-efficacy beliefs towards educational technologies integration in the classroom at the two colleges in Tanzania that prepare secondary education teachers. Using regression analysis, the study found out that the determinants of self-efficacy beliefs among pre-service teachers towards…

  2. Improving the Work-Integrated Learning Experience through a Third-Party Advisory Service

    ERIC Educational Resources Information Center

    Jackson, Denise; Ferns, Sonia; Rowbottom, David; Mclaren, Diane

    2017-01-01

    This study trialled a Work-Integrated Learning (WIL) Advisory Service, provided by the Chamber of Commerce and Industry of Western Australia (CCIWA) in collaboration with four WA universities. The service was established to broker relationships between industry and universities, support employers engaged in WIL and enhance the WIL experience for…

  3. Hybrid High-Impact Pedagogies: Integrating Service-Learning with Three Other High-Impact Pedagogies

    ERIC Educational Resources Information Center

    Bringle, Robert G.

    2017-01-01

    This article proposes enhancing student learning through civic engagement by considering the advantages of integrating service-learning with study away, research, and internships and pre-professional courses into first-order, second-order, and third-order hybrid high-impact pedagogies. Service-learning contributes numerous attributes to the other…

  4. Integrated semantics service platform for the Internet of Things: a case study of a smart office.

    PubMed

    Ryu, Minwoo; Kim, Jaeho; Yun, Jaeseok

    2015-01-19

    The Internet of Things (IoT) allows machines and devices in the world to connect with each other and generate a huge amount of data, which has a great potential to provide useful knowledge across service domains. Combining the context of IoT with semantic technologies, we can build integrated semantic systems to support semantic interoperability. In this paper, we propose an integrated semantic service platform (ISSP) to support ontological models in various IoT-based service domains of a smart city. In particular, we address three main problems for providing integrated semantic services together with IoT systems: semantic discovery, dynamic semantic representation, and semantic data repository for IoT resources. To show the feasibility of the ISSP, we develop a prototype service for a smart office using the ISSP, which can provide a preset, personalized office environment by interpreting user text input via a smartphone. We also discuss a scenario to show how the ISSP-based method would help build a smart city, where services in each service domain can discover and exploit IoT resources that are wanted across domains. We expect that our method could eventually contribute to providing people in a smart city with more integrated, comprehensive services based on semantic interoperability.

  5. Integrated Semantics Service Platform for the Internet of Things: A Case Study of a Smart Office

    PubMed Central

    Ryu, Minwoo; Kim, Jaeho; Yun, Jaeseok

    2015-01-01

    The Internet of Things (IoT) allows machines and devices in the world to connect with each other and generate a huge amount of data, which has a great potential to provide useful knowledge across service domains. Combining the context of IoT with semantic technologies, we can build integrated semantic systems to support semantic interoperability. In this paper, we propose an integrated semantic service platform (ISSP) to support ontological models in various IoT-based service domains of a smart city. In particular, we address three main problems for providing integrated semantic services together with IoT systems: semantic discovery, dynamic semantic representation, and semantic data repository for IoT resources. To show the feasibility of the ISSP, we develop a prototype service for a smart office using the ISSP, which can provide a preset, personalized office environment by interpreting user text input via a smartphone. We also discuss a scenario to show how the ISSP-based method would help build a smart city, where services in each service domain can discover and exploit IoT resources that are wanted across domains. We expect that our method could eventually contribute to providing people in a smart city with more integrated, comprehensive services based on semantic interoperability. PMID:25608216

  6. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  7. Measuring and Supporting Pre-Service Teachers' Self-Efficacy towards Computers, Teaching, and Technology Integration

    ERIC Educational Resources Information Center

    Killi, Carita; Kauppinen, Merja; Coiro, Julie; Utriainen, Jukka

    2016-01-01

    This paper reports on two studies designed to examine pre-service teachers' self-efficacy beliefs. Study I investigated the measurement properties of a self-efficacy beliefs questionnaire comprising scales for computer self-efficacy, teacher self-efficacy, and self-efficacy towards technology integration. In Study I, 200 pre-service teachers…

  8. Integrated orbital servicing and payloads study. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A study is summarized in which a comparison was made of the following modes of maintaining a satellite system: (1) expendable mode in which failed satellites are replaced, (2) on-orbit servicing where a satellite can be fixed by unmanned module exchange in space, and (3) ground refurbishment in which the satellite is brought back to ground for repairs. It was concluded that on-orbit maintenance is the most cost-effective mode and that it is technically feasible. It can be used to repair failed satellites, to improve reliability of operating satellites, and to update equipment. On-orbit servicing can increase program flexibility and satellite reliability, lifetime, and availability. The significant conclusions and results of two studies are summarized.

  9. Does hearing aid use affect audiovisual integration in mild hearing impairment?

    PubMed

    Gieseler, Anja; Tahden, Maike A S; Thiel, Christiane M; Colonius, Hans

    2018-04-01

    There is converging evidence for altered audiovisual integration abilities in hearing-impaired individuals and those with profound hearing loss who are provided with cochlear implants, compared to normal-hearing adults. Still, little is known on the effects of hearing aid use on audiovisual integration in mild hearing loss, although this constitutes one of the most prevalent conditions in the elderly and, yet, often remains untreated in its early stages. This study investigated differences in the strength of audiovisual integration between elderly hearing aid users and those with the same degree of mild hearing loss who were not using hearing aids, the non-users, by measuring their susceptibility to the sound-induced flash illusion. We also explored the corresponding window of integration by varying the stimulus onset asynchronies. To examine general group differences that are not attributable to specific hearing aid settings but rather reflect overall changes associated with habitual hearing aid use, the group of hearing aid users was tested unaided while individually controlling for audibility. We found greater audiovisual integration together with a wider window of integration in hearing aid users compared to their age-matched untreated peers. Signal detection analyses indicate that a change in perceptual sensitivity as well as in bias may underlie the observed effects. Our results and comparisons with other studies in normal-hearing older adults suggest that both mild hearing impairment and hearing aid use seem to affect audiovisual integration, possibly in the sense that hearing aid use may reverse the effects of hearing loss on audiovisual integration. We suggest that these findings may be particularly important for auditory rehabilitation and call for a longitudinal study.

  10. Cornerstone: Foundational Models and Services for Integrated Battle Planning

    DTIC Science & Technology

    2012-06-01

    Cornerstone’s Plan Management Service also initializes the Plan Repository, a PostgreSQL knowledge base storing all past, current, and potential future...SDB supports a range of underlying SQL database instances for storage; we have demonstrated compatibility with both PostgreSQL and MySQL. The use...CRUDF) • Managed Objects – Request – Task – Mission • Repository – Underlying storage is OWL RDF triples stored in a SQL database • PostgreSQL , MySQL

  11. Evaluating the Early Impact of Integrated Children's Services. Round 1 Summary Report

    ERIC Educational Resources Information Center

    Lord, Pippa; Kinder, Kay; Wilkin, Anne; Atkinson, Mary; Harland, Jennie

    2008-01-01

    In early 2007, at the start of the Local Authorities Research Consortium's (LARC's) first year of work, local authorities (LAs) wanted to know if integration of services was having an impact on outcomes. One year on, the question has become--how can we make integrated working deliver better outcomes faster and more consistently? The shift in…

  12. Service-Learning and Integrated Course Redesign: Principles of Management and the Campus Kitchen Metaproject

    ERIC Educational Resources Information Center

    Flannery, Brenda L.; Pragman, Claudia H.

    2010-01-01

    This article describes the process of redesigning a Principles of Management course to integrate a service-learning metaproject. The metaproject was Campus Kitchen, a food recovery and delivery program operated on a handful of university campuses across the United States. We used L. Dee Fink's integrated course design approach as well as systems…

  13. Integrating Information Services in an Academic Setting: The Organizational and Technical Challenge.

    ERIC Educational Resources Information Center

    Branin, Joseph J.; And Others

    1994-01-01

    The University of Minnesota's Integrated Information Center focused on both technical and organizational integration to bring coherence and unity to support and delivery of information services. After six years, while unexpected progress has been made with end users and technological issues have progressed well, organizational issues continue to…

  14. TPACK Competencies and Technology Integration Self-Efficacy Perceptions of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Keser, Hafize; Karaoglan Yilmaz, Fatma Gizem; Yilmaz, Ramazan

    2015-01-01

    This study compared the technological pedagogical content knowledge (TPACK) competency of pre-service teachers with their self-efficacy perception towards technology integration, based on various variables; and the correlation between their TPACK competencies and self-efficacy perceptions towards technology integration were examined. The study…

  15. Changing Personal Epistemologies in Early Childhood Pre-Service Teachers Using an Integrated Teaching Program

    ERIC Educational Resources Information Center

    Brownlee, Jo; Petriwskyj, Anne; Thorpe, Karen; Stacey, Phillip; Gibson, Megan

    2011-01-01

    This study investigated changes in pre-service teachers' personal epistemologies as they engaged in an integrated teaching program. Personal epistemology refers to individual beliefs about the nature of knowing and knowledge and has been shown to influence teaching practice. An integrated approach to teaching, based on both an "implicit"…

  16. Literacy Enrichment and Technology Integration in Pre-Service Teacher Education

    ERIC Educational Resources Information Center

    Keengwe, Jared, Ed.; Onchwari, Grace, Ed.; Hucks, Darrell, Ed.

    2014-01-01

    With the emergence of innovative technologies, the digital nature of learning environments has changed the face of education. The integration of these technologies into classroom instruction is essential for promoting student learning. "Literacy Enrichment and Technology Integration in Pre-Service Teacher Education" examines the various…

  17. Inquiry of Pre-Service Teachers' Concern about Integrating Web 2.0 into Instruction

    ERIC Educational Resources Information Center

    Hao, Yungwei; Lee, Kathryn S.

    2017-01-01

    To promote technology integration, it is essential to address pre-service teacher (PST) concerns about facilitating technology-enhanced learning environments. This study adopted the Concerns-Based Adoption Model to investigate PST concern on Web 2.0 integration. Four hundred and eighty-nine PSTs in a teacher education university in north Taiwan…

  18. Influencing Factors and Integration of ICT into Teaching Practices of Pre- Service and Starting Teachers

    ERIC Educational Resources Information Center

    Aslan, Aydin; Zhu, Chang

    2016-01-01

    Teachers need to be competent in integrating ICT into education to support teaching and learning process. This study aims to investigate both the pre-service and starting teachers' perceptions for ICT-related variables--perceived ICT competence, perceived competence in ICT integration, attitudes towards ICT, anxiety around ICT usage, external…

  19. Investigating Variables Predicting Turkish Pre-service Teachers' Integration of ICT into Teaching Practices

    ERIC Educational Resources Information Center

    Aslan, Aydin; Zhu, Chang

    2017-01-01

    Pre-service teachers need to acquire information and communications technology (ICT) competency in order to integrate ICT into their teaching practices. This research was conducted to investigate to what extent ICT-related variables--such as perceived ICT competence, perceived competence in ICT integration, attitudes toward ICT, anxiety around ICT…

  20. Structural integrity of materials in nuclear service: a bibliography

    SciTech Connect

    Heddleson, F.A.

    1977-06-07

    This report contains 679 abstracts from the Nuclear Safety Information Center (NSIC) computer file dated 1973 through 1976 covering material properties with respect to structural integrity. All materials important to the nuclear industry (except concrete) are covered for mechanical properties, chemical properties, corrosion, fracture or failure, radiation damage, creep, cracking, and swelling. Keyword, author, and permuted-title indexes are included for the convenience of the user.

  1. How does vineyard management intensity affect ecosystem services and disservices - insights from a meta-analysis

    NASA Astrophysics Data System (ADS)

    Winter, Silvia; Zaller, Johann G.; Kratschmer, Sophie; Pachinger, Bärbel; Strauss, Peter; Bauer, Thomas; Paredes, Daniel; Gómez, José A.; Guzmán, Gema; Landa, Blanca; Nicolai, Annegret; Burel, Francoise; Cluzeau, Daniel; Popescu, Daniela; Bunea, Claudiu-Ioan; Potthoff, Martin; Guernion, Muriel; Batáry, Péter

    2016-04-01

    Viticultural agro-ecosystems provide a range of different ecosystem services which are affected by management decisions of winegrowers. At the global scale, vineyards are often high intensity agricultural systems with bare soil or inter-row vegetation consisting of only a few plant species. These systems primarily aim at optimizing wine production by reducing competition for water and nutrients between grapevines and weeds and by preventing the outbreak of pests and diseases. At the same time, this kind of management is often associated with ecosystem disservices such as high rates of soil erosion, degradation of soil structure and fertility, contamination of groundwater and decline of biodiversity. Recently, several initiatives across the world tried to overcome detrimental effects of that management style by creating biodiversity friendly vineyards. The consequences of establishing divers cover crop mixes or tolerating spontaneous vegetation in vineyards for ecosystem services (including yield) overstretching local case studies has not been investigated yet. This meta-analysis will provide an overview of all published studies comparing the effects of different vineyard management practices on a range of different ecosystem services like biodiversity, pest control, pollination, soil conservation and carbon sequestration. The aggregated effect size will point out which management measures can provide the best overall net sum of ecosystem services. This meta-analysis is part of the transdisciplinary BiodivERsA project VineDivers and will ultimately lead into management and policy recommendations for various stakeholder groups engaged in viticulture.

  2. On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems

    PubMed Central

    García-Valls, Marisol; Touahria, Imad Eddine

    2017-01-01

    Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded

  3. On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems.

    PubMed

    García-Valls, Marisol; Touahria, Imad Eddine

    2017-06-08

    Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability. As a result, the underlying communication backbone is broadly undefined as concerns the enabling software technology (including the middleware) and associated algorithms that meet the ICE requirements of the flexible integration of medical devices and services. Supporting the on line composition of services in a medical system is also not part of ICE; however, supporting this behavior would enable flexible orchestration of functions (e.g., addition and/or removal of services and medical equipment) on the fly. iLandis one of the few software technologies that supports on line service composition and reconfiguration, ensuring time-bounded transitions across different service orchestrations; it supports the design, deployment and on line reconfiguration of applications, which this paper applies to service-based eHealth domains. This paper designs the integration between ICE architecture and iLand middleware to enhance the capabilities of ICE with on line service composition and the time-bounded reconfiguration of medical systems based on distributed services. A prototype implementation of a service-based eHealth system for the remote monitoring of patients is described; it validates the enhanced capacity of ICE to support dynamic reconfiguration of the application services. Results show that the temporal cost of the on line reconfiguration of the eHealth application is bounded

  4. Factors Affecting Quality of Emergency Service in Iran’s Military Hospitals: A Qualitative Study

    PubMed Central

    Zaboli, Rouhollah; Shokri, Mohamad; Javadi, Maryam Seyed; Teymourzadeh, Ehsan; Ameryoun, Ahmad

    2016-01-01

    Introduction Quality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran. Methods This qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis. Results Four basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes. Conclusion The factors affecting the quality of emergency services in Iran’s selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services. PMID:27790355

  5. How did the Canterbury earthquakes affect physiotherapists and physiotherapy services? A qualitative study.

    PubMed

    Mulligan, Hilda; Smith, Catherine M; Ferdinand, Sandy

    2015-03-01

    The recent earthquakes in Canterbury New Zealand ended lives and resulted in disruption to many aspect of life for survivors, including physiotherapists. Physiotherapists often volunteer vital rehabilitation services in the wake of global disasters; however, little is known about how physiotherapists cope with disasters that affect their own communities. The purpose of this study was to investigate how the Canterbury earthquakes affected physiotherapists and physiotherapy services. We use a General Inductive Approach to analyse data obtained from purposively sampled physiotherapists or physiotherapy managers in the Canterbury region. Interviews were audio-recorded and transcribed verbatim. We analysed data from interviews with 27 female and six male participants. We identified four themes: 'A life-changing earthquake' that described how both immediate and on-going events led to our second theme 'Uncertainty'. Uncertainty eroded feelings of resilience, but this was tempered by our third theme 'Giving and receiving support'. Throughout these three themes, we identified a further theme 'Being a physiotherapist'. This theme explains how physiotherapists and physiotherapy services were and still are affected by the Canterbury earthquakes. We recommend that disaster planning occurs at individual, departmental, practice and professional levels. This planning will enable physiotherapists to better cope in the event of a disaster and would help to provide professional bodies with a cohesive set of skills that can be shared with health agencies and rescue organizations. We recommend that the apparently vital skill of listening is explored through further research in order for it to be better accepted as a core physiotherapy skill. Copyright © 2014 John Wiley & Sons, Ltd.

  6. A novel EDA glove based on textile-integrated electrodes for affective computing.

    PubMed

    Lanatà, Antonio; Valenza, Gaetano; Scilingo, Enzo Pasquale

    2012-11-01

    This paper reports on performance evaluation of a preliminary system prototype based on a fabric glove, with integrated textile electrodes placed at the fingertips, able to acquire and process the electrodermal response (EDR) to discriminate affective states. First, textile electrodes have been characterized in terms of voltage-current characteristics and trans-surface electric impedance. Next, signal quality of EDR acquired simultaneously from textile and standard electrodes was comparatively evaluated. Finally, a dedicated experiment in which 35 subjects were enrolled, aiming at discriminating different affective states using only EDR was designed and realized. A new set of features extracted from non-linear methods were used, improving remarkably successful recognition rates. Results are, indeed, very satisfactory and promising in the field of affective computing.

  7. Exercise, Affect, and Adherence: An Integrated Model and a Case for Self-Paced Exercise

    PubMed Central

    Williams, David M.

    2014-01-01

    This paper reviews research relevant to a proposed conceptual model of exercise adherence that integrates the dual mode model and hedonic theory. Exercise intensity is posited to influence affective response to exercise via interoceptive (e.g., ventilatory drive) and cognitive (e.g., perceived autonomy) pathways; affective response to exercise is posited to influence exercise adherence via anticipated affective response to future exercise. The potential for self-paced exercise to enhance exercise adherence is examined in the context of the proposed model and suggestions are given for future research. Further evidence in support of self-paced exercise could have implications for exercise prescription, especially among overweight, sedentary adults, who are most in need of interventions that enhance adherence to exercise programs. PMID:18971508

  8. Evaluation of services of the integrative health clinic in Hong Kong.

    PubMed

    Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S

    2008-10-01

    (i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

  9. Integrating behavioral health services for homeless mothers and children in primary care.

    PubMed

    Weinreb, Linda; Nicholson, Joanne; Williams, Valerie; Anthes, Fran

    2007-01-01

    This article describes an innovative trauma-informed care management model in which mental health, substance abuse, and support services are integrated for homeless families in primary care. The rationale for service integration in a health care setting is discussed and the conceptual underpinnings of the model are elaborated, drawing from the literature and clinical experience. Service encounter data collected by each staff member over a 1-year period (N = 7,214 encounters) allow for description of program functions and provider roles and activities, an essential step in developing the fidelity indicators necessary for future program replication and rigorous testing in additional settings. The feasibility of implementing an integrated set of services for homeless families in primary care is demonstrated. Practice, training, and research implications are discussed.

  10. Integrated Substance Abuse and Child Welfare Services for Women: A Progress Review

    PubMed Central

    Marsh, Jeanne C.; Smith, Brenda D.

    2010-01-01

    A review of empirical literature reveals improvements in service utilization and outcomes for women when substance abuse and child welfare services are integrated. The increased use of substances by women involved in the child welfare system has resulted in a call for integrated, coordinated, evidence-based practices. Since the late 1990s, specific system- and service-level strategies have been developed to coordinate and integrate the provision of substance abuse and child welfare services such that women are remaining in treatment longer and are more likely to reduce substance use and be reunited with their children. The strategies reviewed provide useful guidelines for developing components of effective, evidence-based programs for substance-involved women in the child welfare system. PMID:21499525

  11. Community and health worker perceptions and preferences regarding integration of other health services with routine vaccinations: four case studies.

    PubMed

    Ryman, Tove K; Wallace, Aaron; Mihigo, Richard; Richards, Patricia; Schlanger, Karen; Cappelier, Kelli; Ndiaye, Serigne; Modjirom, Ndoutabe; Tounkara, Baba; Grant, Gavin; Anya, Blanche; Kiawi, Emmanuel C; Ochieng, Cliff; Kone, Sekou; Tesfaye, Habtamu; Trayner, Nathan; Watkins, Margaret; Luman, Elizabeth T

    2012-03-01

    Integration of routine vaccination and other maternal and child health services is becoming more common and the services being integrated more diverse. Yet knowledge gaps remain regarding community members and health workers acceptance, priorities, and concerns related to integration. Qualitative health worker interviews and community focus groups were conducted in 4 African countries (Kenya, Mali, Ethiopia, and Cameroon). Integration was generally well accepted by both community members and health workers. Most integrated services were perceived positively by the communities, although perceptions around socially sensitive services (eg, family planning and human immunodeficiency virus) differed by country. Integration benefits reported by both community members and health workers across countries included opportunity to receive multiple services at one visit, time and transportation cost savings, increased service utilization, maximized health worker efficiency, and reduced reporting requirements. Concerns related to integration included being labor intensive, inadequate staff to implement, inadequately trained staff, in addition to a number of more broad health system issues (eg, stockouts, wait times). Communities generally supported integration, and integrated services may have the potential to increase service utilization and possibly even reduce the stigma of certain services. Some concerns expressed related to health system issues rather than integration, per se, and should be addressed as part of a wider approach to improve health services. Improved planning and patient flow and increasing the number and training of health staff may help to mitigate logistical challenges of integrating services.

  12. Entrepreneurship management in health services: an integrative model.

    PubMed

    Guo, Kristina L

    2006-01-01

    This research develops an integrated systems model of entrepreneurship management as a method for achieving health care organizational survival and growth. Specifically, it analyzes current health care environment challenges, identifies roles of managers and discusses organizational theories that are relevant to the health care environment, outlines the role of entrepreneurship in health care, and describes the entrepreneurial manager in the entrepreneurial management process to produce desirable organizational outcomes. The study concludes that as current health care environment continues to show intense competition, entrepreneurial managers are responsible for creating innovations, managing change, investing in resources, and recognizing opportunities in the environment to increase organizational viability.

  13. An integrative fuzzy Kansei engineering and Kano model for logistics services

    NASA Astrophysics Data System (ADS)

    Hartono, M.; Chuan, T. K.; Prayogo, D. N.; Santoso, A.

    2017-11-01

    Nowadays, customer emotional needs (known as Kansei) in product and especially in services become a major concern. One of the emerging services is the logistics services. In obtaining a global competitive advantage, logistics services should understand and satisfy their customer affective impressions (Kansei). How to capture, model and analyze the customer emotions has been well structured by Kansei Engineering, equipped with Kano model to strengthen its methodology. However, its methodology lacks of the dynamics of customer perception. More specifically, there is a criticism of perceived scores on user preferences, in both perceived service quality and Kansei response, whether they represent an exact numerical value. Thus, this paper is proposed to discuss an approach of fuzzy Kansei in logistics service experiences. A case study in IT-based logistics services involving 100 subjects has been conducted. Its findings including the service gaps accompanied with prioritized improvement initiatives are discussed.

  14. Integrating personal medicine into service delivery: empowering people in recovery.

    PubMed

    MacDonald-Wilson, Kim L; Deegan, Patricia E; Hutchison, Shari L; Parrotta, Nancy; Schuster, James M

    2013-12-01

    Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  15. A Framework for Sharing and Integrating Remote Sensing and GIS Models Based on Web Service

    PubMed Central

    Chen, Zeqiang; Lin, Hui; Chen, Min; Liu, Deer; Bao, Ying; Ding, Yulin

    2014-01-01

    Sharing and integrating Remote Sensing (RS) and Geographic Information System/Science (GIS) models are critical for developing practical application systems. Facilitating model sharing and model integration is a problem for model publishers and model users, respectively. To address this problem, a framework based on a Web service for sharing and integrating RS and GIS models is proposed in this paper. The fundamental idea of the framework is to publish heterogeneous RS and GIS models into standard Web services for sharing and interoperation and then to integrate the RS and GIS models using Web services. For the former, a “black box” and a visual method are employed to facilitate the publishing of the models as Web services. For the latter, model integration based on the geospatial workflow and semantic supported marching method is introduced. Under this framework, model sharing and integration is applied for developing the Pearl River Delta water environment monitoring system. The results show that the framework can facilitate model sharing and model integration for model publishers and model users. PMID:24901016

  16. A framework for sharing and integrating remote sensing and GIS models based on Web service.

    PubMed

    Chen, Zeqiang; Lin, Hui; Chen, Min; Liu, Deer; Bao, Ying; Ding, Yulin

    2014-01-01

    Sharing and integrating Remote Sensing (RS) and Geographic Information System/Science (GIS) models are critical for developing practical application systems. Facilitating model sharing and model integration is a problem for model publishers and model users, respectively. To address this problem, a framework based on a Web service for sharing and integrating RS and GIS models is proposed in this paper. The fundamental idea of the framework is to publish heterogeneous RS and GIS models into standard Web services for sharing and interoperation and then to integrate the RS and GIS models using Web services. For the former, a "black box" and a visual method are employed to facilitate the publishing of the models as Web services. For the latter, model integration based on the geospatial workflow and semantic supported marching method is introduced. Under this framework, model sharing and integration is applied for developing the Pearl River Delta water environment monitoring system. The results show that the framework can facilitate model sharing and model integration for model publishers and model users.

  17. Integrated web system of geospatial data services for climate research

    NASA Astrophysics Data System (ADS)

    Okladnikov, Igor; Gordov, Evgeny; Titov, Alexander

    2016-04-01

    Georeferenced datasets are currently actively used for modeling, interpretation and forecasting of climatic and ecosystem changes on different spatial and temporal scales. Due to inherent heterogeneity of environmental datasets as well as their huge size (up to tens terabytes for a single dataset) a special software supporting studies in the climate and environmental change areas is required. An approach for integrated analysis of georefernced climatological data sets based on combination of web and GIS technologies in the framework of spatial data infrastructure paradigm is presented. According to this approach a dedicated data-processing web system for integrated analysis of heterogeneous georeferenced climatological and meteorological data is being developed. It is based on Open Geospatial Consortium (OGC) standards and involves many modern solutions such as object-oriented programming model, modular composition, and JavaScript libraries based on GeoExt library, ExtJS Framework and OpenLayers software. This work is supported by the Ministry of Education and Science of the Russian Federation, Agreement #14.613.21.0037.

  18. Implementation of a Safer Conception Service for HIV-Affected Couples in South Africa

    PubMed Central

    Schwartz, Sheree R; Bassett, Jean; Sanne, Ian; Phofa, Rebecca; Yende, Nompumelelo; Van Rie, Annelies

    2016-01-01

    Objective To describe the development and implementation of a safer conception service in a resource-limited setting. Methods Qualitative work to inform the design of a safer conception service was conducted with clients and providers at Witkoppen Health and Welfare Centre, a primary health center in Johannesburg, South Africa. Services began in July 2013, for HIV-affected participants planning conception within six months and included counseling about timed unprotected intercourse and home-based self-insemination, early initiation of combined antiretroviral therapy (cART) for HIV-infected individuals, pre-exposure prophylaxis (PrEP) for HIV-uninfected partners and circumcision for men. Participants were enrolled into an implementation science study evaluating method uptake, acceptability, and pregnancy and HIV transmission outcomes. Results Findings to-date from 51 qualitative participants and 128 clinical cohort participants (82 women and 46 men, representing 82 partnerships) are presented. All men were accompanied by female partners, whereas 56% of women attended with their male partner. Fifteen of 46 couples (33%) were in confirmed serodiscordant relationships, however of the 36 additional women attending alone, 56% were unaware of their partners’ HIV status or believed them to be HIV-uninfected. The majority of HIV-infected women (86%) and men (71%) were on cART at enrollment, however only 47% on cART were virally suppressed. Timed unprotected intercourse, self-insemination and cART were common choices for participants; few elected PrEP. Conclusions Lessons learned from early implementation demonstrate feasibility of safer conception services, however reaching discordant couples, cART-naïve infected partners, and men remain challenges. Creating demand for safer conception services among those at highest risk for HIV transmission is necessary. PMID:24991901

  19. Implementation of a safer conception service for HIV-affected couples in South Africa.

    PubMed

    Schwartz, Sheree R; Bassett, Jean; Sanne, Ian; Phofa, Rebecca; Yende, Nompumelelo; Van Rie, Annelies

    2014-07-01

    To describe the development and implementation of a safer conception service in a resource-limited setting. Qualitative work to inform the design of a safer conception service was conducted with clients and providers at Witkoppen Health and Welfare Centre, a primary health center in Johannesburg, South Africa. Services began in July 2013 for HIV-affected participants planning conception within 6 months and included counseling about timed unprotected intercourse and home-based self-insemination, early initiation of combined antiretroviral therapy (cART) for HIV-infected individuals, pre-exposure prophylaxis for HIV-uninfected partners and circumcision for men. Participants were enrolled into an implementation science study evaluating method uptake, acceptability, and pregnancy and HIV transmission outcomes. Findings to-date from 51 qualitative participants and 128 clinical cohort participants (82 women and 46 men, representing 82 partnerships) are presented. All men were accompanied by female partners, whereas 56% of women attended with their male partner. Fifteen of the 46 couples (33%) were in confirmed serodiscordant relationships; however, of the 36 additional women attending alone, 56% were unaware of their partners' HIV status or believed them to be HIV-uninfected. The majority of the HIV-infected women (86%) and men (71%) were on cART at enrollment; however, only 47% on cART were virally suppressed. Timed unprotected intercourse, self-insemination and cART were common choices for participants; few elected pre-exposure prophylaxis. Lessons learned from early implementation demonstrate feasibility of safer conception services; however, reaching discordant couples, cART-naïve infected partners, and men remain challenges. Creating demand for safer conception services among those at highest risk for HIV transmission is necessary.

  20. Integration of sexually transmitted infection (STI) services into HIV care and treatment services for women living with HIV: a systematic review.

    PubMed

    Kennedy, Caitlin E; Haberlen, Sabina A; Narasimhan, Manjulaa

    2017-06-21

    To review and critically appraise the existing evidence on integration of sexually transmitted infection (STI) services into HIV care and treatment services for women living with HIV. Systematic review. Four electronic databases were searched through 16February 2017 using keywords for HIV, STIs and integration. Reference lists of included articles and other reviews were also screened. We included studies that compared women living with HIV who received STI services integrated into HIV care and treatment services with those who received HIV care and treatment services without integrated STI services or standard of care. Of 170 articles identified, 3 studies reported in 4 articles were included. Two studies evaluated comprehensive care for people living with HIV in the UK; in both cases, quality and uptake of STI services seemed to improve following integration. The third study conducted a comparative case study across different models of care in Swaziland: two clinics integrated with sexual and reproductive health services (including STI services), and two stand-alone HIV clinics (without STI services). Coverage for Pap smears among women living with HIV was higher at the fully integrated site, but there was no significant difference in the prevalence of sexual health screening or advice on sexual health. Reported client satisfaction was generally higher at the stand-alone HIV clinic, and a diverse range of factors related to implementation of different care models challenged the notion that integrated services are always superior or desired. While there is a limited evidence base for integrating STI services into HIV care and treatment services, existing studies indicate that integration is feasible and has the potential for positive outcomes. However, diverse population needs and health system factors must be considered when designing models of care to provide STI services to women living with HIV. © Article author(s) (or their employer(s) unless otherwise stated

  1. Do positive affectivity and boundary preferences matter for work-family enrichment? A study of human service workers.

    PubMed

    McNall, Laurel A; Scott, Lindsay D; Nicklin, Jessica M

    2015-01-01

    More individuals than ever are managing work and family roles, but relatively little research has been done exploring whether boundary preferences help individuals benefit from multiple role memberships. Drawing on Greenhaus and Powell's (2006) work-family enrichment theory, along with Boundary Theory (Ashforth, Kreiner, & Fugate, 2000) and Conservation of Resources Theory (Hobfoll, 2002), we explore the impact of personal characteristics as enablers of work-family enrichment, and in turn, work outcomes relevant to human service workers: turnover intentions and emotional exhaustion. In a 2-wave study of 161 human service employees, we found that individuals high in positive affectivity were more likely to experience both work-to-family and family to-work enrichment, whereas those with preferences toward integration were more likely to experience work-to-family enrichment (but not family to-work enrichment). In turn, work-to-family enrichment (but not family to-work enrichment) was related to lower turnover intentions and emotional exhaustion. Enrichment served as a mediating mechanism for only some of the hypothesized relationships. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  2. Information Systems Integration and Enterprise Application Integration (EAI) Adoption: A Case from Financial Services

    ERIC Educational Resources Information Center

    Lam, Wing

    2007-01-01

    Increasingly, organizations find that they need to integrate large number of information systems in order to support enterprise-wide business initiatives such as e-business, supply chain management and customer relationship management. To date, organizations have largely tended to address information systems (IS) integration in an ad-hoc manner.…

  3. HIV and family planning service integration and voluntary HIV counselling and testing client composition in Ethiopia.

    PubMed

    Bradley, H; Bedada, A; Tsui, A; Brahmbhatt, H; Gillespie, D; Kidanu, A

    2008-01-01

    Integrating voluntary HIV counselling and testing (VCT) with family planning and other reproductive health services may be one effective strategy for expanding VCT service delivery in resource poor settings. Using 30,257 VCT client records with linked facility characteristics from Ethiopian non-governmental, non-profit, reproductive health clinics, we constructed multi-level logistic regression models to examine associations between HIV and family planning service integration modality and three outcomes: VCT client composition, client-initiated HIV testing and client HIV status. Associations between facility HIV and family planning integration level and the likelihood of VCT clients being atypical family planning client-types, versus older (at least 25 years old), ever-married women were assessed. Relative to facilities co-locating services in the same compound, those offering family planning and HIV services in the same rooms were 2-13 times more likely to serve atypical family planning client-types than older, ever-married women. Facilities where counsellors jointly offered HIV and family planning services and served many repeat family planning clients were significantly less likely to serve single clients relative to older, married women. Younger, single men and older, married women were most likely to self-initiate HIV testing (78.2 and 80.6% respectively), while the highest HIV prevalence was seen among older, married men and women (20.5 and 34.2% respectively). Compared with facilities offering co-located services, those integrating services at room- and counsellor-levels were 1.9-7.2 times more likely to serve clients initiating HIV testing. These health facilities attract both standard material and child health (MCH) clients, who are at high risk for HIV in these data, and young, single people to VCT. This analysis suggests that client types may be differentially attracted to these facilities depending on service integration modality and other facility

  4. Integrating neotropical migratory birds into Forest Service plans for ecosystem management

    Treesearch

    Deborah M. Finch; William M. Block; Reg A. Fletcher; Leon F. Fager

    1993-01-01

    The USDA Forest Service is undergoing a major change in focus in response to public interests, growing concern for sustaining natural resources, and new knowledge about wildlife, fisheries, forests and grasslands, and how they interact at the ecosystem level. This shift in direction affects how Forest Service lands are managed, what research is conducted, how resource...

  5. Delivering post-rape care services: Kenya’s experience in developing integrated services

    PubMed Central

    Theobald, SJ; Nyamato, E; Ajema, C; Muchela, H; Kibaru, J; Rogena, E; Taegtmeyer, M

    2009-01-01

    Abstract Problem Comprehensive service delivery models for providing post-rape care are largely from resource-rich countries and do not translate easily to resource-limited settings such as Kenya, despite an identified need and high rates of sexual violence and HIV. Approach Starting in 2002, we undertook to work through existing governmental structures to establish and sustain health sector services for survivors of sexual violence. Local setting In 2003 there was a lack of policy, coordination and service delivery mechanisms for post-rape care services in Kenya. Post-exposure prophylaxis against HIV infection was not offered. Relevant changes A standard of care and a simple post-rape care systems algorithm were designed. A counselling protocol was developed. Targeted training that was knowledge-, skills- and values-based was provided to clinicians, laboratory personnel and trauma counsellors. The standard of care included clinical evaluation and documentation, clinical management, counselling and referral mechanisms. Between early 2004 and the end of 2007, a total of 784 survivors were seen in the three centres at an average cost of US$ 27, with numbers increasing each year. Almost half (43%) of these were children less than 15 years of age. Lessons learned This paper describes how multisectoral teams at district level in Kenya agreed that they would provide post-exposure prophylaxis, physical examination, sexually transmitted infection and pregnancy prevention services. These services were provided at casualty departments as well as through voluntary HIV counselling and testing sites. The paper outlines which considerations they took into account, who accessed the services and how the lessons learned were translated into national policy and the scale-up of post-rape care services through the key involvement of the Division of Reproductive Health. PMID:19649371

  6. The National Digital Information Infrastructure Preservation Program; Metadata Principles and Practicalities; Challenges for Service Providers when Importing Metadata in Digital Libraries; Integrated and Aggregated Reference Services.

    ERIC Educational Resources Information Center

    Friedlander, Amy; Duval, Erik; Hodgins, Wayne; Sutton, Stuart; Weibel, Stuart L.; McClelland, Marilyn; McArthur, David; Giersch, Sarah; Geisler, Gary; Hodgkin, Adam

    2002-01-01

    Includes 6 articles that discuss the National Digital Information Infrastructure Preservation Program at the Library of Congress; metadata in digital libraries; integrated reference services on the Web. (LRW)

  7. More than what the eye can see: the emotional journey and experience of powerlessness of integrated care service users and their carers

    PubMed Central

    Boudioni, Markella; Hallett, Nina; Lora, Cristina; Couchman, Wendy

    2015-01-01

    Purpose This article presents the emotional journey and experience of powerlessness of integrated care service users and carers. Materials and methods The experiences of seven integrated care service users and carers affected by complex conditions in a London borough were captured as video stories. The integrated care service coordinated a system of health and social care: primary care, community matrons, social workers, and the voluntary sector. The service was designed to respond to identified cases of high-risk individuals with long-term, multiple, and age-related conditions needing preventive interventions. The video stories were analyzed by researchers in collaboration with service users using a visual thematic qualitative approach. This report is part of an independent analysis of the integrated care service evaluation that used the experience-based codesign model. Results The findings are presented in the respective contexts of people with complex conditions and their carers. The overwhelming feelings and emotions of both were loss of control and power throughout their emotional journey, with family carers adopting a protective attitude toward the patients. Their experience of powerlessness was variable throughout their emotional journey. They were affected more strongly when in need of extra help and support and while they were undergoing the process of receiving extra services. When they were receiving help and support outside and within hospitals, some participants were empowered, gaining skills and knowledge by being provided with the mechanisms to cope with their condition at present and in the future. Conclusion Feelings of powerlessness were very common among integrated care service users and their carers. Powerless/empowerment has been poorly investigated to date. Visual methods and collaborative visual analysis with service users have proved to be powerful methods too, but have been rarely reported. PMID:25848232

  8. Assessing the legacy of a legislative Workgroup for bidirectional integration of services.

    PubMed

    Sanchez, Katherine; Frost, Lynda E; Held, Mary Lehman

    2014-10-01

    Across the USA, health care systems are recognizing the value of integrating behavioral health services and primary care. The Texas Legislature took a unique approach to integration, passing legislation creating a Workgroup to explore key issues, identify best practices, and recommend policy and practice changes. This article situates the Workgroup in a rapidly evolving policy environment, describing the passage of integrated health care legislation in Texas, the Integration of Health and Behavioral Health Services Workgroup that was created by the legislation, and the policy recommendations that emerged from the Workgroup. The article analyzes how the Workgroup process intersected with a changing policy environment in Texas and nationally, opening the door for essential collaboration and partnership. The Workgroup ultimately laid the groundwork for integration's key role in a comprehensive Medicaid transformation waiver designed to expand access, improve population health and satisfaction with treatment, while better managing costs.

  9. Delivering HIV services in partnership: factors affecting collaborative working in a South African HIV programme.

    PubMed

    Jobson, Geoffrey A; Grobbelaar, Cornelis J; Mabitsi, Moyahabo; Railton, Jean; Peters, Remco P H; McIntyre, James A; Struthers, Helen E

    2017-01-13

    The involvement of Global Health Initiatives (GHIs) in delivering health services in low and middle income countries (LMICs) depends on effective collaborative working at scales from the local to the international, and a single GHI is effectively constructed of multiple collaborations. Research is needed focusing on how collaboration functions in GHIs at the level of health service management. Here, collaboration between local implementing agencies and departments of health involves distinct power dynamics and tensions. Using qualitative data from an evaluation of a health partnership in South Africa, this article examines how organisational power dynamics affected the operation of the partnership across five dimensions of collaboration: governance, administration, organisational autonomy, mutuality, and norms of trust and reciprocity. Managing the tension between the power to provide resources held by the implementing agency and the local Departments' of Health power to access the populations in need of these resources proved critical to ensuring that the collaboration achieved its aims and shaped the way that each domain of collaboration functioned in the partnership. These findings suggest that it is important for public health practitioners to critically examine the ways in which collaboration functions across the scales in which they work and to pay particular attention to how local power dynamics between partner organisations affect programme implementation.

  10. A Platform for Mobile Service Provisioning Based on SOA-Integration

    NASA Astrophysics Data System (ADS)

    Decker, Michael; Bulander, Rebecca

    A middleware platform designed for the provisioning of data services for mobile computers using wireless data communication (e.g. smartphones or PDAs) has to offer a variety of different features. Some of these features have to be provided by external parties, e.g. billing or content syndication. The integration of all these features while considering mobile-specific challenges is a demanding task. In the article at hand we thus describe a middleware platform for mobile services which follows the idea of a so called Enterprise Service Bus (ESB). We explain the concept of ESB and argue why an ESB is an appropriate fundament for a platform for mobile service provisioning.

  11. Model establishing and performance analysis of service stratum traffic in the integrated sensing network

    NASA Astrophysics Data System (ADS)

    Ge, Zhiqun; Wang, Ying; Zhang, Xiaolu; Zheng, Yu; Zhao, Xinqun; Sun, Xiaohan

    2017-01-01

    We propose a time-division hybrid-user data flow model scheme based on semi-Markov state-transition algorithm for multiclass business and service in Integrated Sensing Network (ISN). Two typical flow models, visual sense and auditory sense service models, are set up due to the real situation of service stratum traffic, respectively. The experimental system based on the Asynchronous Optical Packet Switching (AOPS) network simulation platform is established for the feasibility of the proposed data flow model. The results show that the proposed models achieve reasonable packet loss rate and delay time in the case of different business and service levels.

  12. Integrating postabortion care, menstrual regulation and family planning services in Bangladesh: a pre-post evaluation.

    PubMed

    Biswas, Kamal K; Pearson, Erin; Shahidullah, S M; Sultana, Sharmin; Chowdhury, Rezwana; Andersen, Kathryn L

    2017-03-11

    In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients whose procedures are often performed using sub-optimal uterine evacuation technology and typically do not receive postabortion contraceptive services. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care. A pre-post evaluation was conducted in the six large intervention facilities. Structured client exit interviews were administered to all uterine evacuation clients presenting in the 2-week data collection period for each facility at baseline (n = 105; December 2011-January 2012) and endline (n = 107; February-March 2013). Primary outcomes included service integration indicators such as provision of menstrual regulation, postabortion care and family planning services in both facility types, and quality of care indicators such as provision of pain management, provider communication and women's satisfaction with the services received. Outcomes were compared between baseline and endline for Directorate General of Family Planning and Directorate General of Health Services facilities, and chi-square tests and t-tests were used to test for differences between baseline and endline. At the end of the project there was an increase in menstrual

  13. Towards More Nuanced Classification of NGOs and Their Services to Improve Integrated Planning across Disaster Phases

    PubMed Central

    Towe, Vivian L.; Acosta, Joie D.; Chandra, Anita

    2017-01-01

    Nongovernmental organizations (NGOs) are being integrated into U.S. strategies to expand the services that are available during health security threats like disasters. Identifying better ways to classify NGOs and their services could optimize disaster planning. We surveyed NGOs about the types of services they provided during different disaster phases. Survey responses were used to categorize NGO services as core—critical to fulfilling their organizational mission—or adaptive—services implemented during a disaster based on community need. We also classified NGOs as being core or adaptive types of organizations by calculating the percentage of each NGO’s services classified as core. Service types classified as core were mainly social services, while adaptive service types were those typically relied upon during disasters (e.g., warehousing, food services, etc.). In total, 120 NGOs were classified as core organizations, meaning they mainly provided the same services across disaster phases, while 100 NGOs were adaptive organizations, meaning their services changed. Adaptive NGOs were eight times more likely to report routinely participating in disaster planning as compared to core NGOs. One reason for this association may be that adaptive NGOs are more aware of the changing needs in their communities across disaster phases because of their involvement in disaster planning. PMID:29160810

  14. Towards More Nuanced Classification of NGOs and Their Services to Improve Integrated Planning across Disaster Phases.

    PubMed

    Towe, Vivian L; Acosta, Joie D; Chandra, Anita

    2017-11-21

    Nongovernmental organizations (NGOs) are being integrated into U.S. strategies to expand the services that are available during health security threats like disasters. Identifying better ways to classify NGOs and their services could optimize disaster planning. We surveyed NGOs about the types of services they provided during different disaster phases. Survey responses were used to categorize NGO services as core -critical to fulfilling their organizational mission-or adaptive -services implemented during a disaster based on community need. We also classified NGOs as being core or adaptive types of organizations by calculating the percentage of each NGO's services classified as core. Service types classified as core were mainly social services, while adaptive service types were those typically relied upon during disasters (e.g., warehousing, food services, etc.). In total, 120 NGOs were classified as core organizations, meaning they mainly provided the same services across disaster phases, while 100 NGOs were adaptive organizations, meaning their services changed. Adaptive NGOs were eight times more likely to report routinely participating in disaster planning as compared to core NGOs. One reason for this association may be that adaptive NGOs are more aware of the changing needs in their communities across disaster phases because of their involvement in disaster planning.

  15. Development and application of a method for quantifying factors affecting chloramine decay in service reservoirs.

    PubMed

    Sathasivan, Arumugam; Krishna, K C Bal; Fisher, Ian

    2010-08-01

    Service reservoirs play an important role in maintaining water quality in distribution systems. Several factors affect the reservoir water quality, including bulk water reactions, stratification, sediment accumulation and wall reactions. It is generally thought that biofilm and sediments can harbour microorganisms, especially in chloraminated reservoirs, but their impact on disinfectant loss on disinfectant loss has not been quantified. Hence, debate exists as to the extent of the problem. To quantify the impact, the reservoir acceleration factor (F(Ra)) is defined. This factor represents the acceleration of chloramine decay arising from all causes, including changes in retention time, assuming that the reservoir is completely mixed. Such an approach quantifies the impact of factors, other than chemical reactions, in the bulk water. Data from three full-scale chloraminated service reservoirs in distribution systems of Sydney, Australia, were analysed to demonstrate the generality of the method. Results showed that in two large service reservoirs (404 x 10(3) m(3) and 82 x 10(3) m(3)) there was minimal impact from biofilm/sediment. However, in a small reservoir (3 x 10(3) m(3)), the biofilm/sediment had significant impact. In both small and large reservoirs, the effect of stratification was significant. (c) 2010 Elsevier Ltd. All rights reserved.

  16. Health Systems Integration of Sexual and Reproductive Health and HIV Services in Sub-Saharan Africa: A Scoping Study

    PubMed Central

    Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-01-01

    Objective: Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. Methods: We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. Results: The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Conclusions: Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery. PMID:25436826

  17. Health systems integration of sexual and reproductive health and HIV services in sub-Saharan Africa: a scoping study.

    PubMed

    Hope, Rebecca; Kendall, Tamil; Langer, Ana; Bärnighausen, Till

    2014-12-01

    Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. We examined the literature on national and international strategies to integrate SRH and HIV services using a scoping study methodology. Current policy frameworks, national HIV strategies and research, and gray literature on integration were mapped. Five countries in sub-Saharan Africa with experience of integrating SRH and HIV services were purposively sampled for detailed thematic analysis, according to the health systems functions of governance, policy and planning, financing, health workforce organization, service organization, and monitoring and evaluation. The major international health policies and donor guidance now support integration. Most integration research has focused on linkages of SRH and HIV front-line services. Yet, the common problems with implementation are related to delayed or incomplete integration of higher level health systems functions: lack of coordinated leadership and unified national integration policies; separate financing streams for SRH and HIV services and inadequate health worker training, supervision and retention. Rigorous health systems research on the integration of SRH and HIV services is urgently needed. Priority research areas include integration impact, performance, and economic evaluation to inform the planning, financing, and coordination of integrated service delivery.

  18. ARTIE: An Integrated Environment for the Development of Affective Robot Tutors.

    PubMed

    Imbernón Cuadrado, Luis-Eduardo; Manjarrés Riesco, Ángeles; De La Paz López, Félix

    2016-01-01

    Over the last decade robotics has attracted a great deal of interest from teachers and researchers as a valuable educational tool from preschool to highschool levels. The implementation of social-support behaviors in robot tutors, in particular in the emotional dimension, can make a significant contribution to learning efficiency. With the aim of contributing to the rising field of affective robot tutors we have developed ARTIE (Affective Robot Tutor Integrated Environment). We offer an architectural pattern which integrates any given educational software for primary school children with a component whose function is to identify the emotional state of the students who are interacting with the software, and with the driver of a robot tutor which provides personalized emotional pedagogical support to the students. In order to support the development of affective robot tutors according to the proposed architecture, we also provide a methodology which incorporates a technique for eliciting pedagogical knowledge from teachers, and a generic development platform. This platform contains a component for identiying emotional states by analysing keyboard and mouse interaction data, and a generic affective pedagogical support component which specifies the affective educational interventions (including facial expressions, body language, tone of voice,…) in terms of BML (a Behavior Model Language for virtual agent specification) files which are translated into actions of a robot tutor. The platform and the methodology are both adapted to primary school students. Finally, we illustrate the use of this platform to build a prototype implementation of the architecture, in which the educational software is instantiated with Scratch and the robot tutor with NAO. We also report on a user experiment we carried out to orient the development of the platform and of the prototype. We conclude from our work that, in the case of primary school students, it is possible to identify, without

  19. ARTIE: An Integrated Environment for the Development of Affective Robot Tutors

    PubMed Central

    Imbernón Cuadrado, Luis-Eduardo; Manjarrés Riesco, Ángeles; De La Paz López, Félix

    2016-01-01

    Over the last decade robotics has attracted a great deal of interest from teachers and researchers as a valuable educational tool from preschool to highschool levels. The implementation of social-support behaviors in robot tutors, in particular in the emotional dimension, can make a significant contribution to learning efficiency. With the aim of contributing to the rising field of affective robot tutors we have developed ARTIE (Affective Robot Tutor Integrated Environment). We offer an architectural pattern which integrates any given educational software for primary school children with a component whose function is to identify the emotional state of the students who are interacting with the software, and with the driver of a robot tutor which provides personalized emotional pedagogical support to the students. In order to support the development of affective robot tutors according to the proposed architecture, we also provide a methodology which incorporates a technique for eliciting pedagogical knowledge from teachers, and a generic development platform. This platform contains a component for identiying emotional states by analysing keyboard and mouse interaction data, and a generic affective pedagogical support component which specifies the affective educational interventions (including facial expressions, body language, tone of voice,…) in terms of BML (a Behavior Model Language for virtual agent specification) files which are translated into actions of a robot tutor. The platform and the methodology are both adapted to primary school students. Finally, we illustrate the use of this platform to build a prototype implementation of the architecture, in which the educational software is instantiated with Scratch and the robot tutor with NAO. We also report on a user experiment we carried out to orient the development of the platform and of the prototype. We conclude from our work that, in the case of primary school students, it is possible to identify, without

  20. Involvement of Right STS in Audio-Visual Integration for Affective Speech Demonstrated Using MEG

    PubMed Central

    Hagan, Cindy C.; Woods, Will; Johnson, Sam; Green, Gary G. R.; Young, Andrew W.

    2013-01-01

    Speech and emotion perception are dynamic processes in which it may be optimal to integrate synchronous signals emitted from different sources. Studies of audio-visual (AV) perception of neutrally expressed speech demonstrate supra-additive (i.e., where AV>[unimodal auditory+unimodal visual]) responses in left STS to crossmodal speech stimuli. However, emotions are often conveyed simultaneously with speech; through the voice in the form of speech prosody and through the face in the form of facial expression. Previous studies of AV nonverbal emotion integration showed a role for right (rather than left) STS. The current study therefore examined whether the integration of facial and prosodic signals of emotional speech is associated with supra-additive responses in left (cf. results for speech integration) or right (due to emotional content) STS. As emotional displays are sometimes difficult to interpret, we also examined whether supra-additive responses were affected by emotional incongruence (i.e., ambiguity). Using magnetoencephalography, we continuously recorded eighteen participants as they viewed and heard AV congruent emotional and AV incongruent emotional speech stimuli. Significant supra-additive responses were observed in right STS within the first 250 ms for emotionally incongruent and emotionally congruent AV speech stimuli, which further underscores the role of right STS in processing crossmodal emotive signals. PMID:23950977

  1. Feature binding and affect: emotional modulation of visuo-motor integration.

    PubMed

    Colzato, Lorenza S; van Wouwe, Nelleke C; Hommel, Bernhard

    2007-01-28

    The primate cortex represents the external world in a distributed fashion, which calls for a mechanism that integrates and binds the features of a perceived or processed event. Animal and patients studies provide evidence that feature binding in the visual cortex is driven by the muscarinic-cholinergic system, whereas visuo-motor integration may be under dopaminergic control. Consistent with this scenario, we present indication that the binding of visual and action features is modulated by emotions through the probable stimulation of the dopaminergic system. Interestingly, the impact of emotions on binding was restricted to tasks in which shape was task-relevant, suggesting that extracting affective information is not automatic but requires attention to shape.

  2. TLC surface integrity affects the detection of alkali adduct ions in TLC-MALDI analysis.

    PubMed

    Dong, Yonghui; Ferrazza, Ruggero; Anesi, Andrea; Guella, Graziano; Franceschi, Pietro

    2017-09-01

    Direct coupling of thin-layer chromatography (TLC) with matrix-assisted laser desorption ionization (MALDI) mass spectrometry allows fast and detailed characterization of a large variety of analytes. The use of this technique, however, presents great challenges in semiquantitative applications because of the complex phenomena occurring at the TLC surface. In our laboratory, we recently observed that the ion intensities of several alkali adduct ions were significantly different between the top and interior layer of the TLC plate. This indicates that the integrity of the TLC surface can have an important effect on the reproducibility of TLC- MALDI analyses. Graphical Abstract MALDI imaging reveals that surface integrity affects the detection of alkali adductions in TLC-MALDI.

  3. The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation

    PubMed Central

    2011-01-01

    Background The complexity and inter-related nature of biological data poses a difficult challenge for data and tool integration. There has been a proliferation of interoperability standards and projects over the past decade, none of which has been widely adopted by the bioinformatics community. Recent attempts have focused on the use of semantics to assist integration, and Semantic Web technologies are being welcomed by this community. Description SADI - Semantic Automated Discovery and Integration - is a lightweight set of fully standards-compliant Semantic Web service design patterns that simplify the publication of services of the type commonly found in bioinformatics and other scientific domains. Using Semantic Web technologies at every level of the Web services "stack", SADI services consume and produce instances of OWL Classes following a small number of very straightforward best-practices. In addition, we provide codebases that support these best-practices, and plug-in tools to popular developer and client software that dramatically simplify deployment of services by providers, and the discovery and utilization of those services by their consumers. Conclusions SADI Services are fully compliant with, and utilize only foundational Web standards; are simple to create and maintain for service providers; and can be discovered and utilized in a very intuitive way by biologist end-users. In addition, the SADI design patterns significantly improve the ability of software to automatically discover appropriate services based on user-needs, and automatically chain these into complex analytical workflows. We show that, when resources are exposed through SADI, data compliant with a given ontological model can be automatically gathered, or generated, from these distributed, non-coordinating resources - a behaviour we have not observed in any other Semantic system. Finally, we show that, using SADI, data dynamically generated from Web services can be explored in a manner

  4. Integrating Negative Affect Measures in a Measurement Model: Assessing the Function of Negative Affect as Interference to Self-Regulation

    ERIC Educational Resources Information Center

    Magno, Carlo

    2010-01-01

    The present study investigated the composition of negative affect and its function as inhibitory to thought processes such as self-regulation. Negative affect in the present study were composed of anxiety, worry, thought suppression, and fear of negative evaluation. These four factors were selected based on the criteria of negative affect by…

  5. Integration of prevention of mother-to-child HIV transmission into maternal health services in Senegal.

    PubMed

    Cisse, C

    2017-06-01

    The objective of this study was to assess the level of integration of prevention of mother-to-child HIV transmission (PMTCT) in facilities providing services for maternal, newborn, and child health (MNCH) and reproductive health (RH) in Senegal. The survey, conducted from August through November, 2014, comprised five parts : a literature review to assess the place of this integration in the health policies, standards, and protocols in effect in Senegal; an analysis by direct observation of attitudes and practices of 25 healthcare providers at 5 randomly-selected obstetrics and gynecology departments representative of different levels of the health pyramid; a questionnaire evaluating knowledge and attitudes of 10 providers about the integration of PMTCT services into MNCH/RH facilities; interviews to collect the opinions of 70 clients, including 16 HIV-positive, about the quality of PMTCT services they received; and a questionnaire evaluating knowledge and opinions of 14 policy-makers/managers of health programs focusing on mothers and children about this integration. The literature review revealed several constraints impeding this integration : the policy documents, standards, and protocols of each of the programs involved do not clearly indicate the modalities of this integration; the programs are housed in two different divisions while the national Program against the Human Immunodeficiency Virus reports directly to the Prime Minister; program operations remains generally vertical; the resources for the different programs are not sufficiently shared; there is no integrated training module covering integrated management of pregnancy and delivery; and supervision for each of the different programs is organized separately.The observation of the providers supporting women during pregnancy, during childbirth, and in the postpartum period, showed an effort to integrate PMTCT into the MNCH/RH services delivered daily to clients. But this desire is hampered by many

  6. Associations between level of services integration and nurses' workplace well-being.

    PubMed

    Longpré, Caroline; Dubois, Carl-Ardy; Nguemeleu, Eric Tchouaket

    2014-01-01

    To respond better to population needs, in recent years Quebec has invested in improving the integration of services and care pathways. Nurses are on the front lines of these transformation processes, which require them to adopt new clinical practices. This updating of practices can be a source of both satisfaction and stress. The aim of this study was to gain a better understanding of the relationship between the transformation processes underlying services integration and nurses' workplace well-being. This study was based on a descriptive cross-sectional correlational design. The target population included all nurses working in four care pathways in a Quebec healthcare establishment: palliative oncology services, mental health services, autonomy support for the elderly, and chronic obstructive pulmonary disease. In all, 107 nurses took part in the study and completed a questionnaire sent to them. Hierarchical linear regression analyses were used to examine the relationship between level of integration, measured using the Development Model for Integrated Care; nurses' perceptions of organizational change, measured on four dimensions (challenge, responsibility, threat, control); and nurses' workplace well-being, measured on three dimensions (negative stress, positive stress, satisfaction), as defined by the Flexihealth model. Nurses in the palliative oncology care pathway, which was at a more advanced level of integration, presented a lower negative stress level and a higher positive stress level than did nurses in other care pathways. Their mean satisfaction score was also higher. More advanced integration was associated with nurses' feeling less threatened, as well as improved workplace well-being. The perception of threat appeared to be a significant mediating variable in the relationship between level of integration and well-being. The association observed between level of services integration and workplace well-being contributes to a better understanding of

  7. Factors affecting utilization of youth friendly health services in Lagos State, Nigeria.

    PubMed

    Femi-Adebayo, Toriola Temitope; Kuyinu, Yetunde; Adejumo, Olusola Adedeji; Goodman, Olayinka

    2017-09-15

    Background Youth friendly health services (YFHS) are services that attract, respond to the needs of and retain young people for continuing care. This study was conducted to determine the factors affecting utilization of government (GYFF) and non-governmental youth friendly facilities (NGYFF) in Lagos state, Nigeria. Methods A descriptive cross-sectional study was conducted. A total of 543 adolescents aged 15-24 years, between August 1, 2014 and October 31, 2014 were consecutively recruited from 10 (five government and five non-governmental) youth friendly health facilities that had been in operation for at least 6 months prior to the study. Logistic regression was used to determine predictors of utilization of youth friendly health facilities. Results Overall, the mean age of respondents was 17.9 ± 2.8. However, the mean age of respondents at GYFF (18.5 ± 3.0) was significantly higher than those at NGYFF (17.1 ± 2.5) (p < 0.001). Of the 567 youths enrolled, 196 (34.6%) had good utilization of youth friendly facilities (YFF) (34% from the GYFF and 35.2% from the NGYFF). Marital status, school attendance, having a baby, satisfaction with visit, perception that information shared was kept confidential and accessibility of the youth friendly services were associated with utilization of YFF (p < 0.05). Confidentiality and access to facilities were predictors of utilization of YFF. Conclusion There is poor utilization of both government and non-governmental youth friendly services in Lagos, Nigeria. There is a need for both the government and private sector to harmonize resources aimed at encouraging utilization of YFF in Lagos, Nigeria.

  8. Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

    PubMed

    Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

    2017-08-31

    The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

  9. Addressing the Medical and Support Service Needs of People Living with HIV (PLWH) through Program Collaboration and Service Integration (PCSI)

    PubMed Central

    Bernard, Stephanie; Tailor, Amrita; Jones, Patricia; Alexander, Donna E.

    2017-01-01

    Background Approximately 1.2 million Americans are living with HIV, and about 50,000 new infections occur each year. People living with HIV (PLWH) have numerous medical and psychosocial needs that impact HIV disease progression and challenge treatment outcomes. Purpose Using CDC’s Program Collaboration and Service Integration (PCSI) framework, we examined strategies, challenges, and lessons learned from a local health department’s efforts to institute PCSI to address the diverse needs of their patients with HIV. Methods We captured case study data through: 1) semi-structured interviews with key program administrators, 2) analysis of program documents, and 3) site observations and review of clinic procedures. Results Findings highlight the importance of co-locating services, partnering to leverage resources, and conducting cross-training of staff. Providing co-located services reduced wait times and enhanced coordination of care. Partnering to leverage resources increased patient referrals and enhanced access to comprehensive services. Staff cross-training resulted in more coordinated care and efficient service delivery. Conclusion The results show that PCSI is essential for optimal care for PLWH. Incorporating PCSI was a vital component of the health department’s comprehensive approach to addressing the multiple medical and support service needs of its HIV-infected clients. PMID:28217034

  10. Addressing the Medical and Support Service Needs of People Living with HIV (PLWH) through Program Collaboration and Service Integration (PCSI).

    PubMed

    Bernard, Stephanie; Tailor, Amrita; Jones, Patricia; Alexander, Donna E

    2016-01-01

    Approximately 1.2 million Americans are living with HIV, and about 50,000 new infections occur each year. People living with HIV (PLWH) have numerous medical and psychosocial needs that impact HIV disease progression and challenge treatment outcomes. Using CDC's Program Collaboration and Service Integration (PCSI) framework, we examined strategies, challenges, and lessons learned from a local health department's efforts to institute PCSI to address the diverse needs of their patients with HIV. We captured case study data through: 1) semi-structured interviews with key program administrators, 2) analysis of program documents, and 3) site observations and review of clinic procedures. Findings highlight the importance of co-locating services, partnering to leverage resources, and conducting cross-training of staff. Providing co-located services reduced wait times and enhanced coordination of care. Partnering to leverage resources increased patient referrals and enhanced access to comprehensive services. Staff cross-training resulted in more coordinated care and efficient service delivery. The results show that PCSI is essential for optimal care for PLWH. Incorporating PCSI was a vital component of the health department's comprehensive approach to addressing the multiple medical and support service needs of its HIV-infected clients.

  11. Integrating cervical cancer screening and preventive treatment with family planning and HIV-related services.

    PubMed

    White, Heather L; Meglioli, Alejandra; Chowdhury, Raveena; Nuccio, Olivia

    2017-07-01

    Cervical cancer is a leading cause of mortality in Sub-Saharan Africa-in large part because of inadequate coverage of screening and preventive treatment services. A number of programs have begun integrating cervical cancer prevention services into existing family planning or HIV/AIDS service delivery platforms, to rapidly expand "screen and treat" programs and mitigate cervical cancer burden. Drawing upon a review of literature and our experiences, we consider benefits and challenges associated with such programs in Sub-Saharan Africa. We then outline steps that can optimize uptake and sustainability of integrated sexual and reproductive health services. These include increasing coordination among implementing organizations for efficient use of resources; task shifting for services that can be provided by nonphysicians; mobilizing communities via trusted frontline health workers; strengthening management information systems to allow for monitoring of multiple services; and prioritizing an operational research agenda to provide further evidence on the cost-effectiveness and benefits of integrated service delivery. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  12. The fundamentals of integrating service in a post-licensure RN to BSN program.

    PubMed

    Washington-Brown, Linda; Ritchie, Arlene

    2014-01-01

    Integrating service in a post-licensure registered nurse to bachelor of science in nursing (RN to BSN) program provides licensed registered nurse (RN) students the opportunity to learn, develop, and experience different cultures while serving the community and populations in need (McKinnon & Fitzpatrick, 2012). Service to the community, integrated with academic learning can be applied in a wide variety of settings, including schools, universities, and community faith-based organizations. Academic service-learning (ASL) can involve a group of students, a classroom, or an entire school. In the RN to BSN program, the authors use a student-directed service learning approach that integrates service-learning throughout the curriculum. RN students are introduced to service-learning at program orientation prior to the start of classes and receive reinforcement and active engagement throughout the curriculum. The students and volunteer agencies receive and give benefits from the services provided and the life lessons gained through mentorship, education, and hands-on experiences.

  13. How Arizona Medicaid Accelerated the Integration of Physical and Behavioral Health Services.

    PubMed

    Bachrach, Deborah; Boozang, Patricia M; Davis, Hailey E

    2017-05-01

    ISSUE: In most states, one agency has responsibility for Medicaid enrollees' physical health services and at least one other agency has responsibility for their behavioral health services. Apportioning responsibility for the physical and behavioral health of Medicaid beneficiaries into different agencies inevitably leads to different--and sometimes misaligned--policy goals, program priorities, and purchasing strategies, thereby impeding the delivery of integrated care. GOAL: To describe the rationale, process, and impact of Arizona's 2015 consolidation of its physical and behavioral health services agencies into its Medicaid agency. METHOD: The study is based on published research, Arizona Medicaid agency materials, and interviews with 34 individuals, including representatives from the current Medicaid agency and previous behavioral health services agency, health plans, primary care and behavioral health providers, consumers, the justice system, and the health information exchange. FINDINGS AND CONCLUSIONS: Consolidation has led to increased attention to behavioral health services and behavioral and physical health integration, enabled more strategic purchasing and streamlined regulatory processes, and enhanced communication, collaboration, and mutual trust across sectors. Arizona’s experience offers lessons to policymakers as they consider how best to integrate physical and behavioral health services and ensure that Medicaid is an efficient and effective purchaser of health care services.

  14. Integrating antiretroviral therapy in methadone maintenance therapy clinics: Service provider perceptions

    PubMed Central

    Lin, Chunqing; Cao, Xiaobin; Li, Li

    2014-01-01

    Background Using methadone maintenance therapy (MMT) clinics to deliver antiretroviral therapy (ART) is an effective strategy to promote treatment initiation and adherence for HIV-positive drug users. This paper describes the implementation barriers perceived by service providers for an intervention pilot designed to integrate ART services in MMT clinics. Methods The study was conducted in six MMT clinics in Sichuan province, China. Two service providers selected from each of the six clinics underwent training in administering ART. The trained providers delivered ART-related services in their clinics. A focus group was conducted among the service providers to assess their experiences and perceived challenges in delivering integrated services. Results Barriers at policy, institutional, provider, and client levels were identified. Policy level barriers included household registration restrictions and a lack of insurance coverage for testing expenses. Inefficient coordination between treatment sites and MMT clinics was an obstacle at the institutional level. Insufficient training and added workload were barriers at the provider level. Finally, conflict with daily dosing habits was identified as the primary reason that clients did not accept ART. Conclusion Although integrating ART into MMT clinics is beneficial, multilevel barriers to implementation need to be addressed. This study documents the need for treatment transferability and insurance coverage, protection of client confidentiality, proper provider training, coordination with treatment sites, and individualized ART service for MMT clients. PMID:24939555

  15. Factors affecting success of an integrated community-based telehealth system.

    PubMed

    Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

    2015-01-01

    The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

  16. Interventions and approaches to integrating HIV and mental health services: a systematic review

    PubMed Central

    Chuah, Fiona Leh Hoon; Haldane, Victoria Elizabeth; Cervero-Liceras, Francisco; Ong, Suan Ee; Sigfrid, Louise A; Murphy, Georgina; Watt, Nicola; Balabanova, Dina; Hogarth, Sue; Maimaris, Will; Otero, Laura; Buse, Kent; McKee, Martin; Piot, Peter; Perel, Pablo; Legido-Quigley, Helena

    2017-01-01

    Abstract Background The frequency in which HIV and AIDS and mental health problems co-exist, and the complex bi-directional relationship between them, highlights the need for effective care models combining services for HIV and mental health. Here, we present a systematic review that synthesizes the literature on interventions and approaches integrating these services. Methods This review was part of a larger systematic review on integration of services for HIV and non-communicable diseases. Eligible studies included those that described or evaluated an intervention or approach aimed at integrating HIV and mental health care. We searched multiple databases from inception until October 2015, independently screened articles identified for inclusion, conducted data extraction, and assessed evaluative papers for risk of bias. Results Forty-five articles were eligible for this review. We identified three models of integration at the meso and micro levels: single-facility integration, multi-facility integration, and integrated care coordinated by a non-physician case manager. Single-site integration enhances multidisciplinary coordination and reduces access barriers for patients. However, the practicality and cost-effectiveness of providing a full continuum of specialized care on-site for patients with complex needs is arguable. Integration based on a collaborative network of specialized agencies may serve those with multiple co-morbidities but fragmented and poorly coordinated care can pose barriers. Integrated care coordinated by a single case manager can enable continuity of care for patients but requires appropriate training and support for case managers. Involving patients as key actors in facilitating integration within their own treatment plan is a promising approach. Conclusion This review identified much diversity in integration models combining HIV and mental health services, which are shown to have potential in yielding positive patient and service delivery

  17. Haematological cancers: improving outcomes. A summary of updated NICE service guidance in relation to Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS).

    PubMed

    Snowden, John A; O'Connell, Susan; Hawkins, James; Dalley, Chris; Jack, Andrew; Mannari, Deepak; McNamara, Chris; Scott, Mike; Shenton, Geoff; Soilleux, Elizabeth; Macbeth, Fergus

    2017-06-01

    Haematological malignancies are a diverse group of cancers that affect the blood, bone marrow and lymphatic systems. Laboratory diagnosis of haematological malignancies is dependent on combining several technologies, including morphology, immunophenotyping, cytogenetics and molecular genetics correlated clinical details and classification according to the current WHO guidelines. The concept of the Specialised Integrated Haematological Malignancy Diagnostic Services (SIHMDS) has evolved since the UK National Institute for Health and Care Excellence (NICE) Improving Outcomes Guidance (IOG) in 2003 and subsequently various models of delivery have been established. As part of the 2016 update to the NICE IOG, these models were systematically evaluated and recommendations produced to form the basis for quality standards for future development of SIHMDS. We provide a summary of the systematic review and recommendations. Although the recommendations pertain to the UK National Health Service (NHS), they have relevance to the modern delivery of diagnostic services internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Achieving End-to-End QoS in the Next Generation Internet: Integrated Services Over Differentiated Service Networks

    NASA Technical Reports Server (NTRS)

    Bai, Haowei; Atiquzzaman, Mohammed; Ivancic, William

    2001-01-01

    Currently there are two approaches to provide Quality of Service (QoS) in the next generation Internet: An early one is the Integrated Services (IntServ) with the goal of allowing end-to-end QoS to be provided to applications; the other one is the Differentiated Services (DiffServ) architecture providing QoS in the backbone. In this context, a DiffServ network may be viewed as a network element in the total end-to-end path. The objective of this paper is to investigate the possibility of providing end-to-end QoS when IntServ runs over DiffServ backbone in the next generation Internet. Our results show that the QoS requirements of IntServ applications can be successfully achieved when IntServ traffic is mapped to the DiffServ domain in next generation Internet.

  19. Achieving End-to-End QoS in the Next Generation Internet: Integrated Services over Differentiated Service Networks

    NASA Technical Reports Server (NTRS)

    Bai, Haowei; Atiquzzaman, Mohammed; Ivancic, William

    2001-01-01

    Currently there are two approaches to provide Quality of Service (QoS) in the next generation Internet: An early one is the Integrated Services (IntServ) with the goal of allowing end-to-end QoS to be provided to applications; the other one is the Differentiated Services (DiffServ) architecture providing QoS in the backbone. In this context, a DiffServ network may be viewed as a network element in the total end-to-end path. The objective of this paper is to investigate the possibility of providing end-to-end QoS when IntServ runs over DiffServ backbone in the next generation Internet. Our results show that the QoS requirements of IntServ applications can be successfully achieved when IntServ traffic is mapped to the DiffServ domain in next generation Internet.

  20. Bio-jETI: a service integration, design, and provisioning platform for orchestrated bioinformatics processes.

    PubMed

    Margaria, Tiziana; Kubczak, Christian; Steffen, Bernhard

    2008-04-25

    With Bio-jETI, we introduce a service platform for interdisciplinary work on biological application domains and illustrate its use in a concrete application concerning statistical data processing in R and xcms for an LC/MS analysis of FAAH gene knockout. Bio-jETI uses the jABC environment for service-oriented modeling and design as a graphical process modeling tool and the jETI service integration technology for remote tool execution. As a service definition and provisioning platform, Bio-jETI has the potential to become a core technology in interdisciplinary service orchestration and technology transfer. Domain experts, like biologists not trained in computer science, directly define complex service orchestrations as process models and use efficient and complex bioinformatics tools in a simple and intuitive way.

  1. Utilization of integrated HIV and sexual and reproductive health services among women in Uganda.

    PubMed

    Rutaremwa, Gideon; Kabagenyi, Allen

    2016-09-20

    While the rationale for integration of HIV and sexual and reproductive health (HIV and SRH) services is strong, there is paucity of information on which population groups most utilize these services. Such studies would inform policy and programs on integration of services. The overall objective of this assessment is to provide information to researchers, planners and policy makers on the best practices for integrated services in order to maximize feasibility of scaling up. Specifically, this research paper identifies demographic and socioeconomic factors that are most related to utilization of integrated services in Uganda. This manuscript uses data from a sample of 9,691 women interviewed during the Uganda AIDS Indicator Survey (UAIS) of 2011. The selection criteria of the study respondents for this paper included women of reproductive age 15 - 49 years. The dependent variable is whether the respondent utilized integrated HIV and SRH services during pregnancy and delivery of the last child, while independent variables include; region of residence, age-group of woman, marital status, rural-urban residence, wealth indicator and educational level attainment. In the main analysis, a binary logistic regression model was fitted to the data. Log-odds of utilizing integrated services were significantly higher among those women with a primary education (OR = 1.2, 95 % CI = 1.0-1.4, p < 0.05) compared to those with no education. Women from the Central part of Uganda were more likely to utilize integrated HIV and SRH services (OR = 1.3, 95 % CI = 1.0-1.7, p < 0.05), further the log-odds of utilizing integrated HIV and SRH services were significantly higher among women residing in Northern region (OR = 1.6, 95 % CI = 1.2-2.2, p < 0.01). The odds of utilization of integrated HIV and SRH services were higher for currently married women (OR = 6.6, 95 % CI = 5.5-8.0, p < 0.01) and the formerly married (OR = 3.4, 95 % CI

  2. Bringing it All Together: NODC's Geoportal Server as an Integration Tool for Interoperable Data Services

    NASA Astrophysics Data System (ADS)

    Casey, K. S.; Li, Y.

    2011-12-01

    The US National Oceanographic Data Center (NODC) has implemented numerous interoperable data technologies in recent years to enhance the discovery, understanding, and use of the vast quantities of data in the NODC archives. These services include OPeNDAP's Hyrax server, Unidata's THREDDS Data Server (TDS), NOAA's Live Access Server (LAS), and most recently the ESRI ArcGIS Server. Combined, these technologies enable NODC to provide access to its data holdings and products through most of the commonly-used standardized web services like the Data Access Protocol (DAP) and the Open Geospatial Consortium suite of services such as the Web Mapping Service (WMS) and Web Coverage Service (WCS). Despite the strong demand for and use of these services, the acronym-rich environment of services can also result in confusion for producers of data to the NODC archives, for consumers of data from the NODC archives, and for the data stewards at the archives as well. The situation is further complicated by the fact that NODC also maintains some ad hoc services like WODselect, and that not all services can be applied to all of the tens of thousands of collections in the NODC archive; where once every data set was available only through FTP and HTTP servers, now many are also available from the LAS, TDS, Hyrax, and ArcGIS Server. To bring order and clarity to this potentially confusing collection of services, NODC deployed the Geoportal Server into its Archive Management System as an integrating technology that brings together its various data access, visualization, and discovery services as well as its overall metadata management workflows. While providing an enhanced web-based interface for more integrated human-to-machine discovery and access, the deployment also enables NODC for the first time to support a robust set of machine-to-machine discovery services such as the Catalog Service for the Web (CS/W), OpenSearch, and Search and Retrieval via URL (SRU) . This approach allows NODC

  3. The experience of clinical supervision for nurses and healthcare assistants in a secure adolescent service: Affecting service improvement.

    PubMed

    McCarron, R H; Eade, J; Delmage, E

    2018-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses. Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In

  4. Dignity Through Integrated Symptom Management: Lessons From the Breathlessness Support Service.

    PubMed

    Gysels, Marjolein; Reilly, Charles C; Jolley, Caroline J; Pannell, Caty; Spoorendonk, Femke; Moxham, John; Bausewein, Claudia; Higginson, Irene J

    2016-10-01

    Dignity is poorly conceptualized and little empirically explored in end-of-life care. A qualitative evaluation of a service offering integrated palliative and respiratory care for patients with advanced disease and refractory breathlessness uncovered an unexpected outcome, it enhanced patients' dignity. To analyze what constitutes dignity for people suffering from refractory breathlessness with advanced disease, and its implications for the concept of dignity. Qualitative study of cross-sectional interviews with 20 patients as part of a Phase III evaluation of a randomized controlled fast-track trial. The interviews were transcribed verbatim, imported into NVivo, and analyzed through constant comparison. The findings were compared with Chochinov et al.'s dignity model. The model was adapted with the themes and subthemes specific to patients suffering from breathlessness. The findings of this study underscore the applicability of the conceptual model of dignity for patients with breathlessness. There were many similarities in themes and subthemes. Differences specifically relevant for patients suffering from severe breathlessness were as follows: 1) physical distress and psychological mechanisms are interlinked with the disability and dependence breathlessness causes, in the illness-related concerns, 2) stigma is an important component of the social dignity inventory, 3) conditions and perspectives need to be present to practice self-care in the dignity-conserving repertoire. Dignity is an integrated concept and can be affected by influences from other areas such as illness-related concerns. The intervention shows that targeting the symptom holistically and equipping patients with the means for self-care realized the outcome of dignity. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Research into the influence of internal interdepartmental integration on service innovation and customer loyalty

    NASA Astrophysics Data System (ADS)

    Huang, Jui-Chan; Wu, Tzu-Jung; Wen, Hao-Ming; Hsin-Fei, Wu; Hairui, Ji

    2017-06-01

    It is the most important for the company to improve customer value and customer loyalty through service innovation. However, at present, only researches related to organizations or consumer behaviors are conducted, there is rare research into the combination between organization level and consumer behavior, and this research tries to explore this aspect, which is the motivation and contribution of this research. This research aims to explore the relationship between "Interdepartmental Integration", "Service Innovation" and "Customer Loyalty", according to the analysis results, the relationship between "interdepartmental integration and service innovation" and "service innovation and customer loyalty" has a low positive correlation and it reaches significant level; it shows the relationship between "interdepartmental interaction and progressive innovation" and "interdepartmental collaboration and fundamental innovation" is significant.

  6. Assessing Assessment: Examination of Pre-Service Physics Teachers' Attitudes towards Assessment and Factors Affecting Their Attitudes

    ERIC Educational Resources Information Center

    Ogan-Bekiroglu, Feral

    2009-01-01

    The purpose of this study was to determine pre-service physics teachers' attitudes towards assessment. It was also aimed to examine the factors affecting their attitudes. Two factors were considered. The first was difficulties that pre-service teachers experienced relating to assessment. The second factor was teachers' self-efficacy regarding…

  7. Relational continuity of care in integrated maternity and child health clinics improve parents’ service experiences

    PubMed Central

    Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Rautava, Päivi

    2014-01-01

    Introduction In the Finnish primary health care, relational continuity of care is implemented in integrated maternity and child health clinics where the same nurse takes care of the family from the pregnancy until the child reaches school age. The aim of this study was to clarify the association between this relational continuity of care and the availability, utilisation and selected features of the maternity and child health clinic services, as evaluated by the parents. Methods A comparative, cross-sectional service evaluation survey was used. Eighteen months after their baby's delivery, mothers (N = 987) and fathers (N = 835) from Southwest Finland evaluated specific maternity and child health clinic services. Comparisons were made between the parents who had relational continuity of care in the integrated maternity and child health clinics and those who did not. Results Home visits were more frequently provided when relational continuity of care in integrated maternity and child health clinics existed. Parents who had this relational continuity of care, evaluated several features of the service, especially provided support, more positively than parents who did not. Conclusions Relational continuity of care in integrated maternity and child health clinics seems to increase parents’ satisfaction with the services and might increase the provision of home visits. PMID:25411571

  8. Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

    PubMed

    Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

    2013-08-23

    Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are

  9. Theta phase coherence in affective picture processing reveals dysfunctional sensory integration in psychopathic offenders.

    PubMed

    Tillem, Scott; Ryan, Jonathan; Wu, Jia; Crowley, Michael J; Mayes, Linda C; Baskin-Sommers, Arielle

    2016-09-01

    Psychopathic offenders are described as emotionally cold, displaying deficits in affective responding. However, research demonstrates that many of the psychopathy-related deficits are moderated by attention, such that under conditions of high attentional and perceptual load psychopathic offenders display deficits in affective responses, but do not in conditions of low load. To date, most studies use measures of defensive reflex (i.e., startle) and conditioning manipulations to examine the impact of load on psychopathy-related processing, but have not examined more direct measures of attention processing. In a sample of adult male offenders, the present study examined time-frequency EEG phase coherence in response to a picture-viewing paradigm that manipulated picture familiarity to assess neural changes in processing based on perceptual demands. Results indicated psychopathy-related differences in the theta response, an index of readiness to perceive and integrate sensory information. These data provide further evidence that psychopathic offenders have disrupted integration of sensory information. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. How absent negativity relates to affect and motivation: an integrative relief model

    PubMed Central

    Deutsch, Roland; Smith, Kevin J. M.; Kordts-Freudinger, Robert; Reichardt, Regina

    2015-01-01

    The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO. PMID:25806008

  11. Integrating Information Services for Dental Schools into a Health Sciences Library *

    PubMed Central

    Darling, Louise

    1970-01-01

    Standards for dental school libraries are first discussed, and the actual state of such libraries described. Advantages and disadvantages of combining the dental library with the health sciences library are weighed. A description is given of the experience at UCLA of integrating dentistry into the total Biomedical Library, with details on serial and monograph selection, together with figures on the size of the collection. Services required of a dental library are detailed, and particular services offered by UCLA described. PMID:5439908

  12. The impact of federal systems integration initiatives on services for mentally ill homeless persons.

    PubMed

    Dennis, D L; Steadman, H J; Cocozza, J J

    2000-09-01

    Nearly everyone writing on homelessness over the past 15 years has called for comprehensive integrated systems of care to address the multiple and complex needs of people who become homeless, especially those with mental illness. What is often overlooked is that calls for systems integration are far from new. Although the names have changed over the years, the underlying concepts have not. The purposes of this paper are fourfold: (1) to clarify the distinction between services integration and systems integration; (2) to map the evolution of federal programs to demonstrate that most of these really have been focused on services integration rather than systems integration; (3) to assess the extent that data from these programs supports the idea of systems integration; and (4) to show how the current ACCESS demonstration for persons who are homeless and mentally ill is likely to provide answers that prior programs have not. Without these new data, systems integration, as one solution to the problems of homelessness, remains a theory without empirical evidence; albeit a theory with persuasive conceptual underpinnings.

  13. Integrating Music Therapy Services and Speech-Language Therapy Services for Children with Severe Communication Impairments: A Co-Treatment Model

    ERIC Educational Resources Information Center

    Geist, Kamile; McCarthy, John; Rodgers-Smith, Amy; Porter, Jessica

    2008-01-01

    Documenting how music therapy can be integrated with speech-language therapy services for children with communication delay is not evident in the literature. In this article, a collaborative model with procedures, experiences, and communication outcomes of integrating music therapy with the existing speech-language services is given. Using…

  14. Graph-Based Semantic Web Service Composition for Healthcare Data Integration

    PubMed Central

    2017-01-01

    Within the numerous and heterogeneous web services offered through different sources, automatic web services composition is the most convenient method for building complex business processes that permit invocation of multiple existing atomic services. The current solutions in functional web services composition lack autonomous queries of semantic matches within the parameters of web services, which are necessary in the composition of large-scale related services. In this paper, we propose a graph-based Semantic Web Services composition system consisting of two subsystems: management time and run time. The management-time subsystem is responsible for dependency graph preparation in which a dependency graph of related services is generated automatically according to the proposed semantic matchmaking rules. The run-time subsystem is responsible for discovering the potential web services and nonredundant web services composition of a user's query using a graph-based searching algorithm. The proposed approach was applied to healthcare data integration in different health organizations and was evaluated according to two aspects: execution time measurement and correctness measurement. PMID:29065602

  15. The development of integrated service centre system for professional teachers empowerment in North Sumatera

    NASA Astrophysics Data System (ADS)

    Gultom, S.; Simanjorang, M. M.; Muchtar, Z.; Mansyur, A.

    2018-03-01

    Based on Act number 12 in year 2012 the function of higher education is related to individual, social community, knowledge and technology development. Hence, higher education providers need to think and develop policies in order to improve their service and fulfil the higher education function. As part of the effort to fulfil its function Universitas Negeri Medan (Unimed), which historically was a pre-service teacher training institute, should has a special interest on improving teachers’ professionalism. The Act number 14 in year 2005 described requirements for professional teacher, including academic qualification and set of competencies possessed by the teacher. The Act also guaranties teachers’ right to have opportunities for improving their competencies and academic qualification through training and other professionalism development programme. The question is how this guarantee can be implemented. In order to answer this question a developmental study has been done which aimed on developing an integrated service centre system for professional teachers empowerment. As the name implies, this integrated service centre system is expected to be a real manifestation of Unimed’s support towards the improvement of professional teachers quality, which in the end will boils down to the improvement of national education services quality. The result of this study is an integrated service centre system for professional teachers empowerment that fulfils the professionalism principles described in the Act number 14 in year 2005, which has been developed by considering problems faced by and also supports needed by teachers post certification programme.

  16. Integrating ICT as an Integral Teaching and Learning Tool into Pre-Service Teacher Training Courses

    ERIC Educational Resources Information Center

    Steketee, Carole

    2005-01-01

    Even though a wide cross-section of society today has accepted Information and Communications Technology (ICT) as an entrenched characteristic of its culture, education has been slow to adopt it as an integral tool within the classroom (Cuban, 2001; Elliott, 2004). Many reasons for this lethargy have been purported in the literature, ranging from…

  17. Factors Affecting Early Services for Children Who Are Hard of Hearing.

    PubMed

    Harrison, Melody; Page, Thomas A; Oleson, Jacob; Spratford, Meredith; Unflat Berry, Lauren; Peterson, Barbara; Welhaven, Anne; Arenas, Richard M; Moeller, Mary Pat

    2016-01-01

    To describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for children who are deaf and hard of hearing (CDHH). Participants included 122 EI professionals who completed an online questionnaire annually and 131 parents who participated in annual telephone interviews. Most families received EI in the home. Family participation in this setting was significantly higher than in services provided elsewhere. EI professionals were primarily teachers of CDHH or speech-language pathologists. Caseload composition was correlated moderately to strongly with most provider comfort levels. Level of preparation to support spoken language weakly to moderately correlated with provider comfort with 18 specific skills. Results suggest family involvement is highest when EI is home-based, which supports the need for EI in the home whenever possible. Access to hands-on experience with this population, reflected in a high percentage of CDHH on providers' current caseloads, contributed to professional comfort. Specialized preparation made a modest contribution to comfort level.

  18. Factors Affecting Early Services for Children Who Are Hard of Hearing

    PubMed Central

    Page, Thomas A.; Oleson, Jacob; Spratford, Meredith; Unflat Berry, Lauren; Peterson, Barbara; Welhaven, Anne; Arenas, Richard M.; Moeller, Mary Pat

    2016-01-01

    Purpose To describe factors affecting early intervention (EI) for children who are hard of hearing, we analyzed (a) service setting(s) and the relationship of setting to families' frequency of participation, and (b) provider preparation, caseload composition, and experience in relation to comfort with skills that support spoken language for children who are deaf and hard of hearing (CDHH). Method Participants included 122 EI professionals who completed an online questionnaire annually and 131 parents who participated in annual telephone interviews. Results Most families received EI in the home. Family participation in this setting was significantly higher than in services provided elsewhere. EI professionals were primarily teachers of CDHH or speech-language pathologists. Caseload composition was correlated moderately to strongly with most provider comfort levels. Level of preparation to support spoken language weakly to moderately correlated with provider comfort with 18 specific skills. Conclusions Results suggest family involvement is highest when EI is home-based, which supports the need for EI in the home whenever possible. Access to hands-on experience with this population, reflected in a high percentage of CDHH on providers' current caseloads, contributed to professional comfort. Specialized preparation made a modest contribution to comfort level. PMID:26440475

  19. ‘Trust and teamwork matter’: Community health workers' experiences in integrated service delivery in India

    PubMed Central

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011–2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive ‘teamwork’ and ‘building trust with the community’ (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology – which the health workers espouse – is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration. PMID:25025872

  20. Patients’ Preference for Integrating Homoeopathy Services within the Secondary Health Care Settings in India

    PubMed Central

    Manchanda, Rajkumar; Koley, Munmun; Saha, Subhranil; Sarkar, Debabrata; Mondal, Ramkumar; Thakur, Prosenjit; Biswas, Debjyoti; Rawat, Birendra Singh; Rajachandrasekar, Bhuvaneswari; Mittal, Renu

    2016-01-01

    Indian patients’ preference for integrated homoeopathy services remains underresearched. Two earlier surveys revealed favorable attitude toward and satisfaction from integrated services. The objectives of this study were to examine knowledge, attitudes, and practice of homoeopathy and to evaluate preference toward its integration into secondary-level health care. A cross-sectional survey was conducted during May to October 2015 among 659 adult patients visiting randomly selected secondary-level conventional health care setups in Kolkata, Mumbai, Kottayam, and New Delhi (India) using a self-administered 24-item questionnaire in 4 local vernaculars (Bengali, Marathi, Malayalam, and Hindi). Knowledge and practice scores were compromised; attitude scores toward integration and legal regulation were high. Respondents were uncertain regarding side effects of homoeopathy and concurrent use and interactions with conventional medicines. A total of 82.40% (95% confidence interval = 79.23, 85.19) of the participants were in favor of integrating homoeopathy services. Preference was significantly higher in Delhi and lower in Kottayam. Probable strategic measures for further development of integrated models are discussed. PMID:27215693

  1. 'Trust and teamwork matter': community health workers' experiences in integrated service delivery in India.

    PubMed

    Mishra, Arima

    2014-01-01

    A comprehensive and integrated approach to strengthen primary health care has been the major thrust of the National Rural Health Mission (NRHM) that was launched in 2005 to revamp India's rural public health system. Though the logic of horizontal and integrated health care to strengthen health systems has long been acknowledged at policy level, empirical evidence on how such integration operates is rare. Based on recent (2011-2012) ethnographic fieldwork in Odisha, India, this article discusses community health workers' experiences in integrated service delivery through village-level outreach sessions within the NRHM. It shows that for health workers, the notion of integration goes well beyond a technical lens of mixing different health services. Crucially, they perceive 'teamwork' and 'building trust with the community' (beyond trust in health services) to be critical components of their practice. However, the comprehensive NRHM primary health care ideology - which the health workers espouse - is in constant tension with the exigencies of narrow indicators of health system performance. Our ethnography shows how monitoring mechanisms, the institutionalised privileging of statistical evidence over field-based knowledge and the highly hierarchical health bureaucratic structure that rests on top-down communications mitigate efforts towards sustainable health system integration.

  2. Curbing publicly-funded family planning services in Iran: who is affected?

    PubMed

    Erfani, Amir

    2017-01-01

    In response to a persistent low fertility rate in the country, the Supreme Leader of Iran in 2012 called for the shift to pronatalist population policies. Consequently, Iran's Parliament proposed a bill to curb the provision of contraceptive knowledge and services as a solution to raising the country's low fertility rate. This study aimed to investigate which groups of women will be adversely affected if the provision of subsidised contraceptive methods [i.e. sterilisation, intrauterine device (IUD) and injections] is curbed. This study used recent data from the 2014 Tehran Survey of Fertility (n=3012) conducted among a representative sample of 3012 married women of reproductive age, and used multinomial logistic regression analysis to identify women with a higher likelihood of using government-funded contraceptive methods. Currently 82% of married women living in Tehran use a contraceptive method. The use of long-acting contraception, namely sterilisation and IUDs, declined from 34% in 2000 to 20% in 2014, and the prevalence of male methods (withdrawal and condoms) increased from 33% to 55% in the same period. Multivariate results showed that women who have a large number of children, want no more children, live in poor districts, and have low education are more likely to use long-acting contraceptive methods than withdrawal and condoms. Women of low socioeconomic status who want to stop childbearing are the most vulnerable subgroups of the population if the publicly-funded family planning services are curbed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. The tsunami service bus, an integration platform for heterogeneous sensor systems

    NASA Astrophysics Data System (ADS)

    Haener, R.; Waechter, J.; Kriegel, U.; Fleischer, J.; Mueller, S.

    2009-04-01

    1. INTRODUCTION Early warning systems are long living and evolving: New sensor-systems and -types may be developed and deployed, sensors will be replaced or redeployed on other locations and the functionality of analyzing software will be improved. To ensure a continuous operability of those systems their architecture must be evolution-enabled. From a computer science point of view an evolution-enabled architecture must fulfill following criteria: • Encapsulation of and functionality on data in standardized services. Access to proprietary sensor data is only possible via these services. • Loose coupling of system constituents which easily can be achieved by implementing standardized interfaces. • Location transparency of services what means that services can be provided everywhere. • Separation of concerns that means breaking a system into distinct features which overlap in functionality as little as possible. A Service Oriented Architecture (SOA) as e. g. realized in the German Indonesian Tsunami Early Warning System (GITEWS) and the advantages of functional integration on the basis of services described below adopt these criteria best. 2. SENSOR INTEGRATION Integration of data from (distributed) data sources is just a standard task in computer science. From few well known solution patterns, taking into account performance and security requirements of early warning systems only functional integration should be considered. Precondition for this is that systems are realized compliant to SOA patterns. Functionality is realized in form of dedicated components communicating via a service infrastructure. These components provide their functionality in form of services via standardized and published interfaces which could be used to access data maintained in - and functionality provided by dedicated components. Functional integration replaces the tight coupling at data level by a dependency on loosely coupled services. If the interfaces of the service providing

  4. Factors Affecting Definitions of and Approaches to Integrative Medicine: A Mixed Methods Study Examining China's Integrative Medicine Development

    PubMed Central

    Zhang, Weijun; Pritzker, Sonya E.; Hui, Ka-Kit

    2015-01-01

    Aim. This study identifies existing definitions and approaches among China's integrative medicine (IM) experts and examines relationships with key characteristics distinguishing individual experts. Methods. Snowball sampling was used to select 73 IM experts for semistructured interviews. In this mixed methods study, we first identified definitions and approaches through analyzing core statements. Four key factors, including age, education, practice type, and working environment, were then chosen to evaluate the associations with the definitions. Results. Four unique definitions were identified, including IM as a “new medicine” (D1), as a combination of western medicine (WM) and Chinese medicine (CM) (D2), as a modernization of CM (D3), and as a westernization of CM (D4). D4 was mostly supported by those working in WM organizations, while D3 was more prominent from individuals working in CM organizations (P = 0.00004). More than 64% clinicians had D2 while only 1 (5.9%) nonclinician had D2. Only 1 clinician (1.8%) had D4 while almost 30% nonclinicians had D4 (P = 0.0001). Among nonclinicians working in WM organizations, 83.3% of them had D4 (P = 0.001). Conclusion. Findings indicate that institutional structure and practice type are factors affecting IM approaches. These results carry implications for the ways in which western countries move forward with the definition and implementation of IM. PMID:25792999

  5. Factors influencing the successful integration of ambulance volunteers and first responders into ambulance services.

    PubMed

    O'Meara, Peter; Tourle, Vianne; Rae, John

    2012-09-01

    This study identifies the factors associated with the successful integration of ambulance volunteers and first responders into major ambulance services in Australia and New Zealand and then proposes a model of volunteer management for ambulance services. All ten members of the Australasian Council of Ambulance Authorities completed a questionnaire describing their volunteer and first-responder staff, their numbers and deployment, and the management and integration of volunteers within their respective organisations. Eight senior managers responsible for ambulance volunteers and first responders from six States of Australia and one region of New Zealand subsequently participated in semistructured interviews. Analysis of interview transcripts and publicly available data revealed facilitative factors associated with strong, vibrant ambulance volunteer systems. These facilitative factors are commitment to volunteer models of service delivery; a degree of management decentralisation and volunteer input into decision-making; commitment of resources towards the volunteer model; and the organisational integration of volunteers into the ambulance service. The proposed facilitative model of volunteer management developed aims to encourage the adoption of positive and innovative strategies to improve the integration of ambulance volunteers and first responders in ambulance services. The model consists of four components: leadership; integrative processes; resource commitment; and relative autonomy. The first three of these relate directly to the organisation, while the fourth concerns the volunteers themselves. If these approaches were replicated more widely, a viable and effective volunteer emergency health response system could be established in those areas where it is uneconomic or impractical to provide a salaried ambulance service staffed with professionally qualified paramedics. © 2012 Blackwell Publishing Ltd.

  6. Integrating cognitive and affective dimensions of pain experience into health professions education

    PubMed Central

    Murinson, Beth B; Mezei, Lina; Nenortas, Elizabeth

    2011-01-01

    Pain is prevalent in clinical settings, and yet it is relatively under-represented in the education of most students in the health professions. Because pain includes both sensory-discriminative and affective features, teaching students about pain presents unique challenges and opportunities. The present article describes the evolution of a new blueprint for clinical excellence that, among other competencies, incorporates a need for the emotional development of clinical trainees. The framework has been applied to the development and implementation of two new courses in pain. The first course is designed to provide a comprehensive foundation of medical knowledge regarding pain, while integratively introducing students to the affective dimensions of pain. The second course is designed to enhance students’ appreciation for the protean effects of pain through use of the humanities to represent medical experience. It is concluded that, to be most effective, fostering the emotional development of trainees in the health professions necessitates the incorporation of affect-focused learning objectives, educational tasks and assessment methods. PMID:22184551

  7. God imagery and affective outcomes in a spiritually integrative inpatient program.

    PubMed

    Currier, Joseph M; Foster, Joshua D; Abernethy, Alexis D; Witvliet, Charlotte V O; Root Luna, Lindsey M; Putman, Katharine M; Schnitker, Sarah A; VanHarn, Karl; Carter, Janet

    2017-08-01

    Religion and/or spirituality (R/S) can play a vital, multifaceted role in mental health. While beliefs about God represent the core of many psychiatric patients' meaning systems, research has not examined how internalized images of the divine might contribute to outcomes in treatment programs/settings that emphasize multicultural sensitivity with R/S. Drawing on a combination of qualitative and quantitative information with a religiously heterogeneous sample of 241 adults who completed a spiritually integrative inpatient program over a two-year period, this study tested direct/indirect associations between imagery of how God views oneself, religious comforts and strains, and affective outcomes (positive and negative). When accounting for patients' demographic and religious backgrounds, structural equation modeling results revealed: (1) overall effects for God imagery at pre-treatment on post-treatment levels of both positive and negative affect; and (2) religious comforts and strains fully mediated these links. Secondary analyses also revealed that patients' generally experienced reductions in negative emotion in God imagery over the course of their admission. These findings support attachment models of the R/S-mental health link and suggest that religious comforts and strains represent distinct pathways to positive and negative domains of affect for psychiatric patients with varying experiences of God. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Integrating cognitive and affective dimensions of pain experience into health professions education.

    PubMed

    Murinson, Beth; Mezei, Lina; Nenortas, Elizabeth

    2011-01-01

    Pain is prevalent in clinical settings, and yet it is relatively under-represented in the education of most students in the health professions. Because pain includes both sensory-discriminative and affective features, teaching students about pain presents unique challenges and opportunities. The present article describes the evolution of a new blueprint for clinical excellence that, among other competencies, incorporates a need for the emotional development of clinical trainees. The framework has been applied to the development and implementation of two new courses in pain. The first course is designed to provide a comprehensive foundation of medical knowledge regarding pain, while integratively introducing students to the affective dimensions of pain. The second course is designed to enhance students' appreciation for the protean effects of pain through use of the humanities to represent medical experience. It is concluded that, to be most effective, fostering the emotional development of trainees in the health professions necessitates the incorporation of affect-focused learning objectives, educational tasks, and assessment methods.

  9. Integrative Western and Traditional Chinese Medicine service model for low back pain.

    PubMed

    Sit, Regina W S; Wong, Wendy; Law, Sheung Wai; Wu, Justin C Y

    2016-07-01

    Low back pain (LBP) is a common, costly, and debilitating condition that creates a heavy socioeconomic burden on the global health care systems. In Western Medicine (WM), the treatment goals are to relieve pain, reduce disability, and enhance rehabilitation. In Traditional Chinese Medicine (TCM), acupuncture is frequently used to rebalance the vital energy "Qi". Whilst numerous literatures are available from WM and TCM in the management of LBP, the value of an integrative WMTCM therapy remains unknown. This article aims to introduce an integrative WM-TCM service model for LBP, which is now available at the Hong Kong Institute of Integrative Medicine, the Chinese University of Hong Kong.

  10. Service user integration into social work education: lessons learned from nordic participatory action projects.

    PubMed

    Angelin, Anna

    2015-01-01

    Service users have lacked substantial influence, access, and participation in social work education in Norway and Sweden. In this article the author presents comparative analyses of two participatory projects that have developed and implemented practices that integrate service users into academic social work education and empower service users. The Norwegian HUSK project and the Social Work as Mobilization and Entrepreneurship course, also known as the "Mobilization course," at Lund University in Sweden demonstrate collaboration between research, social work education, and service users. The conclusions focus on the importance of the empowering processes by including recognition and dialogue, co-learning in practice, and the use of neutral venues to ensure effective user participation. The inclusion of service users in social work education can improve both practice and education.

  11. A Smart Modeling Framework for Integrating BMI-enabled Models as Web Services

    NASA Astrophysics Data System (ADS)

    Jiang, P.; Elag, M.; Kumar, P.; Peckham, S. D.; Liu, R.; Marini, L.; Hsu, L.

    2015-12-01

    Serviced-oriented computing provides an opportunity to couple web service models using semantic web technology. Through this approach, models that are exposed as web services can be conserved in their own local environment, thus making it easy for modelers to maintain and update the models. In integrated modeling, the serviced-oriented loose-coupling approach requires (1) a set of models as web services, (2) the model metadata describing the external features of a model (e.g., variable name, unit, computational grid, etc.) and (3) a model integration framework. We present the architecture of coupling web service models that are self-describing by utilizing a smart modeling framework. We expose models that are encapsulated with CSDMS (Community Surface Dynamics Modeling System) Basic Model Interfaces (BMI) as web services. The BMI-enabled models are self-describing by uncovering models' metadata through BMI functions. After a BMI-enabled model is serviced, a client can initialize, execute and retrieve the meta-information of the model by calling its BMI functions over the web. Furthermore, a revised version of EMELI (Peckham, 2015), an Experimental Modeling Environment for Linking and Interoperability, is chosen as the framework for coupling BMI-enabled web service models. EMELI allows users to combine a set of component models into a complex model by standardizing model interface using BMI as well as providing a set of utilities smoothing the integration process (e.g., temporal interpolation). We modify the original EMELI so that the revised modeling framework is able to initialize, execute and find the dependencies of the BMI-enabled web service models. By using the revised EMELI, an example will be presented on integrating a set of topoflow model components that are BMI-enabled and exposed as web services. Reference: Peckham, S.D. (2014) EMELI 1.0: An experimental smart modeling framework for automatic coupling of self-describing models, Proceedings of HIC 2014

  12. Offering Mental Health Services in a Conflict Affected Region of Pakistan: Who Comes, and Why?

    PubMed Central

    Shah, Safieh; Van den Bergh, Rafael; Van Bellinghen, Benedicte; Severy, Nathalie; Sadiq, Sana; Afridi, Sher Ali; Akhtar, Asma; Maïkére, Jacob; Van Overloop, Catherine; Saeed-ur-Rehman; Khilji, Tahir Bashir-ud-Din; Saleem-ur-Rehman; van Griensven, Johan; Schneider, Serge; Bosman, Philippe; Guillergan, Erwin Lloyd D.; Dazzi, Francesca; Zachariah, Rony

    2014-01-01

    Background North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details. Methodology/Principal Findings A retrospective study using routinely collected programme data was conducted from February to December 2012. A total of 1545 consultations were conducted for 928 patients (86% females). There were 71(8%) children and adolescents. An increase was observed from February to July, followed by a decline. 163 new patients (18%) were on psychotropic medication at presentation. The most common morbidity in females (36%) were symptoms of adjustment disorders and acute reactions. Depression and anxiety were common in both genders while post traumatic disorder was frequent in males (21%). Out of the 928 new patients, 639(69%) had a follow up visit planned with their psychologist, but only 220(34%) new patients returned for a follow up visit. Conclusion In a district hospital, mental health services managed by psychologists were well attended. There is a need to consider widening the current package of care to cater to the diversity of mental health disorders, gender difference, children and adolescents. Standardized diagnostic and monitoring tools would also need to be adapted accordingly and to assess patient progress. Innovative approaches to tackle the problem of the low return rate are needed. PMID:24963793

  13. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings

    PubMed Central

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    Introduction HIV-affected women and couples often desire children and many accept HIV risk in order to attempt pregnancy and satisfy goals for a family. Risk reduction strategies to mitigate sexual and perinatal HIV transmission include biomedical and behavioural approaches. Current efforts to integrate HIV and reproductive health services offer prime opportunities to incorporate strategies for HIV risk reduction during pregnancy attempts. Key client and provider values about services to optimize pregnancy in the context of HIV risk provide insights for the design and implementation of large-scale “safer conception” programmes. Discussion Through our collective experience and discussions at a multi-disciplinary international World Health Organization–convened workshop to initiate the development of guidelines and an algorithm of care to support the delivery of services for HIV-affected women and couples attempting pregnancy, we identified four values that are key to the implementation of these programmes: (1) understanding fertility care and an ability to identify potential fertility problems; (2) providing equity of access to resources enabling informed decision-making about reproductive choices; (3) creating enabling environments that reduce stigma associated with HIV and infertility; and (4) creating enabling environments that encourage disclosure of HIV status and fertility status to partners. Based on these values, recommendations for programmes serving HIV-affected women and couples attempting pregnancy include the following: incorporation of comprehensive reproductive health counselling; training to support the transfer and exchange of knowledge between providers and clients; care environments that reduce the stigma of childbearing among HIV-affected women and couples; support for safe and voluntary disclosure of HIV and fertility status; and increased efforts to engage men in reproductive decision-making at times that align with women's desires

  14. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings.

    PubMed

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    HIV-affected women and couples often desire children and many accept HIV risk in order to attempt pregnancy and satisfy goals for a family. Risk reduction strategies to mitigate sexual and perinatal HIV transmission include biomedical and behavioural approaches. Current efforts to integrate HIV and reproductive health services offer prime opportunities to incorporate strategies for HIV risk reduction during pregnancy attempts. Key client and provider values about services to optimize pregnancy in the context of HIV risk provide insights for the design and implementation of large-scale "safer conception" programmes. Through our collective experience and discussions at a multi-disciplinary international World Health Organization-convened workshop to initiate the development of guidelines and an algorithm of care to support the delivery of services for HIV-affected women and couples attempting pregnancy, we identified four values that are key to the implementation of these programmes: (1) understanding fertility care and an ability to identify potential fertility problems; (2) providing equity of access to resources enabling informed decision-making about reproductive choices; (3) creating enabling environments that reduce stigma associated with HIV and infertility; and (4) creating enabling environments that encourage disclosure of HIV status and fertility status to partners. Based on these values, recommendations for programmes serving HIV-affected women and couples attempting pregnancy include the following: incorporation of comprehensive reproductive health counselling; training to support the transfer and exchange of knowledge between providers and clients; care environments that reduce the stigma of childbearing among HIV-affected women and couples; support for safe and voluntary disclosure of HIV and fertility status; and increased efforts to engage men in reproductive decision-making at times that align with women's desires. Programmes, policies and guidelines

  15. The Place of Technology Integration in Saudi Pre-Service Teacher Education: Matching Policy with Practice

    ERIC Educational Resources Information Center

    Al-Zahrani, Abdulrahman

    2015-01-01

    The current study aims at understanding the place of technology integration in Saudi pre-service teacher education curriculum. To achieve this, a sequential qualitative approach was implemented in two main stages. First, national and curriculum policies were thematically analysed. Based on this, semi- structured interviews with three key…

  16. Smartphone Application Enabling Global Graph Exploitation and Proactive Dissemination Service (DSPro) Integration (Revised Fiscal Year 2015)

    DTIC Science & Technology

    2015-09-01

    ARL-TN-0696 ● SEP 2015 US Army Research Laboratory Smartphone Application Enabling Global Graph Exploitation and Proactive...US Army Research Laboratory Smartphone Application Enabling Global Graph Exploitation and Proactive Dissemination Service (DSPro) Integration...September 2015 2. REPORT TYPE Final 3. DATES COVERED (From - To) October 2014–July 2015 4. TITLE AND SUBTITLE Smartphone Application Enabling Global

  17. Frogs, fish and forestry: An integrated watershed network paradigm conserves biodiversity and ecological services

    Treesearch

    Hartwell H. Welsh Jr.

    2011-01-01

    Successfully addressing the multitude of stresses influencing forest catchments, their native biota, and the vital ecological services they provide humanity will require adapting an integrated view that incorporates the full range of natural and anthropogenic disturbances acting on these landscapes and their embedded fluvial networks. The concepts of dendritic networks...

  18. Facilitating Middle Level Pre-Service Teachers' Literacy Integration in Early Field Experiences

    ERIC Educational Resources Information Center

    Leckie, Alisa; Wall, Amanda

    2016-01-01

    This study explored how pre-service teachers integrated literacy in middle level social studies. This study was conducted in the context of the Common Core State Standards (CCSS) and their focus on disciplinary literacy, the Council for the Accreditation of Educator Preparation (CAEP) Standards and their focus on rich clinical experiences, and…

  19. Generic Service Integration in Adaptive Learning Experiences Using IMS Learning Design

    ERIC Educational Resources Information Center

    de-la-Fuente-Valentin, Luis; Pardo, Abelardo; Kloos, Carlos Delgado

    2011-01-01

    IMS Learning Design is a specification to capture the orchestration taking place in a learning scenario. This paper presents an extension called Generic Service Integration. This paradigm allows a bidirectional communication between the course engine in charge of the orchestration and conventional Web 2.0 tools. This communication allows the…

  20. Three Studies of Service-Learning as an Approach to Movement Integration in Elementary Classrooms

    ERIC Educational Resources Information Center

    Michael, Robert D., Jr.

    2017-01-01

    This dissertation consists of three studies that examine service-learning (SL) as an approach to incorporating movement integration (MI) in elementary classrooms as part of a comprehensive school physical activity program (CSPAP). All three studies attempt to advance the knowledge base about using partnership approaches to supporting school based…

  1. Integrating Local Databases with Remote Files, Print Materials and Reference Services.

    ERIC Educational Resources Information Center

    Pope, Nolan F.

    1982-01-01

    Discusses the impact of local online databases on library reference services, including their integration with remote files such as Dialog, Orbit, and the Information Bank. Online catalog databases, multiple local databases (analytics for journal articles, indexes), and batch processing of data are noted. Six references are cited. (EJS)

  2. SeWeR: a customizable and integrated dynamic HTML interface to bioinformatics services.

    PubMed

    Basu, M K

    2001-06-01

    Sequence analysis using Web Resources (SeWeR) is an integrated, Dynamic HTML (DHTML) interface to commonly used bioinformatics services available on the World Wide Web. It is highly customizable, extendable, platform neutral, completely server-independent and can be hosted as a web page as well as being used as stand-alone software running within a web browser.

  3. Integrating Community Services and Research: A Livelihood Needs Assessment at the Countryside of the Philippines

    ERIC Educational Resources Information Center

    Garcia, Rosario Cano

    2017-01-01

    This study assessed the integration of community services and research through the livelihood needs assessment of a countryside in the Philippines particularly Sitio Malanas, Lettac Sur, Santol, La Union as basis of the actions in addressing the needs. Specifically, the livelihood situation and needs were determined and proposed actions for the…

  4. An Analysis of the Integration of Instructional Technology in Pre-Service Teacher Education in Zimbabwe

    ERIC Educational Resources Information Center

    Chitiyo, Rodwell; Harmon, Stephen W.

    2009-01-01

    In the context of continuous innovations in information and communication technology (ICT) and its impact on higher education, this study explored the integration of instructional technology (IT) by university lecturers in pre-service secondary school teacher education programs in Zimbabwe. Specifically, the study examined how lecturers integrate…

  5. Teaching-Service integration within the National Professional Health Education Reorientation Program.

    PubMed

    Vendruscolo, Carine; Prado, Marta Lenise do; Kleba, Maria Elisabeth

    2016-09-01

    This integrative literature review aimed at identifying the characteristics and describing how teaching-service integration is expressed in studies on Pró-Saúde (Charitable institution for social and hospital assistance) published in Brazil in the period 2007-2012. For the search, the term National Professional Health Education Reorientation Program was entered in the following databases: Virtual Health Library (BVS), Google Scholar and the Bank of Theses of the Coordination for the Improvement of Higher Education Personnel (CAPES). Forty-one publications were selected with the following inclusion criteria: scientific papers; theses and dissertations; studies in English, Portuguese or Spanish. The critical review of studies was performed through a comprehensive reading of the texts. Outcomes are presented in two categories: Dialogue and partnership as tools for teaching-service integration and Movements of change in teaching-service through Pró-Saúde. Studies have shown that changes in professional education and practice are possible and necessary, especially when supported by strategies that encourage active participation of subjects and confirm teaching-service integration as opportunity for dialogue, promoted by this inducing policy.

  6. Reculturing for Equity through Integrated Services: A Case Study of One District's Reform

    ERIC Educational Resources Information Center

    Dentith, Audrey; Frattura, Elise; Kaylor, Maria

    2013-01-01

    The purpose of this paper is to analyse the early stages of an urban district's special education reform effort in which the entire district moved from a programme model to an integrated services delivery approach. We studied teacher and building administrator's responses garnered through focus group, individual interviews and observations at five…

  7. Teaching Diversity through Service-Learning: An Integrative Praxis Pedagogical Approach

    ERIC Educational Resources Information Center

    Rice, Julie Steinkopf; Horn, Terri

    2014-01-01

    Service-learning has been shown to be an effective technique for teaching diversity; however, the literature is scant concerning theoretically informed approaches. This study fills that void by drawing upon the work of Freire, Rendón, and others. After describing how an integrative praxis approach is applied in a sociology course, the authors…

  8. Motivating Pre-Service Teachers in Technology Integration of Web 2.0 for Teaching Internships

    ERIC Educational Resources Information Center

    Kim, Hye Jeong; Jang, Hwan Young

    2015-01-01

    The aim of this study was to examine the predictors of pre-service teachers' use of Web 2.0 tools during a teaching internship, after a course that emphasized the use of the tools for instructional activities. Results revealed that integrating Web 2.0 tools during their teaching internship was strongly predicted by participants' perceived…

  9. Evaluating the Early Impact of Integrated Children's Services. Round 1 Final Report

    ERIC Educational Resources Information Center

    Lord, Pippa; Kinder, Kay; Wilkin, Anne; Atkinson, Mary; Harland, Jennie

    2008-01-01

    The focus of the Local Authorities Research Consortium's (LARC's) first year was to identify the early impact of integrated children's services and the features that promote or hinder success in improving outcomes for children and young people. The research operated in varied localities within the 14 participating Local Authorities (LAs), with one…

  10. Decision support for the integrated restoration and protection strategy of the Forest Service, Northern Region

    Treesearch

    Keith Reynolds; Barry Bollenbacher; Chip Fisher; Melissa Hart; Mary Manning; Eric Henderson; Bruce. Sims

    2016-01-01

    This report documents a decision-support process developed in the U.S. Department of Agriculture, Forest Service, Northern Region to assess management opportunities as part of an ecosystem-based approach to management that emphasizes ecological resilience. The decision-support system described in this work implements what is known as the Integrated Restoration and...

  11. Pre-Service Teachers' Perceptions of ICT Integration in Teacher Education in Turkey

    ERIC Educational Resources Information Center

    Aslan, Aydin; Zhu, Chang

    2015-01-01

    Information and Communication Technology (ICT) integration in teacher education and teaching practices of teachers is a complicated and challenging issue. As far as pre-service teachers are concerned, this becomes critical because they need to be equipped with the competencies for their future teaching practices. The objective of this study is to…

  12. Secondary Mathematics Pre-Service Teachers' Processes of Selection and Integration of Technology

    ERIC Educational Resources Information Center

    Uzan, Erol

    2017-01-01

    This study investigated secondary mathematics pre-service teachers' (PSTs) knowledge of resources in terms of digital technologies, and explored the processes of both selection and integration of technology into their lesson plans. This study employed a case study design. Participants were six secondary mathematics PSTs who enrolled in a methods…

  13. Process-oriented integration and coordination of healthcare services across organizational boundaries.

    PubMed

    Tello-Leal, Edgar; Chiotti, Omar; Villarreal, Pablo David

    2012-12-01

    The paper presents a methodology that follows a top-down approach based on a Model-Driven Architecture for integrating and coordinating healthcare services through cross-organizational processes to enable organizations providing high quality healthcare services and continuous process improvements. The methodology provides a modeling language that enables organizations conceptualizing an integration agreement, and identifying and designing cross-organizational process models. These models are used for the automatic generation of: the private view of processes each organization should perform to fulfill its role in cross-organizational processes, and Colored Petri Net specifications to implement these processes. A multi-agent system platform provides agents able to interpret Colored Petri-Nets to enable the communication between the Healthcare Information Systems for executing the cross-organizational processes. Clinical documents are defined using the HL7 Clinical Document Architecture. This methodology guarantees that important requirements for healthcare services integration and coordination are fulfilled: interoperability between heterogeneous Healthcare Information Systems; ability to cope with changes in cross-organizational processes; guarantee of alignment between the integrated healthcare service solution defined at the organizational level and the solution defined at technological level; and the distributed execution of cross-organizational processes keeping the organizations autonomy.

  14. Integrated Services for Frail Elders (SIPA): A Trial of a Model for Canada

    ERIC Educational Resources Information Center

    Beland, Francois; Bergman, Howard; Lebel, Paule; Dallaire, Luc; Fletcher, John; Contandriopoulos, Andre-Pierre; Solidage, Tousignant Pierre

    2006-01-01

    The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in Canada are still fragmented. SIPA is an integrated service model based on…

  15. Integrating an HTLV-III Screening Program into a Community Based Family Health Service Agency.

    ERIC Educational Resources Information Center

    Klausmeier, Walter W.; Henshaw, Beverly

    Acquired Immune Deficiency Syndrome (AIDS) has become one of the most serious epidemic disease problems in recent years. In 1985 the Public Health Service recommended establishment of test sites where individuals might be tested for Human T Lymphotropic Virus III (HTLV-III) antibody. An HTLV-III antibody screening program was integrated into a…

  16. Integrative Pre-Service Elementary Teacher Training: The Role of Interdisciplinary Collaborative Mathematics

    ERIC Educational Resources Information Center

    Chiatula, Victoria Oliaku

    2015-01-01

    This primer summarizes interdisciplinary collaborative mathematics as an integrative approach to train pre-service elementary teachers to teach math utilizing Junior Achievement USA (JA) educational programs within an elementary Math Methods course. The primer provides a JA historical background/program overview, summarizes the interdisciplinary…

  17. Integrating Community Services and Research: A Livelihood Needs Assessment at the Countryside of the Philippines

    ERIC Educational Resources Information Center

    Garcia, Rosario C.

    2016-01-01

    (Purpose) This study assessed the integration of community services and research through the livelihood needs assessment of a countryside in the Philippines particularly Sitio Malanas, Lettac Sur, Santol, La Union as basis of the actions in addressing the needs. Specifically, the livelihood situation and needs were determined and proposed actions…

  18. Opportunities for and constraints to integration of health services in Poland*

    PubMed Central

    Sobczak, Alicja

    2002-01-01

    Abstract At the beginning of the article the typologies, expected outcomes and forces aiming at health care integration are discussed. Integration is recognised as a multidimensional concept. The suggested typologies of integration are based on structural configurations, co-ordination mechanisms (including clinical co-ordination), and driving forces. A review of the Polish experience in integration/disintegration of health care systems is the main part of the article. Creation of integrated health care management units (ZOZs) in the beginning of the 1970s serves as an example of structural vertical integration missing co-ordination mechanisms. ZOZs as huge, costly and inflexible organisations became subjects of public criticism and discredited the idea of health care integration. At the end of the 1980s and in the decade of the 1990s, management of public health care was decentralised, the majority of ZOZs dismantled, and many health care public providers got the status of independent entities. The private sector developed rapidly. Sickness funds, which in 1999 replaced the previous state system, introduced “quasi-market” conditions where health providers have to compete for contracts. Some providers developed strategies of vertical and horizontal integration to get a competitive advantage. Consolidation of private ambulatory clinics, the idea of “integrated care” as a “contracting package”, development of primary health care and ambulatory specialist clinics in hospitals are the examples of such strategies. The new health policy declared in 2002 has recognised integration as a priority. It stresses the development of payment mechanisms and information base (Register of Health Services – RUM) that promote integration. The Ministry of Health is involved directly in integrated emergency system designing. It seems that after years of disintegration and deregulation the need for effective integration has become obvious. PMID:16896398

  19. Integrating Social Services and Home-Based Primary Care for High-Risk Patients.

    PubMed

    Feinglass, Joe; Norman, Greg; Golden, Robyn L; Muramatsu, Naoko; Gelder, Michael; Cornwell, Thomas

    2018-04-01

    There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more humane and efficient system. The article describes the strengths and weaknesses of research evaluating the effects of social services in addressing social determinants of health, and how social support is critical to successful acute care transition programs. It reviews the history of incorporating social services into care management, and the prospects that recent payment reforms and regulatory initiatives can succeed in stimulating the financial integration of social services into new care coordination initiatives. The article reviews the literature on home-based primary care for the chronically ill and disabled, and suggests that it is the emergence of this care modality that holds the greatest promise for delivery system reform. In the hope of stimulating further discussion and debate, the authors summarize existing viewpoints on how a home-centered system, which integrates social and medical services, might emerge in the next few years.

  20. How to Integrate HIV and Sexual and Reproductive Health Services in Namibia, the Epako Clinic Case Study

    PubMed Central

    Forster, Norbert; Campuzano, Pedro; Kambapani, Rejoice; Brahmbhatt, Heena; Hidinua, Grace; Turay, Mohamed; Ikandi, Simon Kimathi; Kabongo, Leonard; Zariro, Farai

    2017-01-01

    Introduction: During the past two decades, HIV and Sexual and Reproductive Health services in Namibia have been provided in silos, with high fragmentation. As a consequence of this, quality and efficiency of services in Primary Health Care has been compromised. Methods: We conducted an operational research (observational pre-post study) in a public health facility in Namibia. A health facility assessment was conducted before and after the integration of health services. A person-centred integrated model was implemented to integrate all health services provided at the health facility in addition to HIV and Sexual and Reproductive Health services. Comprehensive services are provided by each health worker to the same patients over time (longitudinality), on a daily basis (accessibility) and with a good external referral system (coordination). Prevalence rates of time flows and productivity were done. Results: Integrated services improved accessibility, stigma and quality of antenatal care services by improving the provider-patient communication, reducing the time that patients stay in the clinic in 16% and reducing the waiting times in 14%. In addition, nurse productivity improved 85% and the expected time in the health facility was reduced 24% without compromising the uptake of TB, HIV, outpatient, antenatal care or first visit family planning services. Given the success on many indicators resulting from integration of services, the goal of this paper was to describe “how” health services have been integrated, the “process” followed and presenting some “results” from the integrated clinic. Conclusions: Our study shows that HIV and SRH services can be effectively integrated by following the person-centred integrated model. Based on the Namibian experience on “how” to integrate health services and the “process” to achieve it, other African countries can replicate the model to move away from the silo approach and contribute to the achievement of

  1. Integrating emergency general surgery with a trauma service: impact on the care of injured patients.

    PubMed

    Pryor, John P; Reilly, Patrick M; Schwab, C William; Kauder, Donald R; Dabrowski, G Paul; Gracias, Vicente H; Braslow, Benjamin; Gupta, Rajan

    2004-09-01

    There has been considerable discussion on the national level on the future of trauma surgery as a specialty. One of the leading directions for the field is the integration of emergency general surgery as a wider and more attractive scope of practice. However, there is currently no information on how the addition of an emergency general surgery practice will affect the care of injured patients. We hypothesized that the care of trauma patients would be negatively affected by adding emergency general surgery responsibilities to a trauma service. Our institution underwent a system change in August 2001, where an emergency general surgery (ES) practice was added to an established trauma service. The ES practice included emergency department and in-house consultations for all urgent surgical problems except thoracic and vascular diseases. There were no trauma staff changes during the study period. Trauma registry data (demographics, injuries, injury severity, and procedures) and performance improvement data (peer-review judgments for all identified errors, denied days, audit filters, and deaths) were abstracted for two 15-month periods surrounding this system change. Chi-square, Fisher's exact, and t tests provided between-group comparisons. The trauma staff evaluated a total of 5,874 patients during the 30-month study. There were 1,400 (51%) trauma admissions in the pre-ES group and 1,504 (48%) in the post-ES group, of which 1,278 and 1,434, respectively, met severity criteria for report to our statewide database (Pennsylvania Trauma Outcome Study [PTOS]). There were 163 (12.7% of PTOS) deaths in the pre-ES group compared with 171 (11.9% PTOS) deaths in the post-ES group (p = not significant [NS]). There was one death determined to be preventable by the peer review process for the pre-ES group, and none in the post-ES group. Both groups had 10 potentially preventable deaths, with the remaining mortalities being categorized as nonpreventable (p = NS). Unexpected deaths

  2. Critical insights for a sustainability framework to address integrated community water services: Technical metrics and approaches.

    PubMed

    Xue, Xiaobo; Schoen, Mary E; Ma, Xin Cissy; Hawkins, Troy R; Ashbolt, Nicholas J; Cashdollar, Jennifer; Garland, Jay

    2015-06-15

    Planning for sustainable community water systems requires a comprehensive understanding and assessment of the integrated source-drinking-wastewater systems over their life-cycles. Although traditional life cycle assessment and similar tools (e.g. footprints and emergy) have been applied to elements of these water services (i.e. water resources, drinking water, stormwater or wastewater treatment alone), we argue for the importance of developing and combining the system-based tools and metrics in order to holistically evaluate the complete water service system based on the concept of integrated resource management. We analyzed the strengths and weaknesses of key system-based tools and metrics, and discuss future directions to identify more sustainable municipal water services. Such efforts may include the need for novel metrics that address system adaptability to future changes and infrastructure robustness. Caution is also necessary when coupling fundamentally different tools so to avoid misunderstanding and consequently misleading decision-making. Published by Elsevier Ltd.

  3. Integrated Community Strategies for Linking Youth to Adolescent Reproductive Health Services: A Case Study.

    PubMed

    Sotolongo, Joy; House, L Duane; Swanson, Sally; Davis, Sarah E H

    2017-03-01

    This article describes the development and promotion of a full-service adolescent health center at a local health department intended to increase teen access to contraceptive and reproductive health care. This work was conducted as part of a multicomponent, community-based teen pregnancy prevention initiative in Gaston County, North Carolina. To increase access to adolescent reproductive health services, we implemented multiple integrated strategies: (1) building community support for adolescent reproductive health services; (2) providing technical assistance to the health department in opening the Teen Wellness Center (TWC), a teen-centered, full-service clinic; (3) strengthening referral partnerships between community organizations and clinical services; and (4) educating teens on how to access reproductive health services. Data were collected to examine the change in the number of adolescent reproductive health clients after the opening of the TWC. In the first year, the TWC was opened, 1,675 adolescent clients received reproductive health services, for a 12.5% increase compared with the prior year. The number of adolescent clients who received more than one type of reproductive health services (e.g., wellness visit and family planning services) increased by 133%. The number of adolescent clients who received family planning services increased by 3.8%. The project achieved an increase in adolescent reproductive health clients. Establishment of a teen-centered, full-service clinic and working with youth-serving agencies to increase knowledge of the clinic's services are promising approaches to increasing teen access to reproductive health care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. Mixing positive and negative valence: Affective-semantic integration of bivalent words.

    PubMed

    Kuhlmann, Michael; Hofmann, Markus J; Briesemeister, Benny B; Jacobs, Arthur M

    2016-08-05

    Single words have affective and aesthetic properties that influence their processing. Here we investigated the processing of a special case of word stimuli that are extremely difficult to evaluate, bivalent noun-noun-compounds (NNCs), i.e. novel words that mix a positive and negative noun, e.g. 'Bombensex' (bomb-sex). In a functional magnetic resonance imaging (fMRI) experiment we compared their processing with easier-to-evaluate non-bivalent NNCs in a valence decision task (VDT). Bivalent NNCs produced longer reaction times and elicited greater activation in the left inferior frontal gyrus (LIFG) than non-bivalent words, especially in contrast to words of negative valence. We attribute this effect to a LIFG-grounded process of semantic integration that requires greater effort for processing converse information, supporting the notion of a valence representation based on associations in semantic networks.

  5. Assessing Patients' Preference for Integrating Herbal Medicine Within Primary Care Services in Saudi Arabia.

    PubMed

    Allam, Safaa; Moharam, Maha; Alarfaj, Gada

    2014-07-01

    Family physician advice and follow-up may be important to reduce the negative aspects of locally marketed herbal remedies and improve the patient outcome. There is a lack of studies assessing the preference of Saudi patients for the integration of herbal medicine into primary care services. To examine the knowledge, attitudes, and practice of Saudi patients toward herbal medicine and its integration into primary care services. A cross-sectional study was conducted between February and March 2013 among adult patients attending the family medicine clinics at a primary care center in Riyadh, Saudi Arabia. A self-administered questionnaire (27 items) was developed and administered to all patients. A total of 240 patients were included in the current analysis. The average age was 33.5 ± 9.9 years, and 61% of the patients were women. Approximately 60% of the patients were aware of herbal medicine use and its possible side effects. More than 85% of the patients believed that herbal containers should be labeled with safety information. Approximately 71% of the patients had a favorable attitude toward integrated services. Approximately 65% of the patients used herbal remedies for themselves, and 42% used them for their children. Preference for integrated services was significantly associated with female sex, better knowledge, positive attitudes toward safety and regulations, and higher level of practice. A good knowledge and a very favorable attitude toward integrating herbal medicine into primary care services were found among a group of patients attending a primary care center in Saudi Arabia. © The Author(s) 2014.

  6. Integrated Metabolomics, Transcriptomics and Proteomics Identifies Metabolic Pathways Affected by Anaplasma phagocytophilum Infection in Tick Cells*

    PubMed Central

    Villar, Margarita; Ayllón, Nieves; Alberdi, Pilar; Moreno, Andrés; Moreno, María; Tobes, Raquel; Mateos-Hernández, Lourdes; Weisheit, Sabine; Bell-Sakyi, Lesley; de la Fuente, José

    2015-01-01

    Anaplasma phagocytophilum is an emerging zoonotic pathogen that causes human granulocytic anaplasmosis. These intracellular bacteria establish infection by affecting cell function in both the vertebrate host and the tick vector, Ixodes scapularis. Previous studies have characterized the tick transcriptome and proteome in response to A. phagocytophilum infection. However, in the postgenomic era, the integration of omics datasets through a systems biology approach allows network-based analyses to describe the complexity and functionality of biological systems such as host–pathogen interactions and the discovery of new targets for prevention and control of infectious diseases. This study reports the first systems biology integration of metabolomics, transcriptomics, and proteomics data to characterize essential metabolic pathways involved in the tick response to A. phagocytophilum infection. The ISE6 tick cells used in this study constitute a model for hemocytes involved in pathogen infection and immune response. The results showed that infection affected protein processing in endoplasmic reticulum and glucose metabolic pathways in tick cells. These results supported tick–Anaplasma co-evolution by providing new evidence of how tick cells limit pathogen infection, while the pathogen benefits from the tick cell response to establish infection. Additionally, ticks benefit from A. phagocytophilum infection by increasing survival while pathogens guarantee transmission. The results suggested that A. phagocytophilum induces protein misfolding to limit the tick cell response and facilitate infection but requires protein degradation to prevent ER stress and cell apoptosis to survive in infected cells. Additionally, A. phagocytophilum may benefit from the tick cell's ability to limit bacterial infection through PEPCK inhibition leading to decreased glucose metabolism, which also results in the inhibition of cell apoptosis that increases infection of tick cells. These

  7. Integrated Metabolomics, Transcriptomics and Proteomics Identifies Metabolic Pathways Affected by Anaplasma phagocytophilum Infection in Tick Cells.

    PubMed

    Villar, Margarita; Ayllón, Nieves; Alberdi, Pilar; Moreno, Andrés; Moreno, María; Tobes, Raquel; Mateos-Hernández, Lourdes; Weisheit, Sabine; Bell-Sakyi, Lesley; de la Fuente, José

    2015-12-01

    Anaplasma phagocytophilum is an emerging zoonotic pathogen that causes human granulocytic anaplasmosis. These intracellular bacteria establish infection by affecting cell function in both the vertebrate host and the tick vector, Ixodes scapularis. Previous studies have characterized the tick transcriptome and proteome in response to A. phagocytophilum infection. However, in the postgenomic era, the integration of omics datasets through a systems biology approach allows network-based analyses to describe the complexity and functionality of biological systems such as host-pathogen interactions and the discovery of new targets for prevention and control of infectious diseases. This study reports the first systems biology integration of metabolomics, transcriptomics, and proteomics data to characterize essential metabolic pathways involved in the tick response to A. phagocytophilum infection. The ISE6 tick cells used in this study constitute a model for hemocytes involved in pathogen infection and immune response. The results showed that infection affected protein processing in endoplasmic reticulum and glucose metabolic pathways in tick cells. These results supported tick-Anaplasma co-evolution by providing new evidence of how tick cells limit pathogen infection, while the pathogen benefits from the tick cell response to establish infection. Additionally, ticks benefit from A. phagocytophilum infection by increasing survival while pathogens guarantee transmission. The results suggested that A. phagocytophilum induces protein misfolding to limit the tick cell response and facilitate infection but requires protein degradation to prevent ER stress and cell apoptosis to survive in infected cells. Additionally, A. phagocytophilum may benefit from the tick cell's ability to limit bacterial infection through PEPCK inhibition leading to decreased glucose metabolism, which also results in the inhibition of cell apoptosis that increases infection of tick cells. These results

  8. The Personal Emergency Response System as a Technology Innovation in Primary Health Care Services: An Integrative Review.

    PubMed

    Stokke, Randi

    2016-07-14

    Most western countries are experiencing greater pressure on community care services due to increased life expectancy and changes in policy toward prioritizing independent living. This has led to a demand for change and innovation in caring practices with an expected increased use of technology. Despite numerous attempts, it has proven surprisingly difficult to implement and adopt technological innovations. The main established technological innovation in home care services for older people is the personal emergency response system (PERS), which is widely adopted and used throughout most western countries aiming to support "aging safely in place." This integrative review examines how research literature describes use of the PERS focusing on the users' perspective, thus exploring how different actors experience the technology in use and how it affects the complex interactions between multiple actors in caring practices. The review presents an overview of the body of research on this well-established telecare solution, indicating what is important for different actors in regard to accepting and using this technology in community care services. An integrative review, recognized by a systematic search in major databases followed by a review process, was conducted. The search resulted in 33 included studies describing different actors' experiences with the PERS in use. The overall focus was on the end users' experiences and the consequences of having and using the alarm, and how the technology changes caring practices and interactions between the actors. The PERS contributes to safety and independent living for users of the alarm, but there are also unforeseen consequences and possible improvements in the device and the integrated service. This rather simple and well-established telecare technology in use interacts with the actors involved, creating changes in daily living and even affecting their identities. This review argues for an approach to telecare in which the

  9. The Personal Emergency Response System as a Technology Innovation in Primary Health Care Services: An Integrative Review

    PubMed Central

    2016-01-01

    Background Most western countries are experiencing greater pressure on community care services due to increased life expectancy and changes in policy toward prioritizing independent living. This has led to a demand for change and innovation in caring practices with an expected increased use of technology. Despite numerous attempts, it has proven surprisingly difficult to implement and adopt technological innovations. The main established technological innovation in home care services for older people is the personal emergency response system (PERS), which is widely adopted and used throughout most western countries aiming to support “aging safely in place.” Objective This integrative review examines how research literature describes use of the PERS focusing on the users’ perspective, thus exploring how different actors experience the technology in use and how it affects the complex interactions between multiple actors in caring practices. Methods The review presents an overview of the body of research on this well-established telecare solution, indicating what is important for different actors in regard to accepting and using this technology in community care services. An integrative review, recognized by a systematic search in major databases followed by a review process, was conducted. Results The search resulted in 33 included studies describing different actors’ experiences with the PERS in use. The overall focus was on the end users’ experiences and the consequences of having and using the alarm, and how the technology changes caring practices and interactions between the actors. Conclusions The PERS contributes to safety and independent living for users of the alarm, but there are also unforeseen consequences and possible improvements in the device and the integrated service. This rather simple and well-established telecare technology in use interacts with the actors involved, creating changes in daily living and even affecting their identities

  10. Factors Affecting Staff Perceptions of Tele-ICU Service in Rural Hospitals.

    PubMed

    Ward, Marcia M; Ullrich, Fred; Potter, Andrew J; MacKinney, A Clinton; Kappel, Sarah; Mueller, Keith J

    2015-06-01

    Telemedicine is designed to increase access to specialist care, especially in settings distant from tertiary-care centers. One of the more established telemedicine applications in hospitals is the tele-intensive care unit (tele-ICU). Perceptions of tele-ICU users are not well studied. Thus, we undertook a study focused on assessing staff acceptance at multiple hospitals that had implemented a tele-ICU system. We designed a survey instrument that gathered perceptions on multiple facets of tele-ICU use and administered it to clinical and administrative staff at 28 hospitals that had implemented a tele-ICU system. We also conducted interviews at half of these hospitals to gain a deeper understanding of factors affecting staff perceptions of tele-ICU services. The 145 survey respondents were generally positive about all facets of the service. Analyses found no significant differences in comparisons between critical access and larger hospitals or between clinical and administrative/managerial respondents, although a few differences between providers and nurses emerged. Respondents at hospitals averaging more tele-ICU use and that had implemented it longer were significantly (p<0.05) more positive in their responses on multiple survey items than other respondents. Interviews corroborated and provided insight into survey responses. Tele-ICU was particularly valued when critical access hospitals retained critical care patients during special circumstances and when the tele-ICU hub could monitor patients to provide relief for local providers and nurses. Tele-ICU can aid rural hospitals, but multiple delivery models are warranted to meet disparate needs.

  11. Interoceptive Dysfunction: Toward An Integrated Framework for Understanding Somatic and Affective Disturbance in Depression

    PubMed Central

    Harshaw, Christopher

    2014-01-01

    Depression is characterized by disturbed sleep and eating, a variety of other, nonspecific somatic symptoms, and significant somatic comorbidities. Why there is such close association between cognitive and somatic dysfunction in depression is nonetheless poorly understood. An explosion of research in the area of interoception—the perception and interpretation of bodily signals—over the last decade nonetheless holds promise for illuminating what have until now been obscure links between the social, cognitive-affective, and somatic features of depression. This paper reviews rapidly accumulating evidence that both somatic signaling and interoception are frequently altered in depression. This includes comparative studies showing vagus-mediated effects on depression-like behaviors in rodent models as well as studies in humans indicating both dysfunction in the neural substrates for interoception (e.g., vagus, insula, anterior cingulate cortex) and reduced sensitivity to bodily stimuli in depression. An integrative framework for organizing and interpreting this evidence is put forward which incorporates (a) multiple potential pathways to interoceptive dysfunction; (b) interaction with individual, gender, and cultural differences in interoception; and (c) a developmental psychobiological systems perspective, emphasizing likely differential susceptibility to somatic and interoceptive dysfunction across the lifespan. Combined with current theory and evidence, it is suggested that core symptoms of depression (e.g., anhedonia, social deficits) may be products of disturbed interoceptive-exteroceptive integration. More research is nonetheless needed to fully elucidate the relationship between mind, body, and social context in depression. PMID:25365763

  12. Impairment of sensory-motor integration in patients affected by RLS.

    PubMed

    Rizzo, Vincenzo; Aricò, I; Liotta, G; Ricciardi, L; Mastroeni, C; Morgante, F; Allegra, R; Condurso, R; Girlanda, P; Silvestri, R; Quartarone, A

    2010-12-01

    Much evidence suggests that restless legs syndrome (RLS) is a disorder characterized by an unsuppressed response to sensory urges due to abnormalities in inhibitory pathways that specifically link sensory input and motor output. Therefore, in the present study, we tested sensory-motor integration in patients with RLS, measured by short latency afferent inhibition (SAI) and long latency afferent inhibition (LAI). SAI and LAI were determined using transcranial magnetic stimulation before and after 1 month of dopaminergic treatment in RLS patients. Ten naïve patients with idiopathic RLS and ten healthy age-matched controls were recruited. Patients with secondary causes for RLS (e.g. renal failure, anaemia, low iron and ferritin) were excluded, as well as those with other sleep disorders. Untreated RLS patients demonstrated deficient SAI in the human motor cortex, which proved revertible toward normal values after dopaminergic treatment. We demonstrated an alteration of sensory-motor integration, which is normalized by dopaminergic treatment, in patients affected by RLS. It is likely that the reduction of SAI might contribute significantly to the release of the involuntary movements and might account for the sensory urge typical of this condition.

  13. Evolving the Optical Transport Network Management to Integrate Multiple Technologies and Services

    NASA Astrophysics Data System (ADS)

    Comi, Alberto; Gallina, Marco

    Optical networks are evolving at a fast pace from traditional synchronous digital hierarchy/synchronous optical network (SDH/SONET) and wavelength division multiplexing (WDM) infrastructures, used by client network layers in overlay mode, to a converged multi-service and multi-technology network able to transport traditional time division multiplexing (TDM) traffic and new packet traffic in a flexible way. Alcatel-Lucent is leading the network transformation required by network providers to offer data transport while guaranteeing the same quality and reliability typical of classical transport services. The introduction of new data communication services requires an evolution of the network management platform that needs to integrate new management applications associated with the new technologies and services. The resulting network has to be integrated from service provisioning and management system viewpoints to optimize its use and to reduce the in-field modifications of the transport network. This article describes specificities in the management of multi-service networks, identifying the management architecture able to support the rapid evolution of such environment.

  14. What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

    PubMed Central

    Kemper, Kathi J; Dirkse, Deborah; Eadie, Dee; Pennington, Melissa

    2007-01-01

    Background Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. Methods We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. Results Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). Conclusion There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life. PMID:17291340

  15. Modeling an integrative oncology program within a community-centered oncology service in Israel.

    PubMed

    Ben-Arye, Eran; Schiff, Elad; Shapira, Chen; Frenkel, Moshe; Shalom, Tamar; Steiner, Mariana

    2012-12-01

    Describing the processes that preceded the opening of an integrative oncology program (IOP) within the oncology service (OS) of the largest health maintenance organization in northern Israel. The groundwork towards initiation of the IOP was based on three key elements (1) Interviews with patients, practitioners and directors were performed in order to explore perspectives regarding complementary medicine integration (CM) within the OS; (2) review of research data on CM efficacy and safety in cancer care; (3) critical comparative analysis of seven models of IOPs in Israel, Europe, and the U.S. Ninety-three interviews included 24 patients, 34 conventional practitioners, 9 medical directors, and 26 CM-trained practitioners. The interviews revealed that there is a need for CM in the OS, aimed towards improving patients' well-being during chemotherapy and advanced disease. An integrative oncology score (IOS) was formulated based on 6 themes considered promoters of successful integration. Integration of CM within an oncology service should address patients' needs and research knowledge and be built upon mandatory practitioners' communication. IOP modeling necessitates in-depth study aimed at revealing the OS needs and expectations, adjusting research data to the OS clinical challenges, and tailoring an appropriate model of integrative care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. A Correlational Study of How Airline Customer Service and Consumer Perception of Airline Customer Service Affect the Air Rage Phenomenon

    NASA Technical Reports Server (NTRS)

    Hunter, Joyce A.

    2007-01-01

    Between 1995 and 2000, customer service declined throughout the airline industry, as reported in February 2001 by the U.S. Department of Transportation (2001). One of the biggest problems today within the airline industry is the constant complaining from customers regarding the deterioraton of service (McCollough, Berry, & Yadav, 2000). Since 1995, unfortunately no airline has been immune from service deterioration, as reported by the Airline Quality Rating, an annual report by two airline industry experts who analyzed Department of Transportation statistics (Harrison & Kleinsasser, 1999). The airline' refusal to recognize the issue of customer service has perpetuated an environment that has become dangerous and detrimental to the traveling public as well as to airline employees, which in turn has fueled a new phenomenon, now referred to as "air rage".

  17. Providing primary health care through integrated microfinance and health services in Latin America.

    PubMed

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  18. First, keep it safe: Integration of a complementary medicine service within a hospital.

    PubMed

    Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

    2018-04-17

    This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

  19. Health justice partnerships: initial insights into the delivery of an integrated health and legal service for youth in regional Victoria.

    PubMed

    Ollerenshaw, Alison; Camilleri, Margaret

    2017-01-01

    This article presents interim findings from research examining the implementation of a health justice partnership (HJP) focusing on the legal and health needs of regional young people. HJPs provide an innovative service model offering an integrated health and legal service for the community. HJPs are a relatively new service model for Australia, yet the program is well suited to meet the needs of particular population cohorts, including young people and those in regional locations experiencing complex legal issues. Funded by the Victorian Legal Services Board and Commissioner, an HJP in partnership with three organisations was established in a large regional area in Victoria, Australia. Research is being conducted alongside the program to examine its impact on young people, and the implications on practice for staff in the partner organisations. Findings provide preliminary support for the HJP model with a number of young people - from predominantly disadvantaged backgrounds and with varying legal issues - having been referred to the program in the first 6 months. Referrals were received from both partner agencies and external agencies. Initial client and staff survey responses indicate that the legal problem of the young people was affecting how they feel. While these findings provide preliminary support for the HJP further research will offer longer term insights about HJPs within the Australian context, particularly rural and regional settings.

  20. The Effect of Computer-Assisted Learning Integrated with Metacognitive Prompts on Students' Affective Skills

    NASA Astrophysics Data System (ADS)

    Tatar, Nilgün; Akpınar, Ercan; Feyzioğlu, Eylem Yıldız

    2013-10-01

    The purpose of this study is to investigate the effect of computer-assisted learning integrated with metacognitive prompts on elementary students' affective skills on the subject of electricity. The researchers developed educational software to enable students to easily and comprehensively learn the concepts in the subject of electricity. A case study method was used. Eighteen students from the seventh grade (12-13 years) participated in the study. Students' views on their performances while using educational software and the impact of the software on their affective skills towards the subject of electricity were examined. Data were collected by open-ended questions in the educational software. According to the research results, there were students who had negative attitudes and perceptions before starting to learn about the subject of electricity. Interactive activities, animations, and visual experiments in the educational software were effective in overcoming the students' negative attitudes and perceptions about the subject. Besides, students who assessed their own performances during the learning process believed themselves to be more successful over time. In the light of the research results, some suggestions are made for future studies.

  1. Clinical outcomes associated with receipt of integrated pharmacy services by hemodialysis patients: a quality improvement report.

    PubMed

    Weinhandl, Eric D; Arneson, Thomas J; St Peter, Wendy L

    2013-09-01

    Reducing medication-related problems and improving medication adherence in hemodialysis patients may improve clinical outcomes. In 2005, a large US dialysis organization created an integrated pharmacy program for its patients. We aimed to compare the outcomes of hemodialysis patients enrolled in this program and matched control patients. Quality improvement report. Hemodialysis patients with concurrent Medicare and Medicaid eligibility who chose to receive program services and propensity score-matched controls; the propensity score was an estimated function of demographic characteristics, comorbid conditions, medication exposure, serum concentrations, and vascular access method. Program services included medication delivery, refill management, medication list reviews, telephonic medication therapy management, and prior authorization assistance. Relative rates of death and hospitalization. Survival estimates calculated with the Kaplan-Meier method; mortality hazards compared with Cox regression; hospitalization rates compared with Poisson regression. In outcome models, there were 8,864 patients receiving integrated pharmacy services and 43,013 matched controls. In intention-to-treat and as-treated analyses, mortality HRs for patients receiving integrated pharmacy services versus matched controls were 0.92 (95% CI, 0.86-0.97) and 0.79 (95% CI, 0.74-0.84), respectively. Corresponding relative rates of hospital admissions were 0.98 (95% CI, 0.95-1.01) and 0.93 (95% CI, 0.90-0.96), respectively, and of hospital days, 0.94 (95% CI, 0.90-0.98) and 0.86 (95% CI, 0.82-0.90), respectively. Cumulative incidences of disenrollment from the pharmacy program were 23.4% at 12 months and 37.0% at 24 months. Patients were not randomly assigned to receive integrated pharmacy services; as-treated analyses may be biased because of informative censoring by disenrollment from the pharmacy program; data regarding use of integrated pharmacy services were lacking. Receipt of integrated

  2. Component-based mediation services for the integration of medical applications.

    PubMed

    Xu, Y; Sauquet, D; Degoulet, P; Jaulent, M-C

    2003-03-01

    Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health-care information systems. The European project SynEx aims at developing an integration platform for both new and legacy applications on each partner's site. We developed, in this project, mediation services based on the generic and reusable software components that facilitate the construction of an integration platform and ease the communication and the meaningful transformation among distributed and heterogeneous applications. The main component of the mediation services is named Pilot, which serves as an intelligent broker. It uses a multi-agents service model allowing the integration platform to be multi-servers. It transforms a client request into a valid high level service on the platform. Each service is broken up into several elementary steps by the Pilot. For each step, the Pilot uses an agent to realize the operation configured by the step. At runtime, the Pilot synchronizes the execution of different steps. To ease the communication and the interaction with the heterogeneous systems, an agent can integrate a Mediator. The Mediators are the communication and interpretation tools within the mediation services. We have developed a generic model that can be specialized for creating specific mediators for the different use cases. The mediator model uses two interfaces to connect the mediator with two systems that need to communicate. Each interface deals with the three aspects through three managers (the Communication Manager, the Syntax Manager and the Semantic Manager). Some ready-to-use specializations are developed for some well defined cases which can reduce the development effort. Once a manager is specialized, it can be used in different combinations with other managers to resolve different problems. The meaningful transformation is ensured on a semantic level in each mediator through the Semantic Model

  3. Strengthening systems for integrated early childhood development services: a cross-national analysis of governance.

    PubMed

    Britto, Pia Rebello; Yoshikawa, Hirokazu; van Ravens, Jan; Ponguta, Liliana Angelica; Reyes, Maria; Oh, Soojin; Dimaya, Roland; Nieto, Ana María; Seder, Richard

    2014-01-01

    While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs. © 2014 New York Academy of Sciences.

  4. TogoWS: integrated SOAP and REST APIs for interoperable bioinformatics Web services

    PubMed Central

    Katayama, Toshiaki; Nakao, Mitsuteru; Takagi, Toshihisa

    2010-01-01

    Web services have become widely used in bioinformatics analysis, but there exist incompatibilities in interfaces and data types, which prevent users from making full use of a combination of these services. Therefore, we have developed the TogoWS service to provide an integrated interface with advanced features. In the TogoWS REST (REpresentative State Transfer) API (application programming interface), we introduce a unified access method for major database resources through intuitive URIs that can be used to search, retrieve, parse and convert the database entries. The TogoWS SOAP API resolves compatibility issues found on the server and client-side SOAP implementations. The TogoWS service is freely available at: http://togows.dbcls.jp/. PMID:20472643

  5. Integration of Specialized Pain Control Services in Palliative Care: A Nationwide Web-based Survey.

    PubMed

    Page, Nivedita Dilip

    2017-01-01

    Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking. An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored. Majority of palliative physicians came across situations where specialists in pain would control the patients' pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients. Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available.

  6. Integration of Specialized Pain Control Services in Palliative Care: A Nationwide Web-based Survey

    PubMed Central

    Page, Nivedita Dilip

    2017-01-01

    Introduction: Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking. Materials and Methods: An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored. Results: Majority of palliative physicians came across situations where specialists in pain would control the patients’ pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients. Conclusions: Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available. PMID:28503043

  7. Integrating medical abortion into safe abortion services: experience from three pilot sites in South Africa.

    PubMed

    Kawonga, Mary; Blanchard, Kelly; Cooper, Diane; Cullingworth, Lee; Dickson, Kim; Harrison, Teresa; von Mollendorf, Claire; Winikoff, Beverly

    2008-07-01

    South Africa's Choice on Termination of Pregnancy Act of 1996 provides for safe termination of pregnancy (TOP) in designated facilities in the public and private health sectors. In 2001, mifepristone-misoprostol medical abortion was approved for TOP up to 56 days, but this method is not yet available in the public sector. Information on the operational requirements for integrating mifepristone-misoprostol medical abortion into South Africa's public sector safe abortion services is required to guide policy decisions. This study trained health workers to provide medical abortion to 290 women attending three TOP sites. Prospective data were collected to ascertain women's experience of the method, pregnancy outcome, women's and provider's acceptability of the method, and the operational requirements for providing medical abortion. Twenty-nine (10%) women were lost to follow-up; 261 (90%) women had a confirmed abortion outcome, of whom 93% had a complete abortion. Given the option, the vast majority of women opted to use misoprostol at home. No serious side effects were reported; pain (66%), and heavy bleeding (67%) were the most common side effects. Most (96%) women were very satisfied with the experience. Health providers were satisfied with providing medical abortion and recommended its introduction to complement existing surgical TOP services. This study demonstrates that integration of medical abortion into public sector services is feasible. The results of this study will guide policy decisions about integrating medical abortion into South Africa's public sector safe abortion services, within the context of the existing enabling legislative framework.

  8. Integration of primary health services: being put together does not mean they will work together.

    PubMed

    Lawn, Sharon; Lloyd, Andrea; King, Alison; Sweet, Linda; Gum, Lyn

    2014-01-30

    This paper reports on an Australian experience of co-locating a range of different primary health services into one building, with the aim of providing integrated services. It discusses some of the early challenges involved with moving services together and reasons why collaborative and integrated working relationships to improve the clients' journey, may remain elusive. Ethnographic observational data was collected within a GP plus site as part of day-to-day interactions between the research officer and health professionals. This involved observations of team processes within and across teams at the site. Observations were thematically analysed using a social anthropological approach. Three main themes arose from the analysis: Infrastructural impediments to collaboration; Territorialism; and Interprofessional practice (IPP) simply not on the agenda. The experience of this setting demonstrates that dedicated staff and resources are needed to keep IPP on the agenda of health service organisations. This is especially important where organisations are attempting to implement new models of collaborative and co-located services. Furthermore, it shows that establishing IPP within newly co-located services is a process that needs time to develop, as part of teams building trust with each other in new circumstances, in order to eventually build a new cultural identity for the co-located services. Co-located health service systems can be complex, with competing priorities and differing strategic plans and performance indicators to meet. This, coupled with the tendency for policy makers to move on to their next issue of focus, and to shift resources in the process, means that adequate time and resources for IPP are often overlooked. Shared interprofessional student placements may be one way forward.

  9. The Costs of Delivering Integrated HIV and Sexual Reproductive Health Services in Limited Resource Settings

    PubMed Central

    Obure, Carol Dayo; Sweeney, Sedona; Darsamo, Vanessa; Michaels-Igbokwe, Christine; Guinness, Lorna; Terris-Prestholt, Fern; Muketo, Esther; Nhlabatsi, Zelda; Warren, Charlotte E.; Mayhew, Susannah; Watts, Charlotte; Vassall, Anna

    2015-01-01

    Objective To present evidence on the total costs and unit costs of delivering six integrated sexual reproductive health and HIV services in a high and medium HIV prevalence setting, in order to support policy makers and planners scaling up these essential services. Design A retrospective facility based costing study conducted in 40 non-government organization and public health facilities in Kenya and Swaziland. Methods Economic and financial costs were collected retrospectively for the year 2010/11, from each study site with an aim to estimate the cost per visit of six integrated HIV and SRH services. A full cost analysis using a combination of bottom-up and step-down costing methods was conducted from the health provider’s perspective. The main unit of analysis is the economic unit cost per visit for each service. Costs are converted to 2013 International dollars. Results The mean cost per visit for the HIV/SRH services ranged from $Int 14.23 (PNC visit) to $Int 74.21 (HIV treatment visit). We found considerable variation in the unit costs per visit across settings with family planning services exhibiting the least variation ($Int 6.71-52.24) and STI treatment and HIV treatment visits exhibiting the highest variation in unit cost ranging from ($Int 5.44-281.85) and ($Int 0.83-314.95), respectively. Unit costs of visits were driven by fixed costs while variability in visit costs across facilities was explained mainly by technology used and service maturity. Conclusion For all services, variability in unit costs and cost components suggest that potential exists to reduce costs through better use of both human and capital resources, despite the high proportion of expenditure on drugs and medical supplies. Further work is required to explore the key drivers of efficiency and interventions that may facilitate efficiency improvements. PMID:25933414

  10. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    PubMed

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  11. Global health: Integrating national laboratory health systems and services in resource-limited settings.

    PubMed

    Parsons, Linda M; Somoskovi, Akos; Lee, Evan; Paramasivan, Chinnambedu N; Schneidman, Miriam; Birx, Deborah; Roscigno, Giorgio; Nkengasong, John

    2012-01-01

    Laboratory systems worldwide are challenged not only by the need to compete for scarce resources with other sections of national health care programmes, but also with the lack of understanding of the critical role that laboratories play in the accurate diagnosis and monitoring of patients suffering from high-burdens of disease. An effective approach to establishing cost-effective laboratory systems that provide rapid and accurate test results for optimal impact on patient care is to move away from disease-specific programmes and establish integrated laboratory services. An integrated laboratory network provides all primary diagnostic services needed for care and treatment without requiring patients to go to different laboratory facilities for specific tests. Such a network focuses on providing quality-assured basic laboratory testing through the use of common specimen collection, reporting and diagnostic platforms that can be used across diseases. An integrated laboratory system also provides specimen transport to specialised laboratories and an environment conducive to the introduction and use of new and more complex technologies that would benefit the patient population and public health systems as a whole. As such, this article described various strategies for, and practical examples of, the successful integration of laboratory services.

  12. A stakeholder visioning exercise to enhance chronic care and the integration of community pharmacy services.

    PubMed

    Franco-Trigo, L; Tudball, J; Fam, D; Benrimoj, S I; Sabater-Hernández, D

    2018-02-21

    Collaboration between relevant stakeholders in health service planning enables service contextualization and facilitates its success and integration into practice. Although community pharmacy services (CPSs) aim to improve patients' health and quality of life, their integration in primary care is far from ideal. Key stakeholders for the development of a CPS intended at preventing cardiovascular disease were identified in a previous stakeholder analysis. Engaging these stakeholders to create a shared vision is the subsequent step to focus planning directions and lay sound foundations for future work. This study aims to develop a stakeholder-shared vision of a cardiovascular care model which integrates community pharmacists and to identify initiatives to achieve this vision. A participatory visioning exercise involving 13 stakeholders across the healthcare system was performed. A facilitated workshop, structured in three parts (i.e., introduction; developing the vision; defining the initiatives towards the vision), was designed. The Chronic Care Model inspired the questions that guided the development of the vision. Workshop transcripts, researchers' notes and materials produced by participants were analyzed using qualitative content analysis. Stakeholders broadened the objective of the vision to focus on the management of chronic diseases. Their vision yielded 7 principles for advanced chronic care: patient-centered care; multidisciplinary team approach; shared goals; long-term care relationships; evidence-based practice; ease of access to healthcare settings and services by patients; and good communication and coordination. Stakeholders also delineated six environmental factors that can influence their implementation. Twenty-four initiatives to achieve the developed vision were defined. The principles and factors identified as part of the stakeholder shared-vision were combined in a preliminary model for chronic care. This model and initiatives can guide policy

  13. Bridging the gap: an integrated paediatric to adult clinical service for young adults with kidney failure.

    PubMed

    Harden, P N; Walsh, G; Bandler, N; Bradley, S; Lonsdale, D; Taylor, J; Marks, S D

    2012-06-01

    Transition from paediatric to adult care of young adults with chronic diseases is poorly coordinated, often delayed, and usually managed through a single referral letter. About 35% of young adults lose a successfully functioning kidney transplant within 36 months of transfer from paediatric to adult services. Before and after study of the impact of a new integrated paediatric-adult clinical service for patients with kidney failure. Adult renal centre in Oxford and two paediatric renal centres in London. An integrated paediatric-young adult joint transition clinic and care pathway was established in 2006, in conjunction with a young adult clinical service with regular community based clinics. Previously, young adult transplant recipients were transferred by a single referral letter to an adult renal consultant and managed in a conventional adult clinic. Rates of acute rejection and loss of kidney transplants five years before and five years after the introduction of the integrated young adult care pathway. EFFECTS OF THE CHANGE: Nine young adult kidney transplant recipients were transferred directly to adult care between 2000 and 2006 (group 1). From 2006 to 2010, 12 young adult transplant recipients underwent integrated transition into the new young adult service (group 2). Six transplants were lost in group 1 (67%) compared with no transplant losses in group 2. Implementing an integrated transition clinic, coupled with improving young adults' healthcare experience through a young adult clinic, improved patient adherence to regular medication and engagement with healthcare providers, as judged by reduced transplant failure rates. This model may be applicable to other young adult populations with chronic disease transferring to adult healthcare.

  14. Integrating PMTCT Into Maternal, Newborn, and Child Health and Related Services: Experiences From the Global Plan Priority Countries.

    PubMed

    Kiragu, Karusa; Collins, Lynn; Von Zinkernagel, Deborah; Mushavi, Angela

    2017-05-01

    The urgency to scale-up sustainable programs for the prevention of mother-to-child transmission of HIV (PMTCT) prompted priority countries of the Global Plan Toward the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan) to expand the delivery of PMTCT services through greater integration with sexual and reproductive health and child health services. Countries approached integration-what, where, and how services are provided-in diverse ways, with predominantly favorable results. Approaches to integrated services have increased access to a broader range of PMTCT interventions, and they also have proved to be largely acceptable to clients and providers. The integration of PMTCT interventions with maternal, newborn, and child health settings was supported by strategies to reconfigure service delivery to provide additional services, including shifting tasks to nurses (such as initiating antiretroviral therapy and providing long-term follow-up). This was complemented by supporting community outreach and integrating HIV and sexual and reproductive health services bidirectionally, including by providing family planning through antiretroviral therapy clinics and HIV testing in family planning clinics. A systematic and rigorous study of country experiences integrating HIV and maternal, newborn, and child health services, including maternal and pediatric TB services, cost analysis, could provide valuable lessons and demonstrate how such integration can improve systems for health care delivery.

  15. Commercial aviation : factors affecting efforts to improve air service at small community airports

    DOT National Transportation Integrated Search

    2003-01-01

    The nations small communities face a range of fundamental economic : challenges in obtaining and retaining the commercial airline service they : desire or making their existing service more attractive to potential : passengers. The smallest of the...

  16. Integrating adolescent-friendly health services into the public health system: an experience from rural India.

    PubMed

    Mehra, Sunil; Sogarwal, Ruchi; Chandra, Murari

    2013-01-01

    Although India's health policy is directed toward improving adolescent reproductive health, adolescent-friendly health services are scarce. The intervention for "integrating adolescent-friendly health services into the public health system" is an effort to improve the health status of adolescents in rural areas of the Varanasi (Arajiline) and Bangalore (Hosakote) districts in India. The purpose of this article is to describe the features of the intervention and investigate the impact on improving awareness and utilization of services by adolescent as well as quality of ARSH services in the intervention districts. Data from project monitoring, community survey (737 adolescents), exit interviews (120 adolescents), assessment of adolescent sexual and reproductive health clinics (n = 4), and health service statistics were used. Descriptive analyses and paired t-tests were used to compare the two intervention districts. Overall, the percentage of adolescents who were aware of the services being offered at a health-care facility was higher in Hosakote (range: 56.2% to 74.7%) as compared to Arajiline (range: 67.3% to 96.9); 23.3% and 42.6% of adolescents in Arajiline and Hosakote typically sought multiple services at any one visit. A large percentage of clients (Arajiline: 81.7%; Hosakote: 95.0%) were satisfied with the services they received from the facility. The relative change in uptake of services from the first quarter (January to March 2009) to the last quarter (October to December 2010) was significantly higher in Arajiline (7.93, P = 0.020) than in Hosakote (0.78, P = 0.007). The intervention had positive results for the public health system and the services are being scaled up to different blocks of the districts, under a public-private partnership.

  17. Integration and co-location of HIV/AIDS, tuberculosis and drug treatment services.

    PubMed

    Sylla, Laurie; Bruce, R Douglas; Kamarulzaman, Adeeba; Altice, Frederick L

    2007-08-01

    Injection drug use (IDU) plays a critical role in the HIV epidemic in several countries throughout the world. In these countries, injection drug users are at significant risk for both HIV and tuberculosis, and active IDU negatively impacts treatment access, adherence and retention. Comprehensive strategies are therefore needed to effectively deliver preventive, diagnostic and curative services to these complex patient populations. We propose that developing co-located integrated care delivery systems should become the focus of national programmes as they continue to scale-up access to antiretroviral medications for drug users. Existing data suggest that such a programme will expand services for each of these diseases; increase detection of tuberculosis (TB) and HIV; improve medication adherence; increase entry into substance use treatment; decrease the likelihood of adverse drug events; and improve the effectiveness of prevention interventions. Key aspects of integration programmes include: co-location of services convenient to the patient; provision of effective substance use treatment, including pharmacotherapies; cross-training of generalist and specialist care providers; and provision of enhanced monitoring of drug-drug interactions and adverse side effects. Central to implementing this agenda will be fostering the political will to fund infrastructure and service delivery, expanding street-level outreach to IDUs, and training community health workers capable of cost effectively delivering these services.

  18. Integration and co-location of HIV/AIDS, tuberculosis and drug treatment services

    PubMed Central

    Sylla, Laurie; Bruce, R. Douglas; Kamarulzaman, Adeeba; Altice, Frederick L.

    2008-01-01

    Injection drug use (IDU) plays a critical role in the HIV epidemic in several countries throughout the world. In these countries, injection drug users are at significant risk for both HIV and tuberculosis, and active IDU negatively impacts treatment access, adherence and retention. Comprehensive strategies are therefore needed to effectively deliver preventive, diagnostic and curative services to these complex patient populations. We propose that developing co-located integrated care delivery systems should become the focus of national programmes as they continue to scale-up access to antiretroviral medications for drug users. Existing data suggest that such a programme will expand services for each of these diseases; increase detection of tuberculosis (TB) and HIV; improve medication adherence; increase entry into substance use treatment; decrease the likelihood of adverse drug events; and improve the effectiveness of prevention interventions. Key aspects of integration programmes include: co-location of services convenient to the patient; provision of effective substance use treatment, including pharmacotherapies; cross-training of generalist and specialist care providers; and provision of enhanced monitoring of drug-drug interactions and adverse side effects. Central to implementing this agenda will be fostering the political will to fund infrastructure and service delivery, expanding street-level outreach to IDUs, and training community health workers capable of cost effectively delivering these services. PMID:17689379

  19. Embedded Promotions in Online Services: How Goal-Relevance Ambiguity Shapes Response and Affect

    ERIC Educational Resources Information Center

    Brasel, S. Adam

    2010-01-01

    Adding promotions to online services is increasingly commonplace, yet consumers may have difficulty determining whether service-embedded promotions are goal-relevant, due to the linear and transactional nature of online services. This contextual effect of goal-relevance ambiguity on promotions is explored across three studies. An exploratory study…

  20. Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting.

    ERIC Educational Resources Information Center

    Gillette, Joyce L.; And Others

    1982-01-01

    Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…

  1. How Outpatient Substance Abuse Treatment Unit Director Activities May Affect Provision of Community Outreach Services

    ERIC Educational Resources Information Center

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri

    2013-01-01

    Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…

  2. 'Drug adherence levels are falling down again': health worker perceptions of women's service utilization before and after integration of HIV/AIDS services into general care in India.

    PubMed

    Shukla, Shrivridhi; Muchomba, Felix M; McCoyd, Judith L M

    2018-03-26

    Integrated models of HIV/AIDS service delivery are believed to have advantages over stand-alone models of care from health planners' and providers' perspectives. Integration models differ, yet there is little information about the influence of differing models on workers' beliefs about models' efficacy. Here, we examine the effect of integration of HIV care into the general health system in India. In 2014, India replaced its stand-alone model of HIV service delivery-Community Care Centers (CCCs)-with a purported integrated model that delivers HIV medical services at general hospitals and HIV psychosocial services at nearby Care and Support Centers (CSCs). We examine 15 health workers' perceptions of how change from the earlier stand-alone model to the current model impacted women's care in a district in Uttar Pradesh, India. Results indicate that (1) Women's antiretroviral (ART) adherence and utilization of psychosocial support service for HIV/AIDS suffered when services were not provided at one site; (2) Provision of inpatient care in the CCC model offered women living in poverty personal safety in accessing HIV health services and promoted chances of competent ART usage and repeat service utilization; and (3) Although integration of HIV services with the general health system was perceived to improve patient anonymity and decrease chances of HIV-related stigma and discrimination, resource shortages continued to plague the integrated system while shifting costs of time and money to the patients. Findings suggest that integration efforts need to consider the context of service provision and the gendered nature of access to HIV care.

  3. Integrity Analysis of Real-Time Ppp Technique with Igs-Rts Service for Maritime Navigation

    NASA Astrophysics Data System (ADS)

    El-Diasty, M.

    2017-10-01

    Open sea and inland waterways are the most widely used mode for transporting goods worldwide. It is the International Maritime Organization (IMO) that defines the requirements for position fixing equipment for a worldwide radio-navigation system, in terms of accuracy, integrity, continuity, availability and coverage for the various phases of navigation. Satellite positioning systems can contribute to meet these requirements, as well as optimize marine transportation. Marine navigation usually consists of three major phases identified as Ocean/Coastal/Port approach/Inland waterway, in port navigation and automatic docking with alert limit ranges from 25 m to 0.25 m. GPS positioning is widely used for many applications and is currently recognized by IMO for a future maritime navigation. With the advancement in autonomous GPS positioning techniques such as Precise Point Positioning (PPP) and with the advent of new real-time GNSS correction services such as IGS-Real-Time-Service (RTS), it is necessary to investigate the integrity of the PPP-based positioning technique along with IGS-RTS service in terms of availability and reliability for safe navigation in maritime application. This paper monitors the integrity of an autonomous real-time PPP-based GPS positioning system using the IGS real-time service (RTS) for maritime applications that require minimum availability of integrity of 99.8 % to fulfil the IMO integrity standards. To examine the integrity of the real-time IGS-RTS PPP-based technique for maritime applications, kinematic data from a dual frequency GPS receiver is collected onboard a vessel and investigated with the real-time IGS-RTS PPP-based GPS positioning technique. It is shown that the availability of integrity of the real-time IGS-RTS PPP-based GPS solution is 100 % for all navigation phases and therefore fulfil the IMO integrity standards (99.8 % availability) immediately (after 1 second), after 2 minutes and after

  4. Internationalisation of information services for publishers' open access policies: the DINI multilingual integration layer

    PubMed Central

    Scholze, Frank

    2008-01-01

    It is essential for the strategy of open access self-archiving that scientific authors are given comprehensive information on publisher copyright policies. DINI, the German Initiative for Networked Information, has developed a German (and potentially multilingual) interface to the English SHERPA/RoMEO service to provide additional information on German publishers' open access policies. As a next step, this interface was enhanced to an integration layer combining different sources on publisher copyright policies. This integration layer can be used in many different contexts. Together with the SHERPA/RoMEO team, DINI aims to build an international support structure for open access information. PMID:18662383

  5. Assessment of health system challenges and opportunities for possible integration of diabetes mellitus and tuberculosis services in South-Eastern Amhara Region, Ethiopia: a qualitative study.

    PubMed

    Workneh, Mahteme Haile; Bjune, Gunnar Aksel; Yimer, Solomon Abebe

    2016-04-19

    The double burden of tuberculosis (TB) and diabetes mellitus (DM) is a significant public health problem in low and middle income countries. However, despite the known synergy between the two disease conditions, services for TB and DM have separately been provided. The objective of this study was to explore health system challenges and opportunities for possible integration of DM and TB services. This was a descriptive qualitative study which was conducted in South-Eastern Amhara Region, Ethiopia. Study participants included health workers (HWs), program managers and other stakeholders involved in TB and DM prevention and control activities. Purposive sampling was applied to select respondents. In order to capture diversity of opinions among participants, maximum variation sampling strategy was applied in the recruitment of study subjects. Data were collected by conducting four focus group discussions and 12 in-depth interviews. Collected data were transcribed verbatim and were thematically analyzed using NVivo 10 software program. A total of 44 (12 in-depth interviews and 32 focus group discussion) participants were included in the study. The study participants identified a number of health system challenges and opportunities affecting the integration of TB-DM services. The main themes identified were: 1. Unavailability of system for continuity of DM care. 2. Inadequate knowledge and skills of health workers. 3. Frequent stockouts of DM supplies. 4. Patient's inability to pay for DM services. 5. Poor DM data management. 6. Less attention given to DM care. 7. Presence of a well-established TB control program up to the community level. 8. High level of interest and readiness among HWs, program managers and leaders at different levels of the health care delivery system. The study provided insights into potential health systems challenges and opportunities that need to be considered in the integration of TB-DM services. Piloting TB and DM integrated services in

  6. Clinical Integration and How It Affects Student Retention in Undergraduate Athletic Training Programs

    PubMed Central

    Young, Allison; Klossner, Joanne; Docherty, Carrie L; Dodge, Thomas M; Mensch, James M

    2013-01-01

    Context A better understanding of why students leave an undergraduate athletic training education program (ATEP), as well as why they persist, is critical in determining the future membership of our profession. Objective To better understand how clinical experiences affect student retention in undergraduate ATEPs. Design Survey-based research using a quantitative and qualitative mixed-methods approach. Setting Three-year undergraduate ATEPs across District 4 of the National Athletic Trainers' Association. Patients or Other Participants Seventy-one persistent students and 23 students who left the ATEP prematurely. Data Collection and Analysis Data were collected using a modified version of the Athletic Training Education Program Student Retention Questionnaire. Multivariate analysis of variance was performed on the quantitative data, followed by a univariate analysis of variance on any significant findings. The qualitative data were analyzed through inductive content analysis. Results A difference was identified between the persister and dropout groups (Pillai trace = 0.42, F1,92 = 12.95, P = .01). The follow-up analysis of variance revealed that the persister and dropout groups differed on the anticipatory factors (F1,92 = 4.29, P = .04), clinical integration (F1,92 = 6.99, P = .01), and motivation (F1,92 = 43.12, P = .01) scales. Several themes emerged in the qualitative data, including networks of support, authentic experiential learning, role identity, time commitment, and major or career change. Conclusions A perceived difference exists in how athletic training students are integrated into their clinical experiences between those students who leave an ATEP and those who stay. Educators may improve retention by emphasizing authentic experiential learning opportunities rather than hours worked, by allowing students to take on more responsibility, and by facilitating networks of support within clinical education experiences. PMID:23672327

  7. Clinical integration and how it affects student retention in undergraduate athletic training programs.

    PubMed

    Young, Allison; Klossner, Joanne; Docherty, Carrie L; Dodge, Thomas M; Mensch, James M

    2013-01-01

    A better understanding of why students leave an undergraduate athletic training education program (ATEP), as well as why they persist, is critical in determining the future membership of our profession. To better understand how clinical experiences affect student retention in undergraduate ATEPs. Survey-based research using a quantitative and qualitative mixed-methods approach. Three-year undergraduate ATEPs across District 4 of the National Athletic Trainers' Association. Seventy-one persistent students and 23 students who left the ATEP prematurely. Data were collected using a modified version of the Athletic Training Education Program Student Retention Questionnaire. Multivariate analysis of variance was performed on the quantitative data, followed by a univariate analysis of variance on any significant findings. The qualitative data were analyzed through inductive content analysis. A difference was identified between the persister and dropout groups (Pillai trace = 0.42, F(1,92) = 12.95, P = .01). The follow-up analysis of variance revealed that the persister and dropout groups differed on the anticipatory factors (F(1,92) = 4.29, P = .04), clinical integration (F(1,92) = 6.99, P = .01), and motivation (F(1,92) = 43.12, P = .01) scales. Several themes emerged in the qualitative data, including networks of support, authentic experiential learning, role identity, time commitment, and major or career change. A perceived difference exists in how athletic training students are integrated into their clinical experiences between those students who leave an ATEP and those who stay. Educators may improve retention by emphasizing authentic experiential learning opportunities rather than hours worked, by allowing students to take on more responsibility, and by facilitating networks of support within clinical education experiences.

  8. Dietary zinc restriction and repletion affects DNA integrity in healthy men123

    PubMed Central

    Song, Yang; Chung, Carolyn S; Bruno, Richard S; Traber, Maret G; Brown, Kenneth H; King, Janet C

    2009-01-01

    Background: Zinc plays an important role in antioxidant defense and the maintenance of cellular DNA integrity. However, no experimental human studies have been performed to examine the role of zinc status on DNA damage. Objective: We evaluated the effects of dietary zinc depletion and repletion on DNA strand breaks, oxidative stress, and antioxidant defenses in healthy men. Design: Nine healthy men with reported mean daily zinc intakes >11 mg/d were recruited. Subjects completed 3 consecutive dietary periods: baseline (days 1 to 13; 11 mg Zn/d), zinc depletion (days 14 to 55; 0.6 mg Zn/d for 1 wk and 4 mg Zn/d for 5 wk), and zinc repletion (days 56 to 83; 11 mg Zn/d for 4 wk with 20 mg supplemental Zn for first 7 d). Blood samples were collected on days 1, 13, 35, 55, and 83. DNA damage in peripheral blood cells, plasma oxidative stress, and antioxidant defense biomarkers were assessed. Results: Dietary zinc depletion (6 wk) was associated with increased DNA strand breaks in peripheral blood cells (day 13 compared with day 55; P < 0.05), changes that were ameliorated by zinc repletion (day 55 compared with day 83; P < 0.05). Plasma zinc concentrations were negatively correlated with DNA strand breaks (r = −0.60, P = 0.006) during the zinc-depletion period. Plasma α- and γ-tocopherol concentrations, plasma total antioxidant capacity, and erythrocyte superoxide dismutase activity did not change significantly, and plasma F2-isoprostanes were unaffected by dietary period. Conclusions: Changes in dietary zinc intake affected DNA single-strand breaks. Zinc appears to be a critical factor for maintaining DNA integrity in humans. PMID:19515738

  9. Accessibility, continuity and appropriateness: key elements in assessing integration of perinatal services.

    PubMed

    D'Amour, Danielle; Goulet, Lise; Labadie, Jean-François; Bernier, Liette; Pineault, Raynald

    2003-09-01

    A trend toward the reduction in the length of hospital stays has been widely observed. This increasing shift is particularly evident in perinatal care. A stay of less than 48 hours after delivery has been shown to have no negative effects on the health of either the mother or the baby as long as they receive an adequate follow-up. This implies a close integration between hospital and community health services. The present article addresses the following questions: To what extent are postnatal services accessible to mothers and neonates? Are postnatal services in the community in continuity with those of the hospital? Are the services provided by the appropriate source of care? The authors conducted a telephone survey among 1158 mothers in a large urban area in the province of Quebec, Canada. The results were compared to clinical guidelines widely recognised by professionals. The results show serious discrepancies with these guidelines. The authors found a low accessibility to services: less than half of the mothers received a home visit by a nurse. In terms of continuity of care, less than 10% of the mothers received a follow-up telephone call within the recommended time frame and only 18% benefited from a home visit within the recommended period. Finally, despite guidelines to the contrary, hospitals continue to intervene after discharge. This results in a duplication of services for 44.7% of the new-borns. On the other hand, 40.7% are not seen in the recommended period after hospital discharge at all. These results raise concerns about the integration of services between agencies. Following earlier work, the present authors have grouped explanatory factors under four dimensions: the strategic dimension, particularly leadership; the structural dimension, including the size of the network; the technological dimension, with respect to information transmission system; and the cultural dimension, which concerns the collaboration process and the development of

  10. Defects in Protein Folding Machinery Affect Cell Wall Integrity and Reduce Ethanol Tolerance in S. cerevisiae.

    PubMed

    Narayanan, Aswathy; Pullepu, Dileep; Reddy, Praveen Kumar; Uddin, Wasim; Kabir, M Anaul

    2016-07-01

    The chaperonin complex CCT/TRiC (chaperonin containing TCP-1/TCP-1 ring complex) participates in the folding of many crucial proteins including actin and tubulin in eukaryotes. Mutations in genes encoding its subunits can affect protein folding and in turn, the physiology of the organism. Stress response in Saccharomyces cerevisiae is important in fermentation reactions and operates through overexpression and underexpression of genes, thus altering the protein profile. Defective protein folding machinery can disturb this process. In this study, the response of cct mutants to stress conditions in general and ethanol in specific was investigated. CCT1 mutants showed decreased resistance to different conditions tested including osmotic stress, metal ions, surfactants, reducing and oxidising agents. Cct1-3 mutant with the mutation in the conserved ATP-binding region showed irreversible defects than other mutants. These mutants were found to have inherent cell wall defects and showed decreased ethanol tolerance. This study reveals that cell wall defects and ethanol sensitivity are linked. Genetic and proteomic analyses showed that the yeast genes RPS6A (ribosomal protein), SCL1 (proteasomal subunit) and TDH3 (glyceraldehyde-3-phosphate dehydrogenase) on overexpression, improved the growth of cct1-3 mutant on ethanol. We propose the breakdown of common stress response pathways caused by mutations in CCT complex and the resulting scarcity of functional stress-responsive proteins, affecting the cell's defence against different stress agents in cct mutants. Defective cytoskeleton and perturbed cell wall integrity reduce the ethanol tolerance in the mutants which are rescued by the extragenic suppressors.

  11. Candidate genes affecting Drosophila life span identified by integrating microarray gene expression analysis and QTL mapping.

    PubMed

    Lai, Chao-Qiang; Parnell, Laurence D; Lyman, Richard F; Ordovas, Jose M; Mackay, Trudy F C

    2007-03-01

    The current increase in life expectancy observed in industrialized societies underscores the need to achieve a better understanding of the aging process that could help the development of effective strategies to achieve healthy aging. This will require not only identifying genes involved in the aging process, but also understanding how their effects are modulated by environmental factors, such as dietary intake and life style. Although the human genome has been sequenced, it may be impractical to study humans or other long-lived organisms to gain a mechanistic understanding about the aging process. Thus, short-lived animal models are essential to identifying the mechanisms and genes that affect the rate and quality of aging as a first step towards identifying genetic variants in humans. In this study, we investigated gene expression changes between two strains of Drosophila (Oregon and 2b) for which quantitative trait loci (QTLs) affecting life span were identified previously. We collected males and females from both strains at young and old ages, and assessed whole genome variation in transcript abundance using Affymetrix GeneChips. We observed 8217 probe sets with detectable transcripts. A total of 2371 probe sets, representing 2220 genes, exhibited significant changes in transcript abundance with age; and 839 probe sets were differentially expressed between Oregon and 2b. We focused on the 359 probe sets (representing 354 genes) that exhibited significant changes in gene expression both with age and between strains. We used these genes to integrate the analysis of microarray gene expression data, bioinformatics, and the results of genetic mapping studies reported previously, to identify 49 candidate genes and four pathways that could potentially be responsible for regulating life span and involved in the process of aging in Drosophila and humans.

  12. Unified Electronic Currency Based on the Fourth Party Platform Integrated Payment Service

    NASA Astrophysics Data System (ADS)

    Yong, Xu; Qiqi, Hu

    This paper presents a solution of unified e-currency based on the fourth party platform integrated payment service. The purpose of the paper is to solve the problem of distribution and resource-wasting caused by the lack of unified electronic currency, and to solve regulatory difficulties due to regulation size caused by a wide variety of e-currency. Methods: This article first analyzes the problems in the development of electronic money, and then proposes the concept of a unified electronic currency based on the fourth party platform integrated payment service. Besides, it proposes a unified mechanism and transaction procedures for unified e-currency, and analyzes the liquidation process, security and regulatory requirements, which are involved in using unified electronic currency.

  13. Multi-Disciplinary Data Services: Standards-based Coverage Services Fostering Integration; The EarhServer approach

    NASA Astrophysics Data System (ADS)

    Beccati, Alan; Baumann, Peter

    2014-05-01

    data/metadata query language over a standardized data model increases the potential for an integrated use of data coming from a variety of sources. This writing elaborates on the suitability of the EarthServer infrastructure and its current developments to promote creation of multi-disciplinary data access and processing services.

  14. How to integrate social care services into primary health care? An experience from Iran.

    PubMed

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad

    2016-01-01

    Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country.

  15. How to integrate social care services into primary health care? An experience from Iran

    PubMed Central

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad

    2016-01-01

    Background: Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. Methods: This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Results: Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Conclusion: Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country. PMID:27683649

  16. Health system factors affecting implementation of integrated management of childhood illness (IMCI): qualitative insights from a South African province.

    PubMed

    Pandya, Himani; Slemming, Wiedaad; Saloojee, Haroon

    2018-03-01

    The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework. In-depth interviews were conducted with 38 districts, provincial and national respondents involved with IMCI co-ordination and delivery, exploring their involvement in, and perceptions of, IMCI strategy implementation. Identified barriers included poor definition of elements of a service package for children and how IMCI aligned with this, incompetence of trained nurses exacerbated by inappropriate rotation practices, use of inappropriate indicators to track progress, multiple cadres coordinating similar activities with poor role delineation, and fragmented, vertical governance of programmes included within IMCI, such as immunization. Enabling practices in one district included the use of standardized child health records incorporating IMCI activities and stringent practice monitoring through record audits. Using IMCI as a case study, our work highlights critical health system deficiencies affecting service delivery for young children which need to be resolved to reposition IMCI within the broader child 'survive, thrive and transform' agenda. Recommendations for appropriate health system strengthening include the need for redefining IMCI within a broader PHC service package for children, prioritizing post-training supervision and mentoring of practitioners through appropriate duty allocation and

  17. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya

    PubMed Central

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-01-01

    Abstract The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client–provider consultation sessions. The cross-sectional study observed 366 client–provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63–0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07–14.21), adequate infrastructure (5.29; 95% CI: 2.89–7.69) and reagents (1.48; 95% CI: 1.02–1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92–4.36), job satisfaction (2.02; 95% CI: 1.21–2.83) and supervision (1.01; 95% CI: 0.35–1.68), while workload (−0.88; 95% CI: −1.75 to − 0.01) was negatively associated. Technical quality of the client–provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client–provider consultation sessions

  18. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    PubMed

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  19. Single, Integrated, Service-Centric Model of Military Health System Governance

    DTIC Science & Technology

    that keeps pace with the operational agility and organizational flexibility requirements to support globally integrated operations is clear. This...of the research is to establish what the model of governance of the Military Health System should be. That, with other recommendations, should be the...foundation for the impending transformation. The research found that the model of governance should be a single service model with regional health

  20. Towards the integration of StoRM on Amazon Simple Storage Service (S3)

    NASA Astrophysics Data System (ADS)

    Andreozzi, S.; Magnoni, L.; Zappi, R.

    2008-07-01

    In Grid systems, a core resource being shared among geographically-dispersed communities of users is the storage. For this resource, a standard interface specification (Storage Resource Management or SRM) was defined and is being evolved in the context of the Open Grid Forum. By implementing this interface, all storage resources part of a Grid could be managed in an homogenous fashion. In this work, we consider the extension of StoRM (STOrage Resource Manager, an implementation of SRM v2.2) in order to integrate a new type of storage resource: the Amazon Simple Storage Service (Amazon S3). Amazon S3 is a simple Web services interface offering access to the same highly scalable, reliable, fast, inexpensive data storage infrastructure that Amazon uses to run its own global network of Web sites. By performing this integration, we offer to the Grid community the capability to manage and access an incredible amount of storage resources freeing them from considering the costs associated with server maintenance, or whether they have enough storage available. The characteristics of StoRM are suitable for a smooth integration with Amazon S3. In particular, StoRM is designed to be easily adapted to the underlying storage resource via a plug-in mechanism, therefore a new plugin for integration with the Amazon S3 Web Service will be written. As regards the access policies, StoRM translates the Grid authorization rules into the Amazon S3 ones and applies them to the Amazon Web Services identity.

  1. Integration of Service Learning Into a Doctoral-Level Qualitative Research Methodology Course.

    PubMed

    Bryant, Keneshia; Matthews, Ellyn; DeClerk, Leonie

    This article provides an overview of the integration of a pilot service learning (SL) project in a doctoral-level qualitative research course. Faculty partnered with a nonprofit organization that prepares former foster youth for the challenges of adulthood. The project objectives were to (1) increase students' knowledge/skills in qualitative methods, research ethics, and cultural/social issues and (2) promote community collaboration. The outcomes demonstrate that the project was feasible, valuable, and aligned with the principles of SL.

  2. A fungal transcription factor essential for starch degradation affects integration of carbon and nitrogen metabolism

    PubMed Central

    Xiong, Yi; Qin, Lina; Kennedy, Megan; Bauer, Diane; Barry, Kerrie; Northen, Trent R.; Grigoriev, Igor V.

    2017-01-01

    In Neurospora crassa, the transcription factor COL-26 functions as a regulator of glucose signaling and metabolism. Its loss leads to resistance to carbon catabolite repression. Here, we report that COL-26 is necessary for the expression of amylolytic genes in N. crassa and is required for the utilization of maltose and starch. Additionally, the Δcol-26 mutant shows growth defects on preferred carbon sources, such as glucose, an effect that was alleviated if glutamine replaced ammonium as the primary nitrogen source. This rescue did not occur when maltose was used as a sole carbon source. Transcriptome and metabolic analyses of the Δcol-26 mutant relative to its wild type parental strain revealed that amino acid and nitrogen metabolism, the TCA cycle and GABA shunt were adversely affected. Phylogenetic analysis showed a single col-26 homolog in Sordariales, Ophilostomatales, and the Magnaporthales, but an expanded number of col-26 homologs in other filamentous fungal species. Deletion of the closest homolog of col-26 in Trichoderma reesei, bglR, resulted in a mutant with similar preferred carbon source growth deficiency, and which was alleviated if glutamine was the sole nitrogen source, suggesting conservation of COL-26 and BglR function. Our finding provides novel insight into the role of COL-26 for utilization of starch and in integrating carbon and nitrogen metabolism for balanced metabolic activities for optimal carbon and nitrogen distribution. PMID:28467421

  3. An integrated telemedicine platform for the assessment of affective physiological states

    PubMed Central

    Katsis, Christos D; Ganiatsas, George; Fotiadis, Dimitrios I

    2006-01-01

    AUBADE is an integrated platform built for the affective assessment of individuals. The system performs evaluation of the emotional state by classifying vectors of features extracted from: facial Electromyogram, Respiration, Electrodermal Activity and Electrocardiogram. The AUBADE system consists of: (a) a multisensorial wearable, (b) a data acquisition and wireless communication module, (c) a feature extraction module, (d) a 3D facial animation module which is used for the projection of the obtained data through a generic 3D face model; whereas the end-user will be able to view the facial expression of the subject in real time, (e) an intelligent emotion recognition module, and (f) the AUBADE databases where the acquired signals along with the subject's animation videos are saved. The system is designed to be applied to human subjects operating under extreme stress conditions, in particular car racing drivers, and also to patients suffering from neurological and psychological disorders. AUBADE's classification accuracy into five predefined emotional classes (high stress, low stress, disappointment, euphoria and neutral face) is 86.0%. The pilot system applications and components are being tested and evaluated on Maserati's car. racing drivers. PMID:16879757

  4. A fungal transcription factor essential for starch degradation affects integration of carbon and nitrogen metabolism

    DOE PAGES

    Xiong, Yi; Wu, Vincent W.; Lubbe, Andrea; ...

    2017-05-03

    In Neurospora crassa, the transcription factor COL-26 functions as a regulator of glucose signaling and metabolism. Its loss leads to resistance to carbon catabolite repression. Here, we report that COL-26 is necessary for the expression of amylolytic genes in N. crassa and is required for the utilization of maltose and starch. Additionally, the Δcol-26 mutant shows growth defects on preferred carbon sources, such as glucose, an effect that was alleviated if glutamine replaced ammonium as the primary nitrogen source. This rescue did not occur when maltose was used as a sole carbon source. Transcriptome and metabolic analyses of the Δcol-26more » mutant relative to its wild type parental strain revealed that amino acid and nitrogen metabolism, the TCA cycle and GABA shunt were adversely affected. Phylogenetic analysis showed a single col-26 homolog in Sordariales, Ophilostomatales, and the Magnaporthales, but an expanded number of col-26 homologs in other filamentous fungal species. Deletion of the closest homolog of col-26 in Trichoderma reesei, bglR, resulted in a mutant with similar preferred carbon source growth deficiency, and which was alleviated if glutamine was the sole nitrogen source, suggesting conservation of COL-26 and BglR function. Our finding provides novel insight into the role of COL-26 for utilization of starch and in integrating carbon and nitrogen metabolism for balanced metabolic activities for optimal carbon and nitrogen distribution.« less

  5. Integration of Nutrition Into Extension and Advisory Services: A Synthesis of Experiences, Lessons, and Recommendations.

    PubMed

    Fanzo, Jessica; Marshall, Quinn; Dobermann, Darja; Wong, Joyce; Merchan, Rafael I; Jaber, Mona I; Souza, Alejandro; Verjee, Neelam; Davis, Kristin

    2015-06-01

    The need for nutrition-sensitive agriculture is well recognized and of growing interest to global development players. Extension and advisory services (EAS), with their established infrastructure, provide a unique opportunity for nutrition interventions to be implemented at scale with significant reach. To assess current integration of nutrition in EAS, document training provided to EAS agents, and identify challenges and opportunities for the integration of nutrition. A mixed methodology was used, which included a systematic literature review covering the following databases: PubMed, ISI Web of Science, Agris, Google Scholar, Econlit, and IBSS. In addition, online surveys and semistructured key informant interviews with stakeholders were performed. Data were collected between December 2012 and June 2013. Based on this study, the most common integration of nutrition into EAS is through efforts to increase the availability of nutritious food. The nutrition training of extension agents is often inadequate, particularly in the realm beyond technical agricultural skill. Additionally, a lack of career opportunities discourages EAS agents form engaging with nutrition integration. The major challenges to integrating nutrition into EAS centered on lack of training for agents, unclear organizational mandates, lack of female inclusion, lack of mobility, and systemic challenges between agriculture and nutrition sectors. Key opportunities for integration efforts are engaging communities, creating a demand for nutrition, and use of innovative communications. This study demonstrates a large degree of variability across programs in the integration and implementation of nutrition activities into EAS, providing differing opinions on the feasibility of integration. Although the need for nutrition-sensitive agriculture is known, and there is agreement that EAS would provide a positive framework, there are still challenges impeding a simple integration of nutrition into EAS as a

  6. Integrated network management for Space Station Freedom - A concept of services management

    NASA Astrophysics Data System (ADS)

    Smith, J. F.; Quincey, D. S.

    The communications services between the operators, crew, and users of the Space Station Freedom (SSF) will be provided by a set of networks that includes the local area and the wide area networks and a number of gateways for tying the networks together. An integrating system of end-to-end network management will be provided to deliver the communications services to the users and enable the users to operate the networks as if they were using a single network. This paper describes the SSF Project (SSFP) Communications Systems, provides the summary of the SSFP communications services and describes the management models, with particular attention given to the Network Services Management (NSM) Function, which is a concept of the customer network management. In this concept, the management of the services is performed by the 'mapping' of the services onto the physical network in which there will be management entity for each of the member networks/gateways/element of the end-to-end SSF communications and information system.

  7. Developing a framework for gathering and using service user experiences to improve integrated health and social care: the SUFFICE framework.

    PubMed

    Ward, Vicky; Pinkney, Lisa; Fry, Gary

    2016-09-08

    More people than ever receive care and support from health and social care services. Initiatives to integrate the work of health and social care staff have increased rapidly across the UK but relatively little has been done to chart and improve their impact on service users. Our aim was to develop a framework for gathering and using service user feedback to improve integrated health and social care in one locality in the North of England. We used published literature and interviews with health and social care managers to determine the expected service user experiences of local community-based integrated teams and the ways in which team members were expected to work together. We used the results to devise qualitative data collection and analysis tools for gathering and analyzing service user feedback. We used developmental evaluation and service improvement methodologies to devise a procedure for developing service improvement plans. We identified six expected service user experiences of integrated care and 15 activities that health and social care teams were expected to undertake. We used these to develop logic models and tools for collecting and analysing service user experiences. These include a narrative interview schedule, a plan for analyzing data, and a method for synthesizing the results into a composite 'story'. We devised a structured service improvement procedure which involves teams of health and social care staff listening to a composite service user story, identifying how their actions as a team may have contributed to the story and developing a service improvement plan. This framework aims to put service user experiences at the heart of efforts to improve integration. It has been developed in collaboration with National Health Service (NHS) and Social Care managers. We expect it to be useful for evaluating and improving integrated care initiatives elsewhere.

  8. Integration of family planning services into a sexually transmitted disease clinic setting.

    PubMed

    Shlay, Judith C; McEwen, Dean; Bell, Deborah; Maravi, Moises; Rinehart, Deborah; Fang, Hai; Devine, Sharon; Mickiewicz, Theresa; Dreisbach, Susan

    2013-08-01

    Sexually transmitted diseases (STDs) and unintended pregnancy are significant and costly public health concerns. Integrating family planning services (FPS) into STD visits provides an opportunity to address both concerns simultaneously. Our objectives were to create an electronic eligibility reminder to identify male and female patients eligible for FPS during an STD clinic visit and measure FPS use, additional cost of integrated services, and patient/provider satisfaction and to explore the impact on incident pregnancy and STDs. Quasi-experimental design compared enrollment and patient/provider satisfaction before (2008) and after implementation (2010). Incident pregnancy and STD 12 months after the initial visit before and after were explored. Time and cost were calculated. Quantitative and qualitative analyses were performed. A total of 9695 clients (male, 5842; female, 3853) in 2008 and 10,021 clients (male, 5852; female, 4169) in 2010 were eligible for FPS. Enrollment in FPS increased (2008: 51.6%, 2010: 95.3%; P < 0.01). Total additional cost was US$29.25/visit, and additional staff time was 4.01 minutes for integrated visits. Staff satisfaction increased and client satisfaction remained high. Among women returning within 12 months (39.6% in 2008, 37.1% in 2010), pregnancies were lower among enrolled versus nonenrolled women for 2008 (7.7% vs. 19.5%, P < 0.01) and 2010 (13.1% vs. 25.9%, P = 0.05). Incident STDs did not differ. An electronic eligibility reminder of FPS increased FPS use. Integration of FPS with STD services is feasible, is well accepted, and increases costs minimally. Integration may reduce pregnancy rates without increasing STD rates.

  9. Do biopesticides affect the demographic traits of a parasitoid wasp and its biocontrol services through sublethal effects?

    PubMed

    Biondi, Antonio; Zappalà, Lucia; Stark, John D; Desneux, Nicolas

    2013-01-01

    Pesticide risk assessments are usually based on short-term acute toxicity tests, while longer-term population dynamic related traits, critical to the success of biological control and Integrated Pest Management (IPM) programs, are often overlooked. This is increasingly important with respect to new biopesticides that frequently cause no short-term acute effects, but that can induce multiple physiological and behavioral sublethal effects, leading to a decrease in population growth and ecosystem services. In this study we assessed the lethal and sublethal effects of six biopesticides [abamectin, azadirachtin, Bacillus thuringiensis, borax plus citrus oil (Prev-Am®), emamectin benzoate, and spinosad], used in tomato crops to control the invasive pest Tuta absoluta (Lepidoptera: Gelechiidae), on adults and pupae of the parasitoid Bracon nigricans (Hymenoptera: Braconidae). Data on female survival and production of female offspring were used to calculate population growth indexes as a measure of population recovery after pesticide exposure. Spinosad caused 100% and 80% mortality in exposed adults (even 10 d after the treatment) and pupae, respectively. Although most of the biopesticides had low levels of acute toxicity, multiple sublethal effects were observed. The biocontrol activity of both females that survived 1-h and 10-d old residues, and females that emerged from topically treated pupae was significantly affected by the application of the neurotoxic insecticides emamectin benzoate and abamectin. Furthermore, very low B. nigricans demographic growth indices were estimated for these two insecticides, indicating potential local extinction of the wasp populations. Among the tested products, Bt proved to be the safest for B. nigricans adults and pupae. Our findings emphasize that acute toxicity assessment alone cannot fully predict the actual impact of pesticides on non-target parasitoids. Thus, sublethal effects related to the species specific life-history variables

  10. Do Biopesticides Affect the Demographic Traits of a Parasitoid Wasp and Its Biocontrol Services through Sublethal Effects?

    PubMed Central

    Biondi, Antonio; Zappalà, Lucia; Stark, John D.; Desneux, Nicolas

    2013-01-01

    Pesticide risk assessments are usually based on short-term acute toxicity tests, while longer-term population dynamic related traits, critical to the success of biological control and Integrated Pest Management (IPM) programs, are often overlooked. This is increasingly important with respect to new biopesticides that frequently cause no short-term acute effects, but that can induce multiple physiological and behavioral sublethal effects, leading to a decrease in population growth and ecosystem services. In this study we assessed the lethal and sublethal effects of six biopesticides [abamectin, azadirachtin, Bacillus thuringiensis, borax plus citrus oil (Prev-Am®), emamectin benzoate, and spinosad], used in tomato crops to control the invasive pest Tuta absoluta (Lepidoptera: Gelechiidae), on adults and pupae of the parasitoid Bracon nigricans (Hymenoptera: Braconidae). Data on female survival and production of female offspring were used to calculate population growth indexes as a measure of population recovery after pesticide exposure. Spinosad caused 100% and 80% mortality in exposed adults (even 10 d after the treatment) and pupae, respectively. Although most of the biopesticides had low levels of acute toxicity, multiple sublethal effects were observed. The biocontrol activity of both females that survived 1-h and 10-d old residues, and females that emerged from topically treated pupae was significantly affected by the application of the neurotoxic insecticides emamectin benzoate and abamectin. Furthermore, very low B. nigricans demographic growth indices were estimated for these two insecticides, indicating potential local extinction of the wasp populations. Among the tested products, Bt proved to be the safest for B. nigricans adults and pupae. Our findings emphasize that acute toxicity assessment alone cannot fully predict the actual impact of pesticides on non-target parasitoids. Thus, sublethal effects related to the species specific life-history variables

  11. Efficacy of hospital in the home services providing care for patients admitted from emergency departments: an integrative review.

    PubMed

    Varney, Jane; Weiland, Tracey J; Jelinek, George

    2014-06-01

    Increases in emergency department (ED) demand may compromise patient outcomes, leading not only to overcrowding in the ED, increased ED waiting times and increased ED length of stay, but also compromising patient safety; the risk of adverse events is known to rise in the presence of overcrowding. Hospital in the home (HiTH) services may offer one means of reducing ED demand. This integrative review sought to assess the efficacy of admission-avoidance HiTH services that admit patients directly from the ED. Papers published between 1995 and 2013 were identified through searches of Medline, CINAHL and Google. English-language studies that assessed the efficacy of a HiTH service and that recruited at least one-third of the participants directly from the ED were included in the review. A HiTH service was considered one that provided health professional support to patients at home for a time-limited period, thus avoiding the need for hospitalization. Twenty-two articles met the inclusion criteria for this review. The interventions were diverse in terms of the clinical interventions delivered, the range and intensity of health professional input and the conditions treated. The studies included in the review found no effect on clinical outcomes, rates of adverse events or complications, although patient satisfaction and costs were consistently and favourably affected by HiTH treatment. Given evidence suggesting that HiTH services which recruit patients directly from the ED contribute to cost-savings, greater patient satisfaction and safety and efficacy outcomes that are at least equivalent to those associated with hospital-based care, the expansion of such programmes might therefore be considered a priority for policy makers.

  12. Perceived stigma reductions following participation in mental health services integrated within community-based HIV primary care.

    PubMed

    Farber, Eugene W; Shahane, Amit A; Brown, Jennifer L; Campos, Peter E

    2014-01-01

    HIV stigma remains a significant challenge for individuals living with HIV disease that can adversely affect overall well-being and patterns of HIV health service engagement. Finding ways to effectively address stigma concerns is, therefore, an important consideration in the clinical management of HIV disease. This study examined changes in perceived stigma in a sample of 48 adults living with HIV disease as an outcome of their participation in a mental health services program integrated with community-based HIV primary care. Participants completed a self-report instrument that provided a multidimensional measure of perceived HIV stigma, including distancing, blaming, and discrimination dimensions. This scale was administered at the baseline mental health service visit and then re-administered at the three-month follow-up point. Study results showed reductions in self-reported perceived HIV stigma over time for the distancing (t = 4.01, p = 0.000, d = 0.43), blaming (t = 2.79, p = 0.008, d = 0.35), and discrimination (t = 2.90, p = 0.006, d = 0.42) dimensions of stigma. These findings suggest that participation in HIV mental health services may have a favorable impact on perceived HIV stigma. Implications of these findings are discussed, including possible mechanisms that might explain the observed results as well as suggested directions for future research in this area. Randomized controlled trials would represent an important next step to investigate the extent to which HIV mental health services can reduce levels of perceived HIV stigma.

  13. An optimized bandwidth efficient demand assigned protocol for integrated Mobile Satellite Services

    NASA Technical Reports Server (NTRS)

    Yan, T.-Y.; Wang, C. C.

    1985-01-01

    This paper describes the design of a demand assigned protocol based on bandwidth efficiency for integrated services of a Mobile Satellite System (MSS). An MSS provides data (closed-ended) and voice (open-ended) communications services for a large number of mobile users dispersed over a wide geographical area. Each mobile requests its desired service through a designated set of channels to a network management center. Either pure or slotted ALOHA random access scheme can be used to make connection requests, while data and voice communications are demand assigned. All channels have equal bandwidth and can be adaptively used for reservation requests, data connections or voice connections to maximize the bandwidth utilization. In this paper, perfect communications channels are assumed. It has been shown that, for the case considered, using the slotted ALOHA scheme for making connection requests can save about 30 percent on the total number of channels over using the pure ALHOA scheme.

  14. An interactive integrative approach to translating knowledge and building a "learning organization" in health services management.

    PubMed Central

    Chunharas, Somsak

    2006-01-01

    This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization. PMID:16917653

  15. A transdisciplinary approach for supporting the integration of ecosystem services into land and water management

    NASA Astrophysics Data System (ADS)

    Fatt Siew, Tuck; Döll, Petra

    2015-04-01

    Transdisciplinary approaches are useful for supporting integrated land and water management. However, the implementation of the approach in practice to facilitate the co-production of useable socio-hydrological (and -ecological) knowledge among scientists and stakeholders is challenging. It requires appropriate methods to bring individuals with diverse interests and needs together and to integrate their knowledge for generating shared perspectives/understanding, identifying common goals, and developing actionable management strategies. The approach and the methods need, particularly, to be adapted to the local political and socio-cultural conditions. To demonstrate how knowledge co-production and integration can be done in practice, we present a transdisciplinary approach which has been implemented and adapted for supporting land and water management that takes ecosystem services into account in an arid region in northwestern China. Our approach comprises three steps: (1) stakeholder analysis and interdisciplinary knowledge integration, (2) elicitation of perspectives of scientists and stakeholders, scenario development, and identification of management strategies, and (3) evaluation of knowledge integration and social learning. Our adapted approach has enabled interdisciplinary and cross-sectoral communication among scientists and stakeholders. Furthermore, the application of a combination of participatory methods, including actor modeling, Bayesian Network modeling, and participatory scenario development, has contributed to the integration of system, target, and transformation knowledge of involved stakeholders. The realization of identified management strategies is unknown because other important and representative decision makers have not been involved in the transdisciplinary research process. The contribution of our transdisciplinary approach to social learning still needs to be assessed.

  16. Quantifying causal mechanisms to determine how protected areas affect poverty through changes in ecosystem services and infrastructure

    PubMed Central

    Ferraro, Paul J.; Hanauer, Merlin M.

    2014-01-01

    To develop effective environmental policies, we must understand the mechanisms through which the policies affect social and environmental outcomes. Unfortunately, empirical evidence about these mechanisms is limited, and little guidance for quantifying them exists. We develop an approach to quantifying the mechanisms through which protected areas affect poverty. We focus on three mechanisms: changes in tourism and recreational services; changes in infrastructure in the form of road networks, health clinics, and schools; and changes in regulating and provisioning ecosystem services and foregone production activities that arise from land-use restrictions. The contributions of ecotourism and other ecosystem services to p